Nanomedicine therapeutics and diagnostics are the goal.

Science.gov (United States)

Miller, Andrew D

2016-07-01

Understanding and exploiting molecular mechanisms in biology is central to chemical biology. In 20 years, chemical biology research has advanced from simple mechanistic studies using isolated biological macromolecules to molecular-level and nanomolecular-level mechanistic studies involving whole organisms. This review documents the best of my personal and collaborative academic research work that has made use of a solid organic chemistry and chemical biology approach toward nanomedicine, in which my focus has been on the design, creation and use of synthetic, self-assembly lipid-based nanoparticle technologies for the functional delivery of active pharmaceutical ingredients to target cells in vivo. This research is now leading to precision therapeutics approaches (PTAs) for the treatment of diseases that may define the future of nanomedicine.

Component-resolved evaluation of the content of major allergens in therapeutic extracts for specific immunotherapy of honeybee venom allergy

DEFF Research Database (Denmark)

Blank, Simon; Etzold, Stefanie; Darsow, Ulf

2017-01-01

Allergen-specific immunotherapy is the only curative treatment of honeybee venom (HBV) allergy, which is able to protect against further anaphylactic sting reactions. Recent analyses on a molecular level have demonstrated that HBV represents a complex allergen source that contains more relevant...... major allergens than formerly anticipated. Moreover, allergic patients show very diverse sensitization profiles with the different allergens. HBV-specific immunotherapy is conducted with HBV extracts which are derived from pure venom. The allergen content of these therapeutic extracts might differ due...... to natural variations of the source material or different down-stream processing strategies of the manufacturers. Since variations of the allergen content of therapeutic HBV extracts might be associated with therapeutic failure, we adressed the component-resolved allergen composition of different therapeutic...

Goal-Directed Fluid Resuscitation Protocol Based on Arterial Waveform Analysis of Major Burn Patients in a Mass Burn Casualty.

Science.gov (United States)

Chiao, Hao-Yu; Chou, Chang-Yi; Tzeng, Yuan-Sheng; Wang, Chih-Hsin; Chen, Shyi-Gen; Dai, Niann-Tzyy

2018-02-01

Adequate fluid titration during the initial resuscitation period of major burn patients is crucial. This study aimed to evaluate the feasibility and efficacy of a goal-directed fluid resuscitation protocol that used hourly urine output plus the arterial waveform analysis FloTrac (Edwards LifeSciences, Irvine, Calif) system for major burns to avoid fluid overload. We conducted a retrospective cohort study of 43 major burn patients at the Tri-Service General Hospital after the Formosa Fun Coast Dust Explosion on June 27, 2015. Because of the limited capacity of intensive care units (ICUs), 23 intubated patients were transferred from the burn wards or emergency department to the ICU within 24 hours. Fluid administration was adjusted to achieve a urine output of 30 to 50 mL/h, cardiac index greater than 2.5 L/min/m, and stroke volume variation (SVV) less than 12%. The hourly crystalloid fluid infusion rate was titrated based on SVV and hourly urine output. Of the 23 critically burned patients admitted to the ICU, 13 patients who followed the goal-directed fluid resuscitation protocol within 12 hours postburn were included in the analysis. The mean age (years) was 21.8, and the mean total body surface area (TBSA) burned (%) was 68.0. The mean Revised Baux score was 106.8. All patients sustained inhalation injury. The fluid volumes administered to patients in the first 24 hours and the second 24 hours (mL/kg/% total body surface area) were 3.62 ± 1.23 and 2.89 ± 0.79, respectively. The urine outputs in the first 24 hours and the second 24 hours (mL/kg/h) were 1.13 ± 0.66 and 1.53 ± 0.87, respectively. All patients achieved the established goals within 32 hours postburn. In-hospital mortality rate was 0%. The SVV-based goal-directed fluid resuscitation protocol leads to less unnecessary fluid administration during the early resuscitation phase. Clinicians can efficaciously manage the dynamic body fluid changes in major burn patients under the guidance of the protocol.

Neuroimaging Mechanisms of Therapeutic Transcranial Magnetic Stimulation for Major Depressive Disorder.

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Philip, Noah S; Barredo, Jennifer; Aiken, Emily; Carpenter, Linda L

2018-03-01

Research into therapeutic transcranial magnetic stimulation (TMS) for major depression has dramatically increased in the last decade. Understanding the mechanism of action of TMS is crucial to improve efficacy and develop the next generation of therapeutic stimulation. Early imaging research provided initial data supportive of widely held assumptions about hypothesized inhibitory or excitatory consequences of stimulation. Early work also indicated that while TMS modulated brain activity under the stimulation site, effects at deeper regions, in particular, the subgenual anterior cingulate cortex, were associated with clinical improvement. Concordant with earlier findings, functional connectivity studies also demonstrated that clinical improvements were related to changes distal, rather than proximal, to the site of stimulation. Moreover, recent work suggests that TMS modulates and potentially normalizes functional relationships between neural networks. An important observation that emerged from this review is that similar patterns of connectivity changes are observed across studies regardless of TMS parameters. Though promising, we stress that these imaging findings must be evaluated cautiously given the widespread reliance on modest sample sizes and little implementation of statistical validation. Additional limitations included use of imaging before and after a course of TMS, which provided little insight into changes that might occur during the weeks of stimulation. Furthermore, as studies to date have focused on depression, it is unclear whether our observations were related to mechanisms of action of TMS for depression or represented broader patterns of functional brain changes associated with clinical improvement. Published by Elsevier Inc.

The effects of treatment adherence and treatment-specific therapeutic competencies on outcome and goal attainment in telephone-based therapy with caregivers of people with dementia.

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Schinköthe, Denise; Altmann, Uwe; Wilz, Gabriele

2015-01-01

Contradictory results have been found for the impact of therapist's adherence and competence on intervention outcomes. Most studies focus on generic aspects of competence and adherence, rather than taking into account treatment-specific aspects or specific challenges of the clientele. Appropriate analyses are lacking for cognitive behavioral therapy (CBT) with caregivers of people with dementia. In a sample of 43 caregivers, we examined adherence and different competence ratings of 80 complete sessions, as predictors of symptom change and goal attainment. Therapist's competence was evaluated by four raters, using an adapted version of the cognitive therapy scale (CTS) on three subscales of competence: General therapeutic (GT), session-structuring (SS), and treatment-specific CBT technique (CT). Therapist's adherence to the manual was also assessed. The results show that GT competencies were associated with lower post-test depression scores and that CT competencies predicted a decrease in caregiver burden and higher goal attainment, while SS competencies predicted higher post-test burden. Therapist's adherence had no relationship to outcome, but the higher application of modifying dysfunctional thoughts was associated with higher goal attainment. The results suggest the importance of treatment-specific competencies for outcome. Future research should identify empirically what kind of therapeutic behavior is appropriate to the challenges of a specific clientele such as caregivers of people with dementia.

Millennium development goals: Examining Kenya constraints in achieving the eight goals

Directory of Open Access Journals (Sweden)

Wambua Leonard Munyao

2013-06-01

Full Text Available This paper examines Kenya’s performance in achieving the famous millennium development goals. The paper provides the government and other stakeholders with proper understanding of the constraints of achieving the millennium development goals as well as reflecting the phase and the passion of the country in achieving this important development goal. The paper further seeks to stress the importance of this goal in reducing poverty in the country. The paper has cited some key factors undermining achieving of the millennium development goals in Kenya. Major recommendations that can contribute towards achieving of the millennium development goals have also been made.

Relationships among alexithymia, therapeutic alliance, and psychotherapy outcome in major depressive disorder.

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Quilty, Lena C; Taylor, Graeme J; McBride, Carolina; Bagby, R Michael

2017-08-01

Previous studies have found that alexithymia predicts process and outcome of psychodynamic psychotherapy across a range of psychiatric disorders. There is preliminary evidence that alexithymia may exert its effects on outcome through the therapist. Other studies have found that alexithymia does not influence outcome of cognitive-behavioral therapy (CBT). The aim of the current study was to investigate the capacity of alexithymia to predict therapist- and patient-rated therapeutic alliance and response to CBT and interpersonal psychotherapy (IPT) for major depressive disorder. A total of 75 adults with major depressive disorder were randomized to receive weekly sessions of manualized individual CBT or IPT for a period of 16 weeks. Pre-treatment alexithymia exhibited a positive direct effect on depression change, and a negative indirect effect on depression change via patient-rated alliance at week 13. There was no mediating role of therapist-rated alliance. Although these findings are preliminary, they suggest that pre-treatment alexithymia has meaningful links to psychotherapy process and outcome, and that nuanced analyses incorporating intervening variables are necessary to elucidate the nature of these links. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

An Investigation of Task and Ego Oriented Goals of the Students Majoring at the Faculty of Sport Sciences

Science.gov (United States)

Belli, Emre

2015-01-01

The aim of this study is to explore the task and ego oriented goals of the students majoring at the Faculty of Sports Sciences at Ataturk University. For data collection, "The Task and Ego Orientation in Sport Questionnaire", which was developed by Duda (1) and adapted into Turkish by Toros and Yetim (2), was used in the current study to…

Growth goals, maturity, and well-being.

Science.gov (United States)

Bauer, Jack J; McAdams, Dan P

2004-01-01

In 2 studies (125 college students and 51 adults), 2 forms of growth goals (exploratory and intrinsic) were compared with 2 forms of personality development (social-cognitive maturity and social-emotional well-being). Participants whose narratives of major life goals emphasized conceptual exploration were especially likely to have high levels of maturity (measured as ego development; J. Loevinger, 1976), whereas those whose goals emphasized intrinsic interests (K. M. Sheldon & T. Kasser, 1995) were especially likely to have high levels of well-being. Participants who had coherent hierarchies of growth goals on the levels of major life goals and everyday goals were especially likely to have high levels of personality development. Finally, growth goals accounted for some relationships between age and personality development. Growth goals are discussed in terms of intentional self-development and specific developmental paths. (c) 2003 APA

Therapeutic Inertia and Treatment Intensification.

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Josiah Willock, Robina; Miller, Joseph B; Mohyi, Michelle; Abuzaanona, Ahmed; Muminovic, Meri; Levy, Phillip D

2018-01-29

This review aims to emphasize how therapeutic inertia, the failure of clinicians to intensify treatment when blood pressure rises or remains above therapeutic goals, contributes to suboptimal blood pressure control in hypertensive populations. Studies reveal that the therapeutic inertia is quite common and contributes to suboptimal blood pressure control. Quality improvement programs and standardized approaches to support antihypertensive treatment intensification are ways to combat therapeutic inertia. Furthermore, programs that utilize non-physician medical professionals such as pharmacists and nurses demonstrate promise in mitigating the effects of this important problem. Therapeutic inertia impedes antihypertensive management and requires a broad effort to reduce its effects. There is an ongoing need for renewed focus and research in this area to improve hypertension control.

The contribution of goal specificity to goal achievement in collaborative goal setting for the management of asthma.

Science.gov (United States)

Smith, Lorraine; Alles, Chehani; Lemay, Kate; Reddel, Helen; Saini, Bandana; Bosnic-Anticevich, Sinthia; Emmerton, Lynne; Stewart, Kay; Burton, Debbie; Krass, Ines; Armour, Carol

2013-01-01

Goal setting was investigated as part of an implementation trial of an asthma management service (PAMS) conducted in 96 Australian community pharmacies. Patients and pharmacists identified asthma-related issues of concern to the patient and collaboratively set goals to address these. Although goal setting is commonly integrated into disease state management interventions, the nature of goals, and their contribution to goal attainment and health outcomes are not well understood. To identify and describe: 1) goals set collaboratively between adult patients with asthma and their pharmacist, 2) goal specificity and goal achievement, and 3) describe the relationships between specificity, achievement, asthma control and asthma-related quality of life. Measures of goal specificity, and goal achievement were developed and applied to patient data records. Goals set were thematically analyzed into goal domains. Proportions of goals set, goals achieved and their specificity were calculated. Correlational and regression analyses were undertaken to determine the relationships between goal specificity, goal achievement, asthma control and asthma-related quality of life. Data were drawn from 498 patient records. Findings showed that patients set a wide range and number of asthma-related goals (N = 1787) and the majority (93%) were either achieved or being working toward by the end of the study. Goal achievement was positively associated with specific and moderately specific goals, but not non-specific goals. However, on closer inspection, an inconsistent pattern of relationships emerged as a function of goal domain. Findings also showed that goal setting was associated with end-of-study asthma control but not to asthma-related quality of life. Pharmacists can help patients to set achievable and specific asthma management goals, and these have the potential to directly impact health outcomes such as asthma control. Goal specificity appears to be an important feature in the

Stereotype threat's effect on women's achievement in chemistry: The interaction of achievement goal orientation for women in science majors

Science.gov (United States)

Conway-Klaassen, Janice Marjorie

"Stereotype threat is being at risk of confirming, as a self-characteristic, a negative stereotype about one's group" (C. M. Steele & Aronson, 1995, p. 797). A stereotype threat effect then is described as the detrimental impact on a person's performance or achievement measurements when they are placed in a stereotype threat environment. For women, the negative stereotype that exists in our culture states that women are typically not as capable as men in mathematics or science subjects. This study specifically explored the potential impact of stereotype threat on women who have chosen a science-based college major. They were tested in the domain of chemistry, which is related to mathematics and often involves high level of mathematics skills. I attempted to generate a stereotype threat in the participants through describing a chemistry challenge exam as either one that had consistently shown a gender bias against women and to create a nullification effect by describing the exam as one that had shown no gender bias in the past. In the third experimental condition acting as a control, participants received only generic instructions related to taking the test itself. The second part of this study investigated whether stereotype threat effects could impact women's achievement goal orientations. In previous studies performance avoidance goal orientations have been associated with individuals placed in a stereotype threat environment. The findings on the stereotype threat effect were not significant for the chemistry challenge test achievement scores. This may be due to several factors. One factor may be the design of the chemistry challenge test and the instructions for the test. The other factor may be the women in this study. As individuals who have chosen a science based major, they may have developed coping skills and strategies that reduced the impact of a stereotype threat. It is also possible that the testing environment itself generated an implicit stereotype

Functional Neurosurgery in the Treatment of Severe Obsessive Compulsive Disorder and Major Depression: Overview of Disease Circuits and Therapeutic Targeting for the Clinician

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Shah, Dhwani B.; Pesiridou, Angeliki; Baltuch, Gordon H.; Malone, Donald A.; O’Reardon, John P.

2008-01-01

Over the past 20 years, there has been a concerted effort to expand our understanding of the neural circuitry involved in the pathogenesis of psychiatric disorders. Distinct neuronal circuits and networks have been implicated in obsessive compulsive disorder (OCD) and major depressive disorder (MDD) involving feedback loops between the cortex, striatum, and thalamus. When neurosurgery is used as a therapeutic tool in severe OCD and MDD, the goal is to modulate specific targets or nodes within these networks in an effort to produce symptom relief. Currently, four lesioning neurosurgical procedures are utilized for treatment refractory OCD and MDD: cingulotomy, capsulotomy, subcaudate tractotomy, and limbic leucotomy. Deep brain stimulation (DBS) is a novel neurosurgical approach that has some distinct advantages over lesioning procedures. With DBS, the desired clinical effect can be achieved by reversible, high frequency stimulation in a nucleus or at a node in the circuit without the need to produce an irreversible lesion. Recent trials of deep brain stimulation in both OCD and MDD at several neuroanatomical targets have reported promising early results in highly refractory patients and with a good safety profile. Future definitive trials in MDD and OCD are envisaged. PMID:19727257

Different accounting approaches to harvested wood products in national greenhouse gas inventories: their incentives to achievement of major policy goals

International Nuclear Information System (INIS)

Hashimoto, Seiji

2008-01-01

The 2006 IPCC Guidelines for National Greenhouse Gas Inventories provide four accounting approaches to harvested wood products (HWP). These differ in the way they define system boundaries. Therefore, reported national carbon emissions differ according to the accounting approach used, and the implications of each accounting approach differ for different countries. This paper investigates four IPCC accounting approaches, as well as the 1996 IPCC default approach, to determine whether they provide incentives to achievement of major policy goals related to climate, forest, trade, and waste, taking into account indirect effects of wood use change (i.e., the effects on forest carbon stocks and on carbon emissions from the use of other fuels and materials). Conclusions are as follows: (1) The analyses produced many different results from those of previous studies. These differences appear to be attributable to whether or not the indirect effects of wood use change are taken into account and the reference scenarios that are assumed; (2) The best approaches for achieving each policy goal differ, and the best approaches for particular policy goals might pose problems for other policy goals; (3) Overall, the IPCC default approach is the best accounting approach from the viewpoint of greater compatibility with, or integration across, the array of policy goals, although it does not address the issue of an increasing global carbon stock in HWP

Pengaruh Goal Setting terhadap Performance : Tinjauan Teoritis

OpenAIRE

Ginting, Surya Dharma; Ariani, D. Wahyu

2004-01-01

This article is the conceptual view of goal setting theory and effects of goal setting on individual performance. Goal setting is recognized, and is a major theory of work motivation. Difficult goals have consistently been shown to lead to higher levels of performance than easy goals. If there is no commitment, a goal can have no motivational effect. Goals are central to current treatments of work motivation, and goal commitment is a necessary condition for difficult goals to result in higher...

Interpersonal psychotherapy (IPT) in major depressive disorder.

Science.gov (United States)

Brakemeier, Eva-Lotta; Frase, Lukas

2012-11-01

In this article, we will introduce interpersonal psychotherapy as an effective short-term treatment strategy in major depression. In IPT, a reciprocal relationship between interpersonal problems and depressive symptoms is regarded as important in the onset and as a maintaining factor of depressive disorders. Therefore, interpersonal problems are the main therapeutic targets of this approach. Four interpersonal problem areas are defined, which include interpersonal role disputes, role transitions, complicated bereavement, and interpersonal deficits. Patients are helped to break the interactions between depressive symptoms and their individual interpersonal difficulties. The goals are to achieve a reduction in depressive symptoms and an improvement in interpersonal functioning through improved communication, expression of affect, and proactive engagement with the current interpersonal network. The efficacy of this focused and structured psychotherapy in the treatment of acute unipolar major depressive disorder is summarized. This article outlines the background of interpersonal psychotherapy, the process of therapy, efficacy, and the expansion of the evidence base to different subgroups of depressed patients.

Control to goal of cardiometabolic risk factors among Nigerians ...

African Journals Online (AJOL)

2011-07-12

Jul 12, 2011 ... Therapeutic goals used to define risk or poor control were values adopted by expert groups such as ... medical wards in urban healthcare centers showed that .... *Status of control was based on the mean observed value.

Therapeutic approaches to genetic disorders

African Journals Online (AJOL)

salah

Although prevention is the ideal goal for genetic disorders, various types of therapeutic ... The patient being ... pirical or aimed at controlling or mediating signs and symptoms without care. ... plications and gene therapy approaches .... genes family, have opened a wide and .... cancer where nanoparticles are used to.

Patient-relevant treatment goals in psoriasis.

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Blome, Christine; Gosau, Ramona; Radtke, Marc A; Reich, Kristian; Rustenbach, Stephan J; Spehr, Christina; Thaçi, Diamant; Augustin, Matthias

2016-03-01

Patient-oriented care requires therapeutic decisions to agree with the patients' treatment needs and goals. This study addressed the following questions: What is important to psoriasis patients starting systemic treatment? How stable are these preferences within the first year of treatment? Are treatment goals associated with age, gender, or treatment success? The importance of treatment goals was assessed for patients with moderate-to-severe psoriasis in the German Psoriasis Registry (PsoBest) at baseline (onset of a systemic treatment; n = 3066) and at a 1-year follow-up (n = 1444) using the Patient Benefit Index (PBI). Treatment success was measured with PBI global score and Psoriasis Area Severity Index (PASI). Patients with moderate-to-severe psoriasis pursued a wide range of different goals. The most general treatment goals were rated most relevant, including skin healing and quick skin improvement (94.8/94.5 % "quite" or "very" important), confidence in the therapy (93.0 %), control over the disease (92.3 %), and a clear diagnosis and therapy (89.6 %). Further important goals related to not being in fear of the disease getting worse (84.8 %), reduction in itching (83.9 %), burning (70.6 %), and pain (60.6 %) as well as attaining a normal everyday life (78.4 %) and low treatment burden (64.2-77.9 %). Goals were mostly not associated with sex and gender. Goal importance slightly increased with treatment success. In a substantial proportion of patients (30.3-54.7 %) goal importance changed within 1 year after onset of systemic treatment. We conclude that treatment goal importance should be assessed in clinical practice on a regular basis.

Severe hypercholesterolaemia: therapeutic goals and eligibility criteria for LDL apheresis in Europe.

NARCIS (Netherlands)

Thompson, G.R.; Catapano, A.; Saheb, S.; Atassi-Dumont, M.; Barbir, M.; Eriksson, M.; Paulweber, B.; Sijbrands, E.; Stalenhoef, A.F.H.; Parhofer, K.G.

2010-01-01

PURPOSE OF REVIEW: Despite the use of currently available lipid-lowering therapies, a significant proportion of patients with severe hypercholesterolaemia do not reach treatment goals and consequently remain at increased risk for cardiovascular disease (CVD). On the basis of clinical experience,

Comparing Three Models of Achievement Goals: Goal Orientations, Goal Standards, and Goal Complexes

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Senko, Corwin; Tropiano, Katie L.

2016-01-01

Achievement goal theory (Dweck, 1986) initially characterized mastery goals and performance goals as opposites in a good-bad dualism of student motivation. A later revision (Harackiewicz, Barron, & Elliot, 1998) contended that both goals can provide benefits and be pursued together. Perhaps both frameworks are correct: Their contrasting views…

Therapeutic Sleep for Traumatic Brain Injury

Science.gov (United States)

2017-06-01

AWARD NUMBER: W81XWH-16-1-0166 TITLE: Therapeutic Sleep for Traumatic Brain Injury PRINCIPAL INVESTIGATOR: Ravi Allada CONTRACTING...1. REPORT DATE June 2017 2. REPORT TYPE Annual 3. DATES COVERED 1June2016 - 31May2017 4. TITLE AND SUBTITLE Therapeutic Sleep for Traumatic Brain ...proposal will test the hypothesis that correcting sleep disorders can have a therapeutic effect onTraumatic Brain Injury (TBI) The majority of TBI

The Network Model of Depression as a Basis for New Therapeutic Strategies for Treating Major Depressive Disorder in Parkinson’s Disease

Science.gov (United States)

D’Ostilio, Kevin; Garraux, Gaëtan

2016-01-01

The high prevalence of major depressive disorder in people with Parkinson’s disease (PD), its negative impact on health-related quality of life and the low response rate to conventional pharmacological therapies call to seek innovative treatments. Here, we review the new approaches for treating major depressive disorder in patients with PD within the framework of the network model of depression. According to this model, major depressive disorder reflects maladaptive neuronal plasticity. Non-invasive brain stimulation (NIBS) using high frequency repetitive transcranial magnetic stimulation (rTMS) over the prefrontal cortex has been proposed as a feasible and effective strategy with minimal risk. The neurobiological basis of its therapeutic effect may involve neuroplastic modifications in limbic and cognitive networks. However, the way this networks reorganize might be strongly influenced by the environment. To address this issue, we propose a combined strategy that includes NIBS together with cognitive and behavioral interventions. PMID:27148016

Therapeutic alliance in dietetic practice for weight loss: Insights from health coaching.

Science.gov (United States)

Nagy, Annaliese; McMahon, Anne; Tapsell, Linda; Deane, Frank; Arenson, Danielle

2018-02-13

The psychological construct of 'therapeutic alliance' can be used to better understand the effectiveness of consultations, particularly goal setting for weight management. We analysed audio-recorded health coaching sessions during a weight loss trial to explore relationships between therapeutic alliance and various contextual factors. Audio recordings of 50 health coaching sessions were analysed. After assessing fidelity to the protocol, therapeutic alliance was measured using an adapted Working Alliance Inventory Observer-rated Short Version (WAI-O-S), and examined by (i) identifying relationships between contextual factors and WAI-O-S scores (Spearman's coefficients); (ii) testing the impact of preparatory exercises and body mass index on WAI-O-S scores (one-way analysis of variance and least-squared differences tests) and (iii) comparing differences in WAI-O-S scores based on relationship status, gender and follow-up session completion (independent samples t-tests). Fidelity was high (mean 88%). WAI-O-S total scores ranged from 55 to 70 (out of 84). Session duration was significantly correlated with WAI-O-S component of 'Bond' (r = 0.42, P = 0.002). Those who completed preparatory exercises had significantly higher total WAI-O-S scores, 'Goal' and 'Task' scores. Participants who completed the follow-up session scored significantly higher for 'Goal' compared to no follow-up. Spending more time in a session appears related to increased bonding, a key component of therapeutic alliance. Preparatory work may help build therapeutic alliance and agreement on goals appears to influence follow-up completion. These exploratory findings provide directions for research addressing the professional relationship in dietetic consultations for weight loss. © 2018 Dietitians Association of Australia.

Triple antithrombotic therapy is the independent predictor for the occurrence of major bleeding complications: analysis of percent time in therapeutic range.

Science.gov (United States)

Naruse, Yoshihisa; Sato, Akira; Hoshi, Tomoya; Takeyasu, Noriyuki; Kakefuda, Yuki; Ishibashi, Mayu; Misaki, Masako; Abe, Daisuke; Aonuma, Kazutaka

2013-08-01

Triple antithrombotic therapy increases the risk of bleeding events in patients undergoing percutaneous coronary intervention. However, it remains unclear whether good control of percent time in therapeutic range is associated with reduced occurrence of bleeding complications in patients undergoing triple antithrombotic therapy. This study included 2648 patients (70 ± 11 years; 2037 men) who underwent percutaneous coronary intervention with stent in the Ibaraki Cardiovascular Assessment Study registry and received dual antiplatelet therapy with or without warfarin. Clinical end points were defined as the occurrence of major bleeding complications (MBC), major adverse cardiac and cerebrovascular event, and all-cause death. Among these 2648 patients, 182 (7%) patients received warfarin. After a median follow-up period of 25 months (interquartile range, 15-35 months), MBC had occurred in 48 (2%) patients, major adverse cardiac and cerebrovascular event in 484 (18%) patients, and all-cause death in 206 (8%) patients. Multivariable Cox regression analysis revealed that triple antithrombotic therapy was the independent predictor for the occurrence of MBC (hazard ratio, 7.25; 95% confidence interval, 3.05-17.21; Prange value did not differ between the patients with and without MBC occurrence (83% [interquartile range, 50%-90%] versus 75% [interquartile range, 58%-87%]; P=0.7). However, the mean international normalized ratio of prothrombin time at the time of MBC occurrence was 3.3 ± 2.1. Triple antithrombotic therapy did not have a predictive value for the occurrence of all-cause death (P=0.1) and stroke (P=0.2). Triple antithrombotic therapy predisposes patients to an increased risk of MBC regardless of the time in therapeutic range.

Empathic curiosity: resolving goal conflicts that generate emotional distress.

Science.gov (United States)

McEvoy, P; Baker, D; Plant, R; Hylton, K; Mansell, W

2013-04-01

The quality of the therapeutic alliance between therapist and client is consistently identified as a key component of cognitive behavioural interventions. However, relatively little is known about the causal mechanisms that generate the effects that are ascribed to the therapeutic alliance. This paper outlines how one such causal mechanism, empathic curiosity, may operate. The explanation is rooted in control theory, a theory that explains the link between our experiences and our goal-directed behaviour. Empathic curiosity is underpinned by the core skills of empathic listening and maintaining a curious attitude. From a control theory perspective, the value of this type of listening may be reinforced when speak to people about their salient concerns, as they perceive them in the current flow of their conscious thoughts. This can be facilitated by linking curious questions to the non-verbal disruptions in their body posture and conversational flow. The approach is illustrated using three case examples. In all three examples, the clients involved were able to reflect upon and re-organize conflicting goals that had been a source of significant emotional distress. © 2012 Blackwell Publishing.

Hemodynamic and oxygen transport patterns for outcome prediction, therapeutic goals, and clinical algorithms to improve outcome. Feasibility of artificial intelligence to customize algorithms.

Science.gov (United States)

Shoemaker, W C; Patil, R; Appel, P L; Kram, H B

1992-11-01

A generalized decision tree or clinical algorithm for treatment of high-risk elective surgical patients was developed from a physiologic model based on empirical data. First, a large data bank was used to do the following: (1) describe temporal hemodynamic and oxygen transport patterns that interrelate cardiac, pulmonary, and tissue perfusion functions in survivors and nonsurvivors; (2) define optimal therapeutic goals based on the supranormal oxygen transport values of high-risk postoperative survivors; (3) compare the relative effectiveness of alternative therapies in a wide variety of clinical and physiologic conditions; and (4) to develop criteria for titration of therapy to the endpoints of the supranormal optimal goals using cardiac index (CI), oxygen delivery (DO2), and oxygen consumption (VO2) as proxy outcome measures. Second, a general purpose algorithm was generated from these data and tested in preoperatively randomized clinical trials of high-risk surgical patients. Improved outcome was demonstrated with this generalized algorithm. The concept that the supranormal values represent compensations that have survival value has been corroborated by several other groups. We now propose a unique approach to refine the generalized algorithm to develop customized algorithms and individualized decision analysis for each patient's unique problems. The present article describes a preliminary evaluation of the feasibility of artificial intelligence techniques to accomplish individualized algorithms that may further improve patient care and outcome.

MOTIVATION: Goals and Goal Setting

Science.gov (United States)

Stratton, Richard K.

2005-01-01

Goal setting has great impact on a team's performance. Goals enable a team to synchronize their efforts to achieve success. In this article, the author talks about goals and goal setting. This articles complements Domain 5--Teaching and Communication (p.14) and discusses one of the benchmarks listed therein: "Teach the goal setting process and…

Pathogenetic and Therapeutic Applications of Tumor Necrosis Factor-α (TNF-α in Major Depressive Disorder: A Systematic Review

Directory of Open Access Journals (Sweden)

Ke Ma

2016-05-01

Full Text Available Major depressive disorder (MDD is characterized by mood, vegetative, cognitive, and even psychotic symptoms and signs that can cause substantial impairments in quality of life and functioning. Up to now, the exact pathogenesis of MDD remains poorly understood. Recent research has begun to reveal that the pro-inflammatory cytokines, particularly, tumor necrosis factor-α (TNF-α, play an integral role in the pathophysiology of depressive disorders and the mechanism of antidepressant treatment. On the base of several observations: it is found that subsets of MDD patients have enhanced plasma levels TNF-α; antidepressant treatments had linked with the decline of TNF-α; central administration of TNF-α gives rise to sickness behavior which shares features with depression; and a blockade of it can ameliorate depressive symptomatology in animal models and clinical trials. In this review article, we focus on recent evidence linking TNF-α and MDD looking at data from animal and clinical studies, illustrating the pathophysiological role, susceptibility and its therapeutic application in depression. We conclude by discussing future directions for research, in particular the opportunities for the development of novel therapeutics that target TNF-α. This will be very important for designing preventative strategies and for the identification of new drug targets and preventative strategies.

Pathogenetic and Therapeutic Applications of Tumor Necrosis Factor-α (TNF-α) in Major Depressive Disorder: A Systematic Review

Science.gov (United States)

Ma, Ke; Zhang, Hongxiu; Baloch, Zulqarnain

2016-01-01

Major depressive disorder (MDD) is characterized by mood, vegetative, cognitive, and even psychotic symptoms and signs that can cause substantial impairments in quality of life and functioning. Up to now, the exact pathogenesis of MDD remains poorly understood. Recent research has begun to reveal that the pro-inflammatory cytokines, particularly, tumor necrosis factor-α (TNF-α), play an integral role in the pathophysiology of depressive disorders and the mechanism of antidepressant treatment. On the base of several observations: it is found that subsets of MDD patients have enhanced plasma levels TNF-α; antidepressant treatments had linked with the decline of TNF-α; central administration of TNF-α gives rise to sickness behavior which shares features with depression; and a blockade of it can ameliorate depressive symptomatology in animal models and clinical trials. In this review article, we focus on recent evidence linking TNF-α and MDD looking at data from animal and clinical studies, illustrating the pathophysiological role, susceptibility and its therapeutic application in depression. We conclude by discussing future directions for research, in particular the opportunities for the development of novel therapeutics that target TNF-α. This will be very important for designing preventative strategies and for the identification of new drug targets and preventative strategies. PMID:27187381

Hemorrhagic Cardioembolic Stroke Secondary to a Left Ventricular Thrombus: a Therapeutic Dilemma

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Khalil Al-Farsi

2013-01-01

Full Text Available Cardiogenic embolism is a major cause of stroke and often leads to significant morbidity and mortality. Despite the recent advances in our understanding of the pathophysiology of stroke and its risk factors, diagnosis and therapy; some case scenarios still present a real challenge for the treating physicians. We report a case of a 50 year old male patient presenting with multi-territory cerebral infarctions due to a left ventricular mobile thrombus complicated with hemorrhagic transformation at the time of presentation. Gradual introduction of anticoagulation coupled with a multidisciplinary team approach advocating careful daily clinical assessment of the patient and regular echocardiographic and neuroimaging studies have resulted in a better management and achievement of therapeutic goals.

Design of therapeutic vaccines as a novel antibody therapy for cardiovascular diseases.

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Nakagami, Hironori

2017-09-01

Vaccines are primarily used worldwide as a preventive medicine for infectious diseases and have recently been applied to cancer. We and others have developed therapeutic vaccines designed for cardiovascular diseases that are notably different from previous vaccines. In the case of cancer vaccines, a specific protein in cancer cells is a target antigen, and the activation of cytotoxic T cells (CTL) is required to kill and remove the antigen-presenting cancer cells. Our therapeutic vaccines work against hypertension by targeting angiotensin II (Ang II) as the antigen, which is an endogenous hormone. Therapeutic vaccines must avoid CTL activation and induce the blocking antibodies for Ang II. The goal of our therapeutic vaccine for cardiovascular diseases is to induce the specific antibody response toward the target protein without inducing T-cell or antibody-mediated inflammation through the careful selection of the target antigen, carrier protein and adjuvants. The goal of our therapeutic vaccine is similar to that of antibody therapy. Recently, multiple antibody-based drugs have been developed for cancer, immune-related diseases, and dyslipidemia, which are efficient but expensive. If the effect of a therapeutic vaccine is nearly equivalent to antibody therapy as an alternative approach, the lower medical cost and improvement in drug adherence can be advantages of therapeutic vaccines. In this review, we will describe our concept of therapeutic vaccines for cardiovascular diseases and the future directions of therapeutic vaccines as novel antibody therapies. Copyright © 2017. Published by Elsevier Ltd.

Abnormal function of monoamine oxidase-A in comorbid major depressive disorder and cardiovascular disease: pathophysiological and therapeutic implications (review).

Science.gov (United States)

Machado-Vieira, Rodrigo; Mallinger, Alan G

2012-11-01

The association between major depressive disorder (MDD) and cardiovascular disease (CVD) is among the best described medical comorbidities. The presence of MDD increases the risk of cardiac admissions and mortality and increases healthcare costs in patients with CVD, and similarly, CVD affects the course and outcome of MDD. The potential shared biological mechanisms involved in these comorbid conditions are not well known. However, the enzyme monoamine oxidase-A (MAO-A), which has a key role in the degradation of catecholamines, has been associated with the pathophysiology and therapeutics of both MDD and CVD. Increased MAO-A activity results in the dysregulation of downstream targets of this enzyme and thus affects the pathophysiology of the two diseases. These deleterious effects include altered noradrenaline turnover, with a direct elevation in oxidative stress parameters, as well as increased platelet activity and cytokine levels. These effects were shown to be reversed by MAO inhibitors. Here, a model describing a key role for the MAO-A in comorbid MDD and CVD is proposed, with focus on the shared pathophysiological mechanisms and the potential therapeutic relevance of agents targeting this enzyme.

Profiling Prostate Cancer Therapeutic Resistance

OpenAIRE

Cameron A. Wade; Natasha Kyprianou

2018-01-01

The major challenge in the treatment of patients with advanced lethal prostate cancer is therapeutic resistance to androgen-deprivation therapy (ADT) and chemotherapy. Overriding this resistance requires understanding of the driving mechanisms of the tumor microenvironment, not just the androgen receptor (AR)-signaling cascade, that facilitate therapeutic resistance in order to identify new drug targets. The tumor microenvironment enables key signaling pathways promoting cancer cell survival ...

Glycosylation profiles of therapeutic antibody pharmaceuticals.

Science.gov (United States)

Wacker, Christoph; Berger, Christoph N; Girard, Philippe; Meier, Roger

2011-11-01

Recombinant antibodies specific for human targets are often used as therapeutics and represent a major class of drug products. Their therapeutic efficacy depends on the formation of antibody complexes resulting in the elimination of a target molecule or the modulation of specific signalling pathways. The physiological effects of antibody therapeutics are known to depend on the structural characteristics of the antibody molecule, specifically on the glycosylation which is the result of posttranslational modifications. Hence, production of therapeutic antibodies with a defined and consistent glycoform profile is needed which still remains a considerable challenge to the biopharmaceutical industry. To provide an insight into the industries capability to control their manufacturing process and to provide antibodies of highest quality, we conducted a market surveillance study and compared major oligosaccharide profiles of a number of monoclonal antibody pharmaceuticals sampled on the Swiss market. Product lot-to-lot variability was found to be generally low, suggesting that a majority of manufacturers have implemented high quality standards in their production processes. However, proportions of G0, G1 and G2 core-fucosylated chains derived from different products varied considerably and showed a bias towards the immature agalactosidated G0 form. Interestingly, differences in glycosylation caused by the production cell type seem to be of less importance compared with process related parameters such as cell growth. Copyright © 2011 Elsevier B.V. All rights reserved.

Aiming at a Moving Target: Theoretical and Methodological Considerations in the Study of Intraindividual Goal Conflict between Personal Goals

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Julia Gorges

2017-11-01

Full Text Available Multiple-goal pursuit and conflict between personal life-defining goals can be considered part of everyday business in most individuals' lives. Given the potentially detrimental effects of goal conflict—for example, impaired well-being or poor performance—the literature on goal conflict is surprisingly scattered due to heterogeneous methodological approaches and technical terms. Little empirical research has addressed the conceptualization of goal conflict against the background of differing understandings from a structure-like and a process-like perspective. In the present article, we outline theoretical foundations of goal conflict from two perspectives: a structure- and a process-like perspective. Based on a comparative analysis and integration of these two perspectives, we systematically review empirical studies on goal conflict over 30 years of research. In doing so, we identify and discuss important conceptual dimensions of goal conflict, namely, goal conflict as a cognitive construct and an experiential instance, a focus on goal interrelations or on specific goal properties, and resource vs. inherent conflict, and the potential of these distinctions to further research on goal conflict. Finally, we present major challenges and pose questions that need to be addressed by future research.

Aiming at a Moving Target: Theoretical and Methodological Considerations in the Study of Intraindividual Goal Conflict between Personal Goals.

Science.gov (United States)

Gorges, Julia; Grund, Axel

2017-01-01

Multiple-goal pursuit and conflict between personal life-defining goals can be considered part of everyday business in most individuals' lives. Given the potentially detrimental effects of goal conflict-for example, impaired well-being or poor performance-the literature on goal conflict is surprisingly scattered due to heterogeneous methodological approaches and technical terms. Little empirical research has addressed the conceptualization of goal conflict against the background of differing understandings from a structure-like and a process-like perspective. In the present article, we outline theoretical foundations of goal conflict from two perspectives: a structure- and a process-like perspective. Based on a comparative analysis and integration of these two perspectives, we systematically review empirical studies on goal conflict over 30 years of research. In doing so, we identify and discuss important conceptual dimensions of goal conflict, namely, goal conflict as a cognitive construct and an experiential instance, a focus on goal interrelations or on specific goal properties, and resource vs. inherent conflict, and the potential of these distinctions to further research on goal conflict. Finally, we present major challenges and pose questions that need to be addressed by future research.

Goal setting in sport and exercise: research and practical applications

OpenAIRE

Weinberg,Robert S.

2013-01-01

The purpose of this paper was to briefly review the major theoretical and empirical research in goal setting related to sport and develop applications for best practice. Different types of goals were discussed and Locke's theory of goal setting provided the foundation for future research. After briefly reviewing the goal setting literature in sport and organizational settings, principles for how to apply goal setting to enhance performance were developed. The development and implementations o...

Prevalence of Obesity and Its Influence on Achievement of Cardiometabolic Therapeutic Goals in Chinese Type 2 Diabetes Patients: An Analysis of the Nationwide, Cross-Sectional 3B Study.

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Xianghai Zhou

Full Text Available There are few data on the prevalence of obesity and its influence on achieving blood glucose, blood pressure, and blood lipid (3B goals in Chinese type 2 diabetes outpatients.Patient demographic data, anthropometric measurements, medications, and blood glucose and lipid profiles of 24,512 type 2 diabetes patients from a large, geographically diverse study (CCMR-3B were analyzed. Using cut-points for body mass index (BMI and waist circumference (WC recommended by the Working Group on Obesity in China, overweight and obesity were defined as BMIs of 24-27.9 kg/m2 and ≥28.0 kg/m2. Central obesity was defined as a waist circumference ≥80 cm in women and ≥85 cm in men. The 3B therapeutic goals were HbA1c<7.0%, BP<140/90 mmHg and LDL-C<2.6 mmol/L.Overall, 43.0% of type 2 diabetes patients were overweight and 16.7% were obese; 13.3% of overweight and and 10.1% of obese patients achieved all the 3B target goals. Overweight or obese patients were less likely to achieve 3B goals than those with normal BMIs. More than a half the overweight or obese patients (69.6% were centrally obese. Patients with abdominal obesity were less likely to achieve cardiometabolic targets than those without abdominal obesity. In multivariate logistic regression analysis, female, higher BMI and waist circumference, smoking, drinking, sedentary lifestyle, and longer diabetes duration were significantly correlated with failure to achieve 3B control goals.Obesity is highly prevalent and associated with poor 3B control in Chinese type 2 diabetes patients. In clinical practice, more attention and resources should focus on weight loss for such patients.

Outcome of Gaucher Disease in India: Lessons from Prevalent Diagnostic and Therapeutic Practices.

Science.gov (United States)

Muranjan, Mamta; Patil, Smita

2016-08-08

To study disease severity and response to enzyme replacement therapy in Gaucher disease. Updated data was captured from records of 37 patients (35 reported previously) with confirmed diagnosis of Gaucher disease from January 1995 through December 2011 (31, 83.8 %) and prospectively from January 2012 through June 2013 (6, 16.2 %). Severity of manifestations was determined by Gaucher disease Severity Score Index. Response to enzyme replacement therapy was assessed in terms of attainment of therapeutic goals. Moderate to severe manifestations (domain score of > 2) were observed in treated patients at baseline (83%, 58%, 66% and 25% for anemia, thrombocytopenia, hepatomegaly and leucopenia, respectively and 100% for splenomegaly and elevated plasma chitotriosidase). None of the 11 patients treated with synthetic enzyme (average annual dose 23 to 53 units/kg) attained all therapeutic goals in the recommended time frame, particularly the visceral, skeletal and growth domains. Early onset of moderate to severe disease in Indian patients mandates early therapy with optimum doses to ensure attainment of all recommended therapeutic goals.

Vocational Education and Training and the Therapeutic Turn

Science.gov (United States)

Hyland, Terry

2006-01-01

The concept of "therapeutic education" is being increasingly used in contemporary education policy studies to identify learning initiatives which are dominated by objectives linked to personal and social skills, emotional intelligence and building self-esteem. Contemporary educational goals connected with such strategies have been…

Neurodevelopmental Treatment (NDT): Therapeutic Intervention and Its Efficacy.

Science.gov (United States)

Stern, Francine Martin; Gorga, Delia

1988-01-01

Use of neurodevelopmental treatment, also known as the Bobath method, is discussed, including its history, philosophy, goals, and treatment emphasis with infants and children with movement disorders. Examples of children before and after therapeutic intervention illustrate use of the technique, and controversies in measuring therapy efficacy are…

Some ethical issues in feminist-oriented therapeutic groups for women.

Science.gov (United States)

Lakin, M

1991-04-01

Review of the origins of group psychotherapy reveals concerns with social as well as with personal "psychopathology." Thus, group processes have been mobilized for curative or change purposes for ideological as well as individual therapeutic goals. Psychopolitical as well as personal change are the goals for some groups. The ethical problem stems from a persistent assumption that the group's processes are inherently benign and curative and beneficial to individual participants. A more sophisticated understanding takes into account their essential neutrality and their potential use (or abuse) for purposes of ideological persuasion that may or may not be personally therapeutic. As in other ethically implicated issues in the psychotherapies, the question becomes one of treatment versus exploitation, or therapy for the individual versus recruitment on behalf of a cause.

Key components of effective collaborative goal setting in the chronic care encounter.

Science.gov (United States)

Bigi, Sarah

2014-01-01

Collaborative goal setting in patient-provider communication with chronic patients is the phase in which--after collecting the data regarding the patient's health--it is necessary to make a decision regarding the best therapy and behaviors the patient should adopt until the next encounter. Although it is considered a pivotal phase of shared decision making, there remain a few open questions regarding its components and its efficacy: What are the factors that improve or impede agreement on treatment goals and strategies?; What are the 'success conditions' of collaborative goal setting?; How can physicians effectively help patients make their preferences explicit and then co-construct with them informed preferences to help them reach their therapeutic goals? Using the theoretical framework of dialogue types, an approach developed in the field of Argumentation Theory, it will be possible to formulate hypotheses on the success conditions' and effects on patient commitment of collaborative goal setting.

Goal pursuit, goal adjustment, and affective well-being following lower limb amputation.

Science.gov (United States)

Coffey, Laura; Gallagher, Pamela; Desmond, Deirdre; Ryall, Nicola

2014-05-01

This study examined the relationships between tenacious goal pursuit (TGP), flexible goal adjustment (FGA), and affective well-being in a sample of individuals with lower limb amputations. Cross-sectional, quantitative. Ninety-eight patients recently admitted to a primary prosthetic rehabilitation programme completed measures of TGP, FGA, positive affect, and negative affect. Hierarchical regression analyses revealed that TGP and FGA accounted for a significant proportion of the variance in both positive and negative affect, controlling for sociodemographic and clinical characteristics. TGP was significantly positively associated with positive affect, while FGA was significantly negatively associated with negative affect. Moderated regression analyses indicated that the beneficial effect of FGA on negative affect was strongest at high levels of amputation-related pain intensity and low levels of TGP. TGP and FGA appear to influence subjective well-being in different ways, with TGP promoting the experience of positive affect and FGA buffering against negative affect. TGP and FGA may prove useful in identifying individuals at risk of poor affective outcomes following lower limb amputation and represent important targets for intervention in this patient group. What is already known on this subject? The loss of a limb has a significant impact on several important life domains. Although some individuals experience emotional distress following amputation, the majority adjust well to their limb loss, with some achieving positive change or growth as a result of their experiences. Theories of self-regulation propose that disruptions in goal attainment have negative affective consequences. The physical, social, and psychological upheaval caused by limb loss is likely to threaten the attainment of valued goals, which may leave individuals vulnerable to negative psychosocial outcomes if they do not regulate their goals in response to these challenges. According to the dual

Therapeutic conflicts in emergency department patients with multimorbidity: a cross-sectional study.

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Stefan Markun

Full Text Available Patients with multimorbidity are an increasing concern in healthcare. Clinical practice guidelines, however, do not take into account potential therapeutic conflicts caused by co-occurring medical conditions. This makes therapeutic decisions complex, especially in emergency situations.The aim of this study was to identify and quantify therapeutic conflicts in emergency department patients with multimorbidity.We reviewed electronic records of all patients ≥18 years with two or more concurrent active medical conditions, admitted from the emergency department to the hospital ward of the University Hospital Zurich in January 2009. We cross-tabulated all active diagnoses with treatments recommended by guidelines for each diagnosis. Then, we identified potential therapeutic conflicts and classified them as either major or minor conflicts according to their clinical significance.166 emergency inpatients with multimorbidity were included. The mean number of active diagnoses per patient was 6.6 (SD±3.4. We identified a total of 239 therapeutic conflicts in 49% of the of the study population. In 29% of the study population major therapeutic conflicts, in 41% of the patients minor therapeutic conflicts occurred.Therapeutic conflicts are common among multimorbid patients, with one out of two experiencing minor, and one out of three experiencing major therapeutic conflicts. Clinical practice guidelines need to address frequent therapeutic conflicts in patients with co-morbid medical conditions.

Therapeutic conflicts in emergency department patients with multimorbidity: a cross-sectional study.

Science.gov (United States)

Markun, Stefan; Holzer, Barbara M; Rodak, Roksana; Kaplan, Vladimir; Wagner, Claudia C; Battegay, Edouard; Zimmerli, Lukas

2014-01-01

Patients with multimorbidity are an increasing concern in healthcare. Clinical practice guidelines, however, do not take into account potential therapeutic conflicts caused by co-occurring medical conditions. This makes therapeutic decisions complex, especially in emergency situations. The aim of this study was to identify and quantify therapeutic conflicts in emergency department patients with multimorbidity. We reviewed electronic records of all patients ≥18 years with two or more concurrent active medical conditions, admitted from the emergency department to the hospital ward of the University Hospital Zurich in January 2009. We cross-tabulated all active diagnoses with treatments recommended by guidelines for each diagnosis. Then, we identified potential therapeutic conflicts and classified them as either major or minor conflicts according to their clinical significance. 166 emergency inpatients with multimorbidity were included. The mean number of active diagnoses per patient was 6.6 (SD±3.4). We identified a total of 239 therapeutic conflicts in 49% of the of the study population. In 29% of the study population major therapeutic conflicts, in 41% of the patients minor therapeutic conflicts occurred. Therapeutic conflicts are common among multimorbid patients, with one out of two experiencing minor, and one out of three experiencing major therapeutic conflicts. Clinical practice guidelines need to address frequent therapeutic conflicts in patients with co-morbid medical conditions.

Safety goals for commercial nuclear power plants

International Nuclear Information System (INIS)

Roe, J.W.

1988-01-01

In its official policy statement on safety goals for the operation of nuclear power plants, the Nuclear Regulatory Commission (NRC) set two qualitative goals, supported by two quantitative objectives. These goals are that (1) individual members of the public should be provided a level of protection from the consequences of nuclear power plant operation such that individuals bear no significant additional risk to life and health; and (2) societal risks to life and health from nuclear power plant operation should be comparable to or less than the risks of generating electricity by viable competing technologies and should not be a significant addition to other societal risks. As an alternative, this study proposes four quantitative safety goals for nuclear power plants. It begins with an analysis of the NRC's safety-goal development process, a key portion of which was devoted to delineating criteria for evaluating goal-development methods. Based on this analysis, recommendations for revision of the NRC's basic benchmarks for goal development are proposed. Using the revised criteria, NRC safety goals are evaluated, and the alternative safety goals are proposed. To further support these recommendations, both the NRC's goals and the proposed goals are compared with the results of three major probabilistic risk assessment studies. Finally, the potential impact of these recommendations on nuclear safety is described

Evolving paradigms in clinical pharmacology and therapeutics for the treatment of Duchenne muscular dystrophy.

Science.gov (United States)

Huard, J; Mu, X; Lu, A

2016-08-01

Progressive muscle weakness and degeneration due to the lack of dystrophin eventually leads to the loss of independent ambulation by the middle of the patient's second decade, and a fatal outcome due to cardiac or respiratory failure by the third decade. More specifically, loss of sarcolemmal dystrophin and the dystrophin-associated glycoprotein (DAG) complex promotes muscle fiber damage during muscle contraction. This process results in an efflux of creatine kinase (CK), an influx of calcium ions, and the recruitment of T cells, macrophages, and mast cells to the damaged muscle, causing progressive myofiber necrosis. For the last 20 years, the major goal in the development of therapeutic approaches to alleviate muscle weakness in DMD has been centered on the restoration of dystrophin or proteins that are analogous to dystrophin, such as utrophin, through a variety of modalities including cell therapy, gene therapy, gene correction, and the highly promising techniques utilizing CRISPR/Cas9 technology. Despite the development of new therapeutic options, there still exist numerous challenges that we must face with regard to these new strategies and, consequently, we still do not have any feasible options available to ultimately slow the progression of this devastating disease. The purpose of this article is to highlight the current knowledge and advancements in the evolving paradigms in clinical pharmacology and therapeutics for this devastating musculoskeletal disease. © 2016 American Society for Clinical Pharmacology and Therapeutics.

Commercially available interactive video games in burn rehabilitation: therapeutic potential.

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Parry, Ingrid S; Bagley, Anita; Kawada, Jason; Sen, Soman; Greenhalgh, David G; Palmieri, Tina L

2012-06-01

Commercially available interactive video games (IVG) like the Nintendo Wii™ (NW) and PlayStation™II Eye Toy (PE) are increasingly used in the rehabilitation of patients with burn. Such games have gained popularity in burn rehabilitation because they encourage range of motion (ROM) while distracting from pain. However, IVGs were not originally designed for rehabilitation purposes but rather for entertainment and may lack specificity for achieving rehabilitative goals. Objectively evaluating the specific demands of IVGs in relation to common burn therapy goals will determine their true therapeutic benefit and guide their use in burn rehabilitation. Upper extremity (UE) motion of 24 normal children was measured using 3D motion analysis during play with the two types of IVGs most commonly described for use after burn: NW and PE. Data was analyzed using t-tests and One-way Analysis of Variance. Active range of motion for shoulder flexion and abduction during play with both PE and NW was within functional range, thus supporting the idea that IVGs offer activities with therapeutic potential to improve ROM. PE resulted in higher demands and longer duration of UE motion than NW, and therefore may be the preferred tool when UE ROM or muscular endurance are the goals of rehabilitation. When choosing a suitable IVG for application in rehabilitation, the user's impairment together with the therapeutic attributes of the IVG should be considered to optimize outcome. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

[Therapeutic touch and anorexia nervosa].

Science.gov (United States)

Satori, Nadine

2016-01-01

An innovative practice, therapeutic touch has been used for around ten years in the treatment of eating disorders. Delivered by nurse clinicians having received specific training, this approach is based on nursing diagnoses which identify the major symptoms of this pathology. The support is built around the body and its perceptions. Through the helping relationship, it mobilises the patient's resources to favour a relationship of trust, a letting-go, physical, psychological and emotional relaxation, and improves the therapeutic alliance. Copyright © 2016. Published by Elsevier Masson SAS.

Treatment goals of pulmonary hypertension.

LENUS (Irish Health Repository)

McLaughlin, Vallerie V

2013-12-24

With significant therapeutic advances in the field of pulmonary arterial hypertension, the need to identify clinically relevant treatment goals that correlate with long-term outcome has emerged as 1 of the most critical tasks. Current goals include achieving modified New York Heart Association functional class I or II, 6-min walk distance >380 m, normalization of right ventricular size and function on echocardiograph, a decreasing or normalization of B-type natriuretic peptide (BNP), and hemodynamics with right atrial pressure <8 mm Hg and cardiac index >2.5 mg\\/kg\\/min(2). However, to more effectively prognosticate in the current era of complex treatments, it is becoming clear that the "bar" needs to be set higher, with more robust and clearer delineations aimed at parameters that correlate with long-term outcome; namely, exercise capacity and right heart function. Specifically, tests that accurately and noninvasively determine right ventricular function, such as cardiac magnetic resonance imaging and BNP\\/N-terminal pro-B-type natriuretic peptide, are emerging as promising indicators to serve as baseline predictors and treatment targets. Furthermore, studies focusing on outcomes have shown that no single test can reliably serve as a long-term prognostic marker and that composite treatment goals are more predictive of long-term outcome. It has been proposed that treatment goals be revised to include the following: modified New York Heart Association functional class I or II, 6-min walk distance ≥ 380 to 440 m, cardiopulmonary exercise test-measured peak oxygen consumption >15 ml\\/min\\/kg and ventilatory equivalent for carbon dioxide <45 l\\/min\\/l\\/min, BNP level toward "normal," echocardiograph and\\/or cardiac magnetic resonance imaging demonstrating normal\\/near-normal right ventricular size and function, and hemodynamics showing normalization of right ventricular function with right atrial pressure <8 mm Hg and cardiac index >2.5 to 3.0 l\\/min\\/m(2).

Therapeutic Potential of Thymoquinone in Glioblastoma Treatment: Targeting Major Gliomagenesis Signaling Pathways

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Fabliha Ahmed Chowdhury

2018-01-01

Full Text Available Glioblastoma multiforme (GBM is one of the most devastating brain tumors with median survival of one year and presents unique challenges to therapy because of its aggressive behavior. Current treatment strategy involves surgery, radiotherapy, immunotherapy, and adjuvant chemotherapy even though optimal management requires a multidisciplinary approach and knowledge of potential complications from both the disease and its treatment. Thymoquinone (TQ, the main bioactive component of Nigella sativa L., has exhibited anticancer effects in numerous preclinical studies. Due to its multitargeting nature, TQ interferes in a wide range of tumorigenic processes and counteract carcinogenesis, malignant growth, invasion, migration, and angiogenesis. TQ can specifically sensitize tumor cells towards conventional cancer treatments and minimize therapy-associated toxic effects in normal cells. Its potential to enter brain via nasal pathway due to volatile nature of TQ adds another advantage in overcoming blood-brain barrier. In this review, we summarized the potential role of TQ in different signaling pathways in GBM that have undergone treatment with standard therapeutic modalities or with TQ. Altogether, we suggest further comprehensive evaluation of TQ in preclinical and clinical level to delineate its implied utility as novel therapeutics to combat the challenges for the treatment of GBM.

The Use of Personal Projects Analysis to Enhance Occupational Therapy Goal Identification

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Mary Egan

2016-01-01

Full Text Available Background: Client-centered occupational therapy begins with the identification of personally-relevant patient goals. This study aimed to determine whether the elicitation module of Personal Projects Analysis (PPA could help patients in an acquired brain injury day hospital program identify more meaningful goals than those identified using the Canadian Occupational Performance Measure (COPM alone. Method: Ten patients completed the COPM. They rated the importance of each goal and their confidence that they could attain each goal. During the next session, using the elicitation module of PPA, they identified personal projects just prior to their brain injuries, current personal projects, and future desired personal projects. They were then invited to revise their COPM goals and re-rate them for importance and confidence. Results: Following completion of the elicitation module of PPA, seven participants changed at least one goal. Of the goals that were changed, half were revised to include the mention of another person. There were no significant changes in average goal importance or perceived attainability. Occupational therapists reported that the elicitation module of PPA helped them get to know their patients better and identify potential therapeutic occupations. Discussion: The elicitation module of PPA may help people develop goals that are more embedded in their social contexts.

The concept and definition of therapeutic inertia in hypertension in primary care: a qualitative systematic review.

Science.gov (United States)

Lebeau, Jean-Pierre; Cadwallader, Jean-Sébastien; Aubin-Auger, Isabelle; Mercier, Alain; Pasquet, Thomas; Rusch, Emmanuel; Hendrickx, Kristin; Vermeire, Etienne

2014-07-02

Therapeutic inertia has been defined as the failure of health-care provider to initiate or intensify therapy when therapeutic goals are not reached. It is regarded as a major cause of uncontrolled hypertension. The exploration of its causes and the interventions to reduce it are plagued by unclear conceptualizations and hypothesized mechanisms. We therefore systematically searched the literature for definitions and discussions on the concept of therapeutic inertia in hypertension in primary care, to try and form an operational definition. A systematic review of all types of publications related to clinical inertia in hypertension was performed. Medline, EMbase, PsycInfo, the Cochrane library and databases, BDSP, CRD and NGC were searched from the start of their databases to June 2013. Articles were selected independently by two authors on the basis of their conceptual content, without other eligibility criteria or formal quality appraisal. Qualitative data were extracted independently by two teams of authors. Data were analyzed using a constant comparative qualitative method. The final selection included 89 articles. 112 codes were grouped in 4 categories: terms and definitions (semantics), "who" (physician, patient or system), "how and why" (mechanisms and reasons), and "appropriateness". Regarding each of these categories, a number of contradictory assertions were found, most of them relying on little or no empirical data. Overall, the limits of what should be considered as inertia were not clear. A number of authors insisted that what was considered deleterious inertia might in fact be appropriate care, depending on the situation. Our data analysis revealed a major lack of conceptualization of therapeutic inertia in hypertension and important discrepancies regarding its possible causes, mechanisms and outcomes. The concept should be split in two parts: appropriate inaction and inappropriate inertia. The development of consensual and operational definitions

Goal motives and multiple-goal striving in sport and academia: A person-centered investigation of goal motives and inter-goal relations.

Science.gov (United States)

Healy, Laura C; Ntoumanis, Nikos; Duda, Joan L

2016-12-01

This investigation extended the goal striving literature by examining motives for two goals being pursued simultaneously. Grounded in self-determination theory, we examined how student-athletes' motives for their sporting and academic goals were associated with inter-goal facilitation and interference. Cross-sectional survey. UK university student-athletes (n=204) identified their most important sporting and academic goals. They then rated their extrinsic, introjected, identified and intrinsic motives for these goals and completed questionnaires assessing inter-goal facilitation and interference. Using a person-centered approach via latent profile analysis, we identified three distinct profiles of goal motives. Auxiliary analyses showed that the profile with high identified motives for both goals reported greater inter-goal facilitation. Extending the previous literature, the findings demonstrate the benefits of autonomous motives when simultaneously pursing goals in sport and academia. Copyright © 2016. Published by Elsevier Ltd.

Implementation of safety goals in NRC's regulatory process

International Nuclear Information System (INIS)

Murley, T.E.

1985-01-01

In May 1983 the Nuclear Regulatory Commission issued a policy statement on Safety Goals For Nuclear Power Plant Operation. The Commission at the same time judged that a two-year evaluation period was necessary to judge the effectiveness of the goals and design objectives, and directed the staff to develop information and understanding as to how to further define and use the design objectives and the cost-benefit guidelines. In carrying out the Commission's mandate, the staff framed three major questions to be addressed during the safety goal evaluation period. These three questions are: 1) to what extent is it practical to use safety goals in the regulatory process. 2) Should the quantitative design objectives be modified or supplemented. If so, how. 3) How should the safety goals be implemented at the end of the evaluation period. The staff's conclusions are discussed

Novel Therapeutic Approaches Targeting MDSC in Myelodysplastic Syndrome

Science.gov (United States)

2017-09-01

mechanisms involved in the initiation of stem cell malignancies is critical for development of effective strategies for prevention and treatment...IL10); hematopoietic stem and progenitor cells (HSPC) 3. ACCOMPLISHMENTS What were the major goals of the project? The major goals of the project...pathway can cause reactive oxygen species (ROS)-induced genomic instability but BI 836858 reduced both ROS and the levels of double strand breaks and

Recent progress in the therapeutic applications of nanotechnology.

Science.gov (United States)

Solomon, Melani; D'Souza, Gerard G M

2011-04-01

The field of pharmaceutical and medical nanotechnology has grown rapidly in recent decades and offers much promise for therapeutic advances. This review is intended to serve as a quick summary of the major areas in the therapeutic application of nanotechnology. Nanotechnology for therapeutic application falls into two broad categories of particulate systems and nanoengineered devices. Recent studies appear to focus on the development of multifunctional particles for drug delivery and imaging and the development of nanotechnology-based biosensors for diagnostic applications. Cancer treatment and diagnosis appears to be the principal focus of many of these applications, but nanotechnology is also finding application in tissue engineering and surface engineering of medical implants. Particulate drug delivery systems in general appear to be poised for increased use in the clinic, whereas nanoengineered implants and diagnostic sensors might well be the next major wave in the medical use of nanotechnology.

Achievement Goals and their Underlying Goal Motivation: Does it Matter Why Sport Participants Pursue their Goals?

Directory of Open Access Journals (Sweden)

Patrick Gaudreau

2016-07-01

Full Text Available This study examined whether the good or bad outcomes associated with mastery-approach (MAP and performance-approach (PAP goals depend on the extent to which they are motivated by autonomous or controlled motivation. A sample of 515 undergraduate students who participated in sport completed measures of achievement goals, motivation of achievement goals, perceived goal attainment, sport satisfaction, and both positive and negative affect. Results of moderated regression analyses revealed that the positive relations of both MAP and PAP goals with perceived goal attainment were stronger for athletes pursuing these goals with high level of autonomous goal motivation. Also, the positive relations between PAP goals and both sport satisfaction and positive affect were stronger at high levels of autonomous goal motivation and controlled goal motivation. The shape of all these significant interactions was consistent with tenets of Self-Determination Theory as controlled goal motivation was negatively associated with positive affect and sport satisfaction and positively associated with negative affect. Overall, these findings demonstrated the importance of considering goal motivation in order to better understand the conditions under which achievement goals are associated with better experiential and performance outcomes in the lives of sport participants.

Ready for goal setting? Process evaluation of a patient-specific goal-setting method in physiotherapy.

Science.gov (United States)

Stevens, Anita; Köke, Albère; van der Weijden, Trudy; Beurskens, Anna

2017-08-31

Patient participation and goal setting appear to be difficult in daily physiotherapy practice, and practical methods are lacking. An existing patient-specific instrument, Patient-Specific Complaints (PSC), was therefore optimized into a new Patient Specific Goal-setting method (PSG). The aims of this study were to examine the feasibility of the PSG in daily physiotherapy practice, and to explore the potential impact of the new method. We conducted a process evaluation within a non-controlled intervention study. Community-based physiotherapists were instructed on how to work with the PSG in three group training sessions. The PSG is a six-step method embedded across the physiotherapy process, in which patients are stimulated to participate in the goal-setting process by: identifying problematic activities, prioritizing them, scoring their abilities, setting goals, planning and evaluating. Quantitative and qualitative data were collected among patients and physiotherapists by recording consultations and assessing patient files, questionnaires and written reflection reports. Data were collected from 51 physiotherapists and 218 patients, and 38 recordings and 219 patient files were analysed. The PSG steps were performed as intended, but the 'setting goals' and 'planning treatment' steps were not performed in detail. The patients and physiotherapists were positive about the method, and the physiotherapists perceived increased patient participation. They became aware of the importance of engaging patients in a dialogue, instead of focusing on gathering information. The lack of integration in the electronic patient system was a major barrier for optimal use in practice. Although the self-reported actual use of the PSG, i.e. informing and involving patients, and client-centred competences had improved, this was not completely confirmed by the objectively observed behaviour. The PSG is a feasible method and tends to have impact on increasing patient participation in the goal

ROCK as a therapeutic target for ischemic stroke.

Science.gov (United States)

Sladojevic, Nikola; Yu, Brian; Liao, James K

2017-12-01

Stroke is a major cause of disability and the fifth leading cause of death. Currently, the only approved acute medical treatment of ischemic stroke is tissue plasminogen activator (tPA), but its effectiveness is greatly predicated upon early administration of the drug. There is, therefore, an urgent need to find new therapeutic options for acute stroke. Areas covered: In this review, we summarize the role of Rho-associated coiled-coil containing kinase (ROCK) and its potential as a therapeutic target in stroke pathophysiology. ROCK is a major regulator of cell contractility, motility, and proliferation. Many of these ROCK-mediated processes in endothelial cells, vascular smooth muscle cells, pericytes, astrocytes, glia, neurons, leukocytes, and platelets are important in stroke pathophysiology, and the inhibition of such processes could improve stroke outcome. Expert commentary: ROCK is a potential therapeutic target for cardiovascular disease and ROCK inhibitors have already been approved for human use in Japan and China for the treatment of acute stroke. Further studies are needed to determine the role of ROCK isoforms in the pathophysiology of cerebral ischemia and whether there are further therapeutic benefits with selective ROCK inhibitors.

Therapeutic Assessment in Psychological Triage Using the PAI.

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Brown, Joshua D; Morey, Leslie C

2016-01-01

This case illustrates the utility of incorporating therapeutic assessment in a triage context that typically involves a focus on gathering information. A man referred to our clinic by a local mental health center was seen by our assessment team for a triage that includes the administration of a single psychological test, the Personality Assessment Inventory (PAI). Although this triage must rapidly gather information to determine client suitability and treatment assignment, we still attempt to work with clients to collaboratively develop goals for this assessment that include addressing questions that are central concerns for the clients. In this case, the test results suggested a severe disorder that accounted for many phenomena that he had been experiencing but had apparently been reluctant to share. The information gathered led to a referral to a different treatment program that could provide pharmacological and more intensive forms of treatment. However, the collaborative bond formed between the assessor and the client during this triage was sufficiently strong that it was our assessor to whom the client turned in a subsequent crisis precipitated by a symptomatic exacerbation. This case illustrates complementary information gathering and therapeutic goals of assessment even in the context of a brief assessment.

The effects of therapeutic touch on pain.

Science.gov (United States)

Monroe, Carolyn Magdalen

2009-06-01

To better understand how Therapeutic Touch can be used in today's health care arena, this integrative literature review will examine current research that will help answer the question, Does Therapeutic Touch reduce pain? An extensive search was conducted of the online databases MEDLINE, CINAHL, Cochrane Library, EMBASE, PsychLIT, and PubMed to retrieve research articles published from 1997 to 2007. Seven studies that were conducted between 1997 and 2004 were found and only five of the seven were included as pertinent evidence to answer the question. All of the research that was reviewed to answer whether Therapeutic Touch could significantly reduce pain revealed a majority of statistically significant positive results for implementing this intervention. Because there are no identified risks to Therapeutic Touch as a pain relief measure, it is safe to recommend despite the limitations of current research. Therapeutic Touch should be considered among the many possible nursing interventions for the treatment of pain.

Annotating DNA variants is the next major goal for human genetics.

Science.gov (United States)

Cutting, Garry R

2014-01-02

Clinical genetic testing has undergone a dramatic transformation in the past two decades. Diagnostic laboratories that previously tested for well-established disease-causing DNA variants in a handful of genes have evolved into sequencing factories identifying thousands of variants of known and unknown medical consequence. Sorting out what does and does not cause disease in our genomes is the next great challenge in making genetics a central feature of healthcare. I propose that closing the gap in our ability to interpret variation responsible for Mendelian disorders provides a grand and unprecedented opportunity for geneticists. Human geneticists are well placed to coordinate a systematic evaluation of variants in collaboration with basic scientists and clinicians. Sharing of knowledge, data, methods, and tools will aid both researchers and healthcare workers in achieving their common goal of defining the pathogenic potential of variants. Generation of variant annotations will inform genetic testing and will deepen our understanding of gene and protein function, thereby aiding the search for molecular targeted therapies. Copyright © 2014 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

Pathogenesis of Graves' disease and therapeutic implications

International Nuclear Information System (INIS)

Seif, F.J.

1997-01-01

Graves' disease presents itself clinically mainly as hyperthyroidism and infiltrative ophthalmopathy and to a minimal extent also as dermopathy and acropachy. Autoimmune processes are the basic pathogenesis. Stimulating antibodies against the TSH receptor cause hyperthyroidism. Autoantibodies and autoreactive T lymphocytes against primarily thyroidal antigens cross-react with similar antigens of the eye muscles and orbital connective tissue, thus spreading the disease from the thyroid to the eyes. The therapeutic goal comprises not only the treatment of hyperthyroidism, but also the induction of a steady immuntolerance in order to minimize the irreversible damage to the eye. The therapeutic armamentarium is formed by antithyroid drugs, glucocorticoids, retrobulbar radition and thyroid ablation, either by nearly total thyroidectomy or by radioiodine. The different indications for both ablative procedures are discussed. (orig.) [de

Get a taste of your goals: promoting motive-goal congruence through affect-focus goal fantasy.

Science.gov (United States)

Job, Veronika; Brandstätter, Veronika

2009-10-01

Studies show that motive-goal congruence is an important predictor of well-being (Baumann, Kaschel, & Kuhl, 2005; Brunstein, Schultheiss, & Grässmann, 1998). However, little is known about the factors that promote congruence between implicit motives and goals. Relying on McClelland's (1985) concept of implicit motives and the theory of fantasy realization (Oettingen, 1999), we postulated that goal fantasies focusing on motive-specific affective incentives promote motive-congruent goal setting. This hypothesis was tested in 3 experimental studies. In Study 1 (n=46) and Study 2 (n=48), participants were asked to select goals in a hypothetical scenario. In Study 3 (n=179), they rated their commitment to personal goals for their actual life situation. The results of all 3 studies supported our hypothesis that participants who focus on motive-specific affective incentives in their goal fantasies set their goals in line with their corresponding implicit motive dispositions.

Selfish goals serve more fundamental social and biological goals.

Science.gov (United States)

Becker, D Vaughn; Kenrick, Douglas T

2014-04-01

Proximate selfish goals reflect the machinations of more fundamental goals such as self-protection and reproduction. Evolutionary life history theory allows us to make predictions about which goals are prioritized over others, which stimuli release which goals, and how the stages of cognitive processing are selectively influenced to better achieve the aims of those goals.

Motivational beliefs, values, and goals.

Science.gov (United States)

Eccles, Jacquelynne S; Wigfield, Allan

2002-01-01

This chapter reviews the recent research on motivation, beliefs, values, and goals, focusing on developmental and educational psychology. The authors divide the chapter into four major sections: theories focused on expectancies for success (self-efficacy theory and control theory), theories focused on task value (theories focused on intrinsic motivation, self-determination, flow, interest, and goals), theories that integrate expectancies and values (attribution theory, the expectancy-value models of Eccles et al., Feather, and Heckhausen, and self-worth theory), and theories integrating motivation and cognition (social cognitive theories of self-regulation and motivation, the work by Winne & Marx, Borkowski et al., Pintrich et al., and theories of motivation and volition). The authors end the chapter with a discussion of how to integrate theories of self-regulation and expectancy-value models of motivation and suggest new directions for future research.

Development and construct validation of the Client-Centredness of Goal Setting (C-COGS) scale.

Science.gov (United States)

Doig, Emmah; Prescott, Sarah; Fleming, Jennifer; Cornwell, Petrea; Kuipers, Pim

2015-07-01

Client-centred philosophy is integral to occupational therapy practice and client-centred goal planning is considered fundamental to rehabilitation. Evaluation of whether goal-planning practices are client-centred requires an understanding of the client's perspective about goal-planning processes and practices. The Client-Centredness of Goal Setting (C-COGS) was developed for use by practitioners who seek to be more client-centred and who require a scale to guide and evaluate individually orientated practice, especially with adults with cognitive impairment related to acquired brain injury. To describe development of the C-COGS scale and examine its construct validity. The C-COGS was administered to 42 participants with acquired brain injury after multidisciplinary goal planning. C-COGS scores were correlated with the Canadian Occupational Performance Measure (COPM) importance scores, and measures of therapeutic alliance, motivation, and global functioning to establish construct validity. The C-COGS scale has three subscales evaluating goal alignment, goal planning participation, and client-centredness of goals. The C-COGS subscale items demonstrated moderately significant correlations with scales measuring similar constructs. Findings provide preliminary evidence to support the construct validity of the C-COGS scale, which is intended to be used to evaluate and reflect on client-centred goal planning in clinical practice, and to highlight factors contributing to best practice rehabilitation.

Induction, maintenance, and reversal of therapeutic hypothermia with an esophageal heat transfer device.

Science.gov (United States)

Kulstad, Erik; Metzger, Anja K; Courtney, D Mark; Rees, Jennifer; Shanley, Patrick; Matsuura, Timothy; McKnite, Scott; Lurie, Keith

2013-11-01

To evaluate a novel esophageal heat transfer device for use in inducing, maintaining, and reversing hypothermia. We hypothesized that this device could successfully induce, maintain (within a 1 °C range of goal temperature), and reverse, mild therapeutic hypothermia in a large animal model over a 30-h treatment protocol. Five female Yorkshire swine, weighing a mean of 65 kg (range 61-70) kg each, were anesthetized with inhalational isoflurane via endotracheal intubation and instrumented. The esophageal device was connected to an external chiller and then placed into the esophagus and connected to wall suction. Reduction to goal temperature was achieved by setting the chiller to cooling mode, and a 24h cooling protocol was completed before rewarming and recovering the animals. Histopathologic analysis was scheduled for 3-14 days after protocol completion. Average baseline temperature for the 5 animals was 38.6 °C (range 38.1-39.2 °C). All swine were cooled successfully, with average rate of temperature decrease of 1.3 °C/h (range 1.1-1.9) °C/h. Standard deviation from goal temperature averaged 0.2 °C throughout the steady-state maintenance phase, and no treatment for shivering was necessary during the protocol. Histopathology of esophageal tissue showed no adverse effects from the device. A new esophageal heat transfer device successfully and safely induced, maintained, and reversed therapeutic hypothermia in large swine. Goal temperature was maintained within a narrow range, and thermogenic shivering did not occur. These findings suggest a useful new modality to induce therapeutic hypothermia. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Development and application of nuclear safety goals in Japan. Lessons learnt from the case of 2003 draft safety goals

International Nuclear Information System (INIS)

Sugawara, Shin-etsu; Inamura, Tomoaki

2016-01-01

The Nuclear Safety Commission in Japan offered a detailed draft of nuclear safety goals to the public in 2003, though its position was ambiguous in nuclear safety regulation. This report shows the circumstances behind the development and application of 2003 draft safety goals based on our interviews with the experts who had been involved in making the draft. According to our interviews, they had intention to utilize safety goals for improving risk management of regulatory authority and nuclear energy industry, such as ameliorating deterministic regulations, accumulating experience of risk assessment and management, promoting related research, and communicating risks with general public. In practice, however, safety goals had functioned as a tool for emphasizing an assertion that 'nuclear power plants had already been safe enough'. We identified the following four major impediments to utilizing safety goals; 1) lack of sharing overall recognition of the importance of establishing safety goals among nuclear community, 2) excessive emphasis of internal event risks which leads to an inferior priority to tackle with the issue of external events risks, 3) adverse effect of 'tunnel-visioned incrementalism', that is, nuclear energy industrial entities are attracted their foci too much on what they have been told to do by regulators or local governments, and, 4) negative attitude to disclose the outcomes of risk assessment for fear of societal reactions. To encourage upcoming safety goals and risk management, this report provides the following points for overcoming these problems; 1) sharing insights on the reasons why nuclear community set up safety goals, 2) introducing the concept of adaptive risk management for maintaining questioning attitude, 3) conducting a periodic review of goal attainment level and also safety goals themselves from the eyes of a detached observer, and, 4) rebuilding relationship with society beginning with arguments with local stakeholders over

Personal goals and factors related to QoL in Dutch homeless people: what is the role of goal-related self-efficacy?

Science.gov (United States)

van der Laan, Jorien; Boersma, Sandra N; van Straaten, Barbara; Rodenburg, Gerda; van de Mheen, Dike; Wolf, Judith R L M

2017-05-01

Very little is known about the personal goals of homeless people and how these relate to their quality of life (QoL). By using survey data on 407 homeless adults upon entry to the social relief system in 2011, we examined the personal goals of homeless adults and the association between their perceived goal-related self-efficacy and their QoL. A hierarchical regression analysis was used to analyse the association between QoL and goal-related self-efficacy, relative to factors contributing to QoL, such as demographic characteristics, socioeconomic resources, health and service use. Results indicate that the majority of homeless adults had at least one personal goal for the coming 6 months and that most goals concerned housing and daily life (94.3%) and finances (83.6%). The QoL of homeless adults appeared to be lower in comparison with general population samples. General goal-related self-efficacy was positively related to QoL (β = 0.09, P = 0.042), independent of socioeconomic resources (i.e. income and housing), health and service use. The strongest predictors of QoL were psychological distress (β = -0.45, P people as the starting point of integrated service programmes and to promote their goal-related self-efficacy by strength-based interventions. © 2017 John Wiley & Sons Ltd.

The interaction between dietary and life goals: using goal systems theory to explore healthy diet and life goals.

Science.gov (United States)

Turner-McGrievy, Gabrielle M; Wright, Julie A; Migneault, Jeffrey P; Quintiliani, Lisa; Friedman, Robert H

2014-01-01

Objective : To examine the types of life and dietary goals individuals report and how these goal domains interact as framed by goal systems theory. Methods : This work is a cross-sectional survey study. Measures included the incidence of common life and dietary goals and how these goals interact with and facilitate each other. Results : The results of a quantitative survey ( n  = 46 participants), which was informed by two focus groups ( n  = 17 participants), showed that participants are trying to achieve several different life (e.g. achieving financial success) and dietary goals (e.g. eating more fruits and vegetables, drinking more water, and losing weight) and that these two types of goals interact to both facilitate and conflict with each other. Having a life goal of exercising was significantly associated with healthy eating goals when compared with other life goals ( p 's goals may be linked and help to facilitate one another. Being in the maintenance phase with the goal of healthy eating was associated with participants feeling like they were more successful in their other non-diet-related health goals ( p  goals can facilitate success in achieving other goals. Conclusions : Life goals can have an impact on a person's ability to achieve and maintain dietary and other health goals. Health educators may help to facilitate long-term behavior change by examining a person's life goals as well as dietary goals.

Unity in Major Themes

DEFF Research Database (Denmark)

Booss-Bavnbek, Bernhelm; Davis, Philip J.

We describe and explain the desire, common among mathematicians, both for unity and independence in its major themes. In the dialogue that follows, we express our spontaneous and considered judgment and reservations; by contrasting the development of mathematics as a goal-driven process as opposed...

[Beat therapeutic inertia in dyslipidemic patient management: A challenge in daily clinical practice] [corrected].

Science.gov (United States)

Morales, Clotilde; Mauri, Marta; Vila, Lluís

2014-01-01

Beat therapeutic inertia in dyslipidemic patient management: a challenge in daily clinical practice. In patients with dyslipidemia, there is the need to reach the therapeutic goals in order to get the maximum benefit in the cardiovascular events risk reduction, especially myocardial infarction. Even having guidelines and some powerful hypolipidemic drugs, the goals of low-density lipoprotein-cholesterol (LDL-c) are often not reached, being of special in patients with a high cardiovascular risk. One of the causes is the therapeutic inertia. There are tools to plan the treatment and make the decisions easier. One of the challenges in everyday clinical practice is to know the needed percentage of reduction in LDL-c. Moreover: it is hard to know which one is the treatment we should use in the beginning of the treatment but also when the desired objective is not reached. This article proposes a practical method that can help solving these questions. Copyright © 2013 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

Goal difficulty and openness to interpersonal goal support.

NARCIS (Netherlands)

Righetti, F.; Kumashiro, M.; Campbell, S.

2014-01-01

When people pursue important goals, they are often surrounded by close others who could provide help and support for the achievement of these goals. The present work investigated whether people are more likely to be open to such interpersonal goal support from a romantic partner when they perceive

Predicting Subsequent Task Performance From Goal Motivation and Goal Failure

Directory of Open Access Journals (Sweden)

Laura Catherine Healy

2015-07-01

Full Text Available Recent research has demonstrated that the cognitive processes associated with goal pursuit can continue to interfere with unrelated tasks when a goal is unfulfilled. Drawing from the self-regulation and goal-striving literatures, the present study explored the impact of goal failure on subsequent cognitive and physical task performance. Furthermore, we examined if the autonomous or controlled motivation underpinning goal striving moderates the responses to goal failure. Athletes (75 male, 59 female, Mage = 19.90 years, SDage = 3.50 completed a cycling trial with the goal of covering a given distance in 8 minutes. Prior to the trial, their motivation was primed using a video. During the trial they were provided with manipulated performance feedback, thus creating conditions of goal success or failure. No differences emerged in the responses to goal failure between the primed motivation or performance feedback conditions. We make recommendations for future research into how individuals can deal with failure in goal striving.

Pro-Social Goals in Achievement Situations: Amity Goal Orientation Enhances the Positive Effects of Mastery Goal Orientation.

Science.gov (United States)

Levontin, Liat; Bardi, Anat

2018-04-01

Research has neglected the utility of pro-social goals within achievement situations. In this article, four studies demonstrate that amity goal orientation, promoting mutual success of oneself together with others, enhances the utility of mastery goal orientation. We demonstrate this in longitudinally predicting performance (Studies 1 and 2) and in maintaining motivation after a disappointing performance (Studies 3 and 4). The studies demonstrate the same interaction effect in academic and in work achievement contexts. Specifically, whereas amity goal orientation did not predict achievement on its own, it enhanced the positive effect of mastery goal orientation. Together, these studies establish the importance of amity goal orientation while also advancing our understanding of the effects of other achievement goal orientations. We suggest future directions in examining the utility of amity goals in other contexts.

Dual-color bioluminescent sensor proteins for therapeutic drug monitoring of antitumor antibodies

NARCIS (Netherlands)

van Rosmalen, M.; Ni, Y.; Vervoort, D.F.M.; Arts, R.; Ludwig, S.K.J.; Merkx, M.

2018-01-01

Monitoring the levels of therapeutic antibodies in individual patients would allow patient-specific dose optimization, with the potential for major therapeutic and financial benefits. Our group recently developed a new platform of bioluminescent sensor proteins (LUMABS; LUMinescent AntiBody Sensor)

Goal conflicts, attainment of new goals, and well-being among managers.

Science.gov (United States)

Kehr, Hugo M

2003-07-01

Researchers widely understand that conflicts among goals inhibit the attainment of these goals. However, this notion comes close to tautological reasoning. To avert this problem, this study examined whether preexisting goal conflict also inhibits success in newly set goals. Using the context of management training, in which managers collectively set new goals, the study variables were assessed at 3 testing periods covering 5 months. Results indicate that goal conflicts that persevere over time were associated with inhibited attainment of new goals but not with decreased subjective well-being (SWB). Goal attainment, however, was positively related to SWB. Interactions of residual changes in goal conflict and goal attainment were associated with positive affect.

A virtual therapeutic environment with user projective agents.

Science.gov (United States)

Ookita, S Y; Tokuda, H

2001-02-01

Today, we see the Internet as more than just an information infrastructure, but a socializing place and a safe outlet of inner feelings. Many personalities develop aside from real world life due to its anonymous environment. Virtual world interactions are bringing about new psychological illnesses ranging from netaddiction to technostress, as well as online personality disorders and conflicts in multiple identities that exist in the virtual world. Presently, there are no standard therapy models for the virtual environment. There are very few therapeutic environments, or tools especially made for virtual therapeutic environments. The goal of our research is to provide the therapy model and middleware tools for psychologists to use in virtual therapeutic environments. We propose the Cyber Therapy Model, and Projective Agents, a tool used in the therapeutic environment. To evaluate the effectiveness of the tool, we created a prototype system, called the Virtual Group Counseling System, which is a therapeutic environment that allows the user to participate in group counseling through the eyes of their Projective Agent. Projective Agents inherit the user's personality traits. During the virtual group counseling, the user's Projective Agent interacts and collaborates to recover and increase their psychological growth. The prototype system provides a simulation environment where psychologists can adjust the parameters and customize their own simulation environment. The model and tool is a first attempt toward simulating online personalities that may exist only online, and provide data for observation.

Trans-species Engineering of Glycosylated Therapeutic Proteins

DEFF Research Database (Denmark)

Yang, Zhang

important to address. Whenever glycosylation has been found to be an important PTM for function or bioactivity, human therapeutics have generally been produced in mammalian Chinese hamster ovary (CHO) cell line. Oglycosylation is one of the most complex regulated PTMs of proteins but also one of the least...... understood. Currently, mammalian cells are required for human O-glycosylation. Increasing efforts have been devoted to engineering non-mammalian cells for production of recombinant proteins with “human-like” glycosylation. Substantial success has been achieved with designed N-glycosylation in both lower......Recombinant expression of therapeutic proteins is one of the major tasks in modern biomedicine. One of the most important factors with respect to therapeutic use in human is posttranslational modifications (PTMs) of the recombinant proteins, of which protein glycosylation is by far the most...

Junctures to the therapeutic goal of diabetes mellitus: Experience in a tertiary care hospital of Kolkata

Directory of Open Access Journals (Sweden)

S K Lahiri

2011-01-01

Conclusion : Patient-providers collaboration is to be developed through a patient-centered care model based on the mutual responsibility of both so that each patient is considered in the mesh of his/her other goals of life and helped to promote empowerment to take informed decision for behavioral change conducive to control the disease.

Protection goals in environmental risk assessment: a practical approach.

Science.gov (United States)

Garcia-Alonso, Monica; Raybould, Alan

2014-12-01

Policy protection goals are set up in most countries to minimise harm to the environment, humans and animals caused by human activities. Decisions on whether to approve new agricultural products, like pesticides or genetically modified (GM) crops, take into account these policy protection goals. To support decision-making, applications for approval of commercial uses of GM crops usually comprise an environmental risk assessment (ERA). These risk assessments are analytical tools, based on science, that follow a conceptual model that includes a problem formulation step where policy protection goals are considered. However, in most countries, risk assessors face major problems in that policy protection goals set in the legislation are stated in very broad terms and are too ambiguous to be directly applicable in ERAs. This means that risk assessors often have to interpret policy protection goals without clear guidance on what effects would be considered harmful. In this paper we propose a practical approach that may help risk assessors to translate policy protection goals into unambiguous (i.e., operational) protection goals and to establish relevant assessment endpoints and risk hypotheses that can be used in ERAs. Examples are provided to show how this approach can be applied to two areas of environmental concern relevant to the ERAs of GM crops.

Control to goal of cardiometabolic risk factors among Nigerians living with type 2 diabetes mellitus.

Science.gov (United States)

Okafor, C I; Ofoegbu, E N

2012-01-01

Cardiovascular risk factors contribute to morbidity and mortality among diabetic patients. National and international guidelines on management of diabetes therefore emphasize control to goals of blood glucose, blood pressure, dyslipidemia, and obesity so as to minimize the development of complications and enhance the patients' quality of life. To evaluate the status of control to goals of cardiometabolic risk factors among the diabetic patients attending the Diabetes clinic of University of Nigeria Teaching Hospital, Enugu. A survey of 233 type 2 diabetic patients recruited from the Diabetes clinic of our hospital was carried out. Standard procedures as described in the WHO STEP instrument were used to determine the waist circumference, weight, height, and systolic and diastolic blood pressure. Fasting blood glucose and lipid profiles were also assessed. Therapeutic goals used to define risk or poor control were values adopted by expert groups such as American diabetes association (ADA), National cholesterol education program (NCEP), American association of clinical endocrinologist (AACE) and International diabetes federation (IDF). There were 98 males and 135 females with mean (SD) duration of diabetes mellitus (DM) of 6.7 (6.3) years. Suboptimal glycemic, blood pressure control and dyslipidemia were observed in 65.7%, 51.9%, 97.1% of the subjects respectively while 60.1% of the subjects were found to be overweight/obese. Comparing the mean indices of risk factors with the recommended therapeutic goals, status of control was optimal for HDL-cholesterol, waist circumference and triglycerides. All the other risk factors were suboptimal. Control to goals of cardiovascular risk factors is poor among the patients. There is the need to identify and tackle the possible contributing factors so as to reduce the morbidity and mortality in these patients.

[Organization of occupational therapeutic service, dynamics and structure of occupational morbidity in Krasnoyarsk area].

Science.gov (United States)

Tereshchenko, Iu A; Zakharinskaia, O N

2010-01-01

The authors present organizational and functional structure of occupational therapeutic service in Krasnoyarsk area, major functional divisions of the territorial occupational therapeutic center and their activities. The article covers analysis of changes in levels and structure of occupational morbidity, defines main ways to optimize occupational therapeutic service for the territorial workers.

Teachers' goal orientations: Effects on classroom goal structures and emotions.

Science.gov (United States)

Wang, Hui; Hall, Nathan C; Goetz, Thomas; Frenzel, Anne C

2017-03-01

Prior research has shown teachers' goal orientations to influence classroom goal structures (Retelsdorf et al., 2010, Learning and Instruction, 20, 30) and to also impact their emotions (Schutz et al., 2007, Emotion in education, Academic Press, Amsterdam, the Netherlands). However, empirical research evaluating possible causal ordering and mediation effects involving these variables in teachers is presently lacking. The present 6-month longitudinal study investigated the relations between varied motivational, behavioural, and emotional variables in practising teachers. More specifically, this study examined the reciprocal, longitudinal relations between teachers' achievement goals, classroom goal structures, and teaching-related emotions, as well as cumulative mediational models in which observed causal relations were evaluated. Participants were 495 practising teachers from Canada (86% female, M = 42 years). Teachers completed a web-based questionnaire at two time points assessing their instructional goals, perceived classroom goal structures, achievement emotions, and demographic items. Results from cross-lagged analyses and structural equation modelling showed teachers' achievement goals to predict their perceived classroom goal structures that, in turn, predicted their teaching-related emotions. The present results inform both Butler's (2012, Journal of Educational Psychology, 104, 726) theory on teachers' achievement goals and Frenzel's (2014, International handbook of emotions in education, Routledge, New York, NY) model of teachers' emotions in showing teachers' instructional goals to both directly predict their teaching-related emotions, as well as indirectly through the mediating effects of classroom goal structures. © 2016 The British Psychological Society.

Heterogeneity among hospitals statewide in percentage shares of the annual growth of surgical caseloads of inpatient and outpatient major therapeutic procedures.

Science.gov (United States)

Dexter, Franklin; Jarvie, Craig; Epstein, Richard H

2018-04-18

Suppose that it were a generalizable finding, in both densely populated and rural states, that there is marked heterogeneity among hospitals in the percentage change in surgical caseload and/or in the total change in caseload. Then, individual hospitals should not simply rely on federal and state forecasts to infer their expected growth. Likewise, individual hospitals and their anesthesiology groups would best not rely on national or US regional surgical trends as causal reasons for local trends in caseload. We examined the potential utility of using state data on surgical caseload to predict local growth by using 6 years of data for surgical cases performed at hospitals in the States of Florida and Iowa. Observational cohort study. 303 hospitals in Iowa and Florida. Cases with major therapeutic procedures in 2010 or 2011 were compared pairwise by hospital with such cases in 2015 and 2016. Changes in counts of cases were decreases or increases, while study of growth set decreases equal to zero. Hospitals in Iowa had slightly lesser percentage changes than did hospitals in Florida (Mann-Whitney P = 0.016). Hospitals in Iowa had greater variability among hospitals in the change in counts of cases with a major therapeutic procedure than did hospitals in Florida (P < 0.0001). The 10% of hospitals with the largest growths in counts of cases accounted for approximately half of the total growth in Iowa (70%) and Florida (54%). The large share of total growth attributable to the upper 10th percentile of hospitals was not caused solely by the hospitals having large percentage growths, based on there being weak correlation between growth and percentage growth, among the hospitals that grew (Iowa: Kendall's tau = 0.286 [SE 0.120]; Florida tau = 0.253 [SE 0.064]). Even if the data from states or federal agencies reported growth in surgical cases, there is too much concentration of growth at a few hospitals for statewide growth rates to be useful for

Achievement goals, social goals, and motivational regulations in physical education settings.

Science.gov (United States)

Cecchini Estrada, José A; González González-Mesa, Carmen; Méndez-Giménez, Antonio; Fernández-Río, Javier

2011-02-01

This study examined the relationship between achievement and social goals, and explored how both goals affect students' level of informed self-determination in Physical Education. Participants were 395 high school students. Three scales were used to assess achievement, social goals, and motivation. Several hierarchical regression analyses revealed that mastery-approach goals were the greatest contributors to the individuals' levels of self-determination. Achievement and social goals were found to be separate predictors of students' levels of self-determination, and this highlights the importance of separating mastery and performance goals into avoidance and approach profiles. Girls reported significantly higher values than boys on responsibility, relationship, and mastery-avoidance goals, whereas boys scored higher on performance-approach goals. Researchers could use achievement and social goals to study students' motivation and achievement in Physical Education settings.

IEP goals for school-age children with speech sound disorders.

Science.gov (United States)

Farquharson, Kelly; Tambyraja, Sherine R; Justice, Laura M; Redle, Erin E

2014-01-01

The purpose of the current study was to describe the current state of practice for writing Individualized Education Program (IEP) goals for children with speech sound disorders (SSDs). IEP goals for 146 children receiving services for SSDs within public school systems across two states were coded for their dominant theoretical framework and overall quality. A dichotomous scheme was used for theoretical framework coding: cognitive-linguistic or sensory-motor. Goal quality was determined by examining 7 specific indicators outlined by an empirically tested rating tool. In total, 147 long-term and 490 short-term goals were coded. The results revealed no dominant theoretical framework for long-term goals, whereas short-term goals largely reflected a sensory-motor framework. In terms of quality, the majority of speech production goals were functional and generalizable in nature, but were not able to be easily targeted during common daily tasks or by other members of the IEP team. Short-term goals were consistently rated higher in quality domains when compared to long-term goals. The current state of practice for writing IEP goals for children with SSDs indicates that theoretical framework may be eclectic in nature and likely written to support the individual needs of children with speech sound disorders. Further investigation is warranted to determine the relations between goal quality and child outcomes. (1) Identify two predominant theoretical frameworks and discuss how they apply to IEP goal writing. (2) Discuss quality indicators as they relate to IEP goals for children with speech sound disorders. (3) Discuss the relationship between long-term goals level of quality and related theoretical frameworks. (4) Identify the areas in which business-as-usual IEP goals exhibit strong quality.

Goal Development Practices of Physical Therapists Working in Educational Environments.

Science.gov (United States)

Wynarczuk, Kimberly D; Chiarello, Lisa A; Gohrband, Catherine L

2017-11-01

The aims of this study were to (1) describe the practices that school-based physical therapists use in developing student goals, and (2) identify facilitators and barriers to development of goals that are specific to participation in the context of the school setting. 46 school-based physical therapists who participated in a previous study on school-based physical therapy practice (PT COUNTS) completed a questionnaire on goal development. Frequencies and cross tabulations were generated for quantitative data. Open-ended questions were analyzed using an iterative qualitative analysis process. A majority of therapists reported that they frequently develop goals collaboratively with other educational team members. Input from teachers, related services personnel, and parents has the most influence on goal development. Qualitative analysis identified five themes that influence development of participation-based goals: (1) school-based philosophy and practice; (2) the educational environment, settings, and routines; (3) student strengths, needs, and personal characteristics; (4) support from and collaboration with members of the educational team; and (5) therapist practice and motivation. Goal development is a complex process that involves multiple members of the educational team and is influenced by many different aspects of practice, the school environment, and student characteristics.

Relations between Classroom Goal Structures and Students' Goal Orientations in Mathematics Classes: When Is a Mastery Goal Structure Adaptive?

Science.gov (United States)

Skaalvik, Einar M.; Federici, Roger A.

2016-01-01

The purpose of this study was to test possible interactions between mastery and performance goal structures in mathematics classrooms when predicting students' goal orientations. More specifically, we tested if the degree of performance goal structure moderated the associations between mastery goal structure and students' goal orientations.…

X-ray analysis of aerosol samples from a therapeutic cave

Energy Technology Data Exchange (ETDEWEB)

Alfoeldy, B. E-mail: alfi@sunserv.kfki.hu; Toeroek, Sz.; Kocsonya, A.; Szokefalvi-Nagy, Z.; Balla, Md.I

2001-04-01

Cave therapy is an efficient therapeutic method to cure asthma, the exact healing effect, however, is not clarified, yet. This study is motivated by the basic assumption that aerosols do play the key role in the cave therapy. This study is based on measurements of single aerosol particles originating from a therapeutic cave of Budapest, Hungary (Szemlohegyi cave). Aerosol particles have been collected in the regions arranged for the therapeutic treatment. Samples were further analysed for chemical and morphological aspects, determining the particle size distribution and classifying them according to elemental composition. Three particle classes have been detected based on major element concentration: alumino-silicate, quartz and calcium carbonate. Calcium ions have well-known physiological influence: anti-spastic, anti-inflammation and excretion reducing effects. Inflammation, accompanying spasm and extreme excretion production cause the smothering stigma, the so-called asthma. Therefore it could be assumed that calcium ions present in high concentration in the cave's atmosphere is the major cause of the healing effect.

X-ray analysis of aerosol samples from a therapeutic cave

International Nuclear Information System (INIS)

Alfoeldy, B.; Toeroek, Sz.; Kocsonya, A.; Szokefalvi-Nagy, Z.; Balla, Md.I.

2001-01-01

Cave therapy is an efficient therapeutic method to cure asthma, the exact healing effect, however, is not clarified, yet. This study is motivated by the basic assumption that aerosols do play the key role in the cave therapy. This study is based on measurements of single aerosol particles originating from a therapeutic cave of Budapest, Hungary (Szemlohegyi cave). Aerosol particles have been collected in the regions arranged for the therapeutic treatment. Samples were further analysed for chemical and morphological aspects, determining the particle size distribution and classifying them according to elemental composition. Three particle classes have been detected based on major element concentration: alumino-silicate, quartz and calcium carbonate. Calcium ions have well-known physiological influence: anti-spastic, anti-inflammation and excretion reducing effects. Inflammation, accompanying spasm and extreme excretion production cause the smothering stigma, the so-called asthma. Therefore it could be assumed that calcium ions present in high concentration in the cave's atmosphere is the major cause of the healing effect

Perspectives for Preventive and Therapeutic HPV Vaccines

Science.gov (United States)

Lin, Ken; Doolan, Kimberley; Hung, Chien-Fu; Wu, T-C

2010-01-01

Cervical cancer is the second most common cause of female cancer death worldwide. Persistent infection with `high risk' HPV genotypes is the major etiological factor in cervical cancer and thus effective vaccination against HPV provides an opportunity to reduce the morbidity and mortality associated with HPV. The FDA has approved two preventive vaccines to limit the spread of HPV. However, these are unlikely to impact upon HPV prevalence and cervical cancer rates for many years. Furthermore, preventive vaccines do not exert therapeutic effects on pre-existing HPV infections and HPV-associated lesions. In order to further impact upon the burden of HPV infections worldwide, therapeutic vaccines are being developed. These vaccines aim to generate a cell-mediated immune response to infected cells. This review discusses current preventive and therapeutic HPV vaccines and their future directions. PMID:20123582

Novel therapeutic approaches in chondrosarcoma.

Science.gov (United States)

Polychronidou, Genovefa; Karavasilis, Vasilios; Pollack, Seth M; Huang, Paul H; Lee, Alex; Jones, Robin L

2017-03-01

Chondrosarcoma is a malignant tumor of bones, characterized by the production of cartilage matrix. Due to lack of effective treatment for advanced disease, the clinical management of chondrosarcomas is exceptionally challenging. Current research focuses on elucidating the molecular events underlying the pathogenesis of this rare bone malignancy, with the goal of developing new molecularly targeted therapies. Signaling pathways suggested to have a role in chondrosarcoma include Hedgehog, Src, PI3k-Akt-mTOR and angiogenesis. Mutations in IDH1/2, present in more than 50% of primary conventional chondrosarcomas, make the development of IDH inhibitors a promising treatment option. The present review discusses the preclinical and early clinical data on novel targeted therapeutic approaches in chondrosarcoma.

Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE)

DEFF Research Database (Denmark)

Peyrin-Biroulet, L; Sandborn, W; Sands, B E

2015-01-01

OBJECTIVES: The Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) program was initiated by the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD). It examined potential treatment targets for inflammatory bowel disease (IBD) to be used for a "treat-t...... target. CONCLUSIONS: Evidence- and consensus-based recommendations for selecting the goals for treat-to-target strategies in patients with IBD are made available. Prospective studies are needed to determine how these targets will change disease course and patients' quality of life....

[Perceptions of classroom goal structures, personal achievement goal orientations, and learning strategies].

Science.gov (United States)

Miki, Kaori; Yamauchi, Hirotsugu

2005-08-01

We examined the relations among students' perceptions of classroom goal structures (mastery and performance goal structures), students' achievement goal orientations (mastery, performance, and work-avoidance goals), and learning strategies (deep processing, surface processing and self-handicapping strategies). Participants were 323 5th and 6th grade students in elementary schools. The results from structural equation modeling indicated that perceptions of classroom mastery goal structures were associated with students' mastery goal orientations, which were in turn related positively to the deep processing strategies and academic achievement. Perceptions of classroom performance goal stractures proved associated with work avoidance-goal orientations, which were positively related to the surface processing and self-handicapping strategies. Two types of goal structures had a positive relation with students' performance goal orientations, which had significant positive effects on academic achievement. The results of this study suggest that elementary school students' perceptions of mastery goal structures are related to adaptive patterns of learning more than perceptions of performance goal structures are. The role of perceptions of classroom goal structure in promoting students' goal orientations and learning strategies is discussed.

Microenvironment acidity as a major determinant of tumor chemoresistance: Proton pump inhibitors (PPIs) as a novel therapeutic approach.

Science.gov (United States)

Taylor, Sophie; Spugnini, Enrico Pierluigi; Assaraf, Yehuda G; Azzarito, Tommaso; Rauch, Cyril; Fais, Stefano

2015-11-01

Despite the major progresses in biomedical research and the development of novel therapeutics and treatment strategies, cancer is still among the dominant causes of death worldwide. One of the crucial challenges in the clinical management of cancer is primary (intrinsic) and secondary (acquired) resistance to both conventional and targeted chemotherapeutics. Multiple mechanisms have been identifiedthat underlie intrinsic and acquired chemoresistance: these include impaired drug uptake, increased drug efflux, deletion of receptors, altered drug metabolism, quantitative and qualitative alterations in drug targets, increased DNA damage repair and various mechanisms of anti-apoptosis. The fast efflux of anticancer drugs mediated by multidrug efflux pumps and the partial or complete reversibility of chemoresistance combined with the absence of genetic mutations suggests a multifactorial process. However, a growing body of recent evidence suggests that chemoresistance is often triggered by the highly acidic microenvironment of tumors. The vast majority of drugs, including conventional chemotherapeutics and more recent biological agents, are weak bases that are quickly protonated and neutralized in acidic environments, such as the extracellular microenvironment and the acidic organelles of tumor cells. It is therefore essential to develop new strategies to overcome the entrapment and neutralization of weak base drugs. One such strategy is the use of proton pump inhibitors which can enhance tumor chemosensitivity by increasing the pH of the tumor microenvironment. Recent clinical trials in animals with spontaneous tumors have indicated that patient alkalization is capable of reversing acquired chemoresistance in a large percentage of tumors that are refractory to chemotherapy. Of particular interest was the benefit of alkalization for patients undergoing metronomic regimens which are becoming more widely used in veterinary medicine. Overall, these results provide

"Clicking" Gene Therapeutics: A Successful Union of Chemistry and Biomedicine for New Solutions

DEFF Research Database (Denmark)

Astakhova, Kira; Ray, Roslyn; Taskova, Maria

2018-01-01

The use of nucleic acid, DNA and RNA, based strategies to disrupt gene expression as a therapeutic is quickly emerging. Indeed, synthetic oligonucleotides represent a major component of modern gene therapeutics. However, the efficiency and specificity of intracellular uptake for nonmodified oligo...

Therapeutic Vaccination for HPV Induced Cervical Cancers

Directory of Open Access Journals (Sweden)

Joeli A. Brinkman

2007-01-01

Full Text Available Cervical Cancer is the second leading cause of cancer–related deaths in women worldwide and is associated with Human Papillomavirus (HPV infection, creating a unique opportunity to treat cervical cancer through anti-viral vaccination. Although a prophylactic vaccine may be available within a year, millions of women, already infected, will continue to suffer from HPV-related disease, emphasizing the need to develop therapeutic vaccination strategies. A majority of clinical trials examining therapeutic vaccination have shown limited efficacy due to examining patients with more advanced-stage cancer who tend to have decreased immune function. Current trends in clinical trials with therapeutic agents examine patients with pre-invasive lesions in order to prevent invasive cervical cancer. However, longer follow-up is necessary to correlate immune responses to lesion regression. Meanwhile, preclinical studies in this field include further exploration of peptide or protein vaccination, and the delivery of HPV antigens in DNA-based vaccines or in viral vectors. As long as pre-clinical studies continue to advance, the prospect of therapeutic vaccination to treat existing lesions seem good in the near future. Positive consequences of therapeutic vaccination would include less disfiguring treatment options and fewer instances of recurrent or progressive lesions leading to a reduction in cervical cancer incidence.

Embedding Career Issues in Advanced Psychology Major Courses

Science.gov (United States)

Halonen, Jane S.; Dunn, Dana S.

2018-01-01

Despite the popularity of the psychology major, complaints regularly arise about the value of majoring in psychology. This article reviews the workforce advantages that accrue to successful psychology students and encourages new strategies for emphasizing the professional development goal in the American Psychological Association's…

Development of Potential Small Molecule Therapeutics for Treatment of Ebola Virus.

Science.gov (United States)

Schafer, Adam Michael; Cheng, Han; Lee, Charles; Du, Ruikun; Han, Julianna; Perez, Jasmine; Peet, Norton; Manicassamy, Balaji; Rong, Lijun

2017-10-10

Ebola virus has caused 26 outbreaks in 10 different countries since its identification in 1976, making it one of the deadliest emerging viral pathogens. The most recent outbreak in West Africa from 2014-16 was the deadliest yet and culminated in 11,310 deaths out of 28,616 confirmed cases. Currently there are no FDA-approved therapeutics or vaccines to treat Ebola virus infections. The slow development of effective vaccines combined with the severity of past outbreaks emphasizes the need to accelerate research into understanding the virus lifecycle and the development of therapeutics for post exposure treatment. Here we present a summary of the major findings on the Ebola virus replication cycle and the therapeutic approaches explored to treat this devastating disease. The major focus of this review is on small molecule inhibitors. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Pharmacological Blockade of Adenosine A2A but Not A1 Receptors Enhances Goal-Directed Valuation in Satiety-Based Instrumental Behavior

Directory of Open Access Journals (Sweden)

Yan Li

2018-04-01

Full Text Available The balance and smooth shift between flexible, goal-directed behaviors and repetitive, habitual actions are critical to optimal performance of behavioral tasks. The striatum plays an essential role in control of goal-directed versus habitual behaviors through a rich interplay of the numerous neurotransmitters and neuromodulators to modify the input, processing and output functions of the striatum. The adenosine receptors (namely A2AR and A1R, with their high expression pattern in the striatum and abilities to interact and integrate dopamine, glutamate and cannabinoid signals in the striatum, may represent novel therapeutic targets for modulating instrumental behavior. In this study, we examined the effects of pharmacological blockade of the A2ARs and A1Rs on goal-directed versus habitual behaviors in different information processing phases of instrumental learning using a satiety-based instrumental behavior procedure. We found that A2AR antagonist acts at the coding, consolidation and expression phases of instrumental learning to modulate animals’ sensitivity to goal-directed valuation without modifying action-outcome contingency. However, pharmacological blockade and genetic knockout of A1Rs did not affect acquisition or sensitivity to goal-valuation of instrumental behavior. These findings provide pharmacological evidence for a potential therapeutic strategy to control abnormal instrumental behaviors associated with drug addiction and obsessive-compulsive disorder by targeting the A2AR.

Therapeutic Inertia in the New Landscape of Multiple Sclerosis Care

Directory of Open Access Journals (Sweden)

Gustavo Saposnik

2018-03-01

Full Text Available The landscape of multiple sclerosis (MS treatment is constantly changing. Significant heterogeneity exists in the efficacy and risks associated with these therapies. Therefore, clinicians have the challenge to tailor treatment based on several factors (disease activity level, risk of progression, individual patient preferences and characteristics, personal expertise, etc., to identify the optimal balance between safety and efficacy. However, most clinicians have limited education in decision-making and formal training in risk management. Together, these factors may lead to therapeutic inertia (TI; defined as the absence of treatment initiation or intensification when therapeutic goals are unmet. TI may lead to suboptimal treatments choices, worse clinical outcomes, and more disability. This article provides a succinct overview on factors influencing TI in MS care.

Therapeutic Drug Monitoring in Rheumatic Diseases

Directory of Open Access Journals (Sweden)

NG Hoi-Yan Alexandra

2016-12-01

Full Text Available The ultimate goal of treating rheumatic disease is to achieve rapid suppression of inflammation, while at the same time minimizing the toxicities from rheumatic drugs. Different patients have different individual pharmacokinetics that can affect the drug level. Moreover, different factors, such as renal function, age or even different underlying diseases, can affect the drug level. Therefore, giving the same dosage of drugs to different patients may result in different drug levels. This article will review the usefulness of therapeutic drug monitoring in maximizing drug efficacy, while reducing the risk of toxicities in Hydroxychloroquine, Mycophenolate Mofetil, Tacrolimus and Tumor Necrosis Factor inhibitors (TNF Inhibitors.

Manufacturing of recombinant therapeutic proteins in microbial systems.

Science.gov (United States)

Graumann, Klaus; Premstaller, Andreas

2006-02-01

Recombinant therapeutic proteins have gained enormous importance for clinical applications. The first recombinant products have been produced in E. coli more than 20 years ago. Although with the advent of antibody-based therapeutics mammalian expression systems have experienced a major boost, microbial expression systems continue to be widely used in industry. Their intrinsic advantages, such as rapid growth, high yields and ease of manipulation, make them the premier choice for expression of non-glycosylated peptides and proteins. Innovative product classes such as antibody fragments or alternative binding molecules will further expand the use of microbial systems. Even more, novel, engineered production hosts and integrated technology platforms hold enormous potential for future applications. This review summarizes current applications and trends for development, production and analytical characterization of recombinant therapeutic proteins in microbial systems.

Therapeutic touch: influence on vital signs of newborns

Science.gov (United States)

Ramada, Nadia Christina Oliveira; Almeida, Fabiane de Amorim; Cunha, Mariana Lucas da Rocha

2013-01-01

ABSTRACT Objective>: To compare vital signs before and after the therapeutic touch observed in hospitalized newborns in neonatal intensive care unit. Methods: This was a quasi-experimental study performed at a neonatal intensive care unit of a municipal hospital, in the city of São Paulo (SP), Brazil. The sample included 40 newborns submitted to the therapeutic touch after a painful procedure. We evaluated the vital signs, such as heart and respiratory rates, temperature and pain intensity, before and after the therapeutic touch. Results: The majority of newborns were male (n=28; 70%), pre-term (n=19; 52%) and born from vaginal delivery (n=27; 67%). Respiratory distress was the main reason for hospital admission (n=16; 40%). There was a drop in all vital signs after therapeutic touch, particularly in pain score, which had a considerable reduction in the mean values, from 3.37 (SD=1.31) to 0 (SD=0.0). All differences found were statistically significant by the Wilcoxon test (p<0.05). Conclusion: The results showed that therapeutic touch promotes relaxation of the baby, favoring reduction in vital signs and, consequently in the basal metabolism rate. PMID:24488378

Motor planning flexibly optimizes performance under uncertainty about task goals.

Science.gov (United States)

Wong, Aaron L; Haith, Adrian M

2017-03-03

In an environment full of potential goals, how does the brain determine which movement to execute? Existing theories posit that the motor system prepares for all potential goals by generating several motor plans in parallel. One major line of evidence for such theories is that presenting two competing goals often results in a movement intermediate between them. These intermediate movements are thought to reflect an unintentional averaging of the competing plans. However, normative theories suggest instead that intermediate movements might actually be deliberate, generated because they improve task performance over a random guessing strategy. To test this hypothesis, we vary the benefit of making an intermediate movement by changing movement speed. We find that participants generate intermediate movements only at (slower) speeds where they measurably improve performance. Our findings support the normative view that the motor system selects only a single, flexible motor plan, optimized for uncertain goals.

Self-regulation of unattainable goals in suicide attempters: the relationship between goal disengagement, goal reengagement and suicidal ideation.

LENUS (Irish Health Repository)

O'Connor, Rory C

2009-02-01

There is growing interest in models of adaptive self-regulation. Recent research suggests that goal disengagement and goal reengagement (i.e., goal adjustment) are implicated in the self-regulation of emotion. This study extends the self-regulation research to investigate the utility of goal adjustment in understanding suicidal risk. To this end, two hundred adults hospitalised following a suicidal episode completed a range of clinical and psychological measures in hospital and were followed up approximately 2.5 months after discharge (Time 2). Hierarchical regression analyses showed that goal reengagement predicted suicidal ideation at Time 2. In addition, the lack of goal reengagement was especially pernicious when reported concomitantly with high disengagement. These predictive effects were independent of baseline mood, attempt status and suicidal intent. The theoretical and clinical implications are discussed.

Using enzyme folding to explore the mechanism of therapeutic touch: a feasibility study.

Science.gov (United States)

Strickland, Mallory L; Boylan, Helen M

2010-07-01

The goal of this research is to design a novel model using protein folding to study Therapeutic Touch, a noncontact form of energy manipulation healing. Presented is a feasibility study suggesting that the denaturation path of ribonuclease A may be a useful model to study the energy exchange underlying therapeutic touch. The folding of ribonuclease A serves as a controlled energy-requiring system in which energy manipulation can be measured by the degree of folding achieved. A kinetic assay and fluorescence spectroscopy are used to assess the enzyme-folding state. The data suggest that the kinetic assay is a useful means of assessing the degree of refolding, and specifically, the enzyme function. However, fluorescence spectroscopy was not shown to be an effective measurement of enzyme structure for the purposes of this work. More research is needed to assess the underlying mechanism of therapeutic touch to complement the existing studies. An enzyme-folding model may provide a useful means of studying the energy exchange in therapeutic touch.

Relating Business Goals to Architecturally Significant Requirements for Software Systems

Science.gov (United States)

2010-05-01

must respond within five seconds” [ EPF 2010]. A major source of architecturally significant requirements is the set of business goals that led to the...Projects for Competitive Advantage, Center for Business Practices, 1999. [ EPF 2010] Eclipse Process Framework Project. Concept: Architecturally

Goals and Strategies for the Human Lunar Reference Architecture

Science.gov (United States)

Seaman, Calvin H.

2010-01-01

The presentation examines common goals for human lunar exploration and strategic guidance. Three major sections include illustrative example goals, introduction to the GPoD campaign, and GPoD overview. The first section includes slides about strategic view of partnerships, the moon as a stepping stone and a uniquely preserved record, human-robotic partnership, innovative engagement, strategic considerations, and evaluation of campaigns against common goals. The second section examines campaigns considered, the philosophy of GPoD, GPoD campaign phase definitions, and GPoD design decision points. The third section examines lunar exploration capabilities, extended stay-relocation exploration mode, notional campaign destinations for GPoD, early robotics phase, development of the GPoD early robotics phase, polar exploration/system validation phase, polar relocatability phase, non-polar relocatability phase, long duration phase, and return to evaluation of campaigns.

Dendrimer advances for the central nervous system delivery of therapeutics.

Science.gov (United States)

Xu, Leyuan; Zhang, Hao; Wu, Yue

2014-01-15

The effectiveness of noninvasive treatment for central nervous system (CNS) diseases is generally limited by the poor access of therapeutic agents into the CNS. Most CNS drugs cannot permeate into the brain parenchyma because of the blood-brain barrier (BBB), and overcoming this has become one of the most significant challenges in the development of CNS therapeutics. Rapid advances in nanotechnology have provided promising solutions to this challenge. This review discusses the latest applications of dendrimers in the treatment of CNS diseases with an emphasis on brain tumors. Dendrimer-mediated drug delivery, imaging, and diagnosis are also reviewed. The toxicity, biodistribution, and transport mechanisms in dendrimer-mediated delivery of CNS therapeutic agents bypassing or crossing the BBB are also discussed. Future directions and major challenges of dendrimer-mediated delivery of CNS therapeutic agents are included.

[Type 2 diabetes: what therapeutic strategy?].

Science.gov (United States)

Grimaldi, A; Hartemann-Heurtier, A

2001-02-17

GOAL OF TREATMENT: Prevention of diabetic micro and macroangiopathy is the goal of treatment in type 2 diabetes mellitus. A well-controlled glucose level is the key to prevention of microangiopathy; there is no threshold level. Antihypertensive treatment, with the goal of blood pressure below 130/80 mmHg is also beneficial in preventing aggravation of microangiopathy. For macroangiopathy, prevention is based in priority on treatment of other risk factors for cardiovascular disease; the threshold level for drug treatment and the therapeutic objective are those defined for secondary prevention in non-diabetic patients, i.e. blood pressure below 140/80 mmHg and LDL cholesterol under 1.30 g/l. The beneficial effect of lower glucose levels on preventing macrovascular risk was not formally demonstrated by the UKPDS, probably because the difference between the control and the treatment group HbA1c levels was minimal, 0.9 points. REVISITING STRATEGY: It is thus time to revisit the preventive strategy for type 2 diabetes mellitus, i.e. step-by-step increments, as currently proposed for worsening glucose levels. Metformine should be prescribed if the HbA1c is above normal in order to achieve the demonstrated benefit in prevention of microangiopathy and in the hope, motivated by pathophysiology data, of preventing insulin failure. Slow-release insulin at bedtime should be added to the oral hypoglycemiants if fasting glucose exceeds 1.60 or 1.80 g/l, even if the HbA1c remains below 8%. NEW HYPOGLYCEMIANTS: The role of these new agents in this more "aggressive" strategy remains to be defined. Glinides will have to demonstrate their superiority over sulfamides (fewer episodes of hypoglycemia with comparable efficacy) to justify their high cost. Glitazones will have to demonstrate a beneficial effect in second intention combination with metformine on cardiovascular morbidity mortality in type 2 diabetes patients with a metabolic insulin-resistance syndrome and visceral obesity

Achieving the millenium and sustainable development goals in Africa

African Journals Online (AJOL)

The point that African continent has been trying to solve its development challenges will be an overstatement. One of the major efforts was the decision taken at the United Nations (UN) Millennium Summit in September 2000 where the Millennium Development Goals (MDGs) was adopted as a framework for the continents ...

Gender, Empathy, and the Choice of the Psychology Major

Science.gov (United States)

Harton, Helen C.; Lyons, Patrick C.

2003-01-01

We compared male and female psychology majors to psychology minors and nonmajors to understand the trends in a growing major in which women outnumber men. A total of 451 psychology majors, minors, and nonmajors from 4 institutions completed a questionnaire measuring empathy, career goals, and perceptions of the importance of empathy for therapy.…

Update on therapeutic management of idiopathic pulmonary fibrosis

Science.gov (United States)

Tzouvelekis, Argyris; Bonella, Francesco; Spagnolo, Paolo

2015-01-01

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive diffuse parenchymal lung disease of unknown origin, with a mortality rate exceeding that of many cancers. The diagnostic process is complex and relies on the clinician integrating clinical, laboratory, radiological, and histological data. In the last decade, major advances in our understanding of the pathogenesis of IPF have shifted the paradigm from a primarily inflammatory process evolving to fibrosis to a condition driven by aberrant wound healing following alveolar epithelial cell injury that results in scarring of the lung, architectural distortion, and irreversible loss of function. Improved understanding of disease pathogenesis has led to the identification of several therapeutic targets and the design of high-quality clinical trials evaluating novel compounds. However, the results of these studies have been mostly disappointing, probably due to the plethora of mediators, growth factors, and signaling pathways involved in the fibrotic process. Most recently, pirfenidone and nintedanib, two compounds with pleiotropic anti-fibrotic properties, have been proven effective in reducing functional decline and disease progression in IPF. This is a major breakthrough. Nevertheless, we still have a long way to go. In fact, neither pirfenidone nor nintedanib is a cure for IPF, and most patients continue to progress despite treatment. As such, comprehensive care of patients with IPF, including management of concomitant conditions and physical debility, as well as timely referral for lung transplantation, remains essential. Several agents with a high potential are currently being tested, and many more are ready for clinical trials. Their completion is critical for achieving the ultimate goal of curing patients with IPF. PMID:25767391

Career Goals in Young Adults: Personal Resources, Goal Appraisals, Attitudes, and Goal Management Strategies

Science.gov (United States)

Haratsis, Jessica M.; Hood, Michelle; Creed, Peter A.

2015-01-01

We tested a model based on the dual-process framework that assessed the relationships among personal resources, career goal appraisals, career attitudes, and career goal management, which have not been previously assessed together. The model (tested on a sample of 486 young adults: 74% female, M[subscript]age = 22 years) proposed that personal…

[Is there a German history of evidence-based medicine? Methodic standards of therapeutic research in the early 20th century and Paul Martini's "Methodology of therapeutic investigation" (1932)].

Science.gov (United States)

Stoll, S; Roelcke, V; Raspe, H

2005-07-29

The article addresses the history of evidence-based medicine in Germany. Its aim was to reconstruct the standard of clinical-therapeutic investigation in Germany at the beginning of the 20 (th) century. By a historical investigation of five important German general medical journals for the time between 1918 and 1932 an overview of the situation of clinical investigation is given. 268 clinical trails are identified, and are analysed in view of their methodological design. Heterogeneous results are found: While few examples of sophisticated methodology exist, the design of the majority of the studies is poor. A response to the situation described can be seen in Paul Martini's book "Methodology of Therapeutic Investigation", first published in 1932. Paul Martini's biography, his criticism of the situation of clinical-therapeutic investigation of his time, the major points of his methodology and the reception of the book in Germany and abroad are described.

Can motto-goals outperform learning and performance goals? Influence of goal setting on performance and affect in a complex problem solving task

Directory of Open Access Journals (Sweden)

Miriam S. Rohe

2016-09-01

Full Text Available In this paper, we bring together research on complex problem solving with that on motivational psychology about goal setting. Complex problems require motivational effort because of their inherent difficulties. Goal Setting Theory has shown with simple tasks that high, specific performance goals lead to better performance outcome than do-your-best goals. However, in complex tasks, learning goals have proven more effective than performance goals. Based on the Zurich Resource Model (Storch & Krause, 2014, so-called motto-goals (e.g., "I breathe happiness" should activate a person’s resources through positive affect. It was found that motto-goals are effective with unpleasant duties. Therefore, we tested the hypothesis that motto-goals outperform learning and performance goals in the case of complex problems. A total of N = 123 subjects participated in the experiment. In dependence of their goal condition, subjects developed a personal motto, learning, or performance goal. This goal was adapted for the computer-simulated complex scenario Tailorshop, where subjects worked as managers in a small fictional company. Other than expected, there was no main effect of goal condition for the management performance. As hypothesized, motto goals led to higher positive and lower negative affect than the other two goal types. Even though positive affect decreased and negative affect increased in all three groups during Tailorshop completion, participants with motto goals reported the lowest rates of negative affect over time. Exploratory analyses investigated the role of affect in complex problem solving via mediational analyses and the influence of goal type on perceived goal attainment.

[Therapeutic Aggressiveness and Liquid Oncology].

Science.gov (United States)

Barón Duarte, F J; Rodríguez Calvo, M S; Amor Pan, J R

2017-01-01

Aggressiveness criteria proposed in the scientific literature a decade ago provide a quality judgment and are a reference in the care of patients with advanced cancer, but their use is not generalized in the evaluation of Oncology Services. In this paper we analyze the therapeutic aggressiveness, according to standard criteria, in 1.001 patients with advanced cancer who died in our Institution between 2010 and 2013. The results seem to show that aggressiveness at the end of life is present more frequently than experts recommend. About 25% of patients fulfill at least one criterion of aggressiveness. This result could be explained by a liquid Oncology which does not prioritize the patient as a moral subject in the clinical appointment. Medical care is oriented to necessities and must be articulated in a model focused on dignity and communication. Its implementation through Advanced Care Planning, consideration of patient's values and preferences, and Limitation of therapeutic effort are ways to reduce aggressiveness and improve clinical practice at the end of life. We need to encourage synergic and proactive attitudes, adding the best of cancer research with the best clinical care for the benefit of human being, moral subject and main goal of Medicine.

Predicting subjective vitality and performance in sports: the role of passion and achievement goals.

Science.gov (United States)

Li, Chiung-Huang

2010-06-01

The major purpose of this study was to test the hypothesized paths from dualistic passions through achievement goals to subjective vitality and performance in sports. 645 high school athletes participated. The proposed structural equation model, with relationships between dualistic passions and subjective vitality and sports performance mediated by achievement goals, fit the data well, especially for mastery-approach and performance-approach goals. Harmonious and obsessive passions may lead athletes to high performance via the adoption of mastery-approach goals. However, these passions seem to have two paths influencing personal functioning: direct effects make players feel energetic, and indirect effects on subjective vitality through adoption of mastery-approach and performance-approach goals.

Does NASA's Constellation Architecture Offer Opportunities to Achieve Multiple Additional Goals in Space?

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Thronson, Harley; Lester, Daniel F.

2008-01-01

Every major NASA human spaceflight program in the last four decades has been modified to achieve goals in space not incorporated within the original design goals: the Apollo Applications Program, Skylab, Space Shuttle, and International Space Station. Several groups in the US have been identifying major future science goals, the science facilities necessary to investigate them, as well as possible roles for augmented versions of elements of NASA's Constellation program. Specifically, teams in the astronomy community have been developing concepts for very capable missions to follow the James Webb Space Telescope that could take advantage of - or require - free-space operations by astronauts and/or robots. Taking as one example, the Single-Aperture Far-InfraRed (SAFIR) telescope with a approx. 10+ m aperture proposed for operation in the 2020 timeframe. According to current NASA plans, the Ares V launch vehicle (or a variant) will be available about the same time, as will the capability to transport astronauts to the vicinity of the Moon via the Orion Crew Exploration Vehicle and associated systems. [As the lunar surface offers no advantages - and major disadvantages - for most major optical systems, the expensive system for landing and operating on the lunar surface is not required.] Although as currently conceived, SAFIR and other astronomical missions will operate at the Sun-Earth L2 location, it appears trivial to travel for servicing to the more accessible Earth-Moon L1,2 locations. Moreover. as the recent Orbital Express and Automated Transfer Vehicle missions have demonstrated, future robotic capabilities should offer capabilities that would (remotely) extend human presence far beyond the vicinity of the Earth. In addition to multiplying the value of NASA's architecture for future human spaceflight to achieve the goals multiple major stakeholders. if humans one day travel beyond the Earth-Moon system - say, to Mars - technologies and capabilities for operating

Goal-Directed and Goal-Less Imitation in Autism Spectrum Disorder

Science.gov (United States)

Wild, Kelly S.; Poliakoff, Ellen; Jerrison, Andrew; Gowen, Emma

2012-01-01

To investigate how people with Autism are affected by the presence of goals during imitation, we conducted a study to measure movement kinematics and eye movements during the imitation of goal-directed and goal-less hand movements. Our results showed that a control group imitated changes in movement kinematics and increased the level that they…

Using therapeutic sound with progressive audiologic tinnitus management.

Science.gov (United States)

Henry, James A; Zaugg, Tara L; Myers, Paula J; Schechter, Martin A

2008-09-01

Management of tinnitus generally involves educational counseling, stress reduction, and/or the use of therapeutic sound. This article focuses on therapeutic sound, which can involve three objectives: (a) producing a sense of relief from tinnitus-associated stress (using soothing sound); (b) passively diverting attention away from tinnitus by reducing contrast between tinnitus and the acoustic environment (using background sound); and (c) actively diverting attention away from tinnitus (using interesting sound). Each of these goals can be accomplished using three different types of sound-broadly categorized as environmental sound, music, and speech-resulting in nine combinations of uses of sound and types of sound to manage tinnitus. The authors explain the uses and types of sound, how they can be combined, and how the different combinations are used with Progressive Audiologic Tinnitus Management. They also describe how sound is used with other sound-based methods of tinnitus management (Tinnitus Masking, Tinnitus Retraining Therapy, and Neuromonics).

Therapeutic touch: influence on vital signs of newborns.

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Ramada, Nadia Christina Oliveira; Almeida, Fabiane de Amorim; Cunha, Mariana Lucas da Rocha

2013-12-01

To compare vital signs before and after the therapeutic touch observed in hospitalized newborns in neonatal intensive care unit. This was a quasi-experimental study performed at a neonatal intensive care unit of a municipal hospital, in the city of São Paulo (SP), Brazil. The sample included 40 newborns submitted to the therapeutic touch after a painful procedure. We evaluated the vital signs, such as heart and respiratory rates, temperature and pain intensity, before and after the therapeutic touch. The majority of newborns were male (n=28; 70%), pre-term (n=19; 52%) and born from vaginal delivery (n=27; 67%). Respiratory distress was the main reason for hospital admission (n=16; 40%). There was a drop in all vital signs after therapeutic touch, particularly in pain score, which had a considerable reduction in the mean values, from 3.37 (SD=1.31) to 0 (SD=0.0). All differences found were statistically significant by the Wilcoxon test (ptouch promotes relaxation of the baby, favoring reduction in vital signs and, consequently in the basal metabolism rate.

Academic goals in surgery.

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Bleier, Joshua I S; Kann, Brian

2013-12-01

The development of an academic surgical career can be an overwhelming prospect, and one that is not intuitive. Establishing a structured plan and support structure is critical to success. Starting a successful academic surgical career begins with defining one's academic goals within several broad categories: personal goals, academic goals, research goals, educational goals, and financial goals. Learning the art of self-promotion is the means by which many of these goals are achieved. It is important to realize that achieving these goals requires a delicate personal balance between work and home life, and the key ways in which to achieve success require establishment of well thought-out goals, a reliable support structure, realistic and clear expectations, and frequent re-evaluation.

Genome Engineering for Personalized Arthritis Therapeutics.

Science.gov (United States)

Adkar, Shaunak S; Brunger, Jonathan M; Willard, Vincent P; Wu, Chia-Lung; Gersbach, Charles A; Guilak, Farshid

2017-10-01

Arthritis represents a family of complex joint pathologies responsible for the majority of musculoskeletal conditions. Nearly all diseases within this family, including osteoarthritis, rheumatoid arthritis, and juvenile idiopathic arthritis, are chronic conditions with few or no disease-modifying therapeutics available. Advances in genome engineering technology, most recently with CRISPR-Cas9, have revolutionized our ability to interrogate and validate genetic and epigenetic elements associated with chronic diseases such as arthritis. These technologies, together with cell reprogramming methods, including the use of induced pluripotent stem cells, provide a platform for human disease modeling. We summarize new evidence from genome-wide association studies and genomics that substantiates a genetic basis for arthritis pathogenesis. We also review the potential contributions of genome engineering in the development of new arthritis therapeutics. Copyright © 2017 Elsevier Ltd. All rights reserved.

Inhibiting DNA Polymerases as a Therapeutic Intervention against Cancer

Directory of Open Access Journals (Sweden)

Anthony J. Berdis

2017-11-01

Full Text Available Inhibiting DNA synthesis is an important therapeutic strategy that is widely used to treat a number of hyperproliferative diseases including viral infections, autoimmune disorders, and cancer. This chapter describes two major categories of therapeutic agents used to inhibit DNA synthesis. The first category includes purine and pyrmidine nucleoside analogs that directly inhibit DNA polymerase activity. The second category includes DNA damaging agents including cisplatin and chlorambucil that modify the composition and structure of the nucleic acid substrate to indirectly inhibit DNA synthesis. Special emphasis is placed on describing the molecular mechanisms of these inhibitory effects against chromosomal and mitochondrial DNA polymerases. Discussions are also provided on the mechanisms associated with resistance to these therapeutic agents. A primary focus is toward understanding the roles of specialized DNA polymerases that by-pass DNA lesions produced by DNA damaging agents. Finally, a section is provided that describes emerging areas in developing new therapeutic strategies targeting specialized DNA polymerases.

Pharmacokinetics and toxicology of therapeutic proteins: Advances and challenges

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Vugmeyster, Yulia; Xu, Xin; Theil, Frank-Peter; Khawli, Leslie A; Leach, Michael W

2012-01-01

Significant progress has been made in understanding pharmacokinetics (PK), pharmacodynamics (PD), as well as toxicity profiles of therapeutic proteins in animals and humans, which have been in commercial development for more than three decades. However, in the PK arena, many fundamental questions remain to be resolved. Investigative and bioanalytical tools need to be established to improve the translation of PK data from animals to humans, and from in vitro assays to in vivo readouts, which would ultimately lead to a higher success rate in drug development. In toxicology, it is known, in general, what studies are needed to safely develop therapeutic proteins, and what studies do not provide relevant information. One of the major complicating factors in nonclinical and clinical programs for therapeutic proteins is the impact of immunogenicity. In this review, we will highlight the emerging science and technology, as well as the challenges around the pharmacokinetic- and safety-related issues in drug development of mAbs and other therapeutic proteins. PMID:22558487

Dendrimer Advances for the Central Nervous System Delivery of Therapeutics

Science.gov (United States)

2013-01-01

The effectiveness of noninvasive treatment for central nervous system (CNS) diseases is generally limited by the poor access of therapeutic agents into the CNS. Most CNS drugs cannot permeate into the brain parenchyma because of the blood-brain barrier (BBB), and overcoming this has become one of the most significant challenges in the development of CNS therapeutics. Rapid advances in nanotechnology have provided promising solutions to this challenge. This review discusses the latest applications of dendrimers in the treatment of CNS diseases with an emphasis on brain tumors. Dendrimer-mediated drug delivery, imaging, and diagnosis are also reviewed. The toxicity, biodistribution, and transport mechanisms in dendrimer-mediated delivery of CNS therapeutic agents bypassing or crossing the BBB are also discussed. Future directions and major challenges of dendrimer-mediated delivery of CNS therapeutic agents are included. PMID:24274162

Therapeutic patient education in heart failure: do studies provide sufficient information about the educational programme?

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Albano, Maria Grazia; Jourdain, Patrick; De Andrade, Vincent; Domenke, Aukse; Desnos, Michel; d'Ivernois, Jean-François

2014-05-01

Therapeutic patient education programmes on heart failure have been widely proposed for many years for heart failure patients, but their efficiency remains questionable, partly because most articles lack a precise programme description, which makes comparative analysis of the studies difficult. To analyse the degree of precision in describing therapeutic patient education programmes in recent randomized controlled trials. Three major recent recommendations on therapeutic patient education in heart failure inspired us to compile a list of 23 relevant items that an 'ideal' description of a therapeutic patient education programme should contain. To discover the extent to which recent studies into therapeutic patient education in heart failure included these items, we analysed 19 randomized controlled trials among 448 articles published in this field from 2005 to 2012. The major elements required to describe a therapeutic patient education programme were present, but some other very important pieces of information were missing in most of the studies we analysed: the patient's educational needs, health literacy, projects, expectations regarding therapeutic patient education and psychosocial status; the educational methodology used; outcomes evaluation; and follow-up strategies. Research into how therapeutic patient education can help heart failure patients will be improved if more precise descriptions of patients, educational methodology and evaluation protocols are given by authors, ideally in a standardized format. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Structuring polymers for delivery of DNA-based therapeutics: updated insights.

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Gupta, Madhu; Tiwari, Shailja; Vyas, Suresh

2012-01-01

Gene therapy offers greater opportunities for treating numerous incurable diseases from genetic disorders, infections, and cancer. However, development of appropriate delivery systems could be one of the most important factors to overcome numerous biological barriers for delivery of various therapeutic molecules. A number of nonviral polymer-mediated vectors have been developed for DNA delivery and offer the potential to surmount the associated problems of their viral counterpart. To address the concerns associated with safety issues, a wide range of polymeric vectors are available and have been utilized successfully to deliver their therapeutics in vivo. Today's research is mainly focused on the various natural or synthetic polymer-based delivery carriers that protect the DNA molecule from degradation, which offer specific targeting to the desired cells after systemic administration, have transfection efficiencies equivalent to virus-mediated gene delivery, and have long-term gene expression through sustained-release mechanisms. This review explores an updated overview of different nonviral polymeric delivery system for delivery of DNA-based therapeutics. These polymeric carriers have been evaluated in vitro and in vivo and are being utilized in various stages of clinical evaluation. Continued research and understanding of the principles of polymer-based gene delivery systems will enable us to develop new and efficient delivery systems for the delivery of DNA-based therapeutics to achieve the goal of efficacious and specific gene therapy for a vast array of clinical disorders as the therapeutic solutions of tomorrow.

Efficacy and safety of a therapeutic interchange from high-dose calcium channel blockers to a fixed-dose combination of amlodipine/benazepril in patients with moderate-to-severe hypertension.

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Hilleman, D E; Reyes, A P; Wurdeman, R L; Faulkner, M

2001-08-01

Recent hypertension trials have demonstrated the importance of achieving goal blood pressures to reduce the risk of target organ damage. In patients with moderate to severe hypertension, the use of high-dose monotherapy and/or combinations of drugs are necessary to achieve these goals. Fixed-dose combination products may be useful in these patients by reducing the number of daily doses required to control blood pressure. The objective of the present study was to evaluate the efficacy and safety of a therapeutic interchange between high-dose calcium channel blocker therapy and a fixed-dose combination of amlodipine/ benazepril (Lotrel; Novartis Pharmaceuticals, USA) in patients with moderate to severe hypertension. A total of 75 patients were switched from amlodipine (n = 25), felodipine (n = 25), and nifedipine-GITS (n = 25) to amlodipine/benazepril. Twenty-eight of the 75 patients (37%) were taking either a beta-blocker or a diuretic in addition to the high-dose calcium channel blocker prior to the switch. Blood pressure control, side effects and the cost of the therapeutic interchange were evaluated in the year following the therapeutic interchange. Sixty-six of the 75 (88%) patients were successfully switched with maintenance of blood pressure control and without the development of new dose-limiting side effects. Reasons for treatment failure after the therapeutic interchange included loss of blood pressure control in five patients and the development of new dose-limiting side effects in four patients. These side effects included cough in three patients and rash in one patient. After accounting for differences in drug acquisition cost and costs related to the switch (clinic and emergency room and laboratory tests), a cost savings of $16030 for all 75 patients was realised in the first year. The per patient-per year cost savings was $214. Our data indicate that a therapeutic interchange from selected high-dose calcium channel blockers to a fixed-dose combination

Guidelines for the undergraduate psychology major: Version 2.0.

Science.gov (United States)

2016-01-01

The APA Guidelines for the Undergraduate Psychology Major: Version 2.0 (henceforth Guidelines 2.0; APA, 2013) represents a national effort to describe and develop high-quality undergraduate programs in psychology. The task force charged with the revision of the original guidelines for the undergraduate major examined the success of the document's implementation and made changes to reflect emerging best practices and to integrate psychology's work with benchmarking scholarship in higher education. Guidelines 2.0 abandoned the original distinction drawn between psychology-focused skills and psychology skills that enhance liberal arts development. Instead, Guidelines 2.0 describes five inclusive goals for the undergraduate psychology major and two developmental levels of student learning outcomes. Suggestions for assessment planning are provided for each of the five learning goals. (c) 2016 APA, all rights reserved).

Goal-Directed Fluid Therapy Based on Stroke Volume Variation in Patients Undergoing Major Spine Surgery in the Prone Position: A Cohort Study.

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Bacchin, Maria Renata; Ceria, Chiara Marta; Giannone, Sandra; Ghisi, Daniela; Stagni, Gaetano; Greggi, Tiziana; Bonarelli, Stefano

2016-09-15

A retrospective observational study. The aim of this study was to test whether a goal-directed fluid therapy (GDFT) protocol, based on stroke volume variation (SVV), applied in major spine surgery performed in the prone position, would be effective in reducing peri-operative red blood cells transfusions. Recent literature shows that optimizing perioperative fluid therapy is associated with lower complication rates and faster recovery. Data from 23 patients who underwent posterior spine arthrodesis surgery and whose intraoperative fluid administration were managed with the GDFT protocol were retrospectively collected and compared with data from 23 matched controls who underwent the same surgical procedure in the same timeframe, and who received a liberal intraoperative fluid therapy. Patients in the GDFT group received less units of transfused red blood cells (primary endpoint) in the intra (0 vs. 2.0, P = 0.0 4) and postoperative period (2.0 vs. 4.0, P = 0.003). They also received a lower amount of intraoperative crystalloids, had fewer blood losses, and lower intraoperative peak lactate. In the postoperative period, patients in the GDFT group had fewer pulmonary complications and blood losses from surgical drains, needed less blood product transfusions, had a shorter intensive care unit stay, and a faster return of bowel function. We found no difference in the total length of stay among the two groups. Our study shows that application of a GDFT based on SVV in major spine surgery is feasible and can lead to reduced blood losses and transfusions, better postoperative respiratory performance, shorter ICU stay, and faster return of bowel function. 3.

Goal Definition

DEFF Research Database (Denmark)

Bjørn, Anders; Laurent, Alexis; Owsianiak, Mikołaj

2018-01-01

The goal definition is the first phase of an LCA and determines the purpose of a study in detail. This chapter teaches how to perform the six aspects of a goal definition: (1) Intended applications of the results, (2) Limitations due to methodological choices, (3) Decision context and reasons...... for carrying out the study, (4) Target audience , (5) Comparative studies to be disclosed to the public and (6) Commissioner of the study and other influential actors. The instructions address both the conduct and reporting of a goal definition and are largely based on the ILCD guidance document (EC...

Cell-based therapeutic strategies for replacement and preservation in retinal degenerative diseases

Science.gov (United States)

Jones, Melissa K.; Lu, Bin; Girman, Sergey; Wang, Shaomei

2017-01-01

Cell-based therapeutics offer diverse options for treating retinal degenerative diseases, such as age-related macular degeneration (AMD) and retinitis pigmentosa (RP). AMD is characterized by both genetic and environmental risks factors, whereas RP is mainly a monogenic disorder. Though treatments exist for some patients with neovascular AMD, a majority of retinal degenerative patients have no effective therapeutics, thus indicating a need for universal therapies to target diverse patient populations. Two main cell-based mechanistic approaches are being tested in clinical trials. Replacement therapies utilize cell-derived retinal pigment epithelial (RPE) cells to supplant lost or defective host RPE cells. These cells are similar in morphology and function to native RPE cells and can potentially supplant the responsibilities of RPE in vivo. Preservation therapies utilize supportive cells to aid in visual function and photoreceptor preservation partially by neurotrophic mechanisms. The goal of preservation strategies is to halt or slow the progression of disease and maintain remaining visual function. A number of clinical trials are testing the safety of replacement and preservation cell therapies in patients; however, measures of efficacy will need to be further evaluated. In addition, a number of prevailing concerns with regards to the immune-related response, longevity, and functionality of the grafted cells will need to be addressed in future trials. This review will summarize the current status of cell-based preclinical and clinical studies with a focus on replacement and preservation strategies and the obstacles that remain regarding these types of treatments. PMID:28111323

Therapeutic options for lip augmentation.

Science.gov (United States)

Segall, Lorne; Ellis, David A F

2007-11-01

Aesthetic ideals vary with emerging fashion trends and within different cultures. However, over the past few decades, fuller lips have been considered a desirable trait. Many younger patients are presenting for lip augmentation to achieve the sought-after look commonly seen in many fashion magazines. In addition, as individuals age, they lose lip volume, with a thinning of the red lip, some effacement of the vermillion border, and elongation and flattening of the white portion of the lip. Rejuvenation of the lips plays a key role in restoring a more youthful appearance. As a result, lip augmentation appeals to a wide spectrum of patients who present with various different aesthetic goals and expectations. Numerous therapeutic options exist for aesthetic lip augmentation, ranging from temporary and permanent injectable fillers to implants and other surgical techniques.

Motivational Goal Bracketing

DEFF Research Database (Denmark)

Nafziger, Julia; Koch, Alexander

It is a puzzle why people often evaluate consequences of choices separately (narrow bracketing) rather than jointly (broad bracketing). We study the hypothesis that a present-biased individual, who faces two tasks, may bracket his goals narrowly for motivational reasons. Goals motivate because th...... of the tasks. Narrow goals have a stronger motivational force and thus can be optimal. In particular, if one task outcome becomes known before working on the second task, narrow bracketing is always optimal.......It is a puzzle why people often evaluate consequences of choices separately (narrow bracketing) rather than jointly (broad bracketing). We study the hypothesis that a present-biased individual, who faces two tasks, may bracket his goals narrowly for motivational reasons. Goals motivate because...

Goals and everyday problem solving: manipulating goal preferences in young and older adults.

Science.gov (United States)

Hoppmann, Christiane A; Blanchard-Fields, Fredda

2010-11-01

In the present study, we examined the link between goal and problem-solving strategy preferences in 130 young and older adults using hypothetical family problem vignettes. At baseline, young adults preferred autonomy goals, whereas older adults preferred generative goals. Imagining an expanded future time perspective led older adults to show preferences for autonomy goals similar to those observed in young adults but did not eliminate age differences in generative goals. Autonomy goals were associated with more self-focused instrumental problem solving, whereas generative goals were related to more other-focused instrumental problem solving in the no-instruction and instruction conditions. Older adults were better at matching their strategies to their goals than young adults were. This suggests that older adults may become better at selecting their strategies in accordance with their goals. Our findings speak to a contextual approach to everyday problem solving by showing that goals are associated with the selection of problem-solving strategies.

Psychological "gel" to bind individuals' goal pursuit: gratitude facilitates goal contagion.

Science.gov (United States)

Jia, Lile; Tong, Eddie M W; Lee, Li Neng

2014-08-01

Past research demonstrates that gratitude affects individuals' self-regulation of behavior primarily through engendering a prosocial tendency. Based on theories proposing that gratitude plays an unique role in fostering communal relationship (e.g., Algoe, 2012), we propose that gratitude can have an incidental effect in facilitating goal contagion: automatically inferring and adopting the goal implied by a social other's behavior. This hypothesis is supported in 3 studies. In Study 1, after being exposed to the behaviors of a social target that implied either a cooperative or a competitive goal, individuals adopted the respective goal and behaved accordingly in a Resource Dilemma Task. This occurred, however, only when they were feeling gratitude and not when they were feeling joy or a neutral mood. In Study 2, after being exposed to a social target's behavior that implied the goal to make money, people feeling gratitude, as compared to those feeling pride or a neutral mood, strove for a future opportunity to earn money. Study 3 further demonstrated that individuals' goal striving behavior was mediated by a heightened level of goal activation. Finally, it was found that gratitude facilitated goal contagion only when the social target was a member of participants' own social group. Through this mechanism, gratitude, thus, seems to bind one's self-regulation with those of social others. Theoretical and practical implications of this new perspective are discussed.

The Therapeutic Relationship and Cognitive Behavioural Therapy: A Case Study of an Adolescent Girl With Depression

Directory of Open Access Journals (Sweden)

Cheryl Joy Easterbrook

2017-02-01

Full Text Available The therapeutic relationship in Cognitive Behavioural Therapy (CBT has been argued to play an essential role in positive outcomes in therapy. However, it is described as necessary and yet, secondary to technique, often receiving little attention in the training of CBT therapists. This case study explores a trainee psychologist’s experience of finding difficulty in feeling authentic and the application of CBT techniques with her client. This difficulty informed the research question; what is the value of the therapeutic relationship in CBT? A hermeneutic approach with a strong emphasis on phenomenology, is used to explore the therapeutic process and the therapeutic relationship that developed between therapist and client. Qualitative descriptions of 11 sessions are divided into themes, these are discussed in relation to what happened in therapy, and are then discussed further regarding discovery and process into the therapeutic relationship. Conclusions from this case study could possibly reveal the value of the therapeutic relationship when working from a CBT approach, and how it seemed to enable the client to achieve her goal in therapy.

Achievement goals, self-handicapping, and performance: a 2 x 2 achievement goal perspective.

Science.gov (United States)

Ntoumanis, Nikos; Thøgersen-Ntoumani, Cecilie; Smith, Alison L

2009-11-01

Elliot and colleagues (2006) examined the effects of experimentally induced achievement goals, proposed by the trichotomous model, on self-handicapping and performance in physical education. Our study replicated and extended the work of Elliot et al. by experimentally promoting all four goals proposed by the 2 x 2 model (Elliot & McGregor, 2001), measuring the participants' own situational achievement goals, using a relatively novel task, and testing the participants in a group setting. We used a randomized experimental design with four conditions that aimed to induce one of the four goals advanced by the 2 x 2 model. The participants (n = 138) were undergraduates who engaged in a dart-throwing task. The results pertaining to self-handicapping partly replicated Elliot and colleagues' findings by showing that experimentally promoted performance-avoidance goals resulted in less practice. In contrast, the promotion of mastery-avoidance goals did not result in less practice compared with either of the approach goals. Dart-throwing performance did not differ among the four goal conditions. Personal achievement goals did not moderate the effects of experimentally induced goals on self-handicapping and performance. The extent to which mastery-avoidance goals are maladaptive is discussed, as well as the interplay between personal and experimentally induced goals.

[Therapeutic algorithm of idiopathic scoliosis in children].

Science.gov (United States)

Ciortan, Ionica; Goţia, D G

2008-01-01

Acquired deformations of spinal cord (scoliosis, kyphosis, lordosis) represent a frequent pathology in child; their treatment is complex, with variable results which depend on various parameters. Mild scoliosis, with an angle less than 30 degrees, is treated with physiotherapy and regular follow-up. If the angle is higher than 30 degrees, the orthopedic corset is required; the angle over 45 degrees impose surgically correction. The indications of every therapeutic method depend on many factors, the main target of the treatment is to prevent the aggravation of the curvature; concerning the surgery, the goal is to obtain a correction as normal as possible of the spinal axis.

Goals and Psychological Accounting

DEFF Research Database (Denmark)

Koch, Alexander Karl; Nafziger, Julia

We model how people formulate and evaluate goals to overcome self-control problems. People often attempt to regulate their behavior by evaluating goal-related outcomes separately (in narrow psychological accounts) rather than jointly (in a broad account). To explain this evidence, our theory...... of endogenous narrow or broad psychological accounts combines insights from the literatures on goals and mental accounting with models of expectations-based reference-dependent preferences. By formulating goals the individual creates expectations that induce reference points for task outcomes. These goal......-induced reference points make substandard performance psychologically painful and motivate the individual to stick to his goals. How strong the commitment to goals is depends on the type of psychological account. We provide conditions when it is optimal to evaluate goals in narrow accounts. The key intuition...

Goal Orientations of General Chemistry Students via the Achievement Goal Framework

Science.gov (United States)

Lewis, Scott E.

2018-01-01

The Achievement Goal Framework describes students' goal orientations as: task-based, focusing on the successful completion of the task; self-based, evaluating performance relative to one's own past performance; or other-based, evaluating performance relative to the performance of others. Goal orientations have been used to explain student success…

Goal Setting in Principal Evaluation: Goal Quality and Predictors of Achievement

Science.gov (United States)

Sinnema, Claire E. L.; Robinson, Viviane M. J.

2012-01-01

This article draws on goal-setting theory to investigate the goals set by experienced principals during their performance evaluations. While most goals were about teaching and learning, they tended to be vaguely expressed and only partially achieved. Five predictors (commitment, challenge, learning, effort, and support) explained a significant…

A therapeutic skating intervention for children with autism spectrum disorder.

Science.gov (United States)

Casey, Amanda Faith; Quenneville-Himbeault, Gabriel; Normore, Alexa; Davis, Hanna; Martell, Stephen G

2015-01-01

The purpose of this study was to evaluate the effects of a highly structured therapeutic skating intervention on motor outcomes and functional capacity in 2 boys with autism spectrum disorder aged 7 and 10 years. This multiple-baseline, single-subject study assigned participants to three 1-hour skating sessions per week for 12 weeks focusing on skill and motor development. Multiple data points assessed (a) fidelity to the intervention and (b) outcomes measures including the Pediatric Balance Scale, Timed Up and Go, floor to stand, Six-Minute Walk Test, goal attainment, and weekly on-ice testing. Improvements were found in balance, motor behavior, and functional capacity by posttest with gains remaining above pretest levels at follow-up. Therapeutic skating may produce physical benefits for children with autism spectrum disorder and offer a viable, inexpensive community-based alternative to other forms of physical activity.

When Medicine Meets Engineering—Paradigm Shifts in Diagnostics and Therapeutics

Directory of Open Access Journals (Sweden)

Aleidy Silva

2013-02-01

Full Text Available During the last two decades, the manufacturing techniques of microfluidics-based devices have been phenomenally advanced, offering unlimited potential for bio-medical technologies. However, the direct applications of these technologies toward diagnostics and therapeutics are still far from maturity. The present challenges lay at the interfaces between the engineering systems and the biocomplex systems. A precisely designed engineering system with narrow dynamic range is hard to seamlessly integrate with the adaptive biological system in order to achieve the design goals. These differences remain as the roadblock between two fundamentally non-compatible systems. This paper will not extensively review the existing microfluidic sensors and actuators; rather, we will discuss the sources of the gaps for integration. We will also introduce system interface technologies for bridging the differences to lead toward paradigm shifts in diagnostics and therapeutics.

Interactions of silica nanoparticles with therapeutics for oxidative stress attenuation in neurons

Science.gov (United States)

White-Schenk, Desiree; Shi, Riyi; Leary, James F.

2015-03-01

Oxidative stress plays a major role in many disease pathologies, notably in the central nervous system (CNS). For instance, after initial spinal cord injury, the injury site tends to increase during a secondary chemical injury process based on oxidative stress from necrotic cells and the inflammatory response. Prevention of this secondary chemical injury would represent a major advance in the treatment of people with spinal cord injuries. Few therapeutics are useful in combating such stress in the CNS due to side effects, low efficacy, or half-life. Mesoporous silica nanoparticles show promise for delivering therapeutics based on the formation of a porous network during synthesis. Ideally, they increase the circulation time of loaded therapeutics to increase the half-life while reducing overall concentrations to avoid side effects. The current study explored the use of silica nanoparticles for therapeutic delivery of anti-oxidants, in particular, the neutralization of acrolein which can lead to extensive tissue damage due to its ability to generate more and more copies of itself when it interacts with normal tissue. Both an FDA-approved therapeutic, hydralazine, and natural product, epigallocatechin gallate, were explored as antioxidants for acrolein with nanoparticles for increased efficacy and stability in neuronal cell cultures. Not only were the nanoparticles explored in neuronal cells, but also in a co-cultured in vitro model with microglial cells to study potential immune responses to near-infrared (NIRF)-labeled nanoparticles and uptake. Studies included nanoparticle toxicity, uptake, and therapeutic response using fluorescence-based techniques with both dormant and activated immune microglia co-cultured with neuronal cells.

Using goal orientations to understand motivation in strength training.

Science.gov (United States)

Gilson, Todd A; Chow, Graig M; Ewing, Martha E

2008-07-01

Despite the importance that today's athletics place on strength training, research exploring the motivation of athletes in this arena is sparse. It is known that not all athletes will use the same motivational cognitions as inspiration, and these differences can be explored through achievement goal orientations. Through questionnaire data and semistructured interviews, the present study investigated how collegiate athletes maintain high levels of motivation over a period of time during strength training and explored relationships among five goal orientations: task-orientation, self-enhancing ego-orientation, self-defeating ego-orientation, social-approval orientation, and work-avoidance orientation. Subjects (N = 133), comprising 90 men and 43 women, were current varsity collegiate athletes from 15 different sports at a major Midwestern university. In addition, using a screener survey to assess achievement goal orientations, 15 subjects from the sample group who demonstrated a stronger inclination to only one achievement goal orientation were interviewed to gain a more in-depth understanding of their motivation cognitions in strength training. Results showed that the strongest achievement goal orientations reported from all athletes were task-orientation and social-approval. Additionally, five higher-order themes (significant others, improvement, competitive demands, being stronger than others, and miscellaneous) were consistent among the interviewed athletes when describing how they stay motivated during strength training. Whereas all athletes were able to describe at least one motivational strategy they employed during strength training, the dominant achievement goal orientation of some athletes influenced their motivational strategy. By employing the T.A.R.G.E.T. model (), strength coaches can foster adaptive achievement goal orientations and thereby enhance intrinsic motivation for athletes engaging in strength training.

Evaluation of financial burden following complications after major surgery in France: Potential return after perioperative goal-directed therapy.

Science.gov (United States)

Landais, Alain; Morel, Morgane; Goldstein, Jacques; Loriau, Jerôme; Fresnel, Annie; Chevalier, Corinne; Rejasse, Gilles; Alfonsi, Pascal; Ecoffey, Claude

2017-06-01

Perioperative goal-directed therapy (PGDT) has been demonstrated to improve postoperative outcomes and reduce the length of hospital stays. The objective of our analysis was to evaluate the cost of complications, derived from French hospital payments, and calculate the potential cost savings and length of hospital stay reductions. The billing of 2388 patients who underwent scheduled high-risk surgery (i.e. major abdominal, gynaecologic, urological, vascular, and orthopaedic interventions) over three years was retrospectively collected from three French hospitals (one public-teaching, one public, and one private hospital). A relationship between mortality, length of hospital stays, cost/patient, and severity scores, based mainly on postoperative complications but also on preoperative clinical status, were analysed. Statistical analysis was performed using Student's t-tests or Wilcoxon tests. Our analyses determined that a severity score of 3 or 4 was associated with complications in 90% of cases and this represented 36% of patients who, compared with those with a score of 1 or 2, were associated with significantly increased costs (€ 8205±3335 to € 22,081±16,090; Prisk surgeries per year), the potential financial savings ranged from € 40M to € 68M, not including the costs of PGDT and its implementation. Our analysis demonstrates that patients with complications are significantly more expensive to care for than those without complications. In our model, it was projected that implementing PGDT during high-risk surgery may significantly reduce healthcare costs and the length of hospital stays in France while probably improving patient access to care and reducing waiting times for procedures. Copyright © 2017. Published by Elsevier Masson SAS.

Performance-approach and performance-avoidance classroom goals and the adoption of personal achievement goals.

Science.gov (United States)

Schwinger, Malte; Stiensmeier-Pelster, Joachim

2011-12-01

Students' perceptions of classroom goals influence their adoption of personal goals. To assess different forms of classroom goals, recent studies have favoured an overall measure of performance classroom goals, compared to a two-dimensional assessment of performance-approach and performance-avoidance classroom goals (PAVCG). This paper considered the relationship between students' perceptions of classroom goals and their endorsement of personal achievement goals. We proposed that three (instead of only two) classroom goals need to be distinguished. We aimed to provide evidence for this hypothesis by confirmatory factor analysis (CFA) and also by divergent associations between the respective classroom goal and students' personal goal endorsement. A total of 871 (474 female) 10th grade students from several German high schools participated in this study. Students responded to items assessing their perception of mastery, performance-approach, and performance-avoidance goals in the classroom. Additionally, the students reported how much they personally pursue mastery, performance-approach, and performance-avoidance goals. All items referred to German as a specific school subject. RESULTS.A CFA yielded empirical support for the proposed distinction of three (instead of only two) different kinds of classroom goals. Moreover, in hierarchical linear modelling (HLM) analyses all three classroom goals showed unique associations with students' personal goal adoption. The findings emphasized the need to distinguish performance-approach and PAVCG. Furthermore, our results suggest that multiple classroom goals have interactive effects on students' personal achievement strivings. ©2010 The British Psychological Society.

How the nursing profession can contribute to sustainable development goals.

Science.gov (United States)

Benton, David; Shaffer, Franklin

2016-11-01

As of 1 January 2016, the UN sustainable development goals (SDGs) became the focus of global efforts on a wide range of development agenda. The SDGs have subsumed the work of the UN millennium development goals (MDGs), so it is timely to reflect on the contribution made by nurses and midwives, so that we can optimise the profession's contribution to the 17 SDGs. This article reports the results of a scientometrics analysis of the published literature related to the MDGs and SDGs indexed in CINAHL, which identified the underlying themes addressed by nurses and midwives. It shows how analysis demonstrates that although nursing was slow to engage with the MDG agenda, it has made some progress in contributing to SDG scholarship. So far this contribution has been narrowly focused, but the profession could contribute to all 17 of the SDG goals. Routine updates of the analysis described here could help monitor progress, identify gaps in nursing's contributions to the goals, and provide further impetus to its engagement in this major global policy initiative.

Clinical decision-making and therapeutic approaches in osteopathy - a qualitative grounded theory study.

Science.gov (United States)

Thomson, Oliver P; Petty, Nicola J; Moore, Ann P

2014-02-01

There is limited understanding of how osteopaths make decisions in relation to clinical practice. The aim of this research was to construct an explanatory theory of the clinical decision-making and therapeutic approaches of experienced osteopaths in the UK. Twelve UK registered osteopaths participated in this constructivist grounded theory qualitative study. Purposive and theoretical sampling was used to select participants. Data was collected using semi-structured interviews which were audio-recorded and transcribed. As the study approached theoretical sufficiency, participants were observed and video-recorded during a patient appointment, which was followed by a video-prompted interview. Constant comparative analysis was used to analyse and code data. Data analysis resulted in the construction of three qualitatively different therapeutic approaches which characterised participants and their clinical practice, termed; Treater, Communicator and Educator. Participants' therapeutic approach influenced their approach to clinical decision-making, the level of patient involvement, their interaction with patients, and therapeutic goals. Participants' overall conception of practice lay on a continuum ranging from technical rationality to professional artistry, and contributed to their therapeutic approach. A range of factors were identified which influenced participants' conception of practice. The findings indicate that there is variation in osteopaths' therapeutic approaches to practice and clinical decision-making, which are influenced by their overall conception of practice. This study provides the first explanatory theory of the clinical decision-making and therapeutic approaches of osteopaths. Copyright © 2013 Elsevier Ltd. All rights reserved.

Citizen Goals Online

Directory of Open Access Journals (Sweden)

Catalin Vrabie

2013-01-01

Full Text Available The purpose of this paper is to give to public institution Web designers a better understanding of the citizens’ objectives when accessing a Web page. Understanding citizen online goals is critical because it gets to the heart of what the public institution website should or could “do.” Approach: The challenge for e-marketers is that for most agencies/institutions, there are likely to be multiple goals that represent the “reason why” citizens could come to the website. For example, a national theatre website might be very effective for people who have already been there, they know effectively what place is the best, who are the actors, etc. Research limitations: The nature of a public institution activity almost dictates the different types of goals that consumers have when visiting the site. It is clear that a citizen has a different goal when accessing a theatre Web page or when he’s accessing a municipality Web page. This is the biggest impediment for drawing a good conceptual model for a public institution Web page. Practical implications: there are likely to be many other goals that could lead people to visit the site, like receiving customer service or leaving a remark. Value: Since citizen online goals represent the starting point for Web design efforts (for public institutions, this article has attempted to highlight the nature and types of goals that e-marketers might consider when planning what their website should do in order to create. Findings: The goal a site visitor has when arriving at a website tends to be very action oriented. If the visitor has never visited the site before, the goal may simply be to evaluate the website and figure out what the site is and if it will help him. On the other hand, if the visitor has reached the site as the result of a directed search or is a repeat visitor, the user goal is likely to be specific and functional. If important citizen goals are not supported by the website, the public

Citizen Goals Online

Directory of Open Access Journals (Sweden)

Catalin Vrabie

2012-07-01

Full Text Available The purpose of this paper is to give to public institution Web designers a better understanding of the citizens’ objectives when accessing a Web page. Understanding citizen online goals is critical because it gets to the heart of what the public institution website should or could “do.”Approach: The challenge for e-marketers is that for most agencies/institutions, there are likely to be multiple goals that represent the “reason why” citizens could come to the website. For example, a national theatre website might be very effective for people who have already been there, they know effectively what place is the best, who are the actors, etc.Research limitations: The nature of a public institution activity almost dictates the different types of goals that consumers have when visiting the site. It is clear that a citizen has a different goal when accessing a theatre Web page or when he’s accessing a municipality Web page. This is the biggest impediment for drawing a good conceptual model for a public institution Web page.Practical implications: there are likely to be many other goals that could lead people to visit the site, like receiving customer service or leaving a remark.Value: Since citizen online goals represent the starting point for Web design efforts (for public institutions, this article has attempted to highlight the nature and types of goals that e-marketers might consider when planning what their website should do in order to create.Findings: The goal a site visitor has when arriving at a website tends to be very action oriented. If the visitor has never visited the site before, the goal may simply be to evaluate the website and figure out what the site is and if it will help him. On the other hand, if the visitor has reached the site as the result of a directed search or is a repeat visitor, the user goal is likely to be specific and functional. If important citizen goals are not supported by the website, the public

Atherosclerotic Plaque Destabilization Mechanisms, Models, and Therapeutic Strategies

NARCIS (Netherlands)

Silvestre-Roig, Carlos; de Winther, Menno P.; Weber, Christian; Daemen, Mat J.; Lutgens, Esther; Soehnlein, Oliver

2014-01-01

Understanding the pathophysiology of atherogenesis and the progression of atherosclerosis have been major goals of cardiovascular research during the previous decades. However, the complex molecular and cellular mechanisms underlying plaque destabilization remain largely obscure. Here, we review how

The portfolio of renewable energy sources for achieving the three E policy goals

International Nuclear Information System (INIS)

Shen, Yung-Chi; Chou, Chiyang James; Lin, Grace T.R.

2011-01-01

Renewable energy is considered by many policy-makers to contribute to achieving at least three major policy goals: the energy goal, the environmental goal, and the economic goal (3E goals). As an innovation-oriented island country with scarce natural resources, Taiwan announced the Sustainable Energy Policy Principles in 2008 that stated that Taiwan's renewable energy policy should accomplish the 3E goals. Several studies point out that specific renewable energy policy goals lead to specific renewable energy sources and technologies because each type of renewable energy has different features. In order to achieve the renewable energy policy goals, this research aims to examine how different policy goals lead to corresponding renewable energy sources. The relative importance of each goal is evaluated by using analytic hierarchy process (AHP). The weight of each policy goal is adjusted separately to construct policy scenarios by the sensitivity analysis. According to the results, non-pumped storage hydropower, wind energy, and solar energy are three sources that could meet the three policy goals at the same time. -- Highlights: →This study aims to propose a portfolio of renewable energy sources to achieve energy, environmental, and economic policy goals for Taiwan. →Non-pumped storage hydropower performs best to achieve energy and environmental goals. →Wind energy performs well to accomplish environmental goal. →Solar energy is the most preferred alternative to achieve economic goal. →The portfolio of non-pumped storage hydropower, wind energy, and solar energy can accomplish the three E policy goals at the same time.

Decalogue of the Spanish Society of Arteriosclerosis to reduce therapeutic inertia.

Science.gov (United States)

Blasco, Mariano; Pérez-Martínez, Pablo; Lahoz, Carlos

Therapeutic inertia (TI) is defined as the failure of the physician to initiate or intensify a treatment when the therapeutic goal has not been achieved. TI can be of 2types: inertia due to lack of prescription of drugs and inertia in the absence of control of a risk factor. The consequences of TI are poor control of risk factors, an increase in potentially preventable events and an increase in costs. There are factors of the doctor himself, the patient and the care organization that determine the presence of TI. Ten measures are proposed to reduce TI: to promote continuing education, to define clearly therapeutic objectives, to establish audits, to implement computerized medical records with alerts, to encourage research in this field, to disseminate clinical practice guidelines, to create motivational incentives, to organize care, to improve the doctor-patient relationship and to involve other health care providers. Copyright © 2017 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.

Goal-Oriented Ethics: Framing the Goal-Setting Concretely

Directory of Open Access Journals (Sweden)

Mathew Illathuparampil

2017-10-01

Full Text Available Joseph Selling, professor emeritus from KU Leuven, Belgium, recently made a significant contribution towards ethical methodology. It is in fact a continuation of the in-house conversations that have been in vogue about methods in moral reasoning since Vatican II in the discipline called theological ethics. What is specific about Selling’s attempt is that he re-orients or reframes the evaluation of the moral event to consider human intentionality or motivation before considering human behavior or human acts. He convincingly establishes his method by a meticulous reading of Thomas Aquinas. This paper is a response to the goal-oriented ethics that he has posited. As illustrated below, this paper evaluates the goal-oriented approach as solid and sufficient. While fully endorsing this approach, this paper argues that the process of ethical goal-setting is to be framed concretely. In a concrete historical context, so that a goal-oriented approach fully serves its purpose, this paper proposes that it is to be reinforced by four supportive pillars, which are in fact assumed by Selling in his work. They are openness to human sciences, conversation among various narratives, positing a theological frame for ethical reasoning, and recourse to non-discursive reasoning.

Goal Orientations, Locus of Control and Academic Achievement in Prospective Teachers: An Individual Differences Perspective

Science.gov (United States)

Bulus, Mustafa

2011-01-01

The aim of this study is to investigate the role of the prospective teachers' locus of control in goal orientations and of both orientations in academic achievement. The participants were 270 undergraduate students studying in different majors at the Faculty of Education in Pamukkale University. Goal Orientations and Locus of Control Scales were…

Goal conflict and goal facilitation as predictors of daily accelerometer-assessed physical activity.

Science.gov (United States)

Presseau, Justin; Tait, Richard I; Johnston, Derek W; Francis, Jill J; Sniehotta, Falko F

2013-12-01

To test whether perceptions of conflicting and facilitating personal goals, and actual daily time spent in their pursuit, predict accelerometer-assessed physical activity (PA). A prospective multilevel design with a daily accelerometer-based assessment of PA over 1 week was used (N = 106). Participants' personal goals were elicited using personal projects analysis. Participants then rated their personal goals in terms of how they were perceived to facilitate and conflict with their regular PA. Items assessing PA-specific intention and perceived behavioral control (PBC) were also embedded within the baseline measures. For the subsequent 7 consecutive days, participants completed a daily diary based on the day reconstruction method, indicating the time spent in daily episodes involving each of their personal goals, and wore an RT3 tri-axial accelerometer. The main outcome was accelerometer-assessed daily time spent in moderate to vigorous physical activity (MVPA). Random intercept multilevel models indicated that perceived goal facilitation, but not perceived goal conflict, predicted MVPA over and above intention and PBC. Daily time pursuing conflicting goals negatively predicted MVPA when subsequently added to the model and in so doing, attenuated the association between perceived goal facilitation and MVPA. Perceived goal facilitation predicts objectively measured PA over and above intention and PBC, but daily time spent in pursuit of conflicting personal goals provides a better account of how alternative goals relate to engaging in regular PA.

Molecular pathology and prostate cancer therapeutics: from biology to bedside.

Science.gov (United States)

Rodrigues, Daniel Nava; Butler, Lisa M; Estelles, David Lorente; de Bono, Johann S

2014-01-01

Prostate cancer (PCa) is the second most commonly diagnosed malignancy in men and has an extremely heterogeneous clinical behaviour. The vast majority of PCas are hormonally driven diseases in which androgen signalling plays a central role. The realization that castration-resistant prostate cancer (CRPC) continues to rely on androgen signalling prompted the development of new, effective androgen blocking agents. As the understanding of the molecular biology of PCas evolves, it is hoped that stratification of prostate tumours into distinct molecular entities, each with its own set of vulnerabilities, will be a feasible goal. Around half of PCas harbour rearrangements involving a member of the ETS transcription factor family. Tumours without this rearrangement include SPOP mutant as well as SPINK1-over-expressing subtypes. As the number of targeted therapy agents increases, it is crucial to determine which patients will benefit from these interventions and molecular pathology will be key in this respect. In addition to directly targeting cells, therapies that modify the tumour microenvironment have also been successful in prolonging the lives of PCa patients. Understanding the molecular aspects of PCa therapeutics will allow pathologists to provide core recommendations for patient management. Copyright © 2013 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Impacts of the Human Gut Microbiome on Therapeutics.

Science.gov (United States)

Vázquez-Baeza, Yoshiki; Callewaert, Chris; Debelius, Justine; Hyde, Embriette; Marotz, Clarisse; Morton, James T; Swafford, Austin; Vrbanac, Alison; Dorrestein, Pieter C; Knight, Rob

2018-01-06

The human microbiome contains a vast source of genetic and biochemical variation, and its impacts on therapeutic responses are just beginning to be understood. This expanded understanding is especially important because the human microbiome differs far more among different people than does the human genome, and it is also dramatically easier to change. Here, we describe some of the major factors driving differences in the human microbiome among individuals and populations. We then describe some of the many ways in which gut microbes modify the action of specific chemotherapeutic agents, including nonsteroidal anti-inflammatory drugs and cardiac glycosides, and outline the potential of fecal microbiota transplant as a therapeutic. Intriguingly, microbes also alter how hosts respond to therapeutic agents through various pathways acting at distal sites. Finally, we discuss some of the computational and practical issues surrounding use of the microbiome to stratify individuals for drug response, and we envision a future where the microbiome will be modified to increase everyone's potential to benefit from therapy.

Effect of radioimmunoassay procedures on therapeutic drug monitoring

International Nuclear Information System (INIS)

Kampa, I.S.

1985-01-01

Methods for the measurement of therapeutic drugs have covered every aspect of analysis from extraction to derivatization. In general, published methods were modified to shorten drug extractions and overall analysis time. The use of different standards, as well as the frequent omission of internal standards, often produced large and clinically unacceptable analytical variations. As a result, physicians would adjust drug dosages according to the physiological response to a standard dose. The introduction of radioimmunoassay techniques for the quantitation of therapeutic drugs have made a significant impact on the clinical chemistry laboratory. The similarities of the various assay methods and the technologists' familiarity with the assay protocols have produced clinically relevant results. Clinical laboratories are now able to frequently analyze a large number of samples with acceptable accuracy and precision. The esoteric test once performed infrequently is today a routine analytical assay often performed STAT. Therapeutic drug monitoring has become a major activity in many clinical laboratories

(Goal Number 8) in achieving the Millennium Development Goals

African Journals Online (AJOL)

In 2000, the United Nations (UN) made a Millennium Declaration that commits governments across the globe to develop the lives of the people by 2015. This declaration is known as Millennium Development Goals (MDGs). This paper will examine the role that every government has to play in achieving the goals by focusing ...

Therapeutic follow-up in hospitalization: social inclusion, recovery of citizenship and respect for individuality

Directory of Open Access Journals (Sweden)

Regina Célia Fiorati

2008-01-01

Full Text Available This study was carried out in a psychiatric crisis hospitalization unit, with the aim of drawing up a proposal for implementing therapeutic follow-up as part of the therapeutic program at this unit. The concept of therapeutic follow-up was envisaged as an important resource to be included in psychosocial rehabilitation projects, with the following goals: linking users with extra-hospital services, avoiding re-hospitalization and achieving inclusion in social networks. The study consisted of an exploratory-descriptive case study with a qualitative approach to data. Participant observation and a field diary were the techniques used for gathering and recording data. The difficulties experienced were correlated with the spheres of social networks, family, institutional relationships and society. The results included heeding the patient's and the family's suffering and including users in social networks, extra-hospital services and community organizations.

Dynamics of multiple-goal pursuit.

Science.gov (United States)

Louro, Maria J; Pieters, Rik; Zeelenberg, Marcel

2007-08-01

The authors propose and test a model of multiple-goal pursuit that specifies how individuals allocate effort among multiple goals over time. The model predicts that whether individuals decide to step up effort, coast, abandon the current goal, or switch to pursue another goal is determined jointly by the emotions that flow from prior goal progress and the proximity to future goal attainment, and proximally determined by changes in expectancies about goal attainment. Results from a longitudinal diary study and 2 experiments show that positive and negative goal-related emotions can have diametrically opposing effects on goal-directed behavior, depending on the individual's proximity to goal attainment. The findings resolve contrasting predictions about the influence of positive and negative emotions in volitional behavior, critically amend the goal gradient hypothesis, and provide new insights into the dynamics and determinants of multiple-goal pursuit.

Achievement goals and interpersonal behaviour: How mastery and performance goals shape information exchange

NARCIS (Netherlands)

Poortvliet, P.M.; Janssen, O.; Van Yperen, N.W.; Van de Vliert, E.

2007-01-01

The present research examines the impact of achievement goals on task-related information exchange. Studies 1 and 2 reveal that relative to those with mastery goals or no goal, individuals pursuing performance goals were less open in their information giving to exchange partners. Study 2 further

Introduction to the Theme "New Methods and Novel Therapeutic Approaches in Pharmacology and Toxicology".

Science.gov (United States)

Insel, Paul A; Amara, Susan G; Blaschke, Terrence F; Meyer, Urs A

2017-01-06

Major advances in scientific discovery and insights can result from the development and use of new techniques, as exemplified by the work of Solomon Snyder, who writes a prefatory article in this volume. The Editors have chosen "New Methods and Novel Therapeutic Approaches in Pharmacology and Toxicology" as the Theme for a number of articles in this volume. These include ones that review the development and use of new experimental tools and approaches (e.g., nanobodies and techniques to explore protein-protein interactions), new types of therapeutics (e.g., aptamers and antisense oligonucleotides), and systems pharmacology, which assembles (big) data derived from omics studies together with information regarding drugs and patients. The application of these new methods and therapeutic approaches has the potential to have a major impact on basic and clinical research in pharmacology and toxicology as well as on patient care.

A therapeutic HIV vaccine using coxsackie-HIV recombinants: a possible new strategy.

Science.gov (United States)

Halim, S S; Collins, D N; Ramsingh, A I

2000-10-10

The ultimate goal in the treatment of HIV-infected persons is to prevent disease progression. A strategy to accomplish this goal is to use chemotherapy to reduce viral load followed by immunotherapy to stimulate HIV-specific immune responses that are observed in long-term asymptomatic individuals. An effective, live, recombinant virus, expressing HIV sequences, would be capable of inducing both CTL and CD4(+) helper T cell responses. To accomplish these goals, the viral vector must be immunogenic yet retain its avirulent phenotype in a T cell-deficient host. We have identified a coxsackievirus variant, CB4-P, that can induce protective immunity against a virulent variant. In addition, the CB4-P variant remains avirulent in mice lacking CD4(+) helper T cells, suggesting that CB4-P may be uniquely suited as a viral vector for a therapeutic HIV vaccine. Two strategies designed to elicit CTL and CD4(+) helper T cell responses were used to construct CB4-P/HIV recombinants. Recombinant viruses were viable, genetically stable, and retained the avirulent phenotype of the parental virus. In designing a viral vector for vaccine development, an issue that must be addressed is whether preexisting immunity to the vector would affect subsequent administration of the recombinant virus. Using a test recombinant, we showed that prior exposure to the parental CB4-P virus did not affect the ability of the recombinant to induce a CD4(+) T cell response against the foreign sequence. The results suggest that a "cocktail" of coxsackie/HIV recombinants may be useful as a therapeutic HIV vaccine.

Advances in the delivery of RNA therapeutics: from concept to clinical reality.

Science.gov (United States)

Kaczmarek, James C; Kowalski, Piotr S; Anderson, Daniel G

2017-06-27

The rapid expansion of the available genomic data continues to greatly impact biomedical science and medicine. Fulfilling the clinical potential of genetic discoveries requires the development of therapeutics that can specifically modulate the expression of disease-relevant genes. RNA-based drugs, including short interfering RNAs and antisense oligonucleotides, are particularly promising examples of this newer class of biologics. For over two decades, researchers have been trying to overcome major challenges for utilizing such RNAs in a therapeutic context, including intracellular delivery, stability, and immune response activation. This research is finally beginning to bear fruit as the first RNA drugs gain FDA approval and more advance to the final phases of clinical trials. Furthermore, the recent advent of CRISPR, an RNA-guided gene-editing technology, as well as new strides in the delivery of messenger RNA transcribed in vitro, have triggered a major expansion of the RNA-therapeutics field. In this review, we discuss the challenges for clinical translation of RNA-based therapeutics, with an emphasis on recent advances in delivery technologies, and present an overview of the applications of RNA-based drugs for modulation of gene/protein expression and genome editing that are currently being investigated both in the laboratory as well as in the clinic.

Therapeutic Enzymes: Applications and Approaches to Pharmacological Improvement.

Science.gov (United States)

Yari, Maryam; Ghoshoon, Mohammad B; Vakili, Bahareh; Ghasemi, Younes

2017-01-01

Among therapeutic proteins, enzymes represent small and of course profitable market. They can be used to treat important, rare, and deadly diseases. Enzyme therapy is the only available treatment for certain disorders. Here, pharmaceutical enzymes are reviewed. They are categorized in four main groups, enzymes in replacement therapy, enzymes in cancer treatment, enzymes for fibrinolysis, and finally enzymes that are used topically for various treatments. Furthermore, enzyme gene therapy and future perspective of therapeutic enzymes are mentioned in brief. There are many important approved enzymes in pharmaceutical market. Several approaches such as point mutation, fusion protein designing, glycoengineering, and PEGylation were used to achieve improved enzymes. Although sometimes enzymes were engineered to facilitate production and purification process, appropriate delivery to target sites, extending half-life, and reducing immunogenicity are among the main goals of engineering approaches. Overall, enzymes play a critical role in treatment of common and rare diseases. Evaluation of new enzymes as well as improvement of approved enzymes are of the most important challenges in biotechnology. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

The transition from youth to adulthood and the importance of hope and life goals

DEFF Research Database (Denmark)

Olsen, Jan Brødslev; Hansen, Claus D.

It is widely accepted among scholars (Erikson, Levinson, Arnett, Marcia) that the transition from childhood to adulthood is a life-period in its own right and with its own developmental efforts and tasks. It is therefore obvious that hope and life goals must play an important role in this period....... The presentation examines the possible links between hope defined as ‘a positive motivational state’, the major life goals young adults have set themselves and their socioeconomic background. The presentation is based on the longitudinal study “The West Jutland Cohort Study”, a birth cohort study of all...... adolescents born in 1989 (n=3,054) living in Ringkjøbing County, Denmark in 2004. The third wave of the study included the Trait Hope Scale (Snyder 2002) as well as several items tapping into the major life goals that the young adults were pursuing at age 20/21. The results show clear socioeconomic...

Goal-Directed Visual Attention Drives Health Goal Priming: An Eye-Tracking Experiment

NARCIS (Netherlands)

Laan, van der Laura N.; Hooge, I.T.C.; Smeets, P.A.M.

2017-01-01

Objective: Several lab and field experiments have shown that goal priming interventions can be highly effective in promoting healthy food choices. Less is known, however, about the mechanisms by which goal priming affects food choice. This experiment tested the hypothesis that goal priming affects

Goals are not selfish.

Science.gov (United States)

von Hippel, William; von Hippel, Frank A

2014-04-01

The metaphor of selfish goals is misguided. Organisms can be considered vessels that further the interests of their genes, but not vessels that further the interests of their goals. Although goals can act at cross-purposes to each other and to longevity, such trade-offs are predicted by evolutionary theory. The metaphor of selfish goals provides no purchase on this problem.

Goal-setting in clinical medicine.

Science.gov (United States)

Bradley, E H; Bogardus, S T; Tinetti, M E; Inouye, S K

1999-07-01

The process of setting goals for medical care in the context of chronic disease has received little attention in the medical literature, despite the importance of goal-setting in the achievement of desired outcomes. Using qualitative research methods, this paper develops a theory of goal-setting in the care of patients with dementia. The theory posits several propositions. First, goals are generated from embedded values but are distinct from values. Goals vary based on specific circumstances and alternatives whereas values are person-specific and relatively stable in the face of changing circumstances. Second, goals are hierarchical in nature, with complex mappings between general and specific goals. Third, there are a number of factors that modify the goal-setting process, by affecting the generation of goals from values or the translation of general goals to specific goals. Modifying factors related to individuals include their degree of risk-taking, perceived self-efficacy, and acceptance of the disease. Disease factors that modify the goal-setting process include the urgency and irreversibility of the medical condition. Pertinent characteristics of the patient-family-clinician interaction include the level of participation, control, and trust among patients, family members, and clinicians. The research suggests that the goal-setting process in clinical medicine is complex, and the potential for disagreements regarding goals substantial. The nature of the goal-setting process suggests that explicit discussion of goals for care may be necessary to promote effective patient-family-clinician communication and adequate care planning.

Motivational Goal Bracketing: An Experiment

DEFF Research Database (Denmark)

Koch, Alexander; Nafziger, Julia

We study in an online, real-effort experiment how the bracketing of non-binding goals affects performance in a work-leisure self-control problem. We externally induce the goal bracket - daily goals or a weekly goal - and within that bracket let subjects set goals for how much they want to work over...... a one-week period. Our theoretical model predicts (i) that weekly goals create incentives to compensate for a lower than desired performance today with the promise to work harder tomorrow, whereas daily goals exclude such excuses; (ii) that subjects with daily goals set higher goals in aggregate...... and work harder than those with weekly goals. Our data support these predictions. Surprisingly, however, when goals are combined with an externally enforced commitment that requires subjects to spend less than a minute each day on the task to get started working, performance deteriorates because of high...

A new therapeutic community: development of a compassion-focussed and contextual behavioural environment.

Science.gov (United States)

Veale, David; Gilbert, Paul; Wheatley, Jon; Naismith, Iona

2015-01-01

Social relationships and communities provide the context and impetus for a range of psychological developments, from genetic expression to the development of core self-identities. This suggests a need to think about the therapeutic changes and processes that occur within a community context and how communities can enable therapeutic change. However, the 'therapeutic communities' that have developed since the Second World War have been under-researched. We suggest that the concept of community, as a change process, should be revisited within mainstream scientific research. This paper briefly reviews the historical development of therapeutic communities and critically evaluates their current theory, practice and outcomes in a systematic review. Attention is drawn to recent research on the nature of evolved emotion regulation systems, the way these are entrained by social relationships, the importance of affiliative emotions in the regulation of threat and the role of fear of affiliative emotions in psychopathology. We draw on concepts from compassion-focussed therapy, social learning theory and functional analytical psychotherapy to consider how members of a therapeutic community can be aware of each other's acts of courage and respond using compassion. Living in structured and affiliative-orientated communities that are guided by scientific models of affect and self-regulation offers potential therapeutic advantages over individual outpatient therapy for certain client groups. This conclusion should be investigated further. Key Practitioner Message Current therapeutic community practice is not sufficiently evidence based and may not be maximizing the potential therapeutic value of a community. Compassion-focussed therapy and social learning theory offer new approaches for a therapeutic environment, involving an understanding of the role, nature and complexities of compassionate and affiliative relationships from staff and members, behavioural change guided by

Defining safety goals. 2. Basic Consideration on Defining Safety Goals

International Nuclear Information System (INIS)

Hakata, T.

2001-01-01

The purpose of this study is to develop basic safety goals that are rational and consistent for all nuclear facilities, including nuclear power plants and fuel cycle facilities. Basic safety goals (risk limits) by an index of radiation dose are discussed, which are based on health effects of detriment and fatality and risk levels presumably accepted by society. The contents of this paper are the personal opinions of the author. The desirable structure of safety goals is assumed to be 'basic safety goals plus specific safety goals (or supplemental safety goals) for each sort of facility, which reflects their characteristics'. The requisites of the basic safety goals must include (a) rational bases (scientific and social), (b) comprehensiveness (common to all sorts of nuclear facilities covering from normal to accidental conditions), and (c) applicability. To meet the requirements, the basic safety goals might have to be a risk profile expression by an index of radiation dose. The societal rationality is consideration of absolute risk levels (10 -6 or 10 -7 /yr) and/or relative risk factors (such as 0.1% of U.S. safety goals) that the general public accepts as tolerable. The following quantitative objectives are adopted in this study for protection of average individuals in the vicinity of a nuclear facility: 1. The additive annual radiation dose during normal operation must be -4 /yr (health detriment), 2x10 -6 /yr (latent cancer and severe hereditary effects), and 10 -7 /yr (acute fatality) from the statistics in Japan. The radiation effects on human beings are determined by recommendations of UNSCEAR (Ref. 1) and ICRP. The health effects considered are non-severe stochastic health detriment, i.e., detectable opacities of lens of eye (threshold 5 0.5 to 2 Sv), depression of hematopoiesis of bone marrow (0.5 Sv), and depression of reproductive capability (temporary sterility of testes ) (0.15 Sv). The LD 50/60 of acute fatality is ∼4 Sv, and fatalities by latent

Intra Articular Therapeutic Delivery for Post Traumatic Osteoarthritis

Science.gov (United States)

2016-10-01

size distribution therapeutic timepoints EPIC-µCT Articular cartilage Subchondral bone Osteophytes Proteoglycans 3. OVERALL PROJECT SUMMARY: In...joint degeneration induced by MMT. Previously documented in Year 1 annual report: Changes in articular cartilage and subchondral bone morphology...and resulted in increased cartilage thickness at 3 weeks. The majority of alterations to subchondral bone (density, thickness) were detected at 3

Self-regulation of health behavior: social psychological approaches to goal setting and goal striving.

Science.gov (United States)

Mann, Traci; de Ridder, Denise; Fujita, Kentaro

2013-05-01

The goal of this article is to review and highlight the relevance of social psychological research on self-regulation for health-related theory and practice. We first review research on goal setting, or determining which goals to pursue and the criteria to determine whether one has succeeded. We discuss when and why people adopt goals, what properties of goals increase the likelihood of their attainment, and why people abandon goals. We then review research on goal striving, which includes the planning and execution of actions that lead to goal attainment, and the processes that people use to shield their goals from being disrupted by other competing goals, temptations, or distractions. We describe four types of strategies that people use when pursuing goals. We find that self-regulation entails the operation of a number of psychological mechanisms, and that there is no single solution that will help all people in all situations. We recommend a number of strategies that can help people to more effectively set and attain health-related goals. We conclude that enhancing health behavior requires a nuanced understanding and sensitivity to the varied, dynamic psychological processes involved in self-regulation, and that health is a prototypical and central domain in which to examine the relevance of these theoretical models for real behavior. We discuss the implications of this research for theory and practice in health-related domains. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Goal Conflict and Goal Commitment among Campus Parking Administrators in Higher Education

Science.gov (United States)

McKinney, David R.

2014-01-01

The purpose of this study was to determine the degree to which campus parking administrators in public higher education perceive they are experiencing goal conflict and the degree to which they differ in commitment to goals related to generating revenue and goals related to academics and service. The study also sought to determine the relationship…

Goal conflict and goal facilitation in community-based cardiac rehabilitation: a theory-based interview study.

Science.gov (United States)

Presseau, Justin; Boyd, Emily; Francis, Jill J; Sniehotta, Falko F

2015-01-01

Theories often consider behaviors in isolation of conflicting and facilitating personal goals. We conducted interviews with 13 people in cardiac rehabilitation, investigating whether eliciting physical activity (PA) control beliefs sufficiently captures goal conflict and goal facilitation. We assessed PA, intention, and control beliefs using standard elicitation methods and then assessed goal conflict and goal facilitation. Twelve participants described conflicting, and all described facilitating, personal goals. Most goal facilitation (94%) and conflict (82%) beliefs were identified beyond the control belief elicitation. Goal facilitation and conflict are not captured in a standard control belief elicitation and may supplement single-behavior models to understand PA.

Does monitoring goal progress promote goal attainment? A meta-analysis of the experimental evidence.

Science.gov (United States)

Harkin, Benjamin; Webb, Thomas L; Chang, Betty P I; Prestwich, Andrew; Conner, Mark; Kellar, Ian; Benn, Yael; Sheeran, Paschal

2016-02-01

Control theory and other frameworks for understanding self-regulation suggest that monitoring goal progress is a crucial process that intervenes between setting and attaining a goal, and helps to ensure that goals are translated into action. However, the impact of progress monitoring interventions on rates of behavioral performance and goal attainment has yet to be quantified. A systematic literature search identified 138 studies (N = 19,951) that randomly allocated participants to an intervention designed to promote monitoring of goal progress versus a control condition. All studies reported the effects of the treatment on (a) the frequency of progress monitoring and (b) subsequent goal attainment. A random effects model revealed that, on average, interventions were successful at increasing the frequency of monitoring goal progress (d+ = 1.98, 95% CI [1.71, 2.24]) and promoted goal attainment (d+ = 0.40, 95% CI [0.32, 0.48]). Furthermore, changes in the frequency of progress monitoring mediated the effect of the interventions on goal attainment. Moderation tests revealed that progress monitoring had larger effects on goal attainment when the outcomes were reported or made public, and when the information was physically recorded. Taken together, the findings suggest that monitoring goal progress is an effective self-regulation strategy, and that interventions that increase the frequency of progress monitoring are likely to promote behavior change. (c) 2016 APA, all rights reserved).

Goal setting in practice : the effects of personality and perceptions of the goal-setting process on job satisfaction and goal commitment

NARCIS (Netherlands)

Bipp, T.; Kleingeld, P.A.M.

2011-01-01

Purpose – The purpose of this study was to investigate how individual perceptions by employees of a goal-setting program and personality traits influence job satisfaction and goal commitment. Design/methodology/approach – Using the German version of Locke and Latham’s goal-setting questionnaire, 97

Therapeutic management of acute pulmonary embolism.

Science.gov (United States)

Tromeur, Cécile; Van Der Pol, Liselotte M; Couturaud, Francis; Klok, Frederikus A; Huisman, Menno V

2017-08-01

Acute pulmonary embolism (PE) is a potentially fatal manifestation of venous thromboembolism. Prompt anticoagulant treatment is crucial for PE patients, which can decrease morbidity and mortality. Risk assessment is the cornerstone of the therapeutic management of PE. It guides physicians to the most appropriate treatment and selects patients for early discharge or home treatment. Areas covered: Here, we review the current treatments of acute PE according to contemporary risk stratification strategies, highlighting each step of PE therapeutic management. Expert commentary: Currently, direct oral anticoagulants (DOACs) represent the first-line therapy of patients presenting with non-high risk PE with a better risk-benefit ratios than vitamin K antagonists (VKAs) due to lower risk of major bleeding. Only high-risk patients with PE who present in shock should be treated with systematic thrombolysis, while surgical thrombectomy or catheter direct thrombolysis (CDT) should only be considered when thrombolysis is contraindicated because of too high bleeding risk.

Goal selection versus process control while learning to use a brain-computer interface

Science.gov (United States)

Royer, Audrey S.; Rose, Minn L.; He, Bin

2011-06-01

A brain-computer interface (BCI) can be used to accomplish a task without requiring motor output. Two major control strategies used by BCIs during task completion are process control and goal selection. In process control, the user exerts continuous control and independently executes the given task. In goal selection, the user communicates their goal to the BCI and then receives assistance executing the task. A previous study has shown that goal selection is more accurate and faster in use. An unanswered question is, which control strategy is easier to learn? This study directly compares goal selection and process control while learning to use a sensorimotor rhythm-based BCI. Twenty young healthy human subjects were randomly assigned either to a goal selection or a process control-based paradigm for eight sessions. At the end of the study, the best user from each paradigm completed two additional sessions using all paradigms randomly mixed. The results of this study were that goal selection required a shorter training period for increased speed, accuracy, and information transfer over process control. These results held for the best subjects as well as in the general subject population. The demonstrated characteristics of goal selection make it a promising option to increase the utility of BCIs intended for both disabled and able-bodied users.

Disentangling self-management goal setting and action planning: A scoping review.

Directory of Open Access Journals (Sweden)

Stephanie Anna Lenzen

Full Text Available The ongoing rise in the numbers of chronically ill people necessitates efforts for effective self-management. Goal setting and action planning are frequently used, as they are thought to support patients in changing their behavior. However, it remains unclear how goal setting and action planning in the context of self-management are defined in the scientific literature. This study aimed to achieve a better understanding of the various definitions used.A scoping review was conducted, searching PubMed, Cinahl, PsychINFO and Cochrane. Inclusion and exclusion criteria were formulated to ensure the focus on goal setting/action planning and self-management. The literature was updated to December 2015; data selection and charting was done by two reviewers. A qualitative content analysis approach was used.Out of 9115 retrieved articles, 58 met the inclusion criteria. We created an overview of goal setting phases that were applied (preparation, formulation of goals, formulation of action plan, coping planning and follow-up. Although the phases we found are in accordance with commonly known frameworks for goal setting, it was striking that the majority of studies (n = 39, 67% did not include all phases. We also prepared an overview of components and strategies for each goal setting phase. Interestingly, few strategies were found for the communication between patients and professionals about goals/action plans. Most studies (n = 35, 60% focused goal setting on one single disease and on a predefined lifestyle behavior; nearly half of the articles (n = 27, 47% reported a theoretical framework.The results might provide practical support for developers of interventions. Moreover, our results might encourage professionals to become more aware of the phases of the goal setting process and of strategies emphasizing on patient reflection. However, more research might be useful to examine strategies to facilitate communication about goals/action plans. It might

Therapeutic Oligonucleotides Targeting Liver Disease: TTR Amyloidosis

Directory of Open Access Journals (Sweden)

Christoph Niemietz

2015-09-01

Full Text Available The liver has become an increasingly interesting target for oligonucleotide therapy. Mutations of the gene encoding transthyretin (TTR, expressed in vast amounts by the liver, result in a complex degenerative disease, termed familial amyloid polyneuropathy (FAP. Misfolded variants of TTR are linked to the establishment of extracellular protein deposition in various tissues, including the heart and the peripheral nervous system. Recent progress in the chemistry and formulation of antisense (ASO and small interfering RNA (siRNA designed for a knockdown of TTR mRNA in the liver has allowed to address the issue of gene-specific molecular therapy in a clinical setting of FAP. The two therapeutic oligonucleotides bind to RNA in a sequence specific manner but exploit different mechanisms. Here we describe major developments that have led to the advent of therapeutic oligonucleotides for treatment of TTR-related disease.

Policy for setting and assessing regulatory safety goals. Peer discussions on regulatory practices

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-10-01

This publication pertains to future planning for enhancement of good practices and it describes the experience to date in developing and implementing the policy for setting and assessing regulatory safety goals for nuclear facilities in 22 Member States. Senior regulators from these 22 Member States participated in four Peer Group discussions in 1993/94 which considered the policy used for setting and assessing regulatory safety goals. This publication presents the consensus views reached by the majority of these senior regulators.

Policy for setting and assessing regulatory safety goals. Peer discussions on regulatory practices

International Nuclear Information System (INIS)

1995-10-01

This publication pertains to future planning for enhancement of good practices and it describes the experience to date in developing and implementing the policy for setting and assessing regulatory safety goals for nuclear facilities in 22 Member States. Senior regulators from these 22 Member States participated in four Peer Group discussions in 1993/94 which considered the policy used for setting and assessing regulatory safety goals. This publication presents the consensus views reached by the majority of these senior regulators

Enhancing Congruence between Implicit Motives and Explicit Goal Commitments: Results of a Randomized Controlled Trial.

Science.gov (United States)

Roch, Ramona M; Rösch, Andreas G; Schultheiss, Oliver C

2017-01-01

Objective: Theory and research suggest that the pursuit of personal goals that do not fit a person's affect-based implicit motives results in impaired emotional well-being, including increased symptoms of depression. The aim of this study was to evaluate an intervention designed to enhance motive-goal congruence and study its impact on well-being. Method: Seventy-four German students (mean age = 22.91, SD = 3.68; 64.9% female) without current psychopathology, randomly allocated to three groups: motivational feedback (FB; n = 25; participants learned about the fit between their implicit motives and explicit goals), FB + congruence-enhancement training (CET; n = 22; participants also engaged in exercises to increase the fit between their implicit motives and goals), and a no-intervention control group ( n = 27), were administered measures of implicit motives, personal goal commitments, happiness, depressive symptoms, and life satisfaction 3 weeks before (T1) and 6 weeks after (T2) treatment. Results: On two types of congruence measures derived from motive and goal assessments, treated participants showed increases in agentic (power and achievement) congruence, with improvements being most consistent in the FB+CET group. Treated participants also showed a trend-level depressive symptom reduction, but no changes on other well-being measures. Although increases in overall and agentic motivational congruence were associated with increases in affective well-being, treatment-based reduction of depressive symptoms was not mediated by treatment-based agentic congruence changes. Conclusion: These findings document that motivational congruence can be effectively enhanced, that changes in motivational congruence are associated with changes in affective well-being, and they suggest that individuals' implicit motives should be considered when personal goals are discussed in the therapeutic process.

Punishment goals of crime victims.

Science.gov (United States)

Orth, Uli

2003-04-01

Research on subjective punishment goals has focused on the perspective of third-party observers of criminal offenses and neglected the perspective of victims. This study investigates punishment goals among 174 adult crime victims (rape and nonsexual assault) for each participant's real criminal case. Scales measuring support for punishment goals are constructed by factor analysis of an 18-item list. Results show that 5 highly supported goals can be distinguished: retaliation, recognition of victim status, confirmation of societal values, victim security, and societal security. Analysis of relations between punishment goal scales and personal variables, situational variables, and demanded punishment severity corroborates the view that the punishment goals revealed can be classified according to the two independent dichotomies of moral versus instrumental goals, and micro versus macro goals.

Snakebite Prognostic Factors: Leading Factors of Weak Therapeutic Response Following Snakebite Envenomation

Directory of Open Access Journals (Sweden)

Bita Dadpour

2012-12-01

Full Text Available Background: The goal of antivenom administration for snake-bitten patients is to achieve therapeutic response (initial control, which means reversal of the venom-induced effects through neutralizing the venom. The aim of this study was to identify snakebite prognostic factors of weak therapeutic response prior to antivenom administration. Methods: This was a retrospective study of patients with viperidae snakebite envenomation who were admitted to Mashhad Toxicology Centre during 2007-2011. Demographic features, clinical manifestations and snakebite severity score (SSS were collected prior to antivenom administration. Total number of antivenom vials administered to achieve therapeutic response and duration of hospitalization were also recorded. Potential factors in snakebite prognosis were analyzed by comparing in two groups of achieving therapeutic response with less than 5 vials and over 5 to calculate odds ratio.  Results: Total of 108 patients (male/female: 85/23 with mean (SD age of 34.5 (17.0 were studied. The most common manifestations included fang marks (100%, pain (100%, ecchymosis (89%, swelling (83%, blister formation (48% and thrombocytopenia (25%. In univariate analysis, thrombocytopenia (P=0.01, spontaneous bleeding (P=0.02, coagulopathic disturbances (P=0.007, swelling (P=0.003, progressive swelling (P=0.005, ecchymosis (P=0.05 and respiratory distress (P= 0.05 were significantly correlated to weak therapeutic response. Swelling and spontaneous bleeding were the strongest snakebite prognostic factors, as respectively they put the patients at 12.4 and 10.4 fold risks for difficult achievement of therapeutic response. Conclusions: In snakebite, some clinical manifestations in the first hours of admission and prior to antivenom administration are associated with weak therapeutic response. Identifying these prognostic factors, can assist health care providers to better estimate the patient’s needs and predict the final

Exploring fair and ambitious mitigation contributions under the Paris Agreement goals

NARCIS (Netherlands)

Pan, Xunzhang; Elzen, den Michel; Höhne, Niklas; Teng, Fei; Wang, Lining

2017-01-01

In order to achieve the Paris Agreement goals of keeping the temperature rise well below 2 °C or even 1.5 °C, all countries would need to make fair and ambitious contributions to reducing emissions. A vast majority of countries have adopted reduction targets by 2030 in their Nationally Determined

Islamic Educational Goals, Methods, and Content, with Emphasis on Shia' Faith

Science.gov (United States)

Alavi, Hamid Reza

2013-01-01

As a major world religion representing approximately 20% of the human family, Islam holds particular and significant educational perspectives. The purpose of this article is to identify and interpret the viewpoints of Islam on education (with emphasis on Shia' faith). To accomplish this aim, "educational goals" from the viewpoint of Islam have…

Health transformation plan: Goals achievement in Nemazee hospital

Directory of Open Access Journals (Sweden)

Ali Akbar Ahmadi

2016-01-01

Full Text Available Introduction: The main purpose of this study was to assess fulfillment of goals about “Health Transformation Plan (HTP of Ministry of Health, Treatment and Medical Education” from the perspective of managers, which is as one of the most important management challenges in the Health System Reform Plan. These goals included six packages determined by the Ministry of Health, Treatment and Medical Education, the fulfillment of each of which one was evaluated separately as sub-goals in the current study. Finally, the rank of each package in comparison to other packages was determined and presented, using means rank test (Friedman test. Method: This study was conducted using a questionnaire in which comments of the senior and middle managers of Nemazee hospital were collected as the research data. Due to the fact that about one year has passed since the beginning of implementation of HTP and since there were no documented methods or questionnaires, the researcher designed a self-made questionnaire. The basis of designing the questionnaire was the set of guidelines developed for Health System Reform Plan. These guidelines include goals that a hospital should achieve during implementation of Health System Reform Plan. After sharing these goals with senior and middle managers of Nemazee hospital (as the place of research, they were converted to a questionnaire including 20 questions. The questionnaire included the goals that must be achieved in Nemazee hospital of Shiraz during the implementation of the plan. After designing the questionnaire, a preliminary test was taken to assess the reliability. Results: Cronbach’s alpha coefficient (0.88 showed a high rate of reliability in the above questionnaire. After the final data collection, the questionnaire was tested in a sample of 100 senior and middle managers; the results showed that about six packages were specified by the Ministry of Health, Treatment and Medical Education. The majority of

Stability and Change in Social Goals as Related to Goal Structures and Engagement in School

Science.gov (United States)

Madjar, Nir

2017-01-01

The current studies explored (a) the extended external validity of social-goal-orientation framework; (b) the mediating role of social goals between classroom goal structures and students' engagement; and (c) whether changes in social goals can be explained by classroom goal structures and engagement. Study 1 was cross-sectional (N = 317), and…

Shopping the way to my goals: an analysis of purchase impact on perceived goal progress

Directory of Open Access Journals (Sweden)

Manuela Albornoz Gonçalves

Full Text Available Abstract This article examines the impact of goal related purchases on goal progress perception, and whether this perception depends on the strength of association between product and goal. To test how consumers perceive the act of purchasing goal-related products, three experiments were conducted in an online setting. Participants exposed to purchasing situations perceived greater goal progress than participants exposed to usage situation or a control group. In addition, studies show that this effect is a result of strength of association between product and goal, since participants exposed to more instrumental products perceived greater goal progress than participants exposed to less instrumental products. Therefore, these studies demonstrate how consumers interpret goal related purchases, and the mechanism that influences this interpretation.

The role of expectation in the therapeutic outcomes of alcohol and drug addiction treatments.

Science.gov (United States)

Spagnolo, Primavera A; Colloca, Luana; Heilig, Markus

2015-05-01

Throughout history, patient-physician relationships have been acknowledged as an important component of the therapeutic effects of any pharmacological treatment. Here, we discuss the role of physicians' expectations in influencing the therapeutic outcomes of alcohol and drug addiction pharmacological treatments. As largely demonstrated, such expectations and attitudes may contribute to produce placebo and nocebo effects that in turn affect the course of the disease and the response to the therapy. This article is aimed at discussing the current insights into expectations, placebo and nocebo mechanisms and their impact on the therapeutic outcomes of alcohol and drug addiction treatments; with the goal of informing physicians and other health care providers about the potentially widespread implications for clinical practice and for a successful treatment regimen. Published by Oxford University Press on behalf of Medical Council on Alcohol 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Manufacturing of Human Extracellular Vesicle-Based Therapeutics for Clinical Use

Directory of Open Access Journals (Sweden)

Mario Gimona

2017-06-01

Full Text Available Extracellular vesicles (EVs derived from stem and progenitor cells may have therapeutic effects comparable to their parental cells and are considered promising agents for the treatment of a variety of diseases. To this end, strategies must be designed to successfully translate EV research and to develop safe and efficacious therapies, whilst taking into account the applicable regulations. Here, we discuss the requirements for manufacturing, safety, and efficacy testing of EVs along their path from the laboratory to the patient. Development of EV-therapeutics is influenced by the source cell types and the target diseases. In this article, we express our view based on our experience in manufacturing biological therapeutics for routine use or clinical testing, and focus on strategies for advancing mesenchymal stromal cell (MSC-derived EV-based therapies. We also discuss the rationale for testing MSC-EVs in selected diseases with an unmet clinical need such as critical size bone defects, epidermolysis bullosa and spinal cord injury. While the scientific community, pharmaceutical companies and clinicians are at the point of entering into clinical trials for testing the therapeutic potential of various EV-based products, the identification of the mode of action underlying the suggested potency in each therapeutic approach remains a major challenge to the translational path.

The therapeutic relationship in e-therapy for mental health: a systematic review.

Science.gov (United States)

Sucala, Madalina; Schnur, Julie B; Constantino, Michael J; Miller, Sarah J; Brackman, Emily H; Montgomery, Guy H

2012-08-02

E-therapy is defined as a licensed mental health care professional providing mental health services via e-mail, video conferencing, virtual reality technology, chat technology, or any combination of these. The use of e-therapy has been rapidly expanding in the last two decades, with growing evidence suggesting that the provision of mental health services over the Internet is both clinically efficacious and cost effective. Yet there are still unanswered concerns about e-therapy, including whether it is possible to develop a successful therapeutic relationship over the Internet in the absence of nonverbal cues. Our objective in this study was to systematically review the therapeutic relationship in e-therapy. We searched PubMed, PsycINFO, and CINAHL through August 2011. Information on study methods and results was abstracted independently by the authors using a standardized form. From the 840 reviewed studies, only 11 (1.3%) investigated the therapeutic relationship. The majority of the reviewed studies were focused on the therapeutic alliance-a central element of the therapeutic relationship. Although the results do not allow firm conclusions, they indicate that e-therapy seems to be at least equivalent to face-to-face therapy in terms of therapeutic alliance, and that there is a relationship between the therapeutic alliance and e-therapy outcome. Overall, the current literature on the role of therapeutic relationship in e-therapy is scant, and much more research is needed to understand the therapeutic relationship in online environments.

Goal setting in psychotherapy: the relevance of approach and avoidance goals for treatment outcome.

Science.gov (United States)

Wollburg, Eileen; Braukhaus, Christoph

2010-07-01

The present study is the first aimed at investigating the influence of goal definition on treatment outcome in a sample of depressed patients. Data from 657 inpatients admitted to a psychosomatic clinic in Germany being treated in a cognitive-behavioral therapy program were analyzed. Treatment goals were identified as either approach or avoidance, and the sample was classified accordingly. Patients who identified approach goals only were placed in the approach group, and those who identified at least one avoidance goal were placed in the avoidance group. Results showed that framing goals using avoidance terms was associated with less symptomatic improvement but did not affect goal attainment. Findings from this research should be utilized in practice not only for process management such as individual treatment planning but also to control outcome quality. Furthermore, goal definition should be considered as a control variable in research on depression.

Students' Perceptions of Parental and Teacher Academic Involvement: Consequences on Achievement Goals

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Regner, Isabelle; Loose, Florence; Dumas, Florence

2009-01-01

The present study examined whether students' perceptions of two major facets of parental and teacher academic involvement (i.e., academic support and academic monitoring), contribute to the process of students' achievement goals adoption. French junior high-school students completed two questionnaires assessing first their perceptions of parental…

Family Traditions, Cultural Values, and the Clinician's Countertransference: Therapeutic Assessment of a Young Sicilian Woman.

Science.gov (United States)

Fantini, Francesca

2016-01-01

Despite recent advances in models and instruments to understand the role of a client's cultural background, clinical psychologists are not immune to implicit cultural biases that are potentially damaging to the therapeutic alliance. In this article, I present a Therapeutic Assessment with a young Sicilian woman conducted in a university-based student clinic in Italy. During the assessment, I assumed that because we were both Italians, my client shared my perspective (northern Italian) about family and individual values, which resulted in a therapeutic impasse when I responded on the basis of my individual and culturally shaped view of interpersonal and family relationships without appreciating important differences between my own and my client's microcultures. To overcome the impasse, I had to openly acknowledge such differences and reorient myself to my client's goals. I discuss the core processes involved in such a repair in the context of a cross-cultural psychological assessment.

A roadmap for the EU White Paper goal on Urben Transport

DEFF Research Database (Denmark)

Gudmundsson, Henrik; Schippl, Jens; Leiren, Merethe Dotterud

2015-01-01

in urban transport by 2030; and to phase them out by 2050; and to achieve “essentially CO2-free city logistics in major urban centres by 2030.” The question driving the research behind this paper is how to realise this dual urban transport goal for 2030, taking into consideration existing trends, available...

Therapeutic Efficacy Comparison of 5 Major EGFR-TKIs in Advanced EGFR-positive Non-Small-cell Lung Cancer: A Network Meta-analysis Based on Head-to-Head Trials.

Science.gov (United States)

Zhang, Yaxiong; Zhang, Zhonghan; Huang, Xiaodan; Kang, Shiyang; Chen, Gang; Wu, Manli; Miao, Siyu; Huang, Yan; Zhao, Hongyun; Zhang, Li

2017-09-01

Five major first- and second-generation epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), including erlotinib, gefitinib, icotinib, afatinib, and dacomitinib, are currently optional for patients with advanced non-small-cell lung cancer (NSCLC) who harbor EGFR mutations. However, there was no head-to-head-based network meta-analysis among all the TKIs in EGFR-mutated populations. Eligible literature was searched from an electronic database. Data of objective response rate, disease control rate, progression-free survival, and overall survival were extracted from enrolled studies. Multiple treatment comparisons based on Bayesian network integrated the efficacy of all included treatments. Six phase III randomized trials involving 1055 EGFR-mutated patients with advanced NSCLC were enrolled. Multiple treatment comparisons showed that 5 different EGFR-TKIs shared equivalent therapeutic efficacy in terms of all outcome measures. Rank probabilities indicated that dacomitinib and afatinib had potentially better efficacy compared with erlotinib, gefitinib, and icotinib in the EGFR-mutated patients. When compared with other agents, potential survival benefits (progression-free and overall survival) were observed in dacomitinib, whereas afatinib showed a better rank probability in overall response rate and disease control rate. Our study indicated a preferable therapeutic efficacy in the second-generation TKIs (dacomitinib and afatinib) when compared with the first-generation TKIs (erlotinib, gefitinib, and icotinib). Copyright © 2016 Elsevier Inc. All rights reserved.

Achievement goals affect metacognitive judgments

Science.gov (United States)

Ikeda, Kenji; Yue, Carole L.; Murayama, Kou; Castel, Alan D.

2017-01-01

The present study examined the effect of achievement goals on metacognitive judgments, such as judgments of learning (JOLs) and metacomprehension judgments, and actual recall performance. We conducted five experiments manipulating the instruction of achievement goals. In each experiment, participants were instructed to adopt mastery-approach goals (i.e., develop their own mental ability through a memory task) or performance-approach goals (i.e., demonstrate their strong memory ability through getting a high score on a memory task). The results of Experiments 1 and 2 showed that JOLs of word pairs in the performance-approach goal condition tended to be higher than those in the mastery-approach goal condition. In contrast, cued recall performance did not differ between the two goal conditions. Experiment 3 also demonstrated that metacomprehension judgments of text passages were higher in the performance-approach goal condition than in the mastery-approach goals condition, whereas test performance did not differ between conditions. These findings suggest that achievement motivation affects metacognitive judgments during learning, even when achievement motivation does not influence actual performance. PMID:28983496

From goal motivation to goal progress: the mediating role of coping in the Self-Concordance Model.

Science.gov (United States)

Gaudreau, Patrick; Carraro, Natasha; Miranda, Dave

2012-01-01

The present studies examined the mediating role of self-regulatory mechanisms in the relationship between goal motivation and goal progress in the Self-Concordance Model. First, a systematic review, using meta-analytical path analysis, supported the mediating role of effort and action planning in the positive association between autonomous goal motivation and goal progress. Second, results from two additional empirical studies, using structural equation modeling, lent credence to the mediating role of coping in the relationship between goal motivation and goal progress of university students. Autonomous goal motivation was positively associated with task-oriented coping, which predicted greater goal progress during midterm exams (Study 1, N=702) and at the end of the semester in a different sample (Study 2, N=167). Controlled goal motivation was associated with greater disengagement-oriented coping (Study 1 and Study 2) and lesser use of task-oriented coping (Study 2), which reduced goal progress. These results held up after controlling for perceived stress (Study 2). Our findings highlight the importance of coping in the "inception-to-attainment" goal process because autonomous goal motivation indirectly rather than directly predicts goal progress of university students through their usage of task-oriented coping.

Curricular Goals and Personal Goals in Master's Thesis Projects: Dutch Student-Supervisor Dyads

Science.gov (United States)

de Kleijn, Renske A. M.; Meijer, Paulien C.; Brekelmans, Mieke; Pilot, Albert

2013-01-01

To be effective, feedback should be goal-related. In order to better understand goal-related feedback in Master's thesis projects, the present study explores the goals of supervisors and students in supervision dyads and similarities and differences within and between these dyads. Twelve supervisors and students were interviewed, and their goals…

Doubling the number of physics majors who teach

Science.gov (United States)

Marder, Michael

2009-03-01

The American Physical Society has adopted a doubling initiative to increase the number of physics majors. One of the main motivations is to increase the number of physics majors certified to teach secondary physics. I will review some of the possible strategies for reaching this goal, and discuss some of the steps we have taken with UTeach, the program for secondary science and mathematics teacher preparation at The University of Texas at Austin.I will discuss the roles of curriculum revision, financial support, and community support in convincing majors to teach. Finally, I will talk about the expansion of UTeach into engineering.

Self-regulation through Goal Setting

DEFF Research Database (Denmark)

Koch, Alexander; Nafziger, Julia

2011-01-01

Goals are an important motivator. But little is known about why and how people set them. We address this issue in a model based on two stylized facts. i) Goals serve as reference points for performance. ii) Present-biased preferences create self-control problems. We show the power and limits...... of self-regulation through goals. Goals increase an individual's motivation - but only up to a certain point. And they are painful self-disciplining devices. Greater self-control problems may result in tougher goals; but for a severe present bias goals either lack motivating force, or are too painful...

Predicting race performance in triathlon: the role of perfectionism, achievement goals, and personal goal setting.

Science.gov (United States)

Stoeber, Joachim; Uphill, Mark A; Hotham, Sarah

2009-04-01

The question of how perfectionism affects performance is highly debated. Because empirical studies examining perfectionism and competitive sport performance are missing, the present research investigated how perfectionism affected race performance and what role athletes' goals played in this relationship in two prospective studies with competitive triathletes (Study 1: N = 112; Study 2: N = 321). Regression analyses showed that perfectionistic personal standards, high performance-approach goals, low performance-avoidance goals, and high personal goals predicted race performance beyond athletes' performance level. Moreover, the contrast between performance-avoidance and performance-approach goals mediated the relationship between perfectionistic personal standards and performance, whereas personal goal setting mediated the relationship between performance-approach goals and performance. The findings indicate that perfectionistic personal standards do not undermine competitive performance, but are associated with goals that help athletes achieve their best possible performance.

Next Generation Sequencing Identifies Five Major Classes of Potentially Therapeutic Enzymes Secreted by Lucilia sericata Medical Maggots.

Science.gov (United States)

Franta, Zdeněk; Vogel, Heiko; Lehmann, Rüdiger; Rupp, Oliver; Goesmann, Alexander; Vilcinskas, Andreas

2016-01-01

Lucilia sericata larvae are used as an alternative treatment for recalcitrant and chronic wounds. Their excretions/secretions contain molecules that facilitate tissue debridement, disinfect, or accelerate wound healing and have therefore been recognized as a potential source of novel therapeutic compounds. Among the substances present in excretions/secretions various peptidase activities promoting the wound healing processes have been detected but the peptidases responsible for these activities remain mostly unidentified. To explore these enzymes we applied next generation sequencing to analyze the transcriptomes of different maggot tissues (salivary glands, gut, and crop) associated with the production of excretions/secretions and/or with digestion as well as the rest of the larval body. As a result we obtained more than 123.8 million paired-end reads, which were assembled de novo using Trinity and Oases assemblers, yielding 41,421 contigs with an N50 contig length of 2.22 kb and a total length of 67.79 Mb. BLASTp analysis against the MEROPS database identified 1729 contigs in 577 clusters encoding five peptidase classes (serine, cysteine, aspartic, threonine, and metallopeptidases), which were assigned to 26 clans, 48 families, and 185 peptidase species. The individual enzymes were differentially expressed among maggot tissues and included peptidase activities related to the therapeutic effects of maggot excretions/secretions.

Goal directed fluid therapy decreases postoperative morbidity but not mortality in major non-cardiac surgery: a meta-analysis and trial sequential analysis of randomized controlled trials.

Science.gov (United States)

Som, Anirban; Maitra, Souvik; Bhattacharjee, Sulagna; Baidya, Dalim K

2017-02-01

Optimum perioperative fluid administration may improve postoperative outcome after major surgery. This meta-analysis and systematic review has been aimed to determine the effect of dynamic goal directed fluid therapy (GDFT) on postoperative morbidity and mortality in non-cardiac surgical patients. Meta-analysis of published prospective randomized controlled trials where GDFT based on non-invasive flow based hemodynamic measurement has been compared with a standard care. Data from 41 prospective randomized trials have been included in this study. Use of GDFT in major surgical patients does not decrease postoperative hospital/30-day mortality (OR 0.70, 95 % CI 0.46-1.08, p = 0.11) length of post-operative hospital stay (SMD -0.14; 95 % CI -0.28, 0.00; p = 0.05) and length of ICU stay (SMD -0.12; 95 % CI -0.28, 0.04; p = 0.14). However, number of patients having at least one postoperative complication is significantly lower with use of GDFT (OR 0.57; 95 % CI 0.43, 0.75; p infection (p = 0.002) and postoperative hypotension (p = 0.04) are also decreased with used of GDFT as opposed to a standard care. Though patients who received GDFT were infused more colloid (p infection, abdominal complications and postoperative hypotension is reduced.

Immunological mechanism underlying the immune response to tecombinant human protein therapeutics

NARCIS (Netherlands)

Sauerborn, M.S.; Brinks, V.; Jiskoot, W.; Schellekens, H.

2010-01-01

Recombinant human (rhu) protein therapeutics are powerful tools to treat several severe diseases such as multiple sclerosis and diabetes mellitus, among others. A major drawback of these proteins is the production of anti-drug antibodies (ADAs). In some cases, these ADAs have neutralizing capacity

Perception in the service of goal pursuit : Motivation to attain goals enhances the perceived size of goal instrumental objects.

NARCIS (Netherlands)

Veltkamp, M.; Aarts, H.; Custers, R.

2008-01-01

Two experiments tested the functional perception hypothesis (Bruner, 1957) according to which objects that are instrumental in attaining ones' goals are perceived to be bigger if one is motivated to attain these goals. Study 1 demonstrated that participants perceived a glass of water to be bigger

Maternal Feeding Goals and Restaurant Menu Choices for Young Children.

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Domoff, Sarah E; Kiefner-Burmeister, Allison; Hoffmann, Debra A; Musher-Eizenman, Dara

2015-08-01

Childhood obesity remains a major public health issue. One recent effort to improve the obesogenic environment is mandating that restaurants provide calorie and other nutritional content on menus. Little is known about whether maternal feeding for young children is influenced by calorie disclosure on menus. This study examined (1) whether maternal feeding goals associate with mothers' food selections for their young children and (2) whether mothers change entrée and side selections for their children when calories/fat grams are listed on menus. One-hundred seventy mothers of children ages of 3-6 years participated in an online survey. Most participants identified as white (76.5%), with a mean BMI of 25.68 (standard deviation=5.94). Mothers were presented two menus (one with and one without calorie/fat information). The goal of feeding for the child's familiarity with the food was significantly associated with mothers' selection of original side dish and entrées, with greater endorsement of this goal associated with choosing high-calorie/-fat sides and entrées. Feeding for natural content was associated with mothers' selection of original entrée, with greater endorsement of this goal associated with choosing low-calorie/-fat entrées. Significantly fewer mothers chose a higher-calorie entrée when there was menu labeling. Maternal feeding goals are associated with mothers' selection of entrée and side dishes on restaurant menus. Results from this study suggest that menu labeling of calories and fat grams may influence entrée choices by mothers. Targeting mothers' feeding goals and labeling restaurant menus may improve the diets of young children.

Update on therapeutic interventions for the management of achalasia.

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Gunasingam, Nishmi; Perczuk, Adam; Talbot, Michael; Kaffes, Arthur; Saxena, Payal

2016-08-01

Achalasia is a primary esophageal motility disorder. It is the absence of peristalsis in the esophageal body and inability of the lower esophageal sphincter to relax, which characterizes this rare condition. Its features typically include dysphagia, regurgitation, chest pain, and weight loss. The ultimate goal in treating achalasia is to relieve the patient's symptoms, improve esophageal emptying, and prevent further dilatation of the esophagus. Current treatment modalities targeted at achalasia include pharmacological therapy, endoscopic therapy, and surgery. This review focuses on the current therapeutic options and explores the role of peroral endoscopic myotomy in the management armamentarium. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Increasing the risk of spontaneous abortion and major malformations in newborns following use of serotonin reuptake inhibitors during pregnancy: A systematic review and updated meta-analysis

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Nikfar Shekoufeh

2012-11-01

Full Text Available Abstract Selective serotonin reuptake inhibitors (SSRIs are the most frequently used antidepressants during pregnancy. There are conflicting results about their influence on pregnancy outcomes. The goal of this study was to update our previous meta-analysis about pregnancy outcomes following exposure to SSRIs. For this purpose, all relevant databases were searched from 1990 to March 2012 for studies investigating the pregnancy outcomes following exposure to any therapeutic dosage of any SSRI (fluoxetine, paroxetine, citalopram, escitalopram, sertraline, fluvoxamine during pregnancy. Types of outcome investigated were spontaneous abortion, major malformations, cardiovascular malformations, and minor malformations. A total of 25 studies met our criteria and were included in the meta-analysis. The odds ratio (OD values are 1.87 (95% CI: 1.5 to 2.33, P

Toxin-Based Therapeutic Approaches

Science.gov (United States)

Shapira, Assaf; Benhar, Itai

2010-01-01

Protein toxins confer a defense against predation/grazing or a superior pathogenic competence upon the producing organism. Such toxins have been perfected through evolution in poisonous animals/plants and pathogenic bacteria. Over the past five decades, a lot of effort has been invested in studying their mechanism of action, the way they contribute to pathogenicity and in the development of antidotes that neutralize their action. In parallel, many research groups turned to explore the pharmaceutical potential of such toxins when they are used to efficiently impair essential cellular processes and/or damage the integrity of their target cells. The following review summarizes major advances in the field of toxin based therapeutics and offers a comprehensive description of the mode of action of each applied toxin. PMID:22069564

Goal striving, goal attainment, and well-being: adapting and testing the self-concordance model in sport.

Science.gov (United States)

Smith, Alison; Ntoumanis, Nikos; Duda, Joan

2007-12-01

Grounded in self-determination theory (Deci & Ryan, 1985) and the self-concordance model (Sheldon & Elliot, 1999), this study examined the motivational processes underlying goal striving in sport as well as the role of perceived coach autonomy support in the goal process. Structural equation modeling with a sample of 210 British athletes showed that autonomous goal motives positively predicted effort, which, in turn, predicted goal attainment. Goal attainment was positively linked to need satisfaction, which, in turn, predicted psychological well-being. Effort and need satisfaction were found to mediate the associations between autonomous motives and goal attainment and between attainment and well-being, respectively. Controlled motives negatively predicted well-being, and coach autonomy support positively predicted both autonomous motives and need satisfaction. Associations of autonomous motives with effort were not reducible to goal difficulty, goal specificity, or goal efficacy. These findings support the self-concordance model as a framework for further research on goal setting in sport.

Personalized Symptom Goals and Patient Global Impression on Clinical Changes in Advanced Cancer Patients.

Science.gov (United States)

Mercadante, Sebastiano; Adile, Claudio; Lanzetta, Gaetano; Mystakidou, Kyriaki; Maltoni, Marco; Soares, Luiz Guilherme; De Santis, Stefano; Ferrera, Patrizia; Valenti, Marco; Rosati, Marta; Rossi, Romina; Cortegiani, Andrea; Masedu, Francesco; Marinangeli, Franco; Aielli, Federica

2018-05-16

The aim of this study was to assess the patients' global impression (PGI) after symptom management, as well as the achievement of personalized symptom goals (PSG). The secondary outcome was to assess related factors. Subjects, Materials, and Methods . Advanced cancer patients admitted to palliative care units rated symptom intensity by using the Edmonton Symptom Assessment Score (ESAS) at admission and then after 1 week. For each symptom, patient-reported PGI and PSG, as well as the rate of PSG response, were evaluated. Eight hundred seventy-six patients were taken into consideration for this study. A mean of 1.71-2.16 points was necessary to perceive a bit better improvement of symptom intensity. Most patients had a PSG of ≤3. A statistically significant number of patients achieved their PSG after starting palliative care. Patients with high intensity of ESAS items at admission achieved a more favorable PGI response. In the multivariate analysis, symptom intensity and PSG were the most frequent factors independently associated to a best PGI, whereas high levels of Karnofsky had a lower odd ratio. PSG and PGI seem to be relevant for patients' assessment and decision-making process, translating in terms of therapeutic intervention. Some factors may be implicated in determining the individual target and clinical response. Personalized symptom goals and global impression of change are relevant for patients' assessment and decision-making process, translating in terms of therapeutic intervention. Some factors may be implicated in determining the individual target and clinical response. © AlphaMed Press 2018.

Can children identify and achieve goals for intervention? A randomized trial comparing two goal-setting approaches.

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Vroland-Nordstrand, Kristina; Eliasson, Ann-Christin; Jacobsson, Helén; Johansson, Ulla; Krumlinde-Sundholm, Lena

2016-06-01

The efficacy of two different goal-setting approaches (children's self-identified goals and goals identified by parents) were compared on a goal-directed, task-oriented intervention. In this assessor-blinded parallel randomized trial, 34 children with disabilities (13 males, 21 females; mean age 9y, SD 1y 4mo) were randomized using concealed allocation to one of two 8-week, goal-directed, task-oriented intervention groups with different goal-setting approaches: (1) children's self-identified goals (n=18) using the Perceived Efficacy and Goal-Setting System, or (2) goals identified by parents (n=16) using the Canadian Occupational Performance Measure (COPM). Participants were recruited through eight paediatric rehabilitation centres and randomized between October 2011 and May 2013. The primary outcome measure was the Goal Attainment Scaling and the secondary measure, the COPM performance scale (COPM-P). Data were collected pre- and post-intervention and at the 5-month follow-up. There was no evidence of a difference in mean characteristics at baseline between groups. There was evidence of an increase in mean goal attainment (mean T score) in both groups after intervention (child-goal group: estimated mean difference [EMD] 27.84, 95% CI 22.93-32.76; parent-goal group: EMD 21.42, 95% CI 16.16-26.67). There was no evidence of a difference in the mean T scores post-intervention between the two groups (EMD 6.42, 95% CI -0.80 to 13.65). These results were sustained at the 5-month follow-up. Children's self-identified goals are achievable to the same extent as parent-identified goals and remain stable over time. Thus children can be trusted to identify their own goals for intervention, thereby influencing their involvement in their intervention programmes. © 2015 Mac Keith Press.

Structurally Based Therapeutic Evaluation: A Therapeutic and Practical Approach to Teaching Medicinal Chemistry.

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Alsharif, Naser Z.; And Others

1997-01-01

Explains structurally based therapeutic evaluation of drugs, which uses seven therapeutic criteria in translating chemical and structural knowledge into therapeutic decision making in pharmaceutical care. In a Creighton University (Nebraska) medicinal chemistry course, students apply the approach to solve patient-related therapeutic problems in…

Alcohol myopia and goal commitment

Directory of Open Access Journals (Sweden)

A. Timur Sevincer

2014-03-01

Full Text Available According to alcohol-myopia theory, acute alcohol consumption leads people to disproportionally focus on the salient rather than the peripheral aspects of a situation. We summarize various studies exploring how myopic processes resulting from acute alcohol intake affect goal commitment. After consuming alcohol student participants felt strongly committed to an important personal goal even though they had low expectations of successfully attaining the goal. However, once intoxicated participants were sober again (i.e., not myopic anymore they failed to act on their goal commitment. In line with alcohol-myopia theory, strong goal commitment as a result of alcohol intake was mediated by intoxicated (vs. sober participants disproportionally focusing on the desirability rather than the feasibility of their goal. Further supporting alcohol-myopia theory, when the low feasibility of attaining a particular goal was experimentally made salient (either explicitly or implicitly by subliminal priming, intoxicated participants felt less committed than those who consumed a placebo. We discuss these effects of acute alcohol intake in the context of research on the effects of chronic alcohol consumption on goal commitment.

Does the NASA Constellation Architecture Offer Opportunities to Achieve Multiple Additional Goals in Space?

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Thronson, Harley; Lester, Daniel

2008-01-01

Every major NASA human spaceflight program in the last four decades has been modified to achieve goals in space not incorporated within the original design goals: the Apollo Applications Program, Skylab, Space Shuttle, and International Space Station. Several groups in the U.S. have been identifying major future science goals, the science facilities necessary to investigate them, as well as possible roles for augmented versions of elements of NASA's Constellation program. Specifically, teams in the astronomy community have been developing concepts for very capable missions to follow the James Webb Space Telescope that could take advantage of - or require - free-space operations by astronauts and/or robots. Taking as one example, the Single-Aperture Far-InfraRed (SAFIR) telescope with a 10+ m aperture proposed for operation in the 2020 timeframe. According to current NASA plans, the Ares V launch vehicle (or a variant) will be available about the same time, as will the capability to transport astronauts to the vicinity of the Moon via the Orion Crew Exploration Vehicle and associated systems. [As the lunar surface offers no advantages - and major disadvantages - for most major optical systems, the expensive system for landing and operating on the lunar surface is not required.] Although as currently conceived, SAFIR and other astronomical missions will operate at the Sun-Earth L2 location, it appears trivial to travel for servicing to the more accessible Earth-Moon L1,2 locations. Moreover, as the recent Orbital Express and Automated Transfer Vehicle Missions have demonstrated, future robotic capabilities should offer capabilities that would (remotely) extend human presence far beyond the vicinity of the Earth.

The ICF-CY and Goal Attainment Scaling: benefits of their combined use for pediatric practice.

Science.gov (United States)

McDougall, Janette; Wright, Virginia

2009-01-01

There is much heterogeneity and disconnect in the approaches used by service providers to conduct needs assessments, set goals and evaluate outcomes for clients receiving pediatric rehabilitation services. The purpose of this article is to describe how the International Classification of Functioning, Disability and Health-Child and Youth (ICF-CY) can be used in combination with Goal Attainment Scaling (GAS), an individualised measure of change, to connect the various phases of the therapeutic process to provide consistent clinical care that is family-centred, collaborative, well directed and accountable. A brief description of both the ICF-CY and GAS as they pertain to pediatric rehabilitation is provided as background. An explanation is given of how the ICF-CY offers a framework through which clients, families and service providers can together identify the areas of clients' needs. In addition, the article discusses how the use of GAS facilitates translation of clients' identified needs into distinct, measurable goals set collaboratively by clients, their families and service providers. Examples of integrated GAS goals set for the various components of the ICF-CY are provided. The utility of GAS as a measure of clinical outcomes for individual clients is also discussed. Used in combination, the ICF-CY and GAS can serve to coordinate, simplify and standardise assessment and outcome evaluation practices for individual clients receiving pediatric rehabilitation services.

A covenant of halflings? developing a roadmap for the european urban transport goal

DEFF Research Database (Denmark)

Gudmundsson, Henrik; Schippl, Jens; Anderton, Karen

2015-01-01

; and to phase them out by 2050; and “To achieve ‘essentially CO2- free city logistics’ in major urban centres by 2030.” This paper describes how the EU FP7 project TRANSFORUM conducted a stakeholder-driven process to produce a roadmap for the urban transport goal. A main conclusion was that the implementation......In the 2011 Transport Policy White Paper, the European Commission introduced ten goals for a more competitive and resource efficient transport system. One of the goal concerns urban transport, with the dual targets: “To halve the use of ‘conventionally-fuelled’ cars in urban transport by 2030...... of a roadmap for urban transport needs to adopt a broad and open approach, given the diversity among member states and cities across Europe. Also it was found that replacing conventional vehicles and fuels is an important but not sufficient strategy to reach the goal. A roadmap to reach towards the ‘halving...

Exploiting Herpes Simplex Virus Entry for Novel Therapeutics

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Deepak Shukla

2013-06-01

Full Text Available Herpes Simplex virus (HSV is associated with a variety of diseases such as genital herpes and numerous ocular diseases. At the global level, high prevalence of individuals who are seropositive for HSV, combined with its inconspicuous infection, remains a cause for major concern. At the molecular level, HSV entry into a host cell involves multiple steps, primarily the interaction of viral glycoproteins with various cell surface receptors, many of which have alternate substitutes. The molecular complexity of the virus to enter a cell is also enhanced by the existence of different modes of viral entry. The availability of many entry receptors, along with a variety of entry mechanisms, has resulted in a virus that is capable of infecting virtually all cell types. While HSV uses a wide repertoire of viral and host factors in establishing infection, current therapeutics aimed against the virus are not as diversified. In this particular review, we will focus on the initial entry of the virus into the cell, while highlighting potential novel therapeutics that can control this process. Virus entry is a decisive step and effective therapeutics can translate to less virus replication, reduced cell death, and detrimental symptoms.

The Association Between Patient Characteristics and the Therapeutic Alliance in Cognitive-Behavioral and Interpersonal Therapy for Bulimia Nervosa

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Constantino, Michael J.; Arnow, Bruce A.; Blasey, Christine; Agras, W. Stewart

2005-01-01

The therapeutic alliance is an established predictor of psychotherapy outcome. However, alliance research in the treatment of eating disorders has been scant, with even less attention paid to correlates of alliance development. The goal of this study was to examine the relation between specific patient characteristics and the development of the…

Therapeutic Songwriting in Music Therapy Part I

DEFF Research Database (Denmark)

Baker, Felicity; Wigram, Tony; Stott, Dave

2008-01-01

Songwriting as therapeutic intervention has received increasing attention in the field of music therapy over the past decade however much of the publications focus on clinical outcomes rather than methods of practice. This paper, part of a two-part research report into trends in the clinical...... practice of songwriting, aims to describe the most frequently employed goal areas across a range of clinical populations and compare these findings with the published literature. Responses to a 21-question on-line survey were obtained from 477 professional music therapists practicing in 29 countries which...... of songwriting clinical practice and the frequency with which songwriting is employed in practice. The data highlights that songwriting is frequently employed in developmental disability and ASD practice, with reports on songwriting with these diagnostic groups being underrepresented in the music therapy...

Malleability in communal goals and beliefs influences attraction to stem careers: evidence for a goal congruity perspective.

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Diekman, Amanda B; Clark, Emily K; Johnston, Amanda M; Brown, Elizabeth R; Steinberg, Mia

2011-11-01

The goal congruity perspective posits that 2 distinct social cognitions predict attraction to science, technology, engineering, or mathematics (STEM) fields. First, individuals may particularly value communal goals (e.g., working with or helping others), due to either chronic individual differences or the salience of these goals in particular contexts. Second, individuals hold beliefs about the activities that facilitate or impede these goals, or goal affordance stereotypes. Women's tendency to endorse communal goals more highly than do men, along with consensual stereotypes that STEM careers impede communal goals, intersect to produce disinterest in STEM careers. We provide evidence for the foundational predictions that gender differences emerge primarily on communal rather than agentic goals (Studies 1a and 3) and that goal affordance stereotypes reflect beliefs that STEM careers are relatively dissociated from communal goals (Studies 1b and 1c). Most critically, we provide causal evidence that activated communal goals decrease interest in STEM fields (Study 2) and that the potential for a STEM career to afford communal goals elicits greater positivity (Study 3). These studies thus provide a novel demonstration that understanding communal goals and goal affordance stereotypes can lend insight into attitudes toward STEM pursuits.

Some evidence for the usefulness of an optimal foraging theory perspective on goal conflict and goal facilitation.

Science.gov (United States)

Tomasik, Martin J; Knecht, Michaela; Freund, Alexandra M

2017-12-01

Based on optimal foraging theory, we propose a metric that allows evaluating the goodness of goal systems, that is, systems comprising multiple goals with facilitative and conflicting interrelations. This optimal foraging theory takes into account expectancy and value, as well as opportunity costs, of foraging. Applying this approach to goal systems provides a single index of goodness of a goal system for goal striving. Three quasi-experimental studies (N = 277, N = 145, and N = 210) provide evidence for the usefulness of this approach for goal systems comprising between 3 to 10 goals. Results indicate that persons with a more optimized goal-system are more conscientious and open to new experience, are more likely to represent their goals in terms of means (i.e., adopt a process focus), and are more satisfied and engaged with their goals. Persons with a suboptimal goal system tend to switch their goals more often and thereby optimize their goal system. We discuss limitations as well as possible future directions of this approach. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Goal Setting as Teacher Development Practice

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Camp, Heather

2017-01-01

This article explores goal setting as a teacher development practice in higher education. It reports on a study of college teacher goal setting informed by goal setting theory. Analysis of study participants' goal setting practices and their experiences with goal pursuit offers a framework for thinking about the kinds of goals teachers might set…

Social determinants of mental disorders and the Sustainable Development Goals: a systematic review of reviews.

Science.gov (United States)

Lund, Crick; Brooke-Sumner, Carrie; Baingana, Florence; Baron, Emily Claire; Breuer, Erica; Chandra, Prabha; Haushofer, Johannes; Herrman, Helen; Jordans, Mark; Kieling, Christian; Medina-Mora, Maria Elena; Morgan, Ellen; Omigbodun, Olayinka; Tol, Wietse; Patel, Vikram; Saxena, Shekhar

2018-04-01

Mental health has been included in the UN Sustainable Development Goals. However, uncertainty exists about the extent to which the major social determinants of mental disorders are addressed by these goals. The aim of this study was to develop a conceptual framework for the social determinants of mental disorders that is aligned with the Sustainable Development Goals, to use this framework to systematically review evidence regarding these social determinants, and to identify potential mechanisms and targets for interventions. We did a systematic review of reviews using a conceptual framework comprising demographic, economic, neighbourhood, environmental events, and social and culture domains. We included 289 articles in the final Review. This study sheds new light on how the Sustainable Development Goals are relevant for addressing the social determinants of mental disorders, and how these goals could be optimised to prevent mental disorders. Copyright © 2018 Elsevier Ltd. All rights reserved.

Therapeutic and prevention strategies against human enterovirus 71 infection

Science.gov (United States)

Kok, Chee Choy

2015-01-01

Human enterovirus 71 (HEV71) is the cause of hand, foot and mouth disease and associated neurological complications in children under five years of age. There has been an increase in HEV71 epidemic activity throughout the Asia-Pacific region in the past decade, and it is predicted to replace poliovirus as the extant neurotropic enterovirus of highest global public health significance. To date there is no effective antiviral treatment and no vaccine is available to prevent HEV71 infection. The increase in prevalence, virulence and geographic spread of HEV71 infection over the past decade provides increasing incentive for the development of new therapeutic and prevention strategies against this emerging viral infection. The current review focuses on the potential, advantages and disadvantages of these strategies. Since the explosion of outbreaks leading to large epidemics in China, research in natural therapeutic products has identified several groups of compounds with anti-HEV71 activities. Concurrently, the search for effective synthetic antivirals has produced promising results. Other therapeutic strategies including immunotherapy and the use of oligonucleotides have also been explored. A sound prevention strategy is crucial in order to control the spread of HEV71. To this end the ultimate goal is the rapid development, regulatory approval and widespread implementation of a safe and effective vaccine. The various forms of HEV71 vaccine designs are highlighted in this review. Given the rapid progress of research in this area, eradication of the virus is likely to be achieved. PMID:25964873

Characterization of the therapeutic properties of Chinese herbal materials by measuring delayed luminescence and dendritic cell-based immunomodulatory response

NARCIS (Netherlands)

Sun, M.; Chang, W.T.; Wijk, E. van; He, M.; Koval, S.; Lin, M.K.; Van Wijk, R.; Hankemeier, T.; Greef, J. van der; Wang, M.

2017-01-01

Based on the traditional Chinese medicine theory, the Chinese pharmacopeia assigns a therapeutic description of “taste” to all herbs; thus, an herb's “taste” is valued in traditional Chinese medicine as a major ethnopharmacological category and reflects the herb's therapeutic properties. These

Molecular Characterization of Gastric Carcinoma: Therapeutic Implications for Biomarkers and Targets

Directory of Open Access Journals (Sweden)

Lionel Kankeu Fonkoua

2018-03-01

Full Text Available Palliative chemotherapy is the mainstay of treatment of advanced gastric carcinoma (GC. Monoclonal antibodies including trastuzumab, ramucirumab, and pembrolizumab have been shown to provide additional benefits. However, the clinical outcomes are often unpredictable and they can vary widely among patients. Currently, no biomarker is available for predicting treatment response in the individual patient except human epidermal growth factor receptor 2 (HER2 amplification and programmed death-ligand 1 (PD-L1 expression for effectiveness of trastuzumab and pembrolizumab, respectively. Multi-platform molecular analysis of cancer, including GC, may help identify predictive biomarkers to guide selection of therapeutic agents. Molecular classification of GC by The Cancer Genome Atlas Research Network and the Asian Cancer Research Group is expected to identify therapeutic targets and predictive biomarkers. Complementary to molecular characterization of GC is molecular profiling by expression analysis and genomic sequencing of tumor DNA. Initial analysis of patients with gastroesophageal carcinoma demonstrates that the ratio of progression-free survival (PFS on molecular profile (MP-based treatment to PFS on treatment prior to molecular profiling exceeds 1.3, suggesting the potential value of MP in guiding selection of individualized therapy. Future strategies aiming to integrate molecular classification and profiling of tumors with therapeutic agents for achieving the goal of personalized treatment of GC are indicated.

Molecular Characterization of Gastric Carcinoma: Therapeutic Implications for Biomarkers and Targets.

Science.gov (United States)

Kankeu Fonkoua, Lionel; Yee, Nelson S

2018-03-09

Palliative chemotherapy is the mainstay of treatment of advanced gastric carcinoma (GC). Monoclonal antibodies including trastuzumab, ramucirumab, and pembrolizumab have been shown to provide additional benefits. However, the clinical outcomes are often unpredictable and they can vary widely among patients. Currently, no biomarker is available for predicting treatment response in the individual patient except human epidermal growth factor receptor 2 (HER2) amplification and programmed death-ligand 1 (PD-L1) expression for effectiveness of trastuzumab and pembrolizumab, respectively. Multi-platform molecular analysis of cancer, including GC, may help identify predictive biomarkers to guide selection of therapeutic agents. Molecular classification of GC by The Cancer Genome Atlas Research Network and the Asian Cancer Research Group is expected to identify therapeutic targets and predictive biomarkers. Complementary to molecular characterization of GC is molecular profiling by expression analysis and genomic sequencing of tumor DNA. Initial analysis of patients with gastroesophageal carcinoma demonstrates that the ratio of progression-free survival (PFS) on molecular profile (MP)-based treatment to PFS on treatment prior to molecular profiling exceeds 1.3, suggesting the potential value of MP in guiding selection of individualized therapy. Future strategies aiming to integrate molecular classification and profiling of tumors with therapeutic agents for achieving the goal of personalized treatment of GC are indicated.

Perirenal hematomas induced by extracorporeal shock wave lithotripsy (ESWL). Therapeutic management.

Science.gov (United States)

Labanaris, Apostolos P; Kühn, Reinhard; Schott, Günter E; Zugor, Vahudin

2007-09-17

Extracorporeal shock wave lithotripsy (ESWL) is nowadays accepted as the treatment of choice for the majority of patients with renal or proximal ureteral calculi. Although, a relatively noninvasive modality with low morbidity, minor or major complications can be noted. A relative severe complication for the patient and confusing for the treating physician is the perirenal hematoma. With review the literature and an example of perirenal hematoma induced by ESWL in a patient treated in our department, we describe its therapeutic management.

Conflicts in Everyday Life: The Influence of Competing Goals on Domestic Energy Conservation

Directory of Open Access Journals (Sweden)

Anneli Selvefors

2015-05-01

Full Text Available A common approach for understanding people’s domestic energy behavior is to study the influence of deterministic factors, such as attitudes, norms and knowledge, on behavior. However, few studies have succeeded in fully explaining people’s behavior based on these factors alone. To further the understanding of people’s everyday energy use, a goal-oriented approach based on activity theory has been applied to discuss energy conservation from a multiple goal perspective based on the findings from an interview study with 42 informants. The findings show that the informants used energy to fulfill goals linked to basic needs or desires related to their well-being. Even though the majority of informants had an explicit goal to reduce their energy consumption, many experienced conflicts with other competing goals, which often made energy conservation undesirable or challenging. The findings suggest that actions to reduce energy use will most often not be prioritized if they cannot be integrated into people’s daily life without jeopardizing their possibilities to achieve their primary goals and satisfy their everyday needs. It is thus vital to consider people’s everyday life and the many conflicts they experience when aiming to understand why people do, or do not, prioritize energy conservation during everyday activities.

Cultural Sensitiveness of School Goals and Students’ Failure in Turkey

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Ismet Sahin

2006-06-01

Full Text Available Education is the means by which society provides for the transmission or advancement of its culture and it is formally done at schools that are the arena of human interaction aimed at producing learning. But some people in that interaction aimed at producing learning cannot achieve as much as the others due to some social or individual factors especially when the society is not homogeneous in terms of culture, language, etc.All cultures do not require the same kinds of knowledge and all may have distinct goals and expectations in education. This study aims at presenting the consensus and conflict in perspectives of students of different ethnic origins on general goals of education and expectations from schools in East and Southeast Turkey. The results will be used to generate a rationale to assume that the failure of students in East and Southeast Turkey where majority of population is ethnically diverse, may be because of the lack of divergent goals and expectations set for school curriculum or that the failure of students is dependent on some other factors except the unique school curriculum unresponsive to cultural or ethnic diversity. For this purpose, the goals of general education (1973, Law number 1739, Item number 2, and school expectations developed by House (1973 were prepared as questionnaire items, piloted, validated and administered to 9373 secondary school students in east and southeast Turkey. The findings of this study were that the students of different ethnic origins value the goals and expectations set for school curriculum in Turkey in significantly different ways.

The Relationship Between Brain Oscillatory Activity and Therapeutic Effectiveness of Transcranial Magnetic Stimulation in the Treatment of Major Depressive Disorder

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Andrew Francis Leuchter

2013-02-01

Full Text Available Major Depressive Disorder (MDD is marked by disturbances in brain functional connectivity. This connectivity is modulated by rhythmic oscillations of brain electrical activity, which enable coordinated functions across brain regions. Oscillatory activity plays a central role in regulating thinking and memory, mood, cerebral blood flow, and neurotransmitter levels, and restoration of normal oscillatory patterns is associated with effective treatment of MDD. Repetitive Transcranial Magnetic Stimulation (rTMS is a robust treatment for MDD, but the mechanism of action (MOA of its benefits for mood disorders remains incompletely understood. Benefits of rTMS have been tied to enhanced neuroplasticity in specific brain pathways. We summarize here the evidence that rTMS entrains and resets thalamocortical oscillators, normalizes regulation and facilitates reemergence of intrinsic cerebral rhythms, and through this mechanism restores normal brain function. This entrainment and resetting may be a critical step in engendering neuroplastic changes and the antidepressant effects of rTMS. It may be possible to modify the method of rTMS administration to enhance this mechanism of action and achieve better antidepressant effectiveness. We propose that rTMS can be administered: 1 synchronized to a patient’s individual alpha rhythm (IAF, or synchronized rTMS (sTMS; 2 as a low magnetic field strength sinusoidal wave form; and, 3 broadly to multiple brain areas simultaneously. We present here the theory and evidence indicating that these modifications could enhance the therapeutic effectiveness of rTMS for the treatment of MDD.

Ecosystem services for meeting sustainable development goals: Challenges and pathways

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Huq Nazmul

2015-01-01

Full Text Available The paper summarizes four presentations of the session “Environment and Wellbeing: The Role of Ecosystems for Sustainable Development” at the international conference “Sustainability in the Water- Energy-Food Nexus” held on 19-20th May 2014 in Bonn, Germany. The aim of the session was to present current stresses on ecosystem services imposed by global development trajectory, potential impacts on Sustainable Development Goals (SDGs and pathways to achieve SDGs. All four presentations agreed that global ecosystem services are under increasing pressure from degradation and may not be able to meet the growing Water-Energy- Food (WEF demands especially for the developing world. Three examples from Tanzania, Cambodia and Niger made attempt to understand how governance policies attributed to natural resource depletion such as forestry and common grazing. The examples showed that governance policies favoring economic development are heavily contributing to clearing up natural resource bases. As a result, there were increasing conflicts among different resource user groups. Two other presentations introduce conceptual pathways to achieve the targets of Sustainable Development Goals (SDGs under current resource stressed regime. The pathways suggested global technologies, decentralized solutions and consumption changes as the major means of achieving global sustainability and poverty eradication without any major trade-offs.

Ecosystem services for meeting sustainable development goals: Challenges and pathways

Directory of Open Access Journals (Sweden)

Huq Nazmul

2015-01-01

Full Text Available The paper summarizes four presentations of the session “Environment and Wellbeing: The Role of Ecosystems for Sustainable Development” at the international conference “Sustainability in the Water- Energy-Food Nexus” held on 19-20th May 2014 in Bonn, Germany. The aim of the session was to present current stresses on ecosystem services imposed by global development trajectory, potential impacts on future Sustainable Development Goals (SDGs and pathways to achieve SDGs. All four presentations agreed that global ecosystem services are under increasing pressure from degradation and may not be able to meet the growing Water-Energy-Food (WEF demands especially for the developing world. Three examples from Tanzania, Cambodia and Niger made attempt to understand how government policies attributed to natural resource depletion such as forestry and common grazing. The examples showed that institutional policies favoring economic development contributing heavily to clearing up natural resource bases. As a result, there were increasing conflicts among different resource user groups. Two other presentations introduce conceptual pathways to achieve the targets of Sustainable Development Goals (SDGs under current resource stressed regime. The pathways suggested global technologies, decentralized solutions and consumption changes as the major means of achieving global sustainability and poverty eradication without any major trade-offs.

A 1% Solution: Establishing and Reaching Enrollment Goals in Geoscience Departments

Science.gov (United States)

Rhodes, D. D.

2005-12-01

Because of the small number of recent graduates, the Department of Geology and Geography at Georgia Southern University was placed on the list of programs to be monitored by the University System of Georgia's Board of Regents in August 1998. With only 23 majors at the time, the need to grow the program was obvious to everyone. Facing the reality that the survival of the Department was at stake, the faculty made enhancing enrollments its highest priority. After consulting a variety of published information and talking to faculty from the incredibly successful Department of Geology and Geography at Northwest Missouri State University, the faculty adopted a goal of having the combined number of geology and geography majors in the department equal 1% of the university's undergraduate enrollment, which then stood at 12,400. The most important move toward the goal occurred when the Department began actively recruiting majors from all introductory geology and geography courses. Recruiting took a variety of forms that ranged from suggesting that students doing well in a course consider majoring in the field to formal presentations on geology and geography as careers. Since the Spring 2001 semester, recruiting talks have been given in every introductory level geography and geology class by a member of the faculty other than the course's instructor. The presentations emphasize how geology and geography promote the development of important marketable skills (e.g., critical thinking, problem solving, writing, public speaking, cultural awareness) and technical expertise (especially GIS) that are essential in obtaining employment and in career advancement. The presentations occur during the week preceding the Thanksgiving holidays, so students will have the opportunity to discuss this important choice with their parents. This schedule also gives students time to make their decision before registration for the spring semester. Soon after the recruitment efforts started the number

Which goals are driving the Energiewende? Making sense of the German Energy Transformation

International Nuclear Information System (INIS)

Joas, Fabian; Pahle, Michael; Flachsland, Christian; Joas, Amani

2016-01-01

In 2010, Germany agreed a plan to increase the share of renewables in power consumption to 80% by 2050, and in 2011 the decision was taken to phase-out nuclear power by 2022. This policy is now widely known as the “Energiewende”. While many global observers consider this program to be primarily driven by the need to tackle climate change, the precise political goals of the Energiewende are, by and large, unclear. In our study we compiled a list of 14 goals put forward in political debates and conducted a “mapping” survey among more than 50 policy experts. We asked them to prioritize the goals based on their personal views and provide arguments for their rankings in ensuing interviews. Our main findings are as follows: (i) a large majority named climate protection among the top-level goals of the Energiewende; at the same time, around 80% of all participants also identified additional goals; (ii) when asked if the Energiewende would make sense even if climate change did not exist, two thirds of the participants agreed, which, when taken with the first finding, demonstrates that the goals and motivations driving the Energiewende are more complex than often assumed. We conclude that for the sake of effective and efficient policies and ever rising climate policy ambition, a public debate and clear specification of the top-level goals are indispensable. - Highlights: •We examine the goals of German energy policy called the “Energiewende”. •We show that policy experts relate up to 14 goals with the Energiewende. •So far the political goals of the Energiewende, and especially their ranking is unclear. •We call for a public debate and a clear specification of the top-level goals of the Energiewende.

Factors that influence therapeutic outcomes in symptomatic gastroesophageal reflux disease.

LENUS (Irish Health Repository)

Quigley, Eamonn M M

2012-02-03

The term "symptomatic gastroesophageal reflux disease" (GERD) refers to those patients who present with the typical GERD symptoms of heartburn and regurgitation, yet do not have endoscopic evidence of esophagitis. The primary goals of managing symptomatic GERD are to control symptoms and improve quality of life. A clinical assessment of the GERD patient can identify important clinical features, such as atypical and extraesophageal symptoms for which acid-suppressive agents tend to be less effective. Performing an endoscopy can further identify the patient as having nonerosive reflux disease, erosive esophagitis, or Barrett\\'s esophagus-diagnoses which can help determine treatment but may not prove predictive of therapeutic response. Determining acid exposure through pH testing can predict therapeutic response, with those revealing an abnormal acid exposure time being more responsive to acid-suppressive therapy. However, the performance of an endoscopy and pH testing on each patient is clearly not practical. Whereas the natural history of symptomatic GERD is still largely undefined, acid-suppressive therapy appears to be the best approach available for both the short-term and long-term management of this disease.

[Other care in Parkinson's disease: Psychological, rehabilitation, therapeutic education and new technologies].

Science.gov (United States)

Dupouy, Julia; Ory-Magne, Fabienne; Brefel-Courbon, Christine

2017-03-01

Diagnosis of Parkinson's disease (PD) is often traumatic. It is then important to organize this announcement in order to support the patient in this major step of his care course. Anxiety and depression are present in about 50% of PD patients. Besides pharmacological treatment, cognitive-behavioral therapy induces improvement in anxio-depressive symptoms. We have to promote physical activity for PD patients, from the beginning of the disease, because it prevents from deconditioning, improves motor and non-motor symptoms, quality of life, and decreases loneliness. Rehabilitation may be also proposed (physiotherapy, speech therapy, occupational therapy). But there is no specific recommendation in PD, and usual activities can be proposed. Therapeutic education is an answer for PD patients who need to know and understand their disease and treatment. Organization of therapeutic education is different depending of the teams: group workshop and/or individual sessions, conduct by doctors or paramedical staff (nurse, physiotherapist, psychologist…). Therapeutic education programs are always evolving. It will soon be proposed therapeutic education for care partners, and some patients may join therapeutic education staff. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

The Multifaceted Uses and Therapeutic Advantages of Nanoparticles for Atherosclerosis Research.

Science.gov (United States)

DiStasio, Nicholas; Lehoux, Stephanie; Khademhosseini, Ali; Tabrizian, Maryam

2018-05-08

Nanoparticles are uniquely suited for the study and development of potential therapies against atherosclerosis by virtue of their size, fine-tunable properties, and ability to incorporate therapies and/or imaging modalities. Furthermore, nanoparticles can be specifically targeted to the atherosclerotic plaque, evading off-target effects and/or associated cytotoxicity. There has been a wealth of knowledge available concerning the use of nanotechnologies in cardiovascular disease and atherosclerosis, in particular in animal models, but with a major focus on imaging agents. In fact, roughly 60% of articles from an initial search for this review included examples of imaging applications of nanoparticles. Thus, this review focuses on experimental therapy interventions applied to and observed in animal models. Particular emphasis is placed on how nanoparticle materials and properties allow researchers to learn a great deal about atherosclerosis. The objective of this review was to provide an update for nanoparticle use in imaging and drug delivery studies and to illustrate how nanoparticles can be used for sensing and modelling, for studying fundamental biological mechanisms, and for the delivery of biotherapeutics such as proteins, peptides, nucleic acids, and even cells all with the goal of attenuating atherosclerosis. Furthermore, the various atherosclerosis processes targeted mainly for imaging studies have been summarized in the hopes of inspiring new and exciting targeted therapeutic and/or imaging strategies.

Professional responsibility in elder law: a synthesis of preventive law and therapeutic jurisprudence.

Science.gov (United States)

Stolle, D P

1996-01-01

This article focuses on the professional responsibilities that a lawyer owes to older clients. Specifically, this article proposes that when working with older clients, lawyers have a responsibility to ensure that their clients have the capacity to manage their own affairs and to ensure their clients' legal, financial, and personal interests are protected in case of sudden future incapacity. Furthermore, a lawyer working with older clients has a responsibility to remain cognizant of the realities of ageing without giving in to the falsities of senior citizen stereotypes. Through an integration of Therapeutic Jurisprudence and Preventive Law, a proactive, client-centered, four-stage framework for advancing therapeutic goals through preventive lawyering is developed. The framework is then applied to a model lawyer/client interaction typical of elder practice. The advantages and limitations of the four-stage framework are discussed.

Goals, styles, and decisions: changes and interactions during the first year of college.

Science.gov (United States)

Galotti, Kathleen M; Clare, Lacey R

2014-01-01

First-year undergraduates participated in a short-term longitudinal study of goal setting and decision making over their first 14 months of college. First, students wrote a mission statement, listed their goals for the upcoming year, and filled out several individual difference style measures. In subsequent sessions, students were surveyed about different decisions pertaining to their choice of college major, course selection, housing, and summer plans. At the beginning of their second year, participants were shown their previously listed goals and surveyed about their progress, their satisfaction with their progress, and their retrospective view of their goals. Additionally, participants responded again to the individual difference measures. A moderate degree of stability was found in the individual difference measures, yet there were several significant changes over the year. Goal evaluation scores correlated with specific individual difference measures, and self-reported descriptions of reactions to how specific decisions were made, but not with behavioral measures of decision making.We speculate on ways in which stylistic measures become part of a construction of a more general narrative identity, shaped in significant ways by the college environment that selectively reinforces some analytic habits of mind.

ERDA's long-term waste management goals and programs

International Nuclear Information System (INIS)

Perge, A.F.; Trice, V.G. Jr.; Walton, R.D. Jr.

1976-01-01

This paper presents an overview of the ERDA's major program for the long-term waste management of radioactive waste and provides a perspective for symposium participants with regard to the interrelationship of specific components of the program that are discussed in detail in other ERDA-sponsored papers. Needs, goals, and plans are reviewed for ERDA's management of the commercially generated wastes which are expected to be delivered to ERDA in accordance with Federal regulations. At present, ERDA responsibilities include long-term management of commercial-level wastes. Possible future regulations may give ERDA responsibility for the long-term management of commercial low-level solid wastes contaminated with transuranic nuclides. Primary planning goals and programs for the development of terminal storage facilities and waste processing technology to produce acceptable waste forms for long-term management are reviewed for each of the waste types identified above. The status of development programs for the long-term management of airborne radionuclides, which may be required at some time in the future, is also reviewed. (author)

Three commitments governments should take on to make Sustainable Development Goals the drivers of a major transformation

International Nuclear Information System (INIS)

Voituriez, Tancrede

2015-01-01

On the basis of the outcome document of the Rio+20 conference, the United Nations General Assembly (UNGA) mandated an Open Working Group (OWG) to propose a set of sustainable development goals (SDGs), for final adoption at the end of the 68. Session of the UN General Assembly in September 2015. 'The transformation potential of the SDG package is so great that many of the countries involved in the negotiations may not even fully comprehend the possible magnitude, which may be similar to that of the industrial or digital revolutions,' the OWG vice chair reckons. This brief explores tangible options for propelling this transformation. (author)

The goal(s of corporate rescue in company law: A comparative analysis

Directory of Open Access Journals (Sweden)

Anthony O. Nwafor

2017-09-01

Full Text Available The concept of corporate rescue lays emphasis on corporate sustainability than liquidation. This trend in corporate legislation which featured in the United Kingdom Insolvency Act of 1986, Australian Corporations Act 2001, Indian Sick Industrial Companies (Special Provisions Act of 1985 (as replaced by Companies Act, 2013 and supplanted by the Insolvency and Bankruptcy Code, 2016 has been adopted in the South African Companies Act of 2008. The goal(s of corporate rescue in some of these jurisdictions are not clearly defined. The paper examines, through a comparative analysis, the relevant statutory provisions in the United Kingdom, India, Australia and South Africa and the attendant judicial interpretations of those provisions with a view to discovering the goal(s of corporate rescue in those jurisdictions. It is argued that while under the United Kingdom and Australian statutory provisions, the administrator could pursue alternative goals of either rescuing the company or achieving better results for the creditors; the South African and Indian statutory provisions do not provide such alternatives. The seeming ancillary purpose of crafting a fair deal for the stakeholders under the South African Companies Act’s provision is not sustainable if the company as an entity cannot be rescued

Toxin-Based Therapeutic Approaches

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Itai Benhar

2010-10-01

Full Text Available Protein toxins confer a defense against predation/grazing or a superior pathogenic competence upon the producing organism. Such toxins have been perfected through evolution in poisonous animals/plants and pathogenic bacteria. Over the past five decades, a lot of effort has been invested in studying their mechanism of action, the way they contribute to pathogenicity and in the development of antidotes that neutralize their action. In parallel, many research groups turned to explore the pharmaceutical potential of such toxins when they are used to efficiently impair essential cellular processes and/or damage the integrity of their target cells. The following review summarizes major advances in the field of toxin based therapeutics and offers a comprehensive description of the mode of action of each applied toxin.

Neurobiology of Major Depressive Disorder

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Rosa Villanueva

2013-01-01

Full Text Available We survey studies which relate abnormal neurogenesis to major depressive disorder. Clinically, descriptive gene and protein expression analysis and genetic and functional studies revised here show that individual alterations of a complex signaling network, which includes the hypothalamic-pituitary-adrenal axis; the production of neurotrophins and growth factors; the expression of miRNAs; the production of proinflammatory cytokines; and, even, the abnormal delivery of gastrointestinal signaling peptides, are able to induce major mood alterations. Furthermore, all of these factors modulate neurogenesis in brain regions involved in MDD, and are functionally interconnected in such a fashion that initial alteration in one of them results in abnormalities in the others. We highlight data of potential diagnostic significance and the relevance of this information to develop new therapeutic approaches. Controversial issues, such as whether neurogenesis is the basis of the disease or whether it is a response induced by antidepressant treatments, are also discussed.

Benefits of and Barriers to Pharmacogenomics-Guided Treatment for Major Depressive Disorder.

Science.gov (United States)

Ahmed, Ahmed T; Weinshilboum, Richard; Frye, Mark A

2018-05-01

Antidepressants have reduced the symptom burden for many Major Depressive Disorder (MDD) patients, but drug-related side effects and treatment resistance continue to present major challenges. Pharmacogenomics represents one approach to enhance antidepressant efficacy and avoid adverse reactions, but concerns remain with regard to the overall "value equation," and several barriers must be overcome to achieve the full potential of MDD pharmacogenomics. © 2018 American Society for Clinical Pharmacology and Therapeutics.

The Predictiveness of Achievement Goals

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Huy P. Phan

2013-11-01

Full Text Available Using the Revised Achievement Goal Questionnaire (AGQ-R (Elliot & Murayama, 2008, we explored first-year university students’ achievement goal orientations on the premise of the 2 × 2 model. Similar to recent studies (Elliot & Murayama, 2008; Elliot & Thrash, 2010, we conceptualized a model that included both antecedent (i.e., enactive learning experience and consequence (i.e., intrinsic motivation and academic achievement of achievement goals. Two hundred seventy-seven university students (151 women, 126 men participated in the study. Structural equation modeling procedures yielded evidence that showed the predictive effects of enactive learning experience and mastery goals on intrinsic motivation. Academic achievement was influenced intrinsic motivation, performance-approach goals, and enactive learning experience. Enactive learning experience also served as an antecedent of the four achievement goal types. On the whole, evidence obtained supports the AGQ-R and contributes, theoretically, to 2 × 2 model.

The Depression Inventory Development Workgroup: A Collaborative, Empirically Driven Initiative to Develop a New Assessment Tool for Major Depressive Disorder.

Science.gov (United States)

Vaccarino, Anthony L; Evans, Kenneth R; Kalali, Amir H; Kennedy, Sidney H; Engelhardt, Nina; Frey, Benicio N; Greist, John H; Kobak, Kenneth A; Lam, Raymond W; MacQueen, Glenda; Milev, Roumen; Placenza, Franca M; Ravindran, Arun V; Sheehan, David V; Sills, Terrence; Williams, Janet B W

2016-01-01

The Depression Inventory Development project is an initiative of the International Society for CNS Drug Development whose goal is to develop a comprehensive and psychometrically sound measurement tool to be utilized as a primary endpoint in clinical trials for major depressive disorder. Using an iterative process between field testing and psychometric analysis and drawing upon expertise of international researchers in depression, the Depression Inventory Development team has established an empirically driven and collaborative protocol for the creation of items to assess symptoms in major depressive disorder. Depression-relevant symptom clusters were identified based on expert clinical and patient input. In addition, as an aid for symptom identification and item construction, the psychometric properties of existing clinical scales (assessing depression and related indications) were evaluated using blinded datasets from pharmaceutical antidepressant drug trials. A series of field tests in patients with major depressive disorder provided the team with data to inform the iterative process of scale development. We report here an overview of the Depression Inventory Development initiative, including results of the third iteration of items assessing symptoms related to anhedonia, cognition, fatigue, general malaise, motivation, anxiety, negative thinking, pain and appetite. The strategies adopted from the Depression Inventory Development program, as an empirically driven and collaborative process for scale development, have provided the foundation to develop and validate measurement tools in other therapeutic areas as well.

Teachers' Understanding of Learning Goals

DEFF Research Database (Denmark)

Krog Skott, Charlotte; Slot, Marie Falkesgaard; Carlsen, Dorthe

will be presented. We expect to deepen our understanding of the relations between the various parameters in the teachers' practice in relation to learning goals and goal-oriented teaching. There is conducted research on the effects of goal-oriented teaching on students' learning both internationally...

Patients' experiences with technology during inpatient rehabilitation: opportunities to support independence and therapeutic engagement.

Science.gov (United States)

Fager, Susan Koch; Burnfield, Judith M

2014-03-01

To understand individuals' perceptions of technology use during inpatient rehabilitation. A qualitative phenomenological study using semi-structured interviews of 10 individuals with diverse underlying diagnoses and/or a close family member who participated in inpatient rehabilitation. Core themes focused on assistive technology usage (equipment set-up, reliability and fragility of equipment, expertise required to use assistive technology and use of mainstream technologies) and opportunities for using technology to increase therapeutic engagement (opportunities for practice outside of therapy, goals for therapeutic exercises and technology for therapeutic exercises: motivation and social interaction). Interviews revealed the need for durable, reliable and intuitive technology without requiring a high level of expertise to install and implement. A strong desire for the continued use of mainstream devices (e.g. cell phones, tablet computers) reinforces the need for a wider range of access options for those with limited physical function. Finally, opportunities to engage in therapeutically meaningful activities beyond the traditional treatment hours were identified as valuable for patients to not only improve function but to also promote social interaction. Assistive technology increases functional independence of severely disabled individuals. End-users (patients and families) identified a need for designs that are durable, reliable, intuitive, easy to consistently install and use. Technology use (adaptive or commercially available) provides a mechanism to extend therapeutic practice beyond the traditional therapy day. Adapting skeletal tracking technology used in gaming software could automate exercise tracking, documentation and feedback for patient motivation and clinical treatment planning and interventions.

ORGANIZATIONAL GOALS--A SYSTEMS APPROACH.

Science.gov (United States)

OHM, ROBERT E.

CONTEMPORARY SYSTEMS THEORISTS HAVE PROVIDED A HELPFUL VIEW OF THE WAY GOAL-STRUCTURE MAY SHAPE ADMINISTRATIVE BEHAVIOR IN EDUCATIONAL ORGANIZATIONS. THE "TRADITIONALIST" VIEW ASSIGNED ORGANIZATIONAL GOALS THE FUNCTIONS OF FORECASTING AND PLANNING. THE "EMERGING MODEL" VIEWED GOALS AS UNDEFINED ELEMENTS REQUIRING LITTLE SYSTEMATIC TREATMENT IN A…

Discovery and design of carbohydrate-based therapeutics.

Science.gov (United States)

Cipolla, Laura; Araújo, Ana C; Bini, Davide; Gabrielli, Luca; Russo, Laura; Shaikh, Nasrin

2010-08-01

Till now, the importance of carbohydrates has been underscored, if compared with the two other major classes of biopolymers such as oligonucleotides and proteins. Recent advances in glycobiology and glycochemistry have imparted a strong interest in the study of this enormous family of biomolecules. Carbohydrates have been shown to be implicated in recognition processes, such as cell-cell adhesion, cell-extracellular matrix adhesion and cell-intruder recognition phenomena. In addition, carbohydrates are recognized as differentiation markers and as antigenic determinants. Due to their relevant biological role, carbohydrates are promising candidates for drug design and disease treatment. However, the growing number of human disorders known as congenital disorders of glycosylation that are being identified as resulting from abnormalities in glycan structures and protein glycosylation strongly indicates that a fast development of glycobiology, glycochemistry and glycomedicine is highly desirable. The topics give an overview of different approaches that have been used to date for the design of carbohydrate-based therapeutics; this includes the use of native synthetic carbohydrates, the use of carbohydrate mimics designed on the basis of their native counterpart, the use of carbohydrates as scaffolds and finally the design of glyco-fused therapeutics, one of the most recent approaches. The review covers mainly literature that has appeared since 2000, except for a few papers cited for historical reasons. The reader will gain an overview of the current strategies applied to the design of carbohydrate-based therapeutics; in particular, the advantages/disadvantages of different approaches are highlighted. The topic is presented in a general, basic manner and will hopefully be a useful resource for all readers who are not familiar with it. In addition, in order to stress the potentialities of carbohydrates, several examples of carbohydrate-based marketed therapeutics are given

Neonatal therapeutic hypothermia outside of standard guidelines: a survey of U.S. neonatologists.

Science.gov (United States)

Burnsed, Jennifer; Zanelli, Santina A

2017-11-01

Therapeutic hypothermia is standard of care in term infants with moderate-to-severe hypoxic-ischaemic encephalopathy (HIE). The goal of this survey was to explore the attitudes of U.S. neonatologists caring for infants with HIE who fall outside of current guidelines. Case-based survey administered to members of the Section on Neonatal-Perinatal Medicine of the American Academy of Pediatrics. A total of 447 responses were analysed, a response rate of 19%. We found significant variability amongst U.S. neonatologists with regard to the use of therapeutic hypothermia for infants with HIE who fall outside standard inclusion criteria. Scenarios with the most variability included HIE in a late preterm infant and HIE following a postnatal code. Provision of therapeutic hypothermia outside of standard guidelines was not influenced by number of years in practice, neonatal intensive care type (NICU) or NICU size. Significant variability in practice exists when caring for infants with HIE who do not meet standard inclusion criteria, emphasizing the need for continued and rigorous research in this area. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

The impact of goal setting and goal orientation on performance during a clerkship surgical skills training program.

Science.gov (United States)

Gardner, Aimee K; Diesen, Diana L; Hogg, Deborah; Huerta, Sergio

2016-02-01

The purpose of this study was to integrate relevant goal-setting theory and to identify if trainees' goal orientations have an impact on the assigned goals-performance relationship. Trainees attended 1 of the 3 goal-training activities (do your best, performance, or learning goals) for knot tying (KT) and camera navigation (CN) during the 3rd-year clerkship rotation. Questionnaires and pretests and/or post-tests were completed. One twenty-seven 3rd-year medical students (age: 25 ± 2.6; 54% women) participated in the training program. Pretraining to post-training performance changes were significant for all groups on both tasks (P goals group (do your best: KTΔ = 2.14, CNΔ = 1.69; performance: KTΔ = 2.49, CNΔ = 2.24; learning: KTΔ = 3.04 CNΔ = 2.76). Correlations between goal orientations and improvement were examined, revealing a unique role of goal orientation for performance improvement. These data indicate that consideration of goal type and trainee goal orientation must be considered during curriculum development to maximize educational value. Copyright © 2016 Elsevier Inc. All rights reserved.

Resident Self-Assessment and Learning Goal Development: Evaluation of Resident-Reported Competence and Future Goals.

Science.gov (United States)

Li, Su-Ting T; Paterniti, Debora A; Tancredi, Daniel J; Burke, Ann E; Trimm, R Franklin; Guillot, Ann; Guralnick, Susan; Mahan, John D

2015-01-01

To determine incidence of learning goals by competency area and to assess which goals fall into competency areas with lower self-assessment scores. Cross-sectional analysis of existing deidentified American Academy of Pediatrics' PediaLink individualized learning plan data for the academic year 2009-2010. Residents self-assessed competencies in the 6 Accreditation Council for Graduate Medical Education (ACGME) competency areas and wrote learning goals. Textual responses for goals were mapped to 6 ACGME competency areas, future practice, or personal attributes. Adjusted mean differences and associations were estimated using multiple linear and logistic regression. A total of 2254 residents reported 6078 goals. Residents self-assessed their systems-based practice (51.8) and medical knowledge (53.0) competencies lowest and professionalism (68.9) and interpersonal and communication skills (62.2) highest. Residents were most likely to identify goals involving medical knowledge (70.5%) and patient care (50.5%) and least likely to write goals on systems-based practice (11.0%) and professionalism (6.9%). In logistic regression analysis adjusting for postgraduate year (PGY), gender, and degree type (MD/DO), resident-reported goal area showed no association with the learner's relative self-assessment score for that competency area. In the conditional logistic regression analysis, with each learner serving as his or her own control, senior residents (PGY2/3+s) who rated themselves relatively lower in a competency area were more likely to write a learning goal in that area than were PGY1s. Senior residents appear to develop better skills and/or motivation to explicitly turn self-assessed learning gaps into learning goals, suggesting that individualized learning plans may help improve self-regulated learning during residency. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

The third international meeting on genetic disorders in the RAS/MAPK pathway: towards a therapeutic approach.

Science.gov (United States)

Korf, Bruce; Ahmadian, Reza; Allanson, Judith; Aoki, Yoko; Bakker, Annette; Wright, Emma Burkitt; Denger, Brian; Elgersma, Ype; Gelb, Bruce D; Gripp, Karen W; Kerr, Bronwyn; Kontaridis, Maria; Lazaro, Conxi; Linardic, Corinne; Lozano, Reymundo; MacRae, Calum A; Messiaen, Ludwine; Mulero-Navarro, Sonia; Neel, Benjamin; Plotkin, Scott; Rauen, Katherine A; Roberts, Amy; Silva, Alcino J; Sittampalam, Sitta G; Zhang, Chao; Schoyer, Lisa

2015-08-01

"The Third International Meeting on Genetic Disorders in the RAS/MAPK Pathway: Towards a Therapeutic Approach" was held at the Renaissance Orlando at SeaWorld Hotel (August 2-4, 2013). Seventy-one physicians and scientists attended the meeting, and parallel meetings were held by patient advocacy groups (CFC International, Costello Syndrome Family Network, NF Network and Noonan Syndrome Foundation). Parent and patient advocates opened the meeting with a panel discussion to set the stage regarding their hopes and expectations for therapeutic advances. In keeping with the theme on therapeutic development, the sessions followed a progression from description of the phenotype and definition of therapeutic endpoints, to definition of genomic changes, to identification of therapeutic targets in the RAS/MAPK pathway, to preclinical drug development and testing, to clinical trials. These proceedings will review the major points of discussion. © 2015 Wiley Periodicals, Inc.

The Role of Public Health Nutrition in Achieving the Sustainable Development Goals in the Asia Pacific Region.

Science.gov (United States)

Binns, Colin; Lee, Mi Kyung; Low, Wah Yun; Zerfas, Alfred

2017-10-01

The Sustainable Development Goals (SDGs) replaced the Millennium Development Goals (MDCs) in 2015, which included several goals and targets primarily related to nutrition: to eradicate extreme poverty and hunger and to reduce child mortality and improve maternal health. In the Asia-Pacific Academic Consortium for Public Health (APACPH) member countries as a group, infant and child mortality were reduced by more than 65% between 1990 and 2015, achieving the MDG target of two-thirds reduction, although these goals were not achieved by several smaller countries. The SDGs are broader in focus than the MDGs, but include several goals that relate directly to nutrition: 2 (zero hunger-food), 3 (good health and well-being-healthy life), and 12 (responsible consumption and production-sustainability). Other SDGs that are closely related to nutrition are 4 and 5 (quality education and equality in gender-education and health for girls and mothers, which is very important for infant health) and 13 (climate action). Goal 3 is "good health and well-being," which includes targets for child mortality, maternal mortality, and reducing chronic disease. The Global Burden of Disease Project has confirmed that the majority of risk for these targets can be attributed to nutrition-related targets. Dietary Guidelines were developed to address public health nutrition risk in the Asia Pacific region at the 48th APACPH 2016 conference and they are relevant to the achievement of the SDGs. Iron deficiency increases the risk of maternal death from haemorrhage, a cause of 300000 deaths world-wide each year. Improving diets and iron supplementation are important public health interventions in the APACPH region. Chronic disease and obesity rates in the APACPH region are now a major challenge and healthy life course nutrition is a major public health priority in answering this challenge. This article discusses the role of public health nutrition in achieving the SDGs. It also examines the role of

A Comparison of the Goals of Studio Professors Conducting Critiques and Art Education Goals for Teaching Criticism.

Science.gov (United States)

Barrett, Terry

1988-01-01

Compares stated goals of studio art course professors for teaching of criticism and the goals stated in art education literature of art teacher taught criticism. States that these goals are in conflict, therefore, future art teachers are being guided by goals for criticism that are not in accord with the goals set forth in their study of art…

Social Cognitive Predictors of Academic Interests and Goals in South Korean Engineering Students

Science.gov (United States)

Kim, Min Sun; Seo, Young Seok

2014-01-01

The purpose of this study was to investigate the applicability of social cognitive career theory (SCCT) in a cross-cultural setting by examining the relationships between the social cognitive variables of South Korean engineering students and their engineering interests and major choice goals across university type and gender. Participants (N =…

Workplace Learning within Teacher Education: The Role of Job Characteristics and Goal Orientation

Science.gov (United States)

Kyndt, Eva; Donche, Vincent; Gijbels, David; Van Petegem, Peter

2014-01-01

Within teacher education, it is widely recognised that internships play a major role in preparing prospective teachers. The current research examines if the learning activities students' undertake in the workplace can be explained by students' goal orientation and their perceptions of the workplace. In addition, it will be investigated…

FOREIGN LANGUAGE TEACHING IN SUDANESE UNIVERSITIES: GOALS, ATTITUDES, AND REALITY

Directory of Open Access Journals (Sweden)

Abdel Rahim Hamid Mugaddam

2012-07-01

Full Text Available Abstract: The goals and means of language study continue in the very center of debates among specialists in language teaching/learning. Different views relating to language and its functions are reflected in two main approaches to language teaching/learning. On the one hand, language is considered to be principally instrumental, a means of communicating thought and information. One the other hand, language is viewed as an important element of human being’s thought processes, perceptions, and self-expressions; and as such, it is placed at the core of translingual and transcultural competence. This paper investigates the current situation of teaching/learning foreign languages in the Sudanese universities with special focus on the goals of teaching these languages and their role in students’ future. Goals of language teaching and students’ attitudes towards the process will be related to the job opportunities available for the students on graduation. Data for the paper have been collected using questionnaires and interviews administered to students and teachers from five language departments at Khartoum University: English, French, German, Russian, and Chinese. Questionnaires and interviews on language attitude will be administered among Four-year language majors representing the four departments. The central question the paper tries to answer is whether there is a realistic match between the goals of language teaching/learning set by policy makers and students’ interests and expectations. Results are expected to contribute to the efforts made to restructure language-in-education curriculum at university level in a way that addresses the expectations of both policy makers and students. Keywords: Foreign language teaching and learning, goals, attitude.

Goals and everyday problem solving: examining the link between age-related goals and problem-solving strategy use.

Science.gov (United States)

Hoppmann, Christiane A; Coats, Abby Heckman; Blanchard-Fields, Fredda

2008-07-01

Qualitative interviews on family and financial problems from 332 adolescents, young, middle-aged, and older adults, demonstrated that developmentally relevant goals predicted problem-solving strategy use over and above problem domain. Four focal goals concerned autonomy, generativity, maintaining good relationships with others, and changing another person. We examined both self- and other-focused problem-solving strategies. Autonomy goals were associated with self-focused instrumental problem solving and generative goals were related to other-focused instrumental problem solving in family and financial problems. Goals of changing another person were related to other-focused instrumental problem solving in the family domain only. The match between goals and strategies, an indicator of problem-solving adaptiveness, showed that young individuals displayed the greatest match between autonomy goals and self-focused problem solving, whereas older adults showed a greater match between generative goals and other-focused problem solving. Findings speak to the importance of considering goals in investigations of age-related differences in everyday problem solving.

Factors associated with therapeutic success in HIV-positive individuals in southern Brazil.

Science.gov (United States)

Silveira, M P T; Maurer, P; Guttier, M C; Moreira, L B

2015-04-01

Therapeutic success is characterized by undetectable viral load, immune reconstitution confirmed by CD4+ T-cell count and no clinical manifestations of disease. High treatment adherence is a major determinant of therapeutic success that needs prevention of viral replication, allowing immune reconstitution. Adherence to treatment minimum wage (IQR 1·0-2·3). Therapeutic success was achieved by 90% (122 patients), and it was associated with previously undetectable viral load (PR = 1·30; 95% CI = 1·13-1·49) and treatment adherence prior to study entry (PR = 1·34; 95% CI = 1·07-1·69), independently of sex, age and previous immune status. When undetectable viral load, CD4+ cell count ≥200 cells/mm(3) and treatment adherence above 95% are included in the definition of therapeutic success, the rate was elevated (90%) and the factors associated were previous history of adherence to HAART and previous undetectable viral load. © 2014 John Wiley & Sons Ltd.

Augmentation of therapeutic potential of curcumin using nanotechnology: current perspectives.

Science.gov (United States)

Sivasami, Pulavendran; Hemalatha, Thiagarajan

2018-02-28

Curcumin, an active principle of Curcuma longa, is extracted from the rhizome. Its therapeutic efficiency has been proved using various in vitro and in vivo models. Inflammatory, neoplastic and preneoplastic diseases are the major targets using curcumin as therapeutic agent. Feasible clinical formulations could not be obtained because of its lack of solubility, stability and higher degradation rate. Recently, many techniques have been evolved to improve the physicochemical properties of pharmacological compounds, thereby increasing their biological activity. Curcumin has been developed using various techniques, particularly micro and nanotechnology to improve its stability and bioavailability. This review focuses on the studies pertaining to the delivery of curcumin in the form of micro and nanosize formulations for the treatment of a variety of diseases.

A theoretical and methodological proposal for the descriptive assessment of therapeutic interactions.

Science.gov (United States)

Froján-Parga, María Xesús; Ruiz-Sancho, Elena M; Calero-Elvira, Ana

2016-01-01

The goal of this study is to show the development of a strategy for a descriptive assessment of the therapeutic interaction. In this study, we develop an observational methodology to analyze the dialogues that took place during 92 sessions conducted in a psychological center in Madrid, Spain, in which 19 adults were treated for various psychological problems by 9 behavioral therapists. A system was developed to codify vocal behavior of both the therapists and the clients; the software The Observer XT was used for recording. Therapeutic interactions were analyzed using sequential analysis. There are three main sequences that synthesize the therapist-client interaction: first, an utterance by the client preceded by a therapist's verbalization, specifically a question (discriminative morphology) and followed by an expression of approval (reinforcement morphology); second, verbalizations of failure or discomfort uttered by the client, followed most often by verbalizations of disapproval (punishing morphology) uttered by the therapist; and third, verbalizations uttered by the client that are discriminated by the therapist after an in-depth explanation and followed by different therapist's utterances (expressions of approval, technical information, etc.). Depending on how the client responds the results in this study present a starting point for the study of the functional sequences that form the basis of therapeutic change.

Intensity and direction of competitive anxiety as a function of goal attainment expectation and competition goal generation.

Science.gov (United States)

O'Brien, M; Hanton, S; Mellalieu, S D

2005-12-01

Jones's control model was adopted to investigate differences in the labelling of symptoms associated with pre-competition anxiety and self-confidence as a function of goal attainment expectation and competition goal generation. Team sport performers (N = 96) were divided into outcome, performance and process goal groups. Anxiety intensity and direction, and self-confidence were then examined as a function of goal expectancy (positive or negative) and perceived input into goal production (input or no input). MANOVA and follow-up ANOVA supported the study predictions. Specifically, participants who reported positive expectations of goal achievement and indicated some input into the goal generation process experienced the most facilitative interpretations of cognitive symptoms and greater self-confidence. The results highlight the need to consider how goals are generated when attempting to foster a sense of control and help athletes cope with the psychological demands of competition.

Financial Planning with Fractional Goals

OpenAIRE

Goedhart, Marc; Spronk, Jaap

1995-01-01

textabstractWhen solving financial planning problems with multiple goals by means of multiple objective programming, the presence of fractional goals leads to technical difficulties. In this paper we present a straightforward interactive approach for solving such linear fractional programs with multiple goal variables. The approach is illustrated by means of an example in financial planning.

Different Goals for Different Folks: A Cross-Cultural Study of Achievement Goals across Nine Cultures

Science.gov (United States)

King, Ronnel B.; McInerney, Dennis M.; Nasser, Ramzi

2017-01-01

Goals are important predictors of key educational outcomes. However, most of the research on goal theory has been conducted in Western societies. In this study we examine how different types of goals (mastery, performance, social, and extrinsic) derived from personal investment theory are associated with key learning outcomes across nine cultural…

Self-regulation through Goal Setting

DEFF Research Database (Denmark)

Koch, Alexander; Nafziger, Julia

self-control problems. We show how goals permit self-regulation, but also that they are painful self-disciplining devices. Greater self-control problems therefore lead to stronger self-regulation through goals only up to a certain point. For severely present-biased preferences, the required goal...... for self-regulation is too painful and the individual rather gives up....

Goal-oriëntation, goal-setting and goal-driven behavior in (minimalist) user instructions

NARCIS (Netherlands)

van der Meij, Hans

2007-01-01

This paper opens with a summary of minimalist design strategies that aim to optimize user instructions. Next, it discusses three recent research efforts to further improve these strategies. The common focus in these efforts is the attention to people’s goal-related management and control of

Materialistic Values and Goals.

Science.gov (United States)

Kasser, Tim

2016-01-01

Materialism comprises a set of values and goals focused on wealth, possessions, image, and status. These aims are a fundamental aspect of the human value/goal system, standing in relative conflict with aims concerning the well-being of others, as well as one's own personal and spiritual growth. Substantial evidence shows that people who place a relatively high priority on materialistic values/goals consume more products and incur more debt, have lower-quality interpersonal relationships, act in more ecologically destructive ways, have adverse work and educational motivation, and report lower personal and physical well-being. Experimentally activating materialistic aims causes similar outcomes. Given these ills, researchers have investigated means of decreasing people's materialism. Successful interventions encourage intrinsic/self-transcendent values/goals, increase felt personal security, and/or block materialistic messages from the environment. These interventions would likely be more effective if policies were also adopted that diminished contemporary culture's focus on consumption, profit, and economic growth.

An Animated Introduction to Relational Databases for Many Majors

Science.gov (United States)

Dietrich, Suzanne W.; Goelman, Don; Borror, Connie M.; Crook, Sharon M.

2015-01-01

Database technology affects many disciplines beyond computer science and business. This paper describes two animations developed with images and color that visually and dynamically introduce fundamental relational database concepts and querying to students of many majors. The goal is for educators in diverse academic disciplines to incorporate the…

Buffering against Performance Classroom Goal Structures: The Importance of Autonomy Support and Classroom Community

Science.gov (United States)

Ciani, Keith D.; Middleton, Michael J.; Summers, Jessica J.; Sheldon, Kennon M.

2010-01-01

The culture of schooling in the United States has become increasingly focused on outwardly proving student competence. Some achievement goal theorists suggest that a major casualty of performance-oriented classroom environments may be student motivation for developing and improving competence. The present study extends across theoretical…

Clarity in Teaching and Active Learning in Undergraduate Microbiology Course for Non-Majors

Science.gov (United States)

Marbach-Ad, Gili; McGinnis, J. Randy; Pease, Rebecca; Dai, Amy H.; Schalk, Kelly A.; Benson, Spencer

2010-01-01

We investigated a pedagogical innovation in an undergraduate microbiology course (Microbes and Society) for non-majors and education majors. The goals of the curriculum and pedagogical transformation were to promote active learning and concentrate on clarity in teaching. This course was part of a longitudinal project (Project Nexus) which…

An empirical examination of negotiated goals and performance-to-goal following the introduction of an incentive bonus plan with participative goal setting

NARCIS (Netherlands)

Anderson, S.W.; Dekker, H.C.; Sedatole, K.L.

2010-01-01

Prior research documents performance improvements following the implementation of pay-for-performance (PFP) bonus plans. However, bonus plans typically pay for performance relative to a goal, and the manager whose performance is to be evaluated often participates in setting the goal. In these

Mechanism of oral tolerance induction to therapeutic proteins.

Science.gov (United States)

Wang, Xiaomei; Sherman, Alexandra; Liao, Gongxian; Leong, Kam W; Daniell, Henry; Terhorst, Cox; Herzog, Roland W

2013-06-15

Oral tolerance is defined as the specific suppression of humoral and/or cellular immune responses to an antigen by administration of the same antigen through the oral route. Due to its absence of toxicity, easy administration, and antigen specificity, oral tolerance is a very attractive approach to prevent unwanted immune responses that cause a variety of diseases or that complicate treatment of a disease. Many researchers have induced oral tolerance to efficiently treat autoimmune and inflammatory diseases in different animal models. However, clinical trials yielded limited success. Thus, understanding the mechanisms of oral tolerance induction to therapeutic proteins is critical for paving the way for clinical development of oral tolerance protocols. This review will summarize progress on understanding the major underlying tolerance mechanisms and contributors, including antigen presenting cells, regulatory T cells, cytokines, and signaling pathways. Potential applications, examples for therapeutic proteins and disease targets, and recent developments in delivery methods are discussed. Copyright © 2012 Elsevier B.V. All rights reserved.

Effects of an Alternative to Suspension Intervention in a Therapeutic High School

Science.gov (United States)

Hernandez-Melis, Claudia; Fenning, Pamela; Lawrence, Elizabeth

2016-01-01

The purpose of the current study was to assess the effects of an alternative to suspension intervention on students' subsequent major referrals. The intervention included activities designed to teach social coping strategies as well as mediation to resolve interpersonal conflicts. The intervention was implemented in a therapeutic high school, and…

Shared goals and development

DEFF Research Database (Denmark)

Blomberg, Olle

2015-01-01

undemanding for children to engage in, and therefore has the potential to play a part in fostering their understanding of other minds. Part of the functional role of shared goals is to enable agents to choose means that are appropriate to realising a goal with others rather than individually. By offering...

The Influence of Money on Goal Pursuit and Decision-Making: Understanding Money's Unique Impact on Goal Pursuit

OpenAIRE

Moran, Nora

2015-01-01

Previous research suggests that activating concepts of money and wealth can increase motivation to achieve personal goals. In this dissertation, I investigate how money affects pursuit of important personal goals, and how this motivation may be affected by goal attainability. In eight studies, I show that priming concepts of money and wealth leads individuals to pursue important personal goals to a greater degree than control groups, but only when a goal is more attainable. In contrast, when...

Therapeutic management of radiation-induced oral mucositis

International Nuclear Information System (INIS)

Doerr, W.; Doelling-Jochem, I.; Baumann, M.; Herrmann, T.

1997-01-01

Background: Acute reactions of oral mucosa are a frequent side effect of radiotherapy, which often necessitates interruption of the treatment. Marked proliferation of tumor stem cells during treatment interruptions may occur in squamous cell carcinomata, which represent the majority of tumors in the head and neck area. Hence a fatal consequence of treatment breaks may be a significant decrease in tumor cure rates. Furthermore, marked acute responses frequently result in increased late sequelae ('consequential damage'). Therefore, amelioration of the mucosal response aiming at avoiding treatment breaks and at reduction of late reactions coul definitely increase the therapeutic success of radiation treatment. Results: A variety of prophylactic and therapeutic methods have been proposed for the management of acute radiation reactions of the oral mucosa. Frequently, their efficiacy has been established for chemotherapy or in combination with other immunosuppressive treatments. Hence, systemical rather than local effects have to be considered. Conclusions: In general, prophylaxis of oral mucositis is mainly based on dental restoration or edentation, in combination with frequent oral hygienic measures after the meals and with antiseptic mouthwashes. Intensive personal care is recommended. The necessity of a percutaneous endoscopic gastrostoma is dependent on the status of the patient and on size and localization of the treatment area, i.e. the impairment of food uptake which is to be expected. Therapeutic intervention is restricted to local or systemic treatment of pain and local application of antimycotics and antibiotics. (orig./VHE) [de

Multiple goals, motivation and academic learning.

Science.gov (United States)

Valle, Antonio; Cabanach, Ramón G; Núnez, José C; González-Pienda, Julio; Rodríguez, Susana; Piñeiro, Isabel

2003-03-01

The type of academic goals pursued by students is one of the most important variables in motivational research in educational contexts. Although motivational theory and research have emphasised the somewhat exclusive nature of two types of goal orientation (learning goals versus performance goals), some studies (Meece, 1994; Seifert, 1995, 1996) have shown that the two kinds of goals are relatively complementary and that it is possible for students to have multiple goals simultaneously, which guarantees some flexibility to adapt more efficaciously to various contexts and learning situations. The principal aim of this study is to determine the academic goals pursued by university students and to analyse the differences in several very significant variables related to motivation and academic learning. Participants were 609 university students (74% women and 26% men) who filled in several questionnaires about the variables under study. We used cluster analysis ('quick cluster analysis' method) to establish the different groups or clusters of individuals as a function of the three types of goals (learning goals, performance goals, and social reinforcement goals). By means of MANOVA, we determined whether the groups or clusters identified were significantly different in the variables that are relevant to motivation and academic learning. Lastly, we performed ANOVA on the variables that revealed significant effects in the previous analysis. Using cluster analysis, three groups of students with different motivational orientations were identified: a group with predominance of performance goals (Group PG: n = 230), a group with predominance of multiple goals (Group MG: n = 238), and a group with predominance of learning goals (Group LG: n = 141). Groups MG and LG attributed their success more to ability, they had higher perceived ability, they took task characteristics into account when planning which strategies to use in the learning process, they showed higher persistence

Goal pursuit, goal adjustment, and affective well-being following lower limb amputation

OpenAIRE

Coffey, Laura; Gallagher, Pamela; Desmond, Deirdre; Ryall, Nicola

2014-01-01

Objectives. This study examined the relationships between tenacious goal pursuit (TGP), flexible goal adjustment (FGA), and affective well-being in a sample of individuals with lower limb amputations. Design. Cross-sectional, quantitative. Methods. Ninety-eight patients recently admitted to a primary prosthetic rehabilitation programme completed measures of TGP, FGA, positive affect, and negative affect. Results. Hierarchical regression analyses revealed that TGP and FGA accounted fo...

Translational research in addiction: toward a framework for the development of novel therapeutics.

Science.gov (United States)

Paterson, Neil E

2011-06-15

The development of novel substance use disorder (SUD) therapeutics is insufficient to meet the medical needs of a growing SUD patient population. The identification of translatable SUD models and tests is a crucial step in establishing a framework for SUD therapeutic development programs. The present review begins by identifying the clinical features of SUDs and highlights the narrow regulatory end-point required for approval of a novel SUD therapeutic. A conceptual overview of dependence is provided, followed by identification of potential intervention targets in the addiction cycle. The main components of the addiction cycle provide the framework for a discussion of preclinical models and their clinical analogs, all of which are focused on isolated behavioral end-points thought to be relevant to the persistence of compulsive drug use. Thus, the greatest obstacle to successful development is the gap between the multiplicity of preclinical and early clinical end-points and the regulatory end-point of sustained abstinence. This review proposes two pathways to bridging this gap: further development and validation of the preclinical extended access self-administration model; inclusion of secondary end-points comprising all of the measures highlighted in the present discussion in Phase 3 trials. Further, completion of the postdictive validation of analogous preclinical and clinical assays is of high priority. Ultimately, demonstration of the relevance and validity of a variety of end-points to the ultimate goal of abstinence will allow researchers to identify truly relevant therapeutic mechanisms and intervention targets, and establish a framework for SUD therapeutic development that allows optimal decision-making and resource allocation. 2011 Elsevier Inc. All rights reserved.

Setting goals in psychotherapy

DEFF Research Database (Denmark)

Emiliussen, Jakob; Wagoner, Brady

2013-01-01

The present study is concerned with the ethical dilemmas of setting goals in therapy. The main questions that it aims to answer are: who is to set the goals for therapy and who is to decide when they have been reached? The study is based on four semi-­‐structured, phenomenological interviews...

[A mid-term review of the Millennium Development Goals: where are we with the goals on health?].

Science.gov (United States)

Kaddar, Miloud

2009-01-01

The eight Millennium Development Goals (MDGs) are the expressed commitment by world leaders to combat the most obvious forms of social inequality in the world: poverty, illiteracy and disease. The MDGs set health priorities and serve as markers of the most fundamental problems to solve: the maternal and child health high mortality, and the fight against major endemic diseases. Thus, health appears in three of the eight goals, and plays a decisive role in achieving the other MDGs such as the eradication of poverty and hunger, promotion of education and gender equality. While progress has been made in various domains and in numerous countries, enormous gaps and lack of funding remain. This is the case for infant mortality and HIV/AIDS, and even more so in the area of maternal mortality reduction especially in sub-Saharan Africa and Southeast Asia. The recent proliferation of forums and international partnerships for health have put at the forefront the targeted health-related MDG, increased financial resources for the benefit of poor countries but have made the architecture of global health even more fragmented and complex. Attempts to align on country priorities, needs and national health plans, and also to harmonize donors and partners' actions and funding according to the 2005 Paris Declaration principles, were difficult to actually materialize. The revitalization of primary health care and the strengthening of health systems are now back on the international and national health agenda.

Enhanced Delivery of Gold Nanoparticles with Therapeutic Potential for Targeting Human Brain Tumors

Science.gov (United States)

Etame, Arnold B.

The blood brain barrier (BBB) remains a major challenge to the advancement and application of systemic anti-cancer therapeutics into the central nervous system. The structural and physiological delivery constraints of the BBB significantly limit the effectiveness of conventional chemotherapy, thereby making systemic administration a non-viable option for the vast majority of chemotherapy agents. Furthermore, the lack of specificity of conventional systemic chemotherapy when applied towards malignant brain tumors remains a major shortcoming. Hence novel therapeutic strategies that focus both on targeted and enhanced delivery across the BBB are warranted. In recent years nanoparticles (NPs) have emerged as attractive vehicles for efficient delivery of targeted anti-cancer therapeutics. In particular, gold nanoparticles (AuNPs) have gained prominence in several targeting applications involving systemic cancers. Their enhanced permeation and retention within permissive tumor microvasculature provide a selective advantage for targeting. Malignant brain tumors also exhibit transport-permissive microvasculature secondary to blood brain barrier disruption. Hence AuNPs may have potential relevance for brain tumor targeting. However, the permeation of AuNPs across the BBB has not been well characterized, and hence is a potential limitation for successful application of AuNP-based therapeutics within the central nervous system (CNS). In this dissertation, we designed and characterized AuNPs and assessed the role of polyethylene glycol (PEG) on the physical and biological properties of AuNPs. We established a size-dependent permeation profile with respect to core size as well as PEG length when AuNPs were assessed through a transport-permissive in-vitro BBB. This study was the first of its kind to systematically examine the influence of design on permeation of AuNPs through transport-permissive BBB. Given the significant delivery limitations through the non

Achievement goals and perfectionism of high school students

Directory of Open Access Journals (Sweden)

Milojević Milica

2009-01-01

Full Text Available This research has been investigating one of the most contemporary approaches of achievement motivation - Achievement Goal Theory, which uses the construct of achievement goals. The construct of achievement goals involves three types of achievement goals: mastery goals, performance approach goals and performance avoidance goals. The main goal of the research was to examine correlation between perfectionism and its aspects with particular types of achievement goals. Also, the goal was to investigate the difference concerning gender regarding the achievement goals. The sample consisted of 200 senior year high school participants. The following instruments were used: Multi-dimensional scale of perfectionism (MSP and Test of achievement goals (TCP. The research results indicate that there is significant positive correlation between: perfectionism with performance approach goals and performance avoidance goals, concern over mistakes and parental expectations with performance approach goals and performance avoidance goals, personal standards and organization with mastery goals and performance approach goals, parental criticism and doubts about action with performance avoidance goals. Significant negative correlation was found between parental criticism and mastery goals. The results concerning the second goal indicates the female subjects have higher average scores in mastery goals.

Molecular Therapeutic Approaches for Pediatric Acute Myeloid Leukemia

Directory of Open Access Journals (Sweden)

Sarah K Tasian

2014-03-01

Full Text Available Approximately two thirds of children with acute myeloid leukemia (AML are cured with intensive multi-agent chemotherapy. However, primary chemorefractory and relapsed AML remains a significant source of childhood cancer mortality, highlighting the need for new therapies. Further therapy intensification with traditional cytotoxic agents is not feasible given the potential for significant toxicity to normal tissues with conventional chemotherapy and the risk for long-term end-organ dysfunction. Significant emphasis has been placed upon the development of molecularly targeted therapeutic approaches for adults and children with high-risk subtypes of AML with the goal of improving remission induction and minimizing relapse. Several promising agents are currently in clinical testing or late preclinical development for AML, including monoclonal antibodies against leukemia cell surface proteins, kinase inhibitors, proteasome inhibitors, epigenetic agents, and chimeric antigen receptor engineered T cell immunotherapies. Many of these therapies have been specifically tested in children with relapsed/refractory AML via phase 1 and 2 trials with a smaller number of new agents under phase 3 evaluation for children with de novo AML. Although successful identification and implementation of new drugs for children with AML remains a formidable challenge, enthusiasm for novel molecular therapeutic approaches is great given the potential for significant clinical benefit for children who will otherwise fail standard therapy.

GOAL-to-HAL translation study

Science.gov (United States)

Flanders, J. H.; Helmers, C. T.; Stanten, S. F.

1973-01-01

This report deals with the feasibility, problems, solutions, and mapping of a GOAL language to HAL language translator. Ground Operations Aerospace Language, or GOAL, is a test-oriented higher order language developed by the John F. Kennedy Space Center to be used in checkout and launch of the space shuttle. HAL is a structured higher order language developed by the Johnson Space Center to be used in writing the flight software for the onboard shuttle computers. Since the onboard computers will extensively support ground checkout of the space shuttle, and since these computers and the software development facilities on the ground use the HAL language as baseline, the translation of GOAL to HAL becomes significant. The issue of feasibility was examined and it was found that a GOAL to HAL translator is feasible. Special problems are identified and solutions proposed. Finally, examples of translation are provided for each category of complete GOAL statement.

Safety goals for nuclear power

International Nuclear Information System (INIS)

Fischhoff, B.

1984-02-01

The key policy question in managing hazardous technologies is often some variant of How safe is safe enough. The US Nuclear Regulatory Commission has recently broached this topic by adopting safety goals defining acceptable risk levels for nuclear power plants. These goals are analyzed here with a general theory of standard setting (Fischhoff, 1983) which asks: (1) Are standards an appropriate policy tool in this case. (2) Can the Commission's safety philosophy be defended. (3) Do the operational goals capture that philosophy. The anlaysis shows the safety goals proposal to be sophisticated in some respects, incomplete in others. More generally, it points to difficulties with the concept of acceptable risk and any attempt to build policy instruments around it. Although focused on the NRC's safety goals, the present analysis is a prototype of what can be learned by similarly detailed consideration of other standards, not only for nuclear power but also for other hazardous technologies, as well as for issues unrelated to safety

Systemic consultation and goal setting

OpenAIRE

Carr, Alan

1993-01-01

Over two decades of empirical research conducted within a positivist framework has shown that goal setting is a particularly useful method for influencing task performance in occupational and industrial contexts. The conditions under which goal setting is maximally effective are now clearly established. These include situations where there is a high level of acceptance and commitment, where goals are specific and challenging, where the task is relatively simple rather than ...

Alcohol myopia and goal commitment

OpenAIRE

Sevincer, A. Timur; Oettingen, Gabriele

2014-01-01

According to alcohol myopia theory, acute alcohol consumption leads people to disproportionally focus on the salient rather than the peripheral aspects of a situation. We summarize various studies exploring how myopic processes resulting from acute alcohol intake affect goal commitment. After consuming alcohol student participants felt strongly committed to an important personal goal even though they had low expectations of successfully attaining the goal. However, once intoxicated participan...

Evolution and Personal Religious Belief: Christian University Biology-Related Majors' Search for Reconciliation

Science.gov (United States)

Winslow, Mark W.; Staver, John R.; Scharmann, Lawrence C.

2011-01-01

The goal of this study was to explore Christian biology-related majors' perceptions of conflicts between evolution and their religious beliefs. This naturalistic study utilized a case study design of 15 undergraduate biology-related majors at or recent biology-related graduates from a mid-western Christian university. The broad sources of data…

Heuristic Search for Planning with Different Forced Goal-Ordering Constraints

Directory of Open Access Journals (Sweden)

Jiangfeng Luo

2013-01-01

Full Text Available Planning with forced goal-ordering (FGO constraints has been proposed many times over the years, but there are still major difficulties in realizing these FGOs in plan generation. In certain planning domains, all the FGOs exist in the initial state. No matter which approach is adopted to achieve a subgoal, all the subgoals should be achieved in a given sequence from the initial state. Otherwise, the planning may arrive at a deadlock. For some other planning domains, there is no FGO in the initial state. However, FGO may occur during the planning process if certain subgoal is achieved by an inappropriate approach. This paper contributes to illustrate that it is the excludable constraints among the goal achievement operations (GAO of different subgoals that introduce the FGOs into the planning problem, and planning with FGO is still a challenge for the heuristic search based planners. Then, a novel multistep forward search algorithm is proposed which can solve the planning problem with different FGOs efficiently.

Imaging of athletic pubalgia and core muscle injuries: clinical and therapeutic correlations.

Science.gov (United States)

Palisch, Andrew; Zoga, Adam C; Meyers, William C

2013-07-01

Athletes frequently injure their hips and core muscles. Accurate diagnosis and proper treatment of groin pain in the athlete can be tricky, frequently posing vexing problem for trainers and physicians. Clinical presentations of the various hip problems overlap with respect to history and physical examination. This article reviews clinical presentations and magnetic resonance imaging findings specific to the various causes of groin pain in the athlete. The focus is on the core muscle injuries (athletic pubalgia or "sports hernia"). The goal is to raise awareness about the variety of injuries that occur and therapeutic options. Copyright © 2013 Elsevier Inc. All rights reserved.

Targeted Delivery of siRNA Therapeutics to Malignant Tumors

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Qixin Leng

2017-01-01

Full Text Available Over the past 20 years, a diverse group of ligands targeting surface biomarkers or receptors has been identified with several investigated to target siRNA to tumors. Many approaches to developing tumor-homing peptides, RNA and DNA aptamers, and single-chain variable fragment antibodies by using phage display, in vitro evolution, and recombinant antibody methods could not have been imagined by researchers in the 1980s. Despite these many scientific advances, there is no reason to expect that the ligand field will not continue to evolve. From development of ligands based on novel or existing biomarkers to linking ligands to drugs and gene and antisense delivery systems, several fields have coalesced to facilitate ligand-directed siRNA therapeutics. In this review, we discuss the major categories of ligand-targeted siRNA therapeutics for tumors, as well as the different strategies to identify new ligands.

Molecular, Phenotypic Aspects and Therapeutic Horizons of Rare Genetic Bone Disorders

Directory of Open Access Journals (Sweden)

Taha Faruqi

2014-01-01

Full Text Available A rare disease afflicts less than 200,000 individuals, according to the National Organization for Rare Diseases (NORD of the United States. Over 6,000 rare disorders affect approximately 1 in 10 Americans. Rare genetic bone disorders remain the major causes of disability in US patients. These rare bone disorders also represent a therapeutic challenge for clinicians, due to lack of understanding of underlying mechanisms. This systematic review explored current literature on therapeutic directions for the following rare genetic bone disorders: fibrous dysplasia, Gorham-Stout syndrome, fibrodysplasia ossificans progressiva, melorheostosis, multiple hereditary exostosis, osteogenesis imperfecta, craniometaphyseal dysplasia, achondroplasia, and hypophosphatasia. The disease mechanisms of Gorham-Stout disease, melorheostosis, and multiple hereditary exostosis are not fully elucidated. Inhibitors of the ACVR1/ALK2 pathway may serve as possible therapeutic intervention for FOP. The use of bisphosphonates and IL-6 inhibitors has been explored to be useful in the treatment of fibrous dysplasia, but more research is warranted. Cell therapy, bisphosphonate polytherapy, and human growth hormone may avert the pathology in osteogenesis imperfecta, but further studies are needed. There are still no current effective treatments for these bone disorders; however, significant promising advances in therapeutic modalities were developed that will limit patient suffering and treat their skeletal disabilities.

Will Synergizing Vaccination with Therapeutics Boost Measles Virus Eradication?

Science.gov (United States)

Plemper, Richard K; Hammond, Anthea L

2014-01-01

Introduction Measles virus is a major human pathogen responsible for approximately 150,000 measles deaths annually. The disease is vaccine preventable and eradication of the virus is considered feasible in principle. However, a herd immunity exceeding 95% is required to prevent sporadic viral outbreaks in a population. Declining disease prevalence combined with public anxieties about vaccination safety has increased vaccine refusal especially in the European region, which has resulted in measles resurgence in some areas. Areas covered Here, we discuss whether synergizing effective measles therapeutics with vaccination could contribute to solving an endgame conundrum of measles elimination by accelerating the eradication effort. Based on an anticipated use for protection of high-risk contacts of confirmed measles cases through post-exposure prophylaxis, we identify key elements of the desirable drug profile, review current disease management strategies and the state of experimental inhibitor candidates, evaluate the risk associated with viral escape from inhibition, and consider the potential of measles therapeutics for the management of persistent viral infection of the CNS. Assuming a post-measles world with waning measles immunity, we contemplate the possible impact of therapeutics on controlling the threat imposed by closely related zoonotic pathogens of the same genus as measles virus. Expert opinion Efficacious therapeutics given for post-exposure prophylaxis of high-risk social contacts of confirmed index cases may aid measles eradication by closing herd immunity gaps due to vaccine refusal or failure in populations with overall good vaccination coverage. The envisioned primarily prophylactic application of measles therapeutics to a predominantly pediatric and/or adolescent patient population dictates the drug profile; the article must be safe and efficacious, orally available, shelf-stable at ambient temperature, and amenable to cost-effective manufacture

APPLICATION OF GOAL SETTING THEORY

OpenAIRE

Yurtkoru, E. Serra; Bozkurt, Tulay; Bekta, Fatos; Ahmed, Mahir Jibril; Kola, Vehap

2017-01-01

The purpose of this study is to test the goal theorymodel originally developed by Locke and Latham in organizational setting inTurkey, and explain its influence on job satisfaction and affective commitment.Also mediating role of task specific strategy and moderating role ofselfefficacy are examined. Locke and Latham’s goal setting measure is adaptedto Turkish. Survey method is employed to collect data from 222 respondents fromautomotive industry. Goal setting dimensions predicted affective co...

A Multi-Criteria Goal Programming Model to Analyze the Sustainable Goals of India

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Srikant Gupta

2018-03-01

Full Text Available There is an ever-growing demand for sustainable development (SD plans, in order to foster a country’s economic growth by implementing suitable policies and initiative programs for the development of the primary, the secondary and the tertiary sectors. We present a multi-criteria modeling approach using the linear programming problem (LPP framework for a simultaneous optimization of these three sectors. Furthermore, we develop a fuzzy goal programming (FGP model that provides an optimal allocation of resources by achieving future goals on the gross domestic product (GDP, the electricity consumption (EC and the greenhouse gas (GHG emissions. Furthermore, a weighted model of FGP is presented to obtain varying solutions according to the priorities set by the decision-maker for achieving future goals of GDP growth, EC and GHG emissions. The presented models provide useful insight for decision-makers when implementing strategies across different sectors. As a model country, we chose India by the year 2030. A study of economic policies and sustainable development goals (SDGs for India is finally carried out.

The Influence of Money on Goal Pursuit and Decision-Making: Understanding Money's Unique Impact on Goal Pursuit

Science.gov (United States)

Moran, Nora

Previous research suggests that activating concepts of money and wealth can increase motivation to achieve personal goals. In this dissertation, I investigate how money affects pursuit of important personal goals, and how this motivation may be affected by goal attainability. In eight studies, I show that priming concepts of money and wealth leads individuals to pursue important personal goals to a greater degree than control groups, but only when a goal is more attainable. In contrast, when a goal is less attainable, those primed with money will be less likely to work towards goals relative to control groups. Furthermore, I examine why money may have a detrimental effect on motivation when individuals are faced with less attainable but important goals, and argue those primed with money become more concerned with maintaining a sense of efficacy, and thus disengage from pursuit when success is less certain. Thus, this research identifies the needs made salient by activating money--validating one's abilities. Finally, I show the relevance of these findings for consumer behavior, and discuss the additional implications of this work, as well as future research directions.

Tougher containment design goals

International Nuclear Information System (INIS)

O'Farrelly, C.

1978-01-01

Present day LWR containment design goals are reviewed, together with their potential failure modes. Rasmussen's estimates of failure probabilities are discussed and the concept of ''delayed failure'' is seen to be a valuable safety goal for hypothetical accidents. The paper investigates the inherent coremelt resistance capability of various containment designs and suggests improvements, with special emphasis on increasing the failure delay times. (author)

The endocrine system and sarcopenia: potential therapeutic benefits.

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McIntire, Kevin L; Hoffman, Andrew R

2011-12-01

Age related muscle loss, known as sarcopenia, is a major factor in disability, loss of mobility and quality of life in the elderly. There are many proposed mechanisms of age-related muscle loss that include the endocrine system. A variety of hormones regulate growth, development and metabolism throughout the lifespan. Hormone activity may change with age as a result of reduced hormone secretion or decreased tissue responsiveness. This review will focus on the complex interplay between the endocrine system, aging and skeletal muscle and will present possible benefits of therapeutic interventions for sarcopenia.

Path-Goal Theory of Leadership

Science.gov (United States)

1975-04-01

Leadership and Turnover Among Managers ," Organization Behavior and Human Performance, 10(1973), pp. 184-200; R. J. House, "A Path-Goal Theory of...of Leadership ." 6R. J. House and G. Dessler, "Path-Goal Theory of Leadership " R. M. Stqg- dill. Managers , Employees, Organization (Ohio State...of Control." 23 R. J. House, "Notes on the Path-Goal Theory of Leadership " (University of Toronto, Faculty of Management Studies, May 1974). 24 R

The Relation Between Goals and Autobiographical Memory

DEFF Research Database (Denmark)

Johannessen, Kim Berg; Rasmussen, Anne Scharling; Berntsen, Dorthe

facilitate recall of goal congruent autobiographical memories which supports the idea of autobiographical memory facilitating goal attainment. Further, no differences between involuntary and voluntary memories with regard to frequency or characteristics of goal related content were found. Yet memories...... related to goals were rated as more central to the person's identity, life story and expectations for the future than non-goal related memories, irrespective of mode of recall. Interestingly, depression and PTSD symptoms correlated positively with the proportion of goal related memories, thereby......The present study examines involuntary (spontaneously retrieved) versus voluntary (deliberately retrieved) autobiographical memories in relation to earlier registered goals measured by the Personal Concern Inventory (Cox & Klinger, 2000). We found that the important and not yet planned goals...

Therapeutic application of lasers in ophthalmology

International Nuclear Information System (INIS)

Misiuk-Hojlo, M.; Krzyzanowska-Berkowska, P.; Hill-Bator, A.

2007-01-01

Lasers have found application in diverse branches of medicine. In ophthalmology, laser technology has various therapeutic and diagnostic applications. The purpose of this article is to review the major therapeutic applications of lasers in different eye disorders. The effects of lasers on biological tissues and different laser techniques as well as the indications for laser therapy in various parts of the eye are discussed. Lasers are used to treat glaucoma and many vascular disorders of the retina. Laser treatment may be useful in preventing the development of neovascularization in diabetic retinopathy, BRVO, or CRVO. Laser techniques are also available for the treatment of the exudative form of age-related macular degeneration (AMD) and some malignant and benign intraocular tumors and in retina abnormalities which predispose to rhegmatogenous retinal detachment. Corneal laser surgery is the most frequently applied laser procedure in ophthalmology. PRK, LASIK, and LASEK are used to correct errors in vision such as myopia, hyperopia, and astigmatism. Laser photocoagulation is also helpful in cataract surgery. Nowadays, lasers have become so universal that it is difficult to imagine ophthalmology without them. We are still witnessing rapid advances in the development of laser techniques, especially in plastic surgery, cataract extraction, and ocular imaging. (authors)

Reforming an Undergraduate Environmental Science Course for Nonscience Majors

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Kazempour, Mahsa; Amirshokoohi, Aidin

2013-01-01

This article discusses the key components of a reform-based introductory undergraduate environmental science course for nonscience majors and elementary teacher candidates as well as the impact of such components on the participants. The main goals for the course were to actively engage the students in their learning and, in doing so, to enhance…

The impact of early symptom change and therapeutic alliance on treatment outcome in cognitive-behavioural therapy for eating disorders.

Science.gov (United States)

Turner, Hannah; Bryant-Waugh, Rachel; Marshall, Emily

2015-10-01

The present study explored the impact of early symptom change (cognitive and behavioural) and the early therapeutic alliance on treatment outcome in cognitive-behavioural therapy (CBT) for the eating disorders. Participants were 94 adults with diagnosed eating disorders who completed a course of CBT in an out-patient community eating disorders service in the UK. Patients completed a measure of eating disorder psychopathology at the start of treatment, following the 6th session and at the end of treatment. They also completed a measure of therapeutic alliance following the 6th session. Greater early reduction in dietary restraint and eating concerns, and smaller levels of change in shape concern, significantly predicted later reduction in global eating pathology. The early therapeutic alliance was strong across the three domains of tasks, goals and bond. Early symptom reduction was a stronger predictor of later reduction in eating pathology than early therapeutic alliance. The early therapeutic alliance did not mediate the relationship between early symptom reduction and later reduction in global eating pathology. Instead, greater early symptom reduction predicted a strong early therapeutic alliance. Early clinical change was the strongest predictor of treatment outcome and this also facilitated the development of a strong early alliance. Clinicians should be encouraged to deliver all aspects of evidence-based CBT, including behavioural change. The findings suggest that this will have a positive impact on both the early therapeutic alliance and later change in eating pathology. Copyright © 2015 Elsevier Ltd. All rights reserved.

Two Years after Molecular Diagnosis of Familial Hypercholesterolemia: Majority on Cholesterol-Lowering Treatment but a Minority Reaches Treatment Goal

Science.gov (United States)

Huijgen, Roeland; Kindt, Iris; Verhoeven, Sjoerd B. J.; Sijbrands, Eric J. G.; Vissers, Maud N.; Kastelein, John J. P.; Hutten, Barbara A.

2010-01-01

Background The risk of premature cardiovascular disease in patients with familial hypercholesterolemia (FH) can be profoundly reduced by cholesterol-lowering therapy, and current guidelines for FH advocate ambitious low-density lipoprotein cholesterol (LDL-C) goals. In the present study, we determined whether these goals are reflected in current clinical practice once FH has been diagnosed. Methodology/Principal Findings In 2008, we sent questionnaires to all subjects (aged 18–65 years) who were molecularly diagnosed with FH in the year 2006 through the screening program in the Netherlands. Of these 1062 subjects, 781 completed the questionnaire (46% males; mean age: 42±12 years; mean LDL-C at molecular diagnosis (baseline): 4.1±1.3 mmol/L). The number of persons that used cholesterol-lowering therapy increased from 397 (51%) at baseline to 636 (81%) after diagnosis. Mean treated LDL-C levels decreased significantly to 3.2±1.1 mmol/L two years after diagnosis. Only 22% achieved the LDL-C target level of ≤2.5 mmol/L. Conclusions/Significance The proportion of patients using cholesterol-lowering medication was significantly increased after FH diagnosis through genetic cascade screening. The attained LDL-C levels were lower than those reported in previous surveys on medication use in FH, which could reflect the effect of more stringent lipid target levels. However, only a minority of the medication users reached the LDL-C target. PMID:20169164

The goal(s) of corporate rescue in company law: A comparative analysis

OpenAIRE

Anthony O. Nwafor

2017-01-01

The concept of corporate rescue lays emphasis on corporate sustainability than liquidation. This trend in corporate legislation which featured in the United Kingdom Insolvency Act of 1986, Australian Corporations Act 2001, Indian Sick Industrial Companies (Special Provisions) Act of 1985 (as replaced by Companies Act, 2013 and supplanted by the Insolvency and Bankruptcy Code, 2016) has been adopted in the South African Companies Act of 2008. The goal(s) of corporate rescue in some of these ju...

ANGIOGRAPHIC ANATOMY OF THE MAJOR ABDOMINAL ARTERIAL BLOOD SUPPLY IN THE DOG.

Science.gov (United States)

Culp, William T N; Mayhew, Philipp D; Pascoe, Peter J; Zwingenberger, Allison

2015-01-01

Vascular-based interventional radiology (IR) procedures are being more regularly performed in veterinary patients for both diagnostic and therapeutic purposes. A complete description of the fluoroscopic arterial anatomy of the canine abdominal cavity has not been published. This information is essential for performance of IR procedures to allow for improved preparation before and during a particular procedure. The primary purpose of this study was to provide a fluoroscopic description of the vascular branching from the abdominal aorta in a ventro-dorsal projection with a secondary goal of producing pictorial reference images of the major abdominal arterial blood vessels. Five healthy female hound type dogs were enrolled and underwent fluoroscopic arteriography. During fluoroscopy, both nonselective and selective arteriography were performed. The nonselective arteriograms were obtained in the aorta at four locations: cranial to the celiac artery, cranial to the renal arteries, cranial to the caudal mesenteric artery, and cranial to the branching of the external iliac arteries. Selective arteriography was conducted by performing injections into the following arteries: celiac, splenic, common hepatic, cranial mesenteric, left and right renal, and caudal mesenteric. Fluoroscopic arteriography allowed for excellent characterization of the aortic ostia and the location of the lower order vascular branches. Future evaluation of vascular-based treatment options will likely increase as the understanding of the normal and pathologic anatomy improves. © 2015 American College of Veterinary Radiology.

Patients' empowerment , physicians' perceptions, and achievement of therapeutic goals in patients with type 1 and type 2 diabetes mellitus in Mexico

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Lavalle-González FJ

2016-07-01

Full Text Available Fernando J Lavalle-González,1 Erwin Chiquete2 On behalf of the IDMPS-3W Collaborative Group (Mexico 1Department of Endocrinology, Hospital Universitario Dr José Eleuterio González, Monterrey, NL, 2Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico Background: Physicians’ perception may not parallel objective measures of therapeutic targets in patients with diabetes. This is an issue rarely addressed in the medical literature. We aimed to analyze physicians’ perception and characteristics of adequate control of patients with diabetes.Patients and methods: We studied information on physicians and their patients who participated in the third wave of the International Diabetes Management Practices Study registry in Mexico. This analysis was performed on 2,642 patients, 203 with type 1 diabetes mellitus (T1DM and 2,439 with type 2 diabetes mellitus (T2DM, treated by 200 physicians.Results: The patients perceived at target had lower hemoglobin A1c (HbA1c and fasting blood glucose than those considered not at target. However, overestimation of the frequency of patients with HbA1c <7% was 41.5% in patients with T1DM and 31.7% in patients with T2DM (underestimation: 2.8% and 8.0%, respectively. The agreement between the physicians’ perception and the class of HbA1c was suboptimal (κ: 0.612. Diabetologists and endocrinologists tested HbA1c more frequently than primary care practitioners, internists, or cardiologists; however, no differences were observed in mean HbA1c, for both T1DM (8.4% vs 7.2%, P=0.42 and T2DM (8.03% vs 8.01%, P=0.87 patients. Nevertheless, insulin users perceived at target, who practiced self-monitoring and self-adjustment of insulin, had a lower mean HbA1c than patients without these characteristics (mean HbA1c in T1DM: 6.8% vs 9.6%, respectively; mean HbA1c in T2DM: 7.0% vs 10.1%, respectively.Conclusion: Although there is a significant

Validation of the Goal Content for Exercise Questionnaire (GCEQ for a sample of elderly Portuguese people

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Raul Antunes

2017-06-01

Full Text Available According Sebire, Standage and Vansteenkiste (2008, goals contents (motives are the major drivers of behavior, giving rise to the goal content theory, which is in the basis of Goal Content for Exercise Questionnaire (GCEQ: Sebire et al., 2008 development. So, the main goal of present study was to conduct the validation of GCEQ for a sample of Portuguese elderly (n = 311, with equal or higher ages than 60 years old (M = 68.53; DP = 6.69. The main results show us that CGEQ measurement model (5 factors, 20 items only present adequate fit to data after the elimination of 3 items: S-Bχ²=219.9, df=109, p=.001, SRMR=.049, TLI=.916, CFI=.934, RMSEA=.057, RMSEA 90% CI=.046-.068, PCFI=.747. Besides that, the 5 factors show us acceptable values of composite reliability: between .76 and .88. Those findings allow us to conclude that GCEQ with 5 factors and 17 items can be used to measure goal content in a population of elderly Portuguese people in physical activity domain.

Therapeutic Nanodevices

Science.gov (United States)

Lee, Stephen; Ruegsegger, Mark; Barnes, Philip; Smith, Bryan; Ferrari, Mauro

Therapeutic nanotechnology offers minimally invasive therapies with high densities of function concentrated in small volumes, features that may reduce patient morbidity and mortality. Unlike other areas of nanotechnology, novel physical properties associated with nanoscale dimensionality are not the raison d'être of therapeutic nanotechnology, whereas the aggregation of multiple biochemical (or comparably precise) functions into controlled nanoarchitectures is. Multifunctionality is a hallmark of emerging nanotherapeutic devices, and multifunctionality can allow nanotherapeutic devices to perform multistep work processes, with each functional component contributing to one or more nanodevice subroutine such that, in aggregate, subroutines sum to a cogent work process. Cannonical nanotherapeutic subroutines include tethering (targeting) to sites of disease, dispensing measured doses of drug (or bioactive compound), detection of residual disease after therapy and communication with an external clinician/operator. Emerging nanotherapeutics thus blur the boundaries between medical devices and traditional pharmaceuticals. Assembly of therapeutic nanodevices generally exploits either (bio)material self-assembly properties or chemoselective bioconjugation techniques, or both. Given the complexity, composition, and the necessity for their tight chemical and structural definition inherent in the nature of nanotherapeutics, their cost of goods (COGs) might exceed that of (already expensive) biologics. Early therapeutic nanodevices will likely be applied to disease states which exhibit significant unmet patient need (cancer and cardiovascular disease), while application to other disease states well-served by conventional therapy may await perfection of nanotherapeutic design and assembly protocols.

Propitious Therapeutic Modulators to Prevent Blood-Spinal Cord Barrier Disruption in Spinal Cord Injury.

Science.gov (United States)

Kumar, Hemant; Ropper, Alexander E; Lee, Soo-Hong; Han, Inbo

2017-07-01

The blood-spinal cord barrier (BSCB) is a specialized protective barrier that regulates the movement of molecules between blood vessels and the spinal cord parenchyma. Analogous to the blood-brain barrier (BBB), the BSCB plays a crucial role in maintaining the homeostasis and internal environmental stability of the central nervous system (CNS). After spinal cord injury (SCI), BSCB disruption leads to inflammatory cell invasion such as neutrophils and macrophages, contributing to permanent neurological disability. In this review, we focus on the major proteins mediating the BSCB disruption or BSCB repair after SCI. This review is composed of three parts. Section 1. SCI and the BSCB of the review describes critical events involved in the pathophysiology of SCI and their correlation with BSCB integrity/disruption. Section 2. Major proteins involved in BSCB disruption in SCI focuses on the actions of matrix metalloproteinases (MMPs), tumor necrosis factor alpha (TNF-α), heme oxygenase-1 (HO-1), angiopoietins (Angs), bradykinin, nitric oxide (NO), and endothelins (ETs) in BSCB disruption and repair. Section 3. Therapeutic approaches discusses the major therapeutic compounds utilized to date for the prevention of BSCB disruption in animal model of SCI through modulation of several proteins.

Does Context, Practice or Competition Affect Female Athletes’ Achievement Goal Dominance, Goal Pursuit, Burnout and Motivation?

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Fernández-Rio Javier

2017-10-01

Full Text Available The goal of this study was to assess the effects of two different achievement sport contexts, practice and competition, on the motivational profile of professional/semi-professional athletes. Forty-eight Spanish national/international-level female athletes (basketball = 18; handball = 12; soccer = 11; volleyball = 7, mean age 25.14 ± 3.43 years, agreed to participate in the study. They completed a questionnaire, prior and after training and competition, to assess achievement goals, achievement goal dominance, goal pursuit, motivational climate, motivation, burnout and perceived recovery-exertion. Data analyses revealed that, both in practice and competition, these team-sport athletes overwhelmingly showed a strong mastery-approach achievement goal in dominance as well as in pursuit. A significant finding was that this group of national/international-level, professional/semi-professional athletes not only adopted a mastery-approach achievement goal, but they also actively pursued it. It is also remarkable that this profile remained stable at post-tests, even after a painful defeat in competition, which produced a significant negative effect on the athletes’ burnout (emotional and physical exhaustion and devaluation of sport participation and self-determined motivation. As expected, the difference between total recovery and perceived exertion significantly increased after practice and competition. National/international-level team-sport professional/semi-professional female athletes held and pursue stable mastery-approach goal dominance.

Personal Investigator: A Therapeutic 3D Game for Adolescent Psychotherapy

OpenAIRE

Coyle, David; Matthews, Mark; Sharry, John; Nisbet, Andy; Doherty, Gavin

2005-01-01

Although mental health problems increase markedly during adolescent years, therapists often find it difficult to engage withadolescents. The majority of disturbed adolescents do not receive professional mental health care and of those who do fewerstill will fully engage with the therapeutic process (Offer et al. 1991; US Surgeon General 1999). Personal Investigator (PI) is a3D computer game specifically designed to help adolescents overcome mental health problems such as depression and helpth...

Cookery demonstrations in GOAL supported clinics

African Journals Online (AJOL)

stunting are high, and various micronutrient deficiencies, including those of ... the household are the underlying causes seen in GOAL- assisted areas. ... feeding. Thus, the nutrition cookery demonstration activity has come to play an important role in mother and child health activities in GOAL-supported clinics and GOAL's.

GOAL Agents Instantiate Intention Logic

OpenAIRE

Hindriks, Koen; van der Hoek, Wiebe

2008-01-01

It is commonly believed there is a big gap between agent logics and computational agent frameworks. In this paper, we show that this gap is not as big as believed by showing that GOAL agents instantiate Intention Logic of Cohen and Levesque. That is, we show that GOAL agent programs can be formally related to Intention Logic.We do so by proving that the GOAL Verification Logic can be embedded into Intention Logic. It follows that (a fragment of) Intention Logic can be used t...

Identity, Intimacy, Status and Sex Dating Goals as Correlates of Goal-Consistent Behavior and Satisfaction in Australian Youth

Science.gov (United States)

Kelly, Marguerite; Zimmer-Gembeck, Melanie J.; Boislard-P., Marie-Aude

2012-01-01

The most common dating goals of adolescents are identity, intimacy, status and sex. In this study of Australian youth (16-30 years, N = 208), dating goals were expected to explain goal-consistent behavior in each domain. Also, goals coupled with consistent behavior were expected to be associated with greater satisfaction in each domain. Age,…

Integrated learning through student goal development.

Science.gov (United States)

Price, Deborah; Tschannen, Dana; Caylor, Shandra

2013-09-01

New strategies are emerging to promote structure and increase learning in the clinical setting. Nursing faculty designed a mechanism by which integrative learning and situated coaching could occur more readily in the clinical setting. The Clinical Goals Initiative was implemented for sophomore-, junior-, and senior-level students in their clinical practicums. Students developed weekly goals reflecting three domains of professional nursing practice. Goals were shared with faculty and staff nurse mentors at the beginning of the clinical day to help guide students and mentors with planning for learning experiences. After 6 weeks, faculty and students were surveyed to evaluate project effectiveness. Faculty indicated that goal development facilitated clinical learning by providing more student engagement, direction, and focus. Students reported that goal development allowed them to optimize clinical learning opportunities and track their growth and progress. Faculty and students indicated the goals promoted student self-learning, autonomy, and student communication with nurse mentors and faculty. Copyright 2013, SLACK Incorporated.

Macromolecular therapeutics.

Science.gov (United States)

Yang, Jiyuan; Kopeček, Jindřich

2014-09-28

This review covers water-soluble polymer-drug conjugates and macromolecules that possess biological activity without attached low molecular weight drugs. The main design principles of traditional and backbone degradable polymer-drug conjugates as well as the development of a new paradigm in nanomedicines - (low molecular weight) drug-free macromolecular therapeutics are discussed. To address the biological features of cancer, macromolecular therapeutics directed to stem/progenitor cells and the tumor microenvironment are deliberated. Finally, the future perspectives of the field are briefly debated. Copyright © 2014 Elsevier B.V. All rights reserved.

Secular trends in mortality associated with new therapeutic strategies in surgical critical illness.

Science.gov (United States)

Hartl, Wolfgang H; Wolf, Hilde; Schneider, Christian P; Küchenhoff, Helmut; Jauch, Karl-Walter

2007-10-01

Since 1999 randomized controlled trials have shown that new therapeutic strategies, such as strict glycemic control, increased use of noninvasive ventilation and of lung-protective ventilation, and early goal-oriented shock therapy, may reduce mortality in selected groups of critically ill patients. Whether these benefits can be translated to a surgical clinical setting is unclear. We wanted to evaluate longitudinally the successive routine implementation of new therapeutic measures and its effect on postsurgical patients admitted to the intensive care unit. We performed a retrospective analysis on data collected prospectively from March 1, 1993 through February 28, 2005. A cohort of 1,802 consecutive cases requiring intensive care therapy for more than 4 days was analyzed. A significant decrease in mortality was observed in the last years of the study. With adjustment for relevant covariates, treatment after the implementation of new therapeutic strategies was identified as an independent factor linked with a reduced risk of death (odds ratio [OR] .518; 95% confidence interval [CI] .337-.796), whereas older age (OR 1.030; 95% CI 1.015-1.045), a high severity score on admission (OR 1.155; 95% CI 1.113-1.198) or during intensive care unit stay (OR 1.187; 95% CI 1.145-1.231), a high number of failing organs (OR 1.918; 95% CI 1.635-2.250), and peritonitis (OR 3.277; 95% CI 2.046-5.246) were independently associated with death. Implementing of a variety of new therapeutic measures into routine care of critically ill surgical patients was associated with improved survival after 2001.

Promising Therapeutic Strategies for Mesenchymal Stem Cell-Based Cardiovascular Regeneration: From Cell Priming to Tissue Engineering

Directory of Open Access Journals (Sweden)

Seung Taek Ji

2017-01-01

Full Text Available The primary cause of death among chronic diseases worldwide is ischemic cardiovascular diseases, such as stroke and myocardial infarction. Recent evidence indicates that adult stem cell therapies involving cardiovascular regeneration represent promising strategies to treat cardiovascular diseases. Owing to their immunomodulatory properties and vascular repair capabilities, mesenchymal stem cells (MSCs are strong candidate therapeutic stem cells for use in cardiovascular regeneration. However, major limitations must be overcome, including their very low survival rate in ischemic lesion. Various attempts have been made to improve the poor survival and longevity of engrafted MSCs. In order to develop novel therapeutic strategies, it is necessary to first identify stem cell modulators for intracellular signal triggering or niche activation. One promising therapeutic strategy is the priming of therapeutic MSCs with stem cell modulators before transplantation. Another is a tissue engineering-based therapeutic strategy involving a cell scaffold, a cell-protein-scaffold architecture made of biomaterials such as ECM or hydrogel, and cell patch- and 3D printing-based tissue engineering. This review focuses on the current clinical applications of MSCs for treating cardiovascular diseases and highlights several therapeutic strategies for promoting the therapeutic efficacy of MSCs in vitro or in vivo from cell priming to tissue engineering strategies, for use in cardiovascular regeneration.

Rights Language in the Sustainable Development Agenda: Has Right to Health Discourse and Norms Shaped Health Goals?

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Lisa Forman

2015-12-01

Full Text Available While the right to health is increasingly referenced in Sustainable Development Goal (SDG discussions, its contribution to global health and development remains subject to considerable debate. This hypothesis explores the potential influence of the right to health on the formulation of health goals in 4 major SDG reports. We analyse these reports through a social constructivist lens which views the use of rights rhetoric as an important indicator of the extent to which a norm is being adopted and/or internalized. Our analysis seeks to assess the influence of this language on goals chosen, and to consider accordingly the potential for rights discourse to promote more equitable global health policy in the future.

Neurotransmitter regulation of adult neurogenesis: putative therapeutic targets.

Science.gov (United States)

Vaidya, V A; Vadodaria, K C; Jha, S

2007-10-01

The evidence that new neuron addition takes place in the mammalian brain throughout adult life has dramatically altered our perspective of the potential for plasticity in the adult CNS. Although several recent reports suggest a latent neurogenic capacity in multiple brain regions, the two major neurogenic niches that retain the ability to generate substantial numbers of new neurons in adult life are the subventricular zone (SVZ) lining the lateral ventricles and the subgranular zone (SGZ) in the hippocampal formation. The discovery of adult neurogenesis has also unveiled a novel therapeutic target for the repair of damaged neuronal circuits. In this regard, understanding the endogenous mechanisms that regulate adult neurogenesis holds promise both for a deeper understanding of this form of structural plasticity, as well as the identification of pathways that can serve as therapeutic targets to manipulate adult neurogenesis. The purpose of the present review is to discuss the regulation of adult neurogenesis by neurotransmitters and to highlight the relevance of these endogenous regulators as targets to modulate adult neurogenesis in a clinical context.

Therapeutic Approaches to Histone Reprogramming in Retinal Degeneration.

Science.gov (United States)

Berner, Andre K; Kleinman, Mark E

2016-01-01

Recent data have revealed epigenetic derangements and subsequent chromatin remodeling as a potent biologic switch for chronic inflammation and cell survival which are important therapeutic targets in the pathogenesis of several retinal degenerations. Histone deacetylases (HDACs) are a major component of this system and serve as a unique control of the chromatin remodeling process. With a multitude of targeted HDAC inhibitors now available, their use in both basic science and clinical studies has widened substantially. In the field of ocular biology, there are data to suggest that HDAC inhibition may suppress neovascularization and may be a possible treatment for retinitis pigmentosa and dry age-related macular degeneration (AMD). However, the effects of these inhibitors on cell survival and chemokine expression in the chorioretinal tissues remain very unclear. Here, we review the multifaceted biology of HDAC activity and pharmacologic inhibition while offering further insight into the importance of this epigenetic pathway in retinal degenerations. Our laboratory investigations aim to open translational avenues to advance dry AMD therapeutics while exploring the role of acetylation on inflammatory gene expression in the aging and degenerating retina.

Therapeutic goals in the treatment of Gaucher disease

NARCIS (Netherlands)

Pastores, Gregory M.; Weinreb, Neal J.; Aerts, Hans; Andria, Generoso; Cox, Timothy M.; Giralt, Manuel; Grabowski, Gregory A.; Mistry, Pramod K.; Tylki-Szymańska, Anna

2004-01-01

Gaucher disease, the most common lysosomal storage disorder, is a heterogeneous multisystem condition. Patients with non-neuronopathic (type 1) Gaucher disease may suffer from hepatomegaly, splenomegaly, thrombocytopenia, bleeding tendencies, anemia, hypermetabolism, skeletal pathology, growth

Illegitimacy Improves Goal Pursuit in Powerless Individuals

OpenAIRE

Willis , Guillermo B.; Guinote , Ana; Rodríguez-Bailón , Rosa

2009-01-01

Abstract The effects of power legitimacy on self-regulation during goal pursuit were examined. Study 1 focused on goal-setting and goal-striving. Specifically, it examined how much time legitimate and illegitimate powerless individuals needed to set goals, and how many means they generated to pursue these goals. Study 2 examined persistence in the face of difficulties. Consistently across these studies illegitimacy improved self-regulation in powerless individuals. Illegitimate pow...

Integration and Diffusion in Sustainable Development Goals: Learning from the Past, Looking into the Future

Directory of Open Access Journals (Sweden)

Norichika Kanie

2014-04-01

Full Text Available One of the next major challenges for research and policy on sustainability is setting the post-2015 Development Agenda. This challenge arises as a direct result of the formal ending of the Millennium Development Goals (MDGs in 2015 and as an outcome of the 2012 United Nations Conference on Sustainable Development (Rio+20. The post-2015 Development Agenda is expected to include two agendas: one on human well-being to advance the MDG targets and the other on planetary well-being, which requires a safe “operating space” within the Earth’s life-support system. In contrast to the MDGs, the Sustainable Development Goals (SDGs are meant to apply to both developing and developed countries and create a space for development within the stable functioning of the Earth’s systems. However, what might this all look like? For answers, this paper reviews the achievements and reflections of the MDGs to date and identifies new challenges entailed in the shift of development goals from “millennium” to “sustainable”. While most of the existing studies look at these two sets of issues separately, combining the two reveals two important features of the SDGs. First, SDGs need to integrate both human and planetary well-being in a goal, and second, goals, or sub-goals, need to be formulated at multiple levels, from global to local levels. While the MDGs represented no integrated goals, some of the existing proposals on SDGs include integrated goals. However, our analysis has shown that they do not present the vertical diffusion of goals. Considering both integration and diffusion in the architecture of SDGs is a remaining task.

The Impact of Interpersonal Style on Ruptures and Repairs in the Therapeutic Alliance Between Offenders and Therapists in Sex Offender Treatment.

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Watson, Rachael; Thomas, Stuart; Daffern, Michael

2017-10-01

The therapeutic relationship is a critical component of psychological treatment. Strain can occur in the relationship, particularly when working with offenders, and more specifically, those offenders with interpersonal difficulties; strain can lead to a rupture, which may affect treatment participation and performance. This study examined ruptures in the therapeutic relationship in sexual offenders participating in offense-focused group treatment. Fifty-four sex offenders rated the therapeutic alliance at the commencement and completion of treatment; at the completion of treatment, they also reported on the occurrence of ruptures and whether they believed these ruptures were repaired. Ruptures were separated by type, according to severity-Each relationship was therefore characterized as experiencing no rupture, a minor rupture, or a major rupture. Offender characteristics including interpersonal style (IPS) and psychopathy were assessed at the commencement of treatment; their relationship with ruptures was examined. Results revealed that more than half of the offenders (approximately 55%) experienced a rupture in the therapeutic alliance, with one in four of these ruptures remaining unresolved. Offenders who did not report a rupture rated the therapeutic alliance significantly higher at the end of treatment compared with those offenders who reported a rupture that was not repaired. Offenders who reported a major rupture in the therapeutic relationship were higher in interpersonal hostility and hostile-dominance. No interpersonal or offense-specific factors affected the likelihood of a rupture repair.

[Nuclear transfer and therapeutic cloning].

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Xu, Xiao-Ming; Lei, An-Min; Hua, Jin-Lian; Dou, Zhong-Ying

2005-03-01

Nuclear transfer and therapeutic cloning have widespread and attractive prospects in animal agriculture and biomedical applications. We reviewed that the quality of oocytes and nuclear reprogramming of somatic donor cells were the main reasons of the common abnormalities in cloned animals and the low efficiency of cloning and showed the problems and outlets in therapeutic cloning, such as some basic problems in nuclear transfer affected clinical applications of therapeutic cloning. Study on isolation and culture of nuclear transfer embryonic stem (ntES) cells and specific differentiation of ntES cells into important functional cells should be emphasized and could enhance the efficiency. Adult stem cells could help to cure some great diseases, but could not replace therapeutic cloning. Ethics also impeded the development of therapeutic cloning. It is necessary to improve many techniques and reinforce the research of some basic theories, then somatic nuclear transfer and therapeutic cloning may apply to agriculture reproduction and benefit to human life better.

Frontiers in nano-therapeutics

CERN Document Server

Tasnim, Nishat; Sai Krishna, Katla; Kalagara, Sudhakar; Narayan, Mahesh; Noveron, Juan C; Joddar, Binata

2017-01-01

This brief highlights recent research advances in the area of nano-therapeutics. Nanotechnology holds immense potential for application in a wide range of biological and engineering applications such as molecular sensors for disease diagnosis, therapeutic agents for the treatment of diseases, a vehicle for delivering therapeutics and imaging agents for theranostic applications, both in-vitro and in-vivo. The brief is grouped into the following sections namely, A) Discrete Nanosystems ; B) Anisotropic Nanoparticles; C) Nano-films/coated/layered and D) Nano-composites.

Achieving Good Outcomes for Asthma Living (GOAL): mixed methods feasibility and pilot cluster randomised controlled trial of a practical intervention for eliciting, setting and achieving goals for adults with asthma.

Science.gov (United States)

Hoskins, Gaylor; Williams, Brian; Abhyankar, Purva; Donnan, Peter; Duncan, Edward; Pinnock, Hilary; van der Pol, Marjon; Rauchhaus, Petra; Taylor, Anne; Sheikh, Aziz

2016-12-08

Despite being a core component of self-management, goal setting is rarely used in routine care. We piloted a primary care, nurse-led intervention called Achieving Good Outcomes for Asthma Living (GOAL) for adults with asthma. Patients were invited to identify and prioritise their goals in preparation for discussing and negotiating an action/coping plan with the nurse at a routine asthma review. The 18-month mixed methods feasibility cluster pilot trial stratified and then randomised practices to deliver usual care (UC) or a goal-setting intervention (GOAL). Practice asthma nurses and adult patients with active asthma were invited to participate. The primary outcome was asthma-specific quality of life. Semi-structured interviews with a purposive patient sample (n = 14) and 10 participating nurses explored GOAL perception. The constructs of normalisation process theory (NPT) were used to analyse and interpret data. Ten practices participated (five in each arm), exceeding our target of eight. However, only 48 patients (target 80) were recruited (18 in GOAL practices). At 6 months post-intervention, the difference in mean asthma-related quality of life (mAQLQ) between intervention and control was 0.1 (GOAL 6.20: SD 0.76 (CI 5.76-6.65) versus UC 6.1: SD 0.81 (CI 5.63-6.57)), less than the minimal clinically important difference (MCID) of 0.5. However, change from baseline was stronger in the intervention group: at 6 months the change in the emotions sub-score was 0.8 for intervention versus 0.2 for control. Costs were higher in the intervention group by £22.17. Routine review with goal setting was considered more holistic, enhancing rapport and enabling patients to become active rather than passive participants in healthcare. However, time was a major barrier for nurses, who admitted to screening out patient goals they believed were unrelated to asthma. The difference in AQLQ score from baseline is larger in the intervention arm than the control, indicating the

Characteristics of therapeutic alliance in musculoskeletal physiotherapy and occupational therapy practice: a scoping review of the literature.

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Babatunde, Folarin; MacDermid, Joy; MacIntyre, Norma

2017-05-30

the therapeutic alliance themes extracted were from patient perspectives. The relationship between adherence and therapeutic alliance was examined by 26 articles of which 57% showed some correlation between therapeutic alliance and adherence. Age moderated the relationship between therapeutic alliance and adherence with younger individuals and an autonomy support environment reporting improved adherence. Prioritized goals, autonomy support and motivation were facilitators of therapeutic alliance. Therapeutic Alliance has been studied in a limited extent in the rehabilitation literature with conflicting frameworks and findings. Potential benefits described for enhancing therapeutic alliance might include better exercise adherence. Several knowledge gaps have been identified with a potential for generating future research priorities for therapeutic alliance in musculoskeletal rehabilitation.

Clinically distinct trajectories of fatigue and their longitudinal relationship with the disturbance of personal goals following a cancer diagnosis.

Science.gov (United States)

Müller, Fabiola; Tuinman, Marrit A; Janse, Moniek; Almansa, Josué; Sprangers, Mirjam A G; Smink, Ans; Ranchor, Adelita V; Fleer, Joke; Hagedoorn, Mariët

2017-09-01

Most studies on fatigue in patients with cancer aggregate its prevalence and severity on a group level, ignoring the possibility that subgroups of patients may differ widely in their development of fatigue. This study aimed to identify subgroups of patients with clinically distinct trajectories of fatigue from diagnosis to 18 months post-diagnosis. As fatigue might trigger goal disturbance, the study also identified trajectories of concrete and abstract goal disturbance and longitudinally examined their co-occurrence with fatigue. Prospective design with quantitative and qualitative method of data collection. Patients with colorectal cancer (n = 183) reported on their levels of fatigue and goal disturbance shortly after diagnosis (T 1 ) and at 7 months (T 2 ) and 18 months (T 3 ) post-diagnosis. Growth mixture model analyses were performed to identify trajectories of fatigue and goal disturbance. Guidelines for the clinical relevance of fatigue were applied. Four clinically distinct trajectories of fatigue were identified as follows: (1) persistent severe fatigue (25.4%), (2) moderate fatigue (56.1%), (3) no fatigue (13.8%), and (4) rapidly improving fatigue (4.7%). The majority of patients with cancer reported high disturbance of their concrete goals, while high disturbance of abstract goals was less evident. Fatigue and concrete goal disturbance co-occurred longitudinally. The fatigue and goal disturbance experienced from diagnosis to 18 months post-diagnosis differ considerably for subgroups of patients with cancer. Fatigue and concrete goal disturbance are persistent burdens in the majority of patients. Investigating symptom burden beyond average trends can guide clinicians to identify patients most in need for treatment. Targeting goal disturbance might benefit the psychological well-being in patients suffering from persistent symptoms. Statement of contribution What is already known on this subject? Fatigue is a common and distressing symptom at all

Paris and its long-term temperature goal: First steps on a long road

Science.gov (United States)

Rogelj, J.

2017-12-01

As a means to achieve its long-term temperature goal, the Paris Agreement put in place a system of regularly updated country pledges alternating with global stocktaking exercises that assess progress towards achieving the Paris goals. By now, the vast majority of countries have submitted their intended actions (also known as Nationally Determined Contributions - NDCs). This begs the question what these amount to and whether they are in line with the agreement`s long-term temperature goal. A structured sensitivity analysis of the emissions implications of the Paris pledges has been carried out, showing that the ambiguity and imprecision of the NDCs leaves open a wide range of possible outcomes by 2030. This range has important implications for the feasibility and cost of pathways that attempt to limit warming to the temperature goals of the Agreement. We identify salient steps to reduce the overall uncertainty, and explore the minimum requirements that have to be met for integrated energy-economy-land models to still find options to stay within the temperature limits of the Paris Agreement. These requirements come under the form of near-term emissions reductions, and assumptions about the deployment of carbon-dioxide removal technologies in the second half of the century.

Shaped Goals: Teaching Undergraduates the Effects of Social Stratification on the Formulation of Goals

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Touzard, Giselle

2009-01-01

This article describes an in-class activity that helps undergraduate students to understand the effects of their socio-economic position on the formulation, pursuit, and achievement of goals. Social stratification and inequality have an initial impact on the formulation of goals. Through this exercise students will perceive the effects of having a…

Rethinking Therapeutic Misconception in Biobanking

DEFF Research Database (Denmark)

Tupasela, Aaro; Snell, Karoliina; Cañada, Jose

2017-01-01

Some authors have noted that in biobank research participants may be guided by what is called therapeutic misconception, whereby participants attribute therapeutic intent to research procedures.This article argues that the notion of therapeutic misconception is increasingly less justified when...... underpinnings for the need to separate research and treatment, and thus the notion of therapeutic misconception in the fi rst place. We call this tension between research and treatment ambivalent research advancement to highlight the difficulties that various actors have in managing such shifts within...

Nucleic Acid Aptamers as Novel Class of Therapeutics to Mitigate Alzheimer's Disease Pathology

DEFF Research Database (Denmark)

K. Tannenberg, Rudi; Al. Shamaileh, Hadi; Lauridsen, Lasse Holm

2013-01-01

Deposition of amyloid-beta (A beta) peptides in the brain is a central event in the pathogenesis of Alzheimer's disease (AD), which makes A beta peptides a crucial target for therapeutic intervention. Significant efforts have been made towards the development of ligands that bind to A beta peptides...... with a goal of early detection of amyloid aggregation and the neutralization of A toxicity. Short single-stranded oligonucleotide aptamers bind with high affinity and specificity to their targets. Aptamers that specifically bind to A beta monomers, specifically the 40 and 42 amino acid species (A beta(1...

Non-HDL-C goals based on the distribution of population percentiles in ELSA-Brasil: Is it time to change?

Science.gov (United States)

Brito, Fabiano A; Pedrosa, William; Maluf, Chams B; Dos Reis, Rodrigo C P; Fedeli, Ligia M G; Castilhos, Cristina; Barreto, Sandhi M; Vidigal, Pedro G

2018-07-01

Non-high-density lipoprotein cholesterol (non-HDL-C) goals are defined as 30 mg/dL (0.78 mmol/L) higher than the respective low-density lipoprotein cholesterol (LDL-C) goals. This definition, however, do not consider the population distribution of non-HDL-C, which could represent a more appropriate individual goal when both markers are discordant. The aim of this study is to establish non-HDL-C goals at the same population percentiles of LDL-C. Non-HDL-C values were assigned at the same percentiles correspondent to the LDL-C treatment goals for 14,837 participants from the Longitudinal Study of Adult Health (ELSA-Brasil) with triglycerides levels ≤ 400 mg/dL (4.52 mmol/L). We also assessed the frequency of reclassification, defined as the number of subjects with LDL-C levels in the recommended therapeutic category, but with non-HDL-C levels above or below the category. The non-HDL-C values, based on correspondent LDL-C population percentiles, were 92 (2.38), 122 (3.16), 156 (4.04), 191 (4.95), and 223 mg/dL (5.78 mmol/L). Among participants with LDL-C <70 mg/dL (1.81 mmol/L), 22.8% were reclassified in a higher category according to the guidelines-based non-HDL-C cut-off and 30.1% according to the population percentile-based cut-off; 25.6% and 64.1%, respectively, if triglycerides concurrently 150-199 mg/dL (1.69-2.25 mmol/L). Our results demonstrated that non-HDL-C percentiles-based goals were up to 8 mg/dL (0.21 mmol/L) lower than the guidelines recommended goal and had a profound impact on the reclassification of participants, notably when LDL-C was <100 mg/dL (2.56 mmol/L), the treatment goal for high risk patients. Therefore, non-HDL-C goals should be changed for reduction of residual risk. Copyright © 2018 Elsevier B.V. All rights reserved.

Traditional biomolecular structure determination by NMR spectroscopy allows for major errors

NARCIS (Netherlands)

Nabuurs, S.B.; Spronk, C.A.E.M.; Vuister, G.W.; Vriend, G.

2006-01-01

One of the major goals of structural genomics projects is to determine the three-dimensional structure of representative members of as many different fold families as possible. Comparative modeling is expected to fill the remaining gaps by providing structural models of homologs of the

Motivational Function of Plans and Goals

Directory of Open Access Journals (Sweden)

Sabina Alispahić

2013-10-01

Full Text Available The academic literature shows that by helping tune out distractions, goals can get individuals' to try harder, work longer, and achieve more. Goals that people set for themselves and that are devoted to attaining mastery are usually healthy. But goals imposed by others—sales targets, quarterly returns, standardized test scores—can sometimes have dangerous side effects (Pink, 2009. Because understanding action demands understanding intention, the idea of motivation is natural and readily expressed in everyday language. Cognitive mental events like goals and expectancies can function as a “spring to action”, a moving force that energizes and directs action in purposive ways (Reeve, 2005. Cognitive studies of motivation are dealing with relationship between cognition and action. Literature is indicating a few cognitive elements that can have motivational significance. The article presents the overview of theory and research about the motivational function of plans and goals, according to Goal setting theory (Locke & Latham, 1990 and Self-determination Theory (Deci & Ryan, 2000. Suggestions for additional research are also indicated.

Predicting Academic Self-Handicapping in Different Age Groups: The Role of Personal Achievement Goals and Social Goals

Science.gov (United States)

Leondari, Angeliki; Gonida, Eleftheria

2007-01-01

Background: Academic self-handicapping refers to the use of impediments to successful performance on academic tasks. Previous studies have shown that it is related to personal achievement goals. A performance goal orientation is a positive predictor of self-handicapping, whereas a task goal orientation is unrelated to self-handicapping. Aims: The…

Reducing therapeutic misconception: A randomized intervention trial in hypothetical clinical trials.

Directory of Open Access Journals (Sweden)

Paul P Christopher

Full Text Available Participants in clinical trials frequently fail to appreciate key differences between research and clinical care. This phenomenon, known as therapeutic misconception, undermines informed consent to clinical research, but to date there have been no effective interventions to reduce it and concerns have been expressed that to do so might impede recruitment. We determined whether a scientific reframing intervention reduces therapeutic misconception without significantly reducing willingness to participate in hypothetical clinical trials.This prospective randomized trial was conducted from 2015 to 2016 to test the efficacy of an informed consent intervention based on scientific reframing compared to a traditional informed consent procedure (control in reducing therapeutic misconception among patients considering enrollment in hypothetical clinical trials modeled on real-world studies for one of five disease categories. Patients with diabetes mellitus, hypertension, coronary artery disease, head/neck cancer, breast cancer, and major depression were recruited from medical clinics and a clinical research volunteer database. The primary outcomes were therapeutic misconception, as measured by a validated, ten-item Therapeutic Misconception Scale (range = 10-50, and willingness to participate in the clinical trial.154 participants completed the study (age range, 23-87 years; 92.3% white, 56.5% female; 74 (48.1% had been randomized to receive the experimental intervention. Therapeutic misconception was significantly lower (p = 0.004 in the scientific reframing group (26.4, 95% CI [23.7 to 29.1] compared to the control group (30.9, 95% CI [28.4 to 33.5], and remained so after controlling for education (p = 0.017. Willingness to participate in the hypothetical trial was not significantly different (p = 0.603 between intervention (52.1%, 95% CI [40.2% to 62.4%] and control (56.3%, 95% CI [45.3% to 66.6%] groups.An enhanced educational intervention augmenting

Acquired hemophilia A: a review of recent data and new therapeutic options.

Science.gov (United States)

Franchini, Massimo; Vaglio, Stefania; Marano, Giuseppe; Mengoli, Carlo; Gentili, Sara; Pupella, Simonetta; Liumbruno, Giancarlo Maria

2017-10-01

Acquired hemophilia A (AHA) is a rare, but potentially life-threatening, bleeding disorder caused by an autoantibody against factor VIII that interferes with its coagulant function. We performed a narrative review focusing on the diagnostic aspects of AHA and on the current treatment strategies with particular regard to new data and therapeutic developments. The management of this severe hemorrhagic disorder is based on the control of bleeding with the use of bypassing agents and on the utilization of a variety of immunosuppressant agents with the goal of eliminating the autoantibody permanently. The optimal management of AHA should be multidisciplinary and requires a close collaboration between physicians from various specialties.

The Relationship between Future Goals and Achievement Goal Orientations: An Intrinsic-Extrinsic Motivation Perspective

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Lee, Jie Qi; McInerney, Dennis M.; Liem, Gregory Arief D.; Ortiga, Yasmin P.

2010-01-01

This research aimed to study the relationships between students' future goals (FGs) and their immediate achievement goal orientations (AGOs) among 5733 Singaporean secondary school students (M age = 14.18, SD = 1.26; 53% boys). To this end, we hypothesized that the relationships between like valenced FGs and AGOs (both intrinsic or both extrinsic)…

Status of prophylactic and therapeutic genital herpes vaccines.

Science.gov (United States)

Awasthi, Sita; Friedman, Harvey M

2014-06-01

A half billion people have genital herpes infections worldwide. Approximately one-fifth of American women between ages 14 and 49 are HSV-2 seropositive. The development of an effective genital herpes vaccine is a global health necessity based on the mental anguish genital herpes causes for some individuals, the fact that pregnant women with genital herpes risk transmitting infection to their newborn children, and the observation that HSV-2 infection is associated with a 3-fold to 4-fold increased probability of HIV acquisition. We review the strengths and limitations of preclinical animal models used to assess genital herpes vaccine candidates and the goals of prophylactic and therapeutic vaccines. We also discuss the current pipeline of vaccine candidates and lessons learned from past clinical trials that serve as a stimulus for new strategies, study designs and endpoint determinations. Copyright © 2014 Elsevier B.V. All rights reserved.

Section on the Neurobiology and Treatment of Mood Disorders (SNMD)

Data.gov (United States)

Federal Laboratory Consortium — The major goal of the SNMD is to conduct therapeutic studies on treatment-resistant depression, with a more recent extension to patients with suicidal ideation and...

Speech and language therapists' perspectives of therapeutic alliance construction and maintenance in aphasia rehabilitation post-stroke.

Science.gov (United States)

Lawton, Michelle; Sage, Karen; Haddock, Gillian; Conroy, Paul; Serrant, Laura

2018-05-01

goal setting, relational strategies; and motivational enhancement techniques. The conceptualization of therapeutic alliance, however, is only provisional. Further research is essential to elucidate the experiences and perceptions of alliance development for people with aphasia undergoing rehabilitation. © 2018 The Authors International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.

Why people stereotype affects how they stereotype: the differential influence of comprehension goals and self-enhancement goals on stereotyping.

Science.gov (United States)

van den Bos, Arne; Stapel, Diederik A

2009-01-01

In four studies, the authors examined the hypothesis that the way people stereotype is determined by the motives that instigate it. Study 1 measured and demonstrated the effectiveness of a commonly used priming technique to manipulate comprehension and self-enhancement goals. Study 2 demonstrated that why people stereotype determines how they stereotype: When a comprehension goal was salient, positive as well as negative stereotypes were applied, whereas a salient self-enhancement goal led to the application of negative but not positive stereotypes. Study 3 replicated these effects with different stereotypes. Study 4 replicated these effects and gave more insight in the consequences of goal fulfillment on stereotyping. Results indicated the fulfillment of a salient self-enhancement or comprehension goal led to the reduction of stereotyping. These effects were goal specific: Fulfillment of a self-enhancement goal decreased enhancement-driven but not comprehension-driven stereotyping; fulfillment of a comprehension goal decreased comprehension-driven but not enhancement-driven stereotyping.

Maximizing therapeutic gain with gemcitabine and fractionated radiation

International Nuclear Information System (INIS)

Mason, Kathy A.; Milas, Luka; Hunter, Nancy R.; Elshaikh, Mohamed; Buchmiller, Lara; Kishi, Kazushi; Hittelman, K. Walter; Ang, K. Kian

1999-01-01

radiotherapy resulted in slight radioprotection (DMF 0.96). Two doses and 5 daily doses of gemcitabine enhanced radiation response by factors of 1.09 and 1.23, respectively. Major factors affecting the response of the jejunal mucosa were apoptotic death of S-phase cells exposed to gemcitabine and cell cycle synchrony of surviving cells. Tumor reoxygenation was found to be a major mechanism for tumor radioenhancement, in addition to those reported earlier. Conclusion: All 3 schedules of drug administration produced therapeutic gain; however, when gemcitabine was given more than once in a 5-fraction radiation treatment schedule, normal tissue toxicity increased. The highest therapeutic gain (1.4) was achieved by giving a single dose of gemcitabine (25 mg/kg) 24 h before the start of fractionated radiotherapy

Single Enteral Loading Dose of Phenobarbital for Achieving Its Therapeutic Serum Levels in Neonates

Science.gov (United States)

Turhan, Ali H.; Atici, Aytug; Okuyaz, Cetin; Uysal, Sercan

2010-01-01

Aim To investigate whether therapeutic serum drug levels may be achieved with a single enteral loading dose of phenobarbital. Methods The study was performed at the Mersin University Hospital in Turkey between April 2004 and August 2006, and included 29 newborn babies with seizure. After the acute treatment of the seizure with midazolam at a dose of 0.1 mg/kg, phenobarbital was administered by orogastric route at a loading dose of 20 mg/kg. Serum phenobarbital concentrations were measured at 0.5, 3, 6, and 12 hours after the loading. Serum phenobarbital levels between 10-30 μg/mL were considered as the therapeutic range. Results The serum phenobarbital levels reached therapeutic values in 9 (31%), 19 (66%), 21 (72%), and 23 (79%) patients at 0.5, 3, 6, and 12 hours after loading, respectively, while they did not reach therapeutic values in 6 patients (21%) after 12 hours. Four of the patients in whom there was no increase in serum phenobarbital levels had hypoxic-ischemic encephalopathy. Conclusion Enteral loading of phenobarbital can achieve therapeutic serum levels in the large majority of newborn babies with seizure and may be safely used in babies with the intact gastrointestinal tract. PMID:20564764

Goals and Personality in Adolescents

Science.gov (United States)

Sanz de Acedo Lizarraga, M. L.; Ugarte, M. D.; Lumbreras, M. Victoria; Sanz de Acedo Baquedano, M. T.

2006-01-01

The purpose of this study was to investigate the influence of personality factors in the value allotted by adolescents to various groups of goals. For this purpose, the "Cuestionario de Personalidad Situacional, CPS" (Situational Personality Questionnaire) and the "Cuestionario de Metas para Adolescentes, CMA" (Goals for…

Safety goals for future nuclear power plants

International Nuclear Information System (INIS)

Todreas, Neil E.

2001-01-01

This talk presents technology goals developed for Generation IV nuclear energy systems that can be made available to the market by 2030 or earlier. These goals are defined in the broad areas of sustainability, safety and reliability, and economics. Sustainability goals focus on fuel utilization, waste management, and proliferation resistance. Safety and reliability goals focus on safe and reliable operation, investment protection, and essentially eliminating the need for emergency response. Economics goals focus on competitive life cycle and energy production costs and financial risk. Future reactors fall in three categories - those which are: Certified or derivatives; Designed to a reasonable extent and based on available technology; In conceptual form only with potential to most fully satisfy the GENIV goals

New Goals of Sustainable Future

Directory of Open Access Journals (Sweden)

Arkady Ursul

2017-02-01

Full Text Available This article investigates the process of transition from the Millennium Development Goals to Sustainable Development Goals (SDGs. The authors have set an objective to demonstrate that SD as a future form of development of civilization from the very beginning had a “target orientation” and from the beginning and anticipated realization and staging of the whole hierarchy of objectives needed for the establishment of an effective global governance. In the future, global development in its “anthropogenic” aspect will be to implement the goals and principles of SD, which will be updated with each new stage of the implementation of this kind of socio-natural evolution. The paper argues the position that the concept of SD should be radically transformed into a “global dimension.” Attention is drawn to the fact that Russia recognized another distant, but very important in the conceptual and theoretical perspective, global goal of “sustainable transition” — formation of the noosphere.

Understanding music’s therapeutic efficacy: Implications for music education

Directory of Open Access Journals (Sweden)

Diane Thram

2014-11-01

Full Text Available In the current era of electronic domination of human experience, be it via cell phone and/or computer addiction, or the ubiquitous television, actual participation in music- making is less and less common for the average person, child or adult. Passive participation through listening is most often cited by people as their major experience with music in their lives. When asked if listening has therapeutic effects, it is rare for anyone to respond in the negative. Likewise, for performers/active participants in music- making, be it solitary or as part of a group, invariably an enhanced sense of well-being from the act of making music is reported. This paper addresses therapeutic aspects of musical participation (singing, clapping, playing an instrument, dancing, listening by providing a historical overview (12th c to present of attitudes toward music’s therapeutic effects. It argues that music exists through the interaction of our biological capacity to make music with our cultural circumstances. How individuals benefit in all aspects their being – physical, mental and emotional – from engaging in the act of making music is illustrated with examples from field research in southern Africa. Finally implications for Music Education are explored which emphasize how more comprehensive integration of music into the curriculum can serve as an antidote to the increasing isolation and alienation of modern life.

Can the sustainable development goals reduce the burden of nutrition-related non-communicable diseases without truly addressing major food system reforms?

Science.gov (United States)

Hawkes, Corinna; Popkin, Barry M

2015-06-16

While the Millennium Development Goals (MDGs; 2000-2015) focused primarily on poverty reduction, hunger and infectious diseases, the proposed Sustainable Development Goals (SDGs) and targets pay more attention to nutrition and non-communicable diseases (NCDs). One of the 169 proposed targets of the SDGs is to reduce premature deaths from NCDs by one third; another is to end malnutrition in all its forms. Nutrition-related NCDs (NR-NCDs) stand at the intersection between malnutrition and NCDs. Driven in large part by remarkable transformations of food systems, they are rapidly increasing in most low and middle income countries (LMICs). The transformation to modern food systems began in the period following World War II with policies designed to meet a very different set of nutritional and food needs, and continued with globalization in the 1990s onwards. Another type of food systems transformation will be needed to shift towards a healthier and more sustainable diet--as will meeting many of the other SDGs. The process will be complex but is necessary. Communities concerned with NCDs and with malnutrition need to work more closely together to demand food systems change.

Therapeutic benefits of Nanoparticles in Stroke

Directory of Open Access Journals (Sweden)

Stavros ePanagiotou

2015-05-01

Full Text Available Stroke represents one of the major causes of death and disability worldwide, for which no effective treatments are available. The thrombolytic drug alteplase (tissue plasminogen activator or tPA is the only treatment for acute ischemic stroke but its use is limited by several factors including short therapeutic window, selective efficacy and subsequent haemorrhagic complications. Numerous preclinical studies have reported very promising results using neuroprotective agents but they have failed at clinical trials because of either safety issues or lack of efficacy. The delivery of many potentially therapeutic neuroprotectants and diagnostic compounds to the brain is restricted by the blood-brain barrier (BBB. Nanoparticles (NPs, which can readily cross the BBB without compromising its integrity, have immense applications in the treatment of ischemic stroke. In this review, potential uses of NPs will be summarized for the treatment of ischemic stroke. Additionally, an overview of targeted NPs will be provided, which could be used in the diagnosis of stroke. Finally, the potential limitations of using NPs in medical applications will be mentioned. Since the use of NPs in stroke therapy is now emerging and is still in development, this review is far from comprehensive or conclusive. Instead, examples of NPs and their current use will be provided, as well as the potentials of NPs in an effort to meet the high demand of new therapies in stroke.

Rights Language in the Sustainable Development Agenda: Has Right to Health Discourse and Norms Shaped Health Goals?

Science.gov (United States)

Forman, Lisa; Ooms, Gorik; Brolan, Claire E

2015-09-29

While the right to health is increasingly referenced in Sustainable Development Goal (SDG) discussions, its contribution to global health and development remains subject to considerable debate. This hypothesis explores the potential influence of the right to health on the formulation of health goals in 4 major SDG reports. We analyse these reports through a social constructivist lens which views the use of rights rhetoric as an important indicator of the extent to which a norm is being adopted and/or internalized. Our analysis seeks to assess the influence of this language on goals chosen, and to consider accordingly the potential for rights discourse to promote more equitable global health policy in the future. © 2015 by Kerman University of Medical Sciences.

Flexible goal attribution in early mindreading.

Science.gov (United States)

Michael, John; Christensen, Wayne

2016-03-01

The 2-systems theory developed by Apperly and Butterfill (2009; Butterfill & Apperly, 2013) is an influential approach to explaining the success of infants and young children on implicit false-belief tasks. There is extensive empirical and theoretical work examining many aspects of this theory, but little attention has been paid to the way in which it characterizes goal attribution. We argue here that this aspect of the theory is inadequate. Butterfill and Apperly's characterization of goal attribution is designed to show how goals could be ascribed by infants without representing them as related to other psychological states, and the minimal mindreading system is supposed to operate without employing flexible semantic-executive cognitive processes. But research on infant goal attribution reveals that infants exhibit a high degree of situational awareness that is strongly suggestive of flexible semantic-executive cognitive processing, and infants appear moreover to be sensitive to interrelations between goals, preferences, and beliefs. Further, close attention to the structure of implicit mindreading tasks--for which the theory was specifically designed--indicates that flexible goal attribution is required to succeed. We conclude by suggesting 2 approaches to resolving these problems. (c) 2016 APA, all rights reserved).

Modulating Neurotrophin Receptor Signaling as a Therapeutic Strategy for Huntington’s Disease

Science.gov (United States)

Simmons, Danielle A.

2017-01-01

Huntington’s disease (HD) is an autosomal dominant neurodegenerative disorder caused by CAG repeat expansions in the IT15 gene which encodes the huntingtin (HTT) protein. Currently, no treatments capable of preventing or slowing disease progression exist. Disease modifying therapeutics for HD would be expected to target a comprehensive set of degenerative processes given the diverse mechanisms contributing to HD pathogenesis including neuroinflammation, excitotoxicity, and transcription dysregulation. A major contributor to HD-related degeneration is mutant HTT-induced loss of neurotrophic support. Thus, neurotrophin (NT) receptors have emerged as therapeutic targets in HD. The considerable overlap between NT signaling networks and those dysregulated by mutant HTT provides strong theoretical support for this approach. This review will focus on the contributions of disrupted NT signaling in HD-related neurodegeneration and how targeting NT receptors to augment pro-survival signaling and/or to inhibit degenerative signaling may combat HD pathologies. Therapeutic strategies involving NT delivery, peptidomimetics, and the targeting of specific NT receptors (e.g., Trks or p75NTR), particularly with small molecule ligands, are discussed. PMID:29254102

[Clinical features and therapeutic response of our anti-SRP positive patients with myositis].

Science.gov (United States)

Botos, Balázs; Nagy-Vincze, Melinda; Dankó, Katalin

2017-09-01

Idiopathic inflammatory myopathies are a group of clinically heterogeneous diseases, which have been classified by myositis specific antibodies recently. The anti-SRP positive subset of this group is characterized by more severe clinical prognosis than other myositis specific antibody positive types. Our goal was to compare 16 anti-SRP positive patients in the Division of Clinical Immunology, Department of Internal Medicine, University of Debrecen with 16 antibody negative ones. Muscle strength validated in both groups by the manual muscle test proved to be significantly decreased both before and after therapy (χ 2 = 0.006 and 0.019) in the anti-SRP positive group. Muscle-specific inflammatory laboratory parameters showed significant difference only in case of LDH-levels after therapy. Both groups showed good clinical response to first line steroid treatment, yet the significantly higher rate of second line administration suggests worse therapeutic response of the antibody positive group. Based on these facts we determined poor clinical prognosis and therapeutic response of the anti-SRP positive group. Orv Hetil. 2017; 158(35): 1382-1389.

Academic Self-Handicapping and Achievement Goals: A Further Examination.

Science.gov (United States)

Midgley, Carol; Urdan, Tim

2001-01-01

This study extends previous research on the relations among students' personal achievement goals, perceptions of the classroom goal structure, and reports of the use of self-handicapping strategies. Surveys, specific to the math domain, were given to 484 7th-grade students in nine middle schools. Personal performance-avoid goals positively predicted handicapping, whereas personal performance-approach goals did not. Personal task goals negatively predicted handicapping. Perceptions of a performance goal structure positively predicted handicapping, and perceptions of a task goal structure negatively predicted handicapping, independent of personal goals. Median splits used to examine multiple goal profiles revealed that students high in performance-avoid goals used handicapping more than did those low in performance-avoid goals regardless of the level of task goals. Students low in performance-avoid goals and high in task goals handicapped less than those low in both goals. Level of performance-approach goals had little effect on the relation between task goals and handicapping. Copyright 2001 Academic Press.

[Limitation of therapeutic effort: Approach to a combined view].

Science.gov (United States)

Bueno Muñoz, M J

2013-01-01

Over the past few decades, we have been witnessing that increasing fewer people pass away at home and increasing more do so within the hospital. More specifically, 20% of deaths now occur in an intensive care unit (ICU). However, death in the ICU has become a highly technical process. This sometimes originates excesses because the resources used are not proportionate related to the purposes pursued (futility). It may create situations that do not respect the person's dignity throughout the death process. It is within this context that the situation of the clinical procedure called "limitation of the therapeutic effort" (LTE) is reviewed. This has become a true bridge between Intensive Care and Palliative Care. Its final goal is to guarantee a dignified and painless death for the terminally ill. Copyright © 2012 Elsevier España, S.L. y SEEIUC. All rights reserved.

The Concept of L2 User and the goals of Second Language Learning

Directory of Open Access Journals (Sweden)

Willy Juanggo

2017-07-01

Full Text Available It is generally considered that knowing one language is not enough in this era. People need to learn a second language in addition to their mother tongue to meet the demand of today’s life as many of them are becoming a part of multilingual society as well as to face the globalisation. This paper aims to demonstrate the reasons of people learning a second by looking at the several goals they want to achieve in current situation and link it to the second language learning in education context. Subsequently, it also provides some criticism against the majority of English language teachings that set native speaker’s competence as the ultimate goal and highlights the concept of L2 user as a new paradigm and its implication to second language learning.

Human Factor in Therapeutic Relationship

Directory of Open Access Journals (Sweden)

Ramazan Akdogan

2011-03-01

Full Text Available herapeutic relationship is a professional relationship that has been structured based on theoretical props. This relationship is a complicated, wide and unique relationship which develops between two people, where both sides' personality and attitudes inevitably interfere. Therapist-client relationship experienced through transference and counter transference, especially in psychodynamic approaches, is accepted as the main aspect of therapeutic process. However, the approaches without dynamic/deterministic tendency also take therapist-client relationship into account seriously and stress uniqueness of interaction between two people. Being a person and a human naturally sometimes may negatively influence the relationship between the therapist and client and result in a relationship going out of the theoretical frame at times. As effective components of a therapeutic process, the factors that stem from being human include the unique personalities of the therapist and the client, their values and their attitude either made consciously or subconsciously. Literature has shown that the human-related factors are too effective to be denied in therapeutic relationship process. Ethical and theoretical knowledge can be inefficient to prevent the negative effects of these factors in therapeutic process at which point a deep insight and supervision would have a critical role in continuing an acceptable therapeutic relationship. This review is focused on the reflection of some therapeutic factors resulting from being human and development of counter transference onto the therapeutic process.

Therapeutic monoclonal antibody N-glycosylation - Structure, function and therapeutic potential.

Science.gov (United States)

Cymer, Florian; Beck, Hermann; Rohde, Adelheid; Reusch, Dietmar

2018-03-01

Therapeutic antibodies (IgG-type) contain several post-translational modifications (PTMs) whereby introducing a large heterogeneity, both structural and functional, into this class of therapeutics. Of these modifications, glycosylation in the fragment crystallizable (Fc) region is the most heterogeneous PTM, which can affect the stability of the molecule and interactions with Fc-receptors in vivo. Hence, the glycoform distribution can affect the mode of action and have implications for bioactivity, safety and efficacy of the drug. Main topics of the manuscript include: What factors influence the (Fc) glycan pattern in therapeutic antibodies and how can these glycans be characterized? How does structure of the Fc-glycan relate to function and what methods are available to characterize those functions? Although heterogeneous in their scope, the different sections are intended to combine current knowledge on structure-function correlations of IgG glycan structures with regard to Fc (effector) functions, as well as basic aspects and methodologies for their assessment. Copyright © 2017. Published by Elsevier Ltd.

Translational nanomedicine--through the therapeutic window.

Science.gov (United States)

Pierce, Robin L

2015-01-01

Translational nanomedicine occurs only through the successful integration of multiple inputs and iterative modifications. The therapeutic window plays a pivotal role in the trajectory of translational nanomedicine. Often defined in terms of the range of dosage for safe and effective therapeutic effect, a second definition of the therapeutic window refers to the often narrow temporal window in which a therapeutic effect can be obtained. Expanding the second definition to explicitly include the spatial dimension, this article explores aspects of the therapeutic spaces created by nanomedicine that shift the traditional dimensions of symptom, sign and pathology. This article analyzes three aspects of the therapeutic window in nanomedicine - temporal, spatial and manner of construction and their impact on the dimensions of modern medicine.

Profiles of Motivated Self-Regulation in College Computer Science Courses: Differences in Major versus Required Non-Major Courses

Science.gov (United States)

Shell, Duane F.; Soh, Leen-Kiat

2013-12-01

The goal of the present study was to utilize a profiling approach to understand differences in motivation and strategic self-regulation among post-secondary STEM students in major versus required non-major computer science courses. Participants were 233 students from required introductory computer science courses (194 men; 35 women; 4 unknown) at a large Midwestern state university. Cluster analysis identified five profiles: (1) a strategic profile of a highly motivated by-any-means good strategy user; (2) a knowledge-building profile of an intrinsically motivated autonomous, mastery-oriented student; (3) a surface learning profile of a utility motivated minimally engaged student; (4) an apathetic profile of an amotivational disengaged student; and (5) a learned helpless profile of a motivated but unable to effectively self-regulate student. Among CS majors and students in courses in their major field, the strategic and knowledge-building profiles were the most prevalent. Among non-CS majors and students in required non-major courses, the learned helpless, surface learning, and apathetic profiles were the most prevalent. Students in the strategic and knowledge-building profiles had significantly higher retention of computational thinking knowledge than students in other profiles. Students in the apathetic and surface learning profiles saw little instrumentality of the course for their future academic and career objectives. Findings show that students in STEM fields taking required computer science courses exhibit the same constellation of motivated strategic self-regulation profiles found in other post-secondary and K-12 settings.

Energy-environment policy goals and instruments and electricity demand response. A framework for the analysis

International Nuclear Information System (INIS)

Rio, Pablo del; Hernandez, F.

2004-01-01

The environment and energy realms have traditionally been two major focus of attention of EU and Member State (MS) policy. This attention has intensified in recent years as a response to, both, internal and external events and strategies (i.e., the Kyoto Protocol). In this context, the EU and its MS have set ambitious goals in the environmental and energy contexts and are already implementing packages of policies and measures. Both policies interact. Although there might be conflicts between both, there are also mutually reinforcing effects with significant policy implications. Actually, as stated in the Amsterdam Treaty, environmental protection is one of the major goals of energy policy (together with 'security of supply' and 'competitive energy systems'). On the other hand, the energy sector is instrumental in the success of environmental policy. In this context, a wide array of measures are currently being implemented in the EU and its MS which have a more or less direct impact on the electricity market. Particularly, Demand Side Management (DSM) activities, promotion of electricity from renewable energy sources (RES-E) and measures aimed at the mitigation of Greenhouse Gas (GHG) emissions are arguably three major instruments which have the potential to contribute to energy and environmental goals. The effectiveness and impact of there measures depends to a large extent on the demand response in the electricity market. Some of there measures affect the electricity demand curve, while others do not have a direct impact on the demand curve but affect the quantity of electricity demand by displacing the electricity supply curve. In turn, the effectiveness of energy and environmental policies may be different when electricity demand response varies (i.e., different elasticity demand). This paper entails an initial effort to provide a theoretical framework for the analysis of the interactions between electricity demand response and the above mentioned energy

Are We Meeting the Goal of Responsible Environmental Behavior: An Examination of Nature and Environmental Education Center Goals.

Science.gov (United States)

Simmons, Deborah A.

1991-01-01

Through two surveys of nature and environmental centers throughout the United States, the author compares the centers' expressed goals with the goals of environmental education. These goals were determined by an accepted behavior model that is considered conducive to environmentally responsible behavior. (17 references) (MCO)

Goal conflict, goal facilitation, and health professionals' provision of physical activity advice in primary care: an exploratory prospective study.

Science.gov (United States)

Presseau, Justin; Francis, Jill J; Campbell, Neil C; Sniehotta, Falko F

2011-07-15

The theory of planned behaviour has well-evidenced utility in predicting health professional behaviour, but focuses on a single behaviour isolated from the numerous potentially conflicting and facilitating goal-directed behaviours performed alongside. Goal conflict and goal facilitation may influence whether health professionals engage in guideline-recommended behaviours, and may supplement the predictive power of the theory of planned behaviour. We hypothesised that goal facilitation and goal conflict contribute to predicting primary care health professionals' provision of physical activity advice to patients with hypertension, over and above predictors of behaviour from the theory of planned behaviour. Using a prospective predictive design, at baseline we invited a random sample of 606 primary care health professionals from all primary care practices in NHS Grampian and NHS Tayside (Scotland) to complete postal questionnaires. Goal facilitation and goal conflict were measured alongside theory of planned behaviour constructs at baseline. At follow-up six months later, participants self-reported the number of patients, out of those seen in the preceding two weeks, to whom they provided physical activity advice. Forty-four primary care physicians and nurses completed measures at both time points (7.3% response rate). Goal facilitation and goal conflict improved the prediction of behaviour, accounting for substantial additional variance (5.8% and 8.4%, respectively) in behaviour over and above intention and perceived behavioural control. Health professionals' provision of physical activity advice in primary care can be predicted by perceptions about how their conflicting and facilitating goal-directed behaviours help and hinder giving advice, over and above theory of planned behaviour constructs. Incorporating features of multiple goal pursuit into the theory of planned behaviour may help to better understand health professional behaviour.

Therapeutic enhancement: nursing intervention category for patients diagnosed with Readiness for Therapeutic Regimen Management.

Science.gov (United States)

Kelly, Cynthia W

2008-04-01

To present a new nursing intervention category called therapeutic enhancement. Fewer than half of North Americans follow their physician's recommendations for diet and exercise, even when such are crucial to their health or recovery. It is imperative that nurses consider new ways to promote healthy behaviours. Therapeutic enhancement is intended to provide such a fresh approach. Traditional intervention techniques focusing on education, contracts, social support and more frequent interaction with physicians appear not to be effective when used alone. Successful strategies have been multidisciplinary; and have included interventions by professional nurses who assist patients to understand their disease and the disease process and that helps them to develop disease-management and self-management skills. Therapeutic enhancement incorporates The Stages of Change Theory, Commitment to Health Theory, Motivational Interviewing techniques and instrumentation specifically designed for process evaluation of health-promoting interventions. This is a critical review of approaches that, heretofore, have not been synthesised in a single published article. Based on the commonly used Stages of Change model, therapeutic enhancement is useful for patients who are at the action stage of change. Using therapeutic enhancement as well as therapeutic strategies identified in Stages of Change Theory, such as contingency management, helping relationships, counterconditioning, stimulus control and Motivational Interviewing techniques, nursing professionals can significantly increase the chances of patients moving from action to the maintenance stage of change for a specific health behaviour. Using the nursing intervention category, therapeutic enhancement can increase caregivers' success in helping patients maintain healthy behaviours.

The therapeutic relationship after psychiatric admission.

LENUS (Irish Health Repository)

Roche, Eric

2014-03-01

The therapeutic relationship is one of the most central and important factors in the treatment of mental health disorders. A better therapeutic relationship is associated with service engagement, medication adherence, and satisfaction with services. This study aimed to compare the demographic and clinical factors associated with the therapeutic relationship in voluntarily and involuntarily admitted psychiatric service users. We found that individuals who had been admitted involuntarily, who had a diagnosis of a psychotic disorder, and who reported higher levels of perceived pressures on admission were more likely to have a poorer therapeutic relationship with their consultant psychiatrist. Greater levels of insight and treatment satisfaction, together with higher levels of procedural justice experienced on admission, were associated with a better therapeutic relationship. We found that the level of perceived coercion on admission was not related to the therapeutic relationship. Targeted interventions to improve the therapeutic relationship, particularly for involuntarily admitted service users, are discussed.

On the nature of motivational orientations: implications of assessed goals and gender differences for motivational goal theory.

Science.gov (United States)

Alonso-Tapia, Jesús; Huertas, Juan A; Ruiz, Miguel A

2010-05-01

In a historical revision of the achievement goal construct, Elliot (2005) recognized that there is little consensus on whether the term "goal" in "achievement goal orientations" (GO) is best represented as an "aim", as an overarching orientation encompassing several "aims", or as a combination of aims and other processes -self-regulation, etc.-. Elliot pointed also that goal theory research provides evidence for different models of GO. As there were no consensus on these issues, we decided to get evidence about the nature and structure of GO, about the role of gender differences in the configuration of such structure, and about relations between GO, expectancies, volitional processes and achievement. A total of 382 university students from different faculties of two public universities of Madrid (Spain) that voluntarily accepted to fill in a questionnaire that assessed different goals, expectancies and self-regulatory processes participated in the study. Scales reliability, confirmatory factor analyses, multiple-group analyses, and correlation and regression analyses were carried out. Results support the trichotomous model of GO, the consideration of GO as a combination of aims and other psychological processes, showed some gender differences and favour the adoption of a multiple goal perspective for explaining students' motivation.

Emphasizing Astrobiology: Highlighting Communication in an Elective Course for Science Majors

Science.gov (United States)

Offerdahl, Erika G.; Prather, Edward E.; Slater, Timothy F.

2004-01-01

The project described here involved the design, implementation, and evaluation of an upper level, undergraduate elective course for science majors. Specific course goals were to help students gain an appreciation of the interdisciplinary nature of astrobiology, understand key ideas in astrobiology, and develop the skills necessary to communicate…

A pragmatic definition of therapeutic synergy suitable for clinically relevant in vitro multicompound analyses.

Science.gov (United States)

Kashif, Muhammad; Andersson, Claes; Åberg, Magnus; Nygren, Peter; Sjöblom, Tobias; Hammerling, Ulf; Larsson, Rolf; Gustafsson, Mats G

2014-07-01

For decades, the standard procedure when screening for candidate anticancer drug combinations has been to search for synergy, defined as any positive deviation from trivial cases like when the drugs are regarded as diluted versions of each other (Loewe additivity), independent actions (Bliss independence), or no interaction terms in a response surface model (no interaction). Here, we show that this kind of conventional synergy analysis may be completely misleading when the goal is to detect if there is a promising in vitro therapeutic window. Motivated by this result, and the fact that a drug combination offering a promising therapeutic window seldom is interesting if one of its constituent drugs can provide the same window alone, the largely overlooked concept of therapeutic synergy (TS) is reintroduced. In vitro TS is said to occur when the largest therapeutic window obtained by the best drug combination cannot be achieved by any single drug within the concentration range studied. Using this definition of TS, we introduce a procedure that enables its use in modern massively parallel experiments supported by a statistical omnibus test for TS designed to avoid the multiple testing problem. Finally, we suggest how one may perform TS analysis, via computational predictions of the reference cell responses, when only the target cell responses are available. In conclusion, the conventional error-prone search for promising drug combinations may be improved by replacing conventional (toxicology-rooted) synergy analysis with an analysis focused on (clinically motivated) TS. ©2014 American Association for Cancer Research.

Nano-based theranostics for chronic obstructive lung diseases: challenges and therapeutic potential

OpenAIRE

Vij, Neeraj

2011-01-01

The major challenges in the delivery and therapeutic efficacy of nano-delivery systems in chronic obstructive airway conditions is airway defense, severe inflammation and mucous hypersecretion. Chronic airway inflammation and mucous hypersecretion are hallmarks of chronic obstructive airway diseases, including asthma, COPD (chronic obstructive pulmonary disease) and CF (cystic fibrosis). Distinct etiologies drive inflammation and mucous hyper secretion in these diseases, that is further induc...

Criteria for achieving actinide reduction goals

International Nuclear Information System (INIS)

Liljenzin, J.O.

1996-01-01

In order to discuss various criteria for achieving actinide reduction goals, the goals for actinide reduction must be defined themselves. In this context the term actinides is interpreted to mean plutonium and the so called ''minor actinides'' neptunium, americium and curium, but also protactinium. Some possible goals and the reasons behind these will be presented. On the basis of the suggested goals it is possible to analyze various types of devices for production of nuclear energy from uranium or thorium, such as thermal or fast reactors and accelerator driven system, with their associated fuel cycles with regard to their ability to reach the actinide reduction goals. The relation between necessary single cycle burn-up values, fuel cycle processing losses and losses to waste will be defined and discussed. Finally, an attempt is made to arrange the possible systems on order of performance with regard to their potential to reduce the actinide inventory and the actinide losses to wastes. (author). 3 refs, 3 figs, 2 tabs

Parental goals and talk with toddlers

OpenAIRE

Rowe, Meredith Lee; Casillas, Allison

2010-01-01

Myriad studies support a relation between parental beliefs and behaviours. This study adds to the literature by focusing on the specific relationship between parental goals and their communication with toddlers. Do parents with different goals talk about different topics with their children? Parents’ goals for their 30-month olds were gathered using semi-structured interviews with 47 primary caregivers, whereas the topics of conversations that took place during interactio...

Therapeutic Engagement as a Predictor of Retention in Adolescent Therapeutic Community Treatment

Science.gov (United States)

Abdel-Salam, Sami; Gunter, Whitney D.

2014-01-01

The adolescent drug problem places a huge toll on society and a heavy burden on the criminal justice system. Research regarding the benefits of therapeutic community (TC) treatment for adolescents has shown it to be effective. Despite the ability of therapeutic communities to lower drug relapse and reduce criminality, a great deal remains unknown…

A randomized trial comparing structured and lifestyle goals in an internet-mediated walking program for people with type 2 diabetes

OpenAIRE

Richardson, Caroline R; Mehari, Kathleen S; McIntyre, Laura G; Janney, Adrienne W; Fortlage, Laurie A; Sen, Ananda; Strecher, Victor J; Piette, John D

2007-01-01

Abstract Background The majority of individuals with type 2 diabetes do not exercise regularly. Pedometer-based walking interventions can help; however, pedometer-based interventions targeting only total daily accumulated steps might not yield the same health benefits as physical activity programs specifying a minimum duration and intensity of physical activity bouts. Methods This pilot randomized trial compared two goal-setting strategies: 1) lifestyle goals targeting total daily accumulated...

Setting Goals for Achievement in Physical Education Settings

Science.gov (United States)

Baghurst, Timothy; Tapps, Tyler; Kensinger, Weston

2015-01-01

Goal setting has been shown to improve student performance, motivation, and task completion in academic settings. Although goal setting is utilized by many education professionals to help students set realistic and proper goals, physical educators may not be using goal setting effectively. Without incorporating all three types of goals and…

[From fantasy to reality: understanding the way of playing of institutionalized children victims of violence through therapeutic play].

Science.gov (United States)

Giacomello, Karina Jorgino; Melo, Luciana de Lione

2011-01-01

This qualitative research is based on the reference framework of Phenomenology--analysis of the structure of the situated phenomenon, and aims to understand institutionalized children victims of violence through therapeutic play sessions. Participants were three sheltered children of preschool age, one boy and two goals. The therapeutic play sessions of the drama type were held in a reserved place and ranged from 30 to 50 minutes, using the following guiding proposal: "Let us play that we are children who live at the shelter?" Two broad theme categories could be captured: playing and pretending and playing and reality. When they are pretending while playing, sometimes calmly, sometimes violently, the children brought contents that evidenced situations in their daily family reality. When they expose their reality, the children addressed questions about the shelter institution and the bond with these professionals and with the relatives. It can be affirmed that therapeutic play allowed for the children's effective communication by expressing their feelings, desires, experiences, criticism against the environment they live in and family relations, besides permitting a moment of pleasure and relaxation.

[Health security--GMOs in therapeutics].

Science.gov (United States)

Trouvin, J-H

2003-03-01

The recent progress in human therapeutics has been made possible thanks to molecular biology and its use in producing proteins having the same sequence and structure as that of human proteins. The use of GMOs allows production of proteins with high added value in therapeutics, which are of satisfactory quality. GMOs may also be directly administered to patients as gene therapy vectors. However, the use of GMOs in therapeutics must take into consideration some risks, particularly those of microbiological contamination, of neo-antigenicity as well as environmental risks with regard to the way of use of the GMO. Nevertheless, those risks are taken in due consideration in the development of these new medicinal products; solutions have been found to allow their use in therapeutics with a very positive benefit/risk ratio. Medicinal products from biotechnology have enabled considerable therapeutic progress without compromising health security.

Goals? What goals? Europeans to hear more about the world's millennium development goals

International Nuclear Information System (INIS)

Bianchi, S.

2005-01-01

The European Union (EU) is quickly becoming the front-runner of development aid to regions in Africa and other developing countries. However, over three-quarters of EU citizens are unaware of development efforts being made on the part of the Union to Third World countries, according to a public opinion poll released by Eurobarometer. In light of the low awareness of the EU's development agenda and the United Nations's Millennium Development Goals, the EU Humanitarian Aid and Development Commission has employed a campaign to raise the level of awareness among the EU's 460 million citizens

Predictors of Academic Self-Handicapping and Achievement: Examining Achievement Goals, Classroom Goal Structures, and Culture

Science.gov (United States)

Urdan, Tim

2004-01-01

The purposes of this study were to examine the predictors and achievement consequences of academic self-handicapping and to explore cultural variations in the pursuit and effects of performance goals and perceived classroom performance goal structures. Data were collected in 2 consecutive academic years from a diverse sample of high school…

Therapeutic cloning: The ethical limits

International Nuclear Information System (INIS)

Whittaker, Peter A.

2005-01-01

A brief outline of stem cells, stem cell therapy and therapeutic cloning is given. The position of therapeutic cloning with regard to other embryonic manipulations - IVF-based reproduction, embryonic stem formation from IVF embryos and reproductive cloning - is indicated. The main ethically challenging stages in therapeutic cloning are considered to be the nuclear transfer process including the source of eggs for this and the destruction of an embryo to provide stem cells for therapeutic use. The extremely polarised nature of the debate regarding the status of an early human embryo is noted, and some potential alternative strategies for preparing immunocompatible pluripotent stem cells are indicated

Therapeutic cloning in the mouse

Science.gov (United States)

Mombaerts, Peter

2003-01-01

Nuclear transfer technology can be applied to produce autologous differentiated cells for therapeutic purposes, a concept termed therapeutic cloning. Countless articles have been published on the ethics and politics of human therapeutic cloning, reflecting the high expectations from this new opportunity for rejuvenation of the aging or diseased body. Yet the research literature on therapeutic cloning, strictly speaking, is comprised of only four articles, all in the mouse. The efficiency of derivation of embryonic stem cell lines via nuclear transfer is remarkably consistent among these reports. However, the efficiency is so low that, in its present form, the concept is unlikely to become widespread in clinical practice. PMID:12949262

Goal Theory and Individual Productivity.

Science.gov (United States)

Frost, Peter J.

The paper provides a review of goal theory as articulated by Edwin Locke. The theory is evaluated in terms of laboratory and field research and its practical usefulnes is explored as a means to improving individual productivity in "real world" organizations Research findings provide support for some goal theory propositions but suggest also the…

Goal conflict, goal facilitation, and health professionals' provision of physical activity advice in primary care: An exploratory prospective study

Directory of Open Access Journals (Sweden)

Campbell Neil C

2011-07-01

Full Text Available Abstract Background The theory of planned behaviour has well-evidenced utility in predicting health professional behaviour, but focuses on a single behaviour isolated from the numerous potentially conflicting and facilitating goal-directed behaviours performed alongside. Goal conflict and goal facilitation may influence whether health professionals engage in guideline-recommended behaviours, and may supplement the predictive power of the theory of planned behaviour. We hypothesised that goal facilitation and goal conflict contribute to predicting primary care health professionals' provision of physical activity advice to patients with hypertension, over and above predictors of behaviour from the theory of planned behaviour. Methods Using a prospective predictive design, at baseline we invited a random sample of 606 primary care health professionals from all primary care practices in NHS Grampian and NHS Tayside (Scotland to complete postal questionnaires. Goal facilitation and goal conflict were measured alongside theory of planned behaviour constructs at baseline. At follow-up six months later, participants self-reported the number of patients, out of those seen in the preceding two weeks, to whom they provided physical activity advice. Results Forty-four primary care physicians and nurses completed measures at both time points (7.3% response rate. Goal facilitation and goal conflict improved the prediction of behaviour, accounting for substantial additional variance (5.8% and 8.4%, respectively in behaviour over and above intention and perceived behavioural control. Conclusions Health professionals' provision of physical activity advice in primary care can be predicted by perceptions about how their conflicting and facilitating goal-directed behaviours help and hinder giving advice, over and above theory of planned behaviour constructs. Incorporating features of multiple goal pursuit into the theory of planned behaviour may help to better

A simple dried blood spot method for therapeutic drug monitoring of the tricyclic antidepressants amitriptyline, nortriptyline, imipramine, clomipramine, and their active metabolites using LC-MS/MS

NARCIS (Netherlands)

Berm, E. J. J.; Paardekooper, J.; Brummel-Mulder, E.; Hak, E.; Wilffert, B.; Maring, J. G.

2015-01-01

Therapeutic drug monitoring (TOM) of tricyclic antidepressants (TCAs) is considered useful in patients with major depressive disorder, since these drugs display large individual differences in clearance, and the therapeutic windows of these drugs are relatively small. We developed an assay for

Leveraging U.S. nuclear weapons policy to advance U.S. nonproliferation goals : implications of major theories of international relations.

Energy Technology Data Exchange (ETDEWEB)

Walter, Andrew

2009-06-01

National policymakers are currently considering a dilemma of critical importance to the continued security of the United States: how can U.S. nuclear weapons policies be leveraged to benefit U.S. nuclear nonproliferation goals in the near-term, without sacrificing U.S. national security? In its role supporting U.S. nuclear weapons policy, Sandia National Laboratories has a responsibility to provide objective technical advice to support policy deliberations on this question. However, to best fulfill this duty Sandia must have a broader understanding of the context of the problem. To help develop this understanding, this paper analyzes the two predominant analytical perspectives of international relations theory to explore their prescriptions for how nuclear weapons and nonproliferation policies interact. As lenses with which to view and make sense of the world, theories of international relations must play a crucial role in framing the trade-offs at the intersection of the nuclear weapons and nonproliferation policy domains. An analysis of what these theories suggest as courses of action to leverage nuclear weapons policies to benefit nonproliferation goals is then offered, with particular emphasis on where the policy prescriptions resulting from the respective theories align to offer near-term policy changes with broad theoretical support. These policy prescriptions are then compared to the 2001 Nuclear Posture Review to understand what the theories indicate policymakers may have gotten right in their dealing with the nuclear dilemma, and where they may have gone wrong. Finally, a brief international relations research agenda is proposed to help address the dilemma between nuclear deterrence and nuclear nonproliferation policies, with particular emphasis on how such an agenda can best support the needs of the policy community and a potential 'all things nuclear' policy deliberation and decision-support framework.

Engineered modular biomaterial logic gates for environmentally triggered therapeutic delivery

Science.gov (United States)

Badeau, Barry A.; Comerford, Michael P.; Arakawa, Christopher K.; Shadish, Jared A.; Deforest, Cole A.

2018-03-01

The successful transport of drug- and cell-based therapeutics to diseased sites represents a major barrier in the development of clinical therapies. Targeted delivery can be mediated through degradable biomaterial vehicles that utilize disease biomarkers to trigger payload release. Here, we report a modular chemical framework for imparting hydrogels with precise degradative responsiveness by using multiple environmental cues to trigger reactions that operate user-programmable Boolean logic. By specifying the molecular architecture and connectivity of orthogonal stimuli-labile moieties within material cross-linkers, we show selective control over gel dissolution and therapeutic delivery. To illustrate the versatility of this methodology, we synthesized 17 distinct stimuli-responsive materials that collectively yielded all possible YES/OR/AND logic outputs from input combinations involving enzyme, reductant and light. Using these hydrogels we demonstrate the first sequential and environmentally stimulated release of multiple cell lines in well-defined combinations from a material. We expect these platforms will find utility in several diverse fields including drug delivery, diagnostics and regenerative medicine.

Synthetic Immunology: Hacking Immune Cells to Expand Their Therapeutic Capabilities.

Science.gov (United States)

Roybal, Kole T; Lim, Wendell A

2017-04-26

The ability of immune cells to survey tissues and sense pathologic insults and deviations makes them a unique platform for interfacing with the body and disease. With the rapid advancement of synthetic biology, we can now engineer and equip immune cells with new sensors and controllable therapeutic response programs to sense and treat diseases that our natural immune system cannot normally handle. Here we review the current state of engineered immune cell therapeutics and their unique capabilities compared to small molecules and biologics. We then discuss how engineered immune cells are being designed to combat cancer, focusing on how new synthetic biology tools are providing potential ways to overcome the major roadblocks for treatment. Finally, we give a long-term vision for the use of synthetic biology to engineer immune cells as a general sensor-response platform to precisely detect disease, to remodel disease microenvironments, and to treat a potentially wide range of challenging diseases.

Quantitative HTGR safety and forced outage goals

International Nuclear Information System (INIS)

Houghton, W.J.; Parme, L.L.; Silady, F.A.

1985-05-01

A key step in the successful implementation of the integrated approach is the definition of the overall plant-level goals. To be effective, the goals should provide clear statements of what is to be achieved by the plant. This can be contrasted to the current practice of providing design-prescriptive criteria which implicitly address some higher-level objective but restrict the designer's flexibility. Furthermore, the goals should be quantifiable in such a way that satisfaction of the goal can be measured. In the discussion presented, two such plant-level goals adopted for the HTGR and addressing the impact of unscheduled occurrences are described. 1 fig

Goals of measurement systems for international safeguards

International Nuclear Information System (INIS)

de Montmollin, J.M.; Weinstock, E.V.

1979-01-01

The safeguards applied by the International Atomic Energy Agency are based on technical performance goals and criteria that have been developed, but not officially adopted by the Agency. The goals derive in part from the external consequences that safeguards are intended to prevent and in some cases on internal considerations of feasibility. To the extent that these goals may not be attainable, as may be the case with large-throughput bulk reprocessing plants, the Agency is placed in a difficult position. In this paper safeguards goals and criteria and their underlying rationales are critically examined. Suggestions for a more rational and workable structure of performance goals are offered

MicroRNAs as Therapeutic Targets for Alzheimer's Disease.

Science.gov (United States)

Di Meco, Antonio; Praticò, Domenico

2016-05-07

Alzheimer's disease (AD) is the most common cause of dementia in the elderly. With increasing longevity and the absence of a cure, AD has become not only a major health problem but also a heavy social and economic burden worldwide. Given this public health challenge, and that the current approved therapy for AD is limited to symptomatic treatment (i.e., cholinesterase inhibitors and NMDA receptor antagonists), exploration of new molecular pathways as novel therapeutic targets remains an attractive option for disease modifying drug development. microRNAs (miRNAs) are short non-coding RNA that control gene expression at the post-translational level by inhibiting translation of specific mRNAs or degrading them. Dysregulation of several miRNAs has been described in AD brains. Interestingly, their molecular targets are pathways that are well-established functional players in the onset and development of AD pathogenesis. Today several molecular tools have been developed to modulate miRNA levels in vitro and in vivo. These scientific advancements are affording us for the first time with the real possibility of targeting in vivo these dysregulated miRNAs as a novel therapeutic approach against AD.

Safety Goal, Multi-unit Risk and PSA Uncertainty

Energy Technology Data Exchange (ETDEWEB)

Yang, Joon-Eon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2015-10-15

The safety goal is an answer of each country to the question 'How safe is safe enough?'. Table 1 shows some examples of the safety goal. However, many countries including Korea do not have the official safety goal for NPPs up to now since the establishment of safety goal is not just a technical issue but a very complex socio-technical issue. In establishing the safety goal for nuclear facilities, we have to consider various factors including not only technical aspects but also social, cultural ones. Recently, Korea is trying to establish the official safety goal. In this paper, we will review the relationship between the safety goal and Probabilistic Safety Assessment (PSA). We will also address some important technical issues to be considered in establishing the safety goal for NPPs from PSA point of view, i.e. a multi-unit risk issue and the uncertainty of PSA. In this paper, we reviewed some issues related to the safety goal and PSA. We believe that the safety goal is to be established in Korea considering the multi-unit risk. In addition, the relationship between the safety goal and PSA should be also defined clearly since PSA is the only way to answer to the question 'How safe is safe enough?'.

Brief Report: Major Depressive Disorder with Psychotic Features in Williams Syndrome--A Case Series

Science.gov (United States)

Valdes, Francisca; Keary, Christopher J.; Mullett, Jennifer E.; Palumbo, Michelle L.; Waxler, Jessica L.; Pober, Barbara R.; McDougle, Christopher J.

2018-01-01

Descriptions of individuals with Williams syndrome (WS) and co-morbid major depressive disorder (MDD) with psychotic features have not appeared in the literature. In addition to reviewing previous reports of psychotic symptoms in persons with WS, this paper introduces clinical histories and therapeutic management strategies for three previously…

Skewed Epigenetics: An Alternative Therapeutic Option for Diabetes Complications

Directory of Open Access Journals (Sweden)

Gabriele Togliatto

2015-01-01

Full Text Available Vascular complications are major causes of morbidity and mortality in type 2 diabetes patients. Mitochondrial reactive oxygen species (ROS generation and a lack of efficient antioxidant machinery, a result of hyperglycaemia, mainly contribute to this problem. Although advances in therapy have significantly reduced both morbidity and mortality in diabetic individuals, diabetes-associated vascular complications are still one of the most challenging health problems worldwide. New healing options are urgently needed as current therapeutics are failing to improve long-term outcomes. Particular effort has recently been devoted to understanding the functional relationship between chromatin structure regulation and the persistent change in gene expression which is driven by hyperglycaemia and which accounts for long-lasting diabetic complications. A detailed investigation into epigenetic chromatin modifications in type 2 diabetes is underway. This will be particularly useful in the design of mechanism-based therapeutics which interfere with long-lasting activating epigenetics and improve patient outcomes. We herein provide an overview of the most relevant mechanisms that account for hyperglycaemia-induced changes in chromatin structure; the most relevant mechanism is called “metabolic memory.”

Short-term therapeutic role of zinc in children infection.

Science.gov (United States)

Das, Rashmi Ranjan; Singh, Meenu; Shafiq, Nusrat

2012-09-01

In contrast to its 'preventive role', no consensus has evolved for the therapeutic role of zinc in pneumonia in children. We conducted a meta-analysis to find the therapeutic role of zinc in children infection (ALRTI). A comprehensive search was performed of the major electronic databases. Randomised controlled trials (RCTs) comparing treatment with zinc versus placebo were included. Seven RCTs (1066 subjects) conducted in developing countries were eligible for inclusion. There was no significant difference between the two groups regarding the time of resolution of severe illness (standardised mean difference (SMD) -0.15 (95% confidence interval (CI) -0.5, 0.2; p=0.4)) and duration of hospitalisation (SMD -0.29 (95% CI -0.68, -0.09; p=0.13)). No significant difference between the two groups was also noted for other parameters (duration of resolution of hypoxia, chest indrawing or tachypnoea, change of antibiotics and treatment failure rates). The adverse events were not significant. To conclude, present available data do not support the efficacy of zinc in treatment of severe ALRTI. Copyright © 2012 Elsevier Ltd. All rights reserved.

Practical goal programming

CERN Document Server

Jones, Dylan

2010-01-01

This book and its treatment of goal programming will help organizations meet targets and objectives. The book includes many worked-out examples and tutorial exercises, and is designed to demostrate and teach its readers good modeling practice.

Therapeutics of Ebola hemorrhagic fever: whole-genome transcriptional analysis of successful disease mitigation.

Science.gov (United States)

Yen, Judy Y; Garamszegi, Sara; Geisbert, Joan B; Rubins, Kathleen H; Geisbert, Thomas W; Honko, Anna; Xia, Yu; Connor, John H; Hensley, Lisa E

2011-11-01

The mechanisms of Ebola (EBOV) pathogenesis are only partially understood, but the dysregulation of normal host immune responses (including destruction of lymphocytes, increases in circulating cytokine levels, and development of coagulation abnormalities) is thought to play a major role. Accumulating evidence suggests that much of the observed pathology is not the direct result of virus-induced structural damage but rather is due to the release of soluble immune mediators from EBOV-infected cells. It is therefore essential to understand how the candidate therapeutic may be interrupting the disease process and/or targeting the infectious agent. To identify genetic signatures that are correlates of protection, we used a DNA microarray-based approach to compare the host genome-wide responses of EBOV-infected nonhuman primates (NHPs) responding to candidate therapeutics. We observed that, although the overall circulating immune response was similar in the presence and absence of coagulation inhibitors, surviving NHPs clustered together. Noticeable differences in coagulation-associated genes appeared to correlate with survival, which revealed a subset of distinctly differentially expressed genes, including chemokine ligand 8 (CCL8/MCP-2), that may provide possible targets for early-stage diagnostics or future therapeutics. These analyses will assist us in understanding the pathogenic mechanisms of EBOV infection and in identifying improved therapeutic strategies.

Proposed goals for radioactive waste management

International Nuclear Information System (INIS)

Bishop, W.P.; Hoos, I.R.; McGrath, P.E.; Metlay, D.S.; Stoneman, W.C.

1978-05-01

A special, seven member, interdisciplinary task group of consultants was established in January 1976 to propose goals for the national waste management program. This is the report of that group. The proposed goals are intended as a basis for the NRC to establish a policy by which to guide and coordinate the activities of government, business, and academic organizations whose responsibility it will be to manage radioactive wastes. The report is based on findings, interpretations and analysis by the authors who examined selected primary literature and interviewed many individuals concerned with waste management. The authors extended the scope of their inquiry and proposed goals to cover 'all technical and societal aspects necessary to an operating waste management system, rather than dealing with the regulatory process alone.' The waste management goals as developed are simple statements of principles which appear to the authors to be important conditions to insure the proper establishment and operation of a system to manage radioactive wastes.' In brief, the goals are designed to protect people and things of value in an equitable manner

Threat and defense as goal regulation: from implicit goal conflict to anxious uncertainty, reactive approach motivation, and ideological extremism.

Science.gov (United States)

Nash, Kyle; McGregor, Ian; Prentice, Mike

2011-12-01

Four studies investigated a goal regulation view of anxious uncertainty threat (Gray & McNaughton, 2000) and ideological defense. Participants (N = 444) were randomly assigned to have achievement or relationship goals implicitly primed. The implicit goal primes were followed by randomly assigned achievement or relationship threats that have reliably caused generalized, reactive approach motivation and ideological defense in past research. The threats caused anxious uncertainty (Study 1), reactive approach motivation (Studies 2 and 3), and reactive ideological conviction (Study 4) only when threat-relevant goals had first been primed, but not when threat-irrelevant goals had first been primed. Reactive ideological conviction (Study 4) was eliminated if participants were given an opportunity to attribute their anxiety to a mundane source. Results support a goal regulation view of anxious uncertainty, threat, and defense with potential for integrating theories of defensive compensation.

Epigenetic Pathways of Oncogenic Viruses: Therapeutic Promises.

Science.gov (United States)

El-Araby, Amr M; Fouad, Abdelrahman A; Hanbal, Amr M; Abdelwahab, Sara M; Qassem, Omar M; El-Araby, Moustafa E

2016-02-01

Cancerous transformation comprises different events that are both genetic and epigenetic. The ultimate goal for such events is to maintain cell survival and proliferation. This transformation occurs as a consequence of different features such as environmental and genetic factors, as well as some types of infection. Many viral infections are considered to be causative agents of a number of different malignancies. To convert normal cells into cancerous cells, oncogenic viruses must function at the epigenetic level to communicate with their host cells. Oncogenic viruses encode certain epigenetic factors that lead to the immortality and proliferation of infected cells. The epigenetic effectors produced by oncogenic viruses constitute appealing targets to prevent and treat malignant diseases caused by these viruses. In this review, we highlight the importance of epigenetic reprogramming for virus-induced oncogenesis, with special emphasis on viral epigenetic oncoproteins as therapeutic targets. The discovery of molecular components that target epigenetic pathways, especially viral factors, is also discussed. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Probabilistic safety assessment goals in Canada

International Nuclear Information System (INIS)

Snell, V.G.

1986-01-01

CANDU safety philosphy, both in design and in licensing, has always had a strong bias towards quantitative probabilistically-based goals derived from comparative safety. Formal probabilistic safety assessment began in Canada as a design tool. The influence of this carried over later on into the definition of the deterministic safety guidelines used in CANDU licensing. Design goals were further developed which extended the consequence/frequency spectrum of 'acceptable' events, from the two points defined by the deterministic single/dual failure analysis, to a line passing through lower and higher frequencies. Since these were design tools, a complete risk summation was not necessary, allowing a cutoff at low event frequencies while preserving the identification of the most significant safety-related events. These goals gave a logical framework for making decisions on implementing design changes proposed as a result of the Probabilistic Safety Analysis. Performing this analysis became a regulatory requirement, and the design goals remained the framework under which this was submitted. Recently, there have been initiatives to incorporate more detailed probabilistic safety goals into the regulatory process in Canada. These range from far-reaching safety optimization across society, to initiatives aimed at the nuclear industry only. The effectiveness of the latter is minor at very low and very high event frequencies; at medium frequencies, a justification against expenditures per life saved in other industries should be part of the goal setting

Hypoxia-regulated therapeutic gene as a preemptive treatment strategy against ischemia/reperfusion tissue injury.

Science.gov (United States)

Pachori, Alok S; Melo, Luis G; Hart, Melanie L; Noiseux, Nicholas; Zhang, Lunan; Morello, Fulvio; Solomon, Scott D; Stahl, Gregory L; Pratt, Richard E; Dzau, Victor J

2004-08-17

Ischemia and reperfusion represent major mechanisms of tissue injury and organ failure. The timing of administration and the duration of action limit current treatment approaches using pharmacological agents. In this study, we have successfully developed a preemptive strategy for tissue protection using an adenoassociated vector system containing erythropoietin hypoxia response elements for ischemia-regulated expression of the therapeutic gene human heme-oxygenase-1 (hHO-1). We demonstrate that a single administration of this vector several weeks in advance of ischemia/reperfusion injury to multiple tissues such as heart, liver, and skeletal muscle yields rapid and timely induction of hHO-1 during ischemia that resulted in dramatic reduction in tissue damage. In addition, overexpression of therapeutic transgene prevented long-term pathological tissue remodeling and normalized tissue function. Application of this regulatable system using an endogenous physiological stimulus for expression of a therapeutic gene may be a feasible strategy for protecting tissues at risk of ischemia/reperfusion injury.

Hypoxia-regulated therapeutic gene as a preemptive treatment strategy against ischemia/reperfusion tissue injury

Science.gov (United States)

Pachori, Alok S.; Melo, Luis G.; Hart, Melanie L.; Noiseux, Nicholas; Zhang, Lunan; Morello, Fulvio; Solomon, Scott D.; Stahl, Gregory L.; Pratt, Richard E.; Dzau, Victor J.

2004-08-01

Ischemia and reperfusion represent major mechanisms of tissue injury and organ failure. The timing of administration and the duration of action limit current treatment approaches using pharmacological agents. In this study, we have successfully developed a preemptive strategy for tissue protection using an adenoassociated vector system containing erythropoietin hypoxia response elements for ischemia-regulated expression of the therapeutic gene human heme-oxygenase-1 (hHO-1). We demonstrate that a single administration of this vector several weeks in advance of ischemia/reperfusion injury to multiple tissues such as heart, liver, and skeletal muscle yields rapid and timely induction of hHO-1 during ischemia that resulted in dramatic reduction in tissue damage. In addition, overexpression of therapeutic transgene prevented long-term pathological tissue remodeling and normalized tissue function. Application of this regulatable system using an endogenous physiological stimulus for expression of a therapeutic gene may be a feasible strategy for protecting tissues at risk of ischemia/reperfusion injury.

[Towards new therapeutic paradigms beyond symptom control in the management of inflammatory bowel diseases.

Science.gov (United States)

Festa, Stefano; Zerboni, Giulia; Aratari, Annalisa; Ballanti, Riccardo; Papi, Claudio

2018-01-01

Inflammatory bowel diseases, Crohn's disease and ulcerative colitis are chronic relapsing conditions that may result in progressive bowel damage, high risk of complications, surgery and permanent disability. The conventional therapeutic approach for inflammatory bowel diseases is based mainly on symptom control. Unfortunately, a symptom-based therapeutic approach has little impact on major long-term disease outcomes. In other chronic disabling conditions such as diabetes, hypertension and rheumatoid arthritis, the development of new therapeutic approaches has led to better outcomes. In this context a "treat to target" strategy has been developed. This strategy is based on identification of high-risk patients, regular assessment of disease activity by means of objective measures, adjustment of treatment to reach the pre-defined target. A treat to target approach has recently been proposed for inflammatory bowel disease with the aim at modifying the natural history of the disease. In this review, the evidence and the limitations of the treat to target paradigm in inflammatory bowel disease are analyzed and discussed.