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Sample records for rational therapeutic interventions

  1. Minimal intervention dentistry: part 1. From 'compulsive' restorative dentistry to rational therapeutic strategies.

    Science.gov (United States)

    Featherstone, J D B; Doméjean, S

    2012-11-01

    The concept of minimal intervention dentistry is based on all the factors that affect the onset and progression of disease and therefore integrates concepts of prevention, control and treatment. The field of minimal intervention dentistry is wide, including the detection of lesions as early as possible, the identification of risk factors (risk assessment) and the implementation of preventive strategies and health education for the patient. When the effects of the disease are present, in the form of a carious lesion, other therapeutic strategies are required, but in this case the least invasive solutions should be chosen, for example remineralisation, therapeutic sealants and restorative care aimed at conserving the maximum amount of sound tissue. This article aims to enlighten dental practitioners as to the foundations of minimal intervention dentistry in order to help them in the implementation of modern concepts into everyday clinical practice.

  2. Guidelines for Rational Cancer Therapeutics

    Directory of Open Access Journals (Sweden)

    Byunghee Yoo

    2017-12-01

    Full Text Available Traditionally, cancer therapy has relied on surgery, radiation therapy, and chemotherapy. In recent years, these interventions have become increasingly replaced or complemented by more targeted approaches that are informed by a deeper understanding of the underlying biology. Still, the implementation of fully rational patient-specific drug design appears to be years away. Here, we present a vision of rational drug design for cancer that is defined by two major components: modularity and image guidance. We suggest that modularity can be achieved by combining a nanocarrier and an oligonucleotide component into the therapeutic. Image guidance can be incorporated into the nanocarrier component by labeling with a specific imaging reporter, such as a radionuclide or contrast agent for magnetic resonance imaging. While limited by the need for additional technological advancement in the areas of cancer biology, nanotechnology, and imaging, this vision for the future of cancer therapy can be used as a guide to future research endeavors.

  3. Therapeutic Crisis Intervention.

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    Holden, Martha J.; Powers, Jane Levine

    1993-01-01

    Describes Therapeutic Crisis Intervention (TCI) program as providing staff with skills, knowledge, and confidence to manage child in crisis to bring about a "maximum amount of lasting response." Contends that, by applying principles of TCI training, direct care worker can attain therapeutic control and maintain dignity of both adult and child…

  4. Implications for Therapeutic Intervention

    Directory of Open Access Journals (Sweden)

    A. L. Hof

    2001-01-01

    Full Text Available Patients with an upper motor neurone syndrome (CP suffer from many disabling primary symptoms: spasms, weakness, and loss of dexterity. These primary ‘neurogenic’ symptoms often lead to secondary disabilities, muscle contractures, and tertiary effects, bone deformations. A common symptom of CP is hypertonia, with. the consequence that the involved muscles remain in an excessively shortened length for most of the time. As a normal reaction of the muscle tissue, the number of sarcomeres is reduced and the muscle fibers shorten permanently: a contracture develops. A possible second type of contracture is that normal muscle lengthening along with bone growth is affected. Current treatments for the secondary effects include (1 reduction of muscle force, (2lengthening of the muscle fibers by serial plaster casts, and (3surgical lengthening of tendons or aponeurosis. The choice of treatment depends on the cause of the functional deficit. Bone tissue also adapts itself to abnormal forces, especially in the growth period. The hypertonias or contractures of CP so may give rise to bone malformations that interfere with function (e.g. femur endorotation or may reduce the action of muscles by changing the lever arm (e.g. ankle varus. Although prevention should always be preferred, a timely surgical intervention cannot always be avoided. The differences in treatment for the various groups require and justify an extensive laboratory investigation, including EMG recordings in gait, measurement of passive elastic properties, and long-term observation of the hypertonia.

  5. Therapeutic interventions in cerebral palsy.

    Science.gov (United States)

    Patel, Dilip R

    2005-11-01

    Various therapeutic interventions have been used in the management of children with cerebral palsy. Traditional physiotherapy and occupational therapy are widely used interventions and have been shown to be of benefit in the treatment of cerebral palsy. Evidence in support of the effectiveness of the neurodevelopmental treatment is equivocal at best. There is evidence to support the use and effectiveness of neuromuscular electrical stimulation in children with cerebral palsy. The effectiveness of many other interventions used in the treatment of cerebral palsy has not been clearly established based on well-controlled trials. These include: sensory integration, body-weight support treadmill training, conductive education, constraint-induced therapy, hyperbaric oxygen therapy, and the Vojta method. This article provides an overview of salient aspects of popular interventions used in the management of children with cerebral palsy.

  6. Complement involvement in periodontitis: molecular mechanisms and rational therapeutic approaches

    Science.gov (United States)

    Hajishengallis, George; Maekawa, Tomoki; Abe, Toshiharu; Hajishengallis, Evlambia; Lambris, John D.

    2015-01-01

    The complement system is a network of interacting fluid-phase and cell surface-associated molecules that trigger, amplify, and regulate immune and inflammatory signaling pathways. Dysregulation of this finely balanced network can destabilize host-microbe homeostasis and cause inflammatory tissue damage. Evidence from clinical and animal model-based studies suggests that complement is implicated in the pathogenesis of periodontitis, a polymicrobial community-induced chronic inflammatory disease that destroys the tooth-supporting tissues. This review discusses molecular mechanisms of complement involvement in the dysbiotic transformation of the periodontal microbiome and the resulting destructive inflammation, culminating in loss of periodontal bone support. These mechanistic studies have additionally identified potential therapeutic targets. In this regard, interventional studies in preclinical models have provided proof-of-concept for using complement inhibitors for the treatment of human periodontitis. PMID:26306443

  7. Brain aging and therapeutic interventions

    DEFF Research Database (Denmark)

    This book brings together most up-to-date information on different aspects of brain aging and on the strategies for intervention and therapy of age-related brain disorders. It includes 18 chapters by leading researchers, and each chapter is a comprehensive and critical review of the topic...

  8. Defining internet-supported therapeutic interventions.

    Science.gov (United States)

    Barak, Azy; Klein, Britt; Proudfoot, Judith G

    2009-08-01

    The field of Internet-supported therapeutic interventions has suffered from a lack of clarity and consistency. The absence of professional leadership and of accepted governing approaches, terminology, professional standards, and methodologies has caused this field to be diffused and unstructured. Numerous terms have been used to label and describe the activities conducted over the Internet for mental and physical health purposes: web-based therapy, e-therapy, cybertherapy, eHealth, e-Interventions, computer-mediated interventions, and online therapy (or counseling), among others. Following a comprehensive review, we conceptualized Internet-supported interventions, using four categories based on prime practice approaches: web-based interventions, online counseling and therapy, Internet-operated therapeutic software, and other online activities (e.g., as supplements to face-to-face therapy). We provide a working definition and detailed description of each category, accompanied by numerous examples. These categories may now serve as guiding definitions and related terminologies for further research and development in this emerging field.

  9. Internet addiction neuroscientific approaches and therapeutical interventions

    CERN Document Server

    Reuter, Martin

    2015-01-01

    This book combines a scholarly introduction with state-of-the-art research in the characterization of Internet addiction. It is intended for a broad audience including scientists, students and practitioners. The first part of the book contains an introduction to Internet addiction and their pathogenesis. The second part of the book is dedicated to an in-depth review of neuroscientific findings which cover studies using a variety of biological techniques including brain imaging and molecular genetics. The last part of the book will focus on therapeutic interventions for Internet addiction.

  10. Opportunities for Therapeutic Intervention During Machine Perfusion.

    Science.gov (United States)

    Karimian, Negin; Yeh, Heidi

    2017-06-01

    There is a vast discrepancy between the number of patients waiting for organ transplantation and the available donor organs. Ex vivo machine perfusion (MP) has emerged in an effort to expand the donor pool, by improving organ preservation, providing diagnostic information, and more recently, acting as a platform for organ improvement. This article reviews the current status of MP with a focus on its role in organ preconditioning and therapeutic interventions prior to transplantation. MP has allowed longer organ preservation compared to conventional static cold storage and allowed the use of organs that might otherwise have been discarded. Moreover, experimental studies have investigated the role of MP in reducing ischemia reperfusion injury of lungs, kidneys and livers by applying mesenchymal stem cells (MSCs), anti-inflammatory agents, cytotopic anticoagulants, and defatting cocktails. MP has opened a new era in the field of organ transplantation and tissue medication.

  11. Molecular mechanisms and therapeutic interventions in sarcopenia

    Directory of Open Access Journals (Sweden)

    Sung Sup Park

    2017-09-01

    Full Text Available Sarcopenia is the degenerative loss of muscle mass and function with aging. Recently sarcopenia was recognized as a clinical disease by the International Classification of Disease, 10th revision, Clinical Modification. An imbalance between protein synthesis and degradation causes a gradual loss of muscle mass, resulting in a decline of muscle function as a progress of sarcopenia. Many mechanisms involved in the onset of sarcopenia include age-related factors as well as activity-, disease-, and nutrition-related factors. The stage of sarcopenia reflecting the severity of conditions assists clinical management of sarcopenia. It is important that systemic descriptions of the disease conditions include age, sex, and other environmental risk factors as well as levels of physical function. To develop a new therapeutic intervention needed is the detailed understanding of molecular and cellular mechanisms by which apoptosis, autophagy, atrophy, and hypertrophy occur in the muscle stem cells, myotubes, and/or neuromuscular junction. The new strategy to managing sarcopenia will be signal-modulating small molecules, natural compounds, repurposing of old drugs, and muscle-specific microRNAs.

  12. Evaluation of impact of teaching clinical pharmacology and rational therapeutics to medical undergraduates and interns.

    Science.gov (United States)

    Desai, Mira K; Panchal, Jigar R; Shah, Samdih; Iyer, Geetha

    2016-01-01

    To find out the impact of teaching clinical pharmacology and rational therapeutics (CPT) to medical undergraduates (UGs) and interns. This cross-sectional, prospective study was conducted on three UGs batches and interns using two pretested validated structured questionnaires, modified from the work of Tobaiqy et al. The study was approved by the Institutional Ethics Committee. ANOVA and Chi-square test were used for statistical analysis. The value of P < 0.05 was considered statistically significant. A total of 379 UGs and 96 interns participated in this study. Mean knowledge score of interns was significantly reduced as compared to UGs (P < 0.0001). A significant increase in confidence for unsupervised prescribing of nonsteroidal anti-inflammatory drugs (99%), oral rehydration salt, iron salts was perceived among interns as compared to UGs (P < 0.05). However, 63.5% confessed problems in selection of drugs, drug-drug interactions, prescribing in special patient population. Although they were confident prescribing fixed dose combination for adult patients (89.5%), majority were hesitant to prescribe opioids (77%), steroids (76%), vaccines (75%), and antihypertensives (62%). The theoretical CPT teaching transfers knowledge to UGs; however, it is not retained in internship and does not adequately prepare interns to prescribe safe and rational drugs.

  13. Effect of information, education and communication intervention on awareness about rational pharmacy practice in pharmacy students.

    Science.gov (United States)

    Gharpure, Kunda; Thawani, Vijay; Sontakke, Smita; Chaudhari, Kiran; Bankar, Mangesh; Diwe, Rajendra

    2011-07-01

    There is a growing indifference among the pharmacy practitioners towards their duty as information providers to the patients. The patients do not always get enough desired information about proper use of medicines from the prescribers also. This contributes to improper use of medicines by the patients. To bring about awareness about rational pharmacy practice in pharmacy students for better service to the patients. The final year students of Bachelor of Pharmacy (B. Pharm) from four colleges of Nagpur were enrolled for the study after informed consent. Their base knowledge was assessed through a written test which comprised of 27 objective questions related to rational pharmacy practice. This was followed by a series of seven articles on rational medicine use, published in leading local English news daily. The participants were reminded to read them on the day of publication of each article. As a backup, the articles were displayed on the notice board of respective colleges. Second intervention was a half day interactive session where series of six lectures were delivered to the participants on the right and wrong approaches in pharmacy practice. Posters about the do's and dont's of rational pharmacy practice were also displayed at the venue. The session was followed by a repeat test using the same pre-test to assess the change. Pre and post intervention data was compared using Fisher's Exact test. It was observed that the intervention did bring about a positive change in the attitude and knowledge of the final year Pharmacy students about rational pharmacy practice. The role of a pharmacist in health care provision is usually overlooked in India. Hence there is strong need for reinforcement in final year B. Pharm when most of the students go in for community service. Such interventions will be helpful in bringing about a positive change towards rational practice of pharmacy. This study showed that a properly timed and meticulously implemented intervention brings

  14. Impact of pharmacist interventions on rational prophylactic antibiotic use and cost saving in elective cesarean section.

    Science.gov (United States)

    Wang, Jingwen; Dong, Mohan; Lu, Yang; Zhao, Xian; Li, Xin; Wen, Aidong

    2015-08-01

    To assess the impact of pharmacist interventions on rational use of prophylactic antibiotics and cost saving in elective cesarean section and the economic outcomes of implementing pharmacist interventions. A pre-to-post intervention design was applied to the practices of prophylactic antibiotic use in the department of gynecology and obstetrics in a Chinese tertiary hospital. Patients admitted during a 3-month period from June to August 2012 and during that from October to December 2012 undergoing elective cesarean section were assigned to the pre-intervention and the post-intervention group, respectively. Pharmacist interventions were performed in the post-intervention group, including obstetrician education, realtime monitoring of clinical records and making recommendations to obstetricians on prophylactic antibiotic prescription based on the criteria set at the beginning of the study. Data from the two groups were then compared to evaluate the outcomes of pharmacist interventions. Cost-outcome analysis was performed to determine the economic effect of implementing pharmacist interventions in preoperative antibiotic prophylaxis. Pharmacist interventions led to significant reductions in antibiotic usage cost/patient-day (p antibiotic cost (p antibiotics (p antibiotic use to the cost of pharmacist time was 27.23 : 1 and the net cost benefit was $65,255.84. This study provides evidence that pharmacist interventions promoted rational use of prophylactic antibiotics and substantial cost saving in elective cesarean section.

  15. Humor: A Therapeutic Intervention for Child Counseling

    Science.gov (United States)

    Berg, Rachelle G.; Parr, Gerald; Bradley, Loretta J.; Berry, Jeremy J.

    2009-01-01

    Counselors utilize many strategies, techniques, and tools when building a therapeutic alliance or addressing children's issues. Due to the serious nature of discussing problems or perhaps because of the fear of seeming insensitive, counselors often overlook humor as a means to enhance therapy. Whether deliberate or spontaneous, humor can add…

  16. Harnessing nanomedicine for therapeutic intervention in glioblastoma.

    Science.gov (United States)

    Gutkin, Anna; Cohen, Zvi R; Peer, Dan

    2016-11-01

    Glioblastoma is a type of brain cancer arises from glial cells. Glioblastoma multiforme (GBM), a subtype of glioblastoma, is the most common and most aggressive primary brain tumor. Currently, GBM therapy includes surgery and post-operative high-doses of radiation and chemotherapy. This therapeutic strategy has a limited contribution in extending the survival rate of GBM patients. Areas covered: Herein, we focus on harnessing nanoscale drug delivery strategies to treat brain malignancies. Specifically, we briefly discuss the challenges facing GBM therapy such as restricted passage across the blood-brain barrier (BBB) and low enhanced permeability and retention effect. Next, we describe different pathways to address these challenges. Finally, we discuss the field of nanomedicine, which emerged as a promising platform for drug delivery to brain malignancies. Expert opinion: Countless strategies have been applied in preclinical and clinical settings to treat GBM. Among them is the use of different types of nanoparticles (NPs) and viruses with different approaches to cross or bypass the BBB. We suggest here a paradigm shift in thinking about crossing the BBB and tumor penetration as fundamental issues that need to be address in order to improve the therapeutic outcome in GBM.

  17. complementary roles of interventional radiology and therapeutic endoscopy in gastroenterology

    DEFF Research Database (Denmark)

    Ray, David M; Srinivasan, Indu; Tang, Shou-Jiang

    2017-01-01

    Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main treatment modality, the advent of both therapeutic endoscopy and interventional...... and luminal strictures. These conditions often require multidisciplinary approaches involving a team of interventional radiologists, gastroenterologists and surgeons. Further, the authors also aim to describe how the fields of interventional radiology and gastrointestinal endoscopy are overlapping...

  18. in Children: Clues for Therapeutic Intervention?

    Directory of Open Access Journals (Sweden)

    Mijna Hadders-Algra

    2001-01-01

    Full Text Available The Neuronal Group Selection Theory (NGST could offer new insights into the mechanisms directing motor disorders, such as cerebral palsy and developmental coordination disorder. According to NGST, normal motor development is characterized by two phases of variability. Variation is not at random but determined by criteria set by genetic information. Development starts with the phase of primary variability,during which variation in motor behavior is not geared to external conditions. At function-specific ages secondary variability starts, during which motor performance can be adapted to specific situations. In both forms, of variability, selection on the basis of afferent information plays a significant role. From the NGST point of view, children with pre- or perinatally acquired brain damage, such as children with cerebral palsy and part of the children with developmental coordination disorder, suffer from stereotyped motor behavior, produced by a limited repertoire or primary (subcortical neuronal networks. These children also have roblems in selecting the most efficient neuronal activity, due to deficits in the processing of sensory information. Therefore, NGST suggests that intervention in these children at early age should aim at an enlargement of the primary neuronal networks. With increasing age, the emphasis of intervention could shift to the provision of ample opportunities for active practice, which might form a compensation for the impaired selection.

  19. Rational design of an enzyme mutant for anti-cocaine therapeutics

    Science.gov (United States)

    Zheng, Fang; Zhan, Chang-Guo

    2008-09-01

    (-)-Cocaine is a widely abused drug and there is no available anti-cocaine therapeutic. The disastrous medical and social consequences of cocaine addiction have made the development of an effective pharmacological treatment a high priority. An ideal anti-cocaine medication would be to accelerate (-)-cocaine metabolism producing biologically inactive metabolites. The main metabolic pathway of cocaine in body is the hydrolysis at its benzoyl ester group. Reviewed in this article is the state-of-the-art computational design of high-activity mutants of human butyrylcholinesterase (BChE) against (-)-cocaine. The computational design of BChE mutants have been based on not only the structure of the enzyme, but also the detailed catalytic mechanisms for BChE-catalyzed hydrolysis of (-)-cocaine and (+)-cocaine. Computational studies of the detailed catalytic mechanisms and the structure-and-mechanism-based computational design have been carried out through the combined use of a variety of state-of-the-art techniques of molecular modeling. By using the computational insights into the catalytic mechanisms, a recently developed unique computational design strategy based on the simulation of the rate-determining transition state has been employed to design high-activity mutants of human BChE for hydrolysis of (-)-cocaine, leading to the exciting discovery of BChE mutants with a considerably improved catalytic efficiency against (-)-cocaine. One of the discovered BChE mutants (i.e., A199S/S287G/A328W/Y332G) has a ˜456-fold improved catalytic efficiency against (-)-cocaine. The encouraging outcome of the computational design and discovery effort demonstrates that the unique computational design approach based on the transition-state simulation is promising for rational enzyme redesign and drug discovery.

  20. 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…

  1. Validity and reliability of the simplified Therapeutic Intervention ...

    African Journals Online (AJOL)

    Validity and reliability of the simplified Therapeutic Intervention Scoring System in intensive care units of a public sector hospital in Johannesburg. ... the validity and reliability of TISS-28 as a suitable measure of quantifying nursing workload in the adult intensive care units (ICUs) of a public sector hospital in Johannesburg.

  2. Consequences of radiopharmaceutical extravasation and therapeutic interventions: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Pol, Jochem van der; Voeoe, Stefan [Maastricht University Medical Centre (MUMC+), Department of Radiology and Nuclear Medicine, Postbox 5800, Maastricht (Netherlands); Bucerius, Jan; Mottaghy, Felix M. [Maastricht University Medical Centre (MUMC+), Department of Radiology and Nuclear Medicine, Postbox 5800, Maastricht (Netherlands); University Hospital, RWTH Aachen University, Department of Nuclear Medicine, Aachen (Germany)

    2017-07-15

    Radiopharmaceutical extravasation can potentially lead to severe soft tissue damage, but little is known about incidence, medical consequences, possible interventions, and effectiveness of these. The aims of this study are to estimate the incidence of extravasation of diagnostic and therapeutic radiopharmaceuticals, to evaluate medical consequences, and to evaluate medical treatment applied subsequently to those incidents. A sensitive and elaborate literature search was performed in Embase and PubMed using the keywords ''misadministration'', ''extravasation'', ''paravascular infiltration'', combined with ''tracer'', ''radionuclide'', ''radiopharmaceutical'', and a list of keywords referring to clinically used tracers (i.e. ''Technetium-99m'', ''Yttrium-90''). Reported data on radiopharmaceutical extravasation and applied interventions was extracted and summarised. Thirty-seven publications reported 3016 cases of diagnostic radiopharmaceutical extravasation, of which three cases reported symptoms after extravasation. Eight publications reported 10 cases of therapeutic tracer extravasation. The most severe symptom was ulceration. Thirty-four different intervention and prevention strategies were performed or proposed in literature. Extravasation of diagnostic radiopharmaceuticals is common. {sup 99m}Tc, {sup 123}I, {sup 18}F, and {sup 68}Ga labelled tracers do not require specific intervention. Extravasation of therapeutic radiopharmaceuticals can give severe soft tissue lesions. Although not evidence based, surgical intervention should be considered. Furthermore, dispersive intervention, dosimetry and follow up is advised. Pharmaceutical intervention has no place yet in the immediate care of radiopharmaceutical extravasation. (orig.)

  3. Therapeutic intervention and parenting style of abusive parents.

    Science.gov (United States)

    Arabgol, Fariba; Hakim-Shooshtari, Mitra; Panaghi, Lili

    2014-12-01

    Victims of abuse comprise a significant proportion of all child psychiatric admissions, with an estimated 30% incidence of lifetime of physical and sexual abuse among child and adolescent outpatients, and as high as 55% among psychiatric inpatients. The present study was conducted to examine the effects of therapeutic intervention and parent management training on parenting skill of abusive parents. The study population consisted of all children who were referred to Child Psychiatric and Pediatric Departments of Imam Hossein Hospital, Tehran, IR Iran diagnosed with child abuse. Children and their families were visited by a psychiatrist for psychiatric problems. Later, the necessary interventions were taken for the children. To study the effect of intervention, parents completed 'Being a Parent and Parenting Scale' before intervention, and then again, in the third and sixth months following the intervention. The interventions included 8 weekly parent management training sessions for all of the involved parents and additional pharmacologic and psychological interventions according to the subjects' needs. Participants included 73 children with the mean age of 6.9 ± 4.3 year, while the mean age of parents was 31.76 ± 6.52 year for the mothers and 38.07 ± 8.45 year for the fathers. General anxiety disorder (30.1%) and depression (27.4%) were the most common psychiatric disorders among mothers. In parenting scale, there were significant differences between the zero and third month in all subscales (P = 0.008), but there was no significant difference in verbosity and overreactivity after 6 months. Laxness showed significant changes over the period (P = 0.03). In viewing the 'Being a Parent Scale', there was no significant difference in satisfaction and competency subscales before and after the intervention. Therapeutic intervention and parent management training improves parenting skill of abusive parents, and this might lead to fewer incidents of abuse or neglect.

  4. Therapeutic Listening as a health intervention strategy: an integrative review

    OpenAIRE

    Ana Cláudia Mesquita; Emilia Campos de Carvalho

    2014-01-01

    Objective To investigate and evaluate the available evidence in the literature regarding the use of Therapeutic Listening as a health intervention strategy. Method Integrative review conducted on the following databases PubMed, CINAHL, The Cochrane Library, EMBASE, LILACS and APA PsycNET without restrictions of year or type of study. The keywords were combined in different ways to ensure extensive search of primary studies. ...

  5. Therapeutic Intervention and Parenting Style of Abusive Parents

    OpenAIRE

    Arabgol, Fariba; Hakim-Shooshtari, Mitra; Panaghi, Lili

    2014-01-01

    Background: Victims of abuse comprise a significant proportion of all child psychiatric admissions, with an estimated 30% incidence of lifetime of physical and sexual abuse among child and adolescent outpatients, and as high as 55% among psychiatric inpatients. Objectives: The present study was conducted to examine the effects of therapeutic intervention and parent management training on parenting skill of abusive parents. Patients and Methods: The study population consisted of all children w...

  6. New Epigenetic Therapeutic Intervention for Metastatic Breast Cancer

    Science.gov (United States)

    2017-04-01

    AWARD NUMBER: W81XWH-15-1-0043 TITLE:New Epigenetic Therapeutic Intervention for Metastatic Breast Cancer PRINCIPAL INVESTIGATOR: Ming-Ming Zhou... Nutritional Sciences, The University of Kentucky, College of Medicine, Lexington, Kentucky 40506, USA. 2Markey Cancer Center, The University of Kentucky...40506, USA. 9 Key Laboratory of Cell Differentiation and Apoptosis of Chinese Minister of Education , Shanghai Jiao Tong University School of Medicine

  7. The Role of Therapeutic Alliance in Mindfulness Interventions

    Science.gov (United States)

    Goldberg, Simon B.; Davis, James M.; Hoyt, William T.

    2013-01-01

    Objective Mindfulness-based interventions have enjoyed a marked increase in support within biomedical and psychological research and practice in the past two decades. Despite the widespread application of these treatments for a range of psychological and medical conditions, there remains a lack of consensus regarding mechanisms through which these interventions effect change. One plausible yet underexplored mechanism is the therapeutic alliance between participants and mindfulness instructors. Methods In this report, data are presented on therapeutic alliance from the mindfulness arm (n = 37) of a randomized controlled trial of a mindfulness-based smoking cessation treatment. Results Results suggest that client-reported therapeutic alliance measured mid-treatment did not significantly predict primary smoking outcomes. Alliance did predict improvement in post-treatment scores on several outcome variables linked to mindfulness practice, including emotion regulation (β =−.24, p = .042), mindfulness (β = .33, p = .007), negative affect (β = −.33, p = .040), as well as treatment compliance (β = .39, p = .011). Conclusion Implications of these relationships and the possible role of therapeutic alliance in mindfulness treatments are explored. PMID:23775222

  8. The role of therapeutic alliance in mindfulness interventions: therapeutic alliance in mindfulness training for smokers.

    Science.gov (United States)

    Goldberg, Simon B; Davis, James M; Hoyt, William T

    2013-09-01

    Mindfulness-based interventions have enjoyed a marked increase in support within biomedical and psychological research and practice in the past two decades. Despite the widespread application of these treatments for a range of psychological and medical conditions, there remains a lack of consensus regarding mechanisms through which these interventions effect change. One plausible yet underexplored mechanism is the therapeutic alliance between participants and mindfulness instructors. In this report, data are presented on therapeutic alliance from the mindfulness arm (n = 37) of a randomized controlled trial of a mindfulness-based smoking cessation treatment. Results suggest that client-reported therapeutic alliance measured midtreatment did not significantly predict primary smoking outcomes. Alliance did predict improvement in posttreatment scores on several outcome variables linked to mindfulness practice, including emotion regulation (β = -.24, p = .042), mindfulness (β = .33, p = .007), negative affect (β = -.33, p = .040), as well as treatment compliance (β = .39, p = .011). Implications of these relationships and the possible role of therapeutic alliance in mindfulness treatments are explored. © 2013 Wiley Periodicals, Inc.

  9. A school-based post-Katrina therapeutic intervention.

    Science.gov (United States)

    Goldman, Eliot E; Bauer, Daliah; Newman, Denise L; Kalka, Elaine; Lochman, John E; Silverman, Wendy K; Jensen, Peter S; Curry, John; Stark, Kevin; Wells, Karen C; Bannon, William M

    2015-05-01

    The current study presents the implementation of a set of school based interventions in a greater New Orleans school district one year following Hurricane Katrina. The interventions included adaptation and implementation of evidence based treatments in a crisis situation with at-risk youth which involved training and clinical challenges. 386 students found to have significant depressive and/or disruptive disorder symptoms received treatment from the School Therapeutic Enhancement Program (STEP). Further, a district-wide mental health needs assessment of middle and high school students (N = 11,861) screened for behavioral and emotional difficulties at the beginning and end of the school year provided a benchmark for community youth's emotional and behavioral distress. High-need intervention students demonstrated clinically significant lower levels of emotional and behavioral problems, depression and inattention in comparison to pre-treatment levels as indicated by multiple informants (i.e., self, parent, teacher). Self-reported distress levels were also lower than screening group students at post-test. These findings support the efficacy of a school-based intervention for youth struggling with the aftereffects of a highly disruptive natural disaster. Implications for utilizing a flexible adaptation of an evidence-based training model involving coaching and consultation are discussed.

  10. Rational design of chemical genetic probes of RNA function and lead therapeutics targeting repeating transcripts.

    Science.gov (United States)

    Disney, Matthew D

    2013-12-01

    RNA is an important yet vastly underexploited target for small molecule chemical probes or lead therapeutics. Small molecules have been used successfully to modulate the function of the bacterial ribosome, viral RNAs and riboswitches. These RNAs are either highly expressed or can be targeted using substrate mimicry, a mainstay in the design of enzyme inhibitors. However, most cellular RNAs are neither highly expressed nor have a lead small molecule inhibitor, a significant challenge for drug discovery efforts. Herein, I describe the design of small molecules targeting expanded repeating transcripts that cause myotonic muscular dystrophy (DM). These test cases illustrate the challenges of designing small molecules that target RNA and the advantages of targeting repeating transcripts. Lastly, I discuss how small molecules might be more advantageous than oligonucleotides for targeting RNA. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Personalized medicine: theranostics (therapeutics diagnostics) essential for rational use of tumor necrosis factor-alpha antagonists.

    Science.gov (United States)

    Bendtzen, Klaus

    2013-04-01

    With the discovery of the central pathogenic role of tumor necrosis factor (TNF)-alpha in many immunoinflammatory diseases, specific inhibition of this pleiotropic cytokine has revolutionized the treatment of patients with several non-infectious inflammatory disorders. As a result, genetically engineered anti-TNF-alpha antibody constructs now constitute one of the heaviest medicinal expenditures in many countries. All currently used TNF antagonists may dramatically lower disease activity and, in some patients, induce remission. Unfortunately, however, not all patients respond favorably, and safety can be severely impaired by immunogenicity, i.e., the ability of a drug to induce anti-drug antibodies (ADA). Assessment of ADA is therefore an important component of the evaluation of drug safety in both pre-clinical and clinical studies and in the process of developing less immunogenic and safer biopharmaceuticals. Therapeutics diagnostics, also called theranostics, i.e., monitoring functional drug levels and neutralizing ADA in the circulation, is central to more effective use of biopharmaceuticals. Hence, testing-based strategies rather than empirical dose-escalation may provide more cost-effective use of TNF antagonists as this allows therapies tailored according to individual requirements rather than the current universal approach to diagnosis. The objective of the present review is to discuss the reasons for recommending theranostics to implement an individualized use of TNF antagonists and to highlight some of the methodological obstacles that have obscured cost-effective ways of using these therapies.

  12. Transferrin trojan horses as a rational approach for the biological delivery of therapeutic peptide domains.

    Science.gov (United States)

    Ali, S A; Joao, H C; Hammerschmid, F; Eder, J; Steinkasserer, A

    1999-08-20

    One novel approach for the biological delivery of peptide drugs is to incorporate the sequence of the peptide into the structure of a natural transport protein, such as human serum transferrin. To examine whether this is feasible, a peptide sequence cleavable by the human immunodeficiency virus type 1 protease (VSQNYPIVL) was inserted into various regions of human serum transferrin, and the resultant proteins were tested for function. Experimentally, molecular modeling was used to identify five candidate insertion sites in surface exposed loops of human serum transferrin that were distant from biologically active domains. These insertions were cloned using polymerase chain reaction mutagenesis, and the proteins were expressed using a baculovirus expression vector system. Analysis of the mutant proteins provided a number of important findings: (a) they retained native human serum transferrin function, (b) the inserted peptide sequence was surface exposed, and most importantly, (c) two of these mutants could be cleaved by human immunodeficiency virus-1 protease. In conclusion, this investigation has validated the use of human serum transferrin as a carrier protein for functional peptide domains introduced into its structure using protein engineering. These findings will be useful for developing a novel class of therapeutic agents for a broad spectrum of diseases.

  13. MUCOLYTIC AGENTS IN PEDIATRICS: RATIONAL SELECTION, THERAPEUTIC EFFECTS AND SPECIFIC ASPECTS OF TREATMENT

    Directory of Open Access Journals (Sweden)

    O. I. Simonova

    2013-01-01

    Full Text Available The article deals with the cough treatment options with mucolytic agents administration at the first several days of acute respiratory tract infections in children. Efficacy of treatment with secretolytic and secretomotoric drugs significantly depends on certain factors. The article contains the criteria of therapeutic efficacy of expectorants. A special attention is given to N-acetylcysteine — a direct acting mucolytic agent, which effect is caused by presence of free sulfhydryl groups, disrupting disulfide bonds between molecules of acid mucopolysaccharides and glycoproteins therefore changing the structure of sputum. Acetylcysteine is active against every type of sputum (mucous, muco-purulent, purulent, that is especially important in treatment of bacterial infections, when it is necessary to quickly decrease sputum thickness, eliminate it from the respiratory tract and prevent dissemination of the infection. High efficacy of acetylcysteine is caused by its unique triple action: mucolytic, antioxidant and antitoxic. Mechanism of action of acetylcysteine is discussed in detail. Timely administered treatment will improve sputum discharge and therefore eliminate one of the main factors of bronchial obstruction and decrease the risk of microbial colonization of the respiratory tract. The article also includes indications, contraindications and dosage regimens of acetylcysteine in children. The most common mistakes and specific aspects of mucolytic drugs in pediatrics are listed in the conclusion. 

  14. Music-based therapeutic interventions for people with dementia.

    Science.gov (United States)

    van der Steen, Jenny T; van Soest-Poortvliet, Mirjam C; van der Wouden, Johannes C; Bruinsma, Manon S; Scholten, Rob Jpm; Vink, Annemiek C

    2017-05-02

    Dementia is a clinical syndrome with a number of different causes which is characterised by deterioration in cognitive, behavioural, social and emotional functions. Pharmacological interventions are available but have limited effect to treat many of the syndrome's features. Less research has been directed towards non-pharmacological treatments. In this review, we examined the evidence for effects of music-based interventions as a treatment. To assess the effects of music-based therapeutic interventions for people with dementia on emotional well-being including quality of life, mood disturbance or negative affect, behavioural problems, social behaviour, and cognition at the end of therapy and four or more weeks after the end of treatment. We searched ALOIS, the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG) on 14 April 2010 using the terms: music therapy, music, singing, sing, auditory stimulation. Additional searches were also carried out on 3 July 2015 in the major healthcare databases MEDLINE, Embase, psycINFO, CINAHL and LILACS; and in trial registers and grey literature sources. On 12 April 2016, we searched the major databases for new studies for future evaluation. We included randomized controlled trials of music-based therapeutic interventions (at least five sessions) for people with dementia that measured any of our outcomes of interest. Control groups either received usual care or other activities. Two reviewers worked independently to screen the retrieved studies against the inclusion criteria and then to extract data and assess methodological quality of the included studies. If necessary, we contacted trial authors to ask for additional data, including relevant subscales, or for other missing information. We pooled data using random-effects models. We included 17 studies. Sixteen studies with a total of 620 participants contributed data to meta-analyses. Participants in the studies had dementia of varying degrees of

  15. Tackling Ebola: new insights into prophylactic and therapeutic intervention strategies.

    Science.gov (United States)

    de Wit, Emmie; Feldmann, Heinz; Munster, Vincent J

    2011-01-27

    Since its discovery in 1976, Ebolavirus has caused periodic outbreaks of viral hemorrhagic fever associated with severe and often fatal disease. Ebolavirus is endemic in Central Africa and the Philippines. Although there is currently no approved treatment available, the past 10 years has seen remarkable progress in our understanding of the pathogenicity of Ebolavirus and the development of prophylactic and post-exposure therapies against it. In vitro and in vivo experiments have shown that Ebolavirus pathogenicity is multifactorial, including viral and host determinants. Besides their function in the virus replication cycle, the viral glycoprotein, nucleoprotein, minor matrix protein and polymerase cofactor are viral determinants of pathogenicity, with evasion of the host innate and adaptive immune responses as the main mechanism. Although no licensed Ebolavirus vaccines are currently available, vaccine research in non-human primates, the 'gold standard' animal model for Ebolavirus, has produced several promising candidates. A combination of DNA vaccination and a recombinant adenovirus serotype 5 boost resulted in cross-protective immunity in non-human primates. A recombinant vesicular stomatitis vaccine vector protected non-human primates in pre- and post-exposure challenge studies. Several antiviral therapies are currently under investigation, but only a few of these have been tested in non-human primate models. Antisense therapies, in which oligonucleotides inhibit viral replication, have shown promising results in non-human primates following post-exposure treatment. In light of the severity of Ebolavirus disease and the observed increase in Ebolavirus outbreaks over the past decade, the expedited translation of potential candidate therapeutics and vaccines from bench to bedside is currently the most challenging task for the field. Here, we review the current state of Ebolavirus research, with emphasis on prophylactic and therapeutic intervention strategies.

  16. Differential Effects of Interventions on the Therapeutic Alliance With Patients With Personality Disorders

    OpenAIRE

    Bond, Michael; Banon, Elisabeth; Grenier, Marcella

    1998-01-01

    The goal of this study was to examine the relationship between clearly defined therapist interventions and the therapeutic alliance with personality-disordered patients. Transcripts of one psychotherapy session for each of 5 subjects taking part in a long-term psychotherapy research project were rated for therapist interventions and therapeutic alliance to determine if specific interventions were followed by enhanced or diminished therapeutic work. Transference interpretations were followed b...

  17. Improving quality measures in colonoscopy and its therapeutic intervention.

    Science.gov (United States)

    Horiuchi, Akira; Tanaka, Naoki

    2014-09-28

    Colonoscopy with polypectomy has been shown to reduce the risk of colon cancer. The critical element in the quality of colonoscopy in terms of polyp detection and removal continues to be the performance of the endoscopist, independent of patient-related factors. Improved results in terms of polyp detection and complete removal have implications regarding the development of screening and surveillance intervals and the reduction of interval cancers after negative colonoscopy. Advances in colonoscopy techniques such as high-definition colonoscopy, hood-assisted colonoscopy and dye-based chromoendoscopy have improved the detection of small and flat-type colorectal polyps. Virtual chromoendoscopy has not proven to improve polyp detection but may be useful to predict polyp pathology. The majority of polyps can be removed endoscopically. Available polypectomy techniques include cold forceps polypectomy, cold snare polypectomy, conventional polypectomy, endoscopic mucosal resection and endoscopic submucosal dissection. The preferred choice depends on the polyp size and characteristics. Other useful techniques include colonoscopic hemostasis for acute colonic diverticular bleeding, endoscopic decompression using colonoscopic stenting, and transanal tube placement for colorectal obstruction. Here we review the current knowledge concerning the improvement of quality measures in colonoscopy and colonoscopy-related therapeutic interventions.

  18. Targeting Metabolic Reprogramming by Influenza Infection for Therapeutic Intervention

    Directory of Open Access Journals (Sweden)

    Heather S. Smallwood

    2017-05-01

    Full Text Available Influenza is a worldwide health and financial burden posing a significant risk to the immune-compromised, obese, diabetic, elderly, and pediatric populations. We identified increases in glucose metabolism in the lungs of pediatric patients infected with respiratory pathogens. Using quantitative mass spectrometry, we found metabolic changes occurring after influenza infection in primary human respiratory cells and validated infection-associated increases in c-Myc, glycolysis, and glutaminolysis. We confirmed these findings with a metabolic drug screen that identified the PI3K/mTOR inhibitor BEZ235 as a regulator of infectious virus production. BEZ235 treatment ablated the transient induction of c-Myc, restored PI3K/mTOR pathway homeostasis measured by 4E-BP1 and p85 phosphorylation, and reversed infection-induced changes in metabolism. Importantly, BEZ235 reduced infectious progeny but had no effect on the early stages of viral replication. BEZ235 significantly increased survival in mice, while reducing viral titer. We show metabolic reprogramming of host cells by influenza virus exposes targets for therapeutic intervention.

  19. Quantification of mixed chimerism allows early therapeutic interventions

    Directory of Open Access Journals (Sweden)

    Jóice Merzoni

    2014-10-01

    Full Text Available Hematopoietic stem cell transplantation is the curative option for patients with myelodysplastic syndrome; however, it requires a long post-transplantation follow-up. A 53-year-old woman with a diagnosis of myelodysplastic syndrome underwent related donor allogeneic hematopoietic stem cell transplantation in July 2006. Three months after transplantation, a comparative short tandem repeat analysis between donor and recipient revealed full chimerism, indicating complete, healthy bone marrow reconstitution. Three years and ten months after hematopoietic stem cell transplantation, the patient developed leukopenia and thrombocytopenia. Another short tandem repeat analysis was carried out which showed mixed chimerism (52.62%, indicating relapsed disease. A donor lymphocyte infusion was administered. The purpose of donor lymphocyte infusion is to induce a graft-versus-leukemia effect; in fact, this donor's lymphocyte infusion induced full chimerism. Successive short tandem repeat analyses were performed as part of post-transplantation follow-up, and in July 2010, one such analysis again showed mixed chimerism (64.25%. Based on this finding, a second donor lymphocyte infusion was administered, but failed to eradicate the disease. In September 2011, the patient presented with relapsed disease, and a second related donor allogeneic hematopoietic stem cell transplantation was performed. Subsequent short tandem repeat analyses revealed full chimerism, indicating complete bone marrow reconstitution. We conclude that quantitative detection of mixed chimerism is an important diagnostic tool that can guide early therapeutic intervention.

  20. The Moving History of Vestibular Stimulation as a Therapeutic Intervention.

    Science.gov (United States)

    Grabherr, Luzia; Macauda, Gianluca; Lenggenhager, Bigna

    2015-01-01

    Although the discovery and understanding of the function of the vestibular system date back only to the 19th century, strategies that involve vestibular stimulation were used long before to calm, soothe and even cure people. While such stimulation was classically achieved with various motion devices, like Cox's chair or Hallaran's swing, the development of caloric and galvanic vestibular stimulation has opened up new possibilities in the 20th century. With the increasing knowledge and recognition of vestibular contributions to various perceptual, motor, cognitive, and emotional processes, vestibular stimulation has been suggested as a powerful and non-invasive treatment for a range of psychiatric, neurological and neurodevelopmental conditions. Yet, the therapeutic interventions were, and still are, often not hypothesis-driven as broader theories remain scarce and underlying neurophysiological mechanisms are often vague. We aim to critically review the literature on vestibular stimulation as a form of therapy in various selected disorders and present its successes, expectations, and drawbacks from a historical perspective.

  1. Targeting Metabolic Reprogramming by Influenza Infection for Therapeutic Intervention

    Energy Technology Data Exchange (ETDEWEB)

    Smallwood, Heather S.; Duan, Susu; Morfouace, Marie; Rezinciuc, Svetlana; Shulkin, Barry L.; Shelat, Anang; Zink, Erika E.; Milasta, Sandra; Bajracharya, Resha; Oluwaseum, Ajayi J.; Roussel, Martine F.; Green, Douglas R.; Pasa-Tolic, Ljiljana; Thomas, Paul G.

    2017-05-01

    Influenza is a worldwide health and financial burden posing a significant risk to the immune-compromised, obese, diabetic, elderly, and pediatric populations. We identified increases in glucose metabolism in the lungs of pediatric patients infected with respiratory pathogens. Using quantitative mass spectrometry, we found metabolic changes occurring after influenza infection in primary human respiratory cells and validated infection-associated increases in c-Myc, glycolysis, and glutaminolysis. We confirmed these findings with a metabolic drug screen that identified the PI3K/mTOR inhibitor BEZ235 as a regulator of infectious virus production. BEZ235 treatment ablated the transient induction of c-Myc, restored PI3K/mTOR pathway homeostasis measured by 4E-BP1 and p85 phosphorylation, and reversed infection-induced changes in metabolism. Importantly, BEZ235 reduced infectious progeny but had no effect on the early stages of viral replication. BEZ235 significantly increased survival in mice, while reducing viral titer. We show metabolic reprogramming of host cells by influenza virus exposes targets for therapeutic intervention.

  2. Neurodegenerative Diseases: Multifactorial Conformational Diseases and Their Therapeutic Interventions

    Directory of Open Access Journals (Sweden)

    Saba Sheikh

    2013-01-01

    Full Text Available Neurodegenerative diseases are multifactorial debilitating disorders of the nervous system that affect approximately 30 millionindividuals worldwide. Neurodegenerative diseases such as Alzheimer’s, Parkinson’s, Huntington’s, and amyotrophic lateral sclerosis diseases are the consequence of misfolding and dysfunctional trafficking of proteins. Beside that, mitochondrial dysfunction, oxidative stress, and/or environmental factors strongly associated with age have also been implicated in causing neurodegeneration. After years of intensive research, considerable evidence has accumulated that demonstrates an important role of these factors in the etiology of common neurodegenerative diseases. Despite the extensive efforts that have attempted to define the molecular mechanisms underlying neurodegeneration, many aspects of these pathologies remain elusive. However, in order to explore the therapeutic interventions directed towards treatment of neurodegenerative diseases, neuroscientists are now fully exploiting the data obtained from studies of these basic mechanisms that have gone awry. The novelty of these mechanisms represents a challenge to the identification of viable drug targets and biomarkers for early diagnosis of the diseases. In this paper, we are reviewing various aspects associated with the disease and the recent trends that may have an application for the treatment of the neurodegenerative disorders.

  3. Effectiveness of multifaceted interventions on rational use of antibiotics for patients with upper respiratory tract infections and acute diarrhea.

    Science.gov (United States)

    Boonyasiri, Adhiratha; Thamlikitkul, Visanu

    2014-03-01

    To implement multifaceted interventions to promote rational use of antibiotics for out-patients with upper respiratory tract infection (URI) and acute diarrhea. The present study was conducted at ambulatory care facility for patients under Social Security Healthcare Benefit Scheme and Universal Health Coverage Scheme of Siriraj Hospital from January to April 2012. Multifaceted interventions were: Training responsible healthcare personnel on rational use of antibiotics, Clinical practice guidelines, Preprinted medical record forms for patients, Throat swab or stool culture to be taken from the patients (if responsible physicians needed these); and provision of brochures containing causes, necessity and harm of antibiotics for URI and acute diarrhea to patients as well as their relatives while waiting for receiving care. Pre-printed medical records were collected every day. Each patient was called on day 3 after receiving care by an investigator to determine clinical responses. There were 1,241 episodes of URI and 210 episodes of acute diarrhea during the study period. Rates of antibiotic prescriptions were 13.0% for URI and 19.1% for acute diarrhea. Throat swab cultures recovered group A beta-hemolytic streptococci in 3.8% of URI patients and non-typhoidal Salmonella spp. in 14.6% of acute diarrhea patients. Clinical responses of the patients on day 3 after receiving care revealed that more than 97% of the patients who received antibiotics and who did not receive antibiotics were cured or improved. Multifaceted interventions are very effective for promoting rational use of antibiotics for out-patients with URI and acute diarrhea at Siriraj Hospital.

  4. Periostin: a promising target of therapeutical intervention for prostate cancer

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    Ding Weihong

    2011-06-01

    RNA-Periostin LNCap cells growed slowly in vitro and in vivo. The tissues of xenografts as PCa were verificated by HE staining. Additionally, the weak positive Periostin expressed tumor cells could be seen in the tissues of 6 xenografts from the group of down-regulated Periostin LNCap cells which had a significant decrease of the amount of Periostin compared to the other two group. Furthermore, our results demonstrated that sliencing Periostin could inhibit migration of LNCap cells in vitro. Conclusions Our data indicates that Periostin as an up-regulated protein in PCa may be a promising target of therapeutical intervention for PCa in future.

  5. STRUCTURE OF THE THERAPEUTIC INTERVENTIONS IN THE GROUP THERAPY OF SCHIZOPHRENIC PATIENTS

    OpenAIRE

    Snežana Manojlović; Julijana Nikolić-Popović

    2002-01-01

    The group and analytically-oriented psychotherapy of schizoid patients shows some peculiarities springing from the characteristics of the schizoid process itself that necessarily impose certain modifications of the therapeutic goals in techniques.The aim of the paper is to determine precisely the specific effect of the illness process upon the group psychotherapy process, that is, implications upon the therapeutic engagement.The verbal therapeutic interventions in a small psycho therapeutic g...

  6. 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.

  7. Alternative Therapeutic Intervention for Individuals with Rett Syndrome

    OpenAIRE

    Lotan, Meir

    2007-01-01

    The individual with Rett syndrome (RS) displays an array of challenging difficulties in all areas of daily living. Since there is no cure for the disorder at this moment, parents of the individual with Rett search for different interventional modalities that will improve the condition and quality of life for their child. During the last few years, many individuals with RS have experienced different kinds of interventions. This paper presents these methods with relevant case stories for others...

  8. Inpatient Group Therapeutic Interventions for Patients with Intellectual Disabilities

    Science.gov (United States)

    Reddy, Vilash

    2015-01-01

    Group therapy can be an effective mode of therapy, used on an inpatient unit, as it can allow patients to become allies in their journey to understand and overcome their mental health needs. The therapeutic principles discussed by Dr Irvin Yalom illustrate the significance and importance of group therapy, which was strongly incorporated into…

  9. The Therapeutic Efficacy of Domestic Violence Victim Interventions.

    Science.gov (United States)

    Hackett, Shannon; McWhirter, Paula T; Lesher, Susan

    2016-04-01

    A meta-analysis on domestic violence interventions was conducted to determine overall effectiveness of mental health programs involving women and children in joint treatment. These interventions were further analyzed to determine whether outcomes are differentially affected based on the outcome measure employed. To date, no meta-analyses have been published on domestic violence victim intervention efficacy. The 17 investigations that met study criteria yielded findings indicating that domestic violence interventions have a large effect size (d = .812), which decreases to a medium effect size when compared to control groups (d = .518). Effect sizes were assessed to determine whether treatment differed according to the focus of the outcome measure employed: (a) external stress (behavioral problems, aggression, or alcohol use); (b) psychological adjustment (depression, anxiety, or happiness); (c) self-concept (self-esteem, perceived competence, or internal locus of control); (d) social adjustment (popularity, loneliness, or cooperativeness); (e) family relations (mother-child relations, affection, or quality of interaction); and (f) maltreatment events (reoccurrence of violence, return to partner). Results reveal that domestic violence interventions across all outcome categories yield effects in the medium to large range for both internalized and externalized symptomatology. Implications for greater awareness and support for domestic violence treatment and programming are discussed. © The Author(s) 2015.

  10. Alternative Therapeutic Intervention for Individuals with Rett Syndrome

    Directory of Open Access Journals (Sweden)

    Meir Lotan

    2007-01-01

    Full Text Available The individual with Rett syndrome (RS displays an array of challenging difficulties in all areas of daily living. Since there is no cure for the disorder at this moment, parents of the individual with Rett search for different interventional modalities that will improve the condition and quality of life for their child. During the last few years, many individuals with RS have experienced different kinds of interventions. This paper presents these methods with relevant case stories for others to share the possibilities. This paper reviews the following interventions: animal-assisted therapy, such as dolphin therapy and dog-assisted therapy; auditory integration training; hyperbaric chamber; manual therapy, such as acupuncture/acupressure, aromatherapy, craniosacral therapy, Mayo facial release, Treager massage, chiropractor, and Reiki; mental modification techniques, such as Lovas and cognitive rehabilitation; motoric interventions, such as advanced biomechanical rehabilitation, patterning/Doman-DeLacato approach, and yoga. The present paper is not a recommendation for any of the above-mentioned techniques, but merely a review of different interventions available for the inquisitive parent of the individual with RS.

  11. Alternative therapeutic intervention for individuals with Rett syndrome.

    Science.gov (United States)

    Lotan, Meir

    2007-05-29

    The individual with Rett syndrome (RS) displays an array of challenging difficulties in all areas of daily living. Since there is no cure for the disorder at this moment, parents of the individual with Rett search for different interventional modalities that will improve the condition and quality of life for their child. During the last few years, many individuals with RS have experienced different kinds of interventions. This paper presents these methods with relevant case stories for others to share the possibilities. This paper reviews the following interventions: animal-assisted therapy, such as dolphin therapy and dog-assisted therapy; auditory integration training; hyperbaric chamber; manual therapy, such as acupuncture/acupressure, aromatherapy, craniosacral therapy, Mayo facial release, Treager massage, chiropractor, and Reiki; mental modification techniques, such as Lovas and cognitive rehabilitation; motoric interventions, such as advanced biomechanical rehabilitation, patterning/Doman-DeLacato approach, and yoga. The present paper is not a recommendation for any of the above-mentioned techniques, but merely a review of different interventions available for the inquisitive parent of the individual with RS.

  12. The Need for Evolutionarily Rational Disease Interventions: Vaccination Can Select for Higher Virulence.

    Directory of Open Access Journals (Sweden)

    Mike Boots

    2015-08-01

    Full Text Available There is little doubt evolution has played a major role in preventing the control of infectious disease through antibiotic and insecticide resistance, but recent theory suggests disease interventions such as vaccination may lead to evolution of more harmful parasites. A new study published in PLOS Biology by Andrew Read and colleagues shows empirically that vaccination against Marek's disease has favored higher virulence; without intervention, the birds die too quickly for any transmission to occur, but vaccinated hosts can both stay alive longer and shed the virus. This is an elegant empirical demonstration of how evolutionary theory can predict potentially dangerous responses of infectious disease to human interventions.

  13. Music and Music Intervention for Therapeutic Purposes in Patients with Ventilator Support; Gamelan Music Perspective

    Directory of Open Access Journals (Sweden)

    Suhartini Suhartini

    2011-01-01

    Full Text Available Background: Gamelan music is one of folk music for Javanese people. Several research studies testing the effects of music were conducted in Western countries. The music studies for therapeutic purposes used classical music commonly. Even in Indonesia, some researchers may use that music for therapeutic purposes. This concern article explains the perspective music and music intervention as therapeutic purposes, view with Javanese classical music.Objectives: To explore the evidence of music and music intervention for therapeutic purposes and to describe the perspective of gamelan music used in nursing interventionMethods: Using five bibliography databases (MEDLINE, CINAHL, Science Direct, Interscience, and Proquest were searched from 1999-2010 for original clinical reports or reviews that evaluated the use of complementary therapy for therapeutic intervention in patients with ventilator support. The term of complementary therapy, anxiety, and pain were used in a comprehensive search of electronic databases. Articles were screened and excluded based on the title and abstract information.Results: Music brings about helpful changes in the emotional and physical health of patients, and has the ability to provide an altered state of physical arousal and subsequent mood improvement by processing a progression of musical notes of varying tone, rhythm, and instrumentation for a pleasing effect.Conclusion: Music can be used for therapeutic purposes, for instance to reduce anxiety, to decrease pain sensation, and some effects of psychological impact. Include, the gamelan music can be offer for patients for Javanese people in Indonesia.Key words: Music, music intervention, therapeutic purposes

  14. Music and Music Intervention for Therapeutic Purposes in Patients with Ventilator Support; Gamelan Music Perspective

    OpenAIRE

    Suhartini Suhartini

    2011-01-01

    Background: Gamelan music is one of folk music for Javanese people. Several research studies testing the effects of music were conducted in Western countries. The music studies for therapeutic purposes used classical music commonly. Even in Indonesia, some researchers may use that music for therapeutic purposes. This concern article explains the perspective music and music intervention as therapeutic purposes, view with Javanese classical music.Objectives: To explore the evidence of music and...

  15. Music-based therapeutic interventions for people with dementia

    NARCIS (Netherlands)

    van der Steen, Jenny T; van Soest-Poortvliet, Mirjam C; van der Wouden, Johannes C; Bruinsma, Manon S; Scholten, Rob Jpm; Vink, Annemiek C

    2017-01-01

    BACKGROUND: Dementia is a clinical syndrome with a number of different causes which is characterised by deterioration in cognitive, behavioural, social and emotional functions. Pharmacological interventions are available but have limited effect to treat many of the syndrome's features. Less research

  16. Dyslipidaemia in diabetes – an approach to therapeutic intervention ...

    African Journals Online (AJOL)

    ... cardiovascular disease and in particular, coronary artery disease. This article discusses the difference between the lipid profiles of type 1 and type 2 diabetes and gives practical guidelines for pharmacological and lifestyle interventions to reduce cardiovascular mortality and hospitalisations. South African Family Practice ...

  17. Therapeutic interventions for acute hamstring injuries: A systematic review

    NARCIS (Netherlands)

    G. Reurink (Gustaaf); G.J. Goudswaard (Gert Jan); J.L. Tol (Johannes); J.A.N. Verhaar (Jan); A. Weir (Adam); M.H. Moen (Maaike)

    2012-01-01

    textabstractBackground Despite the high rate of hamstring injuries, there is no consensus on their management, with a large number of different interventions being used. Recently several new injection therapies have been introduced. Objective To systematically review the literature on the

  18. Music Therapy: A Therapeutic Intervention for Girls with Rett Syndrome.

    Science.gov (United States)

    Coleman, Kathleen A.

    The paper reviews music therapy, the educational background of music therapists, music therapy's various settings, and its use as an intervention with girls with Rett Syndrome. Sample music therapy programs for three girls (aged 5, 14, and 20 years) with Rett Syndrome are presented. The sample programs provide: student descriptions; the girls'…

  19. Therapeutic intervention scoring system-28 (TISS-28: diretrizes para aplicação Therapeutic intervention scoring system-28 (tiss-28: directrices para su aplicación Therapeutic intervention scoring system-28 (tiss-28: directions for application

    Directory of Open Access Journals (Sweden)

    Katia Grillo Padilha

    2005-06-01

    Full Text Available O Therapeutic Intervention Scoring System-28 (TISS-28 é um instrumento que permite dimensionar carga de trabalho de enfermagem em Unidade de Terapia Intensiva e estimar gravidade da doença. Apresenta-se nesta publicação as definições operacionais para sua aplicação, proposta por um grupo de especialistas na área, com vistas a uniformizar o significado de cada um dos itens e evitar vieses de interpretação.El Therapeutic Intervention Scoring System-28 (TISS-28 es un instrumento que permite dimensionar carga de trabajo de enfermería en una Unidad de Terapia Intensiva y estimar la gravedad de la enfermedad. Se presenta en esta publicación las definiciones operacionales para su aplicación, propuesta por un grupo de especialistas en el área, con vistas a uniformizar el significado de cada uno de los items y evitar sesgos de interpretación.Therapeutic Intervention Scoring System-28 (TISS-28 is a tool that enables the measurement of the nursing work load in Intensive Care Units and the estimate of how grave the disease is. In this study are presented the operational definitions for its application, proposed by a group of specialists in the area, with the aim of rendering uniform the meaning of each of the items and preventing interpretation biases.

  20. Microvascular responsiveness in obesity: implications for therapeutic intervention

    Science.gov (United States)

    Bagi, Zsolt; Feher, Attila; Cassuto, James

    2012-01-01

    Obesity has detrimental effects on the microcirculation. Functional changes in microvascular responsiveness may increase the risk of developing cardiovascular complications in obese patients. Emerging evidence indicates that selective therapeutic targeting of the microvessels may prevent life-threatening obesity-related vascular complications, such as ischaemic heart disease, heart failure and hypertension. It is also plausible that alterations in adipose tissue microcirculation contribute to the development of obesity. Therefore, targeting adipose tissue arterioles could represent a novel approach to reducing obesity. This review aims to examine recent studies that have been focused on vasomotor dysfunction of resistance arteries in obese humans and animal models of obesity. Particularly, findings in coronary resistance arteries are contrasted to those obtained in other vascular beds. We provide examples of therapeutic attempts, such as use of statins, ACE inhibitors and insulin sensitizers to prevent obesity-related microvascular complications. We further identify some of the important challenges and opportunities going forward. LINKED ARTICLES This article is part of a themed section on Fat and Vascular Responsiveness. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2012.165.issue-3 PMID:21797844

  1. Therapeutic interventions to disrupt the protein synthetic machinery in melanoma.

    Science.gov (United States)

    Kardos, Gregory R; Robertson, Gavin P

    2015-09-01

    Control of the protein synthetic machinery is deregulated in many cancers, including melanoma, to increase the protein production. Tumor suppressors and oncogenes play key roles in protein synthesis from the transcription of rRNA and ribosome biogenesis to mRNA translation initiation and protein synthesis. Major signaling pathways are altered in melanoma to modulate the protein synthetic machinery, thereby promoting tumor development. However, despite the importance of this process in melanoma development, involvement of the protein synthetic machinery in this cancer type is an underdeveloped area of study. Here, we review the coupling of melanoma development to deregulation of the protein synthetic machinery. We examine existing knowledge regarding RNA polymerase I inhibition and mRNA translation focusing on their inhibition for therapeutic applications in melanoma. Furthermore, the contribution of amino acid biosynthesis and involvement of ribosomal proteins are also reviewed as future therapeutic strategies to target deregulated protein production in melanoma. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Dengue infection associated hemophagocytic syndrome: Therapeutic interventions and outcome.

    Science.gov (United States)

    Wan Jamaludin, Wan Fariza; Periyasamy, Petrick; Wan Mat, Wan Rahiza; Abdul Wahid, S Fadilah

    2015-08-01

    Infection associated hemophagocytic syndrome is increasingly recognized as a potentially fatal complication of dengue fever. It should be suspected with prolonged fever beyond seven days associated with hepatosplenomegaly, hyperferritinemia, worsening cytopenias and development of multiorgan dysfunction. Surge of similar pro-inflammatory cytokines observed in dengue associated hemophagocytic syndrome and multiorgan dysfunction may indicate they are part of related inflammatory spectrum. A proportion of patients recovered with supportive therapy, however most required interventions with corticosteroids, intravenous immunoglobulin or chemotherapy. We report three cases of dengue associated IAHS with good outcome following early recognition and treatment with dexamethasone and intravenous immunoglobulin. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. NGO-provided free HIV treatment and services in Burkina Faso: scarcity, therapeutic rationality and unfair process

    Directory of Open Access Journals (Sweden)

    Ridde Valéry

    2012-03-01

    Full Text Available Abstract Until 2010, Burkina Faso was an exception to the international trend of abolishing user fees for antiretroviral treatment (ART. Patients were still expected to pay 1,500F CFA (2 Euros per month for ART. Nevertheless, many non-governmental organizations (NGOs exempted patients from payment. The objective of this study was to investigate how NGOs selected the beneficiaries of payment exemptions for government-provided ART and rationed out complementary medical and psychosocial services. For this qualitative study, we conducted 13 individual interviews and three focus group discussions (n = 13 persons with program staff in nine NGOs (4,000 patients, two NGO coordinating structures and one national program. These encounters were recorded and transcribed, and their content was thematically analyzed. The results were presented to the NGOs for feedback. Results indicate that there are no concrete guidelines for identifying patients warranting payment exemptions. Formerly, ART was scarce in Burkina Faso and the primary criterion for treatment selection was clinical. Our results suggest that this scarcity, mediated by an approach we call sociotherapeutic rationality (i.e. maximization of clinical success, may have led to inequities in the provision of free ART. This approach may be detrimental to assuring equity since the most impoverished lack resources to pay for services that maximize clinical success (e.g. viral load that would increase their chances of being selected for treatment. However, once selected into treatment, attempts were made to ration-out complementary services more equitably. This study demonstrates the risks entailed by medication scarcity, which presents NGOs and health professionals with impossible choices that run counter to the philosophy of equity in access to treatment. Amid growing concerns of an international funding retreat for ART, it is important to learn from the past in order to better manage the potentially

  4. Therapeutic interventions against reperfusion injury in skeletal muscle.

    Science.gov (United States)

    Wang, Wei Z; Baynosa, Richard C; Zamboni, William A

    2011-11-01

    Ischemia/reperfusion (I/R) injury in the skeletal muscle is inevitable in many vascular and musculoskeletal traumas, diseases, free tissue transfers, and during time-consuming reconstructive and transplantation surgeries. Although skeletal muscle has a higher tolerance to ischemia than other organs, prolonged ischemia can still result in significant complications, including muscle necrosis and apoptosis. One of the major goals in the treatment of ischemia is early restoration of blood flow (reperfusion) to the area at risk. However, reperfusion has led to a new pathophysiologic condition called "reperfusion injury," a phenomenon which actually provokes a distinct degree of tissue injury. The purpose of this review is to examine the current state of understanding of I/R injury as well as to highlight recent developments on I/R interventions including our own experience in this particular field. We expect, as our acquired experience and the increased knowledge of underlying mechanisms of I/R injury, more effective interventions aimed to reduce I/R injury will be developed to interfere with or modulate this particular pathophysiologic processes. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Therapeutic interventions for aging: the case of cellular senescence.

    Science.gov (United States)

    Soto-Gamez, Abel; Demaria, Marco

    2017-05-01

    Organismal aging is a multifactorial process characterized by the onset of degenerative conditions and cancer. One of the key drivers of aging is cellular senescence, a state of irreversible growth arrest induced by many pro-tumorigenic stresses. Senescent cells accumulate late in life and at sites of age-related pathologies, where they contribute to disease onset and progression through complex cell and non-cell autonomous effects. Here, we summarize the mechanisms by which cellular senescence can promote aging, and we offer an extensive description of current potential pharmacological interventions for senescent cells, highlighting limitations and suggesting alternatives. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  6. [Diagnosis and Therapeutic Interventions in Autism Spectrum Disorders in Adulthood].

    Science.gov (United States)

    Krämer, K; Gawronski, A; Vogeley, K

    2016-09-01

    Autism spectrum disorders (ASD) are characterized by disturbed social interaction and communication as well as stereotyped or repetitive behaviors and interests. Although adults with ASD often acquire complex compensatory strategies that help them master social situations in a rule-based fashion, they still show impairments in intuitive processing of social signals and especially nonverbal communication in complex everyday situations. This constitutes a particular challenge for the psychotherapy of ASD. Psychotherapists are required to explicitly inform and act as an agent of the non-autistic world to enable patients to acquire the ability to take different perspectives. The overall aim of cognitive behavioral therapy interventions addressing ASD in adulthood is to extend the patients' behavioral repertoire to improve their quality of life. Thus, besides psychoeducation on ASD and its frequently associated comorbidities, psychotherapy for adults with ASD should focus on the training and development of social-communicative skills. Furthermore, dealing with stress in everyday situations is an important aspect of psychotherapy of these patients. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Therapeutic Interventions for Increasing Ankle Dorsiflexion After Ankle Sprain: A Systematic Review

    Science.gov (United States)

    Terada, Masafumi; Pietrosimone, Brian G.; Gribble, Phillip A.

    2013-01-01

    Context: Clinicians perform therapeutic interventions, such as stretching, manual therapy, electrotherapy, ultrasound, and exercises, to increase ankle dorsiflexion. However, authors of previous studies have not determined which intervention or combination of interventions is most effective. Objective: To determine the magnitude of therapeutic intervention effects on and the most effective therapeutic interventions for restoring normal ankle dorsiflexion after ankle sprain. Data Sources: We performed a comprehensive literature search in Web of Science and EBSCO HOST from 1965 to May 29, 2011, with 19 search terms related to ankle sprain, dorsiflexion, and intervention and by cross-referencing pertinent articles. Study Selection: Eligible studies had to be written in English and include the means and standard deviations of both pretreatment and posttreatment in patients with acute, subacute, or chronic ankle sprains. Outcomes of interest included various joint mobilizations, stretching, local vibration, hyperbaric oxygen therapy, electrical stimulation, and mental-relaxation interventions. Data Extraction: We extracted data on dorsiflexion improvements among various therapeutic applications by calculating Cohen d effect sizes with associated 95% confidence intervals (CIs) and evaluated the methodologic quality using the Physiotherapy Evidence Database (PEDro) scale. Data Synthesis: In total, 9 studies (PEDro score = 5.22 ± 1.92) met the inclusion criteria. Static-stretching interventions with a home exercise program had the strongest effects on increasing dorsiflexion in patients 2 weeks after acute ankle sprains (Cohen d = 1.06; 95% CI = 0.12, 2.42). The range of effect sizes for movement with mobilization on ankle dorsiflexion among individuals with recurrent ankle sprains was small (Cohen d range = 0.14 to 0.39). Conclusions: Static-stretching intervention as a part of standardized care yielded the strongest effects on dorsiflexion after acute ankle sprains. The

  8. Rational and timely haemostatic interventions following cardiac surgery - coagulation factor concentrates or blood bank products.

    Science.gov (United States)

    Tang, Mariann; Fenger-Eriksen, Christian; Wierup, Per; Greisen, Jacob; Ingerslev, Jørgen; Hjortdal, Vibeke; Sørensen, Benny

    2017-06-01

    Cardiac surgery may cause a serious coagulopathy leading to increased risk of bleeding and transfusion demands. Blood bank products are commonly first line haemostatic intervention, but has been associated with hazardous side effect. Coagulation factor concentrates may be a more efficient, predictable, and potentially a safer treatment, although prospective clinical trials are needed to further explore these hypotheses. This study investigated the haemostatic potential of ex vivo supplementation of coagulation factor concentrates versus blood bank products on blood samples drawn from patients undergoing cardiac surgery. 30 adults were prospectively enrolled (mean age=63.9, females=27%). Ex vivo haemostatic interventions (monotherapy or combinations) were performed in whole blood taken immediately after surgery and two hours postoperatively. Fresh-frozen plasma, platelets, cryoprecipitate, fibrinogen concentrate, prothrombin complex concentrate (PCC), and recombinant FVIIa (rFVIIa) were investigated. The haemostatic effect was evaluated using whole blood thromboelastometry parameters, as well as by thrombin generation. Immediately after surgery the compromised maximum clot firmness was corrected by monotherapy with fibrinogen or platelets or combination therapy with fibrinogen. At two hours postoperatively the coagulation profile was further deranged as illustrated by a prolonged clotting time, a reduced maximum velocity and further diminished maximum clot firmness. The thrombin lagtime was progressively prolonged and both peak thrombin and endogenous thrombin potential were compromised. No monotherapy effectively corrected all haemostatic abnormalities. The most effective combinations were: fibrinogen+rFVIIa or fibrinogen+PCC. Blood bank products were not as effective in the correction of the coagulopathy. Coagulation factor concentrates appear to provide a more optimal haemostasis profile following cardiac surgery compared to blood bank products. Copyright © 2017

  9. Individual prognosis regarding effectiveness of a therapeutic intervention using pre-therapeutic "kinesiology muscle test".

    Science.gov (United States)

    Waxenegger, Ingrid; Endler, P Christian; Wulkersdorfer, Beatrix; Spranger, Heinz

    2007-10-22

    Since a therapy's full positive effect and possible adverse effects are individual and not predictable for every single patient, scientists have been searching for methods to predict optimal effects of a therapy. This pilot study investigated the applicability of the "kinesiology muscle test" as a prognostic tool regarding effectiveness in a defined therapeutic procedure. Each of 11 test persons with elevated total cholesterol values received a naturopathic drug supposed to lower cholesterol level on a daily basis for eight consecutive weeks. Prior to treatment the "kinesiology muscle test" was performed, where the patients' ability to maintain a flexed position in a selected joint was evaluated. The resistance created by the patient against the tester's pressure was monitored. Being in touch with healthful or unhealthful chemical substances may, according to the kinesiology literature, increase or decrease this resistance. For testing purposes, the drug was placed onto the patients' skin. The ability of the brachioradial muscle to resist the tester's pressure was determined on a subjective scale (0-100%). The Pearson product-moment correlation coefficient between four variables (total cholesterol value before therapy, total cholesterol value after therapy, difference of total cholesterol values before and after therapy, prior to treatment kinesiology testing) was chosen. A significant correlation between the difference of total cholesterol values before-after and the prior to treatment test was found, as well as a significant correlation between the total cholesterol values after therapy and the prior to treatment kinesiology test.

  10. A longitudinal study of mental health in refugees from Burma: The impact of therapeutic interventions

    Science.gov (United States)

    van Wyk, Sierra; Schweitzer, Robert; Brough, Mark; Vromans, Lyn; Murray, Kate

    2013-01-01

    Objective The present study seeks to examine the impact of therapeutic interventions for refugees within a naturalistic setting. Method Sixty-two refugees from Burma were assessed soon after arriving in Australia. All participants received standard interventions provided by a resettlement organisation which included therapeutic interventions, assessment, social assistance, and referrals where appropriate. At the completion of service provision a follow-up assessment was conducted. Results Over the course of the intervention, participants experienced a significant decrease in symptoms of post-traumatic stress disorder, anxiety, depression and somatisation. Pre-intervention symptoms predicted symptoms post-intervention for post-traumatic stress, anxiety, and somatisation. Post-migration living difficulties, the number of traumas experienced, and the number of contacts with the service agency were unrelated to all mental health outcomes. Conclusions In the first Australian study of its kind, reductions in mental health symptoms post-intervention were significantly linked to pre-intervention symptomatology and the number of therapy sessions predicted post-intervention symptoms of post-traumatic stress. Future studies need to include larger samples and control groups to verify findings. PMID:22431841

  11. Therapeutic singing as an early intervention for swallowing in persons with Parkinson's disease.

    Science.gov (United States)

    Stegemöller, E L; Hibbing, P; Radig, H; Wingate, J

    2017-04-01

    For persons with Parkinson's disease (PD), secondary motor symptoms such as swallow impairment impact the quality of life and are major contributors to mortality. There is a present need for therapeutic interventions aimed at improving swallow function during the early stages of PD. The purpose of this pilot study was to examine the effects of a group therapeutic singing intervention on swallowing in persons with PD with no significant dysphagia symptoms. Cohort study. University in the United States. Twenty-four participants with PD. Eight weeks of group therapeutic singing. Electromyography (EMG) was used to assess muscle activity associated with swallow pre and post the group singing intervention. Swallow quality of life (SWAL-QOL) and the Unified Parkinson's Disease Rating Scale (UPDRS) were also obtained pre- and post-intervention. Participants reported minimal difficulty with swallowing, yet results revealed a significant increase in EMG outcome measures, as well as significant improvement in UPDRS total and UPDRS motor scores. No significant differences were revealed for SWAL-QOL. Increases in EMG timing measures may suggest that group singing results in the prolongation of laryngeal elevation, protecting the airway from foreign material for longer periods of time during swallow. Combined with the improvement in UPDRS clinical measures, therapeutic singing may be an engaging early intervention strategy to address oropharyngeal dysphagia while also benefiting additional clinical symptoms of PD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Culture, context and therapeutic processes: delivering a parent-child intervention in a remote Aboriginal community.

    Science.gov (United States)

    Mares, Sarah; Robinson, Gary

    2012-04-01

    Little is written about the process of delivering mainstream, evidence-based therapeutic interventions for Aboriginal children and families in remote communities. Patterns of interaction between parents and children and expectations about parenting and professional roles and responsibilities vary across cultural contexts. This can be a challenging experience for professionals accustomed to work in urban settings. Language is only a part of cultural difference, and the outsider in a therapeutic group in an Aboriginal community is outside not only in language but also in access to community relationships and a place within those relationships. This paper uses examples from Let's Start, a therapeutic parent-child intervention to describe the impact of distance, culture and relationships in a remote Aboriginal community, on the therapeutic framework, group processes and relationships. Cultural and contextual factors influence communication, relationships and group processes in a therapeutic group program for children and parents in a remote Aboriginal community. Group leaders from within and from outside the community, are likely to have complementary skills. Cultural and contextual factors influence communication, relationships and group processes in a therapeutic group program for children and parents in a remote Aboriginal community. Group leaders from within and from outside the community, are likely to have complementary skills. Program adaptation, evaluation and staff training and support need to take these factors into account to ensure cultural accessibility without loss of therapeutic fidelity and efficacy.

  13. A rational quantitative approach to determine the best dosing regimen for a target therapeutic effect: a unified formalism for antibiotic evaluation.

    Science.gov (United States)

    Li, Jun; Nekka, Fahima

    2013-02-21

    The determination of an optimal dosing regimen is a critical step to enhance the drug efficacy and avoid toxicity. Rational dosing recommendations based on mathematical considerations are increasingly being adopted in the process of drug development and use. In this paper, we propose a quantitative approach to evaluate the efficacy of antibiotic agents. By integrating both pharmacokinetic (PK) and pharmacodynamic (PD) information, this approach gives rise to a unified formalism able to measure the cause-effect of dosing regimens. This new pharmaco-metric allows to cover a whole range of antibiotics, including the two well known concentration and time dependent classes, through the introduction of the Hill-dependency concept. As a direct fallout, our formalism opens a new path toward the bioequivalence evaluation in terms of PK and PD, which associates the in vivo drug concentration and the in vitro drug effect. Using this new approach, we succeeded to reveal unexpected, but relevant behaviors of drug performance when different drug regimens and drug classes are considered. Of particular notice, we found that the doses required to reach the same therapeutic effect, when scheduled differently, exhibit completely different tendencies for concentration and time dependent drugs. Moreover, we theoretically confirmed the previous experimental results of the superiority of the once daily regimen of aminoglycosides. The proposed methodology is appealing for its computational features and can easily be applicable to design fair clinical protocols or rationalize prescription decisions. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. The existing therapeutic interventions for orgasmic disorders: recommendations for culturally competent services, narrative review

    OpenAIRE

    Zahra Salmani; Ali Zargham-Boroujeni; Mehrdad Salehi; Killeen, Therese K.; Effat Merghati-Khoei

    2015-01-01

    Background: In recent years, a growing number of interventions for treatment of female orgasmic problems (FODs) have emerged. Whereas orgasm is a extra biologically and learnable experience, there is a need for practitioners that to be able to select which therapy is the most appropriate to their context. Objective: In this critical literature review, we aimed to assess areas of controversy in the existing therapeutic interventions in FOD with taking into accounted the Iranian cultural mod...

  15. Rational evaluation of the therapeutic effect and dosimetry of auger electrons for radionuclide therapy in a cell culture model.

    Science.gov (United States)

    Shinohara, Ayaka; Hanaoka, Hirofumi; Sakashita, Tetsuya; Sato, Tatsuhiko; Yamaguchi, Aiko; Ishioka, Noriko S; Tsushima, Yoshito

    2017-12-13

    Radionuclide therapy with low-energy auger electron emitters may provide high antitumor efficacy while keeping the toxicity to normal organs low. Here we evaluated the usefulness of an auger electron emitter and compared it with that of a beta emitter for tumor treatment in in vitro models and conducted a dosimetry simulation using radioiodine-labeled metaiodobenzylguanidine (MIBG) as a model compound. We evaluated the cellular uptake of 125I-MIBG and the therapeutic effects of 125I- and 131I-MIBG in 2D and 3D PC-12 cell culture models. We used a Monte Carlo simulation code (PHITS) to calculate the absorbed radiation dose of 125I or 131I in computer simulation models for 2D and 3D cell cultures. In the dosimetry calculation for the 3D model, several distribution patterns of radionuclide were applied. A higher cumulative dose was observed in the 3D model due to the prolonged retention of MIBG compared to the 2D model. However, 125I-MIBG showed a greater therapeutic effect in the 2D model compared to the 3D model (respective EC50 values in the 2D and 3D models: 86.9 and 303.9 MBq/cell), whereas 131I-MIBG showed the opposite result (respective EC50 values in the 2D and 3D models: 49.4 and 30.2 MBq/cell). The therapeutic effect of 125I-MIBG was lower than that of 131I-MIBG in both models, but the radionuclide-derived difference was smaller in the 2D model. The dosimetry simulation with PHITS revealed the influence of the radiation quality, the crossfire effect, radionuclide distribution, and tumor shape on the absorbed dose. Application of the heterogeneous distribution series dramatically changed the radiation dose distribution of 125I-MIBG, and mitigated the difference between the estimated and measured therapeutic effects of 125I-MIBG. The therapeutic effect of 125I-MIBG was comparable to that of 131I-MIBG in the 2D model, but the efficacy was inferior to that of 131I-MIBG in the 3D model, since the crossfire effect is negligible and the homogeneous distribution

  16. Heuristic Evaluation of Ehealth Interventions: Establishing Standards That Relate to the Therapeutic Process Perspective

    Science.gov (United States)

    Muench, Fred

    2016-01-01

    In recent years, the number of available eHealth interventions aimed at treating behavioral and mental health challenges has been growing. From the perspective of health care providers, there is a need for eHealth interventions to be evaluated prior to clinical trials and for the limited resources allocated to empirical research to be invested in the most promising products. Following a literature review, a gap was found in the availability of eHealth interventions evaluation principles related to the patient experience of the therapeutic process. This paper introduces principles and concepts for the evaluation of eHealth interventions developed as a first step in a process to outline general evaluation guidelines that relate to the clinical context from health care providers’ perspective. Our approach was to conduct a review of literature that relates to the examination of eHealth interventions. We identified the literature that was most relevant to our study and used it to define guidelines that relate to the clinical context. We then compiled a list of heuristics we found to be useful for the evaluation of eHealth intervention products’ suitability for empirical examination. Four heuristics were identified with respect to the therapeutic process: (1) the product’s ease of use (ie, usability), (2) the eHealth intervention’s compatibility with the clinical setting, (3) the presence of tools that make it easier for the user to engage in therapeutic activities, and (4) the provision of a feasible therapeutic pathway to growth. We then used this set of heuristics to conduct a detailed examination of MyFitnessPal. This line of work could help to set the bar higher for product developers and to inform health care providers about preferred eHealth intervention designs. PMID:26764209

  17. Does postural sway change in association with manual therapeutic interventions? A review of the literature

    Directory of Open Access Journals (Sweden)

    Ruhe Alexander

    2013-02-01

    Full Text Available Abstract Study design Literature Review Objectives The objective of this literature review was to determine if postural sway changes in association with manual therapeutic interventions and to investigate whether any changes occur in healthy individuals or in association with pain intensity. Summary of Background data Improving postural stability has been proposed as a goal of manual therapeutic interventions. So far, no literature review has addressed whether there is supportive evidence for this and if so, what factors may be associated or causative for observed sway alterations. Search methods Seven online databases (PubMed, MEDLINE, EMBASE, CINAHL, Web of Science, ScienceDirect and the Cochrane library were systematically searched followed by a manual search of the retrieved papers. Selection criteria Studies comparing postural sway derived from bipedal force plate measurements in association with a manual therapeutic intervention, ideally compared to a control group. Data collection and analysis Two reviewers independently screened titles and abstracts for relevance, conducted the data extraction and the risk of bias assessment which was conducted using the RTI item bank. A descriptive analysis was conducted as the heterogeneous study designs prevented pooling of data. Results Nine studies of varying methodological quality met the inclusion criteria. No direct comparison of data across the studies was possible. There was no evidence that manual interventions lead to a change in postural sway in healthy individuals regardless of the body regions addressed by the intervention. There was some indication that postural sway may change at follow-up measurements in pain sufferers; however, this may be due to variations in pain intensity rather than resulting from the intervention itself. Conclusions There is no conclusive scientific evidence that manual therapeutic interventions may exhibit any immediate or long-term effect on COP excursions. Any

  18. Simplified Therapeutic Intervention Scoring System : The TISS-28 items - Results from a multicenter study

    NARCIS (Netherlands)

    Miranda, DR; deRijk, A; Schaufeli, W

    Objectives: To validate a simplified version of the Therapeutic Intervention Scoring System, the TISS-28, and to determine the association of TISS-28 with the time spent on scored and nonscored nursing activities. Design: Prospective, multicenter study. Setting: Twenty-two adult medical, surgical,

  19. Effectiveness of a Therapeutic Summer Camp for Children with ADHD: Phase I Clinical Intervention Trial

    Science.gov (United States)

    Hantson, Julie; Wang, Pan Pan; Grizenko-Vida, Michael; Ter-Stepanian, Marina; Harvey, William; Joober, Ridha; Grizenko, Natalie

    2012-01-01

    Objective: The objective of this study was to evaluate the effectiveness of a 2-week therapeutic summer day camp for children with ADHD, which included a social skills training program and parent psychoeducation and training program. This was an open-label, nonrandomized Phase I Clinical Intervention Trial. Method: Parents completed the Weiss…

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

    Science.gov (United States)

    Christopher, Paul P; Appelbaum, Paul S; Truong, Debbie; Albert, Karen; Maranda, Louise; Lidz, Charles

    2017-01-01

    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

  1. Therapeutic intervention for internalized stigma of severe mental illness: A systematic review and meta-analysis.

    Science.gov (United States)

    Tsang, Hector W H; Ching, S C; Tang, K H; Lam, H T; Law, Peggy Y Y; Wan, C N

    2016-05-01

    Internalized stigma can lead to pervasive negative effects among people with severe mental illness (SMI). Although prevalence of internalized stigma is high, there is a dearth of interventions and meanwhile a lack of evidence as to their effectiveness. This study aims at unraveling the existence of different therapeutic interventions and the effectiveness internalized stigma reduction in people with SMI via a systematic review and meta-analysis. Five electronic databases were searched. Studies were included if they (1) involved community or hospital based interventions on internalized stigma, (2) included participants who were given a diagnosis of SMI>50%, and (3) were empirical and quantitative in nature. Fourteen articles were selected for extensive review and five for meta-analysis. Nine studies showed significant decrease in internalized stigma and two showed sustainable effects. Meta-analysis showed that there was a small to moderate significant effect in therapeutic interventions (SMD=-0.43; p=0.003). Among the intervention elements, four studies suggested a favorable effect of psychoeducation. Meta-analysis showed that there was small to moderate significant effect (SMD=-0.40; p=0.001). Most internalized stigma reduction programs appear to be effective. This systematic review cannot make any recommendation on which intervention is more effective although psychoeducation seems most promising. More Randomized Controlled Trials (RCT) on particular intervention components using standard outcome measures are recommended in future studies. Copyright © 2016. Published by Elsevier B.V.

  2. Effects of rational emotive occupational health therapy intervention on the perceptions of organizational climate and occupational risk management practices among electronics technology employees in Nigeria.

    Science.gov (United States)

    Ogbuanya, Theresa Chinyere; Eseadi, Chiedu; Orji, Chibueze Tobias; Ede, Moses Onyemaechi; Ohanu, Ifeanyi Benedict; Bakare, Jimoh

    2017-05-01

    Improving employees' perception of organizational climate, and coaching them to remain steadfast when managing occupational risks associated with their job, might have an important effect on their psychosocial wellbeing and occupational health. This study examined the effects of a rational emotive occupational health therapy intervention program on the perceptions of organizational climate and occupational risk management practices. The participants were 77 electronics technology employees in the south-east of Nigeria. The study used a pretest-posttest control group design. The rational emotive occupational health therapy intervention program significantly improved perceptions of the organizational climate for the people in the treatment group compared to those in the waitlist control group at post-intervention and follow-up assessments. Occupational risk management practices of the employees in the treatment group were also significantly better than those in the waitlist control group at the same 2 assessments. Corporate application of a rational emotive behavior therapy as an occupational health therapy intervention program is essential for improving the perceptions of organizational climate and promoting the adoption of feasible occupational risk management strategies in the workplace.

  3. The therapeutic alliance in internet interventions: A narrative review and suggestions for future research.

    Science.gov (United States)

    Berger, Thomas

    2017-09-01

    Research on Internet interventions has grown rapidly over the recent years and evidence is growing that Internet-based treatments often result in similar outcomes as conventional face-to-face psychotherapy. Yet there are still unanswered concerns such as whether a therapeutic alliance can be established over the Internet and whether the alliance is important in this new treatment format. A narrative review of studies formally assessing the therapeutic alliance in Internet interventions was conducted. It is the first review summarizing findings on the therapeutic alliance that (i) distinguishes between different forms of Internet interventions and (ii) does not restrict itself to specific Internet-based treatment formats such as guided self-help treatments, e-mail or videoconferencing therapies. Independent of communication modalities, diagnostic groups and amount of contact between clients and therapists, client-rated alliance scores were high, roughly equivalent to alliance ratings found in studies on face-to-face therapy. Mixed results were found regarding the therapist-rated alliance and alliance-outcome associations. The review points to the limitations of the available evidence and identifies unanswered questions. It is concluded that one of the major tasks for future research is to identify unique characteristics of the therapeutic alliance in the different treatment formats.

  4. Neuroinflammation in the pathogenesis of Alzheimer´s disease. A rational framework for the search of novel therapeutic approaches

    Directory of Open Access Journals (Sweden)

    Ricardo Benjamin Maccioni

    2014-04-01

    Full Text Available Alzheimer disease (AD is the most common cause of dementia in people over 60 years old. The molecular and cellular alterations that trigger this disease are still diffuse, one of the reasons for the delay in finding an effective treatment. In the search for new targets to search for novel therapeutic avenues, clinical studies in patients who used anti-inflammatory drugs indicating a lower incidence of AD have been of value to support the neuroinflammatory hypothesis of the neurodegenerative processes and the role of innate immunity in this disease. Neuroinflammation appears to occur as a consequence of a series of damage signals, including trauma, infection, oxidative agents, redox iron, oligomers of tau and beta amyloid, etc. In this context, our theory of Neuroimmunomodulation focus on the link between neuronal damage and brain inflammatory process, mediated by the progressive activation of astrocytes and microglial cells with the consequent overproduction of proinflammatory agents. Here, we discuss about the role of microglial and astrocytic cells, the principal agents in neuroinflammation process, in the development of neurodegenerative diseases such as AD. In this context, we also evaluated the potential relevance of natural anti-inflammatory components, which include curcumin and the novel Andean Compound, as agents for AD prevention and as a coadjuvant for AD treatments.

  5. Interaction between therapeutic interventions for Alzheimer’s disease and physiological Aβ clearance mechanisms

    Directory of Open Access Journals (Sweden)

    Christopher eMorrone

    2015-05-01

    Full Text Available Most therapeutic agents are designed to target a molecule or pathway without consideration of the mechanisms involved in the physiological turnover or removal of that target. In light of this and in particular for Alzheimer’s disease, a number of therapeutic interventions are presently being developed/investigated which target the amyloid-β peptide (Aβ. However, the literature has not adequately considered which Aβ physiological clearance pathways are necessary and sufficient for the effective action of these therapeutics. In this review, we evaluate the therapeutic strategies targeting Aβ presently in clinical development, discuss the possible interaction of these treatments with pathways that under normal physiological conditions are responsible for the turnover of Aβ and highlight possible caveats. We consider immunization strategies primarily reliant on a peripheral sink mechanism of action, small molecules that are reliant on entry into the CNS and thus degradation pathways within the brain as well as lifestyle interventions that affect vascular, parenchymal and peripheral degradation pathways. We propose that effective development of Alzheimer’s disease therapeutic strategies targeting Aβ peptide will require consideration of the age- and disease-specific changes to endogenous Aβ clearance mechanisms in order to elicit maximal efficacy.

  6. EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part v - EUS-Guided Therapeutic Interventions (short version)

    DEFF Research Database (Denmark)

    Fusaroli, P; Jenssen, C.; Hocke, Martine

    2016-01-01

    The fifth section of the Guidelines on Interventional Ultrasound (INVUS) of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) assesses the evidence for all the categories of endoscopic ultrasound-guided treatment reported to date. Celiac plexus neurolysis...

  7. The existing therapeutic interventions for orgasmic disorders: recommendations for culturally competent services, narrative review.

    Science.gov (United States)

    Salmani, Zahra; Zargham-Boroujeni, Ali; Salehi, Mehrdad; K Killeen, Therese; Merghati-Khoei, Effat

    2015-07-01

    In recent years, a growing number of interventions for treatment of female orgasmic problems (FODs) have emerged. Whereas orgasm is a extra biologically and learnable experience, there is a need for practitioners that to be able to select which therapy is the most appropriate to their context. In this critical literature review, we aimed to assess areas of controversy in the existing therapeutic interventions in FOD with taking into accounted the Iranian cultural models. For the present study, we conducted an extensive search of electronic databases using a comprehensive search strategy from 1970 till 2014. This strategy was using Google Scholar search, "pearl-growing" techniques and by hand-searching key guidelines, to identify distinct interventions to women's orgasmic problem therapy. We utilized various key combinations of words such as:" orgasm" OR "orgasmic "," female orgasmic dysfunction" OR Female anorgasmia OR Female Orgasmic Disorder ", orgasmic dysfunction AND treatment, "orgasm AND intervention". Selection criteria in order to be included in this review, studies were required to: 1 employ clinical-based interventions, 2 focus on FOD. The majority of interventions (90%) related to non-pharmacological and other were about pharmacological interventions. Self-direct masturbation is suggested as the most privilege treatment in FOD. Reviewing all therapies indicates couple therapy, sexual skill training and sex therapy seem to be more appropriate to be applied in Iranian clinical settings. Since many therapeutic interventions are introduced to inform sexually-related practices, it is important to select an intervention that will be culturally appropriate and sensitive to norms and values. Professionals working in the fields of health and sexuality need to be sensitive and apply culturally appropriate therapies for Iranian population. We further suggest community well defined protocols to screen, assessment and management of women' sexual problems such as FOD

  8. Online learning applied to a course on rational therapeutics: an international comparison between final year students of two medical schools.

    Science.gov (United States)

    Likic, Robert; White, Casey; Cinti, Sandro; Purkiss, Joel; Fantone, Joseph; Chapman, Chris; Bielen, Luka; Francetic, Igor; Engleberg, Cary

    2013-02-01

    Poor prescribing is probably the most common cause of preventable medication errors and many of these events involve junior doctors. In 2009, an electronic problem-based therapeutics course developed at the University of Michigan Medical School (UMMS) was translated and adapted for use at the University of Zagreb Medical School (UZMS). After students from both schools took the course in 2010, we compared their responses with an online questionnaire addressing the course quality and its effectiveness. There were no statistically significant differences in the overall average grades awarded for the course (UZMS 4.11 ± 0.86 vs. UMMS 3.96 ± 0.93; 95% CI mean difference (MD) -0.36, 0.07; P = 0.175) with both student groups expressing high satisfaction rates with its quality, accessibility and overall design. UZMS students reported spending less time working through the course than their American colleagues (2.14 ± 1.01 vs. 2.89 ± 1.02 on a five point Likert scale; 95% CI MD 0.51, 0.99; P students indicated greater difficulty with course materials (3.54 ± 0.59 vs. 3.25 ± 0.59; 95% CI MD -0.42, -0.15; P students. It is possible to adapt and translate successfully whole online teaching resources and implement them internationally in different countries and health care systems, achieving similar, high student satisfaction rates while decreasing administrative and cost burdens. Web based learning may have great potential to offer a cost effective and safe environment in which prescribing skills can be improved. © 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.

  9. The existing therapeutic interventions for orgasmic disorders: recommendations for culturally competent services, narrative review

    Directory of Open Access Journals (Sweden)

    Zahra Salmani

    2015-07-01

    Full Text Available Background: In recent years, a growing number of interventions for treatment of female orgasmic problems (FODs have emerged. Whereas orgasm is a extra biologically and learnable experience, there is a need for practitioners that to be able to select which therapy is the most appropriate to their context. Objective: In this critical literature review, we aimed to assess areas of controversy in the existing therapeutic interventions in FOD with taking into accounted the Iranian cultural models. Materials and Methods: For the present study, we conducted an extensive search of electronic databases using a comprehensive search strategy from 1970 till 2014. This strategy was using Google Scholar search, “pearl-growing” techniques and by hand-searching key guidelines, to identify distinct interventions to women's orgasmic problem therapy. We utilized various key combinations of words such as:" orgasm" OR "orgasmic "," female orgasmic dysfunction" OR Female anorgasmia OR Female Orgasmic Disorder ", orgasmic dysfunction AND treatment, “orgasm AND intervention”. Selection criteria in order to be included in this review, studies were required to: 1 employ clinical-based interventions, 2 focus on FOD. Results: The majority of interventions (90% related to non-pharmacological and other were about pharmacological interventions. Self-direct masturbation is suggested as the most privilege treatment in FOD. Reviewing all therapies indicates couple therapy, sexual skill training and sex therapy seem to be more appropriate to be applied in Iranian clinical settings. Conclusion: Since many therapeutic interventions are introduced to inform sexually-related practices, it is important to select an intervention that will be culturally appropriate and sensitive to norms and values. Professionals working in the fields of health and sexuality need to be sensitive and apply culturally appropriate therapies for Iranian population. We further suggest community well

  10. The existing therapeutic interventions for orgasmic disorders: recommendations for culturally competent services, narrative review

    Science.gov (United States)

    Salmani, Zahra; Zargham-Boroujeni, Ali; Salehi, Mehrdad; K.Killeen, Therese; Merghati-Khoei, Effat

    2015-01-01

    Background: In recent years, a growing number of interventions for treatment of female orgasmic problems (FODs) have emerged. Whereas orgasm is a extra biologically and learnable experience, there is a need for practitioners that to be able to select which therapy is the most appropriate to their context. Objective: In this critical literature review, we aimed to assess areas of controversy in the existing therapeutic interventions in FOD with taking into accounted the Iranian cultural models. Materials and Methods: For the present study, we conducted an extensive search of electronic databases using a comprehensive search strategy from 1970 till 2014. This strategy was using Google Scholar search, “pearl-growing” techniques and by hand-searching key guidelines, to identify distinct interventions to women's orgasmic problem therapy. We utilized various key combinations of words such as:" orgasm" OR "orgasmic "," female orgasmic dysfunction" OR Female anorgasmia OR Female Orgasmic Disorder ", orgasmic dysfunction AND treatment, “orgasm AND intervention”. Selection criteria in order to be included in this review, studies were required to: 1 employ clinical-based interventions, 2 focus on FOD. Results: The majority of interventions (90%) related to non-pharmacological and other were about pharmacological interventions. Self-direct masturbation is suggested as the most privilege treatment in FOD. Reviewing all therapies indicates couple therapy, sexual skill training and sex therapy seem to be more appropriate to be applied in Iranian clinical settings. Conclusion: Since many therapeutic interventions are introduced to inform sexually-related practices, it is important to select an intervention that will be culturally appropriate and sensitive to norms and values. Professionals working in the fields of health and sexuality need to be sensitive and apply culturally appropriate therapies for Iranian population. We further suggest community well defined protocols

  11. Trying to be useful: three different interventions for one therapeutic stance.

    Science.gov (United States)

    Lingiardi, Vittorio

    2013-09-01

    This article is an attempt to analyze therapist's actions or strategies that contribute to an effective therapy session and are clinically useful to the therapeutic process. To link the clinical practice to the empirical research, three kinds of therapist interventions, based on the Psychotherapy Process Q-Set, are described. They include (1) an empathic attitude in dealing with the difficulties of the patient and his or her affective experience, (2) the identification and exploration of recurrent themes in the patient's experience or conduct, and (3) addressing a patient's defenses, to ward off awareness of threatening feelings. For each of these interventions, the author provides both clinical and research data that support their use, as well as verbatim clinical exchanges, which allow a better understanding of the mechanisms of therapeutic actions in real clinical practice. 2013 APA, all rights reserved

  12. [Clinical characterisation and course following therapeutic intervention for swallowing disorders in hospitalised paediatric patients].

    Science.gov (United States)

    Salinas-Valdebenito, Luis; Núñez-Farias, Alicia C; Milagros, Angeli; Escobar-Henríquez, Raúl G

    Swallowing disorders are common in hospitalised patients and are an added difficulty when it comes to discharging them from hospital. Suitable characterisation performed by means of assessments conducted by a neurologist and a speech and language therapist allows for more accurate therapeutic decision-making. To describe swallowing disorders from the speech and language therapy evaluation performed on admission until discharge in paediatric patients and their relation with the therapeutic intervention that was implemented. We performed a retrospective analysis consisting in the examination of the medical records of 38 paediatric patients hospitalised between May 2007 and June 2008. Functional clinical evaluation was carried out in 100% of patients, and a video swallow study was conducted in 34%. Swallowing disorders were characterised as mild, moderate and severe, according to the stage that was altered and aspiratory risk to the airway. A speech therapist provided therapeutic intervention, and parents and caregivers were given special training. Swallowing disorders were chiefly associated to prematurity. The most frequently used therapeutic techniques were: tactile stimulation, providing patterns and training of parents. In the speech and language therapy evaluation performed on admission, 37% of disorders were severe, 21% were moderate and 42% were mild disorders. In most of the newborn infants, progress was favourable, as shown by a shift to normal swallowing in 48% and to mild in 8%. In the 17 preterm newborn infants, there was a change to normal swallowing in 65% and to mild in 12%. Swallowing disorders in this group of patients is mainly associated to prematurity. Systematic therapeutic intervention would help in the recovery from swallowing disorders, especially in preterm newborn infants.

  13. Facilitators and barriers to the provision of therapeutic interventions by school psychologists

    Science.gov (United States)

    Squires, Garry; Bragg, Joanna; Muscutt, Janet; Wasilewski, David

    2014-01-01

    There is growing concern internationally about the prevalence of mental health problems among school-aged children and their access to specialist services. School psychologists (SPs) may be one group of professionals well-positioned to support the well-being of children and young people, due to their position as applied psychologists working within educational settings and their capability to deliver therapeutic interventions. This research considers findings from a large scale, United Kingdom (UK)-wide survey of the views of SPs (N = 455) about facilitators and barriers to the provision of therapeutic interventions to children and young people. Principal Components Analyses of ranked questionnaire responses yielded three components: The role of the SP; training and practice; and support and psychology service context. Quantitative findings were then triangulated, using qualitative responses from the survey. Greater direction and clarification of the role of the SP as a provider of therapeutic interventions is recommended, particularly given the diverse roles undertaken by SPs and competing demands, particularly from assessment activities. PMID:26412911

  14. Liver metastases: interventional therapeutic techniques and results, state of the art

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J.; Mueller, P.K.; Mack, M.G.; Straub, R.; Engelmann, K. [Dept. of Radiology, Univ. of Frankfurt (Germany); Neuhaus, P. [Dept. of Surgery, Humboldt University of Berlin (Germany)

    1999-05-01

    The liver is the most common site of metastatic tumour deposits. Hepatic metastases are the major cause of morbidity and mortality in patients with gastrointestinal carcinomas and other malignant tumours. The rationale and results for interventional therapeutic techniques in the treatment of liver metastases are presented. For the treatment of patients with irresectable liver metastases, alternative local ablative therapeutic modalities have been developed. Technique and results of local interventional therapies are presented such as microwave-, radiofrequency (RF)- and ultrasound ablation, and laser-induced interstitial therapy (LITT), cryotherapy and local drug administration such as alcohol injection, endotumoral chemotherapy and regional chemoembolisation. In addition to cryotherapy, all ablative techniques can be performed percutaneously with low morbidity and mortality. Cryotherapy is an effective and precise technique for inducing tumour necrosis, but it is currently performed via laparotomy. Percutaneous local alcohol injection results in an inhomogeneous distribution in liver metastases with unreliable control rates. Local chemotherapeutic drug instillation and regional chemoembolisation produces relevant but non-reproducible lesions. Laser-induced interstitial thermotherapy (LITT) performed under MRI guidance results in precise and reproducible areas of induced necrosis with a local control of 94 %, and with an improved survival rate. Interventional therapeutic techniques of liver metastases do result in a remarkable local tumour control rate with improved survival results. (orig.) With 5 figs., 1 tab., 43 refs.

  15. Therapeutic Effects of Horseback Riding Interventions: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Stergiou, Alexandra; Tzoufi, Meropi; Ntzani, Evangelia; Varvarousis, Dimitrios; Beris, Alexandros; Ploumis, Avraam

    2017-10-01

    Equine-assisted therapies, such as therapeutic riding and hippotherapy, are believed to have positive physical and emotional effects in individuals with neuromotor, developmental, and physical disabilities. The purpose of this review was to determine whether therapeutic riding and hippotherapy improve balance, motor function, gait, muscle symmetry, pelvic movement, psychosocial parameters, and the patients' overall quality of life. In this study, a literature search was conducted on MEDLINE, CINAHL, MBASE, SportDiscus, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, PEDro, DARE, Google Scholar, and Dissertation Abstracts. Only studies with a control/comparison group or self-controlled studies performing preintervention and postintervention assessment were included. Excluded were (1) studies not providing data on baseline score or end-point outcome, (2) single-subject studies, (3) studies providing only qualitative data, and (4) studies that used a mechanical horse. Sixteen trials were included. The methodologic quality of each study was evaluated using Downs and Black quality assessment tool. Most of the studies showed a trend toward a beneficial effect of therapeutic riding and hippotherapy on balance and gross motor function. The meta-analysis showed improvement in both the Berg Balance Scale and the Gross Motor Function Measure in therapeutic riding and hippotherapy programs. Programs such as therapeutic riding and hippotherapy are a viable intervention option for patients with balance, gait, and psychomotor disorders.

  16. Therapeutic Relationship and Study Adherence in a Community Health Worker-Led Intervention.

    Science.gov (United States)

    Mundorf, Christopher; Shankar, Arti; Peng, Terrance; Hassan, Anna; Lichtveld, Maureen Y

    2017-02-01

    Community health workers (CHWs) are increasingly utilized to reach low-resource communities. A critical domain influencing success is the CHWs' ability to create and maintain a therapeutic relationship with the participants they serve. A limited evidence base exists detailing this construct, and evaluating CHW-participant relationships in the context of CHW-led programs. In a longitudinal study design, data on this therapeutic relationship were collected [as captured using The Scale to Assess the Therapeutic Relationship in Community Mental Health Care (STAR)] on 141 participants who had been assigned to a CHW during their perinatal period. Results indicate that therapeutic relationship was associated with the participant's psychosocial health, and independently predicted study adherence in the longitudinal intervention. Changes in therapeutic relationship over the months following birth were strongly associated with changes in anxiety and depression symptoms. A trustful relationship is critical in ensuring CHWs can effectively reach the population they serve. The findings offer additional psychometric evidence of the uses and benefits of STAR outside of the traditional clinical setting in the context of public health research.

  17. Characterising the tumour morphological response to therapeutic intervention: an ex vivo model

    Directory of Open Access Journals (Sweden)

    Anne Savage

    2013-01-01

    In cancer, morphological assessment of histological tissue samples is a fundamental part of both diagnosis and prognosis. Image analysis offers opportunities to support that assessment through quantitative metrics of morphology. Generally, morphometric analysis is carried out on two-dimensional tissue section data and so only represents a small fraction of any tumour. We present a novel application of three-dimensional (3D morphometrics for 3D imaging data obtained from tumours grown in a culture model. Minkowski functionals, a set of measures that characterise geometry and topology in n-dimensional space, are used to quantify tumour topology in the absence of and in response to therapeutic intervention. These measures are used to stratify the morphological response of tumours to therapeutic intervention. Breast tumours are characterised by estrogen receptor (ER status, human epidermal growth factor receptor (HER2 status and tumour grade. Previously, we have shown that ER status is associated with tumour volume in response to tamoxifen treatment ex vivo. Here, HER2 status is found to predict the changes in morphology other than volume as a result of tamoxifen treatment ex vivo. Finally, we show the extent to which Minkowski functionals might be used to predict tumour grade. Minkowski functionals are generalisable to any 3D data set, including in vivo and cellular systems. This quantitative topological analysis can provide a valuable link among biomarkers, drug intervention and tumour morphology that is complementary to existing, non-morphological measures of tumour response to intervention and could ultimately inform patient treatment.

  18. Comparison of the evolutional process of children with autism spectrum disorders in different language therapeutic interventions.

    Science.gov (United States)

    Tamanaha, Ana Carina; Perissinoto, Jacy

    2011-03-01

    To analyze and compare the extension and the speed of the evolutional process of children with Autism Spectrum Disorders in direct and indirect interventions as opposed to only indirect intervention. The design of this study is a clinical trial. The sample was composed of 11 children diagnosed with Autism (n=6) and Asperger syndrome (n=5) by a multidisciplinary team, that attended specialized speech-language pathology therapy at the institution were the study was carried out. These children were randomly divided into two groups: Therapy Group (TG) - composed by six subjects receiving both direct and indirect intervention; and Orientation Group (OG) - constituted by five subjects receiving exclusively indirect intervention. It was used the Autism Behavior Checklist (ABC) to interview the mothers, and the Sample of Vocal Behavior (SVB), in three occasions: at the beginning of the intervention process (time 0), six months later (time 1) and 12 months later (time 2). It was observed greater speed and extension in the evolutional process of the TG Group, both in the analysis of the Autism Behavior Checklist (total and partial scores) and the Sample of Vocal Behavior, especially in the item Full Language. The performance of children with Asperger syndrome was considered more positive when compared to that of children with autism. There was greater evolution in younger children and with normal, mild, and moderate adaptive functioning. The tendency towards better performance of the children attending direct and indirect intervention showed that this association is fundamental in the therapeutic process of children with Autism Spectrum Disorders.

  19. WINCS Harmoni: Closed-loop dynamic neurochemical control of therapeutic interventions

    Science.gov (United States)

    Lee, Kendall H.; Lujan, J. Luis; Trevathan, James K.; Ross, Erika K.; Bartoletta, John J.; Park, Hyung Ook; Paek, Seungleal Brian; Nicolai, Evan N.; Lee, Jannifer H.; Min, Hoon-Ki; Kimble, Christopher J.; Blaha, Charles D.; Bennet, Kevin E.

    2017-04-01

    There has been significant progress in understanding the role of neurotransmitters in normal and pathologic brain function. However, preclinical trials aimed at improving therapeutic interventions do not take advantage of real-time in vivo neurochemical changes in dynamic brain processes such as disease progression and response to pharmacologic, cognitive, behavioral, and neuromodulation therapies. This is due in part to a lack of flexible research tools that allow in vivo measurement of the dynamic changes in brain chemistry. Here, we present a research platform, WINCS Harmoni, which can measure in vivo neurochemical activity simultaneously across multiple anatomical targets to study normal and pathologic brain function. In addition, WINCS Harmoni can provide real-time neurochemical feedback for closed-loop control of neurochemical levels via its synchronized stimulation and neurochemical sensing capabilities. We demonstrate these and other key features of this platform in non-human primate, swine, and rodent models of deep brain stimulation (DBS). Ultimately, systems like the one described here will improve our understanding of the dynamics of brain physiology in the context of neurologic disease and therapeutic interventions, which may lead to the development of precision medicine and personalized therapies for optimal therapeutic efficacy.

  20. Effects of a rational-emotive health education intervention on stress management and irrational beliefs among technical college teachers in Southeast Nigeria.

    Science.gov (United States)

    Ugwoke, Samuel C; Eseadi, Chiedu; Igbokwe, Chima C; Chiaha, Gertrude T U; Nwaubani, Okechukwu O; Orji, Chibueze Tobias; Ugwuanyi, Leonard T; Chukwuma, Ifeoma S; Edikpa, Edith C; Ogakwu, Vera N; Onu, Eucharia A; Agu, Patricia; Nwobi, Ujunwa A; Omeke, Faith; Okeke, Francisca C; Ezema, Rita N; Abugu, Lawretta I

    2017-08-01

    Stress is the product of how an individual reacts and adapts to the specific demands and threats they encounter while carrying out given tasks. The main purpose of this study was to investigate the effects of a rational-emotive health education intervention (REHEI) on stress management, and irrational beliefs in a sample of technical college teachers in Southeast Nigeria. The study design was a pretest-posttest control group. Repeated measures analysis of variance, paired t test and Mann-Whitney U tests were used to analyze the data collected. The REHEI significantly reduced teacher stress in those teaching staff exposed to the treatment intervention, relative to a waitlist control group. Furthermore, the REHEI program significantly decreased irrational beliefs about teaching in those teaching staff exposed to the treatment intervention compared to a waitlist control group. The REHEI program can be used to coach teachers on how to manage and cope with stress and overcome irrational beliefs in teaching.

  1. Invited commentary: Fostering resilience among Native American youth through therapeutic intervention.

    Science.gov (United States)

    Garrett, Michael Tlanusta; Parrish, Mark; Williams, Cyrus; Grayshield, Lisa; Portman, Tarrell Awe Agahe; Rivera, Edil Torres; Maynard, Elizabeth

    2014-03-01

    This article offers a comprehensive overview and understanding of the needs of Native American Youth for researchers, educators, and practitioners based on current research and practice. Strengths and protective factors are discussed in terms of Native strengths in context, the strengths and resilience of Native ways, Indigenous ways of knowing, the relationship between cultural identity and the tribal nation, the importance of family, the roles of the wisdom keepers, spiritual ways, and communication styles. Contextual influences are explored in terms of the relationship between history and healing from intergenerational grief and trauma, the influence of acculturation, as well as current social, economic, and political issues that affect Native youth. Implications for research and therapeutic intervention are explored in terms of healing from historical trauma and oppression. The authors offer an overview of common presenting issues and recommendations, practical tribally-specific interventions, and reflections on what it means to work from a social justice and client/community advocacy perspective with a focus on providing effective therapeutic, culturally-based interventions with Native children and adolescents that promote resilience and foster positive development with this population.

  2. Complement therapeutics in inflammatory diseases: promising drug candidates for C3-targeted intervention.

    Science.gov (United States)

    Mastellos, D C; Ricklin, D; Hajishengallis, E; Hajishengallis, G; Lambris, J D

    2016-02-01

    There is increasing appreciation that complement dysregulation lies at the heart of numerous immune-mediated and inflammatory disorders. Complement inhibitors are therefore being evaluated as new therapeutic options in various clinical translation programs and the first clinically approved complement-targeted drugs have profoundly impacted the management of certain complement-mediated diseases. Among the many members of the intricate protein network of complement, the central component C3 represents a 'hot-spot' for complement-targeted therapeutic intervention. C3 modulates both innate and adaptive immune responses and is linked to diverse immunomodulatory systems and biological processes that affect human pathophysiology. Compelling evidence from preclinical disease models has shown that C3 interception may offer multiple benefits over existing therapies or even reveal novel therapeutic avenues in disorders that are not commonly regarded as complement-driven, such as periodontal disease. Using the clinically developed compstatin family of C3 inhibitors and periodontitis as illustrative examples, this review highlights emerging therapeutic concepts and developments in the design of C3-targeted drug candidates as novel immunotherapeutics for oral and systemic inflammatory diseases. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Course of life satisfaction in patients with depressive and addictive disorders after therapeutic intervention.

    Science.gov (United States)

    Büssing, Arndt; Heusser, Peter; Mundle, Götz

    2012-05-01

    To analyse the course of life satisfaction during the clinic stay of patients with depressive and/or addictive disorders. In a cohort study, 199 patients with depressive and addictive diseases were asked to complete a series of questionnaires at the start and the end of their psychotherapeutic treatment (on average 4.2 ± 2.3 weeks later). The questionnaires were the Brief Multidimensional Life Satisfaction Scale (BMLSS), the Positive Life Construction/Contentedness/Well-Being Scale from the ERDA (Emotional/Rational Disease Acceptance) questionnaire, Beck's Depression Inventory and the revised Symptom Checklist (SCL-90-R). The psychotherapeutic interventions improved the clinical situation of the patients and resulted in strong effects with respect to positive life construction (d = 1.07) and moderate effects on life satisfaction (d = 0.71). Stronger effects were noted in patients with depressive disorders (d = 0.80) than in patients with addictive disorders (d = 0.69). Regression analyses revealed that pre-treatment life satisfaction can be explained negatively by an escape-avoidance strategy (Escape from Illness), and positively by positive life construction. In contrast, post-treatment life satisfaction can be explained negatively by psychological distress and depression, and positively by positive life construction and living with a partner. The hypothesis that life satisfaction changes are associated with the clinical situation of patients was confirmed. In particular, patients with depressive disorders profited from the psychotherapeutic interventions.

  4. Combining Radiation Epidemiology With Molecular Biology-Changing From Health Risk Estimates to Therapeutic Intervention.

    Science.gov (United States)

    Abend, Michael; Port, Matthias

    2016-08-01

    The authors herein summarize six presentations dedicated to the key session "molecular radiation epidemiology" of the ConRad meeting 2015. These presentations were chosen in order to highlight the promise when combining conventional radiation epidemiology with molecular biology. Conventional radiation epidemiology uses dose estimates for risk predictions on health. However, combined with molecular biology, dose-dependent bioindicators of effect hold the promise to improve clinical diagnostics and to provide target molecules for potential therapeutic intervention. One out of the six presentations exemplified the use of radiation-induced molecular changes as biomarkers of exposure by measuring stabile chromosomal translocations. The remaining five presentations focused on molecular changes used as bioindicators of the effect. These bioindicators of the effect could be used for diagnostic purposes on colon cancers (genomic instability), thyroid cancer (CLIP2), or head and neck squamous cell cancers. Therapeutic implications of gene expression changes were examined in Chernobyl thyroid cancer victims and Mayak workers.

  5. Oxidative stress in cancer and fibrosis: Opportunity for therapeutic intervention with antioxidant compounds, enzymes, and nanoparticles

    Directory of Open Access Journals (Sweden)

    Jingga Morry

    2017-04-01

    Full Text Available Oxidative stress, mainly contributed by reactive oxygen species (ROS, has been implicated in pathogenesis of several diseases. We review two primary examples; fibrosis and cancer. In fibrosis, ROS promote activation and proliferation of fibroblasts and myofibroblasts, activating TGF-β pathway in an autocrine manner. In cancer, ROS account for its genomic instability, resistance to apoptosis, proliferation, and angiogenesis. Importantly, ROS trigger cancer cell invasion through invadopodia formation as well as extravasation into a distant metastasis site. Use of antioxidant supplements, enzymes, and inhibitors for ROS-generating NADPH oxidases (NOX is a logical therapeutic intervention for fibrosis and cancer. We review such attempts, progress, and challenges. Lastly, we review how nanoparticles with inherent antioxidant activity can also be a promising therapeutic option, considering their additional feature as a delivery platform for drugs, genes, and imaging agents.

  6. A mixed-method study of effects of a therapeutic play intervention for children on parental anxiety and parents' perceptions of the intervention.

    Science.gov (United States)

    He, Hong-Gu; Zhu, Li-Xia; Chan, Wai-Chi Sally; Liam, Joanne Li Wee; Ko, Saw Sandar; Li, Ho Cheung William; Wang, Wenru; Yobas, Piyanee

    2015-07-01

    To examine the effects of a therapeutic play intervention for children on parents' perioperative anxiety, the relationship between parents' and their children's anxiety and to explore parents' perceptions of the intervention. Therapeutic play intervention was found to reduce children's perioperative anxiety. Little is known about how such an intervention for children affects their parents' anxiety. A mixed method of randomized controlled trial with qualitative process evaluation was used. Ninety-five pairs of parents and children were recruited between November 2011-August 2013 and randomized into a control or an intervention group. The State Anxiety Scale for Children and the State Anxiety Scale for Adults were used to measure children's and parents' anxiety, respectively, at baseline, on surgery day and around 24 hours after surgery. Parents were interviewed about their perceptions of the intervention. Data were analysed using SPSS version 22·0 and thematic analysis. There was no difference in parents' anxiety after participating with their child in the intervention compared with usual care. There were significantly positive relationships between parents' and their children's baseline anxiety and parents' postoperative anxiety and their children's pre-operative anxiety. Four themes were identified: reducing anxiety, increasing knowledge and understanding about anaesthetic procedure, the worthiness of attending the intervention and suggestions for improvement of the intervention. Therapeutic play intervention had no significant effect on parents' perioperative anxiety. Parents' and their children's perioperative anxiety are correlated. Parents perceived the intervention as helpful preparation for themselves and for their children undergoing elective surgery. © 2015 John Wiley & Sons Ltd.

  7. Natural Compounds as a Therapeutic Intervention following Traumatic Brain Injury: The Role of Phytochemicals.

    Science.gov (United States)

    Scheff, Stephen W; Ansari, Mubeen A

    2017-04-15

    There has been a tremendous focus on the discovery and development of neuroprotective agents that might have clinical relevance following traumatic brain injury (TBI). This type of brain injury is very complex and is divided into two major components. The first component, a primary injury, occurs at the time of impact and is the result of the mechanical insult itself. This primary injury is thought to be irreversible and resistant to most treatments. A second component or secondary brain injury, is defined as cellular damage that is not immediately obvious after trauma, but that develops after a delay of minutes, hours, or even days. This injury appears to be amenable to treatment. Because of the complexity of the secondary injury, any type of therapeutic intervention needs to be multi-faceted and have the ability to simultaneously modulate different cellular changes. Because of diverse pharmaceutical interactions, combinations of different drugs do not work well in concert and result in adverse physiological conditions. Research has begun to investigate the possibility of using natural compounds as a therapeutic intervention following TBI. These compounds normally have very low toxicity and have reduced interactions with other pharmaceuticals. In addition, many natural compounds have the potential to target numerous different components of the secondary injury. Here, we review 33 different plant-derived natural compounds, phytochemicals, which have been investigated in experimental animal models of TBI. Some of these phytochemicals appear to have potential as possible therapeutic interventions to offset key components of the secondary injury cascade. However, not all studies have used the same scientific rigor, and one should be cautious in the interpretation of studies using naturally occurring phytochemical in TBI research.

  8. Therapeutic Interventions for Vascular Parkinsonism: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Miguel-Puga, Adán; Villafuerte, Gabriel; Salas-Pacheco, José; Arias-Carrión, Oscar

    2017-01-01

    Vascular parkinsonism (VP) is defined as the presence of parkinsonian syndrome, evidence of cerebrovascular disease, and an established relationship between the two disorders. However, the diagnosis of VP is problematic, particularly for the clinician confronted with moving from diagnosis to treatment. Given the different criteria used in the diagnosis of VP, the effectiveness of available therapeutic interventions for this disease are currently unknown. To assess the clinical response of all published therapeutic interventions for VP that have been reported in the literature, we conducted a systematic review looking for VP subjects treated with any therapeutic intervention. To clarify the prevalence of responsiveness to levodopa among VP subjects, we conducted a meta-analysis of 17 observational studies retrieved with the search criteria of our review. Also, four studies were included in a second analysis to explore if nigrostriatal lesion affected the prevalence of levodopa response in VP subjects. Relevant articles were identified from MEDLINE, Scopus, and Web of Science published until June 2017. 436 non-duplicate citations were identified for screening, 107 articles were assessed for eligibility, and only 23 observational studies were included in this review. No randomized clinical trials were found. Four different therapies were found in the literature; among them, levodopa was the only one repetitively reported. The calculated event rate of levodopa response in VP subjects was of 0.304 [95% confidence interval (CI) of 0.230-0.388]. The overall odds ratio for good response to levodopa in VP with lesion in the nigrostriatal pathway vs. no lesion in the nigrostriatal pathway was 15.15 (95% CI: 5.2-44.17). Despite the lack of randomized controlled trials, results of this systematic review and meta-analysis show that VP subjects, as operationally defined here, have a low response rate to levodopa; nigrostriatal lesion could be used as a proxy predictor of

  9. Treating tendinopathy: perspective on anti-inflammatory intervention and therapeutic exercise.

    Science.gov (United States)

    Joseph, Michael F; Denegar, Craig R

    2015-04-01

    Tendinopathy is a common and complex disorder. Once viewed as an inflammatory condition labeled tendinitis, it is now viewed along a continuum that can lead to tissue necrosis and risk of tendon rupture. Anti-inflammatory medications can alter symptoms but may also promote tissue degeneration. Loading of the tendon through exercise, especially exercise involving eccentric muscle contraction, has been shown to promote symptom resolution and functional recovery in many patients. This article reviews the pathoetiology of tendinopathy and the role anti-inflammatory interventions and therapeutic exercise in treatment of active patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Tumor viruses and cancer biology: Modulating signaling pathways for therapeutic intervention.

    Science.gov (United States)

    Saha, Abhik; Kaul, Rajeev; Murakami, Masanao; Robertson, Erle S

    2010-11-15

    Tumor viruses have provided relatively simple genetic systems, which can be manipulated for understanding the molecular mechanisms of the cellular transformation process. A growing body of information in the tumor virology field provides several prospects for rationally targeted therapies. However, further research is needed to better understand the multiple mechanisms utilized by these viruses in cancer progression in order to develop therapeutic strategies. Initially viruses were believed to be associated with cancers as causative agents only in animals. It was almost half a century before the first human tumor virus, Epstein-Barr virus (EBV), was identified in 1964. Subsequently, several human tumor viruses have been identified including Kaposi sarcoma associated herpesvirus (KSHV), human Papillomaviruses (HPV), Hepatitis B virus (HBV), Hepatitis C virus (HCV), Human T lymphotropic virus (HTLV-1) and recently identified Merkel cell Polyomavirus (MCPyV). Tumor viruses are sub-categorized as either DNA viruses, which include EBV, KSHV, HPV, HBV, and MCPyV, or RNA viruses such as HCV and HTLV-1. Tumor-viruses induce oncogenesis through manipulating an array of different cellular pathways. These viruses initiate a series of cellular events, which lead to immortalization and proliferation of the infected cells by disrupting the mitotic checkpoint upon infection of the host cell. This is often accomplished by functional inhibition or proteasomal degradation of many tumor suppressor proteins by virally encoded gene products. The virally infected cells can either be eliminated via cell-mediated apoptosis or persist in a state of chronic infection. Importantly, the chronic persistence of infection by tumor viruses can lead to oncogenesis. This review discusses the major human tumor associated viruses and their ability to modulate numerous cell signaling pathways, which can be targeted for potential therapeutic approaches.

  11. Child disaster mental health interventions, part II: Timing of implementation, delivery settings and providers, and therapeutic approaches.

    Science.gov (United States)

    Pfefferbaum, Betty; Sweeton, Jennifer L; Newman, Elana; Varma, Vandana; Noffsinger, Mary A; Shaw, Jon A; Chrisman, Allan K; Nitiéma, Pascal

    This review summarizes current knowledge on the timing of child disaster mental health intervention delivery, the settings for intervention delivery, the expertise of providers, and therapeutic approaches. Studies have been conducted on interventions delivered during all phases of disaster management from pre event through many months post event. Many interventions were administered in schools which offer access to large numbers of children. Providers included mental health professionals and school personnel. Studies described individual and group interventions, some with parent involvement. The next generation of interventions and studies should be based on an empirical analysis of a number of key areas.

  12. Multifactorial causal model of brain (dis)organization and therapeutic intervention: Application to Alzheimer's disease.

    Science.gov (United States)

    Iturria-Medina, Yasser; Carbonell, Félix M; Sotero, Roberto C; Chouinard-Decorte, Francois; Evans, Alan C

    2017-05-15

    Generative models focused on multifactorial causal mechanisms in brain disorders are scarce and generally based on limited data. Despite the biological importance of the multiple interacting processes, their effects remain poorly characterized from an integrative analytic perspective. Here, we propose a spatiotemporal multifactorial causal model (MCM) of brain (dis)organization and therapeutic intervention that accounts for local causal interactions, effects propagation via physical brain networks, cognitive alterations, and identification of optimum therapeutic interventions. In this article, we focus on describing the model and applying it at the population-based level for studying late onset Alzheimer's disease (LOAD). By interrelating six different neuroimaging modalities and cognitive measurements, this model accurately predicts spatiotemporal alterations in brain amyloid-β (Aβ) burden, glucose metabolism, vascular flow, resting state functional activity, structural properties, and cognitive integrity. The results suggest that a vascular dysregulation may be the most-likely initial pathologic event leading to LOAD. Nevertheless, they also suggest that LOAD it is not caused by a unique dominant biological factor (e.g. vascular or Aβ) but by the complex interplay among multiple relevant direct interactions. Furthermore, using theoretical control analysis of the identified population-based multifactorial causal network, we show the crucial advantage of using combinatorial over single-target treatments, explain why one-target Aβ based therapies might fail to improve clinical outcomes, and propose an efficiency ranking of possible LOAD interventions. Although still requiring further validation at the individual level, this work presents the first analytic framework for dynamic multifactorial brain (dis)organization that may explain both the pathologic evolution of progressive neurological disorders and operationalize the influence of multiple interventional

  13. Therapeutic interventions to reduce the risk of progression from prediabetes to type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Portero McLellan KC

    2014-03-01

    Full Text Available Katia Cristina Portero McLellan,1 Kathleen Wyne,2 Evangelina Trejo Villagomez,2 Willa A Hsueh2 1Department of Public Health, School of Medicine, Sao Paulo State University, Botucatu, SP, Brazil; 2Division of Diabetes, Obesity and Lipids, Department of Medicine, The Methodist Hospital Diabetes and Metabolism Institute, and the Houston Methodist Research Institute, Weill Cornell Medical College, Houston, TX, USA Abstract: Clinical trials have demonstrated that it is possible to prevent diabetes through lifestyle modification, pharmacological intervention, and surgery. This review aims to summarize the effectiveness of these various therapeutic interventions in reducing the risk of progression of prediabetes to diabetes, and address the challenges to implement a diabetes prevention program at a community level. Strategies focusing on intensive lifestyle changes are not only efficient but cost-effective and/or cost-saving. Indeed, lifestyle intervention in people at high risk for type 2 diabetes mellitus (T2DM has been successful in achieving sustained behavioral changes and a reduction in diabetes incidence even after the counseling is stopped. Although prediabetes is associated with health and economic burdens, it has not been adequately addressed by interventions or regulatory agencies in terms of prevention or disease management. Lifestyle intervention strategies to prevent T2DM should be distinct for different populations around the globe and should emphasize sex, age, ethnicity, and cultural and geographical considerations to be feasible and to promote better compliance. The translation of diabetes prevention research at a population level, especially finding the most effective methods of preventing T2DM in various societies and cultural settings remains challenging, but must be accomplished to stop this worldwide epidemic. Keywords: lifestyle, T2DM, intervention, prevention

  14. Regulating Critical Period Plasticity: Insight from the Visual System to Fear Circuitry for Therapeutic Interventions

    Directory of Open Access Journals (Sweden)

    Elisa M. Nabel

    2013-11-01

    Full Text Available Early temporary windows of heightened brain plasticity called critical periods developmentally sculpt neural circuits and contribute to adult behavior. Regulatory mechanisms of visual cortex development –the preeminent model of experience-dependent critical period plasticity- actively limit adult plasticity and have proved fruitful therapeutic targets to reopen plasticity and rewire faulty visual system connections later in life. Interestingly, these molecular mechanisms have been implicated in the regulation of plasticity in other functions beyond vision. Applying mechanistic understandings of critical period plasticity in the visual cortex to fear circuitry may provide a conceptual framework for developing novel therapeutic tools to mitigate aberrant fear responses in post traumatic stress disorder. In this review, we turn to the model of experience-dependent visual plasticity to provide novel insights for the mechanisms regulating plasticity in the fear system. Fear circuitry, particularly fear memory erasure, also undergoes age-related changes in experience-dependent plasticity. We consider the contributions of molecular brakes that halt visual critical period plasticity to circuitry underlying fear memory erasure. A major molecular brake in the visual cortex, perineuronal net formation, recently has been identified in the development of fear systems that are resilient to fear memory erasure. The roles of other molecular brakes, myelin-related Nogo receptor signaling and Lynx family proteins– endogenous inhibitors for nicotinic acetylcholine receptor, are explored in the context of fear memory plasticity. Such fear plasticity regulators, including epigenetic effects, provide promising targets for therapeutic interventions.

  15. Interleukin-17 Pathophysiology and Therapeutic Intervention in Cystic Fibrosis Lung Infection and Inflammation.

    Science.gov (United States)

    Hsu, Daniel; Taylor, Patricia; Fletcher, Dave; van Heeckeren, Rolf; Eastman, Jean; van Heeckeren, Anna; Davis, Pamela; Chmiel, James F; Pearlman, Eric; Bonfield, Tracey L

    2016-09-01

    Cystic fibrosis (CF) is characterized by an excessive neutrophilic inflammatory response within the airway as a result of defective cystic fibrosis transmembrane receptor (CFTR) expression and function. Interleukin-17A induces airway neutrophilia and mucin production associated with Pseudomonas aeruginosa colonization, which is associated with the pathophysiology of cystic fibrosis. The objectives of this study were to use the preclinical murine model of cystic fibrosis lung infection and inflammation to investigate the role of IL-17 in CF lung pathophysiology and explore therapeutic intervention with a focus on IL-17. Cftr-deficient mice (CF mice) and wild-type mice (WT mice) infected with P. aeruginosa had robust IL-17 production early in the infection associated with a persistent elevated inflammatory response. Intratracheal administration of IL-17 provoked a neutrophilic response in the airways of WT and CF animals which was similar to that observed with P. aeruginosa infection. The neutralization of IL-17 prior to infection significantly improved the outcomes in the CF mice, suggesting that IL-17 may be a therapeutic target. We demonstrate in this report that the pathophysiological contribution of IL-17 may be due to the induction of chemokines from the epithelium which is augmented by a deficiency of Cftr and ongoing inflammation. These studies demonstrate the in vivo contribution of IL-17 in cystic fibrosis lung disease and the therapeutic validity of attenuating IL-17 activity in cystic fibrosis. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  16. Therapeutic interventions in the Netherlands and Belgium in support of people with profound intellectual and multiple disabilities

    NARCIS (Netherlands)

    Vlaskamp, Carla; Nakken, Han

    For several reasons, people with profound and multiple disabilities may be offered a variety of therapeutic interventions. Thus far, researchers have shown a limited interest in providing an empirical base for these interventions. Research is needed on the theoretical rationale (if any), the

  17. Prediction of the survival and functional ability of severe stroke patients after ICU therapeutic intervention

    Directory of Open Access Journals (Sweden)

    Aoun-Bacha Zeina

    2008-06-01

    Full Text Available Abstract Background This study evaluated the benefits and impact of ICU therapeutic interventions on the survival and functional ability of severe cerebrovascular accident (CVA patients. Methods Sixty-two ICU patients suffering from severe ischemic/haemorrhagic stroke were evaluated for CVA severity using APACHE II and the Glasgow coma scale (GCS. Survival was determined using Kaplan-Meier survival tables and survival prediction factors were determined by Cox multivariate analysis. Functional ability was assessed using the stroke impact scale (SIS-16 and Karnofsky score. Risk factors, life support techniques and neurosurgical interventions were recorded. One year post-CVA dependency was investigated using multivariate analysis based on linear regression. Results The study cohort constituted 6% of all CVA (37.8% haemorrhagic/62.2% ischemic admissions. Patient mean(SD age was 65.8(12.3 years with a 1:1 male: female ratio. During the study period 16 patients had died within the ICU and seven in the year following hospital release. The mean(SD APACHE II score at hospital admission was 14.9(6.0 and ICU mean duration of stay was 11.2(15.4 days. Mechanical ventilation was required in 37.1% of cases. Risk ratios were; GCS at admission 0.8(0.14, (p = 0.024, APACHE II 1.11(0.11, (p = 0.05 and duration of mechanical ventilation 1.07(0.07, (p = 0.046. Linear coefficients were: type of CVA – haemorrhagic versus ischemic: -18.95(4.58 (p = 0.007, GCS at hospital admission: -6.83(1.08, (p = 0.001, and duration of hospital stay -0.38(0.14, (p = 0.40. Conclusion To ensure a better prognosis CVA patients require ICU therapeutic interventions. However, as we have shown, where tests can determine the worst affected patients with a poor vital and functional outcome should treatment be withheld?

  18. Therapeutic interventions in the treatment of eating disorders: A naturalistic study.

    Science.gov (United States)

    Colli, Antonello; Gentile, Daniela; Tanzilli, Annalisa; Speranza, Anna Maria; Lingiardi, Vittorio

    2016-06-01

    This study used naturalistic data from psychodynamic (PD) and cognitive-behavioral (CB) clinicians in the community to offer a portrait of treatments for eating disorder (ED) patients as provided in everyday clinical practice. The research aims were (1) to examine the therapeutic interventions reported by PD and CB clinicians working with ED patients; and (2) to assess the impact of different variables (such as patient personality styles, ED symptomatology, and therapists' theoretical orientation and experience) on the technique use reported by clinicians. A national sample of PD and CB clinicians (N = 105) completed the Shedler-Westen Assessment Procedure-200 (SWAP-200; Westen & Shedler, 1999a, 1999b) to assess personality disorders of a female patient with EDs in their care, as well as the Comparative Psychotherapy Process Scale-Bulimia Nervosa (CPPS-BN; Thompson-Brenner & Westen, 2005) to describe the characteristic interventions used in their treatments. Results showed that PD clinicians tended to use primarily PD interventions, while CB clinicians employed CB techniques supplementing them with a wider range of PD strategies. However, clinicians from both theoretical orientations used adjunctive treatment techniques for EDs at a similar level. In addition, use of PD interventions was strongly associated with the personality styles of ED patients regardless of therapists' orientation, primarily being used more often when patients exhibited dysregulated and impulsive styles. Conversely, use of CB interventions was primarily related to a clinicians' CB orientation, patients with more explicit symptoms of anorexia nervosa, and negatively related to clinicians' years of experience. The clinical implications of these findings were discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  19. Interactive dynamics among therapist interventions, therapeutic alliance and metacognition in the early stages of the psychotherapeutic process.

    Science.gov (United States)

    Locati, Francesca; Rossi, Germano; Parolin, Laura

    2017-04-19

    Several authors have identified a bidirectional link between patient metacognitive functioning and the therapeutic alliance. Specifically, metacognition might be enhanced by a positive alliance with the clinician, whereas metacognitive deficits might impede the alliance. Interestingly, the therapist's technical interventions might influence both therapeutic alliance and metacognitive functioning. However, little is known about the interactions between these dimensions. The aim of the present study is to explore these interactions more fully in the earliest phase of the therapeutic process. Participants included 24 patients and 12 therapists in training. The Metacognition Assessment Scale-Revised, Collaborative Interaction Scale, and Psychodynamic Intervention Rating Scale were employed in the first three sessions of psychotherapy. Sequential analyses revealed that different therapist interventions co-occurred with three different levels of the therapeutic alliance: A first level characterized by a positive collaboration, a second characterized by a neutral collaboration, and a third characterized by ruptures. Importantly, the patient's metacognitive functioning was found to mediate the relationship between the therapeutic intervention and the therapeutic alliance in the positive and neutral levels of collaboration but not in the ruptures one. These findings suggest that a specific interdependence exists among the therapeutic alliance, technical intervention, and metacognitive functioning. Clinical or methodological significance of this article: From a methodological standpoint, the originality of the present study lies in the combination of an interactionist approach, which conceives process factors as interrelated dimensions interacting in non-additive and often nonlinear ways, with analyses at both micro- and macro-analytic levels (i.e., sequential and mediation analyses). From a theoretical standpoint, findings of the present study indicate that specific

  20. Main clinical, therapeutic and technical factors related to patient's maximum skin dose in interventional cardiology procedures.

    Science.gov (United States)

    Journy, N; Sinno-Tellier, S; Maccia, C; Le Tertre, A; Pirard, P; Pagès, P; Eilstein, D; Donadieu, J; Bar, O

    2012-04-01

    The study aimed to characterise the factors related to the X-ray dose delivered to the patient's skin during interventional cardiology procedures. We studied 177 coronary angiographies (CAs) and/or percutaneous transluminal coronary angioplasties (PTCAs) carried out in a French clinic on the same radiography table. The clinical and therapeutic characteristics, and the technical parameters of the procedures, were collected. The dose area product (DAP) and the maximum skin dose (MSD) were measured by an ionisation chamber (Diamentor; Philips, Amsterdam, The Netherlands) and radiosensitive film (Gafchromic; International Specialty Products Advanced Materials Group, Wayne, NJ). Multivariate analyses were used to assess the effects of the factors of interest on dose. The mean MSD and DAP were respectively 389 mGy and 65 Gy cm(-2) for CAs, and 916 mGy and 69 Gy cm(-2) for PTCAs. For 8% of the procedures, the MSD exceeded 2 Gy. Although a linear relationship between the MSD and the DAP was observed for CAs (r=0.93), a simple extrapolation of such a model to PTCAs would lead to an inadequate assessment of the risk, especially for the highest dose values. For PTCAs, the body mass index, the therapeutic complexity, the fluoroscopy time and the number of cine frames were independent explanatory factors of the MSD, whoever the practitioner was. Moreover, the effect of technical factors such as collimation, cinematography settings and X-ray tube orientations on the DAP was shown. Optimising the technical options for interventional procedures and training staff on radiation protection might notably reduce the dose and ultimately avoid patient skin lesions.

  1. Comparison of FEV1reference equations for evaluating a cystic fibrosis therapeutic intervention.

    Science.gov (United States)

    Konstan, Michael W; Wagener, Jeffrey S; VanDevanter, Donald R; Pasta, David J; Millar, Stefanie J; Morgan, Wayne J

    2017-08-01

    The Global Lung Function Initiative (GLI, 2012) developed reference equations for forced expiratory volume in 1 s (FEV 1 ). Previous equations were developed by groups led by Knudson (1983), Wang (1993), Hankinson (1999), and Stanojevic (2008). 1,2,4,6 We assessed how different prediction equations affect the conclusions from a therapeutic intervention study that evaluated the rate of percent predicted FEV 1 (ppFEV 1 ) decline. Using data from the Epidemiologic Study of cystic fibrosis (CF), we re-analyzed our previous study evaluating the relationship of dornase alfa (DA) use with ppFEV 1 using the Knudson, Wang & Hankinson, Stanojevic, and GLI equations. The change in intercept and change in slope of ppFEV 1 from a 2-year pre-index period and 2-year post-index period were compared between the treated (N = 2483) and comparator groups (N = 6992, from 4110 unique patients). Change in intercept for the comparator group was similar across equations except that Wang & Hankinson values were more negative. The difference in change in intercept between the DA and comparator groups ranged from 3.38 to 4.02% predicted. The change in slope for the comparator group ranged from -0.58 to +0.30 ppFEV 1 /year, but the difference in change in slope between the DA and comparator groups was in a narrower range from +0.53 to +0.89 ppFEV 1 /year. Although individual patient results are impacted by the choice of reference equations, the study conclusions from this evaluation of a therapeutic intervention were minimally affected. GLI equations are recommended for future studies, but prior results based on other equations should be accepted as reliable. © 2017 Wiley Periodicals, Inc.

  2. Systematic reviews of therapeutic interventions frequently consider patient-important outcomes.

    Science.gov (United States)

    Ameur, Hayet; Ravaud, Philippe; Fayard, Florence; Riveros, Carolina; Dechartres, Agnes

    2017-04-01

    To determine whether recently published and ongoing systematic reviews of therapeutic interventions assess patient-important outcomes. For this methodological review, we searched MEDLINE via PubMed for recently published systematic reviews and online registry of systematic reviews (PROSPERO) for ongoing systematic reviews. We selected systematic reviews with meta-analyses of randomized controlled trials. We extracted all outcomes defined in the methods section and categorized them. Mortality, other clinical events, pain, quality of life, function, and therapeutic decisions were considered patient-important outcomes. We included 420 systematic reviews: 90 Cochrane reviews, 200 other published reviews, and 130 registered ongoing reviews. Primary outcomes were defined in 85 Cochrane reviews (95%), 98 (49%) other published reviews and all ongoing reviews. At least one patient-important outcome was defined as a primary outcome in 81/85 Cochrane reviews (95%), 78/98 other published reviews (80%), and 117/130 ongoing reviews (90%). Considering all outcomes assessed, at least one patient-important outcome was evaluated in 90/90 Cochrane reviews (100%), 189/200 other published reviews (95%), and 121/130 ongoing reviews (93%). Most recent systematic reviews aim to assess patient-important outcomes, which contrasts with RCTs. These results suggest some important gaps between primary and secondary research. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Bounded Rationality

    National Research Council Canada - National Science Library

    Ballester Pla, Coralio; Hernández, Penélope

    2012-01-01

    The observation of the actual behavior by economic decision makers in the lab and in the field justifies that bounded rationality has been a generally accepted assumption in many socio-economic models...

  4. Patient-Specific Tailored Intervention Improves INR Time in Therapeutic Range and INR Variability in Heart Failure Patients.

    Science.gov (United States)

    Gotsman, Israel; Ezra, Orly; Hirsh Raccah, Bruria; Admon, Dan; Lotan, Chaim; Dekeyser Ganz, Freda

    2017-08-01

    Many patients with heart failure need anticoagulants, including warfarin. Good control is particularly challenging in heart failure patients, with failure. Patients with heart failure taking warfarin therapy (n = 145) were randomized to either standard care or a 1-time intervention assessing potential risk factors for lability of INR, in which they received patient-specific instructions. Time in therapeutic range (TTR) using Rosendaal's linear model was assessed 3 months before and after the intervention. The patient-tailored intervention significantly increased anticoagulation control. The median TTR levels before intervention were suboptimal in the interventional and control groups (53% vs 45%, P = .14). After intervention the median TTR increased significantly in the interventional group compared with the control group (80% [interquartile range, 62%-93%] vs 44% [29%-61%], P failure. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Therapeutic play intervention on children's perioperative anxiety, negative emotional manifestation and postoperative pain: a randomized controlled trial.

    Science.gov (United States)

    He, Hong-Gu; Zhu, Lixia; Chan, Sally Wai-Chi; Liam, Joanne Li Wee; Li, Ho Cheung William; Ko, Saw Sandar; Klainin-Yobas, Piyanee; Wang, Wenru

    2015-05-01

    To examine if therapeutic play intervention could reduce perioperative anxiety, negative emotional manifestation and postoperative pain in children undergoing inpatient elective surgery. Children undergoing surgery commonly experience anxiety and postoperative pain and exhibit negative emotional manifestations. Previous studies have shown inconsistent conclusions about the influence of therapeutic play on children's perioperative anxiety, negative emotional manifestation and postoperative pain. A randomized controlled trial was used. Suitable children were recruited from November 2011-August 2013. They were randomized to receive either routine care (control group, n = 47) or a 1-hour therapeutic play intervention (experimental group, n = 48). Children's state anxiety, negative emotional manifestations and postoperative pain were measured at baseline, on the day of surgery and around 24 hours after surgery. Repeated measures analysis of covariance (ancova) and univariate ancova adjusting for all possible confounding factors were used in the data analysis. The time effect of state anxiety was significant, but no group and interaction (group x time) effects between the control and experimental groups were found. Compared with the control group, children in the experimental group demonstrated significantly lower scores of negative emotional manifestations prior to anaesthesia induction and postoperative pain. Therapeutic play intervention is effective in reducing negative emotional manifestations before anaesthesia induction and in reducing postoperative pain in children undergoing inpatient elective surgery. These results suggest that it is useful to give children with therapeutic play intervention prior to inpatient elective surgery. © 2015 John Wiley & Sons Ltd.

  6. Effects of a rational-emotive health education intervention on stress management and irrational beliefs among technical college teachers in Southeast Nigeria

    Science.gov (United States)

    Ugwoke, Samuel C.; Eseadi, Chiedu; Igbokwe, Chima C.; Chiaha, Gertrude T.U.; Nwaubani, Okechukwu O.; Orji, Chibueze Tobias; Ugwuanyi, Leonard T.; Chukwuma, Ifeoma S.; Edikpa, Edith C.; Ogakwu, Vera N.; Onu, Eucharia A.; Agu, Patricia; Nwobi, Ujunwa A.; Omeke, Faith; Okeke, Francisca C.; Ezema, Rita N.; Abugu, Lawretta I.

    2017-01-01

    Abstract Background: Stress is the product of how an individual reacts and adapts to the specific demands and threats they encounter while carrying out given tasks. The main purpose of this study was to investigate the effects of a rational-emotive health education intervention (REHEI) on stress management, and irrational beliefs in a sample of technical college teachers in Southeast Nigeria. Method: The study design was a pretest–posttest control group. Repeated measures analysis of variance, paired t test and Mann–Whitney U tests were used to analyze the data collected. Results: The REHEI significantly reduced teacher stress in those teaching staff exposed to the treatment intervention, relative to a waitlist control group. Furthermore, the REHEI program significantly decreased irrational beliefs about teaching in those teaching staff exposed to the treatment intervention compared to a waitlist control group. Conclusion: The REHEI program can be used to coach teachers on how to manage and cope with stress and overcome irrational beliefs in teaching. PMID:28767584

  7. Secreted Frizzled-related protein 2 as a target in antifibrotic therapeutic intervention

    Science.gov (United States)

    Mastri, Michalis; Shah, Zaeem; Hsieh, Karin; Wang, Xiaowen; Wooldridge, Bailey; Martin, Sean; Suzuki, Gen

    2013-01-01

    Progressive fibrosis is a pathological hallmark of many chronic diseases responsible for organ failure. Although there is currently no therapy on the market that specifically targets fibrosis, the dynamic fibrogenic process is known to be regulated by multiple soluble mediators that may be therapeutically intervened. The failing hamster heart exhibits marked fibrosis and increased expression of secreted Frizzled-related protein 2 (sFRP2) amenable to reversal by mesenchymal stem cell (MSC) therapy. Given the previous demonstration that sFRP2-null mice subjected to myocardial infarction exhibited reduced fibrosis and improved function, we tested whether antibody-based sFRP2 blockade might counteract the fibrogenic pathway and repair cardiac injury. Cardiomyopathic hamsters were injected intraperitoneally twice a week each with 20 μg of sFRP2 antibody. Echocardiography, histology, and biochemical analyses were performed after 1 mo. sFRP2 antibody increased left ventricular ejection fraction from 40 ± 1.2 to 49 ± 6.5%, whereas saline and IgG control exhibited a further decline to 37 ± 0.9 and 31 ± 3.2%, respectively. Functional improvement is associated with a ∼50% reduction in myocardial fibrosis, ∼65% decrease in apoptosis, and ∼75% increase in wall thickness. Consistent with attenuated fibrosis, both MSC therapy and sFRP2 antibody administration significantly increased the activity of myocardial matrix metalloproteinase-2. Gene expression analysis of the hamster heart and cultured fibroblasts identified Axin2 as a downstream target, the expression of which was activated by sFRP2 but inhibited by therapeutic intervention. sFRP2 blockade also increased myocardial levels of VEGF and hepatocyte growth factor (HGF) along with increased angiogenesis. These findings highlight the pathogenic effect of dysregulated sFRP2, which may be specifically targeted for antifibrotic therapy. PMID:24336656

  8. Neurocysticercosis: a review on status in India, management, and current therapeutic interventions.

    Science.gov (United States)

    Ahmad, Rumana; Khan, Tahmeena; Ahmad, Bilal; Misra, Aparna; Balapure, Anil K

    2017-01-01

    Tapeworms (cestodes) are segmented flatworms responsible for causing diseases that may prove fatal and difficult to treat in the absence of proper treatment and efficient drugs. Neurocysticercosis (NCC) is a common parasitic infection of the central nervous system and a major contributor to epilepsy caused by the metacestode (larva) of the human tapeworm Taenia solium, characterized by a range of pathological symptoms including epileptic seizures, headaches, and hydrocephalus. Cysticercosis is considered as a "biological imprint" of the socioeconomic development of a community in general and a country in particular. It is the single most common cause of epilepsy in the resource-poor endemic regions of the world, including most of South and Central America, India, Southeast Asia, China, and sub-Saharan Africa. A vast degree of variation in the neuropathology and clinical symptoms of NCC often makes it difficult to diagnose and manage. To add to it, emerging drug resistance to known anti-parasitic agents, together with the inability of these agents to prevent re-infection and relapse, further complicates the disease scenario. The aim of the current review was to provide the latest update on NCC with special emphasis on the Indian scenario, along with current and novel methods of diagnosis as well as scope of development for novel detection techniques, novel targets for drug development, and therapeutic interventions, as well as future challenges.

  9. The multiple faces of RAGE--opportunities for therapeutic intervention in aging and chronic disease.

    Science.gov (United States)

    Ramasamy, Ravichandran; Shekhtman, Alexander; Schmidt, Ann Marie

    2016-01-01

    This review focuses on the multi-ligand receptor of the immunoglobulin superfamily--receptor for advanced glycation endproducts (RAGE). The accumulation of the multiple ligands of RAGE in cellular stress milieux links RAGE to the pathobiology of chronic disease and natural aging. In this review, we present a discussion on the ligands of RAGE and the implications of these ligand families in disease. We review the recent literature on the role of ligand-RAGE interaction in the consequences of natural aging; the macro- and microvascular complications of diabetes; obesity and insulin resistance; autoimmune disorders and chronic inflammation; and tumors and Alzheimer's disease. We discuss the mechanisms of RAGE signaling through its intracellular binding effector molecule--the formin DIAPH1. Physicochemical evidence of how the RAGE cytoplasmic domain binds to the FH1 (formin homology 1) domain of DIAPH1, and the consequences thereof, are also reviewed. We discuss the modalities of RAGE antagonism currently in preclinical and clinical studies. Finally, we present the rationale behind potentially targeting the RAGE cytoplasmic domain-DIAPH1 interaction as a logical strategy for therapeutic intervention in the pathological settings of chronic diseases and aging wherein RAGE ligands accumulate and signal.

  10. Universal Stress Proteins as New Targets for Environmental and Therapeutic Interventions of Schistosomiasis

    Directory of Open Access Journals (Sweden)

    Priscilla Masamba

    2016-09-01

    Full Text Available In spite of various control measures and eradication methods that have been in progress, schistosomiasis still prevails as one of the most prevalent debilitating parasitic diseases, typically affecting the poor and the underprivileged that are predominantly concentrated in sub-Saharan Africa. The parasitic schistosome blood fluke responsible for causing the disease completes its complex developmental cycle in two hosts: humans and freshwater snails, where they physically undergo gross modifications to endure the different conditions associated with each host. Just like any other organism, the worm possesses mechanisms that help them respond to environmental insults. It has been hypothesized that a special class of proteins known as Universal Stress Proteins (USPs are up-regulated during sudden environmental changes, thus assisting the worm to tolerate the unfavourable conditions associated with its developmental cycle. The position of praziquantel as the drug of choice against all schistosome infections has been deemed vulnerable due to mounting concerns over drug pressure and so the need for alternative treatment is now a matter of urgency. Therefore, this review seeks to explore the associations and possible roles of USPs in schistosomiasis as well as the functioning of these proteins in the schistosomulae stage in order to develop new therapeutic interventions against this disease.

  11. Results from Therapeutic Touch Interventions in the Newborn: A Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Ana Cristina Ramos

    2016-04-01

    Full Text Available Therapeutic Touch (TT is a contemporary approach to several ancestral healing practices. As one of the oldest vibrational therapies still in use, it is expected to act on the balancing of the human being’s energy field, by the laying hands on. The hands are, therefore, vehicles of comfort, affection, support and healing. This article illustrates a systematic review of the literature (RSL, on the effects of TT in the newborn. Objective: To know the effect of TT in the newborn. Methods: We carried the research on the Online Knowledge Library platform (Biblioteca do Conhecimento Online/B-On by researching on the available electronic databases. The articles which addressed the TT as an intervention in the newborn were included. From the 237 articles found, eight ones were selected according to the inclusion criteria previously established. Results: All studies demonstrated benefits of applying TT, such as calming effect after nursing procedures, because it reduces pain, reduces the motor activity, decreases the level of cortisol, facilitates feeding, suction/ swallowing and thus increases weight, stabilizes vital signs, promotes rest, improves interaction with the environment and saves energy for growth and healing. Conclusions: The practice of TT in the newborn can contribute to his well-being, bringing him physical, psychological and spiritual benefits.

  12. The Multiple Faces of RAGE - Opportunities for Therapeutic Intervention in Aging and Chronic Disease

    Science.gov (United States)

    Ramasamy, Ravichandran; Shekhtman, Alexander; Schmidt, Ann Marie

    2016-01-01

    Introduction This review focuses on the multi-ligand receptor of the immunoglobulin superfamily, receptor for advanced glycation endproducts (RAGE). The accumulation of the multiple ligands of RAGE in cellular stress milieux links RAGE to the pathobiology of chronic disease and natural aging. Areas Covered In this review, we present a discussion on the ligands of RAGE and the implications of these ligand families in disease. We review the recent literature on the role of ligand-RAGE interaction in the consequences of natural aging; the macro- and microvascular complications of diabetes; obesity and insulin resistance; autoimmune disorders and chronic inflammation; tumors and Alzheimer’s disease. We discuss the mechanisms of RAGE signaling through its intracellular binding effector molecule, the formin DIAPH1. Physico-chemical evidence by which the RAGE cytoplasmic domain binds to the FH1 (formin homology 1) domain of DIAPH1, and the consequences, is also reviewed. Expert Opinion We discuss the modalities of RAGE antagonism currently in pre-clinical and clinical studies. Finally, we present the rationale behind potentially targeting the RAGE cytoplasmic domain-DIAPH1 interaction as a logical strategy for therapeutic intervention in the pathological settings of chronic diseases and aging in which RAGE ligands accumulate and signal. PMID:26558318

  13. TRP channels as targets for therapeutic intervention in obesity: focus on TRPV1 and TRPM5.

    Science.gov (United States)

    Palmer, R Kyle; Lunn, Charles A

    2013-01-01

    The disease of obesity is one of the greatest healthcare challenges of our time. The increasing urgency for effective treatment is driving an intensive search for new targets for anti-obesity drug discovery. The TRP channel super family represents a class of proteins now recognized to serve many functions in physiology related to maintenance of health and the development of diseases. A few of these might offer new potential for therapeutic intervention in obesity. Among the TRP channels, TRPV1 appears most closely associated with body weight homeostasis through its influence on energy expenditure. TRPM5 has been thoroughly characterized as a critical component of taste signaling and recently has been implicated in insulin release. Because of its role in taste signaling, we argue that drugs designed to modulate TRPM5 could be useful in controlling energy consumption by impacting taste sensory signals. As drug targets for obesity, both TRPV1 and TRPM5 offer the advantage of operating in compartments that could limit drug distribution to the site of action. The potential for other TRP channels as anti-obesity drug targets also is discussed.

  14. Rational Teaching.

    Science.gov (United States)

    Macmillan, C. J. B.

    1985-01-01

    The recognition of teaching as a special relationship among individuals is currently being overlooked in much contemporary educational research and policymaking. The author examines the philosophy of rationality in teaching and relates it to the educational vision presented in George Orwell's novel, "Nineteen Eighty-Four." (CB)

  15. Football for Inclusion: Examining the Pedagogic Rationalities and the Technologies of Solidarity of a Sports-Based Intervention in Sweden

    Directory of Open Access Journals (Sweden)

    David Ekholm

    2017-06-01

    Full Text Available Sports practices have been emphasised in social policy as a means of responding to social problems. In this article we analyse a sports-based social intervention performed in a “socially vulnerable” area in Sweden. We examine the formation of includable citizens in this project, based on interviews with representatives involved in the project. The material is analysed from a governmentality perspective, focusing on how problems and solutions are constructed as being constitutive of each other. The focus of the analysis is on social solidarity and inclusion as contemporary challenges, and how sport, specifically football, is highlighted as a way of creating social solidarity through a pedagogic rationality—football as a means of fostering citizens according to specific ideals of solidarity and inclusion. The formation of solidarity appears not as a mutual process whereby an integrated social collective is created, but rather as a process whereby those affected by exclusion are given the opportunity to individually adapt to a set of Swedish norms, and to linguistic and cultural skills, as a means of reaching the “inside”. Inclusion seems to be possible as long as the “excluded” adapt to the “inside”, which is made possible by the sports-based pedagogy. In conclusion, social problems and social tensions are spatially located in “the Area” of “the City”, whose social policy, of which this sports-based intervention is a part, maintains rather than reforms the social order that creates these very tensions.

  16. Early Therapeutic Alliance, Treatment Retention, and 12-Month Outcomes in a Healthy Lifestyles Intervention for People with Psychotic Disorders.

    Science.gov (United States)

    Andrews, Michelle; Baker, Amanda L; Halpin, Sean A; Lewin, Terry J; Richmond, Robyn; Kay-Lambkin, Frances J; Filia, Sacha L; Castle, David; Williams, Jill M; Clark, Vanessa; Callister, Robin

    2016-12-01

    Engaging and retaining individuals with psychotic disorders in psychosocial treatments is difficult. Early therapeutic alliance, treatment retention, and 12-month outcomes were examined in a subsample of smokers with a psychotic disorder (N = 178) participating in a healthy lifestyles study comparing a telephone versus face-to-face delivered intervention. Therapeutic alliance was assessed using the Agnew Relationship Measure; primary outcomes were treatment retention and changes in symptoms and health behaviors. Contrary to expectations, early alliance did not predict treatment retention. However, elements of both client- and therapist-rated alliance predicted some clinical outcomes (e.g., higher confidence in the therapeutic alliance at session 1 predicted improvements in 12-month depression). Some modest interactions between early alliance and intervention condition were also identified (e.g., clients initially with lower self-perceived initiative, or higher therapist-perceived bonding benefited preferentially from the telephone-delivered intervention), highlighting the need to further examine the interplay between therapeutic alliance and treatment modality.

  17. Baseline rationing

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Moreno-Ternero, Juan D.; Østerdal, Lars Peter Raahave

    , there exist baselines (to be interpreted as objective entitlements, ideal targets, or past consumption) that might play an important role in the allocation process. The model we present is able to accommodate real-life rationing situations, ranging from resource allocation in the public health care sector......The standard problem of adjudicating conflicting claims describes a situation in which a given amount of a divisible good has to be allocated among agents who hold claims against it exceeding the available amount. This paper considers more general rationing problems in which, in addition to claims...... the family is associated with a standard rule and we show that if the latter obeys some properties reflecting principles of impartiality, priority and solidarity, the former obeys them too....

  18. Experimental Models of Status Epilepticus and Neuronal Injury for Evaluation of Therapeutic Interventions

    Directory of Open Access Journals (Sweden)

    Ramkumar Kuruba

    2013-09-01

    Full Text Available This article describes current experimental models of status epilepticus (SE and neuronal injury for use in the screening of new therapeutic agents. Epilepsy is a common neurological disorder characterized by recurrent unprovoked seizures. SE is an emergency condition associated with continuous seizures lasting more than 30 min. It causes significant mortality and morbidity. SE can cause devastating damage to the brain leading to cognitive impairment and increased risk of epilepsy. Benzodiazepines are the first-line drugs for the treatment of SE, however, many people exhibit partial or complete resistance due to a breakdown of GABA inhibition. Therefore, new drugs with neuroprotective effects against the SE-induced neuronal injury and degeneration are desirable. Animal models are used to study the pathophysiology of SE and for the discovery of newer anticonvulsants. In SE paradigms, seizures are induced in rodents by chemical agents or by electrical stimulation of brain structures. Electrical stimulation includes perforant path and self-sustaining stimulation models. Pharmacological models include kainic acid, pilocarpine, flurothyl, organophosphates and other convulsants that induce SE in rodents. Neuronal injury occurs within the initial SE episode, and animals exhibit cognitive dysfunction and spontaneous seizures several weeks after this precipitating event. Current SE models have potential applications but have some limitations. In general, the experimental SE model should be analogous to the human seizure state and it should share very similar neuropathological mechanisms. The pilocarpine and diisopropylfluorophosphate models are associated with prolonged, diazepam-insensitive seizures and neurodegeneration and therefore represent paradigms of refractory SE. Novel mechanism-based or clinically relevant models are essential to identify new therapies for SE and neuroprotective interventions.

  19. A taxonomy of multinational ethical and methodological standards for clinical trials of therapeutic interventions.

    Science.gov (United States)

    Ashton, Carol M; Wray, Nelda P; Jarman, Anna F; Kolman, Jacob M; Wenner, Danielle M; Brody, Baruch A

    2011-06-01

    If trials of therapeutic interventions are to serve society's interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical-trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. The authors rank-ordered the world's nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as 'core', 39 addressing trials of invasive procedures and a 5% sample (N=55) of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial's stages. Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research.

  20. Rational valuations

    Directory of Open Access Journals (Sweden)

    Georg Spielthenner

    2007-01-01

    Full Text Available Valuations are ubiquitous. We may be for or against genetically modified food; we find some politicians irresponsible; we prefer Beethoven to rock ‘n’ roll or vice versa; some enjoy bird-watching while others find it boring; and we may think that we have to tighten up on green-house gas emissions. Valuing is pervasive and often we are not even aware that we are valuing. However, many of ourvaluations are ill grounded and rationally defective. They are frequently based on misinformation, sloppy thinking, prejudice, and are biased in many ways as psychological research shows. For this reason there is widespread agreement among phi-losophers that we need an account of substantive valuational rationality, both for the theory of practical reasoning and for ethics as well. My main objectin this paper is to outline such an account and to present a principle that allows a non-technical rational criticism of valuations

  1. Bounded Rationality

    Directory of Open Access Journals (Sweden)

    Ballester Pla, Coralio

    2012-03-01

    Full Text Available The observation of the actual behavior by economic decision makers in the lab and in the field justifies that bounded rationality has been a generally accepted assumption in many socio-economic models. The goal of this paper is to illustrate the difficulties involved in providing a correct definition of what a rational (or irrational agent is. In this paper we describe two frameworks that employ different approaches for analyzing bounded rationality. The first is a spatial segregation set-up that encompasses two optimization methodologies: backward induction and forward induction. The main result is that, even under the same state of knowledge, rational and non-rational agents may match their actions. The second framework elaborates on the relationship between irrationality and informational restrictions. We use the beauty contest (Nagel, 1995 as a device to explain this relationship.

    La observación del comportamiento de los agentes económicos tanto en el laboratorio como en la vida real justifica que la racionalidad acotada sea un supuesto aceptado en numerosos modelos socio-económicos. El objetivo de este artículo es ilustrar las dificultades que conlleva una correcta definición de qué es un agente racional (irracional. En este artículo se describen dos marcos que emplean diferentes metodologías para analizar la racionalidad acotada. El primero es un modelo de segregación espacial donde se contrastan dos metodologías de optimización: inducción hacia atrás y hacia adelante. El resultado principal es que, incluso con el mismo nivel de conocimiento, tanto agentes racionales como irracionales podrían coincidir en sus acciones. El segundo marco trabaja sobre la relación entre irracionalidad y restricción de información. Se utiliza el juego llamado “beauty contest” (Nagel 1995 como mecanismo para explicar dicha relación.

  2. Rational Targeting of Cellular Cholesterol in Diffuse Large B-Cell Lymphoma (DLBCL) Enabled by Functional Lipoprotein Nanoparticles: A Therapeutic Strategy Dependent on Cell of Origin.

    Science.gov (United States)

    Rink, Jonathan S; Yang, Shuo; Cen, Osman; Taxter, Tim; McMahon, Kaylin M; Misener, Sol; Behdad, Amir; Longnecker, Richard; Gordon, Leo I; Thaxton, C Shad

    2017-11-06

    Cancer cells have altered metabolism and, in some cases, an increased demand for cholesterol. It is important to identify novel, rational treatments based on biology, and cellular cholesterol metabolism as a potential target for cancer is an innovative approach. Toward this end, we focused on diffuse large B-cell lymphoma (DLBCL) as a model because there is differential cholesterol biosynthesis driven by B-cell receptor (BCR) signaling in germinal center (GC) versus activated B-cell (ABC) DLBCL. To specifically target cellular cholesterol homeostasis, we employed high-density lipoprotein-like nanoparticles (HDL NP) that can generally reduce cellular cholesterol by targeting and blocking cholesterol uptake through the high-affinity HDL receptor, scavenger receptor type B-1 (SCARB1). As we previously reported, GC DLBCL are exquisitely sensitive to HDL NP as monotherapy, while ABC DLBCL are less sensitive. Herein, we report that enhanced BCR signaling and resultant de novo cholesterol synthesis in ABC DLBCL drastically reduces the ability of HDL NPs to reduce cellular cholesterol and induce cell death. Therefore, we combined HDL NP with the BCR signaling inhibitor ibrutinib and the SYK inhibitor R406. By targeting both cellular cholesterol uptake and BCR-associated de novo cholesterol synthesis, we achieved cellular cholesterol reduction and induced apoptosis in otherwise resistant ABC DLBCL cell lines. These results in lymphoma demonstrate that reduction of cellular cholesterol is a powerful mechanism to induce apoptosis. Cells rich in cholesterol require HDL NP therapy to reduce uptake and molecularly targeted agents that inhibit upstream pathways that stimulate de novo cholesterol synthesis, thus, providing a new paradigm for rationally targeting cholesterol metabolism as therapy for cancer.

  3. Integrating between-session interventions (homework) in therapy: the importance of the therapeutic relationship and cognitive case conceptualization.

    Science.gov (United States)

    Cronin, Timothy J; Lawrence, Katherine A; Taylor, Kate; Norton, Peter J; Kazantzis, Nikolaos

    2015-05-01

    Between-session interventions, or homework, are crucial to a range of psychological therapies, including cognitive behavior therapy (CBT). Therapeutic interventions often involve experiencing emotions and situations, or examining strongly held views about their problems, that clients can find distressing. Hence, the clinician faces a particular challenge in collaborating with the client to carry out these interventions between sessions. In this article, we convey how this process in CBT requires not only a consideration of the theoretically meaningful determinants of adherence behavior but also a sophisticated cognitive case conceptualization. Using case material, we illustrate the interplay between in-session design, planning, and review of between-session interventions and the conceptualization. We also include a distinction between generic elements of the therapeutic relationship and CBT-specific elements. The case material also attends to the person of the therapist, and his or her own cognitive and emotional reactions occurring throughout the process of discussing between-session interventions. © 2015 Wiley Periodicals, Inc.

  4. Human microbiome as therapeutic intervention target to reduce cardiovascular disease risk

    NARCIS (Netherlands)

    Koopen, Annefleur M.; Groen, Albert K.; Nieuwdorp, Max

    2016-01-01

    Purpose of review The absolute burden of cardiovascular risk remains high despite currently available preventive and therapeutic options. In search for novel therapeutic leads, mounting evidence has linked the gut microbiota as well as their metabolites to the development of cardiometabolic

  5. Rational decisions

    CERN Document Server

    Binmore, Ken

    2008-01-01

    It is widely held that Bayesian decision theory is the final word on how a rational person should make decisions. However, Leonard Savage--the inventor of Bayesian decision theory--argued that it would be ridiculous to use his theory outside the kind of small world in which it is always possible to ""look before you leap."" If taken seriously, this view makes Bayesian decision theory inappropriate for the large worlds of scientific discovery and macroeconomic enterprise. When is it correct to use Bayesian decision theory--and when does it need to be modified? Using a minimum of mathematics,

  6. In vivo early intervention and the therapeutic effects of 20(s-ginsenoside rg3 on hypertrophic scar formation.

    Directory of Open Access Journals (Sweden)

    Liying Cheng

    Full Text Available Intra-lesional injections of corticosteroids, interferon, and chemotherapeutic drugs are currently the most popular treatments of hypertrophic scar formation. However, these drugs can only be used after HS is formed, and not during the inflammatory phase of wound healing, which regulates the HS forming process.To investigate a new, effective, combining therapeutic and safe drug for early intervention and treatment for hypertrophic scars.Cell viability assay and flow cytometric analysis were studied in vitro. Animal studies were done to investigate the combining therapeutic effects of 20(S-ginsenoside Rg3 (Rg3 on the inflammatory phase of wound healing and HS formation.In vitro studies showed that Rg3 can inhibit HS fibroblasts proliferation and induce HSF apoptosis in a concentration-dependent manner. In vivo studies demonstrated that Rg3 can limit the exaggerated inflammation, and do not delay the wound healing process, which indicates that Rg3 could be used as an early intervention to reduce HS formation. Topical injection of 4 mg/mL Rg3 can reduce HS formation by 34%. Histological and molecular studies revealed that Rg3 injection inhibits fibroblasts proliferation thus reduced the accumulation of collagen fibers, and down-regulates VEGF expression in the HS tissue.Rg3 can be employed as an early intervention and a combining therapeutic drug to reduce inflammation and HS formation as well.

  7. The use of therapeutic massage as a nursing intervention to modify anxiety and the perception of cancer pain.

    Science.gov (United States)

    Ferrell-Torry, A T; Glick, O J

    1993-04-01

    The purpose of this exploratory study was to examine the effects of therapeutic massage (consisting of effleurage, petrissage, and myofascial trigger point therapy) on pain perception, anxiety, and relaxation levels in hospitalized patients experiencing significant cancer pain. Thirty minutes of therapeutic massage was administered on two consecutive evenings to nine hospitalized males diagnosed with cancer and experiencing cancer pain. The subjects' self-reports of pain and relaxation (measured by Visual Analogue Scales) as well as anxiety (measured by the Spielberger State Anxiety Inventory) were recorded before and immediately after the intervention. The objective physiologic measures of heart rate, respiratory rate, and blood pressure were obtained before, immediately after, and, finally, 10 min after the massage intervention. Massage therapy significantly reduced the subjects' level of pain perception (average = 60%) and anxiety (average = 24%) while enhancing their feelings of relaxation by an average of 58%. In addition to these subjective measures, all physiological measures (heart rate, respiratory rate, and blood pressure) tended to decrease from baseline, providing further indication of relaxation. In conclusion, although the exact mechanism is not known, therapeutic massage is a beneficial nursing intervention that promotes relaxation and alleviates the perception of pain and anxiety in hospitalized cancer patients.

  8. A Research Synthesis of Therapeutic Interventions for Whiplash-Associated Disorder (WAD: Part 3 – Interventions for Subacute WAD

    Directory of Open Access Journals (Sweden)

    Robert W Teasell

    2010-01-01

    Full Text Available Whiplash-associated disorder (WAD represents a significant public health problem, resulting in substantial social and economic costs throughout the industrialized world. While many treatments have been advocated for patients with WAD, scientific evidence supporting their effectiveness is often lacking. A systematic review was conducted to evaluate the strength of evidence associated with various WAD therapies. Multiple databases (including Web of Science, EMBASE and PubMed were searched to identify all studies published from January 1980 through March 2009 that evaluated the effectiveness of any clearly defined treatment for acute (less than two weeks, subacute (two to 12 weeks or chronic (longer than 12 weeks WAD. The present article, the third in a five-part series, evaluates the evidence for interventions initiated during the subacute phase of WAD. Thirteen studies that met the inclusion criteria were identified, six of which were randomized controlled trials with ‘good’ overall methodology (median Physiotherapy Evidence Database score of 6. Although some evidence was identified to support the use of interdisciplinary interventions and chiropractic manipulation, the evidence was not strong for any of the evaluated treatments. There is a clear need for further research to evaluate interventions aimed at treating patients with subacute WAD because there are currently no interventions satisfactorily supported by the research literature.

  9. A research synthesis of therapeutic interventions for whiplash-associated disorder (WAD): part 3 - interventions for subacute WAD.

    Science.gov (United States)

    Teasell, Robert W; McClure, J Andrew; Walton, David; Pretty, Jason; Salter, Katherine; Meyer, Matthew; Sequeira, Keith; Death, Barry

    2010-01-01

    Whiplash-associated disorder (WAD) represents a significant public health problem, resulting in substantial social and economic costs throughout the industrialized world. While many treatments have been advocated for patients with WAD, scientific evidence supporting their effectiveness is often lacking. A systematic review was conducted to evaluate the strength of evidence associated with various WAD therapies. Multiple databases (including Web of Science, EMBASE and PubMed) were searched to identify all studies published from January 1980 through March 2009 that evaluated the effectiveness of any clearly defined treatment for acute (less than two weeks), subacute (two to 12 weeks) or chronic (longer than 12 weeks) WAD. The present article, the third in a five-part series, evaluates the evidence for interventions initiated during the subacute phase of WAD. Thirteen studies that met the inclusion criteria were identified, six of which were randomized controlled trials with 'good' overall methodology (median Physiotherapy Evidence Database score of 6). Although some evidence was identified to support the use of interdisciplinary interventions and chiropractic manipulation, the evidence was not strong for any of the evaluated treatments. There is a clear need for further research to evaluate interventions aimed at treating patients with subacute WAD because there are currently no interventions satisfactorily supported by the research literature.

  10. A research synthesis of therapeutic interventions for whiplash-associated disorder (WAD): Part 3 – interventions for subacute WAD

    Science.gov (United States)

    Teasell, Robert W; McClure, J Andrew; Walton, David; Pretty, Jason; Salter, Katherine; Meyer, Matthew; Sequeira, Keith; Death, Barry

    2010-01-01

    Whiplash-associated disorder (WAD) represents a significant public health problem, resulting in substantial social and economic costs throughout the industrialized world. While many treatments have been advocated for patients with WAD, scientific evidence supporting their effectiveness is often lacking. A systematic review was conducted to evaluate the strength of evidence associated with various WAD therapies. Multiple databases (including Web of Science, EMBASE and PubMed) were searched to identify all studies published from January 1980 through March 2009 that evaluated the effectiveness of any clearly defined treatment for acute (less than two weeks), subacute (two to 12 weeks) or chronic (longer than 12 weeks) WAD. The present article, the third in a five-part series, evaluates the evidence for interventions initiated during the subacute phase of WAD. Thirteen studies that met the inclusion criteria were identified, six of which were randomized controlled trials with ‘good’ overall methodology (median Physiotherapy Evidence Database score of 6). Although some evidence was identified to support the use of interdisciplinary interventions and chiropractic manipulation, the evidence was not strong for any of the evaluated treatments. There is a clear need for further research to evaluate interventions aimed at treating patients with subacute WAD because there are currently no interventions satisfactorily supported by the research literature. PMID:21038009

  11. Therapeutic Alliance With a Fully Automated Mobile Phone and Web-Based Intervention: Secondary Analysis of a Randomized Controlled Trial.

    Science.gov (United States)

    Clarke, Janine; Proudfoot, Judith; Whitton, Alexis; Birch, Mary-Rose; Boyd, Megan; Parker, Gordon; Manicavasagar, Vijaya; Hadzi-Pavlovic, Dusan; Fogarty, Andrea

    2016-02-25

    Studies of Internet-delivered psychotherapies suggest that clients report development of a therapeutic alliance in the Internet environment. Because a majority of the interventions studied to date have been therapist-assisted to some degree, it remains unclear whether a therapeutic alliance can develop within the context of an Internet-delivered self-guided intervention with no therapist support, and whether this has consequences for program outcomes. This study reports findings of a secondary analysis of data from 90 participants with mild-to-moderate depression, anxiety, and/or stress who used a fully automated mobile phone and Web-based cognitive behavior therapy (CBT) intervention called "myCompass" in a recent randomized controlled trial (RCT). Symptoms, functioning, and positive well-being were assessed at baseline and post-intervention using the Depression, Anxiety and Stress Scale (DASS), the Work and Social Adjustment Scale (WSAS), and the Mental Health Continuum-Short Form (MHC-SF). Therapeutic alliance was measured at post-intervention using the Agnew Relationship Measure (ARM), and this was supplemented with qualitative data obtained from 16 participant interviews. Extent of participant engagement with the program was also assessed. Mean ratings on the ARM subscales were above the neutral midpoints, and the interviewees provided rich detail of a meaningful and collaborative therapeutic relationship with the myCompass program. Whereas scores on the ARM subscales did not correlate with treatment outcomes, participants' ratings of the quality of their emotional connection with the program correlated significantly and positively with program logins, frequency of self-monitoring, and number of treatment modules completed (r values between .32-.38, P≤.002). The alliance (ARM) subscales measuring perceived empowerment (r=.26, P=.02) and perceived freedom to self-disclose (r=.25, P=.04) also correlated significantly in a positive direction with self

  12. Rational inattention or rational overreaction?

    DEFF Research Database (Denmark)

    Browning, Martin; Hansen, Lars Gårn; Smed, Sinne

    We investigate differences in how consumers of fish react to health information in the mass media. We specify a dynamic empirical model that allows for heterogeneity in all basic parameters of consumer behavior as well as in how consumers react to information. We estimate the model using a unique...... houshold panel tracking consumption, prices, news stories and media habits over 24 quarters. We fi nd that the consumers most likely to be ’rationally ignorant’ of health effects react more dramatically to health news than the consumers who most likely are well informed....

  13. Enlight: A Comprehensive Quality and Therapeutic Potential Evaluation Tool for Mobile and Web-Based eHealth Interventions.

    Science.gov (United States)

    Baumel, Amit; Faber, Keren; Mathur, Nandita; Kane, John M; Muench, Fred

    2017-03-21

    Studies of criteria-based assessment tools have demonstrated the feasibility of objectively evaluating eHealth interventions independent of empirical testing. However, current tools have not included some quality constructs associated with intervention outcome, such as persuasive design, behavior change, or therapeutic alliance. In addition, the generalizability of such tools has not been explicitly examined. The aim is to introduce the development and further analysis of the Enlight suite of measures, developed to incorporate the aforementioned concepts and address generalizability aspects. As a first step, a comprehensive systematic review was performed to identify relevant quality rating criteria in line with the PRISMA statement. These criteria were then categorized to create Enlight. The second step involved testing Enlight on 42 mobile apps and 42 Web-based programs (delivery mediums) targeting modifiable behaviors related to medical illness or mental health (clinical aims). A total of 476 criteria from 99 identified sources were used to build Enlight. The rating measures were divided into two sections: quality assessments and checklists. Quality assessments included usability, visual design, user engagement, content, therapeutic persuasiveness, therapeutic alliance, and general subjective evaluation. The checklists included credibility, privacy explanation, basic security, and evidence-based program ranking. The quality constructs exhibited excellent interrater reliability (intraclass correlations=.77-.98, median .91) and internal consistency (Cronbach alphas=.83-.90, median .88), with similar results when separated into delivery mediums or clinical aims. Conditional probability analysis revealed that 100% of the programs that received a score of fair or above (≥3.0) in therapeutic persuasiveness or therapeutic alliance received the same range of scores in user engagement and content-a pattern that did not appear in the opposite direction. Preliminary

  14. International Children's Continence Society's recommendations for therapeutic intervention in congenital neuropathic bladder and bowel dysfunction in children.

    Science.gov (United States)

    Rawashdeh, Y F; Austin, P; Siggaard, C; Bauer, S B; Franco, I; de Jong, T P; Jorgensen, T M

    2012-06-01

    We present a consensus view of members of the International Children's Continence Society on the therapeutic intervention in congenital neuropatic bladder and bowel dysfunction in children. Discussions were held by a group of pediatric urologists and gastroenterologists appointed by the board. The following draft review document was open to all the ICCS members via the ICCS web site. Feedback was considered by the core authors and by agreement, amendments were made as necessary. The final document is not a systematic literature review. It includes relevant research when available as well as expert opinion on the current understanding of therapeutic intervention in congenital neuropatic bladder and bowel dysfunction in children. Guidelines on pharmalogical and surgical intervention are presented. First the multiple modalities for intervention that do not involve surgical reconstruction are summarized concerning pharmacological agents, medical devices, and neuromodulation. The non-surgical intervention is promoted before undertaking major surgery. Indicators for non-surgical treatments depend on issues related to intravesical pressure, upper urinary tract status, prevalence of urinary tract infections, and the degree of incontinence. The optimal age for treatment of incontinence is also addressed. This is followed by a survey of specific treatments such as anticholinergics, botulinum-A toxin, antibiotics, and catheters. Neuromodulation of the bladder via intravesical electrical stimulation, sacral nerve stimulation, transcutaneous stimulation, and biofeedback is scrutinized. Then follows surgical intervention, which should be tailored to each individual, based on careful consideration of urodynamic findings, medical history, age, and presence of other disability. Treatments mentioned are: urethral dilation, vesicostomy, bladder, augmentation, fascial sling, artificial urinary sphincters, and bladder neck reconstruction and are summarized with regards to success rates

  15. Understanding MHC class I presentation of viral antigens by human dendritic cells as a basis for rational design of therapeutic vaccines

    Directory of Open Access Journals (Sweden)

    Nadine eVan Montfoort

    2014-04-01

    Full Text Available Effective viral clearance requires the induction of virus-specific CD8+ cytotoxic T lymphocytes (CTL. Since dendritic cells (DC have a central role in initiating and shaping virus-specific CTL responses, it is important to understand how DC initiate virus-specific CTL responses. Some viruses can directly infect DC, which theoretically allows direct presentation of viral antigens to CTL, but many viruses target other cells than DC and thus the host depends on the cross-presentation of viral antigens by DC to activate virus-specific CTL.Research in mouse models has highly enhanced our understanding of the mechanisms underlying cross-presentation and the DC subsets involved, however, these results cannot be readily translated towards the role of human DC in MHC class I antigen presentation of human viruses. Here, we summarize the insights gained in the past 20 years on MHC class I presentation of viral antigen by human DC and add to the current debate on the capacities of different human DC subsets herein. Furthermore, possible sources of viral antigens and essential DC characteristics for effective induction of virus-specific CTL are evaluated.We conclude that cross-presentation is not only an efficient mechanism exploited by DC to initiate immunity to viruses that do not infect DC but also to viruses that do infect DC, because cross-presentation has many conceptual advantages and bypasses direct immune modulatory effects of the virus on its infected target cells. Since knowledge on the mechanism of viral antigen presentation and the preferred DC subsets is crucial for rational vaccine design, the obtained insights are very instrumental for the development of effective anti-viral immunotherapy.

  16. Therapeutic interventions for suicide attempts and self-harm in adolescents: systematic review and meta-analysis.

    Science.gov (United States)

    Ougrin, Dennis; Tranah, Troy; Stahl, Daniel; Moran, Paul; Asarnow, Joan Rosenbaum

    2015-02-01

    Suicidal behavior and self-harm are common in adolescents and are associated with elevated psychopathology, risk of suicide, and demand for clinical services. Despite recent advances in the understanding and treatment of self-harm and links between self-harm and suicide and risk of suicide attempt, progress in reducing suicide death rates has been elusive, with no substantive reduction in suicide death rates over the past 60 years. Extending prior reviews of the literature on treatments for suicidal behavior and repetitive self-harm in youth, this article provides a meta-analysis of randomized controlled trials (RCTs) reporting efficacy of specific pharmacological, social, or psychological therapeutic interventions (TIs) in reducing both suicidal and nonsuicidal self-harm in adolescents. Data sources were identified by searching the Cochrane, Medline, PsychINFO, EMBASE, and PubMed databases as of May 2014. RCTs comparing specific therapeutic interventions versus treatment as usual (TAU) or placebo in adolescents (through age 18 years) with self-harm were included. Nineteen RCTs including 2,176 youth were analyzed. TIs included psychological and social interventions and no pharmacological interventions. The proportion of the adolescents who self-harmed over the follow-up period was lower in the intervention groups (28%) than in controls (33%) (test for overall effect z = 2.31; p = .02). TIs with the largest effect sizes were dialectical behavior therapy (DBT), cognitive-behavioral therapy (CBT), and mentalization-based therapy (MBT). There were no independent replications of efficacy of any TI. The pooled risk difference between TIs and TAU for suicide attempts and nonsuicidal self-harm considered separately was not statistically significant. TIs to prevent self-harm appear to be effective. Independent replication of the results achieved by DBT, MBT, and CBT is a research priority. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by

  17. The therapeutic focus in significant sessions of master therapists: a comparison of cognitive-behavioral and psychodynamic-interpersonal interventions.

    Science.gov (United States)

    Goldfried, M R; Raue, P J; Castonguay, L G

    1998-10-01

    Using the Coding System of Therapeutic Focus, this exploratory study was a comparative process analysis of clinically significant sessions obtained from 22 master cognitive-behavior and 14 master psychodynamic-interpersonal therapists. Therapists were nominated by experts in each of these orientations, and clients were seen in a naturalistic setting for problems with anxiety, depression, or both. Relatively few between-groups differences emerged with this master therapist sample. However, regardless of theoretical orientation, several differences were found between those portions of the session labeled by therapists as being clinically significant and those viewed as less significant. As these findings are different from those obtained in a previous study of the therapeutic focus in interventions carried out within the context of a controlled clinical trial, some of the possible factors contributing to these differences are noted.

  18. A Research Synthesis of Therapeutic Interventions for Whiplash-Associated Disorder (WAD: Part 4 – Noninvasive Interventions for Chronic WAD

    Directory of Open Access Journals (Sweden)

    Robert W Teasell

    2010-01-01

    Full Text Available Whiplash-associated disorder (WAD represents a significant public health problem, resulting in substantial social and economic costs throughout the industrialized world. While many treatments have been advocated for patients with WAD, scientific evidence supporting their effectiveness is often lacking. A systematic review was conducted to evaluate the strength of evidence for various WAD therapies. Multiple databases (including Web of Science, EMBASE and PubMed were searched to identify all studies published from January 1980 through March 2009 that evaluated the effectiveness of any clearly defined treatment for acute (less than two weeks, subacute (two to 12 weeks or chronic (longer than 12 weeks WAD. The present article, the fourth in a five-part series, evaluates the evidence for noninvasive interventions initiated during the chronic phase of WAD. Twenty-two studies that met the inclusion criteria were identified, 12 of which were randomized controlled trials with ‘good’ overall methodological quality (median Physiotherapy Evidence Database score of 6. For the treatment of chronic WAD, there is evidence to suggest that exercise programs are effective in relieving whiplash-related pain, at least over the short term. While the majority of a subset of nine studies supported the effectiveness of interdisciplinary interventions, the two randomized controlled trials provided conflicting results. Finally, there was limited evidence, consisting of one supportive case series each, that both manual joint manipulation and myofeedback training may provide some benefit. Based on the available research, exercise programs were the most effective noninvasive treatment for patients with chronic WAD, although many questions remain regarding the relative effectiveness of various exercise regimens.

  19. Rational kinematics

    CERN Document Server

    Angeles, Jorge

    1988-01-01

    A rational study of kinematics is a treatment of the subject based on invariants, i.e., quantities that remain essentially unchanged under a change of observer. An observer is understood to be a reference frame supplied with a clock (Truesdell 1966). This study will therefore include an introduction to invariants. The language of these is tensor analysis and multilinear algebra, both of which share many isomorphic relations, These subjects are treated in full detail in Ericksen (1960) and Bowen and Wang (1976), and hence will not be included here. Only a short account of notation and definitions will be presented. Moreover, definitions and basic concepts pertaining to the kinematics of rigid bodies will be also included. Although the kinematics of rigid bodies can be regarded as a particular case of the kinematics of continua, the former deserves attention on its own merits for several reasons. One of these is that it describes locally the motions undergone by continua. Another reason is that a whole area of ...

  20. Antiviral treatment and other therapeutic interventions for herpes simplex virus epithelial keratitis

    Science.gov (United States)

    Wilhelmus, Kirk R

    2015-01-01

    are limited to superseded interventions. Trifluridine and acyclovir are more effective than idoxuridine or vidarabine and similar in therapeutic effectiveness. Brivudine and foscarnet do not substantially differ in effectiveness from trifluridine or acyclovir. Ganciclovir is at least as effective as acyclovir. The addition of interferon to a nucleoside antiviral agent and the combination of debridement with antiviral treatment need to be further assessed to substantiate any possible advantage in healing. PMID:25879115

  1. Therapeutic Intervention of Learning and Memory Decays by Salidroside Stimulation of Neurogenesis in Aging.

    Science.gov (United States)

    Jin, Huijuan; Pei, Lei; Shu, Xiaogang; Yang, Xin; Yan, Tianhua; Wu, Yan; Wei, Na; Yan, Honglin; Wang, Shan; Yao, Chengye; Liu, Dan; Tian, Qing; Wang, Lin; Lu, Youming

    2016-03-01

    Cognition in all mammals including human beings declines during aging. The cellular events responsible for this decay involve a reduction of neurogenesis in the dentate gyrus. Here, we show that treatment with a nature product from a traditional Chinese medicine, namely salidroside restores the capacity of the dentate gyrus to generate new neurons and intercepts learning and memory decays in mice during aging. We uncover that new neurons in aging mice have functional features of an adult granule neuron by forming excitatory synapses with their putative targeting neurons. Genetic inhibition of synaptic transmission from new neurons abolishes the therapeutic effects of salidroside in behavioral tests. We also identify that salidroside targets CREB transcription for the survival of new neurons in the dentate gyrus of old mice. Thus, salidroside is therapeutically effective against learning and memory decays via stimulation of CREB-dependent functional neurogenesis in aging.

  2. Creating a therapeutic environment: a non-randomised controlled trial of a quiet time intervention for patients in acute care.

    Science.gov (United States)

    Gardner, Glenn; Collins, Christine; Osborne, Sonya; Henderson, Amanda; Eastwood, Misha

    2009-06-01

    Noise is a significant barrier to sleep for acute care hospital patients, and sleep has been shown to be therapeutic for health, healing and recovery. Scheduled quiet time interventions to promote inpatient rest and sleep have been successfully trialled in critical care but not in acute care settings. The study aim was to evaluate a scheduled quiet time intervention in an acute care setting. The study measured the effect of a scheduled quiet time on noise levels, inpatients' rest and sleep behaviour, and wellbeing. The study also examined the impact of the intervention on patients', visitors' and health professionals' satisfaction, and organisational functioning. The study was a multi-centred non-randomised parallel group trial. The research was conducted in the acute orthopaedic wards of two major urban public hospitals in Brisbane, Australia. All patients admitted to the two wards in the 5-month period of the study were invited to participate, with a final sample of 299 participants recruited. This sample produced an effect size of 0.89 for an increase in the number of patients asleep during the quiet time. Demographic data were collected to enable comparison between groups. Data for noise level, sleep status, sleepiness and wellbeing were collected using previously validated instruments: a Castle Model((c)) 824 digital sound level indicator; a three point sleep status scale; the Epworth Sleepiness Scale; and the SF12 V2 questionnaire. The staff, patient and visitor surveys on the experimental ward were adapted from published instruments. Significant differences were found between the two groups in mean decibel level and numbers of patients awake and asleep. The difference in mean measured noise levels between the two environments corresponded to a 'perceived' difference of 2 to 1. There were significant correlations between average decibel level and number of patients awake and asleep in the experimental group, and between average decibel level and number of

  3. Effects of interventions with therapeutic suits (clothing) on impairments and functional limitations of children with cerebral palsy: a systematic review.

    Science.gov (United States)

    Almeida, Kênnea M; Fonseca, Sérgio T; Figueiredo, Priscilla R P; Aquino, Amanda A; Mancini, Marisa C

    Therapeutic suits or clothing whether associated with intensive protocols or not, became popular in the rehabilitation of children with cerebral palsy. Studies have reported positive effects of these suits on children's posture, balance, motor function and gait. A summary of current literature may help guide therapeutic actions. To evaluate the available evidence on the effects of interventions based on the use of therapeutic suits in the treatment of impairments and functional limitations of children with cerebral palsy. Three independent reviewers searched for experimental studies on MEDLINE, SciELO, BIREME, LILACS, PEDro and CENTRAL databases, between October and December 2015 and updated in May 2016. The reviewers evaluated the methodological quality of selected studies using the Checklist for Measuring Quality. The Grading of Recommendations Assessment, Development and Evaluation was used to synthesize the quality of evidence and strength of recommendation. From the 13 studies, two evaluated the Full Body Suit, two tested the Dynamic Elastomeric Fabric Orthose, three evaluated TheraTogs and six tested the TheraSuit/AdeliSuit protocols. The quality of evidence for the Full Body Suit, the Dynamic Elastomeric Fabric Orthose and the TheraSuit/AdeliSuit protocols was very low for body structure and function outcomes, while the evidence for TheraTogs was low quality. Regarding the activity outcomes, the Full Body Suit and TheraSuit showed very low quality evidence while the evidence for TheraSuit/AdeliSuit protocols were of low quality. Enthusiasm with new therapeutic approaches that argue modifications in the neuromusculoskeletal impairments and functional limitations of children with cerebral palsy need to be guided by scientific evaluation. The low quality of evidence suggests caution in recommending the use of these therapeutic suits. New studies could change the findings of this review. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em

  4. Transgenic Mouse Models of Alzheimer Disease: Developing a Better Model as a Tool for Therapeutic Interventions

    Science.gov (United States)

    Kitazawa, Masashi; Medeiros, Rodrigo; LaFerla, Frank M.

    2015-01-01

    Alzheimer disease (AD) is the leading cause of dementia among elderly. Currently, no effective treatment is available for AD. Analysis of transgenic mouse models of AD has facilitated our understanding of disease mechanisms and provided valuable tools for evaluating potential therapeutic strategies. In this review, we will discuss the strengths and weaknesses of current mouse models of AD and the contribution towards understanding the pathological mechanisms and developing effective therapies. PMID:22288400

  5. XIAP as a Molecular Target for Therapeutic Intervention in Prostate Cancer

    Science.gov (United States)

    2007-10-01

    the even- tual development of Alzheimer’s disease (Bush et al., 2003) and transmissible spongiform encephalopathies , respectively (Millhauser, 2004...comprised of two research aims to validate and examine the therapeutic potential of targeting XIAP for the treatment of prostate cancer. In the...were published.. SPECIFIC AIM 2. To validate XIAP as a novel target for the treatment of prostate cancer, using established transgenic and

  6. The role of gastrointestinal endosonography in diagnostic and therapeutic interventional procedures

    DEFF Research Database (Denmark)

    Mortensen, M B

    1999-01-01

    Over the past 15 years endoscopic ultrasonography (EUS) has become an integrated part of gastrointestinal imaging. The more recent development of echoendoscopes and needles for EUS guided fine needle aspiration has stimulated the interest in interventional EUS procedures, both for diagnostic...

  7. Inventory of Novel Animal Models Addressing Etiology of Preeclampsia in the Development of New Therapeutic/Intervention Opportunities.

    Science.gov (United States)

    Erlandsson, Lena; Nääv, Åsa; Hennessy, Annemarie; Vaiman, Daniel; Gram, Magnus; Åkerström, Bo; Hansson, Stefan R

    2016-03-01

    Preeclampsia is a pregnancy-related disease afflicting 3-7% of pregnancies worldwide and leads to maternal and infant morbidity and mortality. The disease is of placental origin and is commonly described as a disease of two stages. A variety of preeclampsia animal models have been proposed, but all of them have limitations in fully recapitulating the human disease. Based on the research question at hand, different or multiple models might be suitable. Multiple animal models in combination with in vitro or ex vivo studies on human placenta together offer a synergistic platform to further our understanding of the etiology of preeclampsia and potential therapeutic interventions. The described animal models of preeclampsia divide into four categories (i) spontaneous, (ii) surgically induced, (iii) pharmacologically/substance induced, and (iv) transgenic. This review aims at providing an inventory of novel models addressing etiology of the disease and or therapeutic/intervention opportunities. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Calcium Regulation of Hemorrhagic Fever Virus Budding: Mechanistic Implications for Host-Oriented Therapeutic Intervention.

    Directory of Open Access Journals (Sweden)

    Ziying Han

    2015-10-01

    Full Text Available Hemorrhagic fever viruses, including the filoviruses (Ebola and Marburg and arenaviruses (Lassa and Junín viruses, are serious human pathogens for which there are currently no FDA approved therapeutics or vaccines. Importantly, transmission of these viruses, and specifically late steps of budding, critically depend upon host cell machinery. Consequently, strategies which target these mechanisms represent potential targets for broad spectrum host oriented therapeutics. An important cellular signal implicated previously in EBOV budding is calcium. Indeed, host cell calcium signals are increasingly being recognized to play a role in steps of entry, replication, and transmission for a range of viruses, but if and how filoviruses and arenaviruses mobilize calcium and the precise stage of virus transmission regulated by calcium have not been defined. Here we demonstrate that expression of matrix proteins from both filoviruses and arenaviruses triggers an increase in host cytoplasmic Ca2+ concentration by a mechanism that requires host Orai1 channels. Furthermore, we demonstrate that Orai1 regulates both VLP and infectious filovirus and arenavirus production and spread. Notably, suppression of the protein that triggers Orai activation (Stromal Interaction Molecule 1, STIM1 and genetic inactivation or pharmacological blockade of Orai1 channels inhibits VLP and infectious virus egress. These findings are highly significant as they expand our understanding of host mechanisms that may broadly control enveloped RNA virus budding, and they establish Orai and STIM1 as novel targets for broad-spectrum host-oriented therapeutics to combat these emerging BSL-4 pathogens and potentially other enveloped RNA viruses that bud via similar mechanisms.

  9. On the value of therapeutic interventions targeting the complement system in acute myocardial infarction.

    Science.gov (United States)

    Emmens, Reindert W; Wouters, Diana; Zeerleder, Sacha; van Ham, S Marieke; Niessen, Hans W M; Krijnen, Paul A J

    2017-04-01

    The complement system plays an important role in the inflammatory response subsequent to acute myocardial infarction (AMI). The aim of this study is to create a systematic overview of studies that have investigated therapeutic administration of complement inhibitors in both AMI animal models and human clinical trials. To enable extrapolation of observations from included animal studies toward post-AMI clinical trials, ex vivo studies on isolated hearts and proof-of-principle studies on inhibitor administration before experimental AMI induction were excluded. Positive therapeutic effects in AMI animal models have been described for cobra venom factor, soluble complement receptor 1, C1-esterase inhibitor (C1-inh), FUT-175, C1s-inhibitor, anti-C5, ADC-1004, clusterin, and glycosaminoglycans. Two types of complement inhibitors have been tested in clinical trials, being C1-inh and anti-C5. Pexelizumab (anti-C5) did not result in reproducible beneficial effects for AMI patients. Beneficial effects were reported in AMI patients for C1-inhibitor, albeit in small patient groups. In general, despite the absence of consistent positive effects in clinical trials thus far, the complement system remains a potentially interesting target for therapy in AMI patients. Based on the study designs of previous animal studies and clinical trials, we discuss several issues which require attention in the design of future studies: adjustment of clinical trial design to precise mechanism of action of administered inhibitor, optimizing the duration of therapy, and optimization of time point(s) on which therapeutic effects will be evaluated. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Identification and Therapeutic Intervention of Co-activated ALK, FGFR2 and EphA5 Kinases in Hepatocellular Carcinoma.

    Science.gov (United States)

    Wang, Xin; Zhang, Minmin; Ping, Fangfang; Liu, Hongchun; Sun, Jingya; Wang, Yueqin; Shen, Aijun; Ding, Jian; Geng, Meiyu

    2018-01-21

    Though kinase inhibitors are heavily investigated in clinic to combat advanced hepatocellular carcinoma (HCC), clinical outcomes are overall disappointing, which may result from the absence of kinase-addicted subsets in HCC. Recently, a combination strategy that simultaneously inhibits multiple kinases are increasingly appreciated in HCC treatment, yet it is challenged by the dynamic nature of kinase network. This study aims to identify kinase clusters that may cooperate to drive the malignant growth of HCC. We reveal that ALK, FGFR2 and EphA5 are the essential kinases that assembled into a functional cluster to sustain the viability of HCC cells through downstream AKT, ERK and p38 dependent signaling pathways. Their co-activation is associated with the poor prognosis for overall survival in about 13% of HCC patients. Therapeutically, combined inhibition of kinases inhibitors or targeting heat shock protein 90 (Hsp90) led to significant therapeutic response in vitro and in vivo. Our findings revealed a paradigm that highlights the cooperation of ALK, FGFR2 and EphA5 kinases in governing growth advantage of HCC cells, which might offer a novel conceptual "combined therapeutic target" for diagnosis and subsequent intervention in subgroup of HCC patients. This article is protected by copyright. All rights reserved. © 2018 by the American Association for the Study of Liver Diseases.

  11. Nanotechnology-Driven Therapeutic Interventions in Wound Healing: Potential Uses and Applications.

    Science.gov (United States)

    Hamdan, Suzana; Pastar, Irena; Drakulich, Stefan; Dikici, Emre; Tomic-Canic, Marjana; Deo, Sapna; Daunert, Sylvia

    2017-03-22

    The chronic nature and associated complications of nonhealing wounds have led to the emergence of nanotechnology-based therapies that aim at facilitating the healing process and ultimately repairing the injured tissue. A number of engineered nanotechnologies have been proposed demonstrating unique properties and multiple functions that address specific problems associated with wound repair mechanisms. In this outlook, we highlight the most recently developed nanotechnology-based therapeutic agents and assess the viability and efficacy of each treatment, with emphasis on chronic cutaneous wounds. Herein we explore the unmet needs and future directions of current technologies, while discussing promising strategies that can advance the wound-healing field.

  12. Nanotechnology-Driven Therapeutic Interventions in Wound Healing: Potential Uses and Applications

    Science.gov (United States)

    2017-01-01

    The chronic nature and associated complications of nonhealing wounds have led to the emergence of nanotechnology-based therapies that aim at facilitating the healing process and ultimately repairing the injured tissue. A number of engineered nanotechnologies have been proposed demonstrating unique properties and multiple functions that address specific problems associated with wound repair mechanisms. In this outlook, we highlight the most recently developed nanotechnology-based therapeutic agents and assess the viability and efficacy of each treatment, with emphasis on chronic cutaneous wounds. Herein we explore the unmet needs and future directions of current technologies, while discussing promising strategies that can advance the wound-healing field. PMID:28386594

  13. Influence of Motor Cortex Stimulation During Motor Training on Neuroplasticity as a Potential Therapeutic Intervention.

    Science.gov (United States)

    Massie, Crystal L; White, Caylen; Pruit, Katie; Freel, Aubrey; Staley, Kaylin; Backes, Morgan

    2017-01-01

    Rehabilitation options to promote neuroplasticity may be enhanced when patients are engaged in motor practice during repetitive transcranial magnetic stimulation (rTMS). Twelve participants completed 3 separate sessions: motor practice, motor practice with rTMS, and rTMS only: motor practice consisted of 30 isometric contractions and subthreshold rTMS was 30, 3-s trains at 10 Hz. Assessments included the Box and Block Test (BBT), force steadiness (10% of the maximum voluntary contraction), and TMS (cortical excitability, intracortical inhibition, and intracortical facilitation). Participants significantly increased BBT scores following the combined condition. Force steadiness improved after all 3 conditions (p motor practice plus rTMS condition. All interventions influenced motor control, yet are likely modulated differently when combining motor practice plus rTMS. These results help guide the clinical utility of rTMS as an intervention to influence motor control.

  14. Peripheral muscle abnormalities in cystic fibrosis: Etiology, clinical implications and response to therapeutic interventions.

    Science.gov (United States)

    Gruet, Mathieu; Troosters, Thierry; Verges, Samuel

    2017-09-01

    Peripheral muscle dysfunction is an important systemic consequence of cystic fibrosis (CF) with major clinical implications, such as exercise intolerance and reduced quality of life. Evidence is now accumulating that lack of physical activity is unlikely to be the sole explanation for peripheral muscle dysfunction of patients with CF. Particularly, the demonstration of CFTR expression in both murine and human skeletal muscle suggests the potential implication of intrinsic CF-related factors. By combining data from both human and animal models, this review describes CF peripheral muscle abnormalities and critically reviews the advances in understanding the impact of the underlying mechanisms. We also describe how peripheral muscles respond to intervention in this population. Methodological concerns and directions for future research are also considered. Peripheral muscle atrophy and weakness is prevalent in patients with CF and associated with reduced aerobic and anaerobic performances. Further investigations are however needed to confirm alterations in peripheral muscle endurance and fatigability. Physical inactivity is probably the major contributor of peripheral muscle abnormalities in patients with CF with mild-to-moderate phenotypes. However, the relative influence of additional factors (e.g. inflammation, metabolic abnormalities) probably increases with disease severity making specific and individualized interventions necessary in severe patients. Exercise training is the most effective intervention to address peripheral muscle dysfunction but other strategies, such as neuromuscular electrical stimulation and nutritional or hormonal supplementation may be of interest in some patients. Investigations are needed to determine whether pharmacological interventions such as CFTR modulators are effective to address this condition. To better elucidate the etiology of peripheral muscle dysfunction in CF, future studies should combine measurements at the cellular level

  15. Retaining critical therapeutic elements of behavioral interventions translated for delivery via the Internet: recommendations and an example using pain coping skills training.

    Science.gov (United States)

    Rini, Christine; Porter, Laura S; Somers, Tamara J; McKee, Daphne C; Keefe, Francis J

    2014-12-19

    Evidence supporting the efficacy of behavioral interventions based on principles of cognitive behavioral therapies has spurred interest in translating these interventions for delivery via the Internet. However, the benefits of this dissemination method cannot be realized unless the translated interventions are as effective as possible. We describe a challenge that must be overcome to ensure this occurs--Internet interventions must retain therapeutic components and processes underlying the success of face-to-face interventions on which they are based. These components and processes vary in the ease with which they can be translated to the online environment. Moreover, some are subtle and may be overlooked, despite being recognized as essential to the success of face-to-face interventions. We provide preliminary guidance for retaining critical therapeutic components and processes in the translation process, using Pain Coping Skills Training for osteoarthritis pain to illustrate methods. Directions for future research are also discussed.

  16. Respiratory virus modulation of host nucleocytoplasmic transport; target for therapeutic intervention?

    Directory of Open Access Journals (Sweden)

    Leon eCaly

    2015-08-01

    Full Text Available The respiratory diseases caused by Rhinovirus, Respiratory Syncytial Virus and Influenza virus represent a large social and financial burden on healthcare worldwide. Although all three viruses have distinctly unique properties in terms of infection and replication, they share the ability to exploit/manipulate the host-cell nucleocytoplasmic transport system in order to replicate effectively and efficiently. This review outlines the various ways in which infection by these viruses impacts on the host nucleocytoplasmic transport system, and examples where inhibition thereof in turn decreases viral replication. The highly conserved nature of the nucleocytoplasmic transport system and the viral proteins that interact with it make this virus-host interface a prime candidate for the development of specific antiviral therapeutics in the future.

  17. Immune disease-associated variants in gene enhancers point to BET epigenetic mechanisms for therapeutic intervention.

    Science.gov (United States)

    Tough, David F; Prinjha, Rab K

    2017-04-01

    Genome-wide association studies have identified thousands of single nucleotide polymorphisms in the human genome that are statistically associated with particular disease traits. In this Perspective, we review emerging data suggesting that most single nucleotide polymorphisms associated with immune-mediated diseases are found in regulatory regions of the DNA - parts of the genome that control expression of the protein encoding genes - rather than causing mutations in proteins. We discuss how the emerging understanding of particular gene regulatory regions, gene enhancers and the epigenetic mechanisms by which they are regulated is opening up new opportunities for the treatment of immune-mediated diseases, focusing particularly on the BET family of epigenetic reader proteins as potential therapeutic targets.

  18. Therapeutical Intervention, Relaxation, Mental Images, and Spirituality (RIME for Spiritual Pain in Terminal Patients. A Training Program

    Directory of Open Access Journals (Sweden)

    Ana Catarina de Araújo Elias

    2006-01-01

    Full Text Available Therapeutic intervention involving the technique of Relaxation, Mental Images, and Spirituality (RIME can foster the redefinition of spiritual pain in terminal patients. A training course was developed to instruct health care professionals in its use, and the results were followed up by evaluating reactions of professionals to its use in intervention with patients. Six subjects (a nurse, a doctor, three psychologists, and an alternative therapist, all skilled in palliative care, were invited to take part in the experience. They worked with 11 terminal patients in public hospitals of the cities of Campinas, Piracicaba, and São Paulo, located in Brazil. The theoretical basis for the study involves action research and phenomenology, and the results were analyzed using both qualitative and quantitative methods. The analysis of the experience of the professionals revealed 5 categories and 15 subcategories. The analysis of the nature of spiritual pain revealed 6 categories and 11 subcategories. The administration of RIME revealed statistically significant differences (p < 0.0001, i.e., patients reported a greater level of well-being at the end than at the beginning of sessions, which suggests that RIME led to the redefinition of spiritual pain for these terminal patients. The training program proposed has shown itself to be effective in preparing health care professionals for the use of RIME intervention.

  19. Leber congenital amaurosis/early-onset severe retinal dystrophy: clinical features, molecular genetics and therapeutic interventions.

    Science.gov (United States)

    Kumaran, Neruban; Moore, Anthony T; Weleber, Richard G; Michaelides, Michel

    2017-09-01

    Leber congenital amaurosis (LCA) and early-onset severe retinal dystrophy (EOSRD) are both genetically and phenotypically heterogeneous, and characterised clinically by severe congenital/early infancy visual loss, nystagmus, amaurotic pupils and markedly reduced/absent full-field electroretinograms. The vast genetic heterogeneity of inherited retinal disease has been established over the last 10 - 20 years, with disease-causing variants identified in 25 genes to date associated with LCA/EOSRD, accounting for 70-80% of cases, with thereby more genes yet to be identified. There is now far greater understanding of the structural and functional associations seen in the various LCA/EOSRD genotypes. Subsequent development/characterisation of LCA/EOSRD animal models has shed light on the underlying pathogenesis and allowed the demonstration of successful rescue with gene replacement therapy and pharmacological intervention in multiple models. These advancements have culminated in more than 12 completed, ongoing and anticipated phase I/II and phase III gene therapy and pharmacological human clinical trials. This review describes the clinical and genetic characteristics of LCA/EOSRD and the differential diagnoses to be considered. We discuss in further detail the diagnostic clinical features, pathophysiology, animal models and human treatment studies and trials, in the more common genetic subtypes and/or those closest to intervention. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Responsiveness of Various Exercise-Testing Protocols to Therapeutic Interventions in COPD

    Directory of Open Access Journals (Sweden)

    Benoit Borel

    2013-01-01

    Full Text Available Exercise intolerance is a key element in the pathophysiology and course of Chronic Obstructive Pulmonary Disease (COPD. As such, evaluating exercise tolerance has become an important part of the management of COPD. A wide variety of exercise-testing protocols is currently available, each protocol having its own strengths and weaknesses relative to their discriminative, methodological, and evaluative characteristics. This paper aims to review the responsiveness of several exercise-testing protocols used to evaluate the efficacy of pharmacological and nonpharmacological interventions to improve exercise tolerance in COPD. This will be done taking into account the minimally important difference, an important concept in the interpretation of the findings about responsiveness of exercise testing protocols. Among the currently available exercise-testing protocols (incremental, constant work rate, or self-paced, constant work rate exercise tests (cycle endurance test and endurance shuttle walking test emerge as the most responsive ones for detecting and quantifying changes in exercise capacity after an intervention in COPD.

  1. Therapeutic landscapes of home: Exploring Indigenous peoples' experiences of a Housing First intervention in Winnipeg.

    Science.gov (United States)

    Alaazi, Dominic A; Masuda, Jeffrey R; Evans, Joshua; Distasio, Jino

    2015-12-01

    In this paper, we explore Indigenous perspectives of culture, place, and health among participants in a landmark Canadian Housing First initiative: At Home/Chez Soi (AHCS) project. Implemented from 2009 to 2013 in Winnipeg and four other Canadian cities, AHCS was a multi-city randomized control trial that sought to test the effectiveness of Housing First as a model for addressing chronic homelessness among people living with mental illnesses. As Winnipeg's homeless population is over 70% Indigenous, significant efforts were made to accommodate the culturally specific health, spiritual, and lifestyle preferences of the project's Indigenous participants. While a daunting challenge from an intervention perspective, Winnipeg's experience also provides a unique opportunity to examine how Indigenous participants' experiences can inform improved housing and mental health policy in Canada. In our study, conducted independently from, but with endorsement of the AHCS project, we utilized a case study approach to explore the experiences of the project's Indigenous participants. Data were collected by means of in-depth qualitative interviews with Indigenous participants (N = 14) and key informant project staff and investigators (N = 6). Our exploratory work demonstrates that despite relative satisfaction with the AHCS intervention, Indigenous peoples' sense of place in the city remains largely disconnected from their housing experiences. We found that structural factors, particularly the shortage of affordable housing and systemic erasure of Indigeneity from the urban sociocultural and political landscape, have adversely impacted Indigenous peoples' sense of place and home. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Leber congenital amaurosis/early-onset severe retinal dystrophy: clinical features, molecular genetics and therapeutic interventions

    Science.gov (United States)

    Kumaran, Neruban; Moore, Anthony T; Weleber, Richard G; Michaelides, Michel

    2017-01-01

    Leber congenital amaurosis (LCA) and early-onset severe retinal dystrophy (EOSRD) are both genetically and phenotypically heterogeneous, and characterised clinically by severe congenital/early infancy visual loss, nystagmus, amaurotic pupils and markedly reduced/absent full-field electroretinograms. The vast genetic heterogeneity of inherited retinal disease has been established over the last 10 - 20 years, with disease-causing variants identified in 25 genes to date associated with LCA/EOSRD, accounting for 70–80% of cases, with thereby more genes yet to be identified. There is now far greater understanding of the structural and functional associations seen in the various LCA/EOSRD genotypes. Subsequent development/characterisation of LCA/EOSRD animal models has shed light on the underlying pathogenesis and allowed the demonstration of successful rescue with gene replacement therapy and pharmacological intervention in multiple models. These advancements have culminated in more than 12 completed, ongoing and anticipated phase I/II and phase III gene therapy and pharmacological human clinical trials. This review describes the clinical and genetic characteristics of LCA/EOSRD and the differential diagnoses to be considered. We discuss in further detail the diagnostic clinical features, pathophysiology, animal models and human treatment studies and trials, in the more common genetic subtypes and/or those closest to intervention. PMID:28689169

  3. Rationalizing Promiscuity Cliffs.

    Science.gov (United States)

    Dimova, Dilyana; Bajorath, Jürgen

    2017-10-11

    Compound promiscuity can be viewed in different ways. We distinguish "bad" promiscuity resulting from chemical liabilities, nonspecific binding, or assay artifacts, from "good" promiscuity representing true multitarget activities. Investigating multitarget activities of small molecules is scientifically stimulating and therapeutically relevant. To better understand the molecular basis of multitarget activities, structure-promiscuity relationships (SPRs) are explored. For this purpose, "promiscuity cliffs" (PCs) have been introduced, which can be rationalized as an extension of the activity cliff (AC) concept. A PC is defined as a pair of structural analogues that are active against different numbers of targets (given a difference threshold). As discussed herein PCs frequently capture surprising SPRs and encode many experimentally testable hypotheses. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. Rationality in Society

    NARCIS (Netherlands)

    Flache, Andreas; Dijkstra, Jacob; Wright, James D.

    2015-01-01

    Contemporary theories of rational behavior in human society augment the orthodox model of rationality both by adding various forms of bounded rationality and relaxing the assumptions of self-interest and materialistic preferences. This entry discusses how these extensions of the theory of rational

  5. Natural products against Alzheimer's disease: Pharmaco-therapeutics and biotechnological interventions.

    Science.gov (United States)

    Dey, Abhijit; Bhattacharya, Raktim; Mukherjee, Anuradha; Pandey, Devendra Kumar

    Alzheimer's disease (AD) is a severe, chronic and progressive neurodegenerative disease associated with memory and cognition impairment ultimately leading to death. It is the commonest reason of dementia in elderly populations mostly affecting beyond the age of 65. The pathogenesis is indicated by accumulation of the amyloid-beta (Aβ) plaques and neurofibrillary tangles (NFT) in brain tissues and hyperphosphorylation of tau protein in neurons. The main cause is considered to be the formation of reactive oxygen species (ROS) due to oxidative stress. The current treatment provides only symptomatic relief by offering temporary palliative therapy which declines the rate of cognitive impairment associated with AD. Inhibition of the enzyme acetylcholinesterase (AChE) is considered as one of the major therapeutic strategies offering only symptomatic relief and moderate disease-modifying effect. Other non-cholinergic therapeutic approaches include antioxidant and vitamin therapy, stem cell therapy, hormonal therapy, use of antihypertensive or lipid-lowering medications and selective phosphodiesterase (PDE) inhibitors, inhibition of β-secretase and γ-secretase and Aβ aggregation, inhibition of tau hyperphosphorylation and intracellular NFT, use of nonsteroidal anti-inflammatory drugs (NSAIDs), transition metal chelators, insulin resistance drugs, etanercept, brain-derived neurotrophic factor (BDNF) etc. Medicinal plants have been reported for possible anti-AD activity in a number of preclinical and clinical trials. Ethnobotany, being popular in China and in the Far East and possibly less emphasized in Europe, plays a substantial role in the discovery of anti-AD agents from botanicals. Chinese Material Medica (CMM) involving Chinese medicinal plants has been used traditionally in China in the treatment of AD. Ayurveda has already provided numerous lead compounds in drug discovery and many of these are also undergoing clinical investigations. A number of medicinal plants

  6. Brain functional domains inform therapeutic interventions in attention-deficit/hyperactivity disorder and pediatric bipolar disorder

    Science.gov (United States)

    Passarotti, Alessandra M; Pavuluri, Mani N

    2011-01-01

    A deeper understanding of how the relationships between impulsivity, reward systems and executive function deficits may be similar or different in attention-deficit/hyperactivity disorder (ADHD) and pediatric bipolar disorder (PBD) is fundamental for better defining phenotypy in these two developmental illnesses, and moving towards improved treatment and intervention. We focus our article on recent neurocognitive and neuroimaging data examining the behavioral and neural aspects of poor behavior regulation, response inhibition and reward systems in ADHD and PBD. In light of recent research evidence, we propose that the common behavioral manifestations of impulsivity in ADHD and PBD may indeed originate from different neural mechanisms mediated by altered reward systems. In order to define and differentiate these mechanisms, unlike previous approaches, our theoretical model examines the interface of the dorsal frontostriatal circuit, involved in behavior regulation, and the ventral frontostriatal circuit, which is involved in reward-related and affect processes. Preliminary evidence suggests that the neural systems involved in impulsivity, reward systems and executive function engage differently in the two illnesses. In PBD, `emotional impulsivity' is predominantly `bottom-up' and emotionally/motivationally driven, and stems from ventral frontostriatal circuitry dysfunction. By contrast, in ADHD `cognitive impulsivity' is predominantly `top-down' and more `cognitively driven', and stems from dorsal frontostriatal dysfunction. We discuss this evidence in view of clinically relevant questions and implications for illness-based intervention. We conclude that the reward-related mechanisms underlying the interactions between executive function, behavior regulation and impulsivity in PBD and ADHD may be differentially compromised, and in accordance differently shape the clinical symptoms of impulsivity and goal-directed behavior. PMID:21651336

  7. Influence of sympathetic autonomic arousal on tics: implications for a therapeutic behavioral intervention for Tourette syndrome.

    Science.gov (United States)

    Nagai, Yoko; Cavanna, Andrea; Critchley, Hugo D

    2009-12-01

    The pharmacological treatment of Tourette syndrome (TS) has improved due to the application of new medications and combinations of medications, coupled to greater phenomenological and neurobiological understanding of the condition. Nevertheless, for many individuals with TS, potentially troublesome tics persist despite optimized drug treatment. Anecdotally, a relationship is frequently described between tic frequency and states of bodily arousal and/or focused attention. The galvanic skin response (GSR) is an accessible and sensitive index of sympathetic nervous activity, reflecting centrally induced changes in peripheral autonomic arousal. Sympathetic nervous arousal, measured using GSR, has been shown to have an inverse relationship with an electroencephalographic index of cortical excitability (slow cortical potential), and GSR arousal biofeedback shows promise as an adjunctive therapy in management of treatment-resistant epilepsy. We examined how changes in sympathetic arousal, induced using GSR biofeedback, impact on tic frequency in individuals with TS. Two different physiological states (sympathetic arousal and relaxation) were induced using GSR biofeedback in 15 individuals with a diagnosis of TS. During both biofeedback sessions, participants were videotaped to monitor the occurrence of tics. We observed significantly lower tics during relaxation biofeedback compared to arousal biofeedback, with tic frequency positively correlating with sympathetic arousal during the arousal session. These findings indicate that the conjunction of focused attention to task and reduced peripheral sympathetic tone inhibits tic expression and suggests a potential therapeutic role of biofeedback relaxation training for tic management in patients with TS.

  8. HIV Capsid is a Tractable Target for Small Molecule Therapeutic Intervention

    Science.gov (United States)

    Irving, Stephen L.; Brown, David G.; Anderson, Marie; Bazin, Richard; Cao, Joan; Ciaramella, Giuseppe; Isaacson, Jason; Jackson, Lynn; Hunt, Rachael; Kjerrstrom, Anne; Nieman, James A.; Patick, Amy K.; Perros, Manos; Scott, Andrew D.; Whitby, Kevin; Wu, Hua; Butler, Scott L.

    2010-01-01

    Despite a high current standard of care in antiretroviral therapy for HIV, multidrug-resistant strains continue to emerge, underscoring the need for additional novel mechanism inhibitors that will offer expanded therapeutic options in the clinic. We report a new class of small molecule antiretroviral compounds that directly target HIV-1 capsid (CA) via a novel mechanism of action. The compounds exhibit potent antiviral activity against HIV-1 laboratory strains, clinical isolates, and HIV-2, and inhibit both early and late events in the viral replication cycle. We present mechanistic studies indicating that these early and late activities result from the compound affecting viral uncoating and assembly, respectively. We show that amino acid substitutions in the N-terminal domain of HIV-1 CA are sufficient to confer resistance to this class of compounds, identifying CA as the target in infected cells. A high-resolution co-crystal structure of the compound bound to HIV-1 CA reveals a novel binding pocket in the N-terminal domain of the protein. Our data demonstrate that broad-spectrum antiviral activity can be achieved by targeting this new binding site and reveal HIV CA as a tractable drug target for HIV therapy. PMID:21170360

  9. Targeting TRPV1 and TRPV2 for potential therapeutic interventions in cardiovascular disease.

    Science.gov (United States)

    Robbins, Nathan; Koch, Sheryl E; Rubinstein, Jack

    2013-06-01

    Cardiovascular disease is a leading cause of morbidity and mortality worldwide, encompassing a variety of cardiac and vascular conditions. Transient receptor potential vanilloid (TRPV) channels, specifically TRPV type 1 (TRPV1) and TRPV type 2 (TRPV2), are relatively recently described channels found throughout the body including within and around the cardiovascular system. They are activated by a variety of stimuli including high temperatures, stretch, and pharmacologic and endogenous ligands. The TRPV1 channel has been found to be an important player in the pathway of the detection of chest pain after myocardial injury. Activation of peripheral TRPV1 via painful stimuli or capsaicin has been shown to have cardioprotective effects, whereas genetic abrogation of TRPV1 results in increased myocardial damage after ischemia and reperfusion injury in comparison to wild-type mice. Furthermore, blood pressure changes have been noted upon TRPV1 stimulation. Similarly, the TRPV2 channel has also been associated with changes in blood pressure and cardiac function depending on how and where the channel is activated. Interestingly, overexpression of TRPV2 channels in the heart induces dystrophic cardiomyopathy; however, stimulation under physiologic conditions leads to improved cardiac function. Probenecid, a TRPV2 agonist, has been studied as a model therapy for its inotropic effects and potential use in the treatment of cardiomyopathy. In this review, we present an up to date account of the growing evidence that supports the study of TRPV1 and TRPV2 channels as targets for therapeutic agents of cardiovascular diseases. Published by Mosby, Inc.

  10. Calorie restriction: A new therapeutic intervention for age-related dry eye disease in rats

    Energy Technology Data Exchange (ETDEWEB)

    Kawashima, Motoko; Kawakita, Tetsuya; Okada, Naoko; Ogawa, Yoko [Department of Ophthalmology, Keio University School of Medicine, Tokyo (Japan); Murat, Dogru [Department of Ocular Surface and Visual Optics, Keio University School of Medicine, Tokyo (Japan); Nakamura, Shigeru; Nakashima, Hideo [Research Center, Ophtecs Corporation, Hyogo (Japan); Shimmura, Shigeto [Department of Ophthalmology, Keio University School of Medicine, Tokyo (Japan); Shinmura, Ken [Division of Geriatric Medicine, Department of Internal Medicine, Keio University School of Medicine, Tokyo (Japan); Tsubota, Kazuo, E-mail: tsubota@sc.itc.keio.ac.jp [Department of Ophthalmology, Keio University School of Medicine, Tokyo (Japan)

    2010-07-09

    A decrease in lacrimal gland secretory function is closely related to aging and leads to an increased prevalence of dry eye syndrome. Since calorie restriction (CR) is considered to prevent functional decline of various organs due to aging, we hypothesized that CR could prevent age-related lacrimal dysfunction. Six-month-old male Fischer 344 rats were randomly divided into ad libitum (AL) and CR (-35%) groups. After 6 months of CR, tear function was examined under conscious state. After euthanasia, lacrimal glands were subjected to histological examination, tear protein secretion stimulation test with Carbachol, and assessment of oxidative stress with 8-hydroxy-2 deoxyguanosine (8-OHdG) and 4-hydroxynonenal (HNE) antibodies. CR significantly improved tear volume and tended to increase tear protein secretion volume after stimulation with Carbachol compared to AL. The acinar unit density was significantly higher in the CR rats compared to AL rats. Lacrimal glands in the CR rats showed a lesser degree of interstitial fibrosis. CR reduced the concentration of 8-OHdG and the extent of staining with HNE in the lacrimal gland, compared to AL. Furthermore, our electron microscopic observations showed that mitochondrial structure of the lacrimal gland obtained from the middle-aged CR rats was preserved in comparison to the AL rats. Collectively, these results demonstrate for the first time that CR may attenuate oxidative stress related damage in the lacrimal gland with preservation of lacrimal gland functions. Although molecular mechanism(s) by which CR maintains lacrimal gland function remains to be resolved, CR might provide a novel therapeutic strategy for treating dry eye syndrome.

  11. The Domestic Cat as a Large Animal Model for Characterization of Disease and Therapeutic Intervention in Hereditary Retinal Blindness

    Directory of Open Access Journals (Sweden)

    Kristina Narfström

    2011-01-01

    Full Text Available Large mammals, including canids and felids, are affected by spontaneously occurring hereditary retinal diseases with similarities to those of humans. The large mammal models may be used for thorough clinical characterization of disease processes, understanding the effects of specific mutations, elucidation of disease mechanisms, and for development of therapeutic intervention. Two well-characterized feline models are addressed in this paper. The first model is the autosomal recessive, slowly progressive, late-onset, rod-cone degenerative disease caused by a mutation in the CEP290 gene. The second model addressed in this paper is the autosomal dominant early onset rod cone dysplasia, putatively caused by the mutation found in the CRX gene. Therapeutic trials have been performed mainly in the former type including stem cell therapy, retinal transplantation, and development of ocular prosthetics. Domestic cats, having large human-like eyes with comparable spontaneous retinal diseases, are also considered useful for gene replacement therapy, thus functioning as effective model systems for further research.

  12. Lymphedema prevalence and treatment benefits in cancer: impact of a therapeutic intervention on health outcomes and costs.

    Science.gov (United States)

    Brayton, Kimberly M; Hirsch, Alan T; O Brien, Patricia J; Cheville, Andrea; Karaca-Mandic, Pinar; Rockson, Stanley G

    2014-01-01

    Lymphedema is a common complication of cancer therapeutics; its prevalence, treatment outcomes, and costs have been poorly defined. The objective of this study was to examine lymphedema prevalence among cancer survivors and to characterize changes in clinical outcomes and costs associated with a defined therapeutic intervention (use of a pneumatic compression devices [PCD]) in a representative, privately insured population. Retrospective analysis of de-identified health claims data from a large national insurer for calendar years 2007 through 2013. Patients were required to have 12 months of continuous insurance coverage prior to PCD receipt (baseline), as well as a 12-month follow-up period. Analyses were performed for individuals with cancer-related lymphedema (n = 1,065). Lymphedema prevalence was calculated: number of patients with a lymphedema claim in a calendar year divided by total number of enrollees. The impact of PCD use was evaluated by comparing rates of a pre-specified set of health outcomes and costs for the 12 months before and after, respectively, PCD receipt. Lymphedema prevalence among cancer survivors increased from 0.95% in 2007 to 1.24% in 2013. PCD use was associated with decreases in rates of hospitalizations (45% to 32%, pLymphedema is a prevalent medical condition that is often a defining attribute of cancer survivorship. The problem is associated with high health care costs; Treatment (in this instance, use of PCD) is associated with significant decreases in adverse clinical outcomes and costs.

  13. Theatre Is a Valid Add-On Therapeutic Intervention for Emotional Rehabilitation of Parkinson's Disease Patients.

    Science.gov (United States)

    Mirabella, Giovanni; De Vita, Paolo; Fragola, Michele; Rampelli, Silvia; Lena, Francesco; Dilettuso, Fulvia; Iacopini, Marta; d'Avella, Raffaella; Borgese, Maria Concetta; Mazzotta, Silvia; Lanni, Deborah; Grano, Marco; Lubrani, Sara; Modugno, Nicola

    2017-01-01

    Conventional medical treatments of Parkinson's disease (PD) are effective on motor disturbances but may have little impact on nonmotor symptoms, especially psychiatric ones. Thus, even when motor symptomatology improves, patients might experience deterioration in their quality of life. We have shown that 3 years of active theatre is a valid complementary intervention for PD as it significantly improves the well-being of patients in comparison to patients undergoing conventional physiotherapy. Our aim was to replicate these findings while improving the efficacy of the treatment. We ran a single-blinded pilot study lasting 15 months on 24 subjects with moderate idiopathic PD. 12 were assigned to a theatre program in which patients underwent "emotional" training. The other 12 underwent group physiotherapy. Patients were evaluated at the beginning and at the end of their treatments, using a battery of eight clinical and five neuropsychological scales. We found that the emotional theatre training improved the emotional well-being of patients, whereas physiotherapy did not. Interestingly, neither of the groups showed improvements in either motor symptoms or cognitive abilities tested by the neuropsychological battery. We confirmed that theatre therapy might be helpful in improving emotional well-being in PD.

  14. Therapeutic Effect of Endovascular Intervention in Arterial Occlusion by Acute Thrombi

    Energy Technology Data Exchange (ETDEWEB)

    La, Dong Il; Kwak, Hyo Sung; Han, Young Min [Chonbuk National University, Jeonju (Korea, Republic of)

    2009-01-15

    To evaluate the efficacy of the intra-arterial treatment of patients with arterial occlusion by acute thrombus. This retrospective study was performed on 44 patients (28 men; 16 women; mean age -66.6 years; range 32-88 years) seen between January 1, 1999 and July 21, 2006, at the Chonbuk National University Hospital and clinically suspected and angiographically proven to have arterial thrombus. The mean symptom duration was 13.8 days (range; 0-31 days) and the treatment methods included IAUK thrombolysis, catheter aspiration thrombectomy, PTA, and stent insertion. The initial success rate for the different treatment methods was 93%. The success rate of the thrombolysis alone and the combined thrombectomy were 16% and 23%, respectively. Thirty-four patients had remnant stenosis following a thrmobolysis and thrombectomy. As a result, 27 patients were treated with PTA at a 30% success rate. Another 6 patients were treated by stent insertion without PTA at a 100% success rate. Stent insertion adjunct to PTA was successful in 89% of cases. The primary patency rates for 3, 6, and 12 months after treatment were 93%, 89%, and 89%, respectively. The secondary patency rates for 3, 6, and 12 months after treatment were 100%, 100% and, 100%, respectively. Our study suggests that the treatment methods including the intervention of the thrombolysis, thrombus removal, angioplasty, and stent insertion for an acute thrombotic arterial occlusion (single or combined), would all be helpful depending on the status of the disease.

  15. Young adults' use of food as a self-therapeutic intervention.

    Science.gov (United States)

    Von Essen, Elisabeth; Mårtensson, Fredrika

    2014-01-01

    The aim of this study was to investigate how young adults use their lived body as a starting point for lifestyle explorations and as a strategy for well-being. The transcripts of 10 interviews with persons 18 to 33 years old, collected in Sweden, were analysed for variation in the practises and experiences related to this way of using food. An application of the descriptive phenomenological psychological research method guided the process. The young adults were: (1) listening to the body; (2) moderating conditions and feelings; (3) developing vitality and resilience; (4) creating mindful space for rest, and (5) participating in creative activity. The results show how young adults perceive their choice of food and related practises associated with positive feelings and experiences as ways to promote well-being and mitigate different problems in life. The usefulness of knowledge about how young adults try to use food for self-therapy by enhancing mind-body awareness is discussed in relation to health issues and food-related interventions.

  16. Yoga and Mindfulness as Therapeutic Interventions for Stroke Rehabilitation: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Asimina Lazaridou

    2013-01-01

    Full Text Available Aim. This paper reports a systematic review and critical appraisal of the evidence on the effectiveness of behavioral therapies such as yoga and mindfulness practices for stroke rehabilitation. Background. The experience of stroke can have a negative impact on both psychological and physical health and on quality of life. Yoga and relevant practices are promising therapies that have been used with patients with a variety of conditions. In order to draw conclusions on effectiveness for stroke patients, the evidence requires systematic assessment. Methods. A comprehensive search of major biomedical and complementary medicine databases was conducted. Relevant research was categorized by study type and appraised according to study design. Results. Five randomized controlled clinical trials and four single case studies were found. Additionally, one qualitative research study was identified. Studies reported positive results, including improvements in cognition, mood, and balance and reductions in stress. Modifications to different yoga practices make comparison between studies difficult, and a lack of controlled studies precludes any firm conclusions on efficacy. Conclusion. Yoga and mindfulness could be clinically valuable self-administered intervention options for stroke rehabilitation. Further research is needed to evaluate these specific practices and their suitability in stroke rehabilitation.

  17. Young adults’ use of food as a self-therapeutic intervention

    Directory of Open Access Journals (Sweden)

    Elisabeth Von Essen

    2014-04-01

    Full Text Available The aim of this study was to investigate how young adults use their lived body as a starting point for lifestyle explorations and as a strategy for well-being. The transcripts of 10 interviews with persons 18 to 33 years old, collected in Sweden, were analysed for variation in the practises and experiences related to this way of using food. An application of the descriptive phenomenological psychological research method guided the process. The young adults were: (1 listening to the body; (2 moderating conditions and feelings; (3 developing vitality and resilience; (4 creating mindful space for rest, and (5 participating in creative activity. The results show how young adults perceive their choice of food and related practises associated with positive feelings and experiences as ways to promote well-being and mitigate different problems in life. The usefulness of knowledge about how young adults try to use food for self-therapy by enhancing mind-body awareness is discussed in relation to health issues and food-related interventions.

  18. The Immunologic Basis for Severe Neonatal Herpes Disease and Potential Strategies for Therapeutic Intervention

    Directory of Open Access Journals (Sweden)

    Soren Gantt

    2013-01-01

    Full Text Available Herpes simplex viruses types 1 and 2 (HSV-1 and HSV-2 infect a large proportion of the world’s population. Infection is life-long and can cause periodic mucocutaneous symptoms, but it only rarely causes life-threatening disease among immunocompetent children and adults. However, when HSV infection occurs during the neonatal period, viral replication is poorly controlled and a large proportion of infants die or develop disability even with optimal antiviral therapy. Increasingly, specific differences are being elucidated between the immune system of newborns and those of older children and adults, which predispose to severe infections and reflect the transition from fetal to postnatal life. Studies in healthy individuals of different ages, individuals with primary or acquired immunodeficiencies, and animal models have contributed to our understanding of the mechanisms that control HSV infection and how these may be impaired during the neonatal period. This paper outlines our current understanding of innate and adaptive immunity to HSV infection, immunologic differences in early infancy that may account for the manifestations of neonatal HSV infection, and the potential of interventions to augment neonatal immune protection against HSV disease.

  19. The immunologic basis for severe neonatal herpes disease and potential strategies for therapeutic intervention.

    Science.gov (United States)

    Gantt, Soren; Muller, William J

    2013-01-01

    Herpes simplex viruses types 1 and 2 (HSV-1 and HSV-2) infect a large proportion of the world's population. Infection is life-long and can cause periodic mucocutaneous symptoms, but it only rarely causes life-threatening disease among immunocompetent children and adults. However, when HSV infection occurs during the neonatal period, viral replication is poorly controlled and a large proportion of infants die or develop disability even with optimal antiviral therapy. Increasingly, specific differences are being elucidated between the immune system of newborns and those of older children and adults, which predispose to severe infections and reflect the transition from fetal to postnatal life. Studies in healthy individuals of different ages, individuals with primary or acquired immunodeficiencies, and animal models have contributed to our understanding of the mechanisms that control HSV infection and how these may be impaired during the neonatal period. This paper outlines our current understanding of innate and adaptive immunity to HSV infection, immunologic differences in early infancy that may account for the manifestations of neonatal HSV infection, and the potential of interventions to augment neonatal immune protection against HSV disease.

  20. Identification of potential cytokine pathways for therapeutic intervention in murine primary biliary cirrhosis.

    Directory of Open Access Journals (Sweden)

    Kazuhito Kawata

    Full Text Available Primary biliary cirrhosis (PBC is considered a model autoimmune disease, with the most highly directed and specific autoantibody in both murine and human autoimmunity, the anti-mitochondrial autoantibody (AMA. However, therapeutic advances in this disease have lagged behind. Herein we have taken advantage of our unique model of murine PBC in which mice immunized with 2-octynoic acid coupled to BSA (2OA-BSA, a compound identified by quantitative structure activity relationships (QSAR of human AMA binding, develop an intense inflammatory cholangitis with striking similarities to humans with PBC. In particular, we have constructed several unique gene-deleted mice, including mice deleted of IL-12p40, IL-12p35, IFN-γ, IL-23p19, IL-17A, IL-17F and IL-22, immunized these animals with 2OA-BSA and followed the natural history of immunopathology to identify key pathways that might provide clues for successful therapy. Our data indicate that whereas both IL-12/Th1 and IL-23/Th17 are involved in cholangitis, it is the IL-12/Th1 signaling pathway that elicits pathology. In fact, deletion of IFN-γ prevents disease and suppresses autoantibodies. Importantly, deletion of the Th17 cytokines IL-17A and IL-22, but not IL-17F, reduces biliary damage; IL-17A-knockout mice have reduced levels of anti-mitochondrial antibody. We further demonstrate that the production of IFN-γ is significantly decreased in the liver of IL-23p19(-/-, IL-17A(-/- and IL-22(-/- mice compared with controls. However, the ability of T cells to produce IFN-γ was not affected in Th17 cytokine-deficient mice. Our data indicate that a deficient Th17 pathway suppresses the accumulation of IFN-γ producing cells in liver during the early phase of cholangitis. In conclusion, whereas IFN-γ has a pivotal role in the early events involved in the pathogenesis of autoimmune cholangitis induced by 2OA-BSA, the IL-23/Th17 pathway potentiates the effects of IL-12/IFN-γ-mediated immunopathology.

  1. The Increasing Complexity of the Oncofetal H19 Gene Locus: Functional Dissection and Therapeutic Intervention

    Directory of Open Access Journals (Sweden)

    Abraham Hochberg

    2013-02-01

    Full Text Available The field of the long non-coding RNA (lncRNA is advancing rapidly. Currently, it is one of the most popular fields in the biological and medical sciences. It is becoming increasingly obvious that the majority of the human transcriptome has little or no-protein coding capacity. Historically, H19 was the first imprinted non-coding RNA (ncRNA transcript identified, and the H19/IGF2 locus has served as a paradigm for the study of genomic imprinting since its discovery. In recent years, we have extensively investigated the expression of the H19 gene in a number of human cancers and explored the role of H19 RNA in tumor development. Here, we discuss recently published data from our group and others that provide further support for a central role of H19 RNA in the process of tumorigenesis. Furthermore, we focus on major transcriptional modulators of the H19 gene and discuss them in the context of the tumor-promoting activity of the H19 RNA. Based on the pivotal role of the H19 gene in human cancers, we have developed a DNA-based therapeutic approach for the treatment of cancers that have upregulated levels of H19 expression. This approach uses a diphtheria toxin A (DTA protein expressed under the regulation of the H19 promoter to treat tumors with significant expression of H19 RNA. In this review, we discuss the treatment of four cancer indications in human subjects using this approach, which is currently under development. This represents perhaps one of the very few examples of an existing DNA-based therapy centered on an lncRNA system. Apart from cancer, H19 expression has been reported also in other conditions, syndromes and diseases, where deregulated imprinting at the H19 locus was obvious in some cases and will be summarized below. Moreover, the H19 locus proved to be much more complicated than initially thought. It houses a genomic sequence that can transcribe, yielding various transcriptional outputs, both in sense and antisense directions. The

  2. Modulation of heat shock transcription factor 1 as a therapeutic target for small molecule intervention in neurodegenerative disease.

    Directory of Open Access Journals (Sweden)

    Daniel W Neef

    2010-01-01

    Full Text Available Neurodegenerative diseases such as Huntington disease are devastating disorders with no therapeutic approaches to ameliorate the underlying protein misfolding defect inherent to poly-glutamine (polyQ proteins. Given the mounting evidence that elevated levels of protein chaperones suppress polyQ protein misfolding, the master regulator of protein chaperone gene transcription, HSF1, is an attractive target for small molecule intervention. We describe a humanized yeast-based high-throughput screen to identify small molecule activators of human HSF1. This screen is insensitive to previously characterized activators of the heat shock response that have undesirable proteotoxic activity or that inhibit Hsp90, the central chaperone for cellular signaling and proliferation. A molecule identified in this screen, HSF1A, is structurally distinct from other characterized small molecule human HSF1 activators, activates HSF1 in mammalian and fly cells, elevates protein chaperone expression, ameliorates protein misfolding and cell death in polyQ-expressing neuronal precursor cells and protects against cytotoxicity in a fly model of polyQ-mediated neurodegeneration. In addition, we show that HSF1A interacts with components of the TRiC/CCT complex, suggesting a potentially novel regulatory role for this complex in modulating HSF1 activity. These studies describe a novel approach for the identification of new classes of pharmacological interventions for protein misfolding that underlies devastating neurodegenerative disease.

  3. Yoga as a Therapeutic Intervention: A Bibliometric Analysis of Published Research Studies from 1967 to 2013

    Science.gov (United States)

    Slutsky, Jeremiah; Singh, Nilkamal; Khalsa, Sat Bir S.

    2015-01-01

    Abstract Objective: A comprehensive bibliometric analysis was conducted on publications for yoga therapy research in clinical populations. Methods: Major electronic databases were searched for articles in all languages published between 1967 and 2013. Databases included PubMed, PsychInfo, MEDLINE, IndMed, Indian Citation Index, Index Medicus for South-East Asia Region, Web of Knowledge, Embase, EBSCO, and Google Scholar. Nonindexed journals were searched manually. Key search words included yoga, yoga therapy, pranayama, asana. All studies met the definition of a clinical trial. All styles of yoga were included. The authors extracted the data. Results: A total of 486 articles met the inclusion criteria and were published in 217 different peer-reviewed journals from 29 different countries on 28,080 study participants. The primary result observed is the three-fold increase in number of publications seen in the last 10 years, inclusive of all study designs. Overall, 45% of the studies published were randomized controlled trials, 18% were controlled studies, and 37% were uncontrolled studies. Most publications originated from India (n=258), followed by the United States (n=122) and Canada (n=13). The top three disorders addressed by yoga interventions were mental health, cardiovascular disease, and respiratory disease. Conclusion: A surge in publications on yoga to mitigate disease-related symptoms in clinical populations has occurred despite challenges facing the field of yoga research, which include standardization and limitations in funding, time, and resources. The population at large has observed a parallel surge in the use of yoga outside of clinical practice. The use of yoga as a complementary therapy in clinical practice may lead to health benefits beyond traditional treatment alone; however, to effect changes in health care policy, more high-quality, evidence-based research is needed. PMID:26196166

  4. Yoga as a Therapeutic Intervention: A Bibliometric Analysis of Published Research Studies from 1967 to 2013.

    Science.gov (United States)

    Jeter, Pamela E; Slutsky, Jeremiah; Singh, Nilkamal; Khalsa, Sat Bir S

    2015-10-01

    A comprehensive bibliometric analysis was conducted on publications for yoga therapy research in clinical populations. Major electronic databases were searched for articles in all languages published between 1967 and 2013. Databases included PubMed, PsychInfo, MEDLINE, IndMed, Indian Citation Index, Index Medicus for South-East Asia Region, Web of Knowledge, Embase, EBSCO, and Google Scholar. Nonindexed journals were searched manually. Key search words included yoga, yoga therapy, pranayama, asana. All studies met the definition of a clinical trial. All styles of yoga were included. The authors extracted the data. A total of 486 articles met the inclusion criteria and were published in 217 different peer-reviewed journals from 29 different countries on 28,080 study participants. The primary result observed is the three-fold increase in number of publications seen in the last 10 years, inclusive of all study designs. Overall, 45% of the studies published were randomized controlled trials, 18% were controlled studies, and 37% were uncontrolled studies. Most publications originated from India (n=258), followed by the United States (n=122) and Canada (n=13). The top three disorders addressed by yoga interventions were mental health, cardiovascular disease, and respiratory disease. A surge in publications on yoga to mitigate disease-related symptoms in clinical populations has occurred despite challenges facing the field of yoga research, which include standardization and limitations in funding, time, and resources. The population at large has observed a parallel surge in the use of yoga outside of clinical practice. The use of yoga as a complementary therapy in clinical practice may lead to health benefits beyond traditional treatment alone; however, to effect changes in health care policy, more high-quality, evidence-based research is needed.

  5. Application of adapted tango as therapeutic intervention for patients with chronic stroke.

    Science.gov (United States)

    Hackney, Madeleine E; Hall, Courtney D; Echt, Katharina V; Wolf, Steven L

    2012-01-01

    Dance has demonstrated beneficial effects on mobility in older individuals with movement disorders; yet, effects of partnered dance remain unexamined in individuals with chronic stroke. The purpose of this study was to describe the effects of adapted tango classes on balance, mobility, gait, endurance, dual-task ability, quality of life (QOL), and enjoyment in an older individual with chronic stroke and visual impairment. D.L. was a 73-year-old African American man, 13 years poststroke with spastic hemiplegia, visual impairment, and multiple comorbidities. D.L. attended 20 1?-hour tango classes adapted for older individuals with sensory and motor impairments over 11 weeks. Measures of balance, mobility, gait, endurance, dual-task ability, and QOL were evaluated before and after the intervention and at 1-month follow-up. D.L. improved on the Berg Balance Scale, 30-s chair stand, Timed Up and Go (single, manual, and cognitive conditions), 6-minute walk test, and backward gait speed. Not all measures improved: balance confidence decreased, and there was no change in forward and fast gait speed or QOL, as measured by the short form-12 and the visual function questionnaire-25. Some gains were maintained at one-month follow-up. D.L. reported enjoying the classes, noted improvement in physical well-being, and wanted to continue the program. Thirty hours of adapted tango lessons improved balance, mobility, endurance, and dual-task ability in a participant with chronic stroke. The participant enjoyed the classes, was adherent, and wished to continue. This is the first reported use of adapted tango dance as rehabilitation for an individual with chronic stroke and low vision.

  6. Therapeutic intervention for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jeffrey M Cohen

    Full Text Available BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS has been treated with several different interventions with limited success. This meta-analysis aims to review all trials reporting on therapeutic intervention for CP/CPPS using the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI. METHODS: We searched Medline, PubMed, the Cochrane Pain, Palliative & Supportive Care Trials, the Cochrane Register of Controlled Trials, CINAHL, ClinicalTrials.gov, and the NIDDK website between 1947 and December 31, 2011 without language or study type restrictions. All RCTs for CP/CPPS lasting at least 6 weeks, with a minimum of 10 participants per arm, and using the NIH-CPSI score, the criterion standard for CP/CPPS, as an outcome measure were included. Data was extracted from each study by two independent reviewers. Gillbraith and I-squared plots were used for heterogeneity testing and Eggers and Peters methods for publication bias. Quality was assessed using a component approach and meta-regression was used to analyze sources of heterogeneity. RESULTS: Mepartricin, percutaneous tibial nerve stimulation (PTNS, and triple therapy comprised of doxazosin + ibuprofen + thiocolchicoside (DIT resulted in clinically and statistically significant reduction in NIH-CPSI total score. The same agents and aerobic exercise resulted in clinically and statistically significant NIH-CPSI pain domain score reduction. Acupuncture, DIT, and PTNS were found to produce statistically and clinically significant reductions in the NIH-CPSI voiding domain. A statistically significant placebo effect was found for all outcomes and time analysis showed that efficacy of all treatments increased over time. Alpha-blockers, antibiotics, and combinations of the two failed to show statistically or clinically significant NIH-CPSI reductions. CONCLUSION: Results from this meta-analysis reflect our current inability to effectively manage CP/CPPS. Clinicians and

  7. Lymphedema prevalence and treatment benefits in cancer: impact of a therapeutic intervention on health outcomes and costs.

    Directory of Open Access Journals (Sweden)

    Kimberly M Brayton

    Full Text Available Lymphedema is a common complication of cancer therapeutics; its prevalence, treatment outcomes, and costs have been poorly defined. The objective of this study was to examine lymphedema prevalence among cancer survivors and to characterize changes in clinical outcomes and costs associated with a defined therapeutic intervention (use of a pneumatic compression devices [PCD] in a representative, privately insured population.Retrospective analysis of de-identified health claims data from a large national insurer for calendar years 2007 through 2013. Patients were required to have 12 months of continuous insurance coverage prior to PCD receipt (baseline, as well as a 12-month follow-up period. Analyses were performed for individuals with cancer-related lymphedema (n = 1,065. Lymphedema prevalence was calculated: number of patients with a lymphedema claim in a calendar year divided by total number of enrollees. The impact of PCD use was evaluated by comparing rates of a pre-specified set of health outcomes and costs for the 12 months before and after, respectively, PCD receipt. Lymphedema prevalence among cancer survivors increased from 0.95% in 2007 to 1.24% in 2013. PCD use was associated with decreases in rates of hospitalizations (45% to 32%, p<0.0001, outpatient hospital visits (95% to 90%, p<0.0001, cellulitis diagnoses (28% to 22%, p = 0.003, and physical therapy use (50% to 41%, p<0.0001. The average baseline health care costs were high ($53,422 but decreased in the year after PCD acquisition (-$11,833, p<0.0001.Lymphedema is a prevalent medical condition that is often a defining attribute of cancer survivorship. The problem is associated with high health care costs; Treatment (in this instance, use of PCD is associated with significant decreases in adverse clinical outcomes and costs.

  8. Evaluation of disease and viral biomarkers as triggers for therapeutic intervention in respiratory mousepox - an animal model of smallpox.

    Science.gov (United States)

    Parker, Scott; Chen, Nanhai G; Foster, Scott; Hartzler, Hollyce; Hembrador, Ed; Hruby, Dennis; Jordan, Robert; Lanier, Randall; Painter, George; Painter, Wesley; Sagartz, John E; Schriewer, Jill; Mark Buller, R

    2012-04-01

    The human population is currently faced with the potential use of natural or recombinant variola and monkeypox viruses as biological weapons. Furthermore, the emergence of human monkeypox in Africa and its expanding environs poses a significant natural threat. Such occurrences would require therapeutic and prophylactic intervention with antivirals to minimize morbidity and mortality of exposed populations. Two orally-bioavailable antivirals are currently in clinical trials; namely CMX001, an ether-lipid analog of cidofovir with activity at the DNA replication stage and ST-246, a novel viral egress inhibitor. Both of these drugs have previously been evaluated in the ectromelia/mousepox system; however, the trigger for intervention was not linked to a disease biomarker or a specific marker of virus replication. In this study we used lethal, intranasal, ectromelia virus infections of C57BL/6 and hairless SKH1 mice to model human disease and evaluate exanthematous rash (rash) as an indicator to initiate antiviral treatment. We show that significant protection can be provided to C57BL/6 mice by CMX001 or ST-246 when therapy is initiated on day 6 post infection or earlier. We also show that significant protection can be provided to SKH1 mice treated with CMX001 at day 3 post infection or earlier, but this is four or more days before detection of rash (ST-246 not tested). Although in this model rash could not be used as a treatment trigger, viral DNA was detected in blood by day 4 post infection and in the oropharyngeal secretions (saliva) by day 2-3 post infection - thus providing robust and specific markers of virus replication for therapy initiation. These findings are discussed in the context of current respiratory challenge animal models in use for the evaluation of poxvirus antivirals. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Therapeutic interventions for gut dysbiosis and related disorders in the elderly: antibiotics, probiotics or faecal microbiota transplantation?

    Science.gov (United States)

    Vemuri, R C; Gundamaraju, R; Shinde, T; Eri, R

    2017-04-26

    Ageing and physiological functions of the human body are inversely proportional to each other. The gut microbiota and host immune system co-evolve from infants to the elderly. Ageing is accompanied by a decline in gut microbial diversity, immunity and metabolism, which increases susceptibility to infections. Any compositional change in the gut is directly linked to gastrointestinal disorders, obesity and metabolic diseases. Increase in opportunistic pathogen invasion in the gut like Clostridium difficile leading to C. difficile infection is more common in the elderly population. Frequent hospitalisation and high prevalence of nosocomial infections with the ageing is also well documented. Long-term utilisation of broad-spectrum antibiotic therapy is being followed in order to control these infections. Nosocomial infections and antibiotic therapy in combination or alone is leading to gastroenteritis followed by Clostridium associated diarrhoea or antibiotic associated diarrhoea. Above all, use of broad-spectrum antibiotics is highly debated all over the world due to growing antimicrobial resistance. The use of narrow spectrum antibiotics could be helpful to some extent. Dietary supplementation of probiotics with prebiotics (synbiotics) or without prebiotics has improved gut commensal diversity and regulated the immune system. The recent emergence of faecal microbiota transplantation has played an important role in treating recurrent Clostridium associated diarrhoea. This review focuses on various therapeutic interventions for gut dysbiosis and gastrointestinal diseases in the elderly. The possible mechanism for antimicrobial resistance and mechanism of action of probiotics are also discussed in detail.

  10. Geroprotectors.org: a new, structured and curated database of current therapeutic interventions in aging and age-related disease.

    Science.gov (United States)

    Moskalev, Alexey; Chernyagina, Elizaveta; de Magalhães, João Pedro; Barardo, Diogo; Thoppil, Harikrishnan; Shaposhnikov, Mikhail; Budovsky, Arie; Fraifeld, Vadim E; Garazha, Andrew; Tsvetkov, Vasily; Bronovitsky, Evgeny; Bogomolov, Vladislav; Scerbacov, Alexei; Kuryan, Oleg; Gurinovich, Roman; Jellen, Leslie C; Kennedy, Brian; Mamoshina, Polina; Dobrovolskaya, Evgeniya; Aliper, Alex; Kaminsky, Dmitry; Zhavoronkov, Alex

    2015-09-01

    As the level of interest in aging research increases, there is a growing number of geroprotectors, or therapeutic interventions that aim to extend the healthy lifespan and repair or reduce aging-related damage in model organisms and, eventually, in humans. There is a clear need for a manually-curated database of geroprotectors to compile and index their effects on aging and age-related diseases and link these effects to relevant studies and multiple biochemical and drug databases. Here, we introduce the first such resource, Geroprotectors (http://geroprotectors.org). Geroprotectors is a public, rapidly explorable database that catalogs over 250 experiments involving over 200 known or candidate geroprotectors that extend lifespan in model organisms. Each compound has a comprehensive profile complete with biochemistry, mechanisms, and lifespan effects in various model organisms, along with information ranging from chemical structure, side effects, and toxicity to FDA drug status. These are presented in a visually intuitive, efficient framework fit for casual browsing or in-depth research alike. Data are linked to the source studies or databases, providing quick and convenient access to original data. The Geroprotectors database facilitates cross-study, cross-organism, and cross-discipline analysis and saves countless hours of inefficient literature and web searching. Geroprotectors is a one-stop, knowledge-sharing, time-saving resource for researchers seeking healthy aging solutions.

  11. Timing of therapeutic intervention determines functional and survival outcomes in a mouse model of late infantile batten disease.

    Science.gov (United States)

    Cabrera-Salazar, Mario A; Roskelley, Eric M; Bu, Jie; Hodges, Bradley L; Yew, Nelson; Dodge, James C; Shihabuddin, Lamya S; Sohar, Istvan; Sleat, David E; Scheule, Ronald K; Davidson, Beverly L; Cheng, Seng H; Lobel, Peter; Passini, Marco A

    2007-10-01

    Classical late infantile neuronal ceroid lipofuscinosis (cLINCL) is a monogenic disorder caused by the loss of tripeptidyl peptidase 1 (TPP1) activity as a result of mutations in CLN2. Absence of TPP1 results in lysosomal storage with an accompanying axonal degeneration throughout the central nervous system (CNS), which leads to progressive neurodegeneration and early death. In this study, we compared the efficacies of pre- and post-symptomatic injections of recombinant adeno-associated virus (AAV) for treating the cellular and functional abnormalities of CLN2 mutant mice. Intracranial injection of AAV1-hCLN2 resulted in widespread human TPP1 (hTPP1) activity in the brain that was 10-100-fold above wild-type levels. Injections before disease onset prevented storage and spared neurons from axonal degeneration, reflected by the preservation of motor function. Furthermore, the majority of CLN2 mutant mice treated pre-symptomatically lived for at least 330 days, compared with a median survival of 151 days in untreated CLN2 mutant controls. In contrast, although injection after disease onset ameliorated lysosomal storage, there was evidence of axonal degeneration, motor function showed limited recovery, and the animals had a median lifespan of 216 days. These data illustrate the importance of early intervention for enhanced therapeutic benefit, which may provide guidance in designing novel treatment strategies for cLINCL patients.

  12. Determinants of Actor Rationality

    DEFF Research Database (Denmark)

    Ellegaard, Chris

    Industrial companies must exercise influence on their suppliers (or supplier actors). Actor rationality is a central theme connected to this management task. In this article, relevant literature is studied with the purpose of shedding light on determinants of actor rationality. Two buyer......-supplier relations are investigated in a multiple case study, leading to the proposal of various additional factors that determine and shape actor rationality. Moreover a conceptual model of rationality determinants in the buyer-supplier relation is proposed, a model that may help supply managers analyse...... and understand actor rationalities. Finally managerial implications are discussed....

  13. A versão simplificada do Therapeutic Intervention Scoring System e seu valor prognóstico La versión simplificada del Therapeutic Intervention Scoring System y su valor pronóstico The simplified version of Therapeutic Intervention Scoring System and its prognostic value

    Directory of Open Access Journals (Sweden)

    Maria Cláudia Moreira da Silva

    2004-06-01

    Full Text Available O estudo avalia a capacidade do Therapeutic Intervention Scoring System (TISS-28 de discriminar pacientes internados em UTI, prováveis de morrer daqueles possíveis de sobreviver e estabelecer a pontuação limiar para alta probabilidade de morte. Os resultados, obtidos da amostra de 200 pacientes internados em 14 UTIs do Município de São Paulo, mostraram que o TISS-28 apresentou associação com mortalidade (p=0,0001. O ponto de corte estabelecido foi 21. Encontrou-se que 80,88% dos que morreram tinham pontuação do TISS-28 maior ou igual, e 68,18% dos sobreviventes tinham pontuação menor que 21. Além disso, quanto ao valor prognóstico do TISS-28, constatou-se acurácia de 0,72.El estudio evalúa la capacidad del Therapeutic Intervention Scoring System (TISS-28 para discriminar pacientes internados en UCI, probables de morir de aquellos posibles de sobrevivir y establecer la puntuación límite para la alta probabilidad de muerte. Los resultados, obtenidos de la muestra de 200 pacientes internados en 14 UCIs del Municipio de São Paulo, mostraron que el TISS-28 presentó asociación con la mortalidad (p=0,0001. El punto de corte establecido fue 21. Se encontró que el 80.88% de los que murieron tenían puntuación del TISS-28 mayor o igual, y 68.18% de los sobrevivientes tenían puntuación menor que 21. Además de eso, en cuanto al valor pronóstico del TISS-28, se constató exactitud de 0.72.The study evaluates the competence of the "TISS-28" to distinguish inpatients at the ICU, between the ones likely to die from the ones likely to survive and to establish a threshold score for high likelihood to death. The findings obtained by the sample of 200 inpatients at 14 ICUs in Sao Paulo County showed that the TISS-28 presented association with mortality (p=0.0001. The cutting score established was 21. It was found that 80.88% of those who died had the TISS-28 score similar or higher and 68.18% of survivors had the score below 21

  14. Application of Rational Restructuring to Anxiety Disorders.

    Science.gov (United States)

    Goldfried, Marvin R.

    1988-01-01

    Outlines theoretical assumptions and research base for rational restructuring, cognitive-behavioral intervention procedure for reducing certain anxiety-related disorders, such as various forms of social-evaluative anxiety (social anxiety, unassertiveness, public speaking, test anxiety). Describes intervention procedures within consultation session…

  15. Driving While Impaired (DWI) Intervention Service Provider Orientations: The Scales of the DWI Therapeutic Educator Inventory (DTEI)

    Science.gov (United States)

    DeMuro, Scott; Wanberg, Kenneth; Anderson, Rachel

    2011-01-01

    The therapeutic educator who provides services to driving while impaired (DWI) offenders is a unique professional hybrid, combining education and therapeutic service delivery. In an effort to understand and address this service provider, a 69-item DWI Therapeutic Educator Inventory (DTEI) was constructed. Using principal components and common…

  16. Rational emotive behaviour therapy in high schools to educate in mental health and empower youth health. A randomized controlled study of a brief intervention.

    Science.gov (United States)

    Sælid, Gry Anette; Nordahl, Hans M

    2017-04-01

    Rational emotive behaviour therapy (REBT) is effective in reducing distress in several target groups. No other study has tested the mental health effects on adolescents in a high school setting while expanding a Cognitive Behaviour-based therapy, REBT, into the concept of mental health literacy. The format of the ABC model, which is an important element of REBT, functioned as a working manual in and between three sessions. This study tested whether knowledge and practical use of the ABC model increased self-esteem and hope, and reduced symptoms of anxiety and depression, and dysfunctional thinking. Sixty-two high school students with subclinical levels of anxiety and depression were randomly allocated into three groups; three individual REBT sessions, or three individual attentional placebo (ATP) sessions or no sessions (control). However, dysfunctional thinking, self-esteem and hope were not measured in the control group. Repeated measures with ANOVA and t-tests were conducted. Both REBT and ATP significantly reduced symptoms of anxiety and depression, but only REBT was significantly different from the control group at the six-month follow-up. Only REBT significantly reduced dysfunctional thinking, and both REBT and ATP significantly increased self-esteem and hope. REBT had both an immediate and a long-term effect. The findings show the potential positive effects of educating well-documented psychological techniques as ordinary education in school. Further research might contribute to decide whether or not to change the school system by enclosing mental health literacy classes for all students.

  17. Persistent frequent attenders in primary care: costs, reasons for attendance, organisation of care and potential for cognitive behavioural therapeutic intervention

    Directory of Open Access Journals (Sweden)

    Morriss Richard

    2012-07-01

    Full Text Available Abstract Background The top 3% of frequent attendance in primary care is associated with 15% of all appointments in primary care, a fivefold increase in hospital expenditure, and more mental disorder and functional somatic symptoms compared to normal attendance. Although often temporary if these rates of attendance last more than two years, they may become persistent (persistent frequent or regular attendance. However, there is no long-term study of the economic impact or clinical characteristics of regular attendance in primary care. Cognitive behaviour formulation and treatment (CBT for regular attendance as a motivated behaviour may offer an understanding of the development, maintenance and treatment of regular attendance in the context of their health problems, cognitive processes and social context. Methods/design A case control design will compare the clinical characteristics, patterns of health care use and economic costs over the last 10 years of 100 regular attenders (≥30 appointments with general practitioner [GP] over 2 years with 100 normal attenders (6–22 appointments with GP over 2 years, from purposefully selected primary care practices with differing organisation of care and patient demographics. Qualitative interviews with regular attending patients and practice staff will explore patient barriers, drivers and experiences of consultation, and organisation of care by practices with its challenges. Cognitive behaviour formulation analysed thematically will explore the development, maintenance and therapeutic opportunities for management in regular attenders. The feasibility, acceptability and utility of CBT for regular attendance will be examined. Discussion The health care costs, clinical needs, patient motivation for consultation and organisation of care for persistent frequent or regular attendance in primary care will be explored to develop training and policies for service providers. CBT for regular attendance will

  18. Rational Expectations in Games

    OpenAIRE

    Robert J. Aumann; Jacques H. Dreze

    2008-01-01

    A player i's actions in a game are determined by her beliefs about other players; these depend on the game's real-life context, not only its formal description. Define a game situation as a game together with such beliefs; call the beliefs— and i's resulting expectation—rational if there is common knowledge of rationality and a common prior. In two-person zero-sum games, i's only rational expectation is the game’s value. In an arbitrary game G, we characterize i's rational expectations in ter...

  19. Rationalizing Boundedly Rational Choice : Sequential Rationalizability and Rational Shortlist Methods

    OpenAIRE

    Manzini, Paola; Mariotti, Marco

    2004-01-01

    A sequentially rationalizable choice function is a choice function which can be obtained by applying sequentially a fixed set of asymmetric binary relations (rationales). A Rational ShortlistMethod (RSM) is a choice function which is sequentially rationalizable by two rationales. These concepts translate into economic language some human choice heuristics studied in psychology. We provide a full characterization of RSMs and study some properties of sequential rationalizability. These properti...

  20. Improvement in anthropometric parameters after rational dietary intervention in women with Polycystic Ovary Syndrom as the best method to support treatment

    Science.gov (United States)

    Szczuko, Małgorzata; Malarczyk, Inez; Zapałowska-Chwyć, Marta

    Polycystic ovary syndrome (PCOS) is a disorder often occurring in women at reproductive age. An important factor in PCOS pathogenesis is insulin resistance, which pronounces hyperandrogenism and leads to the development of various metabolic disorders The aim of this study is to determine the effect of reduction diet with low glycemic index (GI) on anthropometric parameters of women with PCOS and the assessment of the effectiveness of the diet on body mass and adipose tissue reduction The study was performed on 24 women with PCOS diagnosed with Rotterdam’s criteria. Anthropometric measurements and bioelectrical impedance were performed. All participants received 7-day diet and recommendations relating to the change in lifestyle. After three months of using the dietary recommendations the measurements were repeated Statistical significance was observed for body mass (↓on average by 5.93 kg±2.95), BMI (↓2.14 kg/m2±1.2), circumference of: waist (↓7.7 cm±5.9), hip (↓4.8 cm±5.4), arm (↓1.9 cm±3.7) and measurements of skin fold under the shoulder blade (↓4.8 mm±4,6), above iliac crest (↓6.76 mm±5.7) and above triceps brachii muscle (↓5.25 mm±7.4). Considering body composition measurements, statistically significant were differences in the measurements of BCMI (↑18.042±8.8), TBW expressed in percentage (↑2.729±2.75) and in litres (↑0.071±5.15), FM in percentage (↓3.291±5.6) and in kg (3.354 kg±4.9) Body mass reduction using a rational diet with low GI is an effective method to support of PCOS treatment. Using reduction diet for three months together with increased physical activity enables to reduce body weight by on average 5.93 kg, which increases the chances to treat infertility in women. This should be the suggested type of diet in PCOS treatment

  1. Comparison of Estimates between Cohort and Case-Control Studies in Meta-Analyses of Therapeutic Interventions: A Meta-Epidemiological Study.

    Science.gov (United States)

    Lanza, Amy; Ravaud, Philippe; Riveros, Carolina; Dechartres, Agnes

    2016-01-01

    Observational studies are increasingly being used for assessing therapeutic interventions. Case-control studies are generally considered to have greater risk of bias than cohort studies, but we lack evidence of differences in effect estimates between the 2 study types. We aimed to compare estimates between cohort and case-control studies in meta-analyses of observational studies of therapeutic interventions by using a meta-epidemiological study. We used a random sample of meta-analyses of therapeutic interventions published in 2013 that included both cohort and case-control studies assessing a binary outcome. For each meta-analysis, the ratio of estimates (RE) was calculated by comparing the estimate in case-control studies to that in cohort studies. Then, we used random-effects meta-analysis to estimate a combined RE across meta-analyses. An RE studies yielded larger estimates than cohort studies. The final analysis included 23 meta-analyses: 138 cohort and 133 case-control studies. Treatment effect estimates did not significantly differ between case-control and cohort studies (combined RE 0.97 [95% CI 0.86-1.09]). Heterogeneity was low, with between-meta-analysis variance τ2 = 0.0049. Estimates did not differ between case-control and prospective or retrospective cohort studies (RE = 1.05 [95% CI 0.96-1.15] and RE = 0.99 [95% CI, 0.83-1.19], respectively). Sensitivity analysis of studies reporting adjusted estimates also revealed no significant difference (RE = 1.03 [95% CI 0.91-1.16]). Heterogeneity was also low for these analyses. We found no significant difference in treatment effect estimates between case-control and cohort studies assessing therapeutic interventions.

  2. A Rational Expectations Experiment.

    Science.gov (United States)

    Peterson, Norris A.

    1990-01-01

    Presents a simple classroom simulation of the Lucas supply curve mechanism with rational expectations. Concludes that the exercise has proved very useful as an introduction to the concepts of rational and adaptive expectations, the Lucas supply curve, the natural rate hypothesis, and random supply shocks. (DB)

  3. Enculturated Chimpanzees Imitate Rationally

    Science.gov (United States)

    Buttelmann, David; Carpenter, Malinda; Call, Josep; Tomasello, Michael

    2007-01-01

    Human infants imitate others' actions "rationally": they copy a demonstrator's action when that action is freely chosen, but less when it is forced by some constraint (Gergely, Bekkering & Kiraly, 2002). We investigated whether enculturated chimpanzees (Pan troglodytes) also imitate rationally. Using Gergely and colleagues' (2002) basic procedure,…

  4. Defending psychiatry or defending the trivial effects of therapeutic interventions? A citation content analysis of an influential paper.

    Science.gov (United States)

    Cristea, I A; Naudet, F

    2017-11-29

    about antidepressants, 18 (15%) about antipsychotics. Forty (33%) of the citing papers included data. COIs were reported in 55 papers (46%). Univariate and multivariate regressions showed an association between a quote justifying small or modest effects and the point that treatment effectiveness in psychiatry closely resembles that in general medicine. Our evaluation revealed an overwhelmingly uncritical reception and seemed to indicate that beyond defending psychiatry as a discipline, the paper by Leucht et al. served to lend support and credibility to a therapeutic myth: trivial effects of mental health interventions, most often drugs, are to be expected and therefore accepted. Protocol registration: https://osf.io/9dqat/.

  5. Two Concepts of Rationality

    Directory of Open Access Journals (Sweden)

    Danny Frederick

    2010-02-01

    Full Text Available The dominant tradition in Western philosophy sees rationality as dictating. Thus rationality may require that we believe the best explanation and simple conceptual truths and that we infer in accordance with evident rules of inference. I argue that, given what we know about the growth of knowledge, this authoritarian concept of rationality leads to absurdities and should be abandoned. I then outline a libertarian concept of rationality, derived from Popper, which eschews the dictates and which sees a rational agent as one who questions, criticises, conjectures and experiments. I argue that, while the libertarian approach escapes the absurdities of the authoritarian, it requires two significant developments and an important clarification to be made fully consistent with itself.

  6. Irrational Rationality of Terrorism

    Directory of Open Access Journals (Sweden)

    Robert Nalbandov

    2013-12-01

    Full Text Available The present article deals with the ontological problem of applying the rational choice frameworks to the study of terrorism. It testing the application of the rational choice to the “old” (before the end of the Cold War and the “new” (after the end of the Cold War terrorisms. It starts with analyzing the fundamentals of rationality and applies it at two levels: the individual (actors and group (collective via two outlooks: tactical (short-term and strategic (long-term. The main argument of the article is that while the “old” terrorism can be explained by the rational choice theory its “new” version represents a substantial departure from rationality.

  7. What interventions facilitate client progress through the assimilation model? A task analysis of interventions in the psychodynamic treatment of depression.

    Science.gov (United States)

    Meystre, Claudia; Pascual-Leone, Antonio; de Roten, Yves; Despland, Jean-Nicolas; Kramer, Ueli

    2015-01-01

    A variation of task analysis was used to build an empirical model of how therapists may facilitate client assimilation process, described in the Assimilation of Problematic Experiences Scale. A rational model was specified and considered in light of an analysis of therapist in-session performances (N = 117) drawn from six inpatient therapies for depression. The therapist interventions were measured by the Comprehensive Psychotherapeutic Interventions Rating Scale. Consistent with the rational model, confronting interventions were particularly useful in helping clients elaborate insight. However, rather than there being a small number of progress-related interventions at lower levels of assimilation, therapists' use of interventions was broader than hypothesized and drew from a wide range of therapeutic approaches. Concerning the higher levels of assimilation, there was insufficient data to allow an analysis of the therapist's progress-related interventions.

  8. Rational Prescribing in Primary care (RaPP: process evaluation of an intervention to improve prescribing of antihypertensive and cholesterol-lowering drugs

    Directory of Open Access Journals (Sweden)

    Oxman Andrew D

    2006-08-01

    Full Text Available Abstract Background A randomised trial of a multifaceted intervention for improving adherence to clinical practice guidelines for the pharmacological management of hypertension and hypercholesterolemia increased prescribing of thiazides, butdetected no impact onthe use of cardiovascular risk assessment toolsor achievement of treatment targets. We carried out a predominantly quantitative process evaluation to help explain and interpret the trial-findings. Methods Several data-sources were used including: questionnaires completed by pharmacists immediately after educational outreach visits, semi-structured interviews with physicians subjected to the intervention, and data extracted from their electronic medical records. Multivariate regression analyses were conducted to explore the association between possible explanatory variables and the observed variation across practices for the three main outcomes. Results The attendance rate during the educational sessions in each practice was high; few problems were reported, and the physicians were perceived as being largely supportive of the recommendations we promoted, except for some scepticism regarding the use of thiazides as first-line antihypertensive medication. Multivariate regression models could explain only a small part of the observed variation across practices and across trial-outcomes, and key factors that might explain the observed variation in adherence to the recommendations across practices were not identified. Conclusion This study did not provide compelling explanations for the trial results. Possible reasons for this include a lack of statistical power and failure to include potential explanatory variables in our analyses, particularly organisational factors. More use of qualitative research methods in the course of the trial could have improved our understanding.

  9. Improved rational hydrograph method

    Science.gov (United States)

    Crobeddu, E.; Bennis, S.; Rhouzlane, S.

    2007-05-01

    SummaryThis paper presents an improved rational hydrograph method to compute the runoff at the outlet of a small urban catchment. The new formulation, based on the linear system theory, explicitly considers the contributions of pervious and impervious areas, the time variability of rainfall, the initial abstraction on impervious areas and the infiltration on pervious areas. Moreover, the rational method formula appears to be a special case of the proposed rational hydrograph method. A sensitivity analysis conducted on the improved rational hydrograph method has emphasized the most influent parameters. A sequential procedure is proposed to calibrate parameters of the improved rational hydrograph method on the basis of appropriate storm events. The improved rational hydrograph method was applied to 41 rainfall events gauged in 7 different North American and European urban catchments. Runoff computed with the improved rational hydrograph method was compared to measured runoff, as well as to the runoff derived from the nonlinear reservoir model. A good agreement was achieved between simulated and observed runoff hydrographs. Moreover, runoff hydrographs derived with the proposed method are equivalent to those computed with the nonlinear reservoir model.

  10. Review of Therapeutic Interventions for the Upper Limb Classified by Manual Ability in Children with Cerebral Palsy.

    Science.gov (United States)

    Shierk, Angela; Lake, Amy; Haas, Tara

    2016-02-01

    The aim of this literature review was to assemble an inventory of intervention strategies utilized for children diagnosed with cerebral palsy (CP) based on the Manual Ability Classification System (MACS). The purpose of the inventory is to guide physicians and therapists in intervention selection aimed at improving upper limb function in children with CP. The following databases were searched: CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Database of Systematic Reviews, ERIC (Educational Research Information Center), Google Scholar, OTSeeker (Occupational Therapy Systematic Evaluation of Evidence), OVID (Ovid Technologies, Inc.), and PubMed. Inclusion criteria were whether the study (1) identified MACS levels of participants, and (2) addressed the effectiveness of intervention on upper limb function. Overall, 74 articles met the inclusion criteria. The summarized data identified 10 categories of intervention. The majority of participants across studies were MACS level II. The most frequently cited interventions were constraint-induced movement therapy (CIMT), bimanual training, and virtual reality and computer-based training. Multiple interventions demonstrated effectiveness for upper limb improvement at each MACS level. However, there is a need for additional research for interventions appropriate for MACS levels IV and V. To fully develop an intervention inventory based on manual ability, future studies need to report MACS levels of participants, particularly for splinting and therapy interventions used in combination with surgery.

  11. Exploring rationality in schizophrenia

    DEFF Research Database (Denmark)

    Revsbech, Rasmus; Mortensen, Erik Lykke; Owen, Gareth

    2015-01-01

    Background Empirical studies of rationality (syllogisms) in patients with schizophrenia have obtained different results. One study found that patients reason more logically if the syllogism is presented through an unusual content. Aims To explore syllogism-based rationality in schizophrenia. Method...... Thirty-eight first-admitted patients with schizophrenia and 38 healthy controls solved 29 syllogisms that varied in presentation content (ordinary v. unusual) and validity (valid v. invalid). Statistical tests were made of unadjusted and adjusted group differences in models adjusting for intelligence...... differences became non-significant. Conclusions When taking intelligence and neuropsychological performance into account, patients with schizophrenia and controls perform similarly on syllogism tests of rationality....

  12. Intervenções terapêuticas em Unidade de Terapia Intensiva: análise segundo o Therapeutic Intervention Scoring System-28 (TISS-28 Intervenciones terapéuticas en Unidad de Cuidados Intensivos: análisis según el Therapeutic Intervention Scoring System-28 (TISS-28 Therapeutic interventions in Intensive Care Units: analysis according to Therapeutic Intervention Scoring System-28 (TISS-28

    Directory of Open Access Journals (Sweden)

    Paulo Carlos Garcia

    2005-04-01

    Full Text Available O presente estudo teve como objetivos descrever a prevalência diária das categorias de intervenções terapêuticas e identificar a prevalência dos itens componentes de cada categoria de intervenções terapêuticas, segundo o TISS-28. A amostra incluiu 89 admissões consecutivas na UTI geral de um Hospital Universitário do município de São Paulo. Das 7 categorias do TISS-28, houve prevalência na pontuação das categorias Atividades Básicas e Suportes Ventilatório, Cardiovascular e Renal, com freqüência entre 73,0% e 100,0%. A freqüência dos itens componentes da categoria Atividades Básicas foi maior do que 90,0%. O sub-iten medida quantitativa do débito urinário foi pontuado em 98,2% na categoria Suporte Renal. Os resultados obtidos podem imprimir qualidade a assistência prestada aos clientes, na medida em que contribuem para a previsão de recursos humanos e materiais na UTI.El presente estudio tuvo como objectivos, identificar las categorías de intervenciones terapéuticas realizadas en la Unidad de Cuidados Intensivos (UCI y describir la prevalencia diaria de las mismas e identificar los items que la conforman, según el TISS-28. La muestra estuvo constituida por 89 pacientes adultos admitidos consecutivamente en la UCI de un hospital universitario de la municipalidad de São Paulo. Se verificó que las categorías TISS-28 que prevalecieron fueron Actividades Básicas y Soportes Ventilatorio, Cardiovascular y Renal con frecuencias entre 73,0% y 100%. La frecuencia de los ítems componentes de la categoría Actividades Básicas fue prevaliente, ou sea, mayor que el 90,0%. La medida cuantitativa del débito urinario fue puntuado en 98,2% en la categoría Soporte Renal. Los resultados obtenidos pueden imprimir calidad a la asistencia prestada a los clientes, en la medida en que contribuyen a la previsión de recursos humanos y materiales en la UCI.The present study aimed to identify the therapeutic interventions categories

  13. Crab Rationalization Permit Program

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Crab Rationalization Program (Program) allocates BSAI crab resources among harvesters, processors, and coastal communities. The North Pacific Fishery Management...

  14. Evidence for Therapeutic Patient Education Interventions to Promote Cardiovascular Patient Self-Management: A Scientific Statement for Healthcare Professionals From the American Heart Association.

    Science.gov (United States)

    Barnason, Susan; White-Williams, Connie; Rossi, Laura P; Centeno, Mae; Crabbe, Deborah L; Lee, Kyoung Suk; McCabe, Nancy; Nauser, Julie; Schulz, Paula; Stamp, Kelly; Wood, Kathryn

    2017-06-01

    The burden of cardiovascular disease as a chronic illness increasingly requires patients to assume more responsibility for their self-management. Patient education is believed to be an essential component of cardiovascular care; however, there is limited evidence about specific therapeutic patient education approaches used and the impact on patient self-management outcomes. An integrative review of the literature was conducted to critically analyze published research studies of therapeutic patient education for self-management in selected cardiovascular conditions. There was variability in methodological approaches across settings and disease conditions. The most effective interventions were tailored to individual patient needs, used multiple components to improve self-management outcomes, and often used multidisciplinary approaches. This synthesis of evidence expands the base of knowledge related to the development of patient self-management skills and provides direction for more rigorous research. Recommendations are provided to guide the implementation of therapeutic patient education in clinical practice and the design of comprehensive self-management interventions to improve outcomes for cardiovascular patients. © 2017 American Heart Association, Inc.

  15. Pharmacotherapy & Surgical Interventions Available for Obesity Management and Importance of Pancreatic Lipase Inhibitory Phytomolecules as Safer Anti-Obesity Therapeutics.

    Science.gov (United States)

    Sukhdev, Singh; Bhupender, Sharma; Singh, Kanwar Shamsher

    2017-01-01

    The humans worldwide are facing obesity as a major clinical threat because it is linked with cardiovascular diseases which often have serious consequences. Treatments available for body weight loss do not produce permanent weight loss and they often bear some side effects. To achieve safer antiobesetic therapeutics, researchers are moving towards plant-based therapeutic formulations. Many phytomolecules have been identified as anti-lipolytic functions but none of them have reached up to the clinical level. So there is an essential need to develop effective anti-obesetic medications which not only produce sufficient weight loss but also lack side effects. Plants may prove promising option for the same. In this article, medications and surgical procedures have been reviewed and dealt for weight loss and the role of phytomolecules in anti-obesetic therapeutics has been explored.

  16. Could participant-produced photography augment therapeutic interventions for people with intellectual disabilities? A systematic review of the available evidence.

    Science.gov (United States)

    Boulton, Natalie E; Williams, Jonathan; Jones, Robert Sp

    2016-01-01

    People with intellectual disabilities are entitled to equitable access to psychological support. Traditional therapeutic approaches often rely on a person's ability to verbally articulate a description of their life, which can be particularly difficult for emotionally salient information. A systematic literature review was undertaken to determine the evidence base underpinning the use of participant-produced photography within therapeutic settings. Evidence across a range of specialisms was examined in order to extrapolate areas of best practice and make recommendations for its implementation alongside people with intellectual disabilities. A systematic search of peer-reviewed journals identified 13 relevant documents. Participant-produced photography showed promise, although evidence pertaining specifically to people with intellectual disabilities was sparse ( n = 2). Participant-produced photography within therapeutic settings shows promise for people with intellectual disabilities. Methodological limitations made it difficult to derive firm conclusions regarding the effectiveness of different approaches. Implications for clinical and research practice are discussed.

  17. A Systematic Review of Electronic Mindfulness-Based Therapeutic Interventions for Weight, Weight-Related Behaviors, and Psychological Stress.

    Science.gov (United States)

    Lyzwinski, Lynnette Nathalie; Caffery, Liam; Bambling, Matthew; Edirippulige, Sisira

    2017-09-08

    Recent research indicates that mindfulness-based interventions are effective for stress, maladaptive weight-related behaviors, and weight loss. Little is presently known about their applicability and effectiveness when delivered electronically, including through Web-based and mobile device media. The primary aims of this review were to identify what types of electronic mindfulness-based interventions have been undertaken for stress, maladaptive weight-related behaviors, and weight loss, and to assess their overall effectiveness. A systematic search of PubMed (MEDLINE), Embase, CINAHL, and Web of Science databases was undertaken in June 2016. A total of 21 studies were identified that met inclusion criteria and were selected in the final review. Of these, 19 were mindfulness-based interventions for stress reduction. Two were Web-based mindful eating/intuitive eating interventions for weight. Only one electronic mindfulness-based study was identified that targeted both stress and maladaptive weight-related behaviors. Most electronic interventions were effective for stress reduction N = 14/19 (74%). There were insufficient electronic mindfulness-based interventions for weight to determine if they were effective or not. Additionally, no mobile mindfulness-based intervention was identified for weight or weight-related behaviors. Electronic mindfulness-based interventions through diverse media appear to be effective for stress reduction. More studies are needed that target weight and weight-related behaviors as well as studies that target both stress and weight. More randomized controlled trials (RCTs) that assess mobile mindfulness-based apps are needed as we only identified four app trials for stress. Mobile mindfulness-based interventions for weight and weight-related behaviors are a future area of research novelty.

  18. Therapeutic Alliance and Treatment Adherence in Two Interventions for Bulimia Nervosa: A Study of Process and Outcome

    Science.gov (United States)

    Loeb, Katharine L.; Wilson, G. Terence; Labouvie, Erich; Pratt, Elizabeth M.; Hayaki, Jumi; Walsh, B. Timothy; Agras, W. Stewart; Fairburn, Christopher G.

    2005-01-01

    The relationship between therapeutic alliance, therapist adherence to treatment protocol, and outcome was analyzed in a randomized trial of cognitive-behavioral therapy (CBT) and interpersonal psychotherapy for bulimia nervosa. Independent observers rated audiotapes of full-length therapy sessions. Purging frequency was the primary outcome…

  19. The relevance of applying exercise training principles when designing therapeutic interventions for patients with inflammatory myopathies: a systematic review.

    Science.gov (United States)

    Baschung Pfister, Pierrette; de Bruin, Eling D; Tobler-Ammann, Bernadette C; Maurer, Britta; Knols, Ruud H

    2015-10-01

    Physical exercise seems to be a safe and effective intervention in patients with inflammatory myopathy (IM). However, the optimal training intervention is not clear. To achieve an optimum training effect, physical exercise training principles must be considered and to replicate research findings, FITT components (frequency, intensity, time, and type) of exercise training should be reported. This review aims to evaluate exercise interventions in studies with IM patients in relation to (1) the application of principles of exercise training, (2) the reporting of FITT components, (3) the adherence of participants to the intervention, and (4) to assess the methodological quality of the included studies. The literature was searched for exercise studies in IM patients. Data were extracted to evaluate the application of the training principles, the reporting of and the adherence to the exercise prescription. The Downs and Black checklist was used to assess methodological quality of the included studies. From the 14 included studies, four focused on resistance, two on endurance, and eight on combined training. In terms of principles of exercise training, 93 % reported specificity, 50 % progression and overload, and 79 % initial values. Reversibility and diminishing returns were never reported. Six articles reported all FITT components in the prescription of the training though no study described adherence to all of these components. Incomplete application of the exercise training principles and insufficient reporting of the exercise intervention prescribed and completed hamper the reproducibility of the intervention and the ability to determine the optimal dose of exercise.

  20. Lower Extremity Injury Patterns in Elite Ballet Dancers: Ultrasound/MRI Imaging Features and an Institutional Overview of Therapeutic Ultrasound Guided Percutaneous Interventions.

    Science.gov (United States)

    Rehmani, Razia; Endo, Yoshimi; Bauman, Phillip; Hamilton, William; Potter, Hollis; Adler, Ronald

    2015-10-01

    Altered biomechanics from repetitive microtrauma, such as long practice hours in en pointe (tip of the toes) or demi pointe (balls of the feet) predispose ballet dancers to a multitude of musculoskeletal pathologies particularly in the lower extremities. Both ultrasound and magnetic resonance imaging (MRI) are radiation-sparing modalities which can be used to confidently evaluate these injuries, with ultrasound (US) offering the added utility of therapeutic intervention at the same time in experienced hands. The purposes of this paper were: (1) to illustrate the US and MRI features of lower extremity injury patterns in ballet dancers, focusing on pathologies commonly encountered at a single orthopedic hospital; (2) to present complementary roles of both ultrasound and MRI in the evaluation of these injuries whenever possible; (3) to review and present our institutional approach towards therapeutic ultrasound-guided interventions by presenting explicit cases. Online searches were performed using the search criteria of "ballet biomechanics" and "ballet injuries." The results were then further narrowed down by limiting articles published in the past 15 years, modality (US and MRI), anatomical region (foot and ankle, hip and knee) and to major radiology, orthopedics, and sports medicine journals. Performing ballet poses major stress to lower extremities and predisposes dancer to several musculoskeletal injuries. These can be adequately evaluated by both US and MRI. US is useful for evaluating superficial structures such as soft tissues, tendons, and ligaments, particularly in the foot and ankle. MRI provides superior resolution of deeper structures such as joints, bone marrow, and cartilage. In addition, US can be used as a therapeutic tool for providing quick symptomatic improvement in these athletes for who "time is money". Performing ballet may cause major stress to the lower extremities, predominantly affecting the foot and ankle, followed by the knee and hip. US

  1. The Effects of Rational Emotive Education on Locus of Control, Rationality and Anxiety in Primary School Children.

    Science.gov (United States)

    Rosenbaum, Tova; And Others

    1991-01-01

    A study examined the effects of rationale emotive psychoeducational procedures on aspects of mental health with 22 Australian fourth grade girls and 14 control subjects who received an attention control intervention. Rational emotive education increased perceptions of internal locus of control and rationality but did not reduce trait anxiety.…

  2. Standby Gasoline Rationing Plan. Contingency gasoline rationing regulations

    Energy Technology Data Exchange (ETDEWEB)

    1979-02-01

    The Economic Regulatory Administration issues final rules with respect to standby gasoline rationing. The plan is designed for and would be used only in the event of a severe gasoline shortage. The plan provides that eligibility for ration allotments will be primarily on the basis of motor vehicle registrations. DOE will mail government ration checks to the parties named in a national vehicle registration file to be maintained by DOE. Ration recipients may cash these checks for ration coupons at various designated coupon issuance points. Retail outlets and other suppliers will be required to redeem the ration coupons received in exchange for gasoline sold. Supplemental gas will be given to high-priority activities. A ration banking system will be established with two separate and distinct of ration accounts: retail outlets and other suppliers will open redemption accounts for the deposit of redeemed ration rights; and individuals or firms may open ration rights accounts, which will operate in much the same manner as monetary checking accounts. A white market will be permitted for the sale of transfer of ration rights. A percentage of the total ration rights to be issued will be reserved for distribution to the states as a State Ration Reserve, to be used by the states primarily for the relief of hardship. A National Ration Reserave will also be established. All sections of the Standby Gasoline Rationing Regulations are analyzed. (MCW)

  3. A Research Synthesis of Therapeutic Interventions for Whiplash-Associated Disorder (WAD: Part 5 – Surgical and Injection-Based Interventions for Chronic WAD

    Directory of Open Access Journals (Sweden)

    Robert W Teasell

    2010-01-01

    Full Text Available Whiplash-associated disorder (WAD represents a significant public health problem, resulting in substantial social and economic costs throughout the industrialized world. While many treatments have been advocated for patients with WAD, scientific support regarding their effectiveness is often lacking. A systematic review was conducted to evaluate the strength of evidence associated with various WAD therapies. Multiple databases (including Web of Science, EMBASE and PubMed were searched to identify all studies published from January 1980 through March 2009 that evaluated the effectiveness of any well-defined treatment for acute (less than two weeks, subacute (two to 12 weeks or chronic (more than 12 weeks WAD. The present article, the fifth in a five-part series, evaluates the evidence for surgical and injection-based interventions initiated during the chronic phase of WAD. Twenty-five studies were identified that met the inclusion criteria, six of which were randomized controlled trials with ‘good’ overall methodological quality (median Physiotherapy Evidence Database score of 7.5. For the treatment of chronic WAD, there was moderate evidence supporting radiofrequency neurotomy as an effective treatment for whiplash-related pain, although relief is not permanent. Sterile water injections have been demonstrated to be superior to saline injections; however, it is not clear whether this treatment is actually beneficial. There was evidence supporting a wide range of other interventions (eg, carpal tunnel decompression with each of these evaluated by a single nonrandomized controlled trial. There is contradictory evidence regarding the effectiveness of botulinum toxin injections, and cervical discectomy and fusion. The evidence is not yet strong enough to establish the effectiveness of any of these treatments; of all the invasive interventions for chronic WAD, radiofrequency neurotomy appears to be supported by the strongest evidence. Further

  4. Educational and organizational interventions to improve the usefulness of clinical pharmacological advice for personalized drug dosing based on therapeutic drug monitoring.

    Science.gov (United States)

    Pea, Federico; Dose, Lucia; Cojutti, Piergiorgio; Baraldo, Massimo; Fontana, Fabrizio; Favaretti, Carlo; Furlanut, Mario

    2014-11-01

    This study was aimed at increasing the clinical usefulness of clinical pharmacological advice (CPA) for personalized drug dosing based on therapeutic drug monitoring (TDM). Educational and organizational interventions focused on improving the knowledge of clinical pharmacology among hospital healthcare workers and reducing the incidence of errors throughout the process were planned. After a pre-interventional period of risk assessment, different list forms of the types of error occurring in the various phases of the process (Phase 1, request for CPA and blood sampling for TDM; Phase 2, sample delivery to and check in at the CPU; Phase 3, TDM execution and CPA production) were created. In the interventional period, the errors were collected daily and educational programmes were carried out. The pre-intervention error rate was 19.5%, and resulted significantly higher for the requests coming from the medical wards compared with those from the surgical wards or the ICUs (26.0% versus 10.5% versus 13.7%, p < 0.001). The educational programme trained 303 nurses and 145 physicians. Afterwards, the error percentage progressively dropped (15.5% in the 2nd trimester; 12.3% in the 3rd one; 10.5% in the 4th one). The adopted strategy resulted in significant improvements which may be useful both to improve quality of patient care and to reduce waste in healthcare costs. © 2014 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  5. [Rational use of antibiotics].

    Science.gov (United States)

    Walger, P

    2016-06-01

    International and national campaigns draw attention worldwide to the rational use of the available antibiotics. This has been stimulated by the high prevalence rates of drug-resistant pathogens, such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), a threatening spread of development of resistance in Gram-negative rod-shaped bacteria and the selection of Clostridium difficile with a simultaneous clear reduction in the development of new antibiotics. The implementation of antibiotic stewardship programs aims to maintain their effectiveness by a rational use of the available antibiotics. The essential target of therapy with antibiotics is successful treatment of individual patients with bacterial infections. The optimal clinical treatment results can only be achieved when the toxicity, selection of pathogens and development of resistance are minimized. This article presents the principles of a rational antibiotic therapy.

  6. Extending rational maps

    Science.gov (United States)

    Martin, Gaven J.

    We investigate when a rational endomorphism of the Riemann sphere overline{C} extends to a mapping of the upper half-space {H3 which is rational with respect to some measurable conformal structure. Such an extension has the property that it and all its iterates have uniformly bounded distortion. Such maps are called uniformly quasiregular. We show that, in the space of rational mappings of degree d , such an extension is possible in the structurally stable component where there is a single (attracting) component of the Fatou set and the Julia set is a Cantor set. We show that generally outside of this set no such extension is possible. In particular, polynomials can never admit such an extension.

  7. Training Genetic Counsellors to Deliver an Innovative Therapeutic Intervention: their Views and Experience of Facilitating Multi-Family Discussion Groups.

    Science.gov (United States)

    Eisler, Ivan; Flinter, Frances; Grey, Jo; Hutchison, Suzanne; Jackson, Carole; Longworth, Louise; MacLeod, Rhona; McAllister, Marion; Metcalfe, Alison; Patch, Christine; Cope, Buddug; Robert, Glenn; Rowland, Emma; Ulph, Fiona

    2017-04-01

    Innovations in clinical genetics have increased diagnosis, treatment and prognosis of inherited genetic conditions (IGCs). This has led to an increased number of families seeking genetic testing and / or genetic counselling and increased the clinical load for genetic counsellors (GCs). Keeping pace with biomedical discoveries, interventions are required to support families to understand, communicate and cope with their Inherited Genetic Condition. The Socio-Psychological Research in Genomics (SPRinG) collaborative have developed a new intervention, based on multi-family discussion groups (MFDGs), to support families affected by IGCs and train GCs in its delivery. A potential challenge to implementing the intervention was whether GCs were willing and able to undergo the training to deliver the MFDG. In analysing three multi-perspective interviews with GCs, this paper evaluates the training received. Findings suggests that MFDGs are a potential valuable resource in supporting families to communicate genetic risk information and can enhance family function and emotional well-being. Furthermore, we demonstrate that it is feasible to train GCs in the delivery of the intervention and that it has the potential to be integrated into clinical practice. Its longer term implementation into routine clinical practice however relies on changes in both organisation of clinical genetics services and genetic counsellors' professional development.

  8. Fuzzy capital rationing model

    Science.gov (United States)

    Bas, E.; Kahraman, C.

    2009-02-01

    In this paper, we study the fuzzification of Weingartner's pure capital rationing model and its analysis. We develop a primal-dual pair based on t-norm/t-conorm relation for the constraints and objective function for a fully fuzzified pure capital rationing problem except project selection variables. We define the [alpha]-interval under which the weak duality is proved. We perform sensitivity analysis for a change in a budget level or in a cash flow level of a non-basic as well as a basic variable. We analyze the problem based on duality and complementary slackness results. We illustrate the proposed model by computational analysis, and interpret the results.

  9. Development and Validation of Risk Matrices for Crohn's Disease Outcomes in Patients Who Underwent Early Therapeutic Interventions.

    Science.gov (United States)

    Dias, Cláudia Camila; Rodrigues, Pedro Pereira; Coelho, Rosa; Santos, Paula Moura; Fernandes, Samuel; Lago, Paula; Caetano, Cidalina; Rodrigues, Ângela; Portela, Francisco; Oliveira, Ana; Ministro, Paula; Cancela, Eugénia; Vieira, Ana Isabel; Barosa, Rita; Cotter, José; Carvalho, Pedro; Cremers, Isabelle; Trabulo, Daniel; Caldeira, Paulo; Antunes, Artur; Rosa, Isadora; Moleiro, Joana; Peixe, Paula; Herculano, Rita; Gonçalves, Raquel; Gonçalves, Bruno; Sousa, Helena Tavares; Contente, Luís; Morna, Henrique; Lopes, Susana; Magro, Fernando

    2017-04-01

    The establishment of prognostic models for Crohn's disease [CD] is highly desirable, as they have the potential to guide physicians in the decision-making process concerning therapeutic choices, thus improving patients' health and quality of life. Our aim was to derive models for disabling CD and reoperation based solely on clinical/demographic data. A multicentric and retrospectively enrolled cohort of CD patients, subject to early surgery or immunosuppression, was analysed in order to build Bayesian network models and risk matrices. The final results were validated internally and with a multicentric and prospectively enrolled cohort. The derivation cohort included a total of 489 CD patients [64% with disabling disease and 18% who needed reoperation], while the validation cohort included 129 CD patients with similar outcome proportions. The Bayesian models achieved an area under the curve of 78% for disabling disease and 86% for reoperation. Age at diagnosis, perianal disease, disease aggressiveness and early therapeutic decisions were found to be significant factors, and were used to construct user-friendly matrices depicting the probability of each outcome in patients with various combinations of these factors. The matrices exhibit good performance for the most important criteria: disabling disease positive post-test odds = 8.00 [2.72-23.44] and reoperation negative post-test odds = 0.02 [0.00-0.11]. Clinical and demographical risk factors for disabling CD and reoperation were determined and their impact was quantified by means of risk matrices, which are applicable as bedside clinical tools that can help physicians during therapeutic decisions in early disease management.

  10. Reflections of caretakers on the process of implementation of life space crisis intervention at a therapeutic centre for youngsters with emotional and behavioural disorders.

    Science.gov (United States)

    Soenen, Bram; Goethals, Ilse; Spriet, Eline; D'Oosterlinck, Franky; Broekaert, Eric

    2013-06-01

    Life space crisis intervention (LSCI) is a therapeutic and verbal strategy used to intervene when children are in crisis. It has its roots in the work of Aichorn, Redl, Wineman and Bettelheim, and is part of the milieu-therapeutic tradition. In 2000, LSCI was introduced at the Orthopedagogical Observation and Treatment Centre, a school and day unit for 60 children with emotional and behavioural disorders affiliated with the Department of Orthopedagogy at Ghent University (Belgium). The particular position of orientation towards 'therapeutic environments' in the department's history has encouraged the integration of LSCI in the daily activities of the departments' school (Broekaert et al., Int J Ther Communities 30(2):122-145, 2009). In 2003, LSCI was implemented and studied in several Flemish Institutes. Positive effects were found on school results, attendance in the classroom and number of conflicts. In this article, the reflections of the caretakers are taken into account. Analyses of these reflections resulted in 4 major themes: content of job and tasks, the youth in the centre, working with the youth in the centre, and cooperation with colleagues and other teams. The results of this analysis will be discussed.

  11. Interventions to increase adherence to therapeutic exercise in older adults with low back pain and/or hip/knee osteoarthritis: a systematic review and meta-analysis.

    Science.gov (United States)

    Nicolson, Philippa J A; Bennell, Kim L; Dobson, Fiona L; Van Ginckel, Ans; Holden, Melanie A; Hinman, Rana S

    2017-05-01

    To evaluate whether interventions aimed at increasing adherence to therapeutic exercise increase adherence greater than a contextually equivalent control among older adults with chronic low back pain and/or hip/knee osteoarthritis. A systematic review and meta-analysis. Five databases (MEDLINE (PubMed), CINAHL, SportDISCUS (EBSCO), Embase (Ovid) and Cochrane Library) were searched until 1 August 2016. Randomised controlled trials that isolated the effects of interventions aiming to improve adherence to therapeutic exercise among adults ≥45 years of age with chronic low back pain and/or hip/knee osteoarthritis were included. Of 3899 studies identified, nine studies (1045 participants) were eligible. Four studies, evaluating strategies that aimed to increase motivation or using behavioural graded exercise, reported significantly better exercise adherence (d=0.26-1.23). In contrast, behavioural counselling, action coping plans and/or audio/video exercise cues did not improve adherence significantly. Meta-analysis using a random effects model with the two studies evaluating booster sessions with a physiotherapist for people with osteoarthritis revealed a small to medium significant pooled effect in favour of booster sessions (standardised mean difference (SMD) 0.39, 95% CI 0.05 to 0.72, z=2.26, p=0.02, I2=35%). Meta-analysis provides moderate-quality evidence that booster sessions with a physiotherapist assisted people with hip/knee osteoarthritis to better adhere to therapeutic exercise. Individual high-quality trials supported the use of motivational strategies in people with chronic low back pain and behavioural graded exercise in people with osteoarthritis to improve adherence to exercise. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  12. Methods for a longitudinal quantitative outcome with a multivariate Gaussian distribution multi-dimensionally censored by therapeutic intervention.

    Science.gov (United States)

    Sun, Wanjie; Larsen, Michael D; Lachin, John M

    2014-04-15

    In longitudinal studies, a quantitative outcome (such as blood pressure) may be altered during follow-up by the administration of a non-randomized, non-trial intervention (such as anti-hypertensive medication) that may seriously bias the study results. Current methods mainly address this issue for cross-sectional studies. For longitudinal data, the current methods are either restricted to a specific longitudinal data structure or are valid only under special circumstances. We propose two new methods for estimation of covariate effects on the underlying (untreated) general longitudinal outcomes: a single imputation method employing a modified expectation-maximization (EM)-type algorithm and a multiple imputation (MI) method utilizing a modified Monte Carlo EM-MI algorithm. Each method can be implemented as one-step, two-step, and full-iteration algorithms. They combine the advantages of the current statistical methods while reducing their restrictive assumptions and generalizing them to realistic scenarios. The proposed methods replace intractable numerical integration of a multi-dimensionally censored MVN posterior distribution with a simplified, sufficiently accurate approximation. It is particularly attractive when outcomes reach a plateau after intervention due to various reasons. Methods are studied via simulation and applied to data from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study of treatment for type 1 diabetes. Methods proved to be robust to high dimensions, large amounts of censored data, low within-subject correlation, and when subjects receive non-trial intervention to treat the underlying condition only (with high Y), or for treatment in the majority of subjects (with high Y) in combination with prevention for a small fraction of subjects (with normal Y). Copyright © 2013 John Wiley & Sons, Ltd.

  13. Medical Management of Cerebral Vasospasm following Aneurysmal Subarachnoid Hemorrhage: A Review of Current and Emerging Therapeutic Interventions

    Directory of Open Access Journals (Sweden)

    Peter Adamczyk

    2013-01-01

    Full Text Available Cerebral vasospasm is a major source of morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage (aSAH. Evidence suggests a multifactorial etiology and this concept remains supported by the assortment of therapeutic modalities under investigation. The authors provide an updated review of the literature for previous and recent clinical trials evaluating medical treatments in patients with cerebral vasospasm secondary to aSAH. Currently, the strongest evidence supports use of prophylactic oral nimodipine and initiation of triple-H therapy for patients in cerebral vasospasm. Other agents presented in this report include magnesium, statins, endothelin receptor antagonists, nitric oxide promoters, free radical scavengers, thromboxane inhibitors, thrombolysis, anti-inflammatory agents and neuroprotectants. Although promising data is beginning to emerge for several treatments, few prospective randomized clinical trials are presently available. Additionally, future investigational efforts will need to resolve discrepant definitions and outcome measures for cerebral vasospasm in order to permit adequate study comparisons. Until then, definitive recommendations cannot be made regarding the safety and efficacy for each of these therapeutic strategies and medical management practices will continue to be implemented in a wide-ranging manner.

  14. Rationality, Culture and Deterrence

    Science.gov (United States)

    2013-09-01

    University  Press,  2007).   39  George,  Presidential  Decisionmaking.   40  Daniel  Kahneman  and   Amos   Tversky ...experiments, Kahneman and Tversky demonstrated consistent patterns of deviation from the predictions of the rational actor model. Specifically, when given

  15. Rational Imitation For Robots

    OpenAIRE

    Vanderelst Dieter; Alan Winfield

    2016-01-01

    The data, scripts and manuscript source files for our contribution to The 14th International Conference on the Simulation of Adaptive Behavior (SAB2016) entitled Rational Imitation for Robots The upload contains a doc folder describing the data and how to use it.

  16. Alternative Disaster Feeding Ration

    Science.gov (United States)

    2012-06-08

    ration types use alcohol and meat products in their preparation. Other types do not include these ingredients and even come in kosher variants, thus...Department of Defense policy and practice during HA/DR operations. Fiscal costs could drive markets to produce smaller and cheaper products for DLA to

  17. Consumer rationality in choice

    NARCIS (Netherlands)

    Conlon, B.J.

    2001-01-01

    The dissertation concentrates on consumer choice and the ability of current modelling approaches to capture the underlying behaviour of the individual decision-makers. The standard assumption of a rational utility maximising individual and its implications for observed behaviour are examined and

  18. Ideal Theory, Real Rationality

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    as an example of a political philosopher who fails to recognize that actual political and administrative rationality lagely disrupts the relevance of his ideal prescriptopns. Michel Foucault proposed as an antidote to Habermas in a comparativestudy of the two. Machiavellian "verita effettuale" (effective truth...

  19. Total Serum Cholesterol Increases Risk for Development and Progression of Nonproliferative Retinopathy in Patients with Type 1 Diabetes Without Therapeutic Intervention: Prospective, Observational Study.

    Science.gov (United States)

    Bulum, Tomislav; Tomić, Martina; Duvnjak, Lea

    2017-07-01

    Results from studies investigating relationship between serum lipids and risk of development and progression of diabetic retinopathy (DR) in patients with type 1 diabetes (T1DM) are not consistent. The objective of this study was to explore the relationship between serum lipids and risk of development and progression of nonproliferative diabetic retinopathy (NPDR) in T1DM with normal renal function and with no therapeutic intervention that might influence on retinopathy and serum lipids status. A total of 103 T1DM with normal renal function (urinary albumin excretion rate 60 mL min‒11.73m‒2), and before any interventions with lipid-lowering therapy, ACE inhibitors or angiotensin II receptor blockers were included in this study and followed for 41 months. Photodocumented retinopathy status was made according to the EURODIAB protocol. Patients who developed NPDR or progressed to proliferative retinopathy were older (44 vs. 33 years, p <0.001), had longer duration of diabetes (21.1 vs. 13.3 years, p <0.001), and higher serum total cholesterol level (5.1 vs. 4.5 mM/L, p = 0.02) compared to patients without retinopathy. In a backward stepwise Cox's multiple regression analysis serum total cholesterol was significantly associated with risk of development or progression of NPDR in our subjects (p = 0.04), with odds ratios of 1.27-1.91. These data suggest that serum total cholesterol levels are associated with risk of development and progression of NPDR in T1DM and normal renal function. The study was conducted in patients with no therapeutic interventions. Copyright © 2017 IMSS. Published by Elsevier Inc. All rights reserved.

  20. Therapeutic efficacy of vacuum-assisted-closure therapy in the treatment of lymphatic complications following peripheral vascular interventions and surgeries.

    Science.gov (United States)

    Aydin, Ufuk; Gorur, Alper; Findik, Orhan; Yildirim, Abdullah; Kocogullari, Cevdet Ugur

    2015-02-01

    Lymphatic complications, lymphocele and lymphorrhea being the leading, are generally encountered after vascular interventions and surgeries. The present study aimed to evaluate the outcomes of vacuum-assisted-closure (VAC) therapy, which we frequently prefer as the first-choice treatment for such complications. Among patients undergoing peripheral vascular intervention or surgery between January 2008 and February 2012, the medical files of 21 patients who received VAC therapy or other treatment due to symptomatic lymphatic complications were retrospectively analyzed and the results were discussed. Group I consisted of 10 patients (three with lymphocele and seven with lymphorrhea) who underwent VAC therapy as the first-choice treatment, Group II consisted of 11 patients of which 7 patients received various therapies before VAC therapy and 4 patients received other treatments alone. The patients who received VAC therapy as the primary therapy demonstrated more rapid wound healing, early drainage control, and shorter hospital stay. The mean hospital medical cost was €1038 (range, €739-1826) for the patients who primarily underwent VAC therapy; it was calculated to be €2137 (range, €1610-3130) for the other patients (p=0.001). In addition to its safety and good clinical outcomes, VAC therapy also has economic advantages and should be the primary method for the treatment of lymphatic complications. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  1. A new era of therapeutic strategies for chronic thromboembolic pulmonary hypertension by two different interventional therapies; pulmonary endarterectomy and percutaneous transluminal pulmonary angioplasty.

    Directory of Open Access Journals (Sweden)

    Takumi Inami

    and catheter-based interventional therapies leads us to expect the dawn of a new era of therapeutic strategies for CTEPH.

  2. VT - Vermont Rational Service Areas

    Data.gov (United States)

    Vermont Center for Geographic Information — Data Layer Name: Vermont Rational Service Areas (RSAs)Alternate Name: Vermont RSAsOverview:Rational Service Areas (RSAs), originally developed in 2001 and revised in...

  3. Natural history of cardiovascular and renal disease in patients with type 2 diabetes: effect of therapeutic interventions and risk modification.

    Science.gov (United States)

    Mogensen, C E

    1998-11-12

    Several observational studies document a considerably increased risk of advanced renal disease, cardiovascular disease, and early mortality in persons with diabetes. Both epidemiologic and observational studies indicate that progression of cardiovascular disease and renal disease is associated not only with high blood glucose levels, but also with hypertension and dyslipidemia. In persons with type 1 diabetes, hypoglycemic and antihypertensive therapy are important in the prevention of cardiovascular and renal disease. In those with type 2 diabetes, hypoglycemic therapy can help to prevent microvascular disease in the retina and in the kidney, and recent studies show that antihypertensive treatment is important in preventing cardiovascular disease. Thus, a multifactorial intervention program is key to preventing complications of hyperglycemia and, equally important, elevated blood pressure and dyslipidemia.

  4. MOrtality and infectious complications of therapeutic EndoVAscular interventional radiology: a systematic and meta-analysis protocol.

    Science.gov (United States)

    Mellouk Aid, Kaoutar; Tchala Vignon Zomahoun, Hervé; Soulaymani, Abdelmajid; Lebascle, Karin; Silvera, Stephane; Astagneau, Pascal; Misset, Benoit

    2017-04-24

    Endovascular interventional radiology (EIR) is an increasingly popular, mini invasive treatment option for patient with symptomatic vascular disease. The EIR practiced by qualified hands is an effective, well-tolerated procedure that offers relief of patient's symptoms with a low risk of complications. During acute post procedural period, immediate complications may relate to vascular access, restenosis, thromboembolic events, uterine ischemia, infection, necrosis, sepsis, ICU stay, surgical recovery, pain management, treatment failure, and death. Moreover, additional non-life-threatening complications exist, but they are not well described and represent disparate information. A range of databases will be screened consulted to identify the relevant studies: PubMed, EMBASE, The Cochrane Library, NosoBase, and Google Scholar (to identify articles not yet indexed). Scientist librarian used Medical Subject Headings (MeSH) and free terms to construct the search strategy in PubMed. This search strategy will be adapted in other databases. Two coauthors will independently select the relevant studies, extract the relevant data, and assess the risk of bias in the included studies. Any disagreements between the two authors will be solved by a third author. This systematic review will provide a synthesis of EIR complications. The spotlighted results will be analyzed in order to provide a state-of-knowledge synopsis of the current evidence base in relation to the epidemiology of the infectious complications after EIR. In the event of conclusive results, our findings will serve as a reference background to assess guidelines on reality of the problem of the infections linked to endovascular interventional radiology and to formulate of assumptions and propose preventive measures, based on the results of our investigations. These propositions will aim to reduce the risk and/or the severity of these complications in the concerned population in favor a positive medical economics

  5. Proinflammatory Role of Vascular Endothelial Growth Factor in the Pathogenesis of Rheumatoid Arthritis: Prospects for Therapeutic Intervention

    Directory of Open Access Journals (Sweden)

    Seung-Ah Yoo

    2008-01-01

    Full Text Available Recent experimental and clinical studies have placed new emphasis on the role of angiogenesis in chronic inflammatory disease. Vascular endothelial growth factor (VEGF and its receptors are the best characterized system in the regulation of rheumatoid arthritis (RA by angiogenesis. Furthermore, in addition to its angiogenic role, VEGF can act as a direct proinflammatory mediator during the pathogenesis of RA, and protect rheumatoid synoviocytes from apoptosis, which contributes to synovial hyperplasia. Therefore, the developments of synovial inflammation, hyperplasia, and angiogenesis in the joints of RA patients seem to be regulated by a common cue, namely, VEGF. Agents that target VEGF, such as anti-VEGF antibody and aptamer, have yielded promising clinical data in patients with cancer or macular degeneration, and in RA patients, pharmacologic modulations targeting VEGF or its receptor may offer new therapeutic approaches. In this review, the authors integrate current knowledge of VEGF signaling and information on VEGF antagonists gleaned experimentally and place emphasis on the use of synthetic anti-VEGF hexapeptide to prevent VEGF interacting with its receptor.

  6. Expression of SIRT1 in the ovaries of rats with polycystic ovary syndrome before and after therapeutic intervention with exenatide.

    Science.gov (United States)

    Tao, Xin; Zhang, Xiao; Ge, Shu-Qi; Zhang, Er-Hong; Zhang, Bin

    2015-01-01

    To investigate the expression of silent information regulator 1 (SIRT1) in rats with polycystic ovary syndrome (PCOS) and its alteration after exenatide treatment. PCOS rat model was established by dehydroepiandrosterone induction. The animals were randomly divided into exenatide treatment group (EX group, n = 10), metformin treatment group (MF group, n = 10), PCOS group (PCOS group, n = 9) and normal control group (NC group, n = 10). Histological changes of the ovarian tissues were examined by HE staining. SIRT1 expression in the ovarian tissue was detected by RT-PCR and immunohistochemistry. Rats in the PCOS group lost their estrous cycle. Histological observation of the ovary showed saccular dilatation of the follicle, decreased number of corpora lutea, fewer layers of granulosa cells aligned loosely, and thickened layer of theca cells. The changes in reproductive hormones and the development of insulin resistance suggested the successful establishment of the animal models. Immunohistochemistry and Q-PCR detected the mRNA and protein expressions of SIRT1 in the ovary tissues of rats in the normal control group. The SIRT1 expression was significantly lower in PCOS group than in control group (P ovary tissue decreases in PCOS rats (compare with the normal rats) but can be up-regulated after Ex or MF treatment. These drugs may affect the process and development of PCOS by regulating the SIRT1 expression. Exenatide may be therapeutic for PCOS by up-regulating the SITR1 expression.

  7. Notch signaling change in pulmonary vascular remodeling in rats with pulmonary hypertension and its implication for therapeutic intervention.

    Science.gov (United States)

    Qiao, Lina; Xie, Liang; Shi, Kun; Zhou, Tongfu; Hua, Yimin; Liu, Hanmin

    2012-01-01

    Pulmonary hypertension (PH) is a fatal disease that lacks an effective therapy. Notch signaling pathway plays a crucial role in the angiogenesis and vascular remodeling. However, its roles in vascular remodeling in PH have not been well studied. In the current study, using hypoxia-induced PH model in rat, we examined the expression of Notch and its downstream factors. Then, we used vessel strip culture system and γ-secretase inhibitor DAPT, a Notch signaling inhibitor to determine the effect of Notch signaling in vascular remodeling and its potential therapeutic value. Our results indicated that Notch 1-4 were detected in the lung tissue with variable levels in different cell types such as smooth muscle cells and endothelial cells of pulmonary artery, bronchia, and alveoli. In addition, following the PH induction, all of Notch1, Notch3, Notch4 receptor, and downstream factor, HERP1 in pulmonary arteries, mRNA expressions were increased with a peak at 1-2 weeks. Furthermore, the vessel wall thickness from rats with hypoxia treatment increased after cultured for 8 days, which could be decreased approximately 30% by DAPT, accompanied with significant increase of expression level of apoptotic factors (caspase-3 and Bax) and transformation of vascular smooth muscle cell (VSMC) phenotype from synthetic towards contractile. In conclusion, the current study suggested Notch pathway plays an important role in pulmonary vascular remodeling in PH and targeting Notch signaling pathway could be a valuable approach to design new therapy for PH.

  8. Notch signaling change in pulmonary vascular remodeling in rats with pulmonary hypertension and its implication for therapeutic intervention.

    Directory of Open Access Journals (Sweden)

    Lina Qiao

    Full Text Available Pulmonary hypertension (PH is a fatal disease that lacks an effective therapy. Notch signaling pathway plays a crucial role in the angiogenesis and vascular remodeling. However, its roles in vascular remodeling in PH have not been well studied. In the current study, using hypoxia-induced PH model in rat, we examined the expression of Notch and its downstream factors. Then, we used vessel strip culture system and γ-secretase inhibitor DAPT, a Notch signaling inhibitor to determine the effect of Notch signaling in vascular remodeling and its potential therapeutic value. Our results indicated that Notch 1-4 were detected in the lung tissue with variable levels in different cell types such as smooth muscle cells and endothelial cells of pulmonary artery, bronchia, and alveoli. In addition, following the PH induction, all of Notch1, Notch3, Notch4 receptor, and downstream factor, HERP1 in pulmonary arteries, mRNA expressions were increased with a peak at 1-2 weeks. Furthermore, the vessel wall thickness from rats with hypoxia treatment increased after cultured for 8 days, which could be decreased approximately 30% by DAPT, accompanied with significant increase of expression level of apoptotic factors (caspase-3 and Bax and transformation of vascular smooth muscle cell (VSMC phenotype from synthetic towards contractile. In conclusion, the current study suggested Notch pathway plays an important role in pulmonary vascular remodeling in PH and targeting Notch signaling pathway could be a valuable approach to design new therapy for PH.

  9. Summary of Operational Rations

    Science.gov (United States)

    1982-06-01

    dense components, together with inclusion of the D bar {a World War 11 emergency ration, which was not designed to be acceptable) as a confection ...36 units) The biscuits, beverages, sugar, fruit bar, confections , and gum were packaged in a laminated cellophane bag, whi le the canned meat and...entree in a reconstitution package as the main component, with a confection , a cereal or fruitcake bar, coffee, cream, sugar, toilet paper, matches

  10. Reputation and Rational Expectations

    OpenAIRE

    Andersen, Torben; Risager, Ole

    1987-01-01

    The paper considers the importance of reputation in relation to disinflationary policies in a continuous time ration expectations model, where the private sector has incomplete information about the true preferences of the government. It is proved that there is a unique equilibrium with the important property that the costs of disinflation arise in the start of the game where the policy has not yet gained credibility. Published in connection with a visit at the IIES.

  11. Rational imitation for robots

    OpenAIRE

    Vanderelst, D.; Winfield, A. F.

    2016-01-01

    Infants imitate behaviour flexibly. Depending on the circumstances, they copy both actions and their effects or only reproduce the demonstrator’s intended goals. In view of this selective imitation, infants have been called rational imitators. The ability to selectively and adaptively imitate behaviour would be a beneficial capacity for robots. Indeed, selecting what to imitate is one of the outstanding unsolved problems in the field of robotic imitation. In this paper, we first present a for...

  12. Belief and bounded rationality

    OpenAIRE

    Jago, Mark

    2006-01-01

    Predictive accounts of belief ascription, either following the principle of charity or Dennett's intentional stance, have proved popular recently. However, such accounts require us first to treat agents as perfectly rational agents and then revise this assumption as appropriate. I argue that such downwards revision is no easy task and that several proposed accounts are not satisfactory. I propose a way of characterising agent's belief states which shares Dennett's approach but avoids treating...

  13. Between Magic and Rationality

    DEFF Research Database (Denmark)

    In Between Magic and Rationality, Vibeke Steffen, Steffen Jöhncke, and Kirsten Marie Raahauge bring together a diverse range of ethnographies that examine and explore the forms of reflection, action, and interaction that govern the ways different contemporary societies create and challenge...... the limits of reason. The essays here visit an impressive array of settings, including international scientific laboratories, British spiritualist meetings, Chinese villages, Danish rehabilitation centers, and Uzbeki homes, where they encounter a diverse assortment of people whose beliefs and concerns...

  14. Immunomodulatory and therapeutic effects of Hot-nature diet and co-supplemented hemp seed, evening primrose oils intervention in multiple sclerosis patients.

    Science.gov (United States)

    Rezapour-Firouzi, Soheila; Arefhosseini, Seyed Rafie; Mehdi, Farhoudi; Mehrangiz, Ebrahimi-Mamaghani; Baradaran, Behzad; Sadeghihokmabad, Elyar; Mostafaei, Somaiyeh; Fazljou, Seyed Mohammad Bagher; Torbati, Mohammad-ali; Sanaie, Sarvin; Zamani, Fatemeh

    2013-10-01

    Multiple sclerosis (MS) is the most chronic and inflammatory disorder. Because of limited efficacy and adverse side effects, identifying novel therapeutic and protective agents is important. This study was aimed to assess the potential therapeutic effects of hemp seed and evening primrose oils as well as Hot-nature dietary intervention on RRMS patients. In this double blind, randomized trial, 100 MS patients with EDSShemp seed and evening primrose oils with advised Hot-nature diet, "Group B" who received olive oil, "Group C" who received the co-supplemented oils. Mizadj, clinically EDSS and relapse rate as well as immunological factors (IL-4, IFN-γ and IL-17) were assessed at baseline and after 6 months. Mean follow-up was 180±2.9 SD days (N=65, 23 M and 42 F aged 34.25±8.07 years with disease duration 6.80±4.33 years). There was no significant difference in studies parameters at baseline. After 6 months, significant improvements in Mizadj, EDSS and relapse rate were found in the groups A and C, while the group B showed a border significant decrease in relapse rate. Immunological parameters showed improvement in groups A and C, whereas there was worsening condition for group B after the intervention. The co-supplemented hemp seed and evening primrose oils with Hot-nature diet have beneficial effects in improving of clinical score in RRMS patients which were confirmed by immunological findings. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  15. Epigenetic regulation of leptin affects MMP‐13 expression in osteoarthritic chondrocytes: possible molecular target for osteoarthritis therapeutic intervention

    Science.gov (United States)

    Iliopoulos, D; Malizos, K N; Tsezou, A

    2007-01-01

    Objective To investigate whether epigenetic mechanisms can regulate leptin's expression and affect its downstream targets as metalloproteinases 3,9,13 in osteoarthritic chondrocytes. Methods DNA methylation in leptin promoter was measured by DNA bisulfite sequencing, and mRNA expression levels were measured by real‐time quantitative PCR in osteoarthritic as well as in normal cartilage. Osteoarthritic articular cartilage samples were obtained from two distinct locations of the knee (n = 15); from the main defective area of maximum load (advanced osteoarthritis (OA)) and from adjacent macroscopically intact regions (minimal OA). Using small interference RNA, we tested if leptin downregulation would affect matrix metalloproteinase (MMP)‐13 activity. We also evaluated the effect of the demethylating agent, 5′‐Aza‐2‐deoxycytidine (AZA) and of the histone deacetylase inhibitor trichostatin A (TSA) on leptin expression in chondrocyte cultures. Furthermore, we performed chromatin immunoprecipitation in leptin's promoter area. Results We found a correlation between leptin expression and DNA methylation and also that leptin controls MMP‐13 activity in chondrocytes. Leptin's downregulation with small interference RNA inhibited MMP‐13 expression dramatically. After 5‐AZA application in normal chondrocytes, leptin's methylation was decreased, while its expression was upregulated, and MMP‐13 was activated. Furthermore, TSA application in normal chondrocyte cultures increased leptin's expression. Also, chromatin immunoprecipitation in leptin's promoter after TSA treatment revealed that histone H3 lysines 9 and 14 were acetylated. Conclusion We found that epigenetic mechanisms regulate leptin's expression in chondrocytes affecting its downstream target MMP‐13. Small interference RNA against leptin deactivated directly MMP‐13, which was upregulated after leptin's epigenetic reactivation, raising the issue of leptin's therapeutic potential for

  16. Epigenetic regulation of leptin affects MMP-13 expression in osteoarthritic chondrocytes: possible molecular target for osteoarthritis therapeutic intervention.

    Science.gov (United States)

    Iliopoulos, D; Malizos, K N; Tsezou, A

    2007-12-01

    To investigate whether epigenetic mechanisms can regulate leptin's expression and affect its downstream targets as metalloproteinases 3,9,13 in osteoarthritic chondrocytes. DNA methylation in leptin promoter was measured by DNA bisulfite sequencing, and mRNA expression levels were measured by real-time quantitative PCR in osteoarthritic as well as in normal cartilage. Osteoarthritic articular cartilage samples were obtained from two distinct locations of the knee (n = 15); from the main defective area of maximum load (advanced osteoarthritis (OA)) and from adjacent macroscopically intact regions (minimal OA). Using small interference RNA, we tested if leptin downregulation would affect matrix metalloproteinase (MMP)-13 activity. We also evaluated the effect of the demethylating agent, 5'-Aza-2-deoxycytidine (AZA) and of the histone deacetylase inhibitor trichostatin A (TSA) on leptin expression in chondrocyte cultures. Furthermore, we performed chromatin immunoprecipitation in leptin's promoter area. We found a correlation between leptin expression and DNA methylation and also that leptin controls MMP-13 activity in chondrocytes. Leptin's downregulation with small interference RNA inhibited MMP-13 expression dramatically. After 5-AZA application in normal chondrocytes, leptin's methylation was decreased, while its expression was upregulated, and MMP-13 was activated. Furthermore, TSA application in normal chondrocyte cultures increased leptin's expression. Also, chromatin immunoprecipitation in leptin's promoter after TSA treatment revealed that histone H3 lysines 9 and 14 were acetylated. We found that epigenetic mechanisms regulate leptin's expression in chondrocytes affecting its downstream target MMP-13. Small interference RNA against leptin deactivated directly MMP-13, which was upregulated after leptin's epigenetic reactivation, raising the issue of leptin's therapeutic potential for osteoarthritis.

  17. Acute Versus Progressive Onset of Diabetes in NOD Mice: Potential Implications for Therapeutic Interventions in Type 1 Diabetes

    Science.gov (United States)

    Mathews, Clayton E.; Xue, Song; Posgai, Amanda; Lightfoot, Yaima L.; Li, Xia; Lin, Andrea; Wasserfall, Clive; Haller, Michael J.; Schatz, Desmond

    2015-01-01

    Most natural history models for type 1 diabetes (T1D) propose that overt hyperglycemia results after a progressive loss of insulin-secreting β-cell mass and/or function. To experimentally address this concept, we prospectively determined morning blood glucose measurements every other day in multiple cohorts (total n = 660) of female NOD/ShiLtJ mice starting at 8 weeks of age until diabetes onset or 26 weeks of age. Consistent with this notion, a majority of mice that developed diabetes (354 of 489 [72%]) displayed a progressive increase in blood glucose with transient excursions >200 mg/dL, followed by acute and persistent hyperglycemia at diabetes onset. However, 135 of the 489 (28%) diabetic animals demonstrated normal glucose values followed by acute (i.e., sudden) hyperglycemia. Interestingly, diabetes onset occurred earlier in mice with acute versus progressive disease onset (15.37 ± 0.3207 vs. 17.44 ± 0.2073 weeks of age, P < 0.0001). Moreover, the pattern of onset (i.e., progressive vs. acute) dramatically influenced the ability to achieve reversal of T1D by immunotherapeutic intervention, with increased effectiveness observed in situations of a progressive deterioration in euglycemia. These studies highlight a novel natural history aspect in this animal model, one that may provide important guidance for the selection of subjects participating in human trials seeking disease reversal. PMID:26216853

  18. Progression of metastatic castrate-resistant prostate cancer: impact of therapeutic intervention in the post-docetaxel space

    Directory of Open Access Journals (Sweden)

    Sartor A Oliver

    2011-04-01

    Full Text Available Abstract Despite the proven success of hormonal therapy for prostate cancer using chemical or surgical castration, most patients eventually will progress to a phase of the disease that is metastatic and shows resistance to further hormonal manipulation. This has been termed metastatic castrate-resistant prostate cancer (mCRPC. Despite this designation, however, there is evidence that androgen receptor (AR-mediated signaling and gene expression can persist in mCRPC, even in the face of castrate levels of androgen. This may be due in part to the upregulation of enzymes involved in androgen synthesis, the overexpression of AR, or the emergence of mutant ARs with promiscuous recognition of various steroidal ligands. The therapeutic options were limited and palliative in nature until trials in 2004 demonstrated that docetaxel chemotherapy could significantly improve survival. These results established first-line docetaxel as the standard of care for mCRPC. After resistance to further docetaxel therapy develops, treatment options were once again limited. Recently reported results from phase 3 trials have shown that additional therapy with the novel taxane cabazitaxel (with prednisone, or treatment with the antiandrogen abiraterone (with prednisone could improve survival for patients with mCRPC following docetaxel therapy. Compared with mitoxantrone/prednisone, cabazitaxel/prednisone significantly improved overall survival, with a 30% reduction in rate of death, in patients with progression of mCRPC after docetaxel therapy in the TROPIC trial. Similarly, abiraterone acetate (an inhibitor of androgen biosynthesis plus prednisone significantly decreased the rate of death by 35% compared with placebo plus prednisone in mCRPC patients progressing after prior docetaxel therapy in the COU-AA-301 trial. Results of these trials have thus established two additional treatment options for mCRPC patients in the "post-docetaxel space." In view of the continued AR

  19. Rationality in the Cryptographic Model

    DEFF Research Database (Denmark)

    Hubacek, Pavel

    This thesis presents results in the field of rational cryptography. In the first part we study the use of cryptographic protocols to avoid mediation and binding commitment when implementing game theoretic equilibrium concepts. First, we concentrate on the limits of cryptographic cheap talk...... to implement correlated equilibria of two-player strategic games in a sequentially rational way. We show that there exist two-player games for which no cryptographic protocol can implement the mediator in a sequentially rational way; that is, without introducing empty threats. In the context of computational....... The second part presents a study of the problem of verifiable delegation of computation in the rational setting. We define rational arguments, an extension of the recent concept of rational proofs into the computational setting, and give a single round delegation scheme for the class NC1, of search problems...

  20. Establishing and strengthening a medicine and therapeutics committee in a medical college in Nepal: initial experiences.

    Science.gov (United States)

    Shankar, P Ravi; Humagain, Baburam; Piryani, R M; Jha, Nisha; Osti, Bidur

    2009-04-01

    Drug and Therapeutics Committees (DTCs) serve as a forum to bring together various stakeholders to improve drug use. DTCs are a key intervention to promote rational use of medicines. DTCs are however, functioning in only a limited number of hospitals in Nepal. A Medicine and Therapeutics Committee (MTC) was started at KIST Medical College, a new medical school in Lalitpur district, Nepal to promote the rational use of medicines in February 2008. The MTC has members from various departments and the full support of the administration. The MTC has been involved in preparing the hospital medicine list and limiting the number of brands available in the pharmacy. Measures to regulate pharmaceutical promotion have been undertaken. Pharmacovigilance and medication counseling activities have been started. Educational programs for various levels of staff are regularly carried out and drug use in the hospital is periodically monitored. Initial experiences regarding MTC functioning is positive.

  1. $2^n-$rational maps

    OpenAIRE

    Kassotakis, Pavlos; Nieszporski, Maciej; Damianou, Pantelis

    2015-01-01

    We present a natural extension of the notion of nondegenerate rational maps (quadrirational maps) to arbitrary dimensions. We refer to these maps as $2^n-$rational maps. In this note we construct a rich family of $2^n-$rational maps. These maps by construction are involutions and highly symmetric in the sense that the maps and their companion maps have the same functional form.

  2. Overstatement and Rational Market Expectation

    OpenAIRE

    Illoong Kwon; Eunjung Yeo

    2008-01-01

    When an agent overstates his/her true performance, a rational market can simply discount the reported performance, and correctly guess the true performance. This paper shows, however, that such rational market discounting leads to less productive effort by the agent and less performance-pay by the principal. Therefore, a rational market and a profit-maximizing principal can exacerbate the lack of productive effort by the agent.

  3. Randomized clinical trial of therapeutic music video intervention for resilience outcomes in adolescents/young adults undergoing hematopoietic stem cell transplant: a report from the Children's Oncology Group.

    Science.gov (United States)

    Robb, Sheri L; Burns, Debra S; Stegenga, Kristin A; Haut, Paul R; Monahan, Patrick O; Meza, Jane; Stump, Timothy E; Cherven, Brooke O; Docherty, Sharron L; Hendricks-Ferguson, Verna L; Kintner, Eileen K; Haight, Ann E; Wall, Donna A; Haase, Joan E

    2014-03-15

    To reduce the risk of adjustment problems associated with hematopoietic stem cell transplant (HSCT) for adolescents/young adults (AYAs), we examined efficacy of a therapeutic music video (TMV) intervention delivered during the acute phase of HSCT to: 1) increase protective factors of spiritual perspective, social integration, family environment, courageous coping, and hope-derived meaning; 2) decrease risk factors of illness-related distress and defensive coping; and 3) increase outcomes of self-transcendence and resilience. This was a multisite randomized, controlled trial (COG-ANUR0631) conducted at 8 Children's Oncology Group sites involving 113 AYAs aged 11-24 years undergoing myeloablative HSCT. Participants, randomized to the TMV or low-dose control (audiobooks) group, completed 6 sessions over 3 weeks with a board-certified music therapist. Variables were based on Haase's Resilience in Illness Model (RIM). Participants completed measures related to latent variables of illness-related distress, social integration, spiritual perspective, family environment, coping, hope-derived meaning, and resilience at baseline (T1), postintervention (T2), and 100 days posttransplant (T3). At T2, the TMV group reported significantly better courageous coping (Effect Size [ES], 0.505; P = .030). At T3, the TMV group reported significantly better social integration (ES, 0.543; P = .028) and family environment (ES, 0.663; P = .008), as well as moderate nonsignificant effect sizes for spiritual perspective (ES, 0.450; P = .071) and self-transcendence (ES, 0.424; P = .088). The TMV intervention improves positive health outcomes of courageous coping, social integration, and family environment during a high-risk cancer treatment. We recommend the TMV be examined in a broader population of AYAs with high-risk cancers. © 2013 American Cancer Society.

  4. Chicanoizing the Therapeutic Community

    Science.gov (United States)

    Aron, William S.; And Others

    1974-01-01

    Focusing on the drug addiction problem and its antecedent conditions in a Chicano population, the article examines several therapeutic interventions suggested by these conditions and indicates how they might be incorporated into a drug addiction Therapeutic Community treatment program designed to meet the needs of Chicano drug addicts. (Author/NQ)

  5. Meditation as a therapeutic intervention for adults at risk for Alzheimer’s disease. Potential benefits and underlying mechanisms: A mini review

    Directory of Open Access Journals (Sweden)

    Kim E Innes

    2014-04-01

    Full Text Available Alzheimer's disease (AD is a chronic, progressive, brain disorder that affects at least 5.3 million Americans at an estimated cost of $148 billion, figures that are expected to rise steeply in coming years. Despite decades of research, there is still no cure for AD, and effective therapies for preventing or slowing progression of cognitive decline in at-risk populations remain elusive. While the etiology of AD remains uncertain, chronic stress, sleep deficits, and mood disturbance, conditions common in those with cognitive impairment, have been prospectively linked to the development and progression of both chronic illness and memory loss and are significant predictors of AD. Therapies such as meditation that specifically target these risk factors may thus hold promise for slowing and possibly preventing cognitive decline in those at risk. In this paper, we briefly review the existing evidence regarding the potential utility of meditation as a therapeutic intervention for those with and at risk for AD, discuss possible mechanisms underlying the observed benefits of meditation, and outline directions for future research.

  6. Rational pharmacotherapy in The Netherlands : formulary management in Dutch hospitals

    NARCIS (Netherlands)

    Fijn, R; de Jong-van den Berg, LTW; Brouwers, JRBJ

    A survey regarding the management of rational pharmacotherapy was conducted among all Dutch general hospitals in 1998. The response was 99% (n = 120). The presence of a drugs and therapeutics committee and antibiotic policies in Dutch general hospitals appears independent of hospital

  7. Rational Budgeting? The Stanford Case.

    Science.gov (United States)

    Chaffee, Ellen Earle

    The budget decision making process at Stanford University, California, from 1970 through 1979 was evaluated in relation to the allocation of general funds to 38 academic departments. Using Simon's theory of bounded rationality and an organizational level of analysis, the Stanford decision process was tested for its rationality through…

  8. Rationality problem for algebraic tori

    CERN Document Server

    Hoshi, Akinari

    2017-01-01

    The authors give the complete stably rational classification of algebraic tori of dimensions 4 and 5 over a field k. In particular, the stably rational classification of norm one tori whose Chevalley modules are of rank 4 and 5 is given. The authors show that there exist exactly 487 (resp. 7, resp. 216) stably rational (resp. not stably but retract rational, resp. not retract rational) algebraic tori of dimension 4, and there exist exactly 3051 (resp. 25, resp. 3003) stably rational (resp. not stably but retract rational, resp. not retract rational) algebraic tori of dimension 5. The authors make a procedure to compute a flabby resolution of a G-lattice effectively by using the computer algebra system GAP. Some algorithms may determine whether the flabby class of a G-lattice is invertible (resp. zero) or not. Using the algorithms, the suthors determine all the flabby and coflabby G-lattices of rank up to 6 and verify that they are stably permutation. The authors also show that the Krull-Schmidt theorem for G-...

  9. Limited rationality and strategic interaction

    DEFF Research Database (Denmark)

    Fehr, Ernst; Tyran, Jean-Robert

    2008-01-01

    this question in the context of a long-standing and important economic problem: the adjustment of nominal prices after an anticipated monetary shock. Our experiments suggest that two types of bounded rationality-money illusion and anchoring-are important behavioral forces behind nominal inertia. However...... with relatively large real effects. This adjustment difference is driven by price expectations, which are very flexible and forward-looking under substitutability but adaptive and sticky under complementarity. Moreover, subjects' expectations are also considerably more rational under substitutability......Much evidence suggests that people are heterogeneous with regard to their abilities to make rational, forward-looking decisions. This raises the question as to when the rational types are decisive for aggregate outcomes and when the boundedly rational types shape aggregate results. We examine...

  10. Rational points on varieties

    CERN Document Server

    Poonen, Bjorn

    2017-01-01

    This book is motivated by the problem of determining the set of rational points on a variety, but its true goal is to equip readers with a broad range of tools essential for current research in algebraic geometry and number theory. The book is unconventional in that it provides concise accounts of many topics instead of a comprehensive account of just one-this is intentionally designed to bring readers up to speed rapidly. Among the topics included are Brauer groups, faithfully flat descent, algebraic groups, torsors, étale and fppf cohomology, the Weil conjectures, and the Brauer-Manin and descent obstructions. A final chapter applies all these to study the arithmetic of surfaces. The down-to-earth explanations and the over 100 exercises make the book suitable for use as a graduate-level textbook, but even experts will appreciate having a single source covering many aspects of geometry over an unrestricted ground field and containing some material that cannot be found elsewhere. The origins of arithmetic (o...

  11. Rationing medical education.

    African Journals Online (AJOL)

    Persad G, Wertheimer A, Emanuel EJ. Principles for allocation of scarce medical interventions. Lancet. 2009;373(9661):423–431. 9. Walsh K. How to assess your learning needs J R Soc. Medical 2006 99: 29-31. 10. Sandars J, Walsh K. A consumer guide to the world of e-learning. BMJ Career Focus. 2005; 330:96-97. 11.

  12. High-frequency ultrasound imaging of tattoo reactions with histopathology as a comparative method. Introduction of preoperative ultrasound diagnostics as a guide to therapeutic intervention.

    Science.gov (United States)

    Carlsen, K Hutton; Tolstrup, J; Serup, J

    2014-08-01

    Tattoo adverse reactions requiring diagnostic evaluation and treatment are becoming more common. The aim of this study was to assess tattoo reactions by 20-MHz ultrasonography referenced to histopathology as a comparative method. A total of 73 individuals with clinical adverse reactions in their tattoos were studied. Punch biopsies for reference histology were available from 58 patients. The Dermascan C(®) of Cortex Technology, Denmark, was employed. Total skin thickness and echo density of the echolucent band in the outer dermis were measured. Biopsy served for diagnosis and for determination of the level of cellular infiltration in the dermis. In every tattoo reaction studied, the skin affected was found thicker compared with regional control of the same individual (mean difference 0.73 mm). A prominent echolucent band of mean thickness 0.89 mm was demonstrated, primarily located in the very outer dermis but propagating to deeper dermal layers parallel to increasing severity of reactions. The thickness of the echolucent band correlated with the thickness of cellular infiltration determined by microscopic examination, R = 0.6412 (P tattoo reactions showed no distinct characteristics by ultrasound, but mainly displayed themselves by their advanced inflammatory component. It is demonstrated for the first time that ultrasound, with histopathology as the comparative method, can quantify the severity of tattoo reactions and non-invasively diagnose the depth of the inflammatory process in the dermis elicited by the microparticulate tattoo pigment, which itself is too minute to be imaged by ultrasound. Preoperative 20-MHz ultrasound scanning is introduced as a potentially useful method to guide therapeutic interventions by surgery and lasers. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Reasoning, decision making and rationality.

    Science.gov (United States)

    Evans, J S; Over, D E; Manktelow, K I

    1993-01-01

    It is argued that reasoning in the real world supports decision making and is aimed at the achievement of goals. A distinction is developed between two notions of rationality: rationality which is reasoning in such a way as to achieve one's goals--within cognitive constraints--and rationality which is reasoning by a process of logic. This dichotomy is related to the philosophical distinction between practical and theoretical reasoning. It is argued that logicality (rationality) does not provide a good basis for rationality and some psychological research on deductive reasoning is re-examined in this light. First, we review belief bias effects in syllogistic reasoning, and argue that the phenomena do not support the interpretations of irrationality that are often placed upon them. Second, we review and discuss recent studies of deontic reasoning in the Wason selection task, which demonstrate the decision making, and rational nature of reasoning in realistic contexts. The final section of the paper examines contemporary decision theory and shows how it fails, in comparable manner to formal logic, to provide an adequate model for assessing the rationality of human reasoning and decision making.

  14. Rational therapy of osteoarthritis

    Directory of Open Access Journals (Sweden)

    E G Zotkin

    2005-01-01

    Full Text Available Brief information about modem osteoarthritis treatment with simple analgesics, NSAIDs and chondroprotective drugs is presented. Results of a clinical study of ARTRA in combination with diclofenac (31 pts comparing with diclofenac only (31 pts for the treatment of knee osteoarthritis ofll-lll stage are discussed. ARTRA was administered 2 capsules a day during a months and than 1 capsule a day during 5 months. A mean therapeutic dose of diclofenac was given to all pts. ARTRA with diclofenac was more effectively than diclofenac monotherapy improved WOMAC functional index and suppressed pain on visual analog scale and WOMAC. ARTRA was well tolerated.

  15. Two kinds of credit rationing

    Directory of Open Access Journals (Sweden)

    H.W. ARNDT

    2013-12-01

    Full Text Available Some advocates of financial development have made a powerful case against government control of interest rates by resting their case on the discriminatory effects of credit rationing. In doing so they have confused the issues by attributing to government controls the consequences which normally flow from credit rationing by banks even in the absence of legal control. The object of the article is to clear up the confusion by distinguishing more clearly between two kinds of credit rationing, “bank rationing” and “government rationing”.

  16. Approximation of quadrilaterals by rational quadrilaterals in the plane

    Indian Academy of Sciences (India)

    Keywords. Rational triangles and quadrilaterals; rational approximability of polygons; rational points on quartic curves; elliptic curves; torsion points; rational points on varieties and their density.

  17. Rational Expectations and Economic Models.

    Science.gov (United States)

    Sheffrin, Steven M.

    1980-01-01

    Examines how rational expectation models can help describe and predict trends within an economy and explains research needs within the discipline of economics which will enable economists to make more valid predictions. (DB)

  18. Collective action and rationality models

    Directory of Open Access Journals (Sweden)

    Luis Miguel Miller Moya

    2004-01-01

    Full Text Available The Olsonian theory of collective action (Olson, 1965 assumes a model of economic rationality, based on a simple calculus between costs and benefits, that can be hardly hold at present, given the models of rationality proposed recently by several fields of research. In relation to these fields, I will concentrate in two specific proposals, namely: evolutionary game theory and, over all, the theory of bounded rationality. Both alternatives are specially fruitful in order to propose models that do not need a maximizing rationality, or environments of complete and perfect information. Their approaches, based on the possibility of individual learning over the time, have contributed to the analysis of the emergence of social norms, which is something really necessary to the resolution of problems related to cooperation. Thus, this article asserts that these two new theoretical contributions make feasible a fundamental advance in the study of collective action.

  19. Rational reconstructions of modern physics

    CERN Document Server

    Mittelstaedt, Peter

    2013-01-01

    Newton’s classical physics and its underlying ontology are loaded with several metaphysical hypotheses that cannot be justified by rational reasoning nor by experimental evidence. Furthermore, it is well known that some of these hypotheses are not contained in the great theories of Modern Physics, such as the theory of Special Relativity and Quantum Mechanics. This book shows that, on the basis of Newton’s classical physics and by rational reconstruction, the theory of Special Relativity as well as Quantum Mechanics can be obtained by partly eliminating or attenuating the metaphysical hypotheses. Moreover, it is shown that these reconstructions do not require additional hypotheses or new experimental results. In the second edition the rational reconstructions are completed with respect to General Relativity and Cosmology. In addition, the statistics of quantum objects is elaborated in more detail with respect to the rational reconstruction of quantum mechanics. The new material completes the approach of t...

  20. McLuhan and Rationality.

    Science.gov (United States)

    Levinson, Paul

    1981-01-01

    Looks at McLuhan's method of exploration. Considers why he dismisses logic and traditional rationality, how he supports his stance, and why his contribution to communications media theory is not diminished by his attempt to avoid logical accountability. (PD)

  1. The Limitations of Applying Rational Decision-Making Models

    African Journals Online (AJOL)

    suspicion was such that the original child spacing interventions. Malawi Medical Journal, March 1993, Vol. 9, No. 1 were abandoned and the present programme did not begin until 1983. In societies where there is no ... psychology 9, assumes that health behaviour is carried out on the basis of rational decision making. , ,1.

  2. Public policy, rationality and reason

    OpenAIRE

    Rodolfo Canto Sáenz

    2015-01-01

    This work suggests the incorporation of practical reason in the design, implementation and evaluation of public policies, alongside instrumental rationality. It takes two proposals that today point in this direction: Rawls distinction between reasonable (practical reason) and rational (instrumental reason) and what this author calls the CI Procedure (categorical imperative procedure) and Habermas model of deliberative democracy. The main conclusion is that the analysis of public policies can ...

  3. Economic rationality and ethical behavior

    OpenAIRE

    Marc Le Menestrel

    2001-01-01

    This paper argues that economic rationality and ethical behavior cannot be reduced one to the other, casting doubts on the validity of formulas like 'profit is ethical' or 'ethics pays'. In order to express ethical dilemmas as opposing economic interest with ethical concerns, we propose a model of rational behavior that combines these two irreducible dimensions in an open but not arbitrary manner. Behaviors that are neither ethical nor profitable are considered irrational (non-arbitrariness)....

  4. Bounded Rationality in Transposition Processes

    DEFF Research Database (Denmark)

    Vollaard, Hans; Martinsen, Dorte Sindbjerg

    2014-01-01

    perspective may affect the commonly employed explanatory factors of administrative capacities, misfit and the heterogeneity of preferences among veto players. To prevent retrospective rationalisation of the transposition process, this paper traces this process as it unfolded in Denmark and the Netherlands....... As bounded rationality is apparent in the transposition processes in these relatively well-organised countries, future transposition studies should devote greater consideration to the bounded rationality perspective....

  5. Rational Expectations: Retrospect and Prospect

    OpenAIRE

    Hoover, Kevin; Young, Warren

    2011-01-01

    The transcript of a panel discussion marking the fiftieth anniversary of John Muth's "Rational Expectations and the Theory of Price Movements" (Econometrica 1961). The panel consists of Michael Lovell, Robert Lucas, Dale Mortensen, Robert Shiller, and Neil Wallace. The discussion is moderated by Kevin Hoover and Warren Young. The panel touches on a wide variety of issues related to the rational-expectations hypothesis, including: its history, starting with Muth's work at Carnegie Tech; its me...

  6. Interpolation of rational matrix functions

    CERN Document Server

    Ball, Joseph A; Rodman, Leiba

    1990-01-01

    This book aims to present the theory of interpolation for rational matrix functions as a recently matured independent mathematical subject with its own problems, methods and applications. The authors decided to start working on this book during the regional CBMS conference in Lincoln, Nebraska organized by F. Gilfeather and D. Larson. The principal lecturer, J. William Helton, presented ten lectures on operator and systems theory and the interplay between them. The conference was very stimulating and helped us to decide that the time was ripe for a book on interpolation for matrix valued functions (both rational and non-rational). When the work started and the first partial draft of the book was ready it became clear that the topic is vast and that the rational case by itself with its applications is already enough material for an interesting book. In the process of writing the book, methods for the rational case were developed and refined. As a result we are now able to present the rational case as an indepe...

  7. Huntington Disease: Linking Pathogenesis to the Development of Experimental Therapeutics.

    Science.gov (United States)

    Mestre, Tiago A; Sampaio, Cristina

    2017-02-01

    Huntington disease (HD) is an autosomal dominant neurodegenerative condition caused by a CAG trinucleotide expansion in the huntingtin gene. At present, the HD field is experiencing exciting times with the assessment for the first time in human subjects of interventions aimed at core disease mechanisms. Out of a portfolio of interventions that claim a potential disease-modifying effect in HD, the target huntingtin has more robust validation. In this review, we discuss the spectrum of huntingtin-lowering therapies that are currently being considered. We provide a critical appraisal of the validation of huntingtin as a drug target, describing the advantages, challenges, and limitations of the proposed therapeutic interventions. The development of these new therapies relies strongly on the knowledge of HD pathogenesis and the ability to translate this knowledge into validated pharmacodynamic biomarkers. Altogether, the goal is to support a rational drug development that is ethical and cost-effective. Among the pharmacodynamic biomarkers under development, the quantification of mutant huntingtin in the cerebral spinal fluid and PET imaging targeting huntingtin or phosphodiesterase 10A deserve special attention. Huntingtin-lowering therapeutics are eagerly awaited as the first interventions that may be able to change the course of HD in a meaningful way.

  8. HER2 Expression Changes in Breast Cancer Xenografts Following Therapeutic Intervention Can Be Quantified Using PET Imaging and 18F-Labelled Affibody Molecules.

    Science.gov (United States)

    Kramer-Marek, Gabriela; Kiesewetter, Dale O.; Capala, Jacek

    2009-01-01

    Rationale In vivo imaging of HER2 expression may allow direct assessment of HER2 status in tumor tissue and provide means to quantify changes in receptor expression following HER2-targeted therapies. This work describes in vivo characterization of HER2-specific 18F-FBEM-ZHER2:342–Affibody molecule and its application to study the effect of 17-DMAG on HER2 expression by PET imaging. Methods To assess the correlation of signal observed by PET with receptor expression, the tracer was administered to athymic nude mice bearing subcutaneous human breast cancer xenografts with different levels of HER2 expression. To study the down-regulation of HER2, mice were treated with four doses (40 mg/kg) of 17-DMAG, an inhibitor of Hsp90, known to decrease the HER2 expression. Animals were scanned before and after the treatment. After the last scan, mice were euthanized and tumors were frozen for receptor analysis. Results The tracer was eliminated quickly from the blood and normal tissues, providing high tumor/blood and tumor/muscle ratios as early as 20 min post injection. The high contrast images between normal and tumor tissue were recorded for BT474 and MCF7/clone18 tumors. Very low but still detectable uptake was observed for MCF7 tumors and none for MDA-MB-468. The signal correlated with the receptor expression assessed by immunohistochemistry as well as western blot and ELISA. The levels of HER2 expression, estimated by post-treatment PET imaging, decreased 71% (p < 4 × 10−6) and 33% (p < 0.002), respectively, for BT474- and MCF7/clone18-tumor bearing mice. These changes were confirmed by the biodistribution studies, ELISA and western blot. Conclusion Our results suggest that the described 18F-FBEM-ZHER2:342–Affibody molecule can be used to assess HER2 expression in vivo by PET imaging and monitor possible changes of receptor expression in response to therapeutic interventions. PMID:19525458

  9. Incorporation of Therapeutic Interventions in Physiologically Based Pharmacokinetic Modeling of Human Clinical Case Reports of Accidental or Intentional Overdosing with Ethylene Glycol

    Energy Technology Data Exchange (ETDEWEB)

    Corley, Rick A.; McMartin, K. E.

    2005-05-16

    Ethylene glycol is a high production volume chemical used in the manufacture of resins and fibers, antifreeze, deicing fluids, heat transfer and hydraulic fluids. Although occupational uses of ethylene glycol have not been associated with adverse effects, there are case reports where humans have either intentionally or accidentally ingested large quantities of ethylene glycol, primarily from antifreeze. The acute toxicity of ethylene glycol in humans and animals and can proceed through three stages, each associated with a different metabolite: central nervous system depression (ethylene glycol), cardiopulmonary effects associated with metabolic acidosis (glycolic acid) and ultimately renal toxicity (oxalic acid), depending upon the total amounts consumed and effectiveness of therapeutic interventions. A physiologically based pharmacokinetic (PBPK) model developed in a companion paper (Corley et al., 2004) was refined in this study to include clinically relevant treatment regimens for ethylene glycol poisoning such as hemodialysis or metabolic inhibition with either ethanol or fomepizole. Such modifications enabled the model to describe several human case reports which included analysis of ethylene glycol and/or glycolic acid. Such data and model simulations provide important confirmation that the PBPK model developed previously can adequately describe the pharmacokinetics of ethylene glycol in humans following low, occupational or environmentally relevant inhalation exposures, as well as massive oral doses even under conditions where treatments have been employed that markedly affect the disposition of ethylene glycol and glycolic acid. By integrating the case report data sets with controlled studies in this PBPK model, it was demonstrated that fomepizole, if administered early enough in a clinical situation, can be more effective than ethanol or hemodialysis in preventing the metabolism of ethylene glycol to more toxic metabolites. Hemodialysis remains an

  10. Radiation-Induced Esophagitis In Vivo and In Vitro Reveals That Epidermal Growth Factor Is a Potential Candidate for Therapeutic Intervention Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyung Su [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Jeon, Seong-Uk; Lee, Chan-Ju; Kim, Young-Eun; Bok, Seoyeon; Hong, Beom-Ju; Park, Dong-Young [Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, Gyeongbuk (Korea, Republic of); Ahn, G-One, E-mail: goneahn@postech.ac.kr [Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, Gyeongbuk (Korea, Republic of); Kim, Hak Jae, E-mail: khjae@snu.ac.kr [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2016-07-01

    in the irradiated esophagus suggests that EGF may be a potential therapeutic intervention strategy to treat RIE.

  11. Love and rationality: on some possible rational effects of love

    Directory of Open Access Journals (Sweden)

    Gustavo Ortiz-Millán

    Full Text Available In this paper I defend the idea that rather than disrupting rationality, as the common-sense conception has done it, love may actually help us to develop rational ways of thinking and acting. I make the case for romantic or erotic love, since this is the kind of love that is more frequently associated with irrationality in acting and thinking. I argue that this kind of love may make us develop epistemic and practical forms of rationality. Based on an analysis of its characteristic action tendencies, I argue that love may help us to develop an instrumental form of rationality in determining the best means to achieve the object of love. It may also narrow down the number of practical considerations that may help us to achieve our goals. Finally, love may generate rational ways of belief-formation by framing the parameters taken into account in perception and attention, and by bringing into light only a small portion of the epistemic information available. Love may make us perceive reality more acutely.

  12. Rational Combinations of Targeted Agents in AML

    Directory of Open Access Journals (Sweden)

    Prithviraj Bose

    2015-04-01

    Full Text Available Despite modest improvements in survival over the last several decades, the treatment of AML continues to present a formidable challenge. Most patients are elderly, and these individuals, as well as those with secondary, therapy-related, or relapsed/refractory AML, are particularly difficult to treat, owing to both aggressive disease biology and the high toxicity of current chemotherapeutic regimens. It has become increasingly apparent in recent years that coordinated interruption of cooperative survival signaling pathways in malignant cells is necessary for optimal therapeutic results. The modest efficacy of monotherapy with both cytotoxic and targeted agents in AML testifies to this. As the complex biology of AML continues to be elucidated, many “synthetic lethal” strategies involving rational combinations of targeted agents have been developed. Unfortunately, relatively few of these have been tested clinically, although there is growing interest in this area. In this article, the preclinical and, where available, clinical data on some of the most promising rational combinations of targeted agents in AML are summarized. While new molecules should continue to be combined with conventional genotoxic drugs of proven efficacy, there is perhaps a need to rethink traditional philosophies of clinical trial development and regulatory approval with a focus on mechanism-based, synergistic strategies.

  13. Iyengar-Yoga Compared to Exercise as a Therapeutic Intervention during (Neoadjuvant Therapy in Women with Stage I–III Breast Cancer: Health-Related Quality of Life, Mindfulness, Spirituality, Life Satisfaction, and Cancer-Related Fatigue

    Directory of Open Access Journals (Sweden)

    Désirée Lötzke

    2016-01-01

    Full Text Available This study aims to test the effects of yoga on health-related quality of life, life satisfaction, cancer-related fatigue, mindfulness, and spirituality compared to conventional therapeutic exercises during (neoadjuvant cytotoxic and endocrine therapy in women with breast cancer. In a randomized controlled trial 92 women with breast cancer undergoing oncological treatment were randomly enrolled for a yoga intervention (YI (n=45 or for a physical exercise intervention (PEI (n=47. Measurements were obtained before (t0 and after the intervention (t1 as well as 3 months after finishing intervention (t2 using standardized questionnaires. Life satisfaction and fatigue improved under PEI (p<0.05 but not under YI (t0 to t2. Regarding quality of life (EORTC QLQ-C30 a direct effect (t0 to t1; p<0.001 of YI was found on role and emotional functioning, while under PEI only emotional functioning improved. Significant improvements (p<0.001 were observed at both t1 and t2 also for symptom scales in both groups: dyspnea, appetite loss, constipation, and diarrhea. There was no significant difference between therapies for none of the analyzed variables neither for t1 nor for t2. During chemotherapy, yoga was not seen as more helpful than conventional therapeutic exercises. This does not argue against its use in the recovery phase.

  14. A time-series analysis of therapeutic alliance, interventions, and client's clinical status in an evidence-based single-case study: Evidence for establishing change mechanisms in psychotherapy.

    Science.gov (United States)

    Roussos, Andrés J; Gomez Penedo, Juan Martin; Muiños, Roberto

    2018-01-01

    The goal of this study was to analyze the time-series of alliance, interventions, and client's post-sessions clinical status, to establish if alliance and adherence to cognitive-behavioral interventions preceded improvement in psychotherapy Method: A single-case study of a complete Cognitive-Behavioral treatment of a 27-year-old male diagnosed with Generalized Anxiety Disorder treatment was conducted. Alliance, adherence to cognitive-behavioral interventions, and client's therapeutic condition were assessed every two sessions during the entire treatment. After controlling for the effect of autocorrelations, the transfer functions showed that alliance predicted client's clinical condition with a lag of two sessions throughout the entire treatment. However, the inverse relationship was not observed. Results support the hypothesis of a time-lagged association between alliance and subsequent client's changes in their clinical condition in single case of a cognitive-behavioral treatment.

  15. Towards a rational antimicrobial testing policy in the laboratory

    Directory of Open Access Journals (Sweden)

    N Banaji

    2011-01-01

    Full Text Available Antimicrobial policy for prophylactic and therapeutic use of antimicrobials in a tertiary care setting has gained importance. A hospital′s antimicrobial policy as laid down by its hospital infection control team needs to include inputs from the microbiology laboratory, besides the pharmacy and therapeutic committee. Therefore, it is of utmost importance that clinical microbiologists across India follow international guidelines and also take into account local settings, especially detection and presence of resistance enzymes. This article draws a framework for rational antimicrobial testing in our laboratories in tertiary care centers, from the Clinical and Laboratory Standards Institute guidelines. It does not address testing methodologies but suggests ways and means by which antimicrobial susceptibility reporting can be rendered meaningful not only to the treating physician but also to the resistance monitoring epidemiologist. It hopes to initiate some standardization in rational choice of antimicrobial testing in laboratories in the country pertaining to nonfastidious bacteria.

  16. Towards a rational antimicrobial testing policy in the laboratory.

    Science.gov (United States)

    Banaji, N; Oommen, S

    2011-01-01

    Antimicrobial policy for prophylactic and therapeutic use of antimicrobials in a tertiary care setting has gained importance. A hospital's antimicrobial policy as laid down by its hospital infection control team needs to include inputs from the microbiology laboratory, besides the pharmacy and therapeutic committee. Therefore, it is of utmost importance that clinical microbiologists across India follow international guidelines and also take into account local settings, especially detection and presence of resistance enzymes. This article draws a framework for rational antimicrobial testing in our laboratories in tertiary care centers, from the Clinical and Laboratory Standards Institute guidelines. It does not address testing methodologies but suggests ways and means by which antimicrobial susceptibility reporting can be rendered meaningful not only to the treating physician but also to the resistance monitoring epidemiologist. It hopes to initiate some standardization in rational choice of antimicrobial testing in laboratories in the country pertaining to nonfastidious bacteria.

  17. Rationality versus Irrationality in Managerial Decision Making

    OpenAIRE

    Daňková, Tereza

    2013-01-01

    The thesis focuses on rationality in decisions by managers. The terms rationality, irrationality and bounded rationality are defined in the first part. The current state of knowledge on the concept of bounded rationality in decision making is then followed by a specific consideration of managerial decision making. The chosen bounded rationality effects, including heuristics, are also described. The purpose of the second part of this study is to examine experimentally the differential uses of ...

  18. Detoxifying the concept of rationing.

    Science.gov (United States)

    Sabin, James

    2014-01-01

    Andrew Hantel's proposal for dealing with cancer drug shortages exemplifies the kind of clinician-led discussion of rationing the U.S. political process requires. I argue that the U.S. will not get a grip on healthcare cost escalation until we set true budgets for healthcare. We will not be able to do that until the public accepts that rationing, done right, is an ethical necessity, not an ethical abomination. Because endorsing rationing is a third rail for politicians, "top down" leadership is currently impossible. As a result, health professionals must lead a "bottom up" educational process. Hantel shows how this can be done. Copyright 2014 The Journal of Clinical Ethics. All rights reserved.

  19. Rational points on elliptic curves

    CERN Document Server

    Silverman, Joseph H

    2015-01-01

    The theory of elliptic curves involves a pleasing blend of algebra, geometry, analysis, and number theory. This book stresses this interplay as it develops the basic theory, thereby providing an opportunity for advanced undergraduates to appreciate the unity of modern mathematics. At the same time, every effort has been made to use only methods and results commonly included in the undergraduate curriculum. This accessibility, the informal writing style, and a wealth of exercises make Rational Points on Elliptic Curves an ideal introduction for students at all levels who are interested in learning about Diophantine equations and arithmetic geometry. Most concretely, an elliptic curve is the set of zeroes of a cubic polynomial in two variables. If the polynomial has rational coefficients, then one can ask for a description of those zeroes whose coordinates are either integers or rational numbers. It is this number theoretic question that is the main subject of this book. Topics covered include the geometry and ...

  20. Rational choice in field archaelology

    Directory of Open Access Journals (Sweden)

    Cătălin Pavel

    2011-11-01

    Full Text Available In the present article I attempt to apply advances in the study of instrumental and epistemic rationality to field archaeology in order to gain insights into the ways archaeologists reason. The cognitive processes, particularly processes of decision making, that enable archaeologists to conduct the excavation in the trench have not been adequately studied so far. I take my cues from two different bodies of theory. I first inquire into the potential that rational choice theory (RCT may have in modeling archaeological behaviour, and I define subjective expected utility, which archaeologists attempt to maximize, in terms of knowledge acquisition and social gain. Following Elster’s criticism of RCT, I conclude that RCT’s standards for rational action do not correspond with those ostensibly used in field archaeology, but that instrumental rationality has a prominent role in the “archaeological experiment”. I further explore if models proposed as reaction to RCT may account for archaeological decision making. I focus on fast and frugal heuristics, and search for archaeological illustrations for some of the cognitive biases that are better documented in psychological literature. I document confirmation and congruence biases, the endowment effect, observer-expectancy bias, illusory correlation, clustering illusion, sunk cost bias, and anchoring, among others and I propose that some of these biases are used as cognitive tools by archaeologists at work and retain epistemic value. However, I find formal logic to be secondary in the development of archaeological reasoning, with default logic and defeasible logic being used instead. I emphasize scientific knowledge as an actively negotiated social product of human inquiry, and conclude that to describe rationality in field archaeology a bounded rationality model is the most promising avenue of investigation.

  1. Rational Reconstructions of Modern Physics

    CERN Document Server

    Mittelstaedt, Peter

    2011-01-01

    Newton’s classical physics and its underlying ontology are loaded with several metaphysical hypotheses that cannot be justified by rational reasoning nor by experimental evidence. Furthermore, it is well known that some of these hypotheses are not contained in the great theories of modern physics, such as the theory of relativity and quantum mechanics. This book shows that, on the basis of Newton’s classical physics and by rational reconstruction, the theory of relativity as well as quantum mechanics can be obtained by partly eliminating or attenuating the metaphysical hypotheses. Moreover, it is shown that these reconstructions do not require additional hypotheses or new experimental results.

  2. Public policy, rationality and reason

    Directory of Open Access Journals (Sweden)

    Rodolfo Canto Sáenz

    2015-07-01

    Full Text Available This work suggests the incorporation of practical reason in the design, implementation and evaluation of public policies, alongside instrumental rationality. It takes two proposals that today point in this direction: Rawls distinction between reasonable (practical reason and rational (instrumental reason and what this author calls the CI Procedure (categorical imperative procedure and Habermas model of deliberative democracy. The main conclusion is that the analysis of public policies can not be limited to rather narrow limits of science, but requires the contribution of political and moral philosophy.

  3. Rational Polytherapy with Antiepileptic Drugs

    Directory of Open Access Journals (Sweden)

    Jong Woo Lee

    2010-07-01

    Full Text Available Approximately 30–40% of patients do not achieve seizure control with a single antiepileptic drug (AED. With the advent of multiple AEDs in the past 15 years, rational polytherapy, the goal of finding combinations of AEDs that have favorable characteristics, has become of greater importance. We review the theoretical considerations based on AED mechanism of action, animal models, human studies in this field, and the challenges in finding such optimal combinations. Several case scenarios are presented, illustrating examples of rational polytherapy.

  4. Suicide: bad act or good intervention.

    Science.gov (United States)

    Clements, C D; Sider, R C; Perlmutter, R

    1983-01-01

    This article develops a different perspective on the ethics of suicide, based on theoretical and clinical grounds. In terms of value theory, applying "good" or "bad" to the suicide act makes no sense. We need to shift our focus from a search for an ethical statement about suicide (e.g., "rational suicide") to the ethical justification for intervention based on the needs and interests of an affirming therapeutic profession. We choose to intervene because of values we hold about well-functioning, existence, potential for human life; and because as emphatic, social beings, we feel for others and are motivated by that feeling. This justification leads us to suggest a situational case-centered ethics for suicide intervention.

  5. Rational Suicide among the Elderly.

    Science.gov (United States)

    Humphry, Derek

    1992-01-01

    Contends that old age, in and of itself, should never need to be a cause for self-destruction. Further argues that suicide and assisted suicide carried out in the face of terminal illness causing unbearable suffering should be ethically and legally acceptable. Outlines a perspective on rational suicide among the elderly. (Author/NB)

  6. Rational students and resit exams

    NARCIS (Netherlands)

    Kooreman, P.

    2013-01-01

    Resit exams–extra opportunities to do an exam in the same academic year–are widely prevalent in European higher education, but uncommon in the US. I present a simple theoretical model to compare rational student behavior in the case of only one exam opportunity versus the case of two exam

  7. Rational suicide: uncertain moral ground.

    Science.gov (United States)

    Rich, Karen L; Butts, Janie B

    2004-05-01

    The ambiguities involving end-of-life issues, such as physician-assisted suicide and voluntary stopping of eating and drinking, have caused a blurring of the definition of rational suicide and have prompted rich dialogue with moral deliberations that seem to be on disparate paths among bioethicists and other health care professionals. With the evolution of advanced medical technology extending life expectancy in older, disabled, and terminally ill people, rational suicide has become a critical issue of debate. The purpose of this article is to address the ethical positions supporting and opposing rational suicide and to consider whether coherence can be achieved through an ethic of care. Attitudes towards suicide have been controversial, varying from acceptance to non-acceptance depending on social, political and religious influences. Nursing attitudes are no different from general societal attitudes and, consequently, nurses are treading on uncertain moral ground. Nurses who have not reflected on the moral issues involved with rational suicide may be unprepared psychologically and professionally when working with patients who may be contemplating such actions.

  8. A Retrospective Analysis of 5,195 Patient Treatment Sessions in an Integrative Veterinary Medicine Service: Patient Characteristics, Presenting Complaints, and Therapeutic Interventions

    Directory of Open Access Journals (Sweden)

    Justin Shmalberg

    2015-01-01

    Full Text Available Integrative veterinary medicine, the combination of complementary and alternative therapies with conventional care, is increasingly prevalent in veterinary practice and a focus of clinical instruction in many academic teaching institutions. However, the presenting complaints, therapeutic modalities, and patient population in an integrative medicine service have not been described. A retrospective analysis of 5,195 integrative patient treatment sessions in a veterinary academic teaching hospital demonstrated that patients most commonly received a combination of therapeutic modalities (39% of all treatment sessions. The 274 patients receiving multiple modalities were most frequently treated for neurologic and orthopedic disease (50.7% versus 49.6% of all presenting complaints, resp.. Older neutered or spayed dogs (mean age = 9.0 years and Dachshunds were treated more often than expected based on general population statistics. Acupuncture, laser therapy, electroacupuncture, and hydrotherapy were frequently administered (>50% patients. Neurologic patients were more likely to receive acupuncture, electroacupuncture, and therapeutic exercises but less likely than orthopedic patients to receive laser, hydrotherapy, or therapeutic ultrasound treatments (P<0.05. The results suggest that the application of these specific modalities to orthopedic and neurologic diseases should be subjected to increased evidence-based investigations. A review of current knowledge in core areas is presented.

  9. A Retrospective Analysis of 5,195 Patient Treatment Sessions in an Integrative Veterinary Medicine Service: Patient Characteristics, Presenting Complaints, and Therapeutic Interventions

    Science.gov (United States)

    Memon, Mushtaq A.

    2015-01-01

    Integrative veterinary medicine, the combination of complementary and alternative therapies with conventional care, is increasingly prevalent in veterinary practice and a focus of clinical instruction in many academic teaching institutions. However, the presenting complaints, therapeutic modalities, and patient population in an integrative medicine service have not been described. A retrospective analysis of 5,195 integrative patient treatment sessions in a veterinary academic teaching hospital demonstrated that patients most commonly received a combination of therapeutic modalities (39% of all treatment sessions). The 274 patients receiving multiple modalities were most frequently treated for neurologic and orthopedic disease (50.7% versus 49.6% of all presenting complaints, resp.). Older neutered or spayed dogs (mean age = 9.0 years) and Dachshunds were treated more often than expected based on general population statistics. Acupuncture, laser therapy, electroacupuncture, and hydrotherapy were frequently administered (>50% patients). Neurologic patients were more likely to receive acupuncture, electroacupuncture, and therapeutic exercises but less likely than orthopedic patients to receive laser, hydrotherapy, or therapeutic ultrasound treatments (P < 0.05). The results suggest that the application of these specific modalities to orthopedic and neurologic diseases should be subjected to increased evidence-based investigations. A review of current knowledge in core areas is presented. PMID:26798552

  10. Pharmacy and therapeutics committees in Brazil: lagging behind international standards

    National Research Council Canada - National Science Library

    Marques, Dirce Cruz; Zucchi, Paola

    2006-01-01

    .... One approach used to rationalize the use of drugs lies in the creation of pharmacy and therapeutics committees, whose main role is to guide and assist health institutions at all levels in selecting...

  11. Emerging therapeutic strategies for obesity.

    Science.gov (United States)

    Foster-Schubert, Karen E; Cummings, David E

    2006-12-01

    The rising tide of obesity is one of the most pressing health issues of our time, yet existing medicines to combat the problem are disappointingly limited in number and effectiveness. Fortunately, a recent burgeoning of mechanistic insights into the neuroendocrine regulation of body weight provides an expanding list of molecular targets for novel, rationally designed antiobesity pharmaceuticals. In this review, we articulate a set of conceptual principles that we feel could help prioritize among these molecules in the development of obesity therapeutics, based on an understanding of energy homeostasis. We focus primarily on central targets, highlighting selected strategies to stimulate endogenous catabolic signals or inhibit anabolic signals. Examples of the former approach include methods to enhance central leptin signaling through intranasal leptin delivery, use of superpotent leptin-receptor agonists, and mechanisms to increase leptin sensitivity by manipulating SOCS-3, PTP-1B, ciliary neurotrophic factor, or simply by first losing weight with traditional interventions. Techniques to augment signaling by neurochemical mediators of leptin action that lie downstream of at least some levels of obesity-associated leptin resistance include activation of melanocortin receptors or 5-HT2C and 5-HT1B receptors. We also describe strategies to inhibit anabolic molecules, such as neuropeptide Y, melanin-concentrating hormone, ghrelin, and endocannabinoids. Modulation of gastrointestinal satiation and hunger signals is discussed as well. As scientists continue to provide fundamental insights into the mechanisms governing body weight, the future looks bright for development of new and better antiobesity medications to be used with diet and exercise to facilitate substantial weight loss.

  12. Rationality, mental causation and social sciences

    Directory of Open Access Journals (Sweden)

    Mladenović Ivan

    2009-01-01

    Full Text Available The aim of this paper is to investigate the role of mental causation in the context of rational choice theory. The author defends psychological aspect of rational explanation against the challenge of contemporary reductive materialism.

  13. Ligands of Therapeutic Utility for the Liver X Receptors

    Directory of Open Access Journals (Sweden)

    Rajesh Komati

    2017-01-01

    Full Text Available Liver X receptors (LXRs have been increasingly recognized as a potential therapeutic target to treat pathological conditions ranging from vascular and metabolic diseases, neurological degeneration, to cancers that are driven by lipid metabolism. Amidst intensifying efforts to discover ligands that act through LXRs to achieve the sought-after pharmacological outcomes, several lead compounds are already being tested in clinical trials for a variety of disease interventions. While more potent and selective LXR ligands continue to emerge from screening of small molecule libraries, rational design, and empirical medicinal chemistry approaches, challenges remain in minimizing undesirable effects of LXR activation on lipid metabolism. This review provides a summary of known endogenous, naturally occurring, and synthetic ligands. The review also offers considerations from a molecular modeling perspective with which to design more specific LXRβ ligands based on the interaction energies of ligands and the important amino acid residues in the LXRβ ligand binding domain.

  14. Psychology and the Rationality of Emotion*

    OpenAIRE

    Clore, Gerald L

    2011-01-01

    Questions addressed by recent psychological research on emotion include questions about how thought shapes emotion and how emotion, in turn, shapes thought. Research on emotion and cognition paints a somewhat different picture than that seen in traditional discussions of passion and reason. This article reviews several aspects of this research, concentrating specifically on three views of rationality: Rationality as Process, Rationality as Product, and Rationality as Outcome.

  15. Davidson on Turing: Rationality Misunderstood?

    Directory of Open Access Journals (Sweden)

    John-Michael Kuczynski

    2005-12-01

    Full Text Available Alan Turing advocated a kind of functionalism: A machine M is a thinker provided that it responds in certain ways to certain inputs. Davidson argues that Turing’s functionalism is inconsistent with a cer-tain kind of epistemic externalism, and is therefore false. In Davidson’s view, concepts consist of causal liasons of a certain kind between subject and object. Turing’s machine doesn’t have the right kinds of causal li-asons to its environment. Therefore it doesn’t have concepts. Therefore it doesn’t think. I argue that this reasoning is entirely fallacious. It is true that, in some cases, a causal liason between subject and object is part of one’s concept of that object. Consequently, to grasp certain propositions, one must have certain kids of causal ties to one’s environment. But this means that we must rethink some old views on what rationality is. It does not mean, pace Davidson, that a precondition for being rational is being causally embedded in one’s environment in a certain way. If Tur-ing’s machine isn’t capable of thinking (I leave it open whether it is or is not, that has nothing to do with its lacking certain kinds of causal con-nections to the environment. The larger significance of our discussion is this: rationality consists either in one’s ability to see the bearing of purely existential propositions on one another or rationality is simply not to be understood as the ability see the bearing that propositions have on one another.

  16. Rationality and concept of limit

    OpenAIRE

    LECORRE, Thomas

    2016-01-01

    International audience; We present a didactic situation aimed at the formal definition (delta-epsilon) of the limit of a function; the experimentation of this didactic situation has been made many times with French students in the last year of high school and the first year of university using ''scientific debates'' between students. From an excerpt of the script of an experimentation, we study the evolution of students' reasoning. We specifically study the kinds of rationalities used by stud...

  17. Rational Expectation Can Preclude Trades

    OpenAIRE

    Matsuhisa, Takashi; Ishikawa, Ryuichiro

    2003-01-01

    We consider a pure exchange economy under uncertainty in which the traders have the non-partition structure of information. They willing to trade the amounts of state-contingent commodities and they know their own expectations. Common knowledge of these conditions among all the traders can preclude trade if the initial endowments allocation is ex-ante Pareto optimal. Furthermore we introduce rational expectations equilibrium under the non-partition information, and prove the existence theorem...

  18. MultiComponent Exercise and theRApeutic lifeStyle (CERgAS) intervention to improve physical performance and maintain independent living among urban poor older people--a cluster randomised controlled trial.

    Science.gov (United States)

    Loh, Debbie Ann; Hairi, Noran Naqiah; Choo, Wan Yuen; Mohd Hairi, Farizah; Peramalah, Devi; Kandiben, Shathanapriya; Lee, Pek Ling; Gani, Norlissa; Madzlan, Mohamed Faris; Abd Hamid, Mohd Alif Idham; Akram, Zohaib; Chu, Ai Sean; Bulgiba, Awang; Cumming, Robert G

    2015-02-11

    The ability of older people to function independently is crucial as physical disability and functional limitation have profound impacts on health. Interventions that either delay the onset of frailty or attenuate its severity potentially have cascading benefits for older people, their families and society. This study aims to develop and evaluate the effectiveness of a multiComponent Exercise and theRApeutic lifeStyle (CERgAS) intervention program targeted at improving physical performance and maintaining independent living as compared to general health education among older people in an urban poor setting in Malaysia. This cluster randomised controlled trial will be a 6-week community-based intervention programme for older people aged 60 years and above from urban poor settings. A minimum of 164 eligible participants will be recruited from 8 clusters (low-cost public subsidised flats) and randomised to the intervention and control arm. This study will be underpinned by the Health Belief Model with an emphasis towards self-efficacy. The intervention will comprise multicomponent group exercise sessions, nutrition education, oral care education and on-going support and counselling. These will be complemented with a kit containing practical tips on exercise, nutrition and oral care after each session. Data will be collected over four time points; at baseline, immediately post-intervention, 3-months and 6-months follow-up. Findings from this trial will potentially provide valuable evidence to improve physical function and maintain independence among older people from low-resource settings. This will inform health policies and identify locally acceptable strategies to promote healthy aging, prevent and delay functional decline among older Malaysian adults. ISRCTN22749696.

  19. Increasing Adolescents' Subjective Well-Being: Effects of a Positive Psychology Intervention in Comparison to the Effects of Therapeutic Alliance, Youth Factors, and Expectancy for Change

    Science.gov (United States)

    Savage, Jessica Ann

    2011-01-01

    This study investigated the variance in subjective well-being (SWB) of early adolescents ( n = 54) exposed to a positive psychology intervention aimed at increasing positive affect and life satisfaction as well as decreasing negative affect through intentional activities (e.g., gratitude journals, acts of kindness, use of character strengths,…

  20. Bounded rationality and heterogeneous expectations in macroeconomics

    NARCIS (Netherlands)

    Massaro, D.

    2012-01-01

    This thesis studies the effect of individual bounded rationality on aggregate macroeconomic dynamics. Boundedly rational agents are specified as using simple heuristics in their decision making. An important aspect of the type of bounded rationality described in this thesis is that the population of

  1. Book Selection, Collection Development, and Bounded Rationality.

    Science.gov (United States)

    Schwartz, Charles A.

    1989-01-01

    Reviews previously proposed schemes of classical rationality in book selection, describes new approaches to rational choice behavior, and presents a model of book selection based on bounded rationality in a garbage can decision process. The role of tacit knowledge and symbolic content in the selection process are also discussed. (102 references)…

  2. The Functional Difference of Dendritic Cells in HBeAg Negative Chronic Hepatitis B Patients with Three Different Spleen Deficiency Syndromes and the Therapeutic Evaluation of Chinese Medicine Intervention Based on Syndrome Differentiation

    Directory of Open Access Journals (Sweden)

    Lei Wang

    2014-01-01

    Full Text Available Objective. To investigate the dendritic cells (DCs maturity differences of HBeAg negative chronic hepatitis B (CHB patients with different spleen deficiency (SD syndromes and explore the role of syndrome differentiation in the therapeutic evaluation of Chinese medicine. Methods. 120 participants were recruited including three treatment groups in different SD syndrome categories as spleen deficiency with liver depression (SDLD, spleen deficiency with damp heat (SDDH, and spleen deficiency with kidney deficiency (SDKD and one healthy control group; each group had 30 participants. Corresponding drugs were applied. The outcome measures included DC phenotype, liver function, IL-10, IL-12, and HBV-DNA levels. Results. The surface markers of mature DCs and cytokines levels were different in each group; the positive rate of CD80, CD1a, HLA-DR, and CD1a was the lowest in SDKD group. After 3-month intervention, the expression of CD80, CD86, CD1a, HLA-DR, and IL-12 significantly increased, while ALT, AST, and IL-10 significantly decreased (P<0.05 in treatment groups. HBV-DNA level also significantly reduced in both SDKD and SDLD groups (P<0.05. Conclusions. HBeAg negative patients had DCs dysmaturity, and there were differences between different SD syndromes. Chinese medicine intervention according to syndrome differentiation could advance the maturity and function of DCs and improve the therapeutic effect.

  3. Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Concise Review with a Comprehensive Summary of Therapeutic Interventions Emphasizing Supportive Measures.

    Science.gov (United States)

    Schneider, Jeremy A; Cohen, Philip R

    2017-06-01

    Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are two of the most severe dermatologic conditions occurring in the inpatient setting. There is a lack of consensus regarding appropriate management of SJS and TEN. The scientific literature pertaining to SJS and TEN (subsequently referred to as SJS/TEN) is summarized and assessed. In addition, an interventional approach for the clinician is provided. PubMed was searched with the key words: corticosteroids, cyclosporine, etanercept, intravenous immunoglobulin, Stevens-Johnson syndrome, and toxic epidermal necrolysis. The papers generated by the search, and their references, were reviewed. Supportive care is the most universally accepted intervention for SJS/TEN. Specific guidelines differ from the care required for patients with thermal burns. Adjuvant therapies are utilized in most severe cases, but the data are thus far underwhelming and underpowered. Using systemic corticosteroids as sole therapy is not supported. A consensus regarding combined corticosteroids and intravenous immunoglobulin (IVIG) has not been reached. Data regarding IVIG, currently the standard of care for most referral centers, is conflicting. Newer studies regarding cyclosporine and tumor necrosis factor inhibitors are promising, but not powered to provide definitive evidence of efficacy. Data regarding plasmapheresis is equivocal. Thalidomide increases mortality. Clinicians who manage SJS/TEN should seek to employ interventions with the greatest impact on their patients' condition. While supportive care measures may seem an obvious aspect of SJS/TEN patient care, providers should understand that these interventions are imperative and that they differ from the care recommended for other critically ill or burn patients. While adjuvant therapies are frequently discussed and debated for hospitalized patients with SJS/TEN, a standardized management approach is not yet clear based on the current data. Therefore, until further data

  4. Crystal clear: visualizing the intervention mechanism of the PD-1/PD-L1 interaction by two cancer therapeutic monoclonal antibodies.

    Science.gov (United States)

    Tan, Shuguang; Chen, Danqing; Liu, Kefang; He, Mengnan; Song, Hao; Shi, Yi; Liu, Jun; Zhang, Catherine W-H; Qi, Jianxun; Yan, Jinghua; Gao, Shan; Gao, George F

    2016-12-01

    Antibody-based PD-1/PD-L1 blockade therapies have taken center stage in immunotherapies for cancer, with multiple clinical successes. PD-1 signaling plays pivotal roles in tumor-driven T-cell dysfunction. In contrast to prior approaches to generate or boost tumor-specific T-cell responses, antibody-based PD-1/PD-L1 blockade targets tumor-induced T-cell defects and restores pre-existing T-cell function to modulate antitumor immunity. In this review, the fundamental knowledge on the expression regulations and inhibitory functions of PD-1 and the present understanding of antibody-based PD-1/PD-L1 blockade therapies are briefly summarized. We then focus on the recent breakthrough work concerning the structural basis of the PD-1/PD-Ls interaction and how therapeutic antibodies, pembrolizumab targeting PD-1 and avelumab targeting PD-L1, compete with the binding of PD-1/PD-L1 to interrupt the PD-1/PD-L1 interaction. We believe that this structural information will benefit the design and improvement of therapeutic antibodies targeting PD-1 signaling.

  5. On the Construction of Knowledge in the Context of Biographical Interpretations of Illness. Professional Interventions and Collective Therapeutic Processes among Women with Psychosomatic Diseases

    Directory of Open Access Journals (Sweden)

    Kirsten Hohn

    2008-01-01

    Full Text Available Constructing knowledge and dealing with different types and representations of knowledge are analyzed on the basis of interviews with female participants of post clinical psychosomatic groups in the women's health center of Bremen (Germany. This article shows how women's construction of knowledge is based, on the one hand, on interactions with professional experts and the confrontation with their medical, therapeutic and educational knowledge. On the other hand, these constructions emerge against the backdrop of biographical experiences and conceptions as well as in connection with the interactive and collective experiences within the context of the post clinical psychosomatic groups. While the knowledge communicated by the physicians and therapists is kept at a distance or rejected, the collectively produced knowledge through experience is characterized by its possibility to become incorporated into women's biographies. The collective therapeutic processes, the exchange among the women and the (reconstruction of experiences are shown to be relevant especially concerning sexual violence and problematic situations in relationships. URN: urn:nbn:de:0114-fqs0801480

  6. Crystal clear: visualizing the intervention mechanism of the PD-1/PD-L1 interaction by two cancer therapeutic monoclonal antibodies

    Directory of Open Access Journals (Sweden)

    Shuguang Tan

    2016-11-01

    Full Text Available Abstract Antibody-based PD-1/PD-L1 blockade therapies have taken center stage in immunotherapies for cancer, with multiple clinical successes. PD-1 signaling plays pivotal roles in tumor-driven T-cell dysfunction. In contrast to prior approaches to generate or boost tumor-specific T-cell responses, antibody-based PD-1/PD-L1 blockade targets tumor-induced T-cell defects and restores pre-existing T-cell function to modulate antitumor immunity. In this review, the fundamental knowledge on the expression regulations and inhibitory functions of PD-1 and the present understanding of antibody-based PD-1/PD-L1 blockade therapies are briefly summarized. We then focus on the recent breakthrough work concerning the structural basis of the PD-1/PD-Ls interaction and how therapeutic antibodies, pembrolizumab targeting PD-1 and avelumab targeting PD-L1, compete with the binding of PD-1/PD-L1 to interrupt the PD-1/PD-L1 interaction. We believe that this structural information will benefit the design and improvement of therapeutic antibodies targeting PD-1 signaling.

  7. Inflammatory bowel disease: potential therapeutic strategies

    DEFF Research Database (Denmark)

    Nielsen, O H; Vainer, B; Bregenholt, S

    1997-01-01

    This review deals with potential and possibly primary therapeutics that, through insight into the inflammatory cascade, result in more rational treatment principles replacing the classical therapy of inflammatory bowel disease (IBD), i.e. Crohn's disease (CD) and ulcerative colitis (UC). These ne...

  8. Bank credit rationing in Italy: an empirical analysis

    National Research Council Canada - National Science Library

    G.B. PITTALUGA

    2013-01-01

    .... The present paper provides an empirical analysis of bank credit rationing. First, the author verifies the existence of rationing and the forms in which it is practiced, that is, distinguishing between dynamic rationing and equilibrium rationing...

  9. Design, synthesis, and evaluation of Trolox-conjugated amyloid-β C-terminal peptides for therapeutic intervention in an in vitro model of Alzheimer's disease.

    Science.gov (United States)

    Arai, Takuya; Ohno, Akiko; Kazunori, Mori; Kakizawa, Taeko; Kuwata, Hiroshi; Ozawa, Toshihiko; Shibanuma, Motoko; Hara, Shuntaro; Ishida, Seiichi; Kurihara, Masaaki; Miyata, Naoki; Nakagawa, Hidehiko; Fukuhara, Kiyoshi

    2016-09-15

    Two hallmarks of Alzheimer's disease (AD) observed in the brains of patients with the disease include oxidative injury and deposition of protein aggregates comprised of amyloid-β (Aβ) variants. To inhibit these toxic processes, we synthesized antioxidant-conjugated peptides comprised of Trolox and various C-terminal motifs of Aβ variants, TxAβx-n (x=34, 36, 38, 40; n=40, 42, 43). Most of these compounds were found to exhibit anti-aggregation activities. Among them, TxAβ36-42 significantly inhibited Aβ1-42 aggregation, showed potent antioxidant activity, and protected SH-SY5Y cells from Aβ1-42-induced cytotoxicity. Thus, this method represents a promising strategy for developing multifunctional AD therapeutic agents. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Therapeutic intervention scoring system application in a pediatric intensive care unit Aplicação do índice de intervenção terapêutica em unidade de terapia intensiva pediátrica

    Directory of Open Access Journals (Sweden)

    Pedro Celiny Ramos Garcia

    2009-08-01

    Full Text Available Introduction: Indices of gravity aim to estimate the disease’s severity. The Therapeutic Intervention Scoring System – 28 (TISS-28 is used in Intensive Care Units as an indirect index to estimate the disease`s gravity interval, which has also been recently used to relate the nursing workload Objective: To review each operational item/definition of the Therapeutic Intervention Scoring System (TISS-28, making a re-reading in order to systematize the data collection practice in Pediatric Intensive Care Units (PICUs. Materials and Methods: An integrative revision research of medical and nursing literature through the base of data from Medical Literature Analysis and Retrieval System Online (MEDLINE and Scientific Electronic Library Online (SciELO using the terms Intensive Care Units, scales and Therapeutic Intervention Scoring System-28 or TISS-28. The articles were selected according to their relevance, as the authors opinion. Results: Preliminary studies show that the use of TISS-28 in ICU of adults patients, has helped in the evolutionary clinical assessment of the patient’s worsening, besides associations between death and elevated scores. The items/operational definitions evaluated in this score are reviewed in order to facilitate the interpretation of each item in the TISS -28 daily application in Pediatric Intensive Care Unit (PICU. Conclusion: The daily assessment of the 28 TISS variables allows the acquirement of an evolutionary profile of hospitalized children, which can help to increase the knowledge of the hospitalized child clinical picture and its prognosis.Introdução: Índices de gravidade buscam estimar a severidade da doença, sendo o Therapeutic Intenvention Scoring System-28 (Sistema de Escore de Intervenção Terapêutica - TISS-28, usado em Unidades de Terapia Intensiva, um índice indireto para estimar intervalos de gravidade da doença que mais recentemente tem sido usado para relacionar a carga de trabalho de

  11. Induced mild therapeutic hypothermia following cardiac arrest in the setting of acute myocardial infarction and successful primary percutaneous coronary intervention: a case report

    Directory of Open Access Journals (Sweden)

    Paulo César Gobert Damasceno Campos

    2009-03-01

    Full Text Available It was presented the case of a 50-year-old male, with no previous history of cardiovascular disease, who was successfully treated with induced mild hypothermia and primary percutaneous coronary intervention after cardiac arrest and prolonged resuscitation (twelve electrical cardioversions, following acute ST-segment elevation myocardial infarction. The patient had full recovery and uneventful short and long-term neurological course. Mild hypothermia has been considered a safe option for cerebral preservation after cardiopulmonary resuscitation. Several mechanisms mediate brain protection during hypothermia, including a possible prevention of apoptosis (programmed cell death. The role of apoptosis following ischemic and/or hypoxic brain injury is also reviewed.

  12. Paciente com paralisa cerebral coreoatetoide: evolução clínica pós-intervenção Patient with choreoathetoid cerebral palsy: post therapeutic intervention

    Directory of Open Access Journals (Sweden)

    Carolina Castelli Silvério

    2010-04-01

    Full Text Available OBJETIVO: verificar a eficácia da intervenção terapêutica na função de deglutição e na estabilidade clínica de crianças portadoras de paralisia cerebral (PC coreoatetoide com disfagia orofaríngea. MÉTODOS: 11 crianças portadoras de PC do tipo coreoatetoide, com média de idade de três anos e três meses, que frequentaram terapia fonoaudiológica. Foram levantados os seguintes dados: escala de avaliação funcional da alimentação (Functional Oral Intake Scale - FOIS; grau de severidade da disfagia; broncopneumonias (BCP, hipersecretividade pulmonar e peso; consistência alimentar; sinais de penetração e/ou aspiração laringotraqueal. Os dados foram levantados no relatório de avaliação antes da intervenção terapêutica e no relatório final de evolução, no momento da alta. RESULTADOS: com relação à aplicação da escala FOIS, obteve-se que, tanto antes, quanto após a intervenção, a maioria dos pacientes encontrou-se no nível V da escala, com diminuição no segundo momento. Aumento dos pacientes nos níveis III e IV. Após intervenção terapêutica, houve diminuição de pacientes que ingeriam líquidos, aumento do uso do líquido espesso e do pastoso homogêneo. Houve diminuição da severidade da disfagia, redução dos episódios de BCP e de hipersecretividade pulmonar, aumento de peso e redução dos sinais de penetração e/ou aspiração laringotraqueal. CONCLUSÃO: a intervenção fonoaudiológica, dentro de uma equipe multidisciplinar em disfagia, em crianças portadoras de PC coreoatetoide promove deglutição mais segura e eficaz, com redução dos sinais sugestivos de penetração e/ou aspiração laringotraqueal, dos episódios de BCP e de hipersecretividade pulmonar, e aumento do peso.PURPOSE: to investigate the efficacy of therapeutic intervention in swallowing and clinical stability of children with choreoathetoid cerebral palsy and oropharyngeal dysphagia. METHODS: 11 children with choreoathetoid

  13. Grade Expectations: Rationality and Overconfidence

    Science.gov (United States)

    Magnus, Jan R.; Peresetsky, Anatoly A.

    2018-01-01

    Confidence and overconfidence are essential aspects of human nature, but measuring (over)confidence is not easy. Our approach is to consider students' forecasts of their exam grades. Part of a student's grade expectation is based on the student's previous academic achievements; what remains can be interpreted as (over)confidence. Our results are based on a sample of about 500 second-year undergraduate students enrolled in a statistics course in Moscow. The course contains three exams and each student produces a forecast for each of the three exams. Our models allow us to estimate overconfidence quantitatively. Using these models we find that students' expectations are not rational and that most students are overconfident, in agreement with the general literature. Less obvious is that overconfidence helps: given the same academic achievement students with larger confidence obtain higher exam grades. Female students are less overconfident than male students, their forecasts are more rational, and they are also faster learners in the sense that they adjust their expectations more rapidly. PMID:29375449

  14. Grade Expectations: Rationality and Overconfidence

    Directory of Open Access Journals (Sweden)

    Jan R. Magnus

    2018-01-01

    Full Text Available Confidence and overconfidence are essential aspects of human nature, but measuring (overconfidence is not easy. Our approach is to consider students' forecasts of their exam grades. Part of a student's grade expectation is based on the student's previous academic achievements; what remains can be interpreted as (overconfidence. Our results are based on a sample of about 500 second-year undergraduate students enrolled in a statistics course in Moscow. The course contains three exams and each student produces a forecast for each of the three exams. Our models allow us to estimate overconfidence quantitatively. Using these models we find that students' expectations are not rational and that most students are overconfident, in agreement with the general literature. Less obvious is that overconfidence helps: given the same academic achievement students with larger confidence obtain higher exam grades. Female students are less overconfident than male students, their forecasts are more rational, and they are also faster learners in the sense that they adjust their expectations more rapidly.

  15. Rational error in internal medicine.

    Science.gov (United States)

    Federspil, Giovanni; Vettor, Roberto

    2008-03-01

    Epistemologists have selected two basic categories: that of errors committed in scientific research, when a researcher devises or accepts an unfounded hypothesis, and that of mistakes committed in the application of scientific knowledge whereby doctors rely on knowledge held to be true at the time in order to understand an individual patient's signs and symptoms. The paper will deal exclusively with the latter, that is to say the mistakes which physicians make while carrying out their day-to-day medical duties. The paper will deal with the mistakes committed in medicine trying also to offer a classification. It will take into account also examples of mistakes in Bayesian reasoning and mistakes of reasoning committed by clinicians regard inductive reasoning. Moreover, many other mistakes are due to fallacies of deductive logic, logic which they use on a day-to-day basis while examining patients in order to envisage the consequences of the various diagnostic or physiopathologic hypotheses. The existence of a different type of mistakes that are part of the psychology of thought will be also pointed out. We conclude that internists often make mistakes because, unknowingly, they fail to reason correctly. These mistakes can occur in two ways: either because he does not observe the laws of formal logic, or because his practical rationality does not match theoretical rationality and so his reasoning becomes influenced by the circumstances in which he finds himself.

  16. From rational bubbles to crashes

    Science.gov (United States)

    Sornette, D.; Malevergne, Y.

    2001-10-01

    We study and generalize in various ways the model of rational expectation (RE) bubbles introduced by Blanchard and Watson in the economic literature. Bubbles are argued to be the equivalent of Goldstone modes of the fundamental rational pricing equation, associated with the symmetry-breaking introduced by non-vanishing dividends. Generalizing bubbles in terms of multiplicative stochastic maps, we summarize the result of Lux and Sornette that the no-arbitrage condition imposes that the tail of the return distribution is hyperbolic with an exponent μbubble model to arbitrary dimensions d: a number d of market time series are made linearly interdependent via d× d stochastic coupling coefficients. We derive the no-arbitrage condition in this context and, with the renewal theory for products of random matrices applied to stochastic recurrence equations, we extend the theorem of Lux and Sornette to demonstrate that the tails of the unconditional distributions associated with such d-dimensional bubble processes follow power laws, with the same asymptotic tail exponent μmodel and the non-stationary growth rate model) of the RE bubble model that provide two ways of reconciliation with the stylized facts of financial data.

  17. Climatic Droplet Keratopathy in Argentina: Involvement of Environmental Agents in Its Genesis Which Would Open the Prospect for New Therapeutic Interventions

    Directory of Open Access Journals (Sweden)

    María Fernanda Suárez

    2015-01-01

    Full Text Available Climatic droplet keratopathy (CDK is a degenerative corneal disease of unknown etiology. We described CDK for the first time in Latin America in the Argentinean Patagonia (El Cuy. A deeper knowledge of CDK pathogenic mechanisms will provide new therapeutic strategies. For that reason we investigated the prevalence of CDK in El Cuy and its existence in other 3 provinces with similar climate. Patients eyes were examined, habits throughout lives were inquired about, and serum ascorbate (sAA was determined. All individuals work outdoors for most of the day. All regions had normal O3 levels. Individuals from regions 1, 2, and 3 had very low consumption of vegetables/fruits and low sAA levels. Conversely, region 4 individuals had balanced diet and higher sAA concentrations. CDK was only found in region 3 where individuals had partial deficiency of sAA and did not use eye protection. No CDK was found in regions 1 and 2 where individuals had similar work activities and dietary habits to those in region 3 but wear eye protection. No disease was found in region 4 where individuals work outdoors, have balanced diet, and use eye protection. To summarize, the CDK existence was related not only to climate but also to the dietary habits and lack of protection from sunlight.

  18. Climatic Droplet Keratopathy in Argentina: Involvement of Environmental Agents in Its Genesis Which Would Open the Prospect for New Therapeutic Interventions

    Science.gov (United States)

    Suárez, María Fernanda; Correa, Leandro; Crim, Nicolás; Espósito, Evangelina; Monti, Rodolfo; Urrets-Zavalía, Julio Alberto; Serra, Horacio Marcelo

    2015-01-01

    Climatic droplet keratopathy (CDK) is a degenerative corneal disease of unknown etiology. We described CDK for the first time in Latin America in the Argentinean Patagonia (El Cuy). A deeper knowledge of CDK pathogenic mechanisms will provide new therapeutic strategies. For that reason we investigated the prevalence of CDK in El Cuy and its existence in other 3 provinces with similar climate. Patients eyes were examined, habits throughout lives were inquired about, and serum ascorbate (sAA) was determined. All individuals work outdoors for most of the day. All regions had normal O3 levels. Individuals from regions 1, 2, and 3 had very low consumption of vegetables/fruits and low sAA levels. Conversely, region 4 individuals had balanced diet and higher sAA concentrations. CDK was only found in region 3 where individuals had partial deficiency of sAA and did not use eye protection. No CDK was found in regions 1 and 2 where individuals had similar work activities and dietary habits to those in region 3 but wear eye protection. No disease was found in region 4 where individuals work outdoors, have balanced diet, and use eye protection. To summarize, the CDK existence was related not only to climate but also to the dietary habits and lack of protection from sunlight. PMID:26451372

  19. MicroRNA as New Tools for Prostate Cancer Risk Assessment and Therapeutic Intervention: Results from Clinical Data Set and Patients’ Samples

    Directory of Open Access Journals (Sweden)

    Alessio Cannistraci

    2014-01-01

    Full Text Available Prostate cancer (PCa is one of the leading causes of cancer-related death in men. Despite considerable advances in prostate cancer early detection and clinical management, validation of new biomarkers able to predict the natural history of tumor progression is still necessary in order to reduce overtreatment and to guide therapeutic decisions. MicroRNAs are endogenous noncoding RNAs which offer a fast fine-tuning and energy-saving mechanism for posttranscriptional control of protein expression. Growing evidence indicate that these RNAs are able to regulate basic cell functions and their aberrant expression has been significantly correlated with cancer development. Therefore, detection of microRNAs in tumor tissues and body fluids represents a new tool for early diagnosis and patient prognosis prediction. In this review, we summarize current knowledge about microRNA deregulation in prostate cancer mainly focusing on the different clinical aspects of the disease. We also highlight the potential roles of microRNAs in PCa management, while also discussing several current challenges and needed future research.

  20. Rational Drug Use of Nurses

    Directory of Open Access Journals (Sweden)

    Mehtap Sahingoz

    2013-02-01

    Full Text Available ABSTRACT Objective: At this study to be aimed to assess status of the knowledge of nurses who working in public and private health institutions in Sivas province use of medication fort he treatment during their illnesses and patients and the attitudes of rational drug application. Matherials and methods: the researc planned to attend 750 nurses but it has been completed with participation of 641 nurses (Reaching rate 85,5%. This is a descriptive and cross-sectional study. in the study data were collected with a questionaire, percentages stated and chi square test was used for analysis. Results: %95,3 of nurses were females and mean age of them 29.21±4.85 years. The rate of contacting a doktor in case of illness is higher in 39.1% of nurses in the 21-30 age group and 48.6% of nurses working in primary care institutions. The level of self-treating is higher in 45.5 % of nurses working less than a year in profession .In the case of illness, 53% of nurses stated that they had left the medicine when signs of disease over. %98.8 of nurses expressed that they know effects of drugs used and 99.1% of them stated they know the side effects of drugs used. The entire group of postgraduate education status stated that they have not received the drug recommended by others. The level of suggesting a drug to someone else fort he same disease is higher in 65.8% of the group 31 years and older and group working over 40 hours per week. It were determined that used in consultation with the physician 65.2% of nurses antibiotics, 87.5% of them weiht loss drug and 82.7% of them contraceptive . 99.5% of the nurses have expressed that they inform to patients about use of their medications. Among the issues that expressed informations took place the application form of drugs (51.0 %and information of need to consult one if deemed one unexpected effect (59.6% . Also has been identified that of nurses acquired inform about drugs from drug book (vademecum (87.5 % and they

  1. Geometric Rationalization for Freeform Architecture

    KAUST Repository

    Jiang, Caigui

    2016-06-20

    The emergence of freeform architecture provides interesting geometric challenges with regards to the design and manufacturing of large-scale structures. To design these architectural structures, we have to consider two types of constraints. First, aesthetic constraints are important because the buildings have to be visually impressive. Sec- ond, functional constraints are important for the performance of a building and its e cient construction. This thesis contributes to the area of architectural geometry. Specifically, we are interested in the geometric rationalization of freeform architec- ture with the goal of combining aesthetic and functional constraints and construction requirements. Aesthetic requirements typically come from designers and architects. To obtain visually pleasing structures, they favor smoothness of the building shape, but also smoothness of the visible patterns on the surface. Functional requirements typically come from the engineers involved in the construction process. For exam- ple, covering freeform structures using planar panels is much cheaper than using non-planar ones. Further, constructed buildings have to be stable and should not collapse. In this thesis, we explore the geometric rationalization of freeform archi- tecture using four specific example problems inspired by real life applications. We achieve our results by developing optimization algorithms and a theoretical study of the underlying geometrical structure of the problems. The four example problems are the following: (1) The design of shading and lighting systems which are torsion-free structures with planar beams based on quad meshes. They satisfy the functionality requirements of preventing light from going inside a building as shad- ing systems or reflecting light into a building as lighting systems. (2) The Design of freeform honeycomb structures that are constructed based on hex-dominant meshes with a planar beam mounted along each edge. The beams intersect without

  2. Rational inattentiveness in a forecasting experiment

    OpenAIRE

    Goecke, Henry; Luhan, Wolfgang J.; Roos, Michael W. M.

    2013-01-01

    While standard theory assumes rational, optimizing agents under full information, the latter is rarely found in reality. Information has to be acquired and processed—both involving costs. In rational-inattentiveness models agents update their information set only when the benefit outweighs the information cost. We test the rational-inattentiveness model in a controlled laboratory environment. Our design is a forecasting task with costly information and a clear cost–benefit structure. While we...

  3. Trypanosoma cruzi-induced depressive-like behavior is independent of meningoencephalitis but responsive to parasiticide and TNF-targeted therapeutic interventions.

    Science.gov (United States)

    Vilar-Pereira, Glaucia; Silva, Andrea Alice da; Pereira, Isabela Resende; Silva, Rafael Rodrigues; Moreira, Otacílio Cruz; de Almeida, Luciana Rodrigues; de Souza, Amanda Santos; Rocha, Monica Santos; Lannes-Vieira, Joseli

    2012-10-01

    Inflammatory cytokines and microbe-borne immunostimulators have emerged as triggers of depressive behavior. Behavioral alterations affect patients chronically infected by the parasite Trypanosoma cruzi. We have previously shown that C3H/He mice present acute phase-restricted meningoencephalitis with persistent central nervous system (CNS) parasitism, whereas C57BL/6 mice are resistant to T. cruzi-induced CNS inflammation. In the present study, we investigated whether depression is a long-term consequence of acute CNS inflammation and a contribution of the parasite strain that infects the host. C3H/He and C57BL/6 mice were infected with the Colombian (type I) and Y (type II) T. cruzi strains. Forced-swim and tail-suspension tests were used to assess depressive-like behavior. Independent of the mouse lineage, the Colombian-infected mice showed significant increases in immobility times during the acute and chronic phases of infection. Therefore, T. cruzi-induced depression is independent of active or prior CNS inflammation. Furthermore, chronic depressive-like behavior was triggered only by the type I Colombian T. cruzi strain. Acute and chronic T. cruzi infection increased indoleamine 2,3-dioxygenase (IDO) expression in the CNS. Treatment with the selective serotonin reuptake inhibitor (SSRI) fluoxetine abrogated the T. cruzi-induced depressive-like behavior. Moreover, treatment with the parasiticide drug benznidazole abrogated depression. Chronic T. cruzi infection of C57BL/6 mice increased tumor necrosis factor (TNF) expression systemically but not in the CNS. Importantly, TNF modulators (anti-TNF and pentoxifylline) reduced immobility. Therefore, direct or indirect parasite-induced immune dysregulation may contribute to chronic depressive disorder in T. cruzi infection, which opens a new therapeutic pathway to be explored. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Laboratory Evaluation of Australian Ration Packs

    Science.gov (United States)

    1993-08-01

    ration chocolate , instant coffee, and fruit candy; " encapsulated ascorbic acid fortified ration chocolate prepared by Cadbury -Schweppes; "* ascorbyl...palmitate fortified ration chocolate prepared by Cadbury -Schweppes; "* beef meat balls with bacon & vegetables, beef meat balls with sweet & sour sauce...12 2.1 24 24 21 4S .48 48 is CR IoN1 j6 h f 12 12 12 12 12 1 24 24 24 241 48 48 48 4S 2.2.3 Ration Chocolate Cadbury -Schweppes prepared two batches of

  5. Valuation models and Simon's bounded rationality

    National Research Council Canada - National Science Library

    Alexandra Strommer de Farias Godoi

    2009-01-01

    This paper aims at reconciling the evidence that sophisticated valuation models are increasingly used by companies in their investment appraisal with the literature of bounded rationality, according...

  6. PROTOTYPICAL CATEGORIZATION - LINGUOCOGNITIVE FORM OF FLEXIBLE RATIONALITY

    Directory of Open Access Journals (Sweden)

    Svetlana Masalova

    2014-06-01

    Full Text Available The article discusses the prototypical categorization as linguocognitive form of the flexible rationality. Flexible rationality reveals the correlation of the rational and irrational in cognition. The embodiment form of the flexible linguistic consciousness is a concept as a category protoform. The process of formation of the conception from the concept is a prototypical categorization. Serving as the cognitive "tool", prototypical categorization as a linguistic structure demonstrates the perception integrity and meaning system of the cognizing subject as the ontic holistic bearer of the flexible rationality in unity of the anthropological and socio-cultural specifics.

  7. 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.

  8. The Mifne Method - ISRAEL. Early intervention in the treatment of autism/PDD: A therapeutic programme for the nuclear family and their child.

    Science.gov (United States)

    Alonim, Hanna

    2004-07-01

    The paper will present the Mifne (turning point) Method for early intervention in the treatment of the Autism spectrum, which has been developed as an intensive, short-term therapy programme for infants: the youngest infant treated at the Center was five months old. The Mifne approach is derived from attachment theory. The programme is designed to treat families with children under the age of five. The sequential programme includes three stages: 1. Intensive system therapy for the nuclear family that continues for a three week period in residence at the Center. 2. Follow-up treatment takes place at the family home. 3. Integration of the child into mainstream education. A retrospective evaluation of the programme undertaken by the Schneider Children's Medical Center revealed that children showed improvement on almost all items of two scales: the Childhood Autism Rating Scale (CARS) and the Social Behavior Rating Scale (SBRS). Total scores on both scales showed significant improvement after three weeks and after six months. Follow-up data shows that 73% of the children treated at the Center have been integrated in mainstream schools. Clearly, early detection and treatment in the first year of life can redirect the infant's development and might avoid the escalation of autistic symptoms. An illustrative case study is described.

  9. RATIONAL PHARMACOTHERAPY IN TAKOTSUBO CARDIOMYOPATHY

    Directory of Open Access Journals (Sweden)

    S. Marchev

    2012-01-01

    Full Text Available Rational pharmacotherapy in Takotsubo cardiomyopathy is based on clinical picture and data of functional and laboratory investigations of concrete patient. In patients with hypotension and moderate-to-severe left ventricle outflow tract obstruction inotropic agents must not to be used because they can worsen the degree of obstruction. In these patients beta blockers can improve hemodynamics by causing resolution of the obstruction. If intraventricular thrombus is detected, anticoagulation for at least 3 months is recommended. The duration of anticoagulant therapy may be modified depending on the extent of cardiac function recovery and thrombus resolution. For patients without thrombus but with severe left ventricular dysfunction, anticoagulation is recommended until the akinesis or dyskinesis has resolved but not more than 3 months.

  10. Inaugurating Rationalization: Three Field Studies Find Increased Rationalization When Anticipated Realities Become Current.

    Science.gov (United States)

    Laurin, Kristin

    2018-02-01

    People will often rationalize the status quo, reconstruing it in an exaggeratedly positive light. They will even rationalize the status quo they anticipate, emphasizing the upsides and minimizing the downsides of sociopolitical realities they expect to take effect. Drawing on recent findings on the psychological triggers of rationalization, I present results from three field studies, one of which was preregistered, testing the hypothesis that an anticipated reality becoming current triggers an observable boost in people's rationalizations. San Franciscans rationalized a ban on plastic water bottles, Ontarians rationalized a targeted smoking ban, and Americans rationalized the presidency of Donald Trump, more in the days immediately after these realities became current compared with the days immediately before. Additional findings show evidence for a mechanism underlying these behaviors and rule out alternative accounts. These findings carry implications for scholarship on rationalization, for understanding protest behavior, and for policymakers.

  11. Max Weber's Types of Rationality: Cornerstones for the Analysis of Rationalization Processes in History.

    Science.gov (United States)

    Kalberg, Stephen

    1980-01-01

    Explores rationality in Max Weber's works and identifies four types of rationality which play major roles in his writing--practical, theoretical, substantive, and formal. Implications for society and education are discussed. (DB)

  12. Synthetic Biology: Rational Pathway Design for Regenerative Medicine.

    Science.gov (United States)

    Davies, Jamie A

    2016-01-01

    Rational pathway design is the invention of an optimally efficient route from one state (e.g. chemical structure, state of differentiation, physiological state) to another, based on knowledge of biological processes: it contrasts with the use of natural pathways that have evolved by natural selection. Synthetic biology is a hybrid discipline of biology and engineering that offers a means for rationally designed pathways to be realized in living cells. Several areas of regenerative medicine could benefit from rational pathway design, including derivation of patient-specific stem cells, directed differentiation of stem cells, replicating physiological function in an alternative cell type, construction of custom interface tissues and building fail-safe systems into transplanted tissues. Synthetic biological approaches offer the potential for construction of these, for example controllable ex vivo stem cell niches, genetic networks for direct transdifferentiation from adult fibroblast to restricted stem cell without going via induced pluripotent stem cells, signalling pathways for realizing physiological regulation in alternative cell types, morphological modules for producing self-constructing novel 'tissues' and 'kill-switches' for therapeutically applied stem cells. Given the potential of this approach, a closer convergence of the regenerative medicine and synthetic biology research fields seems timely. © 2015 S. Karger AG, Basel.

  13. Clinical therapeutic efficacy of intra-aortic balloon pump as an adjuvant treatment after percutaneous coronary intervention in patients with coronary heart disease associated with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Zi-lan JING

    2015-06-01

    Full Text Available Objective To explore the clinical efficacy of intra-aortic balloon pump (IABP as an auxiliary treatment of percutaneous coronary intervention (PCI in patients with coronary heart disease (CHD associated with chronic kidney disease. Methods One hundred and twenty CHD patients with concomitant chronic kidney disease and receiving PCI in our hospital from Jan. 2000 to Jul. 2014, and 123 simple CHD patients without renal dysfunction, who had undergone PCI with concomitant IABP for the cardiac pump failure, cardiogenic shock, acute left heart failure, unstable angina pectoris (UP which was not allayed by medical treatment, or acute myocardial infarction (AMI, were selected for observation of preoperative condition, in-hospital mortality and prognosis of patients in two groups. Results There was no statistically significant difference in general clinical data including gender, age, and concomitant hypertension and diabetes, and preoperative blood lipid, AST, D-dimer, APTT, and international normalized ratio (INR showed also no statistically significant difference before surgery between two groups of patients (P>0.05. The difference in proportion of AMI, the left main trunk and (or three-branches involvement was of no statistical significance (P>0.05, but there was significant difference in the incidence of previous myocardial infarction, TnT, CK-MB, Cr, BUN, stent number, IABP application time (P0.05 between the two groups. Logistic regression analysis revealed that diabetes and the number of stents were independent risk factors for in-hospital and long-term mortalities. Conclusions By means of the effective cardiac assistance of IABP, CHD patients with renal insufficiency have the same short and long term clinical prognosis as simple CHD patients without renal dysfunction who has undergone PCI. Diabetes and the number of stents are independent risk factors for in-hospital and 1-year mortality. DOI: 10.11855/j.issn.0577-7402.2015.04.03

  14. Intervention research in rational use of drugs : a review

    NARCIS (Netherlands)

    Le Grand, A; Van Hogerzeil, H; Haaijer-Ruskamp, FM; LeGrand, A.

    Many studies have been done to document drug use patterns, and indicate that overprescribing, multi-drug prescribing, misuse of drugs, use of unnecessary expensive drugs and overuse of antibiotics and injections are the most common problems of irrational drug use by prescribers as well as consumers.

  15. Effectiveness of the addition of therapeutic alliance with minimal intervention in the treatment of patients with chronic, nonspecific low back pain and low risk of involvement of psychosocial factors: a study protocol for a randomized controlled trial (TalkBack trial).

    Science.gov (United States)

    Fagundes, Felipe Ribeiro Cabral; de Melo do Espírito Santo, Caique; de Luna Teixeira, Francine Mendonça; Tonini, Thaís Vanelli; Cabral, Cristina Maria Nunes

    2017-01-31

    The stratified model of care has been an effective approach for the treatment of low back pain. However, the treatment of patients with low risk of psychosocial-factor involvement is unclear. The addition of the therapeutic alliance to a minimal intervention may be an option for the treatment of low back pain. This paper reports on the rationale, design and protocol for a randomized controlled trial with blind assessor to assess the effectiveness of the addition of therapeutic alliance with minimal intervention on pain and disability in patients with chronic, nonspecific low back pain. Two hundred and twenty-two patients with chronic, nonspecific low back pain and low risk of involvement of psychosocial factors will be assessed and randomly allocated into three groups (n = 74 patients per group). The Positive Therapeutic Alliance group will receive counseling and guidance with an emphasis on therapeutic alliance and empathy. The Usual Treatment group will receive the same information and counseling with limited interaction with the therapist. The Control group will not receive any intervention. The treatment will be composed by two intervention sessions with a 1-week interval. A blinded assessor will collect the following outcomes at baseline, 1 month, 6 months and 12 months after randomization: pain intensity (Pain Numerical Rating Scale), specific disability (Patient-specific Functional Scale), general disability (Oswestry Disability Index), global perceived effect (Global Perceived Effect Scale), empathy (Consultation and Relational Empathy Measure), credibility and expectations related to treatment. The analysis will be performed using linear mixed models. This will be the first study to understand the effect of combining enhanced therapeutic alliance to a treatment based on counseling, information and advice (minimal intervention). The addition of the therapeutic alliance to minimal intervention may improve the treatment of chronic, nonspecific low back

  16. Rationing medical education | Walsh | African Health Sciences

    African Journals Online (AJOL)

    The purpose of this paper is to discuss the role of rationing in medical education. Medical education is expensive and there is a limit to that which governments, funders or individuals can spend on it. Rationing involves the allocation of resources that are limited. This paper discussed the pros and cons of the application of ...

  17. Wachspress type' rational basis functions over rectangles

    Indian Academy of Sciences (India)

    We use the usual convention regarding the subscripts and throughout this paper, we shall use the notations and definitions given in. [8] unless stated otherwise. Remark 2.1. ..... Appl. 22 (1991) 17±22. [8] Wachspress E L, A Rational Finite Element Basis (New York: Academic Press) (1975). Rational basis functions. 77.

  18. Privacy-Enhancing Auctions Using Rational Cryptography

    DEFF Research Database (Denmark)

    Miltersen, Peter Bro; Nielsen, Jesper Buus; Triandopoulos, Nikolaos

    2009-01-01

    show how to use rational cryptography to approximately implement any given ex interim individually strictly rational equilibrium of such an auction without a trusted mediator through a cryptographic protocol that uses only point-to-point authenticated channels between the players. By “ex interim...

  19. Are Grade Expectations Rational? A Classroom Experiment

    Science.gov (United States)

    Hossain, Belayet; Tsigaris, Panagiotis

    2015-01-01

    This study examines students' expectations about their final grade. An attempt is made to determine whether students form expectations rationally. Expectations in economics, rational or otherwise, carry valuable information and have important implications in terms of both teaching effectiveness and the role of grades as an incentive structure for…

  20. Teaching Rational Expectations at 'A' Level.

    Science.gov (United States)

    Beachill, Bob

    1987-01-01

    Explains the economic concept of Rational Expectations (RE) and demonstrates how it can be introduced to British 'A' level students. Illustrates the implications of RE for the Cobweb and Augmented Phillips Curve market models. Outlines some attractions and limitations of rational expectations. (Author/DH)

  1. Bounded rationality and learning in complex markets

    NARCIS (Netherlands)

    Hommes, C.H.; Barkely Rosser Jr, J.

    2009-01-01

    This chapter reviews some work on bounded rationality, expectation formation and learning in complex markets, using the familiar demand-supply cobweb model. We emphasize two stories of bounded rationality, one story of adaptive learning and another story of evolutionary selection. According to the

  2. Bounded rationality and learning in complex markets

    NARCIS (Netherlands)

    Hommes, C.H.

    2007-01-01

    This chapter reviews some work on bounded rationality, expectation formation and learning in complex markets, using the familiar demand-supply cobweb model. We emphasize two stories of bounded rationality, one story of adaptive learning and another story of evolutionary selection. According to the

  3. Rationality and Belief in Learning Mathematics

    Science.gov (United States)

    Brown, Tony

    2016-01-01

    This paper argues that rationality and belief are mutually formative dimensions of school mathematics, where each term is more politically embedded than often depicted in the field of mathematics education research. School mathematics then presents not so much rational mathematical thought distorted by irrational beliefs but rather a particular…

  4. Decision Making: Rational, Nonrational, and Irrational.

    Science.gov (United States)

    Simon, Herbert A.

    1993-01-01

    Describes the current state of knowledge about human decision-making and problem-solving processes, explaining recent developments and their implications for management and management training. Rational goal-setting is the key to effective decision making and accomplishment. Bounded rationality is a realistic orientation, because the world is too…

  5. Rationality : a social-epistemology perspective

    NARCIS (Netherlands)

    Wenmackers, Sylvia; Vanpoucke, Danny E. P.; Douven, Igor

    Both in philosophy and in psychology, human rationality has traditionally been studied from an “individualistic” perspective. Recently, social epistemologists have drawn attention to the fact that epistemic interactions among agents also give rise to important questions concerning rationality. In

  6. Economic Rationality in the Ultimatum Game

    National Research Council Canada - National Science Library

    Jan Fiala; Oldřich Starý; Helena Fialová; Adéla Holasová; Martina Fialová

    2017-01-01

    .... We offer an oriented interdisciplinary point of view on economic rationality. In the applied section, we describe the main features of the Ultimatum game and summarize the up-to-date theories explaining the non-rational course of the game...

  7. Instrumentally Rational Myopic Planning | Andreou | Philosophical ...

    African Journals Online (AJOL)

    I challenge the view that, in cases where time for deliberation is not an issue, instrumental rationality precludes myopic planning. I show where there is room for instrumentally rational myopic planning, and then argue that such planning is possible not only in theory, it is something human beings can and do engage in.

  8. The rational formula from the runhydrograph

    African Journals Online (AJOL)

    2005-03-18

    Mar 18, 2005 ... Pilgrim and Cordery (1993) stated that the design situation is exactly suited to the probabilistic approach of the rational formula and has little similarity with the deterministic rational formula, so that the criticisms associated with the deterministic approach are not necessarily valid for the probabilistic design ...

  9. FLEXIBLE RATIONALITY AS A COGNITIVE MODEL

    Directory of Open Access Journals (Sweden)

    Svetlana Masalova

    2013-06-01

    Full Text Available The paper considers a flexible rationality as a new category of postnonclassical science that reveals the correlation of rational and irrational in cognition. As leading in the construction of a methodology for the cognitive modelling of the flexible rationality author selected cognitive-discursive and experiential approaches. "Cognitive matrix" of the cognizing subject is represented by the linguistic means (cognition, concept, category - the linguistic form of the flexible rationality. Fulfilling the role of the cognitive "tools", the linguistic structures demonstrate the integrity of the perception and meaning system of the cognizing subject as onticaly holistic bearer of the flexible rationality in the unity of the anthropological and socio-cultural specifics.

  10. Manejo terapéutico de la infección respiratoria aguda posterior a una intervención educativa en Cuba, 2009 Therapeutical management of an acute respiratory infection after an educational intervention in Cuba, 2009

    Directory of Open Access Journals (Sweden)

    Ana Julia García Milián

    2011-12-01

    y organizativos que se realizaron para la implementación de esta guía.Introduction: The appropriate therapeutical management of acute respiratory infections and its decrease is very important. Objectives: To identify the changes in prescription habits of physicians on the therapeutical management of otitis, the common cold and the sinusitis, after an educational intervention. Methods: A two stages study was conducted allowing the screening of the knowledge level of those prescribing the primary health care on the therapeutical management of acute respiratory infections before and after the implementation of the Clinical Practice Guidance approaching this topic, specifically the common cold, pharyngoamygdalitis, sinusitis and otitis. Results: Of the analyzed high acute respiratory infections, the common cold is the entity with the higher percentage of right answers before and after intervention. The pharyngoamygdalitis, after the common cold, is the affection that before intervention had the higher percentages of prescriptions referring to know on therapeutical decisions and the drug selection for treatment; however, afterwards the right responses decreased in the three items. The sinusitis and otitis increased the prescription percentage with a high level of knowledge on therapeutical management of these affections. We conclude that the common cold was the entity with the higher level of knowledge on the therapeutical management before and after intervention, whereas the pharyngoamygdalitis showed more difficulties in the second moment. Conclusions: The level of knowledge increased in the case of sinusitis and the otitis after implementation of the Clinical Practice Guidance; however, the global knowledge level on treatment of acute respiratory infections, was not in correspondence with that we expected from the material and organizing efforts to implement this guidance.

  11. Rational use of medicines - Indian perspective!

    Science.gov (United States)

    Mohanta, G P; Manna, P K

    2015-01-01

    India, the largest democracy in the world, is with a federal structure of 29 states and 7 union territories. With a population of more than 1.2 billion, resource is always a constraint and so is in the health system too. In the federal structure, providing healthcare is largely the responsibility of state governments. Medicines are important component of health care delivery system and quality care is dependent on the availability and proper use of quality medicines. In spite of being known as pharmacy of the third world, poor access to medicines in the country is always a serious concern. Realizing the need of quality use of medicines, several initiatives have been initiated. As early as 1994, seeds of rational use of medicines were sown in the country with two initiatives: establishment of a civil society, Delhi Society for Promoting Rational Use of Drugs (DSPURD) and establishment of government agency in Tamil Nadu, a southern state, called Tamil Medical Services Corporation Limited (TNMSCL). DSPUD was in official association with World Health Organization Country Office for implementing essential medicine programme in the country for two biennia. In addition to organizing sensitising and training programme for healthcare professionals throughout the country, it looked after the procurement and appropriate use of medicines in Delhi government health facilities. TNMSCL has made innovations in medicine management including procurement directly from manufacturers as a part of pooled procurement, establishing warehouses with modern storage facilities and Information Technology enabled management of whole process. TNMSCL Model is now replicated in almost the entire country and even in some small other countries as it is successful in improving access to medicines.The National Government and the State Governments have developed strategies to promote rational use of medicines as a part of improving access and quality care in public health facilities. National

  12. Rationality, institutions and environmental policy

    Energy Technology Data Exchange (ETDEWEB)

    Vatn, Arild [Department of Economics and Resource Management, Norwegian University of Life Sciences, Aas (Norway)

    2005-11-01

    This paper is about how institutions determine choices and the importance of this for environmental policy. The model of individual rational choice from neoclassical economics is compared with the model of socially determined behavior. While in the first case, institutions are either exempted from or understood as mere economizing constraints on behavior, the latter perspective views institutions as basic structures necessary also to enable people to act. The paper develops a way to integrate the individualistic model into the wider perspective of social constructivism by viewing it as a special form of such construction. On the basis of this synthesis three issues with relevance for environmental economics are discussed. First, the role of institutional factors in the process of preference formation is emphasized. Next, the role of institutions for the choice of desired states of the environment is analyzed. Finally, the effect of various policy instruments to motivate people to produce these states is discussed. It is concluded that the core policy issue is to determine which institutional frameworks are most reasonable to apply to which kind of problem. Issues, which from the perspective of neoclassical economics are pure technical, become serious value questions if understood from an institutional perspective.

  13. Urban sustainable mobility. Part 1: Rationality in transport planning

    Directory of Open Access Journals (Sweden)

    Armando CARTENÌ

    2014-12-01

    Full Text Available The impact of the transport sector is in the range of 20%-40% in terms of consumption of fossil fuels and emissions of greenhouse gases and particulate matter. In this context, policies aimed at reducing these effects are very important. Many urban areas are trying to adopt planning strategies aimed to a sustainable use of resources often referred to as sustainable mobility. These policies are very different in terms of costs and expected benefits, and the effects of these policies and their combinations are difficult to anticipate on a purely intuitive basis and sometimes the end effect could be contrary to intuitive expectations (e.g. policies aimed to reduce pollution, ending up in increasing it. In this context, the concept of eco-rational planning assumes a central role. This means identifying the right mixture of interventions to be implemented on the transport system that is: rational for the transport system (e.g. reduction in terms of congestion, traffic accidents, travel time and sustainable for people’s health and for the environmental (e.g. emissions reduction and requires minimal economic resources (e.g. lower monetary cost per unit of CO2 saved. The paper discusses the importance of rational decisions in transport planning.

  14. Cutting healthcare costs without rationing at the bedside: preserving the doctor-patient fiduciary relationship.

    Science.gov (United States)

    Lomas, S J; Rice, C L

    2001-01-01

    In his essay on bedside rationing, Peter Ubel argues that in an era of rising healthcare costs, it is time to relax the patient-centered ethic of physicians as unconditional patient advocates so they can individualize rationing decisions. This paper raises several concerns with the arguments and the examples he provides to make his case. First, he overlooks cost-effectiveness when making medical spending decisions. Second, his examples of wasteful, unproven and potentially harmful interventions call for physician education, not rationing, as he suggests. Third, informed patients can play a role in lowering costs through shared decision making. Fourth, individualized rationing decisions will worsen already pervasive disparities in medical care. The paper envisions the ideal cost-conscious physician as one who is knowledgeable about cost-effective practices, avoids unproven interventions whenever possible, and facilitates shared decision making through patient education. Such an individual would not, however, withhold interventions of proven benefit except when accommodating a patient's preferences for a particular therapy. The doctor and patient can only work together within the constraints of system-wide rationing if the fiduciary relationship is never violated.

  15. Therapeutic approaches to cellulite.

    Science.gov (United States)

    Green, Jeremy B; Cohen, Joel L; Kaufman, Joely; Metelitsa, Andrei I; Kaminer, Michael S

    2015-09-01

    Cellulite is a condition that affects the vast majority of women. Although it is of no danger to one's overall health, cellulite can be psychosocially debilitating. Consequently, much research has been devoted to understanding cellulite and its etiopathogenesis. With additional insights into the underlying causes of its clinical presentation, therapeutic modalities have been developed that offer hope to cellulite sufferers. This review examines evidence for topical treatments, noninvasive energy-based devices, and recently developed minimally invasive interventions that may finally provide a solution. ©2015 Frontline Medical Communications.

  16. Sieving for rational points on hyperelliptic curves

    OpenAIRE

    Siksek, Samir

    2001-01-01

    We give a new and efficient method of sieving for rational points\\ud on hyperelliptic curves. This method is often successful in proving that a\\ud given hyperelliptic curve, suspected to have no rational points, does in fact\\ud have no rational points; we have often found this to be the case even when our\\ud curve has points over all localizations Qp. We illustrate the practicality of the\\ud method with some examples of hyperelliptic curves of genus 1.

  17. Rational Verification in Iterated Electric Boolean Games

    Directory of Open Access Journals (Sweden)

    Youssouf Oualhadj

    2016-07-01

    Full Text Available Electric boolean games are compact representations of games where the players have qualitative objectives described by LTL formulae and have limited resources. We study the complexity of several decision problems related to the analysis of rationality in electric boolean games with LTL objectives. In particular, we report that the problem of deciding whether a profile is a Nash equilibrium in an iterated electric boolean game is no harder than in iterated boolean games without resource bounds. We show that it is a PSPACE-complete problem. As a corollary, we obtain that both rational elimination and rational construction of Nash equilibria by a supervising authority are PSPACE-complete problems.

  18. Many faces of rationality: Implications of the great rationality debate for clinical decision-making.

    Science.gov (United States)

    Djulbegovic, Benjamin; Elqayam, Shira

    2017-10-01

    Given that more than 30% of healthcare costs are wasted on inappropriate care, suboptimal care is increasingly connected to the quality of medical decisions. It has been argued that personal decisions are the leading cause of death, and 80% of healthcare expenditures result from physicians' decisions. Therefore, improving healthcare necessitates improving medical decisions, ie, making decisions (more) rational. Drawing on writings from The Great Rationality Debate from the fields of philosophy, economics, and psychology, we identify core ingredients of rationality commonly encountered across various theoretical models. Rationality is typically classified under umbrella of normative (addressing the question how people "should" or "ought to" make their decisions) and descriptive theories of decision-making (which portray how people actually make their decisions). Normative theories of rational thought of relevance to medicine include epistemic theories that direct practice of evidence-based medicine and expected utility theory, which provides the basis for widely used clinical decision analyses. Descriptive theories of rationality of direct relevance to medical decision-making include bounded rationality, argumentative theory of reasoning, adaptive rationality, dual processing model of rationality, regret-based rationality, pragmatic/substantive rationality, and meta-rationality. For the first time, we provide a review of wide range of theories and models of rationality. We showed that what is "rational" behaviour under one rationality theory may be irrational under the other theory. We also showed that context is of paramount importance to rationality and that no one model of rationality can possibly fit all contexts. We suggest that in context-poor situations, such as policy decision-making, normative theories based on expected utility informed by best research evidence may provide the optimal approach to medical decision-making, whereas in the context

  19. FOOD RATION AND FOOD SERVICE MANAGEMENT.

    Science.gov (United States)

    FOOD DISPENSING, *MILITARY RATIONS, DEPARTMENT OF DEFENSE, DEPARTMENT OF DEFENSE, FOOD, NUTRITION, RESEARCH MANAGEMENT , MANAGEMENT PLANNING AND...CONTROL, ARMY, AIR FORCE, NAVY, LOGISTICS, COST EFFECTIVENESS, MARINE CORPS, MILITARY FORCES(UNITED STATES), MILITARY PROCUREMENT, MANAGEMENT ENGINEERING.

  20. Potential therapeutic interventions for fragile X syndrome

    NARCIS (Netherlands)

    G.J. Levenga (Josien); F.M.S. Vrij (Femke); B.A. Oostra (Ben); R. Willemsen (Rob)

    2010-01-01

    textabstractFragile X syndrome (FXS) is caused by a lack of the fragile X mental retardation protein (FMRP); FMRP deficiency in neurons of patients with FXS causes intellectual disability (IQ<70) and several behavioural problems, including hyperactivity and autistic-like features. In the brain, no

  1. Rationality: a social-epistemology perspective

    OpenAIRE

    Sylvia eWenmackers; Danny Eric Paul Vanpoucke; Igor eDouven

    2014-01-01

    Both in philosophy and in psychology, human rationality has traditionally been studied from an 'individualistic' perspective. Recently, social epistemologists have drawn attention to the fact that epistemic interactions among agents also give rise to important questions concerning rationality. In previous work, we have used a formal model to assess the risk that a particular type of social-epistemic interactions lead agents with initially consistent belief states into inconsistent belief st...

  2. Artificial intelligence techniques for rational decision making

    CERN Document Server

    Marwala, Tshilidzi

    2014-01-01

    Develops insights into solving complex problems in engineering, biomedical sciences, social science and economics based on artificial intelligence. Some of the problems studied are in interstate conflict, credit scoring, breast cancer diagnosis, condition monitoring, wine testing, image processing and optical character recognition. The author discusses and applies the concept of flexibly-bounded rationality which prescribes that the bounds in Nobel Laureate Herbert Simon's bounded rationality theory are flexible due to advanced signal processing techniques, Moore's Law and artificial intellig

  3. Rational Thinking and Reasonable Thinking in Physics

    OpenAIRE

    Isaeva E. A.

    2008-01-01

    The usual concept of space and time, based on Aristotle’s principle of contemplation of the world and of the absoluteness of time, is a product of rational thinking. At the same time, in philosophy, rational thinking differs from reasonable thinking; the aim of logic is to distinguish finite forms from infinite forms. Agreeing that space and time are things of infinity in this work, we shall show that, with regard to these two things, it is nec...

  4. Intergroup conflict and rational decision making.

    Directory of Open Access Journals (Sweden)

    Vicente Martínez-Tur

    Full Text Available The literature has been relatively silent about post-conflict processes. However, understanding the way humans deal with post-conflict situations is a challenge in our societies. With this in mind, we focus the present study on the rationality of cooperative decision making after an intergroup conflict, i.e., the extent to which groups take advantage of post-conflict situations to obtain benefits from collaborating with the other group involved in the conflict. Based on dual-process theories of thinking and affect heuristic, we propose that intergroup conflict hinders the rationality of cooperative decision making. We also hypothesize that this rationality improves when groups are involved in an in-group deliberative discussion. Results of a laboratory experiment support the idea that intergroup conflict -associated with indicators of the activation of negative feelings (negative affect state and heart rate- has a negative effect on the aforementioned rationality over time and on both group and individual decision making. Although intergroup conflict leads to sub-optimal decision making, rationality improves when groups and individuals subjected to intergroup conflict make decisions after an in-group deliberative discussion. Additionally, the increased rationality of the group decision making after the deliberative discussion is transferred to subsequent individual decision making.

  5. A discussion of theoretical and practical rationality

    Energy Technology Data Exchange (ETDEWEB)

    Wahlstroem, B. [Technical Research Centre of Finland, Espoo (Finland). VTT Automation

    1999-12-01

    Theoretical rationality as defined in Expected Utility Theory and amended with other considerations gives a good basis for decision making. One should however always keep in mind that practical rationality often is far more complicated. People use their everyday experience when placed before new problems and this may lead to apparently irrational choices which on a closer scrutiny may be completely rational. Theories in human decision making unfortunately becomes untestable, firstly because a theory taking all considerations into account would be to complex to be practical and secondly because the data needed to test the theory cannot be collected. The benefit of EUT is that it is simple and straightforward as compared with competing theories. In the natural sciences rationality is often seen simply as a problem of optimisation. This view is practical, but it has to include also psychological and sociological considerations. The apparent controversy between natural and behavioural sciences could at least in principle be resolved by a better understanding of the complexity of human rationality. The human mind does not work in isolation, but it is adapted to a social community and a continuously changing environment. Understanding all components of human rationality is a challenge which cannot be solved on a short term basis. An important part of human rationality is connected to the intricate balance between individual and societal utility. The human mind has over thousands of years learnt to resolve that balance, but in the modern society there are decisions which may not be solvable with an intuitive approach and a strategy of trial and error. For these decisions more solid theories of rationality will be needed. EUT can in spite of its dismerits be used as the backbone for such a theory, but it has to be extended with better explanations of both individual and social rationality. If this understanding of the practical aspects of human rationality can be reached

  6. Aplicação do índice de intervenção terapêutica em unidade de terapia intensiva pediátrica = Therapeutic intervention scoring system application in a pediatric intensive care unit

    Directory of Open Access Journals (Sweden)

    Canabarro, Simone Travi

    2009-01-01

    Full Text Available Introdução: Índices de gravidade buscam estimar a severidade da doença, sendo o Therapeutic Intenvention Scoring System-28 (Sistema de Escore de Intervenção Terapêutica - TISS-28, usado em Unidades de Terapia Intensiva, um índice indireto para estimar intervalos de gravidade da doença que mais recentemente tem sido usado para relacionar a carga de trabalho de enfermagem. Objetivo: Revisar cada item/definição operacional do índice de intervenção terapêutica (TISS- 28 procedendo-se uma releitura com o objetivo de sistematizar a prática da coleta de dados em Unidade de Terapia Intensiva Pediátrica (UTIP. Materiais e Métodos: Pesquisa de revisão integrativa de literatura médica e de enfermagem por meio da base de dados Medical Literature Analysis and Retrieval System Online (MEDLINE e Scientific Electronic Library Online (SciELO usando os termos Unidades de terapia intensiva (Intensive care units, Escalas (scales e Therapeutic Intervention Scoring System-28 ou TISS-28. Os artigos foram selecionados de acordo com sua relevância, segundo a opinião dos autores. Resultados: Estudos prévios demonstram que o uso do TISS-28 em UTI de pacientes adultos têm contribuído na avaliação evolutiva clínica da piora do paciente, além de associações entre óbito e pontuações elevadas. Os itens/definições operacionais avaliados neste escore são revisados visando facilitar a interpretação de cada item na aplicação diária do TISS-28, em Unidade de Terapia Intensiva Pediátrica. Conclusão: A avaliação diária das 28 variáveis do TISS permite a obtenção de um perfil evolutivo das crianças internadas, podendo auxiliar no conhecimento do agravamento clínico do quadro da criança internada e de seu prognóstico

  7. MicroRNA therapeutics in cardiovascular medicine

    National Research Council Canada - National Science Library

    Thum, Thomas

    2012-01-01

    Cardiovascular diseases are the most common causes of human morbidity and mortality despite significant therapeutic improvements by surgical, interventional and pharmacological approaches in the last decade. MicroRNAs (miRNAs...

  8. Rational Design of Cancer Nanomedicine: Nanoproperty Integration and Synchronization.

    Science.gov (United States)

    Sun, Qihang; Zhou, Zhuxian; Qiu, Nasha; Shen, Youqing

    2017-04-01

    Current cancer nanomedicines can only mitigate adverse effects but fail to enhance therapeutic efficacies of anticancer drugs. Rational design of next-generation cancer nanomedicines should aim to enhance their therapeutic efficacies. Taking this into account, this review first analyzes the typical cancer-drug-delivery process of an intravenously administered nanomedicine and concludes that the delivery involves a five-step CAPIR cascade and that high efficiency at every step is critical to guarantee high overall therapeutic efficiency. Further analysis shows that the nanoproperties needed in each step for a nanomedicine to maximize its efficiency are different and even opposing in different steps, particularly what the authors call the PEG, surface-charge, size and stability dilemmas. To resolve those dilemmas in order to integrate all needed nanoproperties into one nanomedicine, stability, surface and size nanoproperty transitions (3S transitions for short) are proposed and the reported strategies to realize these transitions are comprehensively summarized. Examples of nanomedicines capable of the 3S transitions are discussed, as are future research directions to design high-performance cancer nanomedicines and their clinical translations. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. Rational Development of Addiction Pharmacotherapies: Successes, Failures, and Prospects

    Science.gov (United States)

    Christopher Pierce, R.; O’Brien, Charles P.; Kenny, Paul J.; Vanderschuren, Louk J. M. J.

    2012-01-01

    There are currently effective, U.S. Food and Drug Administration (FDA)-approved therapies for alcohol, nicotine, and opioid addiction. In some cases these therapeutics were rationally designed and tested using a combination of various animal models of addiction. In many cases, however, effective drug therapies for addiction were derived from the testing of compounds developed for other CNS disorders (e.g., analgesics and antidepressants), which were tested clinically in the absence of prior animal research using addiction models. This article will review the development of eight compounds that are currently most effective in the treatment of alcohol, opioid, and nicotine addiction with an emphasis on pharmacological mechanisms as well as the utility of animal models of addiction in the development of these therapeutics. In contrast to these successes, animal research has identified a number of promising medications for the treatment of psychostimulant addiction, none of which have proven to be effective clinically. This raises questions about the validity of current animal models of psychostimulant addiction. A specific example of an apparently promising pharmacotherapeutic for cocaine addiction (the D1 dopamine receptor antagonist ecopipam) that failed clinically will be examined to determine if this truly represents a challenge to the predictive validity of current models of cocaine addiction. In addition, the development of promising cocaine addiction therapeutics derived from animal research will be reviewed. PMID:22675669

  10. Factors related to rational antibiotic prescriptions in community health centers in Depok City, Indonesia.

    Science.gov (United States)

    Andrajati, Retnosari; Tilaqza, Andri; Supardi, Sudibyo

    Irrational antibiotic prescription is common in developing countries, including in Indonesia. The aims of this study were to evaluate antibiotic prescription patterns and the factors related to the rationale for antibiotic prescriptions in community health centers in Depok City, Indonesia. The study employed a cross-sectional design in eleven primary health centers in Depok City, Indonesia. The sample consisted of 28 physicians and 788 oral antibiotic prescriptions, 392 of which were evaluated for rationality according to local guidelines issued by the Ministry of Health Republic of Indonesia from October to December 2012. Data were analyzed with chi-square tests and logistic regression analysis. The most widely prescribed antibiotics were amoxicillin (73.5%) and co-trimoxazole (17.4%). The most frequent diseases were acute pharyngitis (40.2%) and non-specific respiratory infection (25.4%). Approximately 220 of the 392 prescriptions did not meet the criteria for rational antibiotic prescriptions with regard to antibiotic selection (22.7%), duration of administration (72.3%), frequency of administration (3.2%), or duration and frequency of administration (1.8%). Physicians who had attended training for rational drug use were 2.01 times more rational than physicians who had never attended training. Physicians with a short working period (i.e., rational in prescribing antibiotics than physicians who had been working for longer periods (i.e., >7 years). Most antibiotics were prescribed irrationally. Training for rational drug use and length of practice were factors related to the rationality of antibiotic prescriptions. Suitable interventions are urgently required to encourage the rational prescription of antibiotics in the PHCs. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  11. Topological aspects of rational points on K3 surfaces

    NARCIS (Netherlands)

    Pannekoek, Rene

    2013-01-01

    A common theme in the research on rational points on varieties is: investigating under which conditions rational points are dense with respect to a chosen topology. We prove several existence results concerning K3 surfaces defined over the rational numbers with a dense set of rational points with

  12. Poetry and Therapeutic Factors in Group Therapy.

    Science.gov (United States)

    Goldstein, Marion

    1989-01-01

    Describes the ways in which the use of poetry in group therapy facilitates therapeutic goals consistent with interpersonal theory. Discusses the relationship between poetic interventions and I. D. Yalom's therapeutic factors, and offers a case example of an in-patient therapy group. (SR)

  13. Therapeutic misadventure.

    Science.gov (United States)

    Langford, N J

    2010-10-01

    Therapeutic misadventure can be defined as an injury or an adverse event caused by medical management rather than by an underlying disease. Within the National Health Service there were over 86,000 reported adverse incidents in 2007. In the USA medication errors have been rated as the fourth highest cause of death. Unfortunately one of the greatest contributors to iatrogenic injury is human error. The potential types of misadventure are infinite. Medication errors are a major part of this, being responsible for over 70% of cases that cause serious harm. However, many medication errors caused by slips, lapses, technical errors and mistakes are preventable; intentional violations of safe operating procedures are not. While medication errors were tolerated by society in the past, the readiness to institute criminal proceedings against health-care professionals has increased greatly in the UK over the last decade. The medication process consists of writing prescriptions, dispensing the product, administering it and monitoring its effects. Prescription errors arise owing to incomplete information, lack of appropriate labelling, environmental factors and human blunders. Even with a perfect prescription the right medication must be dispensed and appropriately labelled. Dispensing errors are not uncommon and may be compounded by non-clinical considerations. Administration of a drug by injection is one of the most dangerous aspects of the medication process, especially in inexperienced hands. The final component of medication supply is monitoring the effect of the medication. With short courses of medication such monitoring is easy, but with long-term medication, particularly with potent drugs where the margin between efficacy and toxicity is small, active procedures may be required to ensure toxicity does not ensue. Despite the endeavour of health-care professions to stick to the rule of 'first, do no harm', in reality this is difficult to achieve all of the time. When

  14. Economic Rationality in the Ultimatum Game

    Directory of Open Access Journals (Sweden)

    Jan Fiala

    2017-03-01

    Full Text Available Rigorous application of experimental methodology to the interdisciplinary research of economic decision making is the main purpose of our work. In this paper, we introduce the main decisionmaking theories and outline economic rationality. We explain why we find it useful to discriminate between the “irrational” and “non-rational” components of decision making. We offer an oriented interdisciplinary point of view on economic rationality. In the applied section, we describe the main features of the Ultimatum game and summarize the up-to-date theories explaining the non-rational course of the game. We discuss in detail the reported relations between the nominal value of the stakes and the distribution of the offers and responses. We introduce the blinded, randomized Ultimatum game experiment that we conducted in our laboratory. We stress the importance of anonymity of the study subjects and the difference in salience of a factual reward against a  hypothetical reward. We present the results of our study, showing that a  duly chosen non-monetary reward, directly inconvertible into money, leads to a different offer distribution in the Ultimatum game without the necessity to invest excessive sums of money in the rewards. We compare our results to research published by other authors. According to our theory, the rational, non-rational and irrational components contribute to the decision making in Ultimatum differently depending on the different reward stakes.

  15. RATIONAL CHOICE INSTITUTIONALISM AND THE EUROPEAN NEIGHBOURHOOD POLICY

    OpenAIRE

    Andrei Cristian Balasan; Andreea Maha

    2013-01-01

    The aim of this paper is to highlight the main aspects regarding the rational choice theory in neo-institutionalism, and the role the EU Neighbourhood Policy has nowadays. The protagonist of the rational choice theory in the new institutionalism remains homo-economicus. The theory of rational choice institutionalism challenges the perfect rationality of the individual, rather than the principle of rational choice itself. ENP is a framework for consolidating the Union's relations with neighbou...

  16. Particulate Systems for Targeting of Macrophages: Basic and Therapeutic Concepts

    DEFF Research Database (Denmark)

    Moghimi, Seyed Moien; Parhamifar, Ladan; Ahmadvand, Davoud

    2012-01-01

    Particulate systems in the form of liposomes, polymeric micelles, polymeric nano- and microparticles, and many others offer a rational approach for selective delivery of therapeutic agents to the macrophage from different physiological portals of entry. Particulate targeting of macrophages and in...... at a particular subset of macrophages. Advances in basic and therapeutic concepts of particulate targeting of macrophages and related nanotechnology approaches for immune cell modifications are discussed.Copyright © 2012 S. Karger AG, Basel...

  17. Beyond dogmatism: Rationality in theology and science

    Directory of Open Access Journals (Sweden)

    Wentzel van Huyssteen

    1988-01-01

    Full Text Available The justification of cognitive claims in theology can be dealt with adequately only if the epistemological issues of metaphorical reference, experiential adequacy and explanatory progress are seen as crucial problems for the more encompassing problem of rationality in theology. To claim some form of reality depiction the theologian will have to argue for a plausible theory of reference on the basis of interpreted religious experience. In this discussion important analogies between the rationality of theological theorizing and the rationality of science are revealed. Thus explanatory progress in theology shows itself to be a form of inference to the best explanation, and the rationahty of both theology and science is therefore determined by certain epistemic values.

  18. Changing Conspiracy Beliefs through Rationality and Ridiculing

    Directory of Open Access Journals (Sweden)

    Gábor Orosz

    2016-10-01

    Full Text Available Conspiracy theory (CT beliefs can be harmful. How is it possible to reduce them effectively? Three reduction strategies were tested in an online experiment using general and well-known CT beliefs on a comprehensive randomly assigned Hungarian sample (N = 813: exposing rational counter CT arguments, ridiculing those who hold CT beliefs, and empathizing with the targets of CT beliefs. Several relevant individual differences were measured. Rational and ridiculing arguments were effective in reducing CT, whereas empathizing with the targets of CTs had no effect. Individual differences played no role in CT reduction, but the perceived intelligence and competence of the individual who conveyed the CT belief-reduction information contributed to the success of the CT belief reduction. Rational arguments targeting the link between the object of belief and its characteristics appear to be an effective tool in fighting conspiracy theory beliefs.

  19. Bounded rational choice behaviour: applications in transport

    DEFF Research Database (Denmark)

    Jensen, Anders Fjendbo

    2016-01-01

    Even though the theory of rational behaviour has been challenged for almost 100 years, the dominant approach within the field of transport has been based upon the assumptions of neoclassical economics that we live in a world of rational decision makers who always have perfect knowledge and aim to...... and limited processing may occur due to time constraints, low involvement in the decision at hand, relying on habits or the task requiring too high a mental effort....... to maximise some subjective measure. Where other fields, for example within the social sciences and psychology, have made serious efforts to explore alternative models derived from principles of bounded rationality, this direction has begun to take speed within transport applications only recently. Bounded...

  20. Decision Making: Between Rationality and Reality

    Directory of Open Access Journals (Sweden)

    Marko Polič

    2009-12-01

    Full Text Available Almost by definition decision-making is typical human activity, and therefore important psychological subject. The starting point of its classical conception within psychology could be traced back to economy and mathematic, with ideas of human as rational economic being, and conceptualising decision making as choice between two or more alternatives, and as such being a separate event in space and time. Already in fifties Herbert Simon challenged such a view with his concept of bounded rationality, emerging from the joint effect of internal limitations of the human mind, and the structure of external environments in which the mind operates. During the last decades with the shift to the real word situations where decisions are embedded in larger tasks, becoming so part of the study of action, the lost rational human appeared again as efficient creature in the complex environment. Gigerenzer showed how heuristics help in this process.

  1. Changing Conspiracy Beliefs through Rationality and Ridiculing

    Science.gov (United States)

    Orosz, Gábor; Krekó, Péter; Paskuj, Benedek; Tóth-Király, István; Bőthe, Beáta; Roland-Lévy, Christine

    2016-01-01

    Conspiracy theory (CT) beliefs can be harmful. How is it possible to reduce them effectively? Three reduction strategies were tested in an online experiment using general and well-known CT beliefs on a comprehensive randomly assigned Hungarian sample (N = 813): exposing rational counter CT arguments, ridiculing those who hold CT beliefs, and empathizing with the targets of CT beliefs. Several relevant individual differences were measured. Rational and ridiculing arguments were effective in reducing CT, whereas empathizing with the targets of CTs had no effect. Individual differences played no role in CT reduction, but the perceived intelligence and competence of the individual who conveyed the CT belief-reduction information contributed to the success of the CT belief reduction. Rational arguments targeting the link between the object of belief and its characteristics appear to be an effective tool in fighting conspiracy theory beliefs. PMID:27790164

  2. Rational speculative bubbles: A critical view

    Directory of Open Access Journals (Sweden)

    Radonjić Ognjen

    2007-01-01

    Full Text Available According to the theory of rational bubbles, the bubble is present whenever asset prices progressively diverge from their fundamental value, which occurs because agents expect that asset prices will continue to grow exponentially (self-fulfilling prophecies far in the future and consistently, which promises the realization of ever larger capital gains. In our opinion, the basic shortcoming of this theory refers to the assumption that all market agents are perfectly informed and rational and, accordingly, form homogeneous expectations. The model does not explain decision-making processes or expectation formation, nor does it detect potential psychological and institutional factors that might significantly influence decision making processes and market participants’ reactions to news. Since assumptions of the model critically determine its validity, we conclude that comprehensiveness of the rational bubble model is, to put it mildly, limited.

  3. Rational homotopy theory and differential forms

    CERN Document Server

    Griffiths, Phillip

    2013-01-01

    This completely revised and corrected version of the well-known Florence notes circulated by the authors together with E. Friedlander examines basic topology, emphasizing homotopy theory. Included is a discussion of Postnikov towers and rational homotopy theory. This is then followed by an in-depth look at differential forms and de Tham's theorem on simplicial complexes. In addition, Sullivan's results on computing the rational homotopy type from forms is presented.  New to the Second Edition: *Fully-revised appendices including an expanded discussion of the Hirsch lemma*Presentation of a natu

  4. Rationality: a social-epistemology perspective.

    Science.gov (United States)

    Wenmackers, Sylvia; Vanpoucke, Danny E P; Douven, Igor

    2014-01-01

    Both in philosophy and in psychology, human rationality has traditionally been studied from an "individualistic" perspective. Recently, social epistemologists have drawn attention to the fact that epistemic interactions among agents also give rise to important questions concerning rationality. In previous work, we have used a formal model to assess the risk that a particular type of social-epistemic interactions lead agents with initially consistent belief states into inconsistent belief states. Here, we continue this work by investigating the dynamics to which these interactions may give rise in the population as a whole.

  5. Rational dynamical $\\zeta$ functions for birational transformations

    CERN Document Server

    Abarenkova, N I; Boukraa, S; Hassani, S; Maillard, J M

    1998-01-01

    We propose a conjecture for the exact expression of the dynamical zeta function for a family of birational transformations of two variables, depending on two parameters. This conjectured function is a simple rational expression with integer coefficients. This yields an algebraic value for the topological entropy. Furthermore the generating function for the Arnold complexity is also conjectured to be a rational expression with integer coefficients with the same singularities as for the dynamical zeta function. This leads, at least in this example, to an equality between the Arnold complexity and the exponential of the topological entropy. We also give a semi-numerical method to effectively compute the Arnold complexity.

  6. Empirical Rationality in the Stock Market

    DEFF Research Database (Denmark)

    Raahauge, Peter

    2003-01-01

    Rational expectations models make stringent assumptions on the agent'sknowledge about the true model. This paper introduces a model in which therational agent realizes that using a given model involves approximation errors,and adjusts behavior accordingly. If the researcher accounts for this empi......Rational expectations models make stringent assumptions on the agent'sknowledge about the true model. This paper introduces a model in which therational agent realizes that using a given model involves approximation errors,and adjusts behavior accordingly. If the researcher accounts...

  7. [The role of economics in fair rationing].

    Science.gov (United States)

    Prenzler, A

    2012-10-01

    For several years academic disciplines have discussed the potential conflict between scarcity of funding and fair health care. This review article shows the necessity of involving economic scientists in this discussion as well as their contribution to rationalisation, prioritisation and rationing of health care services. Thereby, it becomes clear that rationing and justice are not a contradiction per se. The interdisciplinary discussion in Germany needs less disciplinary egotism and more willingness to seek solutions and compromises. In this context the procedures followed in other countries can serve as examples.

  8. Rational design of protein kinase inhibitors

    Directory of Open Access Journals (Sweden)

    Yarmoluk S. M.

    2013-07-01

    Full Text Available Modern methodological approaches to rational design of low molecular weight compounds with specific activity in relation to predetermined biomolecular targets are considered by example of development of high effective protein kinase inhibitors. The application of new computational methods that allow to significantly improve the quality of computational experiments (in, particular, accuracy of low molecular weight compounds activity prediction without increase of computational and time costs are highlighted. The effectiveness of strategy of rational design is demonstrated by examples of several own investigations devoted to development of new inhibitors that are high effective and selective towards protein kinases CK2, FGFR1 and ASK1.

  9. Entre a dominação racional-legal e o carisma: o Projeto Tamar e sua intervenção em comunidades pesqueiras do litoral brasileiro Between rational-legal domination and carisma: the Tamar Project and its intervention in fishing communities at the Brazilian coast

    Directory of Open Access Journals (Sweden)

    Dulce Maria Filgueira de Almeida Suassuna

    2005-12-01

    Full Text Available O trabalho discute a implantação e implementação de políticas públicas para o setor ambiental no Brasil, no período compreendido entre 1970 e 2000. Nesse contexto, realiza um estudo de caso do Projeto Tartarugas Marinhas (Projeto Tamar, apresentando uma análise comparativa das formas de intervenção em duas comunidades pesqueiras do litoral brasileiro: Praia do Forte (BA e Regência (ES. Por meio de uma abordagem qualitativa, foram reconstruídos discursos e postos em diálogo para a compreensão. Constatou-se que o Projeto Tamar apresenta formas discursivas que se apóiam no modelo de sustentabilidade causal, isto é, o econômico viabiliza o ambiental. Neste âmbito, verificou-se que a lei e o discurso racional-legal são utilizados como estratégia de dominação em Praia do Forte, enquanto o carisma é parte do tipo ideal de dominação em Regência. Viu-se que essa diferenciação não ocorreu por acaso, mas é fruto de processos de resistência e conflitos que emergiram nas duas comunidades de pescadores e que está relacionada com suas especificidades socioculturais, especificamente quanto à forma como apresentam suas representações sociais e simbólicas sobre a pesca e a caça da tartaruga marinha.The present work discusses the implantation and implementation of political policies for the environmental sector in Brazil during the period between 1970 and 2000. In that context, it performs a study of case of the Sea Turtle Project (Tamar Project, presenting a comparative analysis of the forms of intervention in two fishing communities at the Brazilian cost: Praia do Forte (in the State of Bahia and Regência (in the State of Espírito Santo. Discourses were reconstructed and put into discussion in order to be comprehended, through a qualitative approach. It was verified that the Tamar Project presents discursive forms which lean on the causal sustainability model, which is the economic side makes the environmental side viable

  10. [Rationalizing versus rationing in the practice of clinical nutrition; fourth Jesús Culebras lecture].

    Science.gov (United States)

    Planas Vilà, Mercedes

    2014-01-01

    The current economic situation is the reason for this conference that will be split in two main areas: first, we will focus on general concepts on rationalizing versus rationing in health care, and secondly, on rationing in the practice of clinical nutrition. According to the Spanish Royal Academy of the Language, to rationalize is to organize the production or the work in a manner such the yields are increased or the costs are reduced with the least effort. However, to ration is the action and effect of rationing or limiting the consumption of something to prevent negative consequences. In Europe, the percentage of the Gross National Product dedicated to health care progressively decreases whereas the costs of health care are ever increasing. From the economic viewpoint, this would be the main reason why the health care authorities have no other option but rationing. Until what extent the ethical principle of justice is compatible with rationing? Ethically, it seems that in order to accept rationing, not only a fair distribution of the limited resources should be achieved, but also a rational use of them. If we accept that limiting the health care allowances is necessary, we should then answer some questions: is it ethical not to limit? Who decides what is medically necessary? How is it decided? With no coherent answers to these questions it is ethically difficult to accept rationing from a healthcare viewpoint. When dealing with rationing in the practice of clinical nutrition, we should focus on how rationing impacts on hyponutrition, and more particularly on disease-related hyponutrition, since this is the focus of Clinical Nutrition. Given its importance and its implications, in several countries, including Spain, actions integrated in the European Union strategy "Together for health: a Strategic Approach for the EU 2008-2013", are being performed aimed at taking decisions for preventing and managing hyponutrition. However, restrictions persist with the

  11. 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.

  12. Cognitive-Behavioral Grief Therapy: The ABC Model of Rational-Emotion Behavior Therapy

    Directory of Open Access Journals (Sweden)

    Ruth Malkinson

    2010-12-01

    Full Text Available The article briefly reviews the changes that occurred in the field of grief and bereavement, viewing it as a process of searching for a "rational" meaning to life without the deceased in line with the concept of continuing bonds and thus replacing that of Fred’s concept of decathexis. Cognitive-behavioral therapy (CBT evidenced-based studies for PTSD and complicated grief and the Cognitive-behavioral therapy − Rational-emotion behavior therapy (CBT-REBT model for grief are reviewed. The focus of intervention based on CBT-REBT is to facilitate a healthy adaptation to loss following death. A distinction is made between rational (adaptive and irrational (maladaptive grief processes. Case example illustrating the application of the model specifically a dialogue with repetitive thoughts, are presented.

  13. The Effect of Interactive Group Discussion among Physicians to Promote Rational use of Drugs

    Directory of Open Access Journals (Sweden)

    Alireza Garjani

    2009-02-01

    Full Text Available Background and purpose: Rational use of drugs remains a problem in Iran. Polypharmacy, overuse of antibiotic, misuse and overuse of injections, short consulting time and poor patient compliance are common patterns of irrational use of drugs in Eastern Azarbydjan - Iran. Concerning the promotion of rational use of drugs, this study aimed the effect of educational intervention as interactive group discussion on prescribing behavior of Tabriz Northwest physicians.Methods: Fifty one general physicians from private and public sectors in Northwest of Tabriz were selected randomly and their prescriptions were analyzed. A questionnaire with 8 close questions was completed for each prescription to investigate all aspects of prescribing patterns. By a professional software the information of the prescriptions was analyzed and drug prescribing indicators such as percentage of patients receiving antibiotics, glucocorticoids and other drug groups were determined.The method of intervention included focus group and interactive group discussions. Focus group was built in group of health professionals to collect training material using pre-intervention results for interactive group discussion. The physicians were divided into two groups of control andintervention groups. Following pre-intervention study the physicians of intervention group were discussed and trained in one-day interactive group discussion course using pre-intervention data and educational materials obtained from the focus group discussion.Results: The results of pre-intervention study showed that the average number of drugs in each prescription was 3.82. The percentage of patients receiving antibiotics, corticosteroids and injections were 40.81, 25.94 and 58.04 %, respectively. The results of this survey show great differences from WHO and international standards. Following the intervention the indicators were similar in both intervened and non-intervened groups and also were same as the pre-intervention

  14. Racionalidade terapêutica: elementos médico-sanitários nas demandas judiciais de medicamentos Racionalidad terapéutica: elementos medico-sanitarios en las demandas judiciales de medicamento Rational therapeutics: health-related elements in lawsuits demanding medicines

    Directory of Open Access Journals (Sweden)

    João Mauricio Brambati Sant'Ana

    2011-08-01

    carentes de subsidios clínicos y diagnósticos trae complicaciones de tipo gerencial y sanitaria al sistema de salud, ya que comprometen la asistencia farmacéutica regular y fomentan el uso irracional de medicamentos.OBJECTIVE: To characterize the main medical, scientific and health-related procedural elements upon which decisions are made in individual lawsuits demanding medicines that are considered essential to the Court of Justice. METHODS: Retrospective descriptive study based on 27 cases ruled on by the Court of Appeals in Rio de Janeiro, Southeastern Brazil, in 2006. The original proceedings were solicited from the Central Archive of the Court of Justice of the State of Rio de Janeiro and were photographed and analyzed in full. RESULTS: Prescriptions and medical certificates were present in 100% of the lawsuits. All prescriptions lacked conformity to legislation. No expert medical reports were added, and only 7.4% of the lawsuits presented complementary examinations. In spite of the scarcity of medical information present in the records, all of the demands were granted. CONCLUSIONS: The admission of judicial demands devoid of clinical and diagnostic substantiation results in managerial and health-related constraints on the health system. Besides creating havoc in standard pharmaceutical services, badly justified medicine demands may compromise rational drug use.

  15. Rational and Mechanistic Perspectives on Reinforcement Learning

    Science.gov (United States)

    Chater, Nick

    2009-01-01

    This special issue describes important recent developments in applying reinforcement learning models to capture neural and cognitive function. But reinforcement learning, as a theoretical framework, can apply at two very different levels of description: "mechanistic" and "rational." Reinforcement learning is often viewed in mechanistic terms--as…

  16. Should Teachers be Taught to be Rational?

    Science.gov (United States)

    Floden, Robert E.; Feiman, Sharon

    Teacher education programs have often attempted to make teachers more rational by use of apriori models. These models poorly correspond to teachers' thinking styles. Three distinct reactions to this problem have occurred. One proposed solution is to break the apriori model into separate component skills and to train teachers in each skill. A…

  17. Techno-Optimism and Rational Superstition

    DEFF Research Database (Denmark)

    Wilson, Alexander

    2017-01-01

    successes of technology. The article thus reveals a curious sense in which reason is intrinsically superstitious. I offer an evolutionary explanation for this, showing that the biological origins of reason will by nature tend to produce rational agents which are superstitiously bound to realism...

  18. Solving Rational Expectations Models Using Excel

    Science.gov (United States)

    Strulik, Holger

    2004-01-01

    Simple problems of discrete-time optimal control can be solved using a standard spreadsheet software. The employed-solution method of backward iteration is intuitively understandable, does not require any programming skills, and is easy to implement so that it is suitable for classroom exercises with rational-expectations models. The author…

  19. Macroeconomics after Two Decades of Rational Expectations.

    Science.gov (United States)

    McCallum, Bennett T.

    1994-01-01

    Discusses real business cycle analysis, growth theory, and other economic concepts in the context of the rational expectations revolution in macroeconomics. Focuses on post-1982 research. Concludes that the rejuvenation of growth analysis is an encouraging development because it could lead to changes in welfare policy. (CFR)

  20. Individual expectations, limited rationality and aggregate outcomes

    NARCIS (Netherlands)

    Bao, T.; Hommes, C.H.; Sonnemans, J.; Tuinstra, J.

    2012-01-01

    Recent studies suggest that the type of strategic environment or expectation feedback can have a large impact on whether the market can learn the rational fundamental price. We present an experiment where the fundamental price experiences large unexpected shocks. Markets with negative expectation

  1. Rational Voters in a Partisanship Model

    NARCIS (Netherlands)

    O.H. Swank (Otto)

    1995-01-01

    textabstractThis paper examines a voter model for the US which is interconnected with the partisan theory. In our model, voters are rational and forward-looking. They are perfectly informed about the preferences of political parties and about the state of the economy. The predictions of our voter

  2. Individual expectations, limited rationality and aggregate outcomes

    NARCIS (Netherlands)

    Bao, T.; Hommes, C.; Sonnemans, J.; Tuinstra, J.

    2010-01-01

    Recent studies suggest that the type of strategic environment or expectation feedback may have a large impact on whether the market learns the rational fundamental price. We present an experiment where the fundamental price experiences large unexpected shocks. Markets with negative expectation

  3. Imitation in Infancy: Rational or Motor Resonance?

    Science.gov (United States)

    Paulus, Markus; Hunnius, Sabine; Vissers, Marlies; Bekkering, Harold

    2011-01-01

    The present study investigates the contribution of 2 mechanisms to imitation in infancy. The principle of rational action suggests that infants normatively evaluate the efficiency of observed actions. In contrast, it has been proposed that motor resonance (i.e., the mapping of others' actions onto one's own motor repertoire) plays a central role…

  4. The Assessment of Rational Thinking: IQ ? RQ

    Science.gov (United States)

    Stanovich, Keith E.; West, Richard F.

    2014-01-01

    In this article the authors argue that distinguishing between rationality and intelligence helps explain how people can be, at the same time, intelligent and irrational (Stanovich, 2009). As such, researchers need to study separately the individual differences in cognitive skills that underlie intelligence and the individual differences in…

  5. Critical Thinking and Rational Emotive Behavior Therapy.

    Science.gov (United States)

    Hatcher, Donald; Brown, Tony; Gariglietti, Kelli P.

    2001-01-01

    Notes limitations of Rational Emotive Behavior Therapy (REBT). Suggests that should these weaknesses be addressed, teachers of critical thinking would do well to incorporate REBT into their critical thinking courses. Relates that A. Ellis has suggested that the future of REBT is in integrating it into the educational curriculum as a way of…

  6. Heterogeneous Parking Market Subject to Parking Rationing

    Directory of Open Access Journals (Sweden)

    Saeed Asadi Bagloee

    2015-01-01

    Full Text Available Different types of drivers and parking spaces delineate a heterogeneous parking market for which the literature has yet to provide a model applicable to the real world. The main obstacle is computational complexities of considering various parking restrictions along with traffic congestion on the road network. In this study, the heterogeneity aspects are considered within a Logit parking choice model. A mathematical programming problem was introduced to explicitly consider parking capacities and parking rationing constraints. The parking rationing is defined as any arrangement to reserve parking space for some specific demand such as parking permit, private parking, VIP parking, and different parking durations. Introduction of parking rationing in the presence of other constraints is a unique factor in this study which makes the model more realistic. The algorithm was tested on a central business district case study. The results prove that the algorithm is able to converge rapidly. Among the algorithm’s output are shadow prices of the parking capacity and parking rationing constraints. The shadow prices contain important information which is key to addressing a variety of parking issues, such as the location of parking shortages, identification of fair parking charges, viability of parking permits, and the size of reserved parking.

  7. MINIMAL RATIONAL INTERPOLATION AND PRONYS METHOD

    NARCIS (Netherlands)

    ANTOULAS, AC; WILLEMS, JC

    1990-01-01

    A new method is proposed for dealing with the rational interpolation problem. It is based on the reachability of an appropriately defined pair of matrices. This method permits a complete clarification of several issues raised, but not answered, by the so-called Prony method of fitting a linear model

  8. Rational Choice and the Framing of Decisions.

    Science.gov (United States)

    1986-05-29

    analyzed by Haltiwanger and Waldman (1985) and by Russell and Thaler (1985). Furthermore, Akerlof and Yellen (1985) have presented their near-rationality...aversion, pseudo-certainty, or the money illusion) for public policy, strategic decision making, and macro economic phenomena (see Akerlof & Yellen, 1985...Arrow, 1982). ::. * 4 ~* -** .. .. . . . . . . *. S*. - *. . . . . P . . . . . . . . . . . . . . . . ., Tversky-Kahneman 39 References Akerlof , G. A

  9. Adaptive Rationality, Adaptive Behavior and Institutions

    Directory of Open Access Journals (Sweden)

    Volchik Vyacheslav, V.

    2015-12-01

    Full Text Available The economic literature focused on understanding decision-making and choice processes reveals a vast collection of approaches to human rationality. Theorists’ attention has moved from absolutely rational, utility-maximizing individuals to boundedly rational and adaptive ones. A number of economists have criticized the concepts of adaptive rationality and adaptive behavior. One of the recent trends in the economic literature is to consider humans irrational. This paper offers an approach which examines adaptive behavior in the context of existing institutions and constantly changing institutional environment. It is assumed that adaptive behavior is a process of evolutionary adjustment to fundamental uncertainty. We emphasize the importance of actors’ engagement in trial and error learning, since if they are involved in this process, they obtain experience and are able to adapt to existing and new institutions. The paper aims at identifying relevant institutions, adaptive mechanisms, informal working rules and practices that influence actors’ behavior in the field of Higher Education in Russia (Rostov Region education services market has been taken as an example. The paper emphasizes the application of qualitative interpretative methods (interviews and discourse analysis in examining actors’ behavior.

  10. Rational function optimization using genetic algorithms

    Science.gov (United States)

    Valadan Zoej, M. J.; Mokhtarzade, M.; Mansourian, A.; Ebadi, H.; Sadeghian, S.

    2007-12-01

    In the absence of either satellite ephemeris information or camera model, rational functions are introduced by many investigators as mathematical model for image to ground coordinate system transformation. The dependency of this method on many ground control points (GCPs), numerical complexity, particularly terms selection, can be regarded as the most known disadvantages of rational functions. This paper presents a mathematical solution to overcome these problems. Genetic algorithms are used as an intelligent method for optimum rational function terms selection. The results from an experimental test carried out over a test field in Iran are presented as utilizing an IKONOS Geo image. Different numbers of GCPs are fed through a variety of genetic algorithms (GAs) with different control parameter settings. Some initial constraints are introduced to make the process stable and fast. The residual errors at independent check points proved that sub-pixel accuracies can be achieved even when only seven and five GCPs are used. GAs could select rational function terms in such a way that numerical problems are avoided without the need to normalize image and ground coordinates.

  11. Lifting rationality assumptions in binary aggregation

    NARCIS (Netherlands)

    Grandi, U.; Endriss, U.

    2010-01-01

    We consider problems where several individuals each need to make a yes/no choice regarding a number of issues and these choices then need to be aggregated into a collective choice. Depending on the application at hand, different combinations of yes/no may be considered rational. We can describe such

  12. Can we Rationally Learn to Coordinate?

    NARCIS (Netherlands)

    S. Goyal (Sanjeev); M.C.W. Janssen (Maarten)

    1996-01-01

    textabstractIn this paper we examine the issue whether individual rationality considerations are sufficient to guarantee that individuals will learn to coordinate. This question is central in any discussion of whether social phenomena (read: conventions) can be explained in terms of a purely

  13. A RATIONAL APPROACH TO SEPTIC TANK DESIGN

    African Journals Online (AJOL)

    2012-03-01

    Mar 1, 2012 ... A Rational Approach to Septic Tank Design. 69. Table 1: Schedule of Septic Tank Sizing and Dimensions (PWD, 1943). ... ficiency, hence three classes of plan specifications will be included in the evolving design .... 15 people in a typical Nigerian middle class city, say Enugu. It is required to construct a ...

  14. Global optimization of rational multivariate functions

    NARCIS (Netherlands)

    D. Jibetean

    2001-01-01

    textabstractThe paper deals with unconstrained global minimization of rational functions. A necessary condition is given for the function to have a finite infimum. In case the condition is satisfied, the problem is shown to be equivalent to a specific constrained polynomial optimization problem. In

  15. Rational positive systems for reaction networks

    NARCIS (Netherlands)

    J.H. van Schuppen (Jan)

    2003-01-01

    textabstractThe purpose of the lecture associated with this paper is to present problems, concepts, and theorems of control and system theory for a subclass of the rational positive systems of which examples have been published as models of biochemical cell reaction networks. The recent advances in

  16. Obesity, social inequality and economic rationality

    DEFF Research Database (Denmark)

    Dam, Thea; Jensen, Jørgen Dejgård; Kærgård, Niels

    2008-01-01

    This paper reviews the economic literature related to obesity and consumer decisions, pursuing the overall question, whether the current obesity epidemic and its social bias can be viewed as a result of rational consumption behaviour. We address a number of potential explanations based on consume...

  17. Multiple Equilibria in Noisy Rational Expectations Economies

    DEFF Research Database (Denmark)

    Palvolgyi, Domotor; Venter, Gyuri

    This paper studies equilibrium uniqueness in standard noisy rational expectations economies with asymmetric or differential information a la Grossman and Stiglitz (1980) and Hellwig (1980). We show that the standard linear equilibrium of Grossman and Stiglitz (1980) is the unique equilibrium...

  18. Reflections on Rational-Emotive Therapy.

    Science.gov (United States)

    Ellis, Albert

    1993-01-01

    Reflects rational-emotive therapy (RET) in 1955 and discusses some of its recent constructivist and humanist theories and practice. Distinguishes between general RET, called synonymous with general cognitive-behavioral therapy, from preferential RET, called unique kind of cognitive therapy that partially overlaps with general cognitive-behavioral…

  19. Suicide: rationality and responsibility for life.

    Science.gov (United States)

    Ho, Angela Onkay

    2014-03-01

    Death by suicide is widely held as an undesirable outcome. Most Western countries place emphasis on patient autonomy, a concept of controversy in relation to suicide. This paper explores the tensions between patients' rights and many societies' overarching desire to prevent suicide, while clarifying the relations between mental disorders, mental capacity, and rational suicide. A literature search was conducted using search terms of suicide and ethics in the PubMed and LexisNexis Academic databases. Article titles and abstracts were reviewed and deemed relevant if the paper addressed topics of rational suicide, patient autonomy or rights, or responsibility for life. Further articles were found from reference lists and by suggestion from preliminary reviewers of this paper. Suicidal behaviour in a person cannot be reliably predicted, yet various associations and organizations have developed standards of care for managing patients exhibiting suicidal behaviour. The responsibility for preventing suicide tends to be placed on the treating clinician. In cases where a person is capable of making treatment decisions--uninfluenced by any mental disorder--there is growing interest in the concept of rational suicide. There is much debate about whether suicide can ever be rational. Designating suicide as an undesirable event that should never occur raises the debate of who is responsible for one's life and runs the risk of erroneously attributing blame for suicide. While upholding patient rights of autonomy in psychiatric care is laudable, cases of suicidality warrant a delicate consideration of clinical judgment, duty of care, and legal obligations.

  20. Viagra: : A success story for rationing?

    NARCIS (Netherlands)

    Klein, R.; Sturm, H.

    2002-01-01

    The 1998 launch of Viagra prompted widespread fears about the budgetary consequences for insurers and governments, all the more so since Viagra was only the first of a new wave of so-called lifestyle drugs. The fears have turned out to be greatly exaggerated. This paper analyzes the rationing

  1. A characterization of quasi-rational polygons

    Science.gov (United States)

    Bedaride, Nicolas

    2012-11-01

    The aim of this paper is to study quasi-rational polygons related to the outer billiard. We compare different notions introduced in Gutkin and Simányi (1992 Commun. Math. Phys. 143 431-49) and Schwartz (2009 Outer Billiards on Kites (Annals of Mathematics Studies vol 171) (Princeton, NJ: Princeton University Press)) and make a synthesis of them.

  2. Travel time variability and rational inattention

    DEFF Research Database (Denmark)

    Fosgerau, Mogens; Jiang, Gege

    2017-01-01

    This paper sets up a rational inattention model for the choice of departure time for a traveler facing random travel time. The traveler chooses how much information to acquire about the travel time out-come before choosing departure time. This reduces the cost of travel time variability compared...

  3. Rationality and its limits in Arianism

    Directory of Open Access Journals (Sweden)

    Birjukov, Dmitry

    2008-06-01

    Full Text Available Having considered certain recurrent issues, such as the idea of comprehensibility of God and apopahtic theology, Dmitry Birjukov (Russian Christian Academy, St. Petersburg looks at the rational tendencies in Arianism and, on the basis of available data, shows how from Arius and Asterius to the Neo-Arians the rationalist tendencies in theology gradually increase while apophatic element virtually disappears.

  4. 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.

  5. Therapeutic Effect of Drug Intervention Combined with Exercise Rehabilitation in Treatment of Vascular Dementia%药物干预结合运动康复治疗血管性痴呆疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘素华

    2016-01-01

    目的:分析药物干预结合运动康复治疗血管性痴呆患者的效果。方法选我院收治的血管性痴呆患者124例为研究对象,随机分为观察组和对照组;其中,对照组62例患者口服奥拉西坦治疗,观察组62例患者口服奥拉西坦结合运动康复治疗,比较两组患者智力变化、日常生活能力变化。结果(1)观察组与对照组患者治疗后智力及日常生活能力的变化均与治疗前相比较优(P<0.05);(2)观察组患者治疗后,其智力改善状况及日常生活能力与对照组相比较优(P<0.05)。结论药物干预结合运动康复的治疗方法显著提高了治疗效果,降低患者的痴呆程度,对改善患者的日常生活能力有积极的影响。%Objective To analyze and study the effect of the drug intervention combined with rehabilitation treatment in treatment of vascular dementia patients.Methods 124 cases of vascular dementia patients were selected in our hospital as the research object, according to the random number table method, all the patients were divided into observation group and control group; among them, the control group (62 cases) was treated with oxiracetam oral way drug, observation group (62 cases) was treated with oral oxiracetam combined with rehabilitation exercise, the mental change and the ability of daily life of variable conditions between the two groups before and after treatment were compared.Results(1) The changes of the intelligence and ability of daily living in the observation group and control group after treatment were better than before treatment, (P<0.05); (2) The improvement situation of intelligence and activities of daily living (ADL) in the observation group after treatment were better than the control group (P<0.05). ConclusionDrug intervention combined with rehabilitation exercise therapy can signiifcantly improve the therapeutic effect, reduce the extent of dementia, has a positive effect to

  6. Conflicts in the therapeutic field

    Directory of Open Access Journals (Sweden)

    Antonino Aprea

    2012-06-01

    Full Text Available How the analytical knowledge that compare human consciousness with that, even more disturbing, moving behind his fifth can be said to be “for peace”? It can be - and this will be the contribution of the proposal - the same tortuous and enigmatic of therapeutic practice, with its hesitations and his impulses, to outline a path crossing and overcoming the conflict? May, finally, peace, in the sense of feasibility of intra-and interpersonal dialectic instead of tearing and hostileconfrontation with oneself and with the other, to be a reference in some crucial pivot of ethical therapeutic work? To these questions the intervention seeks to answer retracing some of the highlights of almost three years of therapeutic work with a young woman and her family.

  7. Rational points, rational curves, and entire holomorphic curves on projective varieties

    CERN Document Server

    Gasbarri, Carlo; Roth, Mike; Tschinkel, Yuri

    2015-01-01

    This volume contains papers from the Short Thematic Program on Rational Points, Rational Curves, and Entire Holomorphic Curves and Algebraic Varieties, held from June 3-28, 2013, at the Centre de Recherches Mathématiques, Université de Montréal, Québec, Canada. The program was dedicated to the study of subtle interconnections between geometric and arithmetic properties of higher-dimensional algebraic varieties. The main areas of the program were, among others, proving density of rational points in Zariski or analytic topology on special varieties, understanding global geometric properties of rationally connected varieties, as well as connections between geometry and algebraic dynamics exploring new geometric techniques in Diophantine approximation.

  8. Stenting of bifurcation lesions: a rational approach.

    Science.gov (United States)

    Lefèvre, T; Louvard, Y; Morice, M C; Loubeyre, C; Piéchaud, J F; Dumas, P

    2001-12-01

    The occurrence of stenosis in or next to coronary bifurcations is relatively frequent and generally underestimated. In our experience, such lesions account for 15%-18% of all percutaneous coronary intervention > (PCI). The main reasons for this are (1) the coronary arteries are like the branches of a tree with many ramifications and (2) because of axial plaque redistribution, especially after stent implantation, PCI of lesions located next to a coronary bifurcation almost inevitably cause plaque shifting in the side branches. PCI treatment of coronary bifurcation lesions remains challenging. Balloon dilatation treatment used to be associated with less than satisfactory immediate results, a high complication rate, and an unacceptable restenosis rate. The kissing balloon technique resulted in improved, though suboptimal, outcomes. Several approaches were then suggested, like rotative or directional atherectomy, but these techniques did not translate into significantly enhanced results. With the advent of second generation stents, in 1996, the authors decided to set up an observational study on coronary bifurcation stenting combined with a bench test of the various stents available. Over the last 5 years, techniques, strategies, and stent design have improved. As a result, the authors have been able to define a rational approach to coronary bifurcation stenting. This bench study analyzed the behavior of stents and allowed stents to be discarded that are not compatible with the treatment of coronary bifurcations. Most importantly, this study revealed that stent deformation due to the opening of a strut is a constant phenomenon that must be corrected by kissing balloon inflation. Moreover, it was observed that the opening of a stent strut into a side branch could permit the stenting, at least partly, of the side branch ostium. This resulted in the provocative concept of "stenting both branches with a single stent." Therefore, a simple approach is currently implemented

  9. Rationality and Organization: the Multiple Aspects of an Enigma

    Directory of Open Access Journals (Sweden)

    Victor Natanael Schwetter Silveira

    2008-10-01

    Full Text Available The aim of this article is to make a theoretical discussion about the rationality concept and its impacts over the organization’s context. Starting from the philosophical influences by notions of reason and rationality, a brief historical and philosophical approach is making, discussing about the duality of two basics notions: logic (thought and pragmatic (action. On sequence, the rationality concept it’s considered with regard to Weber’s theory ofbureaucracy. After that, the cognitive boundaries of human rationality are considered and the relationships between rationality, legitimacy and institutionalization are overviewed. Finally, rationality is overviewed based on Critical Theory authors like Habermas (1987a, Horkheimer (2002 and Marcuse (1975. In conclusion, this discussion tries to evidence the range and implications of the multiple facets of rationality concept and also brings concepts to go forward the debates about rationality on organizational theory field.

  10. Bounded rationality alters the dynamics of paediatric immunization acceptance

    National Research Council Canada - National Science Library

    Oraby, Tamer; Bauch, Chris T

    2015-01-01

    ... "rational" decision model that are often described as "bounded rationality". However, the impact of such cognitive effects in the context of paediatric infectious disease vaccines has received relatively little attention...

  11. Behavioral rationality and heterogeneous expectations in complex economic systems

    NARCIS (Netherlands)

    Hommes, C.H.

    2013-01-01

    Recognising that the economy is a complex system with boundedly rational interacting agents, the book presents a theory of behavioral rationality and heterogeneous expectations in complex economic systems and confronts the nonlinear dynamic models with empirical stylized facts and laboratory

  12. Cognitive distance, absorptive capacity and group rationality: a simulation study.

    Directory of Open Access Journals (Sweden)

    Petru Lucian Curşeu

    Full Text Available We report the results of a simulation study in which we explore the joint effect of group absorptive capacity (as the average individual rationality of the group members and cognitive distance (as the distance between the most rational group member and the rest of the group on the emergence of collective rationality in groups. We start from empirical results reported in the literature on group rationality as collective group level competence and use data on real-life groups of four and five to validate a mathematical model. We then use this mathematical model to predict group level scores from a variety of possible group configurations (varying both in cognitive distance and average individual rationality. Our results show that both group competence and cognitive distance are necessary conditions for emergent group rationality. Group configurations, in which the groups become more rational than the most rational group member, are groups scoring low on cognitive distance and scoring high on absorptive capacity.

  13. Rational noncompliance with prescribed medical treatment.

    Science.gov (United States)

    Stewart, Douglas O; DeMarco, Joseph P

    2010-09-01

    Despite the attention that patient noncompliance has received from medical researchers, patient noncompliance remains poorly understood and difficult to alter. With a better theory of patient noncompliance, both greater success in achieving compliance and greater respect for patient decision making are likely. The theory presented, which uses a microeconomic approach, bridges a gap in the extant literature that has so far ignored the contributions of this classic perspective on decision making involving the tradeoff of costs and benefits. The model also generates a surprising conclusion: that patients are typically acting rationally when they refuse to comply with certain treatments. However, compliance is predicted to rise with increased benefits and reduced costs. The prediction that noncompliance is rational is especially true in chronic conditions at the point that treatment begins to move closer to the medically ideal treatment level. Although the details of this theory have not been tested empirically, it is well supported by existing prospective and retrospective studies.

  14. Rationalization with ruled surfaces in architecture

    DEFF Research Database (Denmark)

    Steenstrup, Kasper Hornbak

    This thesis addresses the problems of rationalizing and segmenting large scale 3D models, and how to handle difficult production constraints in this area. The design choices when constructing large scale architecture are influenced by the budget. Therefore I strive to minimize the amount of time...... and material needed for production. This makes advanced free form architecture viable for low cost projects, allowing the architects to realize their designs. By pre-cutting building blocks using hot wire robots, the amount of milling necessary can be reduced drastically. I do this by rationalizing...... the intended shape as a piecewise ruled surface; the developed method was able to cut away up to 95% of the excess material. Methods were developed to minimize the number of blocks necessary to build advanced large scale 3D shapes. Using stochastic optimization to guide the segmentation, it was possible...

  15. On the rationality of Manx crabs

    Directory of Open Access Journals (Sweden)

    Tove Ahlbom

    2014-05-01

    Full Text Available This paper accepts the challenge posed by Godfrey Baldacchino in “Islands and despots”, published in Commonwealth & Comparative Politics in February 2012, to acknowledge and investigate the implications of the “expressions of harmony and solidarity” often observed in small island societies. To do so, aspects of the Isle of Man’s political and social life are discussed from the perspectives of popular rule and rationality. This paper argues that a homogeneity in preferences and the political practices of small island states might be a rational way of protecting a vulnerable economy and thus ensuring economic growth and a sufficient allocation to each island resident of the scarce resources required to survive. Such small island homogeneity and consensualism is therefore not necessarily indicating a deficient democratic practice, but might just connote another way of conducting democratic governance, spawned from a particular way of living and a particular range of needs

  16. . MODERN EDUCATION: FROM RATIONALITY TO REASONABLENESS

    Directory of Open Access Journals (Sweden)

    O. S. Anisimov

    2014-01-01

    Full Text Available The paper deals with the problem of modern education development and criticizes a pragmatic attitude to education. Based on the retrospective historical analysis, the author maintains that educational systems are generally focused on fostering the pragmatic intellect rather than reasoning, which leads to a superficial world perception, and undermines personal analytical potential and capability of strategic problem solving. Concentration on rationality is unlikely to provide a way out of the world crisis. In the author’s view, education demands both the deep and solid comprehension of existential concepts and the reference to the “absolute spirit” of Confucius, Plato, Kant and Hegel. The research is aimed at justifying the civilizational paradigm of education on the basis of Hegelian fundamental ideas of intellectual perception with the emphasis on reasonability instead of rationality. As the most adequate implementation instrument, the author suggests a game simulating technique that combines the benefits of philosophical, scientific and methodological thinking.

  17. Rational Thinking and Reasonable Thinking in Physics

    Directory of Open Access Journals (Sweden)

    Isaeva E. A.

    2008-04-01

    Full Text Available The usual concept of space and time, based on Aristotle’s principle of contemplation of the world and of the absoluteness of time, is a product of rational thinking. At the same time, in philosophy, rational thinking differs from reasonable thinking; the aim of logic is to distinguish finite forms from infinite forms. Agreeing that space and time are things of infinity in this work, we shall show that, with regard to these two things, it is necessary to apply reasonable thinking. Spaces with non-Euclidean geometry, for example Riemannian and Finslerian spaces, in particular, the space of the General Theory of the Relativity (four-dimensional pseudo-Riemannian geometry and also the concept of multi-dimensional space-time are products of reasonable thinking. Consequently, modern physical experiment not dealing with daily occurrences (greater speeds than a low speed to the velocity of light, strong fields, singularities, etc. can be covered only by reasonable thinking.

  18. The Long Life Ration Packet (LLRP)

    Science.gov (United States)

    1991-02-18

    confection , a cereal or fruitcake bar, coffee, cream, sugar, toilet paper, and matches. Some of the menus include cocoa beverage powder as well. There are...article pack, and a confection and stationery pack to meet the requirements of 100 persons for one day. It has normally not been issued with packaged...forth in the present purchase description for assembly of this ration supplement. --OUACCESSOIFS 20 CONFECTION AND TOBACCO PACK TOILET ARTICLE PACK

  19. Cognitive characteristics affecting rational decision making style

    OpenAIRE

    Rosenberg, Charlotte

    2011-01-01

    Abstract Decision making is one of the most important and frequent tasks among managers and employees in an organization. Knowledge about more stable cognitive characteristics underlying decision making styles has been requested. This study aimed to examine the relationship between rational decision making style, cognitive style, self efficacy and locus of control. Possible interaction effects in relation to gender were also analyzed. 186 employees at the Ministry of Defence were surveyed...

  20. Fluid Therapy: Options and Rational Selection.

    Science.gov (United States)

    Byers, Christopher G

    2017-03-01

    Administration of appropriate types and volumes of parenteral fluids is of paramount importance when treating sick and debilitated patients, especially those fighting critical illness. Fluid selection and accurate calculations must be performed logically and accurately to maximize positive outcomes. Knowledge of fluid types, as well as the complex relationship of the body's fluid compartments, helps clinicians develop rational fluid therapy plans for their patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Herbert Simon: bounded rationality and organizations theory

    OpenAIRE

    Estrada, Fernando

    2012-01-01

    This article evaluates Herbert A. Simon’s contribution to organization theory, placing special emphasis on the criterion of bounded rationality. Simon’s criticism of the orthodox version of organizational bureaucracy is interpreted and his analysis is extended to institutional economics. One of Simon’s main achievements in organizational theory consisted of analytically evaluating the psychology of individual and collective behaviour, thereby opening up the way for future investigation by D. ...

  2. [Rational use of antibiotics in hospitals].

    Science.gov (United States)

    Berild, Dag; Haug, Jon Birger

    2008-10-23

    The Norwegian antibiotic policy emphasises use of narrow-spectrum antibiotics and has been regarded as successful. We have a low occurrence of antibiotic resistance, but hospital use of antibiotics in general, and broad-spectrum antibiotics specifically, has increased substantially the last 10 years. We now see a trend towards increasing antibiotic resistance, which will inevitably lead to the same serious resistance problems in Norway as abroad. We have assessed resistance profiles for the most common human pathogens in Norway in the light of literature retrieved through a non-systematic search of PubMed and Norwegian literature on rational antibiotic use. The article emphasises pharmacodynamic and pharmacokinetic aspects, as well as ecological side effects of antibiotics and discusses rational treatment of the most common infections in Norwegian hospitals. Most research in this context is performed in settings with different antibiotic resistance patterns and attitudes towards antibiotic treatment than in Norway; few studies have focused on rational antibiotic use in Norwegian hospitals. We conclude that "old-fashioned" narrow-spectrum antibiotics can still be used in Norwegian hospitals, as there is little resistance to these agents. It is still possible to treat most infections in Norwegian hospitals with narrow-spectrum antibiotics. We encourage physicians to adhere to the Norwegian antibiotic therapy tradition.

  3. Rational design of nanomaterials for water treatment

    KAUST Repository

    Li, Renyuan

    2015-08-26

    The ever-increasing human demand for safe and clean water is gradually pushing conventional water treatment technologies to their limits and it is now a popular perception that the solutions to the existing and future water challenges will highly hinge upon the further development of nanomaterial sciences. The concept of rational design emphasizes ‘design-for-purpose’ and it necessitates a scientifically clear problem definition to initiate the nanomaterial design. The field of rational design of nanomaterials for water treatment has experienced a significant growth in the past decade and is poised to make its contribution in creating advanced next-generation water treatment technologies in the years to come. Within the water treatment context, this review offers a comprehensive and in-depth overview of the latest progress of the rational design, synthesis and applications of nanomaterials in adsorption, chemical oxidation and reduction reactions, membrane-based separation, oil/water separation, and synergistic multifunctional all-in-one nanomaterials/nanodevices. Special attention is paid on chemical concepts of the nanomaterial designs throughout the review.

  4. Rationality in children: the first steps

    Directory of Open Access Journals (Sweden)

    Andrew Woodfield

    1991-12-01

    Full Text Available Not all categorization is conceptual. Many of the experimental findings concerning infant and animal categorization invite the hypothesis that the subjects form abstract perceptual representations, mental models or cognitive maps that are not composed of concepts. The paper is a reflection upon the idea that conceptual categorization involves the ability to make categorical judgements under the guidance of norms of rationality. These include a norm of truth-seeking and a norm of good evidence. Acceptance of these norms implies willingness to defer to cognitive authorities, unwillingness to commit oneself to contradictions, and knowledge of how to reorganize one's representational system upon discovering that one has made a mistake. It is proposed that the cognitive architecture required for basic rationality is similar to that which underlies pretend-play. The representational system must be able to make room for separate 'mental spaces' in which alternatives to the actual world are entertained. The same feature underlies the ability to understand modalities, time, the appearance-reality distinction, other minds, and ethics. Each area of understanding admits of degrees, and mastery (up to normal adult level takes years. But rational concept-management, at least in its most rudimentary form, does not require a capacity to form second-order representations. It requires knowledge of how to operate upon, and compare, the contents of different mental spaces.

  5. Rational suicide: philosophical perspectives on schizophrenia.

    Science.gov (United States)

    Hewitt, Jeanette

    2010-02-01

    Suicide prevention is a National Health Service priority in the United Kingdom. People with mental illness are seen to represent one of the most vulnerable groups for suicide and recent British Government policy has focused on prevention and management of perceived risk. This approach to suicide prevention is constructed under a biomedical model of psychiatry, which maintains that suicidal persons suffer from some form of disease or irrational drive towards self-destruction. Many react to the idea of self-inflicted death with instinctive revulsion, which has prevented serious discussion of the concept of rational suicide, particularly in relation to those with schizophrenia. The idea that there may be circumstances in which suicide can be viewed as rational is discussed within the biomedical approach to ethics and wider literature primarily in relation to physical disease, terminal states and chronic pain. It is not deemed a viable choice for those who are considered 'non-autonomous' due to the controlling forces of mental illness. I propose that suicide is not a consequence of mental illness per se, and that it may be seen as a rational response to a realistic perspective on the course and consequences of living with schizophrenia. The denial of dialogue about the validity of suicidal ideation for people with schizophrenia has led to negative consequences for people with serious mental illness in terms of justice and recognition of person-hood.

  6. Rational design of nanomaterials for water treatment

    Science.gov (United States)

    Li, Renyuan; Zhang, Lianbin; Wang, Peng

    2015-10-01

    The ever-increasing human demand for safe and clean water is gradually pushing conventional water treatment technologies to their limits. It is now a popular perception that the solutions to the existing and future water challenges will hinge upon further developments in nanomaterial sciences. The concept of rational design emphasizes on `design-for-purpose' and it necessitates a scientifically clear problem definition to initiate the nanomaterial design. The field of rational design of nanomaterials for water treatment has experienced a significant growth in the past decade and is poised to make its contribution in creating advanced next-generation water treatment technologies in the years to come. Within the water treatment context, this review offers a comprehensive and in-depth overview of the latest progress in rational design, synthesis and applications of nanomaterials in adsorption, chemical oxidation and reduction reactions, membrane-based separation, oil-water separation, and synergistic multifunctional all-in-one nanomaterials/nanodevices. Special attention is paid to the chemical concepts related to nanomaterial design throughout the review.

  7. NOTES FOR THE CONSTRUCTION OF ENVIRONMENTAL RATIONALITY

    Directory of Open Access Journals (Sweden)

    Munir Jorge Felício

    2015-12-01

    Full Text Available The notes for the construction of Environmental Rationality proposed in this text were gathered from a contribution of an analysis of phenomenology, epistemology, and ontology relating to Marx. This initiative aims to broaden and deepen the understanding of environmental issues whose global changes raise challenges, especially for the scientific community. It is to question the development of the economic rationality from the degradation of natural resources engendered by the current socio-economic development model. This model is based on the increase of productivity, technological expansion and maintains the norm as if natural resources were still considered abundant and limitless. The transition of this Environmental Rationality is a development sought by using the knowledge gained from the analysis possibilities of phenomenology. Among these possibilities, the indicated interdisciplinary schools of thought, as required by epistemology, can become an interesting research strategy, since it has as the starting point the external demands, where the elements of the current environmental issue exist, and its consequences.

  8. Konseling Rational Emotive Behavioral dengan Teknik Pencitraan untuk Meningkatkan Resiliensi Mahasiswa Berstatus Sosial Ekonomi Lemah

    OpenAIRE

    Esya Anesty Mashudi

    2015-01-01

    This research aims to find out the effectiveness of rational emotive behavioral counseling through imagery technique as an effort to enhance the psychological resilience of the students with low socio-economy status. This research used quantitative-qualitative approach with mixed research method. Quasi experimental design to test the effectiveness of the intervention useing non-equivalentpretest-posttest control group design. It was conducted in Universitas Pendidikan Indonesiain Serang Regio...

  9. Rational approach for the management of a medium size bridge stock

    OpenAIRE

    Brühwiler, E.

    2008-01-01

    Infrastructure managers of medium size bridge stocks are being faced with the task of approximating short, mid to long term financial needs for their infrastructure. This task is particularly demanding due to the lack of relevant information, in particular in forecasting bridge condition and intervention costs. It can, therefore, be beneficial to make cost estimations based on structure types and present condition evaluation. In this article a rational approach for the management of the mediu...

  10. Rational Analyses of Information Foraging on the Web

    Science.gov (United States)

    Pirolli, Peter

    2005-01-01

    This article describes rational analyses and cognitive models of Web users developed within information foraging theory. This is done by following the rational analysis methodology of (a) characterizing the problems posed by the environment, (b) developing rational analyses of behavioral solutions to those problems, and (c) developing cognitive…

  11. Rationalization and Modernization of Defense Contractors After Mergers and Acquisitions

    Science.gov (United States)

    2002-04-09

    RATIONALIZATION AND MODERNIZATION OF DEFENSE CONTRACTORS AFTER MERGERS AND ACQUISITIONS BY LIEUTENANT COLONEL ANTHONY B. BELL United States Army...20020806 230 USAWC STRATEGY RESEARCH PROJECT RATIONALIZATION AND MODERNIZATION OF DEFENSE CONTRACTORS AFTER MERGERS AND ACQUISITIONS by Lieutenant...AUTHOR: Lieutenant Colonel Anthony B. Bell TITLE: Rationalization and Modernization of Defense Contractors After Mergers and Acquisitions FORMAT

  12. Can Shneidman's "Ten Commonalities of Suicide" Accommodate Rational Suicide?

    Science.gov (United States)

    Werth, James L., Jr.

    1996-01-01

    Reviews the concept of rational suicide and compares it with one researcher's list of commonalities of suicide. Claims that the list cannot accommodate rational suicide. Suggests that the list is biased against rational suicide and should be renamed so it cannot be maintained that suicide must be irrational. (RJM)

  13. "You can't choose these emotions… they simply jump up": Ambiguities in Resilience-Building Interventions in Israel.

    Science.gov (United States)

    Yankellevich, Ariel; Goodman, Yehuda C

    2017-03-01

    Following the growing critique of the use of Post-Traumatic Stress Disorder in post-disaster interventions, a new type of intervention aimed at building resilience in the face of traumatic events has been making its first steps in the social field. Drawing on fieldwork of a resilience-building program for pre-clinical populations in Israel, we analyze the paradoxes and ambiguities entailed in three inter-related aspects of this therapeutic project: The proposed clinical ideology aimed at immunizing against traumas; the discursive and non-discursive practices used by the mental-health professionals; and, participants' difficulties to inhabit the new resilient subject. These contradictions revolve around the injunction to rationally handle emotions in response to disruptive traumatic events. Hence, the attempt to separate between a sovereign rational subject and a post-traumatic subject is troubled in the face of experiences of trauma and social suffering. Furthermore, we demonstrate how these difficulties reconstitute unresolved tensions between mimetic and anti-mimetic tendencies that have been pervading the understanding of trauma in the therapeutic professions. Finally, we discuss how the construction of the resilient subject challenges the expanding bio-medical and neoliberal self-management paradigm in mental health.

  14. Intervention of Prostate Cancer by a Flavonoid Antioxidant Silymarin

    National Research Council Canada - National Science Library

    Agarwal, Rajesh

    1999-01-01

    ...). We rationalized that targeting this pathway would be useful for PCA intervention, and showed recently that a flavonoid antioxidant silymarin inhibits erbB 1 activation followed by a G 1 arrest...

  15. "Leaky" Rationality: How Research on Behavioral Decision Making Challenges Normative Standards of Rationality.

    Science.gov (United States)

    Keys, Daniel J; Schwartz, Barry

    2007-06-01

    For more than 30 years, decision-making research has documented that people often violate various principles of rationality, some of which are so fundamental that theorists of rationality rarely bother to state them. We take these characteristics of decision making as a given but argue that it is problematic to conclude that they typically represent departures from rationality. The very psychological processes that lead to "irrational" decisions (e.g., framing, mental accounting) continue to exert their influence when one experiences the results of the decisions. That is, psychological processes that affect decisions may be said also to "leak" into one's experience. The implication is that formal principles of rationality do not provide a good enough normative standard against which to assess decision making. Instead, what is needed is a substantive theory of rationality-one that takes subjective experience seriously, considers both direct and indirect consequences of particular decisions, considers how particular decisions fit into life as a whole, and considers the effects of decisions on others. Formal principles may play a role as approximations of the substantive theory that can be used by theorists and decision makers in cases in which the formal principles can capture most of the relevant considerations and leakage into experience is negligible. © 2007 Association for Psychological Science.

  16. RATIONAL CHOICE INSTITUTIONALISM AND THE EUROPEAN NEIGHBOURHOOD POLICY

    Directory of Open Access Journals (Sweden)

    Andreea Maha

    2013-09-01

    Full Text Available The aim of this paper is to highlight the main aspects regarding the rational choice theory in neo-institutionalism, and the role the EU Neighbourhood Policy has nowadays. The protagonist of the rational choice theory in the new institutionalism remains homo-economicus. The theory of rational choice institutionalism challenges the perfect rationality of the individual, rather than the principle of rational choice itself. ENP is a framework for consolidating the Union's relations with neighbouring countries and aims therefore intensifying cooperation with them in order to establish a zone of prosperity, good neighbourliness, stability and security.

  17. What Information Theory Says about Bounded Rational Best Response

    Science.gov (United States)

    Wolpert, David H.

    2005-01-01

    Probability Collectives (PC) provides the information-theoretic extension of conventional full-rationality game theory to bounded rational games. Here an explicit solution to the equations giving the bounded rationality equilibrium of a game is presented. Then PC is used to investigate games in which the players use bounded rational best-response strategies. Next it is shown that in the continuum-time limit, bounded rational best response games result in a variant of the replicator dynamics of evolutionary game theory. It is then shown that for team (shared-payoff) games, this variant of replicator dynamics is identical to Newton-Raphson iterative optimization of the shared utility function.

  18. Models of rational decision making in contemporary economic theory

    Directory of Open Access Journals (Sweden)

    Krstić Bojan

    2015-01-01

    Full Text Available The aim of this paper is to show that the economists can not adequately explain the rational behavior if are focused only on the scientific observations from the model of full rationality and the model instrumental rationality, and the inclusion related model makes 'larger views', which like more reprezentative reflection of the rational behavior represents a solid basis for construction the model of decision-making in contemporary economic science. Taking into account the goal of the work and its specific character, we composed adequate structure of work. In the first part of the paper, we define the model of full rationality, its important characteristics. In the second part, we analyze the model of instrumental rationality. In the analysis of model, we start from the statement, which given in economic theory, that the rational actor uses the best means to achieve their objectives. In the third part, we consider of the basic of the models of value rationality. In the fourth part, we consider key characteristics of the model of bounded rationality. In the last part, we focuse on questioning the basic assumptions of the model of full rationality and the model of instrumental rationality. We especially analyze the personal and social goals preferences of high school students and university students.

  19. Research on Bounded Rationality of Fuzzy Choice Functions

    Directory of Open Access Journals (Sweden)

    Xinlin Wu

    2014-01-01

    Full Text Available The rationality of a fuzzy choice function is a hot research topic in the study of fuzzy choice functions. In this paper, two common fuzzy sets are studied and analyzed in the framework of the Banerjee choice function. The complete rationality and bounded rationality of fuzzy choice functions are defined based on the two fuzzy sets. An assumption is presented to study the fuzzy choice function, and especially the fuzzy choice function with bounded rationality is studied combined with some rationality conditions. Results show that the fuzzy choice function with bounded rationality also satisfies some important rationality conditions, but not vice versa. The research gives supplements to the investigation in the framework of the Banerjee choice function.

  20. Early rationality in action perception and production? A theoretical exposition.

    Science.gov (United States)

    Paulus, Markus; Király, Ildikó

    2013-10-01

    Within recent years, the question of early rationality in action perception and production has become a topic of great interest in developmental psychology. On the one hand, studies have provided evidence for rational action perception and action imitation even in very young infants. On the other hand, scholars have recently questioned these interpretations and proposed that the ability to rationally evaluate actions is not yet in place in infancy. Others have examined the development of the ability to make rational action choices and have indicated limitations of young children's ability to act rationally. This editorial to the special issue on Early Rationality in Action Perception and Production? introduces the reader to the current debate. It elucidates the underlying theoretical assumptions that drive the debate on whether or not young children's action perception and production is rational. Finally, it summarizes the papers and their contributions to the theoretical debate. Copyright © 2013 Elsevier Inc. All rights reserved.