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Sample records for relapse initial development

  1. Early Phase in the Development of Cannabidiol as a Treatment for Addiction: Opioid Relapse Takes Initial Center Stage.

    Science.gov (United States)

    Hurd, Yasmin L; Yoon, Michelle; Manini, Alex F; Hernandez, Stephanie; Olmedo, Ruben; Ostman, Maria; Jutras-Aswad, Didier

    2015-10-01

    Multiple cannabinoids derived from the marijuana plant have potential therapeutic benefits but most have not been well investigated, despite the widespread legalization of medical marijuana in the USA and other countries. Therapeutic indications will depend on determinations as to which of the multiple cannabinoids, and other biologically active chemicals that are present in the marijuana plant, can be developed to treat specific symptoms and/or diseases. Such insights are particularly critical for addiction disorders, where different phytocannabinoids appear to induce opposing actions that can confound the development of treatment interventions. Whereas Δ(9)-tetracannabinol has been well documented to be rewarding and to enhance sensitivity to other drugs, cannabidiol (CBD), in contrast, appears to have low reinforcing properties with limited abuse potential and to inhibit drug-seeking behavior. Other considerations such as CBD's anxiolytic properties and minimal adverse side effects also support its potential viability as a treatment option for a variety of symptoms associated with drug addiction. However, significant research is still needed as CBD investigations published to date primarily relate to its effects on opioid drugs, and CBD's efficacy at different phases of the abuse cycle for different classes of addictive substances remain largely understudied. Our paper provides an overview of preclinical animal and human clinical investigations, and presents preliminary clinical data that collectively sets a strong foundation in support of the further exploration of CBD as a therapeutic intervention against opioid relapse. As the legal landscape for medical marijuana unfolds, it is important to distinguish it from "medical CBD" and other specific cannabinoids, that can more appropriately be used to maximize the medicinal potential of the marijuana plant.

  2. Early Phase in the Development of Cannabidiol as a Treatment for Addiction: Opioid Relapse Takes Initial Center Stage

    OpenAIRE

    Hurd, Yasmin L.; Yoon, Michelle; Manini, Alex F.; Hernandez, Stephanie; Olmedo, Ruben; Ostman, Maria; Jutras-Aswad, Didier

    2015-01-01

    Multiple cannabinoids derived from the marijuana plant have potential therapeutic benefits but most have not been well investigated, despite the widespread legalization of medical marijuana in the USA and other countries. Therapeutic indications will depend on determinations as to which of the multiple cannabinoids, and other biologically active chemicals that are present in the marijuana plant, can be developed to treat specific symptoms and/or diseases. Such insights are particularly critic...

  3. Patterns and Timing of Initial Relapse in Patients Subsequently Undergoing Transplantation for Hodgkin's Lymphoma

    International Nuclear Information System (INIS)

    Dhakal, Sughosh; Biswas, Tithi; Liesveld, Jane L.; Friedberg, Jonathan W.; Phillips, Gordon L.; Constine, Louis S.

    2009-01-01

    Purpose: To evaluate the patterns and timing of initial recurrence in patients with Hodgkin's lymphoma (HL) who subsequently underwent high-dose chemotherapy with autologous stem cell transplantation to enhance our understanding of the natural history of this disease and its modern treatment strategies and to direct approaches to disease surveillance. Methods and Materials: The records of 69 patients with HL who had undergone high-dose chemotherapy with autologous stem cell transplantation in our center between May 1992 and June 2006 were analyzed. The initial diagnosis had been made between April 1982 and January 2005 at a median patient age of 33 years (range, 19-65). The patients were segregated according to the initial stage (Stage I-II vs. III-IV). Results: Early-stage HL patients developed a relapse at a median of 2.1 years (range, 0.5-10.3), with 91% of relapses at the initial disease site, 71% of which (65% overall) were only in previously involved sites. Advanced-stage HL patients developed a relapse at a median of 1.5 years (range, 0.6-10.5), with 97% at the initial site, 71% of which (69% overall) were only in previously involved sites. Single-site relapses occurred in 47% of early- vs. 26% of advanced-stage patients, and extranodal relapses occurred in 12% of early- vs. 31% of advanced-stage patients. Conclusions: Almost all patients with HL who develop relapse and subsequently undergo high-dose chemotherapy with autologous stem cell transplantation initially developed recurrence in previously involved disease sites. Early-stage HL relapses often occurred in single sites, and advanced-stage disease relapses were more likely in multiple and extranodal sites. The interval to recurrence was brief, suggesting that the frequency of screening should be the greatest in the early post-therapy years.

  4. Residual tumor cells that drive disease relapse after chemotherapy do not have enhanced tumor initiating capacity.

    Directory of Open Access Journals (Sweden)

    Ganapati V Hegde

    Full Text Available Although chemotherapy is used to treat most advanced solid tumors, recurrent disease is still the major cause of cancer-related mortality. Cancer stem cells (CSCs have been the focus of intense research in recent years because they provide a possible explanation for disease relapse. However, the precise role of CSCs in recurrent disease remains poorly understood and surprisingly little attention has been focused on studying the cells responsible for re-initiating tumor growth within the original host after chemotherapy treatment. We utilized both xenograft and genetically engineered mouse models of non-small cell lung cancer (NSCLC to characterize the residual tumor cells that survive chemotherapy treatment and go on to cause tumor regrowth, which we refer to as tumor re-initiating cells (TRICs. We set out to determine whether TRICs display characteristics of CSCs, and whether assays used to define CSCs also provide an accurate readout of a cell's ability to cause tumor recurrence. We did not find consistent enrichment of CSC marker positive cells or enhanced tumor initiating potential in TRICs. However, TRICs from all models do appear to be in EMT, a state that has been linked to chemoresistance in numerous types of cancer. Thus, the standard CSC assays may not accurately reflect a cell's ability to drive disease recurrence.

  5. Second myeloablative allogeneic stem cell transplantation (SCT) using cord blood for leukemia relapsed after initial allogeneic SCT.

    Science.gov (United States)

    Konuma, Takaaki; Ooi, Jun; Takahashi, Satoshi; Tomonari, Akira; Tsukada, Nobuhiro; Kato, Seiko; Sato, Aki; Monma, Fumihiko; Kasahara, Senji; Uchimaru, Kaoru; Iseki, Tohru; Tojo, Arinobu; Asano, Shigetaka

    2009-06-01

    There are many reports of second allogeneic stem cell transplantation (allo-SCT) using cord blood (CB) for graft failure after initial allo-SCT. However, the efficacy of second allo-SCT using CB for patients with leukemia relapsed after initial allo-SCT is unknown. We report the results of second allo-SCT using CB in seven adult patients with leukemia relapsed after initial allo-SCT. All patients received a myeloablative conditioning regimen including oral busulfan 16 mg/kg, intravenously fludarabine 100mg/m(2) and cyclophosphamide 120 mg/kg. All but one patient had myeloid reconstitution and four patients remain alive at between 4 and 40 months after second SCT. We conclude that second myeloablative allo-SCT using CB may be feasible in selected patients with the relatively younger age, less organ damage and longer time interval between first and second allo-SCT.

  6. Changes in circulating leptin levels during the initial stage of cessation are associated with smoking relapse.

    Science.gov (United States)

    Lemieux, Andrine; Nakajima, Motohiro; Hatsukami, Dorothy K; Allen, Sharon; al'Absi, Mustafa

    2015-09-01

    Leptin has been linked to tobacco craving and withdrawal-related symptoms. Very few studies have examined leptin prospectively in both male and female nonsmokers and smokers. We examine leptin concentrations prospectively in both male and female nonsmokers and smokers to assess the associations of leptin with psychological symptoms and smoking relapse during ad libitum smoking, the first 48 h post quit, and 4 weeks post-cessation. Self-report psychological, anthropomorphic, and biological measures (cotinine, carbon monoxide, and plasma leptin) were collected before and after 48 h of smoking abstinence. Smokers were stratified at 28 days post quit as abstinent or relapsed if they had smoked daily for seven consecutive days at any point in the 28 days. Leptin concentration (square root transformed ng/ml) increased over the 48-h abstinence, but only in female abstainers. In contrast, leptin was very stable across time for nonsmokers, relapsers, and males. Cox regression supported that increased leptin was associated with decreased risk of relapse. Leptin was correlated negatively with withdrawal symptoms for abstainers only. Females produce more leptin than males and this level increases from ad libitum smoking to 48-h post quit. The current analysis indicates that a leptin increase early in cessation predicts abstinence. The increase in women, but not men, in response to abstinence provides further evidence of important gender differences. The negative correlation between leptin and withdrawal symptoms indicates a possible protective effect of leptin. Further research is ongoing to elucidate the psychological and biological determinants of this effect.

  7. Survival analysis of patients with clinical stages I or II Hodgkin's disease who have relapsed after initial treatment with radiotherapy alone

    DEFF Research Database (Denmark)

    Horwich, A.; Specht, L.; Ashley, S.

    1997-01-01

    relapse included initial stage, age, sex, histology, number of involved areas, mediastinal involvement, E-lesions, B-symptoms, erythrocyte sedimentation rate, alkaline phosphatase, serum albumin and haemoglobin. As well as presentation variables, we analysed the disease-free interval after initial......To aid treatment choice in early stage of Hodgkin's disease, we analysed patients registered in the IDHD Database with clinical stages I or II Hodgkin's disease who were not staged with laparotomy and whose initial treatment was with radiotherapy alone. The factors analysed for outcome after first...... radiotherapy and the extent of disease at relapse. A total of 1364 patients with clinical stage I or II Hodgkin's disease were treated with initial radiotherapy, of whom 473 relapsed. The probability of survival 10 years after relapse was 63%. For cause-specific survival (CSS), both multivariate and univariate...

  8. Laboratory diagnosis of tick-borne African relapsing fevers: latest developments

    Directory of Open Access Journals (Sweden)

    Aurélien eFotso Fotso

    2015-11-01

    Full Text Available In Africa, relapsing fevers caused by ectoparasite-borne Borrelia species are transmitted by ticks, with the exception of Borrelia recurrentis, which is a louse-borne spirochete. These tropical diseases responsible for mild to deadly spirochetemia. Cultured B. crocidurae, B. duttonii and B. hispanica circulate alongside at least six species which have not yet been cultured in vectors. Direct diagnosis is hindered by the use of non-specific laboratory tools. Indeed, microscopic observation of Borrelia spirochaeta in smears of peripheral blood taken from febrile patients lacks sensitivity and specificity. Although best visualised using dark-field microscopy, the organisms can also be detected using Wright-Giemsa or acridine orange stains.. PCR-based detection of specific sequences in total DNA extracted from a specimen can be used to discriminate different relapsing fever Borreliae. In our laboratory, we developed a multiplex real-time PCR assay for the specific detection of B. duttonii/recurrentis and B. crocidurae: Multispacer Sequence Typing accurately identified cultured relapsing fever borreliae and revealed diversity among them. Other molecular typing techniques, such as multilocus sequence analysis of tick-borne relapsing fever borreliae, showed the potential risk of human infection in Africa. Recent efforts to culture and sequence relapsing fever borreliae have provided new information for reassessment of the diversity of these bacteria. Recently, matrix-assisted laser desorption ionization time-of-flight mass spectrometry has been reported as a means of identifying cultured borreliae and of identifying both vectors and vectorised pathogens such as detecting relapsing fever borreliae directly in ticks. The lack of a rapid diagnosis test restricts the management of such diseases. We produced monoclonal antibodies against Borrelia crocidurae in order to develop cheap assays for the rapid detection of relapsing fever borreliae. In this paper

  9. Cervical mature teratoma 17 years after initial treatment of testicular teratocarcinoma: report of a late relapse

    Directory of Open Access Journals (Sweden)

    Alavion Mina

    2007-01-01

    Full Text Available Abstract Background Late relapses of testicular germ cell tumor are uncommon. We report a case of cervical mature teratoma appeared 17 years after treatment of testicular teratocarcinoma. Case presentation A 20- year- old patient underwent left sided orchiectomy followed by systemic therapy and retroperitoneal residual mass resection in 1989. He remained in complete remission for 200 months. In 2005 a huge left supraclavicular neck mass with extension to anterior mediastinum appeared. Radical surgical resection of the mass was performed and pathologic examination revealed mature teratoma. Conclusion This is one of the longest long-term reported intervals of a mature teratoma after treatment of a testicular nonseminoma germ cell tumor. This case emphasizes the necessity for follow up of testicular cancer throughout the patient's life.

  10. Patterns and Timing of Failure for Diffuse Large B-Cell Lymphoma After Initial Therapy in a Cohort Who Underwent Autologous Bone Marrow Transplantation for Relapse

    Energy Technology Data Exchange (ETDEWEB)

    Dhakal, Sughosh; Bates, James E. [Department of Radiation Oncology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York (United States); Casulo, Carla; Friedberg, Jonathan W.; Becker, Michael W.; Liesveld, Jane L. [Department of Medicine, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York (United States); Constine, Louis S., E-mail: louis_constine@urmc.rochester.edu [Department of Radiation Oncology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York (United States)

    2016-10-01

    Purpose: To evaluate the location and timing of initial recurrence in patients with diffuse large B-cell lymphoma (DLBCL) who subsequently underwent high-dose chemotherapy with autologous stem cell transplant (HDC/ASCT), to direct approaches for disease surveillance, elucidate the patterns of failure of contemporary treatment strategies, and guide adjuvant treatment decisions. Methods and Materials: We analyzed consecutive patients with DLBCL who underwent HDC/ASCT between May 1992 and March 2014 at our institution. Of the 187 evaluable patients, 8 had incomplete data, and 79 underwent HDC/ASCT as a component of initial treatment for de novo or refractory DLBCL and were excluded from further analysis. Results: The median age was 50.8 years; the median time to relapse was 1.3 years. Patients were segregated according to the initial stage at diagnosis, with early stage (ES) defined as stage I/II and advanced stage (AS) defined as stage III/IV. In total, 40.4% of the ES and 75.5% of the AS patients relapsed in sites of initial disease; 68.4% of those with ES disease and 75.0% of those with AS disease relapsed in sites of initial disease only. Extranodal relapses were common (44.7% in ES and 35.9% in AS) and occurred in a variety of organs, although gastrointestinal tract/liver (n=12) was most frequent. Conclusions: Most patients with DLBCL who relapse and subsequently undergo HDC/ASCT initially recur in the previously involved disease site(s). Time to recurrence is brief, suggesting that frequency of screening is most justifiably greatest in the early posttherapy years. © 2016 Elsevier Inc.

  11. The innovative development in interferon beta treatments of relapsing-remitting multiple sclerosis

    DEFF Research Database (Denmark)

    Madsen, Claus

    2017-01-01

    The introduction of interferon beta therapies more than 20 years ago marked a milestone in the treatment of relapsing-remitting multiple sclerosis (RRMS) with a significant impact on the approach to modern multiple sclerosis (MS) care. Key learnings and perspectives from the early days of disease...... modifying therapies in MS have improved the knowledge base of MS, need for treatment, and patient care. The continuous development of interferons over the past two decades outlines a journey with increased understanding of the pharmacodynamics and pharmacokinetic mechanisms of interferons, leading...

  12. Leishmania Antigenuria to Predict Initial Treatment Failure and Relapse in Visceral Leishmaniasis/HIV Coinfected Patients: An Exploratory Study Nested Within a Clinical Trial in Ethiopia.

    Science.gov (United States)

    van Griensven, Johan; Mengesha, Bewketu; Mekonnen, Tigist; Fikre, Helina; Takele, Yegnasew; Adem, Emebet; Mohammed, Rezika; Ritmeijer, Koert; Vogt, Florian; Adriaensen, Wim; Diro, Ermias

    2018-01-01

    Background: Biomarkers predicting the risk of VL treatment failure and relapse in VL/HIV coinfected patients are needed. Nested within a two-site clinical trial in Ethiopia (2011-2015), we conducted an exploratory study to assess whether (1) levels of Leishmania antigenuria measured at VL diagnosis were associated with initial treatment failure and (2) levels of Leishmania antigenuria at the end of treatment (parasitologically-confirmed cure) were associated with subsequent relapse. Methods: Leishmania antigenuria at VL diagnosis and cure was determined using KAtex urine antigen test and graded as negative (0), weak/moderate (grade 1+/2+) or strongly-positive (3+). Logistic regression and Kaplan-Meier methods were used to assess the association between antigenuria and (1) initial treatment failure, and (2) relapse over the 12 months after cure, respectively. Results: The analysis to predict initial treatment failure included sixty-three coinfected adults [median age: 30 years interquartile range (IQR) 27-35], median CD4 count: 56 cells/μL (IQR 38-113). KAtex results at VL diagnosis were negative in 11 (17%), weak/moderate in 17 (27%) and strongly-positive in 35 (36%). Twenty (32%) patients had parasitologically-confirmed treatment failure, with a risk of failure of 9% (1/11) with KAtex-negative results, 0% (0/17) for KAtex 1+/2+ and 54% (19/35) for KAtex 3+ results. Compared to KAtex-negative patients, KAtex 3+ patients were at increased risk of treatment failure [odds ratio 11.9 (95% CI 1.4-103.0); P : 0.025]. Forty-four patients were included in the analysis to predict relapse [median age: 31 years (IQR 28-35), median CD4 count: 116 cells/μL (IQR 95-181)]. When achieving VL cure, KAtex results were negative in 19 (43%), weak/moderate (1+/2+) in 10 (23%), and strongly positive (3+) in 15 patients (34%). Over the subsequent 12 months, eight out of 44 patients (18%) relapsed. The predicted 1-year relapse risk was 6% for KAtex-negative results, 14% for KAtex 1

  13. Relapse outcomes, safety, and treatment patterns in patients diagnosed with relapsing-remitting multiple sclerosis and initiated on subcutaneous interferon β-1a or dimethyl fumarate: a real-world study.

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    Ernst, Frank R; Barr, Peri; Elmor, Riad; Wong, Schiffon L

    2017-12-01

    To estimate real-world treatment patterns, safety, and relapse outcomes of subcutaneous (sc) interferon (IFN) β-1a (Rebif) vs dimethyl fumarate (DMF; Tecfidera), to treat relapsing-remitting multiple sclerosis (RRMS). A US retrospective chart review of 450 randomly selected adults newly diagnosed with RRMS who received sc IFN β-1a (n = 143) or DMF (n = 307) was conducted. Patients were either (a) treatment-naïve, initiating first-line treatment with sc IFN β-1a or DMF, or (b) previously treated, switching to sc IFN β-1a or DMF. Two years' follow-up data were captured. Patient characteristics, persistence, and adverse events between treatment groups were compared using t-tests or Chi-square tests. Kaplan-Meier curves with log-rank tests and Cox proportional hazards models were used to compare time to, and risk of non-persistence. Annualized Relapse Rates (ARR) were calculated using a robust variance Poisson model adjusting for covariates. Propensity scores were used to address possible selection bias. One hundred and twelve patients became non-persistent, most commonly due to an adverse event (n = 37). No difference was observed in time to overall non-persistence between sc IFN β-1a and DMF patients. Among treatment-naïve patients, those receiving DMF had 2.4-times the risk (HR = 2.439, 95% CI = 1.007-5.917, p = .0483) of experiencing a discontinuation than patients receiving sc IFN β-1a. Non-persistent patients receiving DMF had 2.3-times the risk (HR = 2.311, 95% CI = 1.350-3.958, p = .0023) of experiencing an adverse event at a given time point than patients prescribed sc IFN β-1a. No differences in relapse risk or ARR between sc IFN β-1a- and DMF-treated patients were observed. sc IFN β-1a-treated patients had comparable persistence and relapse outcomes, and better safety outcomes vs DMF-treated patients across 2 years.

  14. Development of a Virtual Reality Coping Skills Game to Prevent Post-Hospitalization Smoking Relapse in Tobacco Dependent Cancer Patients.

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    Krebs, Paul; Burkhalter, Jack; Lewis, Shireen; Hendrickson, Tinesha; Chiu, Ophelia; Fearn, Paul; Perchick, Wendy; Ostroff, Jamie

    2009-08-01

    Many hospitalized smokers return to smoking after hospital discharge even though continued smoking can compromise treatment effectiveness, reduce survival, increase risk of disease recurrence, and impair quality of life. After leaving a smoke-free hospital, patients encounter smoking cues at home, such as family members who smoke or emotional triggers such as stress, which can elicit powerful urges to smoke and lead to smoking relapse. Enabling smokers to experience such urges in a controlled setting while providing the ability to practice coping skills may be a useful strategy for building quitting self-efficacy. We are developing a virtual reality coping skills (VRCS) game to help hospitalized smokers practice coping strategies to manage these triggers in preparation for returning home after hospitalization. Our multidisciplinary team developed a prototype VRCS game using Second Life, a platform that allowed rapid construction of a virtual reality environment. The prototype contains virtual home spaces (e.g., living room, kitchen) populated with common triggers to smoke and a "toolkit" with scripted actions that enable the avatar to rehearse various coping strategies. Since eliciting and managing urges to smoke is essential to the game's utility as an intervention, we assessed the ability of the prototype virtual environment to engage former smokers in these scenarios. We recruited eight former smokers with a recent history of hospitalization and guided each through a VRCS scenario during which we asked the patient to evaluate the strength of smoking urges and usefulness of coping strategies. Initial data indicate that patients report high urges to smoke (mean = 8.8 on a 10 point scale) when their avatar confronted virtual triggers such as drinking coffee. Patients rated virtual practice of coping strategies, such as drinking water or watching TV, as very helpful (mean = 8.4 on a 10 point scale) in reducing these urges. With further development, this VRCS game

  15. Salvage of relapse of patients with Hodgkin's disease in clinical stages I or II who were staged with laparotomy and initially treated with radiotherapy alone. A report from the international database on Hodgkin's disease

    DEFF Research Database (Denmark)

    Specht, L.; Horwich, A.; Ashley, S.

    1994-01-01

    patients in the International Database on Hodgkin's Disease who were initially in clinical Stages I or II, who were staged with laparotomy, and who relapsed after initial treatment with irradiation alone. Factors analyzed for outcome after first relapse included initial stage, age, sex, histology......PURPOSE: To analyze presentation variables that might indicate a high or low likelihood of success of the treatment of patients relapsing after initial radiotherapy of Hodgkin's disease in clinical Stages I or II who were staged with laparotomy. METHODS AND MATERIALS: Data were analyzed on 681...

  16. Orexin Receptor Targets for Anti-Relapse Medication Development in Drug Addiction

    Directory of Open Access Journals (Sweden)

    Ronald E. See

    2011-06-01

    Full Text Available Drug addiction is a chronic illness characterized by high rates of relapse. Relapse to drug use can be triggered by re-exposure to drug-associated cues, stressful events, or the drug itself after a period of abstinence. Pharmacological intervention to reduce the impact of relapse-instigating factors offers a promising target for addiction treatment. Growing evidence has implicated an important role of the orexin/hypocretin system in drug reward and drug-seeking, including animal models of relapse. Here, we review the evidence for the role of orexins in modulating reward and drug-seeking in animal models of addiction and the potential for orexin receptors as specific targets for anti-relapse medication approaches.

  17. Development and initial validation of a cessation fatigue scale.

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    Mathew, Amanda R; Heckman, Bryan W; Meier, Ellen; Carpenter, Matthew J

    2017-07-01

    Smoking cessation fatigue, or tiredness of attempting to quit smoking, has been posited as a latent construct encompassing loss of motivation, loss of hope in cessation success, decreased self-efficacy, and exhaustion of self-control resources. Despite the potential clinical impact of characterizing cessation fatigue, there is currently no validated measure to assess it. Using a rational scale development approach, we developed a cessation fatigue measure and examined its reliability and construct validity in relation to a) smokers' experience of a recently failed quit attempt (QA) and b) readiness to engage in a subsequent QA. Data were drawn from an online cross-sectional survey of 484 smokers who relapsed from a QA within the past 30days. Exploratory factor analysis identified three factors within the 17-item Cessation Fatigue Scale (CFS), which we labeled: emotional exhaustion, pessimism, and devaluation. High internal consistency was observed for each factor and across the full scale. As expected, CFS overall was positively associated with withdrawal severity and difficulty quitting. CFS was negatively associated with previously validated measures of intention to quit, self-efficacy, and abstinence-related motivational engagement, even after adjusting for nicotine dependence. Findings provide initial validation for a new tool to assess cessation fatigue and contribute needed information on a theory-driven component of cessation-related motivation and relapse risk. Copyright © 2017. Published by Elsevier B.V.

  18. Development and optimization of an in vitro cultivation protocol allows for isolation of Borrelia miyamotoi from patients with hard tick-borne relapsing fever

    NARCIS (Netherlands)

    Koetsveld, Joris; Kolyasnikova, Nadezhda M.; Wagemakers, Alex; Toporkova, Marina G.; Sarksyan, Denis S.; Oei, Anneke; Platonov, Alexander E.; Hovius, Joppe W.

    2017-01-01

    Objectives: Borrelia miyamotoi has been shown to infect humans in Eurasia and North America causing hard tick-borne relapsing fever (HTBRF). In vitro cultivation of B. miyamotoi was described recently; but clinical isolation of relapsing fever Borrelia is cumbersome. Our aim was to develop a

  19. [Relapse: causes and consequences].

    Science.gov (United States)

    Thomas, P

    2013-09-01

    Relapse after a first episode of schizophrenia is the recurrence of acute symptoms after a period of partial or complete remission. Due to its variable aspects, there is no operational definition of relapse able to modelise the outcome of schizophrenia and measure how the treatment modifies the disease. Follow-up studies based on proxys such as hospital admission revealed that 7 of 10 patients relapsed after a first episode of schizophrenia. The effectiveness of antipsychotic medications on relapse prevention has been widely demonstrated. Recent studies claim for the advantages of atypical over first generation antipsychotic medication. Non-adherence to antipsychotic represents with addictions the main causes of relapse long before some non-consensual factors such as premorbid functioning, duration of untreated psychosis and associated personality disorders. The consequences of relapse are multiple, psychological, biological and social. Pharmaco-clinical studies have demonstrated that the treatment response decreases with each relapse. Relapse, even the first one, will contribute to worsen the outcome of the disease and reduce the capacity in general functionning. Accepting the idea of continuing treatment is a complex decision in which the psychiatrist plays a central role besides patients and their families. The development of integrated actions on modifiable risk factors such as psychosocial support, addictive comorbidities, access to care and the therapeutic alliance should be promoted. Relapse prevention is a major goal of the treatment of first-episode schizophrenia. It is based on adherence to the maintenance treatment, identification of prodromes, family active information and patient therapeutical education. Copyright © 2013 L’Encéphale. Published by Elsevier Masson SAS.. All rights reserved.

  20. Extinction of relapsed fear does not require the basolateral amygdala.

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    Lingawi, Nura W; Westbrook, R Frederick; Laurent, Vincent

    2017-03-01

    It is well established that extinguished fears are restored with the passage of time or a change in physical context. These fear restoration phenomena are believed to mimic the conditions under which relapse occurs in patients that have been treated for anxiety disorders by means of cue-exposure therapy. Here, we used a rodent model to extinguish relapsed fear and assess whether this new extinction prevents further relapse. We found that activity in the basolateral amygdala (BLA) is required to initially extinguish conditioned fear, but this activity was not necessary to subsequently extinguish relapsed fear. That is, extinction of spontaneously recovered or renewed fear was spared by BLA inactivation. Yet, this BLA-independent learning of extinction did not protect against further relapse: extinction of relapsed fear conducted without BLA activity was still likely to return after the passage of time or a shift in physical context. These findings have important clinical implications. They indicate that pharmacological agents with anxiolytic properties may disrupt initial cue-exposure therapy but may be useful when therapy is again needed due to relapse. However, they also suggest that these agents will not protect against further relapse, implying the need for developing drugs that target other brain regions involved in fear inhibition. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Social settings and addiction relapse.

    Science.gov (United States)

    Walton, M A; Reischl, T M; Ramanthan, C S

    1995-01-01

    Despite addiction theorists' acknowledgment of the impact of environmental factors on relapse, researchers have not adequately investigated these influences. Ninety-six substance users provided data regarding their perceived risk for relapse, exposure to substances, and involvement in reinforcing activities. These three setting attributes were assessed in their home, work, and community settings. Reuse was assessed 3 months later. When controlling for confounding variables, aspects of the home settings significantly distinguished abstainers from reusers; perceived risk for relapse was the strongest predictor of reuse. Exposure to substances and involvement in reinforcing activities were not robust reuse indicators. The work and community settings were not significant determinants of reuse. These findings offer some initial support for the utility of examining social settings to better understand addiction relapse and recovery. Identification of setting-based relapse determinants provides concrete targets for relapse prevention interventions.

  2. Is High Dose Therapy Superior to Conventional Dose Therapy as Initial Treatment for Relapsed Germ Cell Tumors? The TIGER Trial

    Directory of Open Access Journals (Sweden)

    Darren R. Feldman, Robert Huddart, Emma Hall, Jörg Beyer, Thomas Powles

    2011-01-01

    Full Text Available Metastatic germ cell tumours (GCTs are usually cured with cisplatin based chemotherapy and standard treatment algorithms are established. However when this treatment fails and the disease relapses, standard treatment is much more uncertain. Both conventional dose therapy (CDT and high dose therapy (HDT are widely used, due to the lack of conclusive data supporting one specific approach. A recent retrospective analysis focusing on this population suggested a significant benefit for HDT. Retrospective analyses are prone to bias, and therefore while this data is provocative it is by no mean conclusive. For this reason the international community is supporting a prospective randomised trial in this area comparing CDT(TIP with sequential HDT (TICE. The planned open labelled randomised phase III study (TIGER is due to open in 2011 and will recruit 390 patients to detect a 13% difference in 2 year progression free survival (primary endpoint. It is hoped that this large study will conclusively resolve the uncertainty which currently exists.

  3. Hanford Site sustainable development initiatives

    International Nuclear Information System (INIS)

    Sullivan, C.T.

    1994-05-01

    Since the days of the Manhattan Project of World War II, the economic well being of the Tri-Cities (Pasco, Kennewick, and Richland) of Washington State has been tied to the US Department of Energy missions at the nearby Hanford Site. As missions at the Site changed, so did the economic vitality of the region. The Hanford Site is now poised to complete its final mission, that of environmental restoration. When restoration is completed, the Site may be closed and the effect on the local economy will be devastating if action is not taken now. To that end, economic diversification and transition are being planned. To facilitate the process, the Hanford Site will become a sustainable development demonstration project

  4. Extramedullary Relapse Following Total Marrow and Lymphoid Irradiation in Patients Undergoing Allogeneic Hematopoietic Cell Transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Hyun [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States); Stein, Anthony [Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California (United States); Tsai, Nicole [Department of Biostatistics, City of Hope National Medical Center, Duarte, California (United States); Schultheiss, Timothy E. [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States); Palmer, Joycelynne [Department of Biostatistics, City of Hope National Medical Center, Duarte, California (United States); Liu, An [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States); Rosenthal, Joseph [Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California (United States); Department of Pediatrics, City of Hope National Medical Center, Duarte, California (United States); Forman, Stephen J. [Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California (United States); Wong, Jeffrey Y.C., E-mail: jwong@coh.org [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California (United States)

    2014-05-01

    Purpose: Approximately 5% to 20% of patients who undergo total body irradiation (TBI) in preparation for hematopoietic cell transplantation (HCT) can develop extramedullary (EM) relapse. Whereas total marrow and lymphoid irradiation (TMLI) provides a more conformally targeted radiation therapy for patients, organ sparing has the potential to place the patient at a higher risk for EM relapse than TBI. This study evaluated EM relapse in patients treated with TMLI at our institution. Methods and Materials: Patients eligible for analysis had been enrolled in 1 of 3 prospective TMLI trials between 2006 and 2012. The TMLI targeted bones, major lymph node chains, liver, spleen, testes, and brain, using image-guided tomotherapy with total dose ranging from 12 to 15 Gy. Results: A total of 101 patients with a median age of 47 years were studied. The median follow-up was 12.8 months. Incidence of EM relapse and bone marrow (BM) relapse were 12.9% and 25.7%, respectively. Of the 13 patients who had EM relapse, 4 also had BM relapse, and 7 had EM disease prior to HCT. There were a total of 19 EM relapse sites as the site of initial recurrence: 11 soft tissue, 6 lymph node, 2 skin. Nine of these sites were within the target region and received ≥12 Gy. Ten initial EM relapse sites were outside of the target region: 5 sites received 10.1 to 11.4 Gy while 5 sites received <10 Gy. Pretransplantation EM was the only significant predictor of subsequent EM relapse. The cumulative incidence of EM relapse was 4% at 1 year and 11.4% at 2 years. Conclusions: EM relapse incidence was as frequent in regions receiving ≥10 Gy as those receiving <10 Gy. EM relapse rates following TMLI that included HCT regimens were comparable to published results with regimens including TBI and suggest that TMLI is not associated with an increased EM relapse risk.

  5. Extramedullary Relapse Following Total Marrow and Lymphoid Irradiation in Patients Undergoing Allogeneic Hematopoietic Cell Transplantation

    International Nuclear Information System (INIS)

    Kim, Ji Hyun; Stein, Anthony; Tsai, Nicole; Schultheiss, Timothy E.; Palmer, Joycelynne; Liu, An; Rosenthal, Joseph; Forman, Stephen J.; Wong, Jeffrey Y.C.

    2014-01-01

    Purpose: Approximately 5% to 20% of patients who undergo total body irradiation (TBI) in preparation for hematopoietic cell transplantation (HCT) can develop extramedullary (EM) relapse. Whereas total marrow and lymphoid irradiation (TMLI) provides a more conformally targeted radiation therapy for patients, organ sparing has the potential to place the patient at a higher risk for EM relapse than TBI. This study evaluated EM relapse in patients treated with TMLI at our institution. Methods and Materials: Patients eligible for analysis had been enrolled in 1 of 3 prospective TMLI trials between 2006 and 2012. The TMLI targeted bones, major lymph node chains, liver, spleen, testes, and brain, using image-guided tomotherapy with total dose ranging from 12 to 15 Gy. Results: A total of 101 patients with a median age of 47 years were studied. The median follow-up was 12.8 months. Incidence of EM relapse and bone marrow (BM) relapse were 12.9% and 25.7%, respectively. Of the 13 patients who had EM relapse, 4 also had BM relapse, and 7 had EM disease prior to HCT. There were a total of 19 EM relapse sites as the site of initial recurrence: 11 soft tissue, 6 lymph node, 2 skin. Nine of these sites were within the target region and received ≥12 Gy. Ten initial EM relapse sites were outside of the target region: 5 sites received 10.1 to 11.4 Gy while 5 sites received <10 Gy. Pretransplantation EM was the only significant predictor of subsequent EM relapse. The cumulative incidence of EM relapse was 4% at 1 year and 11.4% at 2 years. Conclusions: EM relapse incidence was as frequent in regions receiving ≥10 Gy as those receiving <10 Gy. EM relapse rates following TMLI that included HCT regimens were comparable to published results with regimens including TBI and suggest that TMLI is not associated with an increased EM relapse risk

  6. A case of relapsed lung abscess caused by Eubacterium brachy infection following an initial diagnosis of pulmonary actinomycosis

    Directory of Open Access Journals (Sweden)

    Hideaki Yamakawa

    2017-01-01

    Full Text Available We report a rare case of lung abscess due to Eubacterium brachy. In this case, an analysis of the aspirate from frank pus revealed Gram-positive coccobacilli. We initially strongly suspected lung abscess associated with actinomycosis because of the chronic/recurrent clinical course and radio-pathological findings such as a granuloma lesion. Although a biochemical analysis revealed Actinomyces sp., 16S rRNA gene sequencing and a phylogenetic tree analysis of the isolated strain confirmed the presence of E. brachy. Some cases previously diagnosed as actinomycosis might be correctly diagnosed as E. brachy infection. Clinicians should be aware that additional studies using 16S rRNA gene sequencing are needed to clarify whether pulmonary infection associated with E. brachy is a similar entity to that of chronic granulomatous infection disease in pulmonary actinomycosis.

  7. NECTAR: initiatives and development 2008-2016

    OpenAIRE

    Dimmock, Nick; Hibbert, Dawn

    2017-01-01

    A poster illustrating the development of NECTAR, the University of Northampton's research repository, since its launch in 2008. Key initiatives and projects are highlighted, along with statistics on deposit activity and downloads.

  8. View all initiatives | IDRC - International Development Research ...

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

    The Open Data for Development program's global network will facilitate and scale innovative approaches to open data to ensure benefits reach citizens in developing countries. Combining research and action to address scaling and sustainability of open data for development initiatives is key to the network's success.

  9. Understanding the Sustainability of Private Development Initiatives

    NARCIS (Netherlands)

    Kinsbergen, Sara; Schulpen, Lau; Ruben, Ruerd

    2017-01-01

    In the Netherlands, there is a large group of small-scale, voluntary development organisations, referred to as Private Development Initiatives (PDIs). By classifying PDI interventions based on their potential sustainability, we aim to enhance our understanding of PDIs as alternative development

  10. AP-VAS 2012 case report: two patients with rheumatoid arthritis suspected of relapsed microscopic polyangiitis after initiation of dialysis.

    Science.gov (United States)

    Sugahara, Mai; Nishi, Takahiro; Tanaka, Shinji; Kurita, Noriaki; Sai, Keiko; Kano, Tatsuya; Nishio, Kyosuke; Sugimoto, Tokuichiro; Mise, Naobumi

    2013-11-01

    We report two patients with rheumatoid arthritis (RA) who were suspected of microscopic polyangiitis during maintenance dialysis. Case 1 was a 52-year-old woman with RA diagnosed at the age of 38 years and treated successfully with gold compounds. At the age of 43 years, she presented with progressive renal dysfunction and abnormal urine sediments, and a renal biopsy revealed crescentic nephritis with advanced glomerular sclerosis. Myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) was not measured on that occasion. She reached end-stage renal failure within 4 months and started peritoneal dialysis. Eight years later, soon after she was switched to hemodialysis, she developed fever of unknown origin. MPO-ANCA was elevated to 37 EU, although there were no other signs or symptoms suggestive of vasculitis. After taking prednisolone orally (10 mg/day), her fever withdrew, and MPO-ANCA became undetectable. Case 2 was a 71-year-old woman with RA diagnosed at the age of 60 years and treated with gold compounds. She developed renal failure of unknown cause (no biopsy was performed), and started hemodialysis at the age of 69 years. One year later, she presented with fever and subsequently developed cough with hemoptysis. MPO-ANCA was elevated to 62 EU. Treatment with azathioprine 50 mg and prednisolone 35 mg daily brought remarkable clinical improvement, and MPO-ANCA became undetectable. These cases highlight the importance of measuring ANCA even in RA patients on dialysis who present with fever of unknown origin or with underlying kidney disease of uncertain etiology.

  11. View all initiatives | IDRC - International Development Research ...

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

    The International Research Chairs Initiative pairs top research talent from universities in Canada with their counterparts in developing countries to address key development challenges. We fund researchers driving global change. Careers · Contact Us · Subscribe · Unsubscribe · Site map. Follow us; Facebook · Twitter ...

  12. New developments in the management of relapsed/refractory multiple myeloma – the role of ixazomib

    Directory of Open Access Journals (Sweden)

    Richardson PG

    2017-08-01

    Full Text Available Paul G Richardson,1 Shaji Kumar,2 Jacob P Laubach,1 Claudia Paba-Prada,1 Neeraj Gupta,3 Deborah Berg,3 Helgi van de Velde,3 Philippe Moreau4 1Division of Hematologic Malignancy, Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Boston, MA, USA; 2Division of Hematology, Mayo Clinic, Rochester, MN, USA; 3Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Ltd, Cambridge, MA, USA; 4Hematology Department, University Hospital Hotel-Dieu, Nantes, France Abstract: Ixazomib is the first oral proteasome inhibitor to be approved, in combination with lenalidomide and dexamethasone, for the treatment of patients with multiple myeloma who have received at least one prior therapy. Approval was on the basis of results from the phase 3, double-blind, placebo-controlled TOURMALINE-MM1 study, which demonstrated a 35% improvement in progression-free survival with the all-oral combination of ixazomib plus lenalidomide–dexamethasone versus lenalidomide–dexamethasone alone (median: 20.6 vs 14.7 months; hazard ratio: 0.74, p=0.012; median follow-up 14.7 months. The addition of ixazomib to the lenalidomide–dexamethasone regimen was associated with limited additional toxicity and had no adverse impact on patient-reported quality of life. Common grade ≥3 adverse events with ixazomib include gastrointestinal adverse events, rash, and thrombocytopenia. Here, we review the efficacy, safety, pharmacokinetics, and patient-reported quality of life data seen with ixazomib, and discuss the role of this oral agent in the treatment of patients with relapsed/refractory multiple myeloma, including in patients with high-risk cytogenetic abnormalities and those with multiple prior therapies. Keywords: ixazomib, multiple myeloma, proteasome inhibitor, clinical, efficacy, tolerability, pharmacokinetics 

  13. View all initiatives | IDRC - International Development Research ...

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

    The Science Granting Councils Initiative in Sub-Saharan Africa is focused on strengthening the capacities of science granting councils in order to support research and evidence-based policies that will contribute to economic and social development in Sub-Saharan Africa. We fund researchers driving global change.

  14. Treatment and outcome of patients with relapsed clear cell sarcoma of the kidney: a combined SIOP and AIEOP study.

    Science.gov (United States)

    Gooskens, S L; Furtwängler, R; Spreafico, F; van Tinteren, H; de Kraker, J; Vujanic, G M; Leuschner, I; Coulomb-L'Herminé, A; Godzinski, J; Schleiermacher, G; Stoneham, S; Bergeron, C; Pritchard-Jones, K; Graf, N; van den Heuvel-Eibrink, M M

    2014-07-15

    Clear cell sarcoma of the kidney (CCSK) is an uncommon paediatric renal tumour. Relapses occur in about 15% of the patients. Since detailed clinical information on relapsed CCSK is scarce, the current study aims to describe outcome of patients with relapsed CCSK treated according to recent European protocols. We analysed prospectively collected data of all CCSK patients who developed a relapse after complete remission at the end of primary treatment, entered onto SIOP and AIEOP trials between 1992 and 2012. Thirty-seven of 237 CCSK patients (16%) treated according to SIOP and AIEOP protocols developed a relapse. Median time from initial diagnosis to relapse was 17 months (range, 5.5 months - 6.6 years). Thirt-five out of thirty-seven relapses (95%) were metastatic; the most common sites of relapse were the brain (n=13), lungs (n=7) and bone (n=5). Relapse treatment consisted of chemotherapy (n=30), surgery (n=19) and/or radiotherapy (n=18), followed by high-dose chemotherapy and autologous bone marrow transplantation (ABMT) in 14 patients. Twenty-two out of thirty-seven patients (59%) achieved a second complete remission (CR); 15 of whom (68%) developed a second relapse. Five-year event-free survival (EFS) after relapse was 18% (95% CI: 4%-32%), and 5-year overall survival (OS) was 26% (95% CI: 10%-42%). In this largest series of relapsed CCSK patients ever described, overall outcome is poor. Most relapses are metastatic and brain relapses are more common than previously recognised. Intensive treatment aiming for local control, followed by high dose chemotherapy and ABMT, seems to be of benefit to enhance survival. Novel development of targeted therapy is urgently required.

  15. African Initiated Churches’ potential as development actors

    Directory of Open Access Journals (Sweden)

    Philipp Öhlmann

    2016-11-01

    Full Text Available African Initiated Churches (AICs are not yet recognised as relevant actors of community development interventions. While it has been acknowledged that many of them provide coping mechanisms in adverse environments, support in social transformation and social capital, little information is available on their role as development actors. In this article, we evaluate the potential of AICs as partners of international development agencies for community development. We draw on interviews and focus group discussions with leaders of various AICs conducted in South Africa in February and March 2016. In particular, we examine the churches’ understanding of development, their view on the separation of spiritual and development activities and their priorities. Moreover, we outline the development activities which they are currently engaged in and analyse the structures they have in place to do so. Our findings indicate that AICs are increasingly active in community development and offer various entry points for possible cooperation.

  16. The Ramakrishna Mission economic PV development initiative

    Energy Technology Data Exchange (ETDEWEB)

    Stone, J.L.; Ullal, H.S. [National Renewable Energy Lab., Golden, CO (United States); Sherring, C. [Sherring Energy Associates, Princeton, NJ (United States)

    1998-09-01

    India is the world`s second most populous country, quickly approaching one billion persons. Although it has a well-developed electricity grid, many of the people have little or no access to electricity and all of the benefits associated with it. There are areas that are isolated from the grid and will not be connected for many years, if ever. One such area is the Sundarbans located in the delta region of the two great rivers, the Ganges and Brahmaputra, partially in India and partially in Bangladesh. It is estimated that 1.5 million people live in this area, crisscrossed by many islands and rivers, who have only marginal supplies of electricity generated primarily from diesel generators and batteries. Working with the regional non-governmental organization (NGO), the Ramakrishna Mission, and the West Bengal Renewable Energy Development Agency, the governments of India and the US initiated a rural electrification initiative to demonstrate the economic and technical feasibility of photovoltaics to provide limited supplies of electricity for such applications as solar home lighting systems (SHS), water pumping, vaccine refrigeration, communications, and economic development activities. This paper details initial results from approximately 30 kilowatts of PV systems installed in the area, including socio-economic impacts and technical performance.

  17. Initial developments in the Stanford SQUIRT program

    Science.gov (United States)

    Kitts, Christopher A.; Twiggs, Robert J.

    1995-01-01

    Stanford University's Department of Aeronautics and Astronautics has commenced full scale development of a new microsatellite initiative. Known as the satellite quick research testbed (SQUIRT) program, the project's goal is to produce student engineered satellites capable of servicing state-of-the-art research payloads on a yearly basis. This program is specifically designed to meet the education and research goals of the department's Satellite Systems Development Laboratory. SQUIRT vehicles are envisioned to consist of a 25 pound, 9 inch tall, 16 inch diameter hexagonal structure with complete processor, communications, power, thermal, and attitude subsystems. These spacecraft cater to low power, volume, and mass research experiments and student developed educational packages. Mission lifetimes of up to one year are considered. Through student participation, voluntary mentoring from the academic and industrial communities, and the extensive use of off-the-shelf components, the cash outlay target for SQUIRT class vehicles is $50,000. This paper discusses the educational and research issues surrounding the development of Stanford's spacecraft design curriculum and the formulation of the SQUIRT program. A technical review of the first SQUIRT satellite, named SAPPHIRE, and an outline of the conceptual plans for other missions is also presented. Additionally, initiatives concerning partner academic institutions and public domain design information are featured.

  18. Relapsing pattern of brain metastasis after brain irradiation in small cell lung cancer

    International Nuclear Information System (INIS)

    Murakami, Masao; Kuroda, Yasumasa; Okamoto, Yoshiaki; Kono, Koichi; Yoden, Eisaku; Mori, Takeki

    1997-01-01

    Many reports concerning radiation therapy for brain metastasis have been published, and which of the various methods urged by these reports provide optional control is still controversial. According to developing diagnosis of metastasis in CNS, therapeutic problems should be referred. We reviewed 67 patients with small cell lung cancer and brain metastasis who underwent brain irradiation (Ave. 47 Gy/5W), and all 15 patients with brain relapse after the irradiation. Relapsing patterns in this clinical setting were divided into local regrowth in the same lesions and re-metastasis (reseeding) in other regions, by reviewing follow up CT and MRI studies. Total survival among 15 patients with brain relapse and 52 without relapse was longer in the former cases than the later: 1-, and 2-year survival (47/19%, 13/8%) and MST (10.8/5.7 months), from the initial brain irradiation. The concerned significant factors limited in younger age, low value of LDH and improvement of NF. Of the 15 patients with brain relapse, 4 developed local regrowth and 11 did re-metastasis. The period of remission since brain irradiation were 172±94.4 and 393±281 days, respectively. Lower number of brain metastasis and lower value of LDH were shown in re-metastasis patients. At the time of brain relapse, 11 patients had recurrence of carcinomatous meningitis. 4 patients were treated with whole brain re-irradiation. All patients died of cancer, including 12 of relapsing CNS diseases and 3 of primary lesion and hepatic metastasis. Leukoencephalopathy developed in 2 patients. Survival since the brain relapse was 2 to 238 days without significant difference in cases of local regrowth and re-metastasis. According to our data on relapsing pattern of brain metastasis after conventional fractionated brain irradiation with an objective dose of 50 Gy, 75% of brain relapse were re-metastasis, we appreciate this irradiation for initial brain metastasis if limited to the brain. (author)

  19. Oil for development initiative annual report 2010

    International Nuclear Information System (INIS)

    2011-01-01

    In 2010, Oil for Development continued to develop its role as a key actor within the field of petroleum related development assistance. Five years after the programme started, we experience a steady demand for our product, which is to provide advice and competence building within petroleum sector management. Our cooperating partners are government agencies and to a lesser extent civil society organizations and parliamentary committees.Main trends in 2010 include the following: OfD continued to be a high priority programme in Norwegian development cooperation. The budget spending was Nok 222 million, 15 million higher than in 2009. The programme provided tailor made assistance to more than 20 countries, taking a holistic approach towards petroleum sector management. This implies that resource management, revenue management and environmental management are addressed in a coordinated manner, and that principles of good governance, such as anti-corruption, transparency and accountability, are cross-cutting. The funding for regional initiatives and South-South cooperation was doubled. (au)

  20. Oil for development initiative annual report 2010

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    In 2010, Oil for Development continued to develop its role as a key actor within the field of petroleum related development assistance. Five years after the programme started, we experience a steady demand for our product, which is to provide advice and competence building within petroleum sector management. Our cooperating partners are government agencies and to a lesser extent civil society organizations and parliamentary committees.Main trends in 2010 include the following: OfD continued to be a high priority programme in Norwegian development cooperation. The budget spending was Nok 222 million, 15 million higher than in 2009. The programme provided tailor made assistance to more than 20 countries, taking a holistic approach towards petroleum sector management. This implies that resource management, revenue management and environmental management are addressed in a coordinated manner, and that principles of good governance, such as anti-corruption, transparency and accountability, are cross-cutting. The funding for regional initiatives and South-South cooperation was doubled. (au)

  1. Next Generation Safeguards Initiative: Human Capital Development

    International Nuclear Information System (INIS)

    Scholz, M.; Irola, G.; Glynn, K.

    2015-01-01

    Since 2008, the Human Capital Development (HCD) subprogramme of the U.S. National Nuclear Security Administration's (NNSA) Next Generation Safeguards Initiative (NGSI) has supported the recruitment, education, training, and retention of the next generation of international safeguards professionals to meet the needs of both the International Atomic Energy Agency (IAEA) and the United States. Specifically, HCD's efforts respond to data indicating that 82% of safeguards experts at U.S. Laboratories will have left the workforce within 15 years. This paper provides an update on the status of the subprogramme since its last presentation at the IAEA Safeguards Symposium in 2010. It highlights strengthened, integrated efforts in the areas of graduate and post-doctoral fellowships, young and midcareer professional support, short safeguards courses, and university engagement. It also discusses lessons learned from the U.S. experience in safeguards education and training as well as the importance of long-range strategies to develop a cohesive, effective, and efficient human capital development approach. (author)

  2. Initial planning of monorail development in Medan

    Science.gov (United States)

    Surbakti, M. S.

    2018-03-01

    Medan City is the third largest city in Indonesia after Jakarta and Surabaya. With a total area of 265.10 km2 and a population of 2.1 million people, it is proper that Medan City has operated a mass transportation system, which can accommodate the needs of the city movement. The current transportation system is dominated by a paratransit that has a capacity of 12 passengers. In fact, the data released by Ditlantas Poldasu and the Department of Transportation of Medan City shows that in 2013 the total number of passenger vehicles is 408,877 units, 99% of which are private vehicles, and there are only 1580 public transport. Planning the bus as a public transportation system in the city of Medan who tried to integrate it with the surrounding cities until now has not been done. One of the problems is the overlap of the bus route with existing public transport routes. This raises resistance from organda as an association of public transport operators located in the city of Medan. Bappeda Medan City in the Year 2014 has done the initial planning of monorail development in Medan City. The results of the study show that economically monorail development is feasible to be implemented and does not compete directly with the existing public transport system. This happens because 90% of monorail routes are in median ring road Medan City, which predicted the next 20 years will experience a large loading.

  3. Organic Marketing Initiatives and Rural Development

    OpenAIRE

    Schmid, Otto; Sanders, Jürn; Midmore, Peter

    2004-01-01

    Over recent decades, organic farmers have come together to form collective marketing initiatives. To begin with, such schemes were often essential as the only means of finding markets for organic products, but farmers today participate in them to pool ideas, capital and skills, and to collectively increase added value of products and market power in the supply chain. However, Organic Marketing Initiatives (OMIs) are not only initiated and managed by farmers but also by consumers, processors o...

  4. Sustainable transportation initiatives in developing countries

    International Nuclear Information System (INIS)

    Figueroa, M.J.

    2000-01-01

    The primary goal of the workshop was to share experiences of sustainable transport practices from invited medium-sized cities in Latin America and Asia. The purpose was to learn how sustainable mechanisms have been incorporated into national planning and implementation systems. Emphasis was given to understand what concrete mechanism work to promote sustainable transport in the selected projects. The workshop included participation of transport economics and engineers, policy makers and policy-advisors, and key representatives from the transportation government and non-governmental sector in El Salvador. Among participants there were also members from academia, private consultants and international NGOs. The workshop provided a basis for outreach in terms of directly informing participants on the specific experiences brought in by the participating countries. The Workshop set out to address the following main objectives: To demonstrate successful examples of transportation initiatives that show positive sustainable economic, environmental and social benefits in selected developing countries; To provide a forum for discussion of sustainable transport paths; To develop a network for information exchange and capacity building; To gather information on concrete mechanisms to promote sustainable transportation; To demonstrate efficient mechanisms and tools for collection and analysis of data in transport; To create an inventory of success stories and alternative visions for the future. Several institutions collaborated in organising the event: the Intermediate Technology Development Group (ITDG-Sri Lanka), The Peace and Development Research Group from Goeteborg University and institutions within El Salvador: Centro Salvadeoreno de Tecnologia Apropiada (CESTA), and the Climate Change Communication office of the Ministry of Environment in Salvador. This volume contains reports of the presentations and discussions that took place at the workshop in San Salvador. The agenda

  5. Sustainable transportation initiatives in developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Figueroa, M J [ed.

    2000-03-01

    The primary goal of the workshop was to share experiences of sustainable transport practices from invited medium-sized cities in Latin America and Asia. The purpose was to learn how sustainable mechanisms have been incorporated into national planning and implementation systems. Emphasis was given to understand what concrete mechanism work to promote sustainable transport in the selected projects. The workshop included participation of transport economics and engineers, policy makers and policy-advisors, and key representatives from the transportation government and non-governmental sector in El Salvador. Among participants there were also members from academia, private consultants and international NGOs. The workshop provided a basis for outreach in terms of directly informing participants on the specific experiences brought in by the participating countries. The Workshop set out to address the following main objectives: To demonstrate successful examples of transportation initiatives that show positive sustainable economic, environmental and social benefits in selected developing countries; To provide a forum for discussion of sustainable transport paths; To develop a network for information exchange and capacity building; To gather information on concrete mechanisms to promote sustainable transportation; To demonstrate efficient mechanisms and tools for collection and analysis of data in transport; To create an inventory of success stories and alternative visions for the future. Several institutions collaborated in organising the event: the Intermediate Technology Development Group (ITDG-Sri Lanka), The Peace and Development Research Group from Goeteborg University and institutions within El Salvador: Centro Salvadeoreno de Tecnologia Apropiada (CESTA), and the Climate Change Communication office of the Ministry of Environment in Salvador. This volume contains reports of the presentations and discussions that took place at the workshop in San Salvador. The agenda

  6. Web-Based Cognitive Behavioral Relapse Prevention Program With Tailored Feedback for People With Methamphetamine and Other Drug Use Problems: Development and Usability Study.

    Science.gov (United States)

    Takano, Ayumi; Miyamoto, Yuki; Kawakami, Norito; Matsumoto, Toshihiko

    2016-01-06

    Although drug abuse has been a serious public health concern, there have been problems with implementation of treatment for drug users in Japan because of poor accessibility to treatment, concerns about stigma and confidentiality, and costs. Therapeutic interventions using the Internet and computer technologies could improve this situation and provide more feasible and acceptable approaches. The objective of the study was to show how we developed a pilot version of a new Web-based cognitive behavioral relapse prevention program with tailored feedback to assist people with drug problems and assessed its acceptance and usability. We developed the pilot program based on existing face-to-face relapse prevention approaches using an open source Web application to build an e-learning website, including relapse prevention sessions with videos, exercises, a diary function, and self-monitoring. When users submitted exercise answers and their diary, researchers provided them with personalized feedback comments using motivational interviewing skills. People diagnosed with drug dependence were recruited in this pilot study from a psychiatric outpatient ward and nonprofit rehabilitation facilities and usability was evaluated using Internet questionnaires. Overall, website usability was assessed by the Web Usability Scale. The adequacy of procedures in the program, ease of use, helpfulness of content, and adverse effects, for example, drug craving, mental distress, were assessed by original structured questionnaires and descriptive form questions. In total, 10 people participated in the study and completed the baseline assessment, 60% completed all relapse prevention sessions within the expected period. The time needed to complete one session was about 60 minutes and most of the participants took 2 days to complete the session. Overall website usability was good, with reasonable scores on subscales of the Web Usability Scale. The participants felt that the relapse prevention

  7. View all initiatives | IDRC - International Development Research ...

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

    View all initiatives. You are looking at projects supported by The William and Flora Hewlett Foundation. Displaying 1 - 2 of 2. Growth and Economic Opportunities for Women. Initiative. Women around the world increasingly participate in economic activities, but they continue to face significant challenges in pursuing better ...

  8. Relapse prevention and smoking cessation.

    Science.gov (United States)

    Davis, J R; Glaros, A G

    1986-01-01

    A multicomponent smoking relapse prevention treatment based on Marlatt and Gordon's (1980) model of the relapse process was developed and evaluated. Behavior-analytic methods were used to develop assessment instruments, training situations, and coping responses. The prevention components were presented in the context of a basic broad-spectrum stop-smoking program, and were compared with the basic program plus discussion control, and the basic program alone. Smoking-related dependent variables generally did not differ between groups at any time from pre-treatment to 12 month follow-up. Only the subjects in the relapse prevention condition improved problem-solving and social skills needed to cope with high-risk situations. These subjects also tended to take longer to relapse and smoke fewer cigarettes at the time of relapse. Subjects above the median level of competence on measures of social skill at post-treatment remained abstinent significantly longer. Maintenance of non-smoking was found to be related to the degree of competence with which individuals deal with high-risk situations. Results are discussed in relation to models of compliance with therapeutic regimens.

  9. Partners and initiatives | IDRC - International Development ...

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

    Results 1 - 10 of 20 ... A longstanding partner, Global Affairs Canada collaborates with us on maternal and ... Collaborative Adaptation Research Initiative in Africa and Asia ... These investments in scientific breakthroughs will improve the health.

  10. Predicting Relapse among Young Adults: Psychometric Validation of the Advanced Warning of Relapse (AWARE) Scale

    Science.gov (United States)

    Kelly, John F.; Hoeppner, Bettina B.; Urbanoski, Karen A.; Slaymaker, Valerie

    2011-01-01

    Objective Failure to maintain abstinence despite incurring severe harm is perhaps the key defining feature of addiction. Relapse prevention strategies have been developed to attenuate this propensity to relapse, but predicting who will, and who will not, relapse has stymied attempts to more efficiently tailor treatments according to relapse risk profile. Here we examine the psychometric properties of a promising relapse risk measure - the Advance WArning of RElapse scale (AWARE) scale (Miller and Harris, 2000) in an understudied but clinically important sample of young adults. Method Inpatient youth (N=303; Age 18-24; 26% female) completed the AWARE scale and the Brief Symptom Inventory-18 (BSI) at the end of residential treatment, and at 1-, 3-, and 6-months following discharge. Internal and convergent validity was tested for each of these four timepoints using confirmatory factor analysis and correlations (with BSI scores). Predictive validity was tested for relapse 1, 3, and 6 months following discharge, as was incremental utility, where AWARE scores were used as predictors of any substance use while controlling for treatment entry substance use severity and having spent time in a controlled environment following treatment. Results Confirmatory factor analysis revealed a single, internally consistent, 25-item factor that demonstrated convergent validity and predicted subsequent relapse alone and when controlling for other important relapse risk predictors. Conclusions The AWARE scale may be a useful and efficient clinical tool for assessing short-term relapse risk among young people and, thus, could serve to enhance the effectiveness of relapse prevention efforts. PMID:21700396

  11. Predicting relapse among young adults: psychometric validation of the Advanced WArning of RElapse (AWARE) scale.

    Science.gov (United States)

    Kelly, John F; Hoeppner, Bettina B; Urbanoski, Karen A; Slaymaker, Valerie

    2011-10-01

    Failure to maintain abstinence despite incurring severe harm is perhaps the key defining feature of addiction. Relapse prevention strategies have been developed to attenuate this propensity to relapse, but predicting who will, and who will not, relapse has stymied attempts to more efficiently tailor treatments according to relapse risk profile. Here we examine the psychometric properties of a promising relapse risk measure-the Advance WArning of RElapse (AWARE) scale (Miller & Harris, 2000) in an understudied but clinically important sample of young adults. Inpatient youth (N=303; Ages 18-24; 26% female) completed the AWARE scale and the Brief Symptom Inventory-18 (BSI) at the end of residential treatment, and at 1-, 3-, and 6-months following discharge. Internal and convergent validity was tested for each of these four timepoints using confirmatory factor analysis and correlations (with BSI scores). Predictive validity was tested for relapse 1, 3, and 6 months following discharge, as was incremental utility, where AWARE scores were used as predictors of any substance use while controlling for treatment entry substance use severity and having spent time in a controlled environment following treatment. Confirmatory factor analysis revealed a single, internally consistent, 25-item factor that demonstrated convergent validity and predicted subsequent relapse alone and when controlling for other important relapse risk predictors. The AWARE scale may be a useful and efficient clinical tool for assessing short-term relapse risk among young people and, thus, could serve to enhance the effectiveness of relapse prevention efforts. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. E-Government: Initiatives, Developments, and Issues.

    Science.gov (United States)

    Aldrich, Duncan; Bertot, John Carlo; McClure, Charles R.

    2002-01-01

    Provides a background of government efforts to incorporate telecommunication and computer technologies to improve government performance and enhance citizen access to government information and services. Describes this symposium issue which discusses key issues that affect the success and implementation of electronic government initiatives. (LRW)

  13. View all initiatives | IDRC - International Development Research ...

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

    Initiative. The Cultivate Africa's Future research partnership is designed to support applied research to combat hunger in sub-Saharan Africa by harnessing the potential for innovation among the region's smallholder farmers, the majority of whom are women. We fund researchers driving global change. Careers · Contact Us ...

  14. Comparison of enrofloxacin and ceftiofur sodium for the treatment of relapse of undifferentiated fever/bovine respiratory disease in feedlot cattle

    Science.gov (United States)

    Abutarbush, Sameeh M.; Schunicht, Oliver C.; Wildman, Brian K.; Hannon, Sherry J.; Jim, G. Kee; Ward, Tracy I.; Booker, Calvin W.

    2012-01-01

    This commercial field trial compared the efficacy of enrofloxacin and ceftiofur sodium in beef cattle at high risk of developing undifferentiated fever (UF), also known as bovine respiratory disease (BRD) that received tilmicosin at feedlot arrival, were diagnosed and initially treated for UF with tilmicosin, and subsequently required a second UF treatment (first relapse). Feedlot cattle (n = 463) were randomly assigned to 2 experimental groups: ENRO or CEF. Second UF relapse, 3rd UF relapse, overall case fatality and BRD case fatality rates were lower in the ENRO group than in the CEF group (P enrofloxacin than ceftiofur sodium for treatment of UF relapse. PMID:22753964

  15. [Evaluation of the relapse prevention guidance for drug-dependent inmates: the intervention using self-teach workbook and group therapy in a "private finance initiative" prison--the first report].

    Science.gov (United States)

    Matsumoto, Toshihiko; Imamura, Fumie; Kobayashi, Ohji; Wada, Kiyoshi; Ozaki, Shiro; Takeuchi, Yoshio; Hasegawa, Masahiko; Imamura, Yoko; Tania, Yuko; Adachi, Yasumori

    2011-04-01

    In Japan, methamphetamine (MAP) abuse has been a serious problem for 60 years, and many of MAP abusers have been incarcerated in prisons as a violator of the Stimulant Control Law in Japan. The purpose of the present study is to evaluate effectiveness of the relapse prevention guidance for drug-dependent inmates using a self-teaching workbook for drug-abusing adolescents and group therapy, conducted in the Harima Rehabilitation Program Center, one of the new prisons which the Ministry of Justice founded cooperating private enterprises as a "Private Finance Initiative" project. We provided for 89 male drug-dependent inmates, incarcerated in the Harima Rehabilitation Program Center, with the relapse prevention guidance consisting of a self-teaching workbook and group therapy, and implement pre-and post-evaluations by the Self-efficacy Scale for Drug Dependence (SES) and the Stages of Change Readiness and Treatment Eagerness Scale, 8th version for Drug Dependence (SOCRATES-8D). After a waiting term, the participants were provided with a self-teaching program, subsequently with a group program. At the point of completing the waiting term, no significant changes were observed in the SES and SOCRATES-8D scores. However, at the point of completing the self-teaching program, the SES scores significantly fell, while the total SOCRATES-8D score and the scores of the two subscales, the "Recognition" and "Ambivalence," significantly rose. Further, at the point of completing the group program, the total scores of the SES and SOCRATES-8D, and the score of the two SOCRATES-8D subscales, the "Recognition" and "Taking Steps," significantly rose. The relapse prevention guidance consisting of a self-teaching workbook and group therapy, conducted in the Harima Rehabilitation Program Center, were supposed to bring same internal changes as the "Stage of Changes" model, proposed by Prochaska and DiClemente, to drug-dependent inmates.

  16. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Treating MS d Comprehensive Care Developing a Healthcare Team Make the Most of Your Doctor Visits Advance Medical Directives d Find an MS Care Provider Partners in MS Care d Managing Relapses Plasmapheresis d Rehabilitation Functional Electrical Stimulation (FES) ...

  17. Developing versus developed companies in Business Excellence initiatives

    DEFF Research Database (Denmark)

    Haffer, Rafal; Kristensen, Kai

    2008-01-01

    The paper reports the advance of Polish companies in Business Excellence initiatives. It indicates how these activities influence their performance. EFQM Excellence Model indicators are used as the evaluation criteria for the study. The performance variable is introduced to ensure the calculation...... of correlations between EFQM model indicators and performance results. The data are next estimated as a structural equation model by partial least squares using SmartPLS software (Ringle et al., 2005). That estimation is conducted on the model of the Danish Business Excellence Index methodology (Kristensen et al...... results from the Business Excellence Model as a proxy for actual financial results in Poland. Data and results from a similar study done in Denmark are also described; thus, a comparison between developing Polish companies and developed Danish ones is included. Poland and Denmark are used as cases of...

  18. Beyond CD19: Opportunities for future development of targeted immunotherapy in pediatric relapsed-refractory acute leukemia

    Directory of Open Access Journals (Sweden)

    Haneen eShalabi

    2015-10-01

    Full Text Available Chimeric antigen receptor (CAR T cell therapy has been used as a targeted approach in cancer therapy. Relapsed and refractory acute leukemia in pediatrics has been difficult to treat with conventional therapy due to dose limiting toxicities. With the recent success of CD 19 CAR in pediatric patients with B cell ALL, this mode of therapy has become a very attractive option for these patients with high risk disease. In this review, we will discuss current treatment paradigms of pediatric acute leukemia, and potential therapeutic targets for additional high risk populations, including T cell ALL, AML, and infant ALL.

  19. Relapsed childhood acute lymphoblastic leukemia in the Nordic countries

    DEFF Research Database (Denmark)

    Oskarsson, Trausti; Söderhäll, Stefan; Arvidson, Johan

    2016-01-01

    Relapse is the main reason for treatment failure in childhood acute lymphoblastic leukemia. Despite improvements in the up-front therapy, survival after relapse is still relatively poor, especially for high-risk relapses. The aims of this study were to assess outcomes following acute lymphoblastic...... leukemia relapse after common initial Nordic Society of Paediatric Haematology and Oncology protocol treatment; to validate currently used risk stratifications, and identify additional prognostic factors for overall survival. Altogether, 516 of 2735 patients (18.9%) relapsed between 1992 and 2011 and were...

  20. Topotecan in the treatment of relapsed small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Elisabeth Quoix

    2008-12-01

    Full Text Available Elisabeth QuoixService de Pneumologie, Hôpitaux Universitaires, Strasbourg, FranceAbstract: Small cell lung cancer (SCLC represents about 15% to 20% of all lung cancers. Chemotherapy is the cornerstone of the treatment, cisplatin–etoposide combination being the most used combination as first-line therapy. Despite high initial chemosensitivity, most SCLC patients will experience relapse sooner or later. Unfortunately, second-line chemotherapy does not result in a high response rate like first-line therapy, most patients having developed wide chemoresistance. This chemoresistance is far more important in refractory patients, ie, those who never responded to first-line therapy or who relapsed within 3 months after the end of chemotherapy, than in sensitive patients, ie, those who relapse more than 3 months after the end of chemotherapy. Topotecan, a topoisomerase I inhibitor, is the most studied drug in this second-line setting and has proved its efficacy as a single agent and in combination. A phase III trial comparing oral topotecan to best supportive care (BSC in relapsed SCLC demonstrated a significant survival benefit as well as a better quality of life. Although the usual schedule is 1.5 mg/m2, days 1–5 intravenously, it is not convenient for patients with relapsed SCLC, especially those who are refractory because of their short survival expectation. Oral topotecan is of similar efficacy and much more convenient with limited stay in a treatment unit and has a comparable toxicity profile for these patients with short expected survival. Combination of topotecan with platinum salts or taxanes does not seem to improve further the outcome of the patients and thus single-agent therapy with topotecan is the standard treatment for relapsed SCLC.Keywords: topotecan, small cell lung cancer, chemoresistance

  1. Distance Learning Plan Development: Initiating Organizational Structures

    National Research Council Canada - National Science Library

    Poole, Clifton

    1998-01-01

    .... Army distance learning plan managers to examine the DLPs they were directing. The analysis showed that neither army nor civilian distance learning plan managers used formalized requirements for organizational structure development (OSD...

  2. View all initiatives | IDRC - International Development Research ...

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

    The International Partnerships for Sustainable Societies are collaborations that produce high-quality research to inform academic, public, and policy debates to contribute to create just, inclusive, and sustainable social and economic development.

  3. Child Soldiers Initiative | IDRC - International Development ...

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

    The involvement of children in fighting forces continues to be widespread, undercutting security and blocking development in many fragile states. Failure to prevent children from being recruited - and effectively reintegrate those who have been - results in their continued vulnerability, undermines peace agreements, and ...

  4. View all initiatives | IDRC - International Development Research ...

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

    The Livestock Vaccine Innovation Fund (LVIF) seeks to improve the health of livestock and the livelihoods of farmers by supporting the development, production, and commercialization of innovative vaccines against neglected livestock diseases (including poultry) in sub-Saharan Africa, South and Southeast Asia.

  5. Think Tank Initiative | IDRC - International Development Research ...

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

    The UK Department for International Development. What we do · Funding · Resources · About IDRC. Knowledge. Innovation. Solutions. Careers · Contact Us · Site map. Sign up now for IDRC news and views sent directly to your inbox each month. Subscribe · Copyright · Open access policy · Privacy policy · Research ethics ...

  6. [Research and control of relapse tuberculosis cases].

    Science.gov (United States)

    Yamagishi, Fumio; Toyota, Makoto

    2009-12-01

    With this symposium, we focused on the relapse of tuberculosis in Japan. Out of 19,893 tuberculosis patients registered in 2007 in Japan, 7.48% were classified as relapse cases. Relapse cases have the risk of acquired drug resistance. But we have few analyses of the proportion of relapse tuberculosis cases with standard short course regimens for six months, factors contributing to tuberculosis relapse and the proportion of drug resistance among relapse TB cases in Japan. Therefore we analyzed the relapse tuberculosis cases in two rural areas and three urban areas. We also analyzed the proportion of drug resistance among relapse cases with the data of drug susceptibility survey of Ryoken. 1. Research of relapse tuberculosis cases: Makoto TOYOTA (Kochi City Public Health Center). To clarify the relapse rate and factors contributing to tuberculosis relapse, we investigated the relapse tuberculosis cases in the municipality where the proportion of elderly tuberculosis patients was high. Out of 902 tuberculosis patients registered in Kochi City Public Health Center during 10 years, 20 pulmonary tuberculosis patients were confirmed relapse cases with initial registered records. Pretreatment cavitations, sputum culture positivity at 2 months, medical miss-management (e.g. number of doses, duration of therapy) and poor adherence were considered to be factors contributing to tuberculosis relapse. Out of 20 relapse cases, 12 cases were detected with symptoms, while only 3 cases were detected by examination in law. 2. A clinical study on relapse cases of pulmonary tuberculosis: Shuichi TAKIKAWA (National Hospital Organization Nishibeppu National Hospital). The relapse of pulmonary tuberculosis was investigated. In the cases with a treatment history before short course chemotherapy, drug resistance rate was high, and thus it needs to be cautious of drug resistance at the time of the retreatment. In the cases with a treatment history of short course chemotherapy, relapse cases

  7. Relapse Prevention: An Introduction to Marlatt’s Cognitive – Behavior Model

    Directory of Open Access Journals (Sweden)

    Farshad Nemati

    2002-10-01

    Full Text Available High rate of relapse after apparently successful treatment is a common problem facing with most approaches to treatment of drug dependency. This has led to the development of a variety of strategies for relapse prevention. Among these, Marlatt’s cognitive – behavioural model has received a good deal of attention. It is based on two major axes: Identification of warning sings and development of necessary skills for coping with risk situations. In fact, client’s perception relating to their abilities to cope with high - risk situations can lead to lapse. Relapes is a function of client’s reaction to this initial lapes.Since formal training for addiction counsellors typically includes instruction on Marlatt’s relapes taxonomy and intervention strategies have been designed based on his classification systems of high – risk stimuli, it is nececsary for addiction counsellors to become familiar with this system. This paper presents an overview of Marlatts taxonomy of high – risk situations for relapse and his approach to relapse prevention. Special attention is given to definition of relapse, stages of relaps and relapse prevention strategies.

  8. Initial investigation into development of accelerated pavement evaluation (APE) vehicle

    CSIR Research Space (South Africa)

    Steyn, WJvdM

    2002-08-01

    Full Text Available n e n t d e f o r m a t i o n [ m m ] Test 1 Test 2 Test 3 Test 4 Initial indication of performance Indication of performance after traffic application TR-2003/9: Initial investigation into development of APE vehicle. 6 2... Restricted Contract Report Initial Investigation into Development of Accelerated Pavement Evaluation (APE) Vehicle. Author: WJvdM Steyn M de Beer PREPARED FOR: PREPARED BY: CSIR Transportek STEP CSIR Transportek PO...

  9. 2-[F-18] fluoro-2-deoxy-D-glucose (FDG) PET in the clinical decision making of esophageal carcinoma: Initial staging and re-staging, evaluating treatment response and residual disease and detecting relapse

    International Nuclear Information System (INIS)

    Basu, S.; Nair, N.; Joseph, J.K.; Sharma, S.; Kanhere, H.

    2004-01-01

    Full text: Accurate initial staging is essential in the management of esophageal carcinoma. The 5-year survival rate is 3% for patients with metastatic disease at the initial assessment, while the same is 42% for patients with nodal disease. 18F-FDG PET is being actively tested regarding its clinical utility at several centers in this malignancy. We at our center are assessing the role of this investigational modality in staging, evaluating treatment response especially after neo-adjuvant therapy and detecting relapse vis-a-vis the other conventionally used modalities e.g. Endoscopic ultrasound (EUS) and the CT scan. The study population consisted of histologically proven cases of esophageal carcinoma who were mainly referred from the department of thoracic surgery of the neighboring Tata Memorial Hospital with few cases from the outside centers. FDG was produced by an automated nucleophilic method based on the Hamacher procedure. Patients were fasting at least for 6 hours. Sixty minutes after injection of 370 MBq FDG, patients were imaged on the dedicated BGO based GE Advance PET scanner (General Electric Medical systems, Milwaukee, WI). Images were reconstructed using the attenuation weighted Ordered Subsets Expectation Maximization (OSEM) algorithm. Axial, coronal, sagittal and 3D images were visually interpreted and foci of increased tracer uptake were considered as disease involvement. The PET scan was interpreted by two experienced nuclear medicine physicians, who were blinded regarding the results of CT scan and EUS except for the location of the primary. The findings of PET were then compared lesion by lesion with that of CT and EUS regarding staging, treatment response evaluation and residual disease evaluation. Till date, the total number of cases of esophageal carcinoma studied was 12, which consisted of primaries in the proximal third (n=1), middle third (n=4) and distal third (n=7). The number of cases assessed for the initial staging purpose was 7

  10. Management of relapsed multiple myeloma: recommendations of the International Myeloma Working Group.

    Science.gov (United States)

    Laubach, J; Garderet, L; Mahindra, A; Gahrton, G; Caers, J; Sezer, O; Voorhees, P; Leleu, X; Johnsen, H E; Streetly, M; Jurczyszyn, A; Ludwig, H; Mellqvist, U-H; Chng, W-J; Pilarski, L; Einsele, H; Hou, J; Turesson, I; Zamagni, E; Chim, C S; Mazumder, A; Westin, J; Lu, J; Reiman, T; Kristinsson, S; Joshua, D; Roussel, M; O'Gorman, P; Terpos, E; McCarthy, P; Dimopoulos, M; Moreau, P; Orlowski, R Z; Miguel, J S; Anderson, K C; Palumbo, A; Kumar, S; Rajkumar, V; Durie, B; Richardson, P G

    2016-05-01

    The prognosis for patients multiple myeloma (MM) has improved substantially over the past decade with the development of new, more effective chemotherapeutic agents and regimens that possess a high level of anti-tumor activity. In spite of this important progress, however, nearly all MM patients ultimately relapse, even those who experience a complete response to initial therapy. Management of relapsed MM thus represents a vital aspect of the overall care for patients with MM and a critical area of ongoing scientific and clinical research. This comprehensive manuscript from the International Myeloma Working Group provides detailed recommendations on management of relapsed disease, with sections dedicated to diagnostic evaluation, determinants of therapy, and general approach to patients with specific disease characteristics. In addition, the manuscript provides a summary of evidence from clinical trials that have significantly impacted the field, including those evaluating conventional dose therapies, as well as both autologous and allogeneic stem cell transplantation. Specific recommendations are offered for management of first and second relapse, relapsed and refractory disease, and both autologous and allogeneic transplant. Finally, perspective is provided regarding new agents and promising directions in management of relapsed MM.

  11. Prognosis of type 1 autoimmune pancreatitis after corticosteroid therapy-induced remission in terms of relapse and diabetes mellitus.

    Directory of Open Access Journals (Sweden)

    Masaki Miyazawa

    Full Text Available Relapse and diabetes mellitus (DM are major problems for the prognosis of autoimmune pancreatitis (AIP. We examined the prognosis of type 1 AIP after corticosteroid therapy (CST-induced remission in terms of relapse and DM.The study enrolled 82 patients diagnosed with type 1 AIP who achieved remission with CST. We retrospectively evaluated the relapse rate in terms of the administration period of CST, clinical factors associated with relapse, and the temporal change in glucose tolerance.During follow-up, 32 patients (39.0% experienced relapse. There was no significant clinical factor that could predict relapse before beginning CST. AIP patients who ceased CST within 2 or 3 years experienced significantly earlier relapse than those who had the continuance of CST (p = 0.050 or p = 0.020. Of the 37 DM patients, 15 patients (40.5% had pre-existing DM, 17 (45.9% showed new-onset DM, and 5 (13.5% developed CST-induced DM. Patients with new-onset DM were significantly more likely to show improvement (p = 0.008 than those with pre-existing DM.It was difficult to predict relapse of AIP based on clinical parameters before beginning CST. Relapse was likely to occur within 3 years after the beginning of CST and maintenance of CST for at least 3 years reduced the risk of relapse. The early initiation of CST for AIP with impaired glucose tolerance is desirable because pre-existing DM is refractory to CST.

  12. Processes of enlightenment : farmer initiatives in rural development in China

    NARCIS (Netherlands)

    Ye, J.

    2002-01-01

    This research concerns development initiatives in rural communities. I define a farmer initiative as the impetus that sufficiently and necessarily drives a farmer (or group of farmers) to formulate a realistic strategic plan, and to implement it in an

  13. Writing for publication: faculty development initiative using social learning theory.

    Science.gov (United States)

    Sanderson, Bonnie K; Carter, Matt; Schuessler, Jenny B

    2012-01-01

    Demonstrating scholarly competency is an expectation for nurse faculty. However, there is hesitancy among some faculty to fully engage in scholarly activities. To strengthen a school of nursing's culture of scholarship, a faculty development writing initiative based on Social Learning Theory was implemented. The authors discuss this initiative to facilitate writing for publication productivity among faculty and the successful outcomes.

  14. Injury and subsequent regeneration of muscles for activation of local innate immunity to facilitate the development and relapse of autoimmune myositis in C57BL/6 mice.

    Science.gov (United States)

    Kimura, Naoki; Hirata, Shinya; Miyasaka, Nobuyuki; Kawahata, Kimito; Kohsaka, Hitoshi

    2015-04-01

    To determine whether injury and regeneration of the skeletal muscles induce an inflammatory milieu that facilitates the development and relapse of autoimmune myositis. The quadriceps of C57BL/6 mice were injured with bupivacaine hydrochloride (BPVC) and evaluated histologically. Macrophages and regenerating myofibers in the treated muscles and differentiating C2C12 myotubes were examined for cytokine expression. Mice were immunized with C protein fragments at the base of the tail and in the right hind footpads (day 0) to evoke systemic anti-C protein immunity and to induce local myositis in the right hind limbs. The contralateral quadriceps muscles were injured with BPVC or phosphate buffered saline (PBS) on day 7 or after spontaneous regression of myositis (day 42). The quadriceps muscle in nonimmunized mice was injured with BPVC on day 7. The muscles were examined histologically 14 days after treatment. The BPVC-injured muscles had macrophage infiltration most abundantly at 3 days after the injection, with emergence of regenerating fibers from day 5. The macrophages expressed inflammatory cytokines, including tumor necrosis factor α, interleukin-1β, and CCL2. Regenerating myofibers and C2C12 myotubes also expressed the cytokines. The BPVC-injected muscles from nonimmunized mice had regenerating myofibers with resolved cell infiltration 14 days after treatment. In mice preimmunized with C protein fragments, the muscles injected with BPVC on day 7 as well as on day 42, but not those injected with PBS, had myositis accompanied by CD8+ T cell infiltration. Injury and regeneration could set up an inflammatory milieu in the muscles and facilitate the development and relapse of autoimmune myositis. Copyright © 2015 by the American College of Rheumatology.

  15. Developing Teachers' Capacity for Teaching Pupils' Initial Reading ...

    African Journals Online (AJOL)

    DrNneka

    that male students performed better on IRMAT than their female counterpart t- calculated 10.80 at ... Key words: Developing, Teachers' Capacity, Teaching, Initial Reading, Multisensory. Approach .... picture that its name starts with the sound.

  16. pupil initiatives in urban nature trail development: pmb moss

    African Journals Online (AJOL)

    .ritzburg is provided. Negotiations and procedures initiated by standard 9 pupils in stimulating authorities and the public to recog~ nise the need for urban trail development and metropolitan open space. (MOSS) are outlined. long-tenn ...

  17. Relapsing polychondritis: commentary

    Directory of Open Access Journals (Sweden)

    R.D. Altman

    2011-09-01

    Full Text Available Relapsing Polychondritis (RP is a multisystem disease of unknown etiology characterized by episodic inflammation of cartilage and potentially progressive degeneration of cartilaginous tissue, such as auricular, nasal and laryngotracheobronchial cartilage. However, many other proteoglycan- rich structures may be involved, such as inner ear, eyes, blood vessels, heart and kidneys (1- 4. RP was first described by Jacksh-Wartenhorst in 1923, who named it “polychondropathia” (5. Pearson et al. (6 introduced the term “relapsing polychondritis” in 1960...

  18. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Clinicians Publications for Your Patients MS Navigator Program Programs and Services for Your Patients Contact Us Clinical Fellows ... Relapsing-remitting MS (RRMS) Relapsing-remitting ...

  19. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... for You and Your Practice Publications for Clinicians Publications for Your Patients MS Navigator Program Programs and Services for Your Patients ... Relapsing-remitting MS (RRMS) Relapsing-remitting MS ( ...

  20. Pupil initiatives in urban nature trail development: PMB MOSS and ...

    African Journals Online (AJOL)

    A brief background to Greenbelt and urban nature trail development in Pietermaritzburg is provided. Negotiations and procedures initiated by standard 9 pupils in stimulating authorities and the public to recognise the need for urban trail development and metropolitan open space (MOSS) are outlined. long-term ...

  1. Paradise nearly Gained. Volume 1: Developing the Frontline Management Initiative.

    Science.gov (United States)

    Barratt-Pugh, Llandis; Soutar, Geoffrey N.

    The Frontline Management Initiative (FMI) provides a framework for competency-based development of frontline managers in Australian enterprises. The FMI's impact on businesses was examined in a national study that included the following activities: focus groups; a national survey of management development and targeted national survey of FMI users;…

  2. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... MS Relapsing-remitting MS (RRMS) Share this page Facebook Twitter Email Relapsing-remitting MS (RRMS) Relapsing-remitting ... Here Start Here Colophon Stay Informed Join Us Facebook Twitter LinkedIn YouTube Pinterest MS Connection About the ...

  3. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Relapsing-remitting MS (RRMS) Share this page Facebook Twitter Email Relapsing-remitting MS (RRMS) Relapsing-remitting MS ( ... Start Here Colophon Stay Informed Join Us Facebook Twitter LinkedIn YouTube Pinterest MS Connection About the Society ...

  4. Treating Multiply Relapsed or Refractory Hairy Cell Leukemia

    Science.gov (United States)

    In this trial, patients with hairy cell leukemia who have not responded or relapsed after initial chemotherapy will be randomly assigned to receive rituximab combined with either pentostatin or bendamustine.

  5. A conceptually new treatment approach for relapsed glioblastoma: Coordinated undermining of survival paths with nine repurposed drugs (CUSP9) by the International Initiative for Accelerated Improvement of Glioblastoma Care

    Science.gov (United States)

    Kast, Richard E.; Boockvar, John A.; Brüning, Ansgar; Cappello, Francesco; Chang, Wen-Wei; Cvek, Boris; Dou, Q. Ping; Duenas-Gonzalez, Alfonso; Efferth, Thomas; Focosi, Daniele; Ghaffari, Seyed H.; Karpel-Massler, Georg; Ketola, Kirsi; Khoshnevisan, Alireza; Keizman, Daniel; Magné, Nicolas; Marosi, Christine; McDonald, Kerrie; Muñoz, Miguel; Paranjpe, Ameya; Pourgholami, Mohammad H.; Sardi, Iacopo; Sella, Avishay; Srivenugopal, Kalkunte S.; Tuccori, Marco; Wang, Weiguang; Wirtz, Christian R.; Halatsch, Marc-Eric

    2013-01-01

    To improve prognosis in recurrent glioblastoma we developed a treatment protocol based on a combination of drugs not traditionally thought of as cytotoxic chemotherapy agents but that have a robust history of being well-tolerated and are already marketed and used for other non-cancer indications. Focus was on adding drugs which met these criteria: a) were pharmacologically well characterized, b) had low likelihood of adding to patient side effect burden, c) had evidence for interfering with a recognized, well-characterized growth promoting element of glioblastoma, and d) were coordinated, as an ensemble had reasonable likelihood of concerted activity against key biological features of glioblastoma growth. We found nine drugs meeting these criteria and propose adding them to continuous low dose temozolomide, a currently accepted treatment for relapsed glioblastoma, in patients with recurrent disease after primary treatment with the Stupp Protocol. The nine adjuvant drug regimen, Coordinated Undermining of Survival Paths, CUSP9, then are aprepitant, artesunate, auranofin, captopril, copper gluconate, disulfiram, ketoconazole, nelfinavir, sertraline, to be added to continuous low dose temozolomide. We discuss each drug in turn and the specific rationale for use- how each drug is expected to retard glioblastoma growth and undermine glioblastoma's compensatory mechanisms engaged during temozolomide treatment. The risks of pharmacological interactions and why we believe this drug mix will increase both quality of life and overall survival are reviewed. PMID:23594434

  6. Early Development of Entrepreneurial Qualities: the Role of Initial Education

    OpenAIRE

    Isobel van der Kuip; Ingrid Verheul

    2003-01-01

    This study attempts to create a better understanding of the role of entrepreneurship education in developing entrepreneurial qualities. Theory and practice are confronted. The paper discusses the extent to which entrepreneurship can be taught, and the way in which it should be taught. The focus is on the phase of initial education.

  7. EFL Teachers' Self-Initiated Professional Development: Perceptions and Practices

    Science.gov (United States)

    Simegn, Birhanu

    2014-01-01

    This study assessed perceptions and practices of secondary schools (Grade 9-12) EFL teachers' self-initiated professional development. A questionnaire of likert scale items and open-ended questions was used to gather data from thirty-two teachers. The teachers were asked to fill out the questionnaire at Bahir Dar University during their…

  8. Initial and transition cycle development for KALIMER uranium fueled core

    International Nuclear Information System (INIS)

    Kim, Sang Ji; Kim, Young In; Kim, Young Jin; Park, Chang Kue

    1998-01-01

    An economic and safe equilibrium Uranium metallic fuelled core having been established, strategic loading schemes for initial and transition cycles to early reach target equilibrium cycles are suggested for U-U and U-Pu transition cycles. An iterative method to find initial core enrichment splits is developed. With non-uniform feed enrichments at the initial core adopted, this iterative method shows KALIMER can reach Uranium equilibrium cycles just after 4 reloads, keeping feed enrichment unchanged from cycle 2. Recycling of self-generated Pu is not sufficient to make KALIMER a pure Pu equilibrium core even after 56 reloads. equilibrium cycles are suggested for U-U and U-Pu transition cycles. An iterative method to find initial core enrichment splits is developed. With non-uniform feed enrichments at the initial core adopted, this iterative method shows KALIMER can reach Uranium equilibrium cycles just after 4 reloads, keeping feed enrichment unchanged from cycle 2. Recycling of self-generated Pu is not sufficient to make KALIMER a pure Pu equilibrium core even after 56 reloads

  9. The Privacy Attitude Questionnaire (PAQ): Initial Development and Validation

    OpenAIRE

    Chignell, Mark H.; Quan-Haase, Anabel; Gwizdka, Jacek

    2003-01-01

    Privacy has been identified as a key issue in a variety of domains, including electronic commerce and public policy. While there are many discussions of privacy issues from a legal and policy perspective, there is little information on the structure of privacy as a psychometric construct. Our goal is to develop a method for measuring attitudes towards privacy that can guide the design and personalization of services. This paper reports on the development of an initial version of the PAQ. Four...

  10. A measure of smoking abstinence-related motivational engagement: development and initial validation.

    Science.gov (United States)

    Simmons, Vani N; Heckman, Bryan W; Ditre, Joseph W; Brandon, Thomas H

    2010-04-01

    Although a great deal of research has focused on measuring motivation and readiness to quit smoking, little research has assessed gross motivational changes after a smoker has made an attempt to quit smoking. Unlike previous single-item global measures of motivation to remain abstinent, we developed the abstinence-related motivational engagement (ARME) scale to evaluate the degree to which abstinence motivation is reflected by an ex-smoker's daily experience in areas that include cognitive effort, priority, vigilance, and excitement. The aim of this study was to collect reliability and initial construct validity data on this new measure. Participants were 199 ex-smokers recruited from the community and smoking cessation Web sites. Participants completed online measures including a global motivation measure, the ARME scale, demographic questionnaire, and a measure of cessation self-efficacy. The 16-item ARME questionnaire demonstrated high internal consistency reliability (alpha = .89). Analyses provided support for convergent, discriminant, and construct validity of the scale. ARME demonstrated the predicted correlation with a traditional measure of global cessation motivation, yet, also as predicted, only the ARME was negatively associated with length of abstinence. Moreover, as hypothesized, ex-smokers engaged in the quitting process via ongoing smoking Web site participation showed higher ARME scores than a comparison community sample. A five-item short form demonstrated similar psychometric properties. This study provided initial support for the ARME construct and offers two versions of a reliable instrument for assessing this construct. Future research will examine the ARME as a predictor of cessation outcome and a potential target for relapse prevention.

  11. Lapse and relapse following inpatient treatment of opiate dependence.

    LENUS (Irish Health Repository)

    Smyth, B P

    2010-06-01

    We conducted a prospective follow-up study of consecutive opiate dependent patients admitted to a residential addiction treatment service for detoxification. We measured the rate of relapse following discharge, and sought to identify factors that were associated with early relapse (i.e., a return to daily opiate use). Follow-up interviews were conducted with 109 patients, of whom, 99 (91%) reported a relapse. The initial relapse occurred within one week in 64 (59%) cases. Multivariate survival analysis revealed that earlier relapse was significantly predicted by younger age, greater heroin use prior to treatment, history of injecting, and a failure to enter aftercare. Unexpectedly, those who were in a relationship with an opiate user had significantly delayed relapse. Those who completed the entire six-week inpatient treatment programme also had a significantly delayed relapse. In order to reduce relapse and the associated increased risk of fatal overdose, services providing residential opiate detoxification should prepare people for admission, strive to retain them in treatment for the full admission period and actively support their entry into planned aftercare in order to improve outcome.

  12. The BRAIN Initiative: developing technology to catalyse neuroscience discovery

    Science.gov (United States)

    Jorgenson, Lyric A.; Newsome, William T.; Anderson, David J.; Bargmann, Cornelia I.; Brown, Emery N.; Deisseroth, Karl; Donoghue, John P.; Hudson, Kathy L.; Ling, Geoffrey S. F.; MacLeish, Peter R.; Marder, Eve; Normann, Richard A.; Sanes, Joshua R.; Schnitzer, Mark J.; Sejnowski, Terrence J.; Tank, David W.; Tsien, Roger Y.; Ugurbil, Kamil; Wingfield, John C.

    2015-01-01

    The evolution of the field of neuroscience has been propelled by the advent of novel technological capabilities, and the pace at which these capabilities are being developed has accelerated dramatically in the past decade. Capitalizing on this momentum, the United States launched the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative to develop and apply new tools and technologies for revolutionizing our understanding of the brain. In this article, we review the scientific vision for this initiative set forth by the National Institutes of Health and discuss its implications for the future of neuroscience research. Particular emphasis is given to its potential impact on the mapping and study of neural circuits, and how this knowledge will transform our understanding of the complexity of the human brain and its diverse array of behaviours, perceptions, thoughts and emotions. PMID:25823863

  13. Development of Ethanol Withdrawal-Related Sensitization and Relapse Drinking in Mice Selected for High or Low Ethanol Preference

    Science.gov (United States)

    Lopez, Marcelo F.; Grahame, Nicholas J.; Becker, Howard C.

    2010-01-01

    Background Previous studies have shown that high alcohol consumption is associated with low withdrawal susceptiblility, while at the same time, other studies have shown that exposure to ethanol vapor increases alcohol drinking in rats and mice. In the present studies, we sought to shed light on this seeming contradiction by using mice selectively bred for High- (HAP) and Low- (LAP) Alcohol Preference, first, assessing these lines for differences in signs of ethanol withdrawal and second, for differences in the efficacy of intermittent alcohol vapor exposure on elevating subsequent ethanol intake. Methods Experiment 1 examined whether these lines of mice differed in ethanol withdrawal-induced CNS hyperexcitability and the development of sensitization to this effect following intermittent ethanol vapor exposure. Adult HAP and LAP lines (replicates 1 and 2), and the C3H/HeNcr inbred strain (included as a control genotype for comparison purposes) received intermittent exposure to ethanol vapor and were evaluated for ethanol withdrawal-induced seizures assessed by scoring handling-induced convulsions (HIC). Experiment 2 examined the influence of chronic intermittent ethanol exposure on voluntary ethanol drinking. Adult male and female HAP-2 and LAP-2 mice, along with male C57BL/6J (included as comparative controls) were trained to drink 10% ethanol using a limited access (2 hr/day) 2-bottle choice paradigm. After stable baseline daily intake was established, mice received chronic intermittent ethanol vapor exposure in inhalation chambers. Ethanol intake sessions resumed 72 hr after final ethanol (or air) exposure for 5 consecutive days. Results Following chronic ethanol treatment, LAP mice exhibited overall greater withdrawal seizure activity compared to HAP mice. In Experiment 2, chronic ethanol exposure/withdrawal resulted in a significant increase in ethanol intake in male C57BL/6J, and modestly elevated intake in HAP-2 male mice. Ethanol intake for male control mice

  14. Prefrontal cortex plasticity mechanisms in drug seeking and relapse

    NARCIS (Netherlands)

    van den Oever, M.C.; Spijker, S.; Smit, A.B.; de Vries, T.J.

    2010-01-01

    Development of pharmacotherapy to reduce relapse rates is one of the biggest challenges in drug addiction research. The enduring nature of relapse suggests that it is maintained by long-lasting molecular and cellular adaptations in the neuronal circuitry that mediates learning and processing of

  15. Relapse prevention in patients with schizophrenia : A nursing intervention study

    NARCIS (Netherlands)

    Meijel, Berno van

    2003-01-01

    This thesis describes a study into the development and testing of a nursing intervention with a view to preventing psychotic relapses in patients suffering from schizophrenia or a related disorder. The purpose of the intervention is to recognise the early signs of an oncoming psychotic relapse. If

  16. Initial teacher education and continuing professional development for science teachers

    DEFF Research Database (Denmark)

    Dolin, Jens; Evans, Robert Harry

    2011-01-01

    Research into ways of improving the initial education and continuing professional development of science teachers is closely related to both common and unique strands. The field is complex since science teachers teach at different educational levels, are often educated in different science subjects......, and belong to various cultures, both educationally and socially. Section 1 presents a review of the research literature across these dimensions and looks at the knowledge, skills and competences needed for teaching science, specific issues within science teacher education, and strategies for educating...... and developing science teachers....

  17. Project management initiative local development through specialized training.

    Directory of Open Access Journals (Sweden)

    Neisy Ramos Acevedo

    2013-09-01

    Full Text Available The local development should complete a group of basic principles, such as: the design for training and the tools information adapted to the particularity of each territory. This training facilitates, also, the articulation of the stocks deployed by the local leaders, and it increases the administration of the knowledge and the transfer of technologies, processes in those that the nexuses are enlarged between the structures and the population, and where the participation of different present actors is potentialized in the territory. During the year 2010 the Ministry of Economy and Planning begins to offer the possibility to finance projects for the local development, nevertheless these initiatives should be accompanied by a rigorous study of feasibility of the investments. The University of Sancti Spíritus, committed in this zeal, designs the Diplomate of Administration of Projects for Local Initiatives, which offers theoretical tools and it develops practical abilities in the different actors of the local development that facilitate the realization of these studies. The exercise of this graduate's culmination consists on the defence of the study of feasibility of those projects that each municipality identifies as priority for its development.

  18. Central diabetes insipidus as a very late relapse limited to the pituitary stalk in Langerhans cell histiocytosis.

    Science.gov (United States)

    Nakagawa, Shunsuke; Shinkoda, Yuichi; Hazeki, Daisuke; Imamura, Mari; Okamoto, Yasuhiro; Kawakami, Kiyoshi; Kawano, Yoshifumi

    2016-07-01

    Central diabetes insipidus (CDI) and relapse are frequently seen in multifocal Langerhans cell histiocytosis (LCH). We present two females with multifocal LCH who developed CDI 9 and 5 years after the initial diagnosis, respectively, as a relapse limited to the pituitary stalk. Combination chemotherapy with cytarabine reduced the mass in the pituitary stalk. Although CDI did not improve, there has been no anterior pituitary hormone deficiency (APHD), neurodegenerative disease in the central nervous system (ND-CNS) or additional relapse for 2 years after therapy. It was difficult to predict the development of CDI in these cases. CDI might develop very late in patients with multifocal LCH, and therefore strict follow-up is necessary, especially with regard to symptoms of CDI such as polydipsia and polyuria. For new-onset CDI with LCH, chemotherapy with cytarabine might be useful for preventing APHD and ND-CNS.

  19. Initiatives to Reduce Earthquake Risk of Developing Countries

    Science.gov (United States)

    Tucker, B. E.

    2008-12-01

    The seventeen-year-and-counting history of the Palo Alto-based nonprofit organization GeoHazards International (GHI) is the story of many initiatives within a larger initiative to increase the societal impact of geophysics and civil engineering. GHI's mission is to reduce death and suffering due to earthquakes and other natural hazards in the world's most vulnerable communities through preparedness, mitigation and advocacy. GHI works by raising awareness in these communities about their risk and about affordable methods to manage it, identifying and strengthening institutions in these communities to manage their risk, and advocating improvement in natural disaster management. Some of GHI's successful initiatives include: (1) creating an earthquake scenario for Quito, Ecuador that describes in lay terms the consequences for that city of a probable earthquake; (2) improving the curricula of Pakistani university courses about seismic retrofitting; (3) training employees of the Public Works Department of Delhi, India on assessing the seismic vulnerability of critical facilities such as a school, a hospital, a police headquarters, and city hall; (4) assessing the vulnerability of the Library of Tibetan Works and Archives in Dharamsala, India; (5) developing a seismic hazard reduction plan for a nonprofit organization in Kathmandu, Nepal that works to manage Nepal's seismic risk; and (6) assisting in the formulation of a resolution by the Council of the Organization for Economic Cooperation and Development (OECD) to promote school earthquake safety among OECD member countries. GHI's most important resource, in addition to its staff and Board of Trustees, is its members and volunteer advisors, who include some of the world's leading earth scientists, earthquake engineers, urban planners and architects, from the academic, public, private and nonprofit sectors. GHI is planning several exciting initiatives in the near future. One would oversee the design and construction of

  20. Development and Pilot Evaluation of an Online Relapse-Prevention Program Based on Acceptance and Commitment Therapy for Chronic Pain Patients

    NARCIS (Netherlands)

    Fledderus, M.; Schreurs, Karlein Maria Gertrudis; Bohlmeijer, Ernst Thomas; Vollenbroek-Hutten, Miriam Marie Rosé

    2015-01-01

    Background: A significant number of chronic pain patients experience a decline in therapeutic effects after rehabilitation. As face-to-face contacts with health care professionals are not always feasible after treatment, new, innovative, fully automated relapse-prevention programs are highly needed.

  1. Modelling of the initial stage of the surface discharge development

    International Nuclear Information System (INIS)

    Gibalov, V.; Pietsch, G.

    1998-01-01

    Computer modelling of the initial stage of the surface discharge was performed by solving numerically the coupled continuity, the Poisson and Townsend ionization equations and taking into account the ionization, attachment and detachment processes. The potential distribution at the dielectric surface and at the boundaries which surround the integration region have been calculated with the charge-image method in a 3D approach. In order to eliminate numerical diffusion effects, the solution of the continuity equation was corrected using a flux correction transport routine. At the positive voltage the development of the discharge channel is determined mainly by the shape of the electrode tip. At the negative voltage the following phases of the discharge may be distinguished: the initial phase, the cathode directed streamer phase resulting in the cathode layer formation, and the propagating phase. The physical processes governing each discharge phase are described in detail. (J.U.)

  2. Tradition as an initiator of rural tourism destinations development

    Directory of Open Access Journals (Sweden)

    Antić Aleksandar

    2015-01-01

    Full Text Available Rural tourism is a form of tourism that best illustrates the importance of tradition in the development of tourist destinations. Music, dance, clothing, culinary specialties of local cuisine, unique natural beauty and the very mentality and hospitality of people in rural areas, represent some of the factors that influence the tourist's consciousness when choosing this type of holiday. The research is focused on the main hypothesis that the tradition is an initiator of rural tourism destinations development. Furthermore, this would imply positive effects in the field of tourism and economy in general and the economy of the region. The goal of the paper is to show the importance of tradition in the cultural identity of rural areas and potentials of tradition in the role of initiating rural tourism destinations development. The interview with staff members in Pozarevac Tourism Organization has helped in the SWOT analysis of the observed rural destination. An empirical research is conducted on a random sample of 232 participants in order to highlight the benefits of rural tourism development in Pozarevac and its surrounding area. The data were processed in SPSS program (version 17.0.

  3. South Africa's Nuclear Skills Development Initiatives

    Energy Technology Data Exchange (ETDEWEB)

    Matube, Ntebatse [NECSA, P.O. BOX 582, 00001 Pretoria (South Africa)

    2008-07-01

    South Africa's long nuclear history has enabled it to develop and explore new nuclear technologies. The country's nuclear industry is becoming innovative and will soon be able to compete within the global nuclear market. This includes projects such as the Pebble-Bed Modular Reactor (PBMR), a generation IV reactor technology, whose construction is anticipated by 2009. This will put South Africa in the fore-front of new technologies. Globally, the nuclear sector is experiencing a renaissance with political support from most governments. The South African government intends to expand the nuclear component in the energy supply mix of the country as a result of an energy crisis resulting from economic growth and thus high demand which will soon outstrip supply. This increased energy demand requires the country to take measures to counteract the crisis. It has been projected that an additional 40000 Megawatts of electricity will be required over the next 20 years in South Africa. Currently about 90% of South Africa's electricity is generated from coal and about 6% from nuclear. The South African electricity utility, Eskom is investigating the expansion of the utility's nuclear power capacity. These investigations are aimed at a potential increase of nuclear capacity to 20000 Megawatts by 2025. Eskom is in the initial phase of the investigation and is considering advanced Pressurized Water Reactors (PWRs) with a combined capacity of around 3500 Megawatts. This planned expansion of the nuclear energy generating program has presented a challenge of developing and maintaining skills and competencies required by the program. The South African government has acknowledged that they do have a challenge and are going to have to develop an aggressive approach to acquire the necessary skills and competencies required for the program. This aggressive approach will have to accelerate the development of nuclear human capital capacity by ensuring that we utilize the

  4. Housing decision making methods for initiation development phase process

    Science.gov (United States)

    Zainal, Rozlin; Kasim, Narimah; Sarpin, Norliana; Wee, Seow Ta; Shamsudin, Zarina

    2017-10-01

    Late delivery and sick housing project problems were attributed to poor decision making. These problems are the string of housing developer that prefers to create their own approach based on their experiences and expertise with the simplest approach by just applying the obtainable standards and rules in decision making. This paper seeks to identify the decision making methods for housing development at the initiation phase in Malaysia. The research involved Delphi method by using questionnaire survey which involved 50 numbers of developers as samples for the primary stage of collect data. However, only 34 developers contributed to the second stage of the information gathering process. At the last stage, only 12 developers were left for the final data collection process. Finding affirms that Malaysian developers prefer to make their investment decisions based on simple interpolation of historical data and using simple statistical or mathematical techniques in producing the required reports. It was suggested that they seemed to skip several important decision-making functions at the primary development stage. These shortcomings were mainly due to time and financial constraints and the lack of statistical or mathematical expertise among the professional and management groups in the developer organisations.

  5. Development of an International Electric Cooperative Initiative on Energy Efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Paul Clark; David South

    2004-05-01

    NRECA conceived of the International Electric Cooperative Initiative on Energy Efficiency (IECIEE) in order to provide an ongoing means of contributing voluntary actions on greenhouse gas emissions mitigation as an integral component of its international programs and projects. This required designing the IECIEE to be integrated directly with the core interests and attributes of participating cooperatives in the U.S. and Latin America, which was the initial focus area selected for the IECIEE. In the case of NRECA International, the core interests related to promoting and strengthening the electric cooperative model, which has proved highly successful in maximizing operational efficiencies in electric power generation, distribution and retailing, as compared to government-owned entities. The approach involved three basic components: (i) establishing the IECIEE mechanism, which involved setting up a functioning organizational vehicle providing for investment, management, and emissions credit accounting; (ii) developing a portfolio of projects in countries where NRECA International could effectively implement the broader mandate of cooperative development as energy efficient suppliers and distributors of electrical energy; and (iii) conducting outreach to obtain the commitment of participants and resources from U.S. and Latin American cooperatives and partnering agencies in the development financing community.

  6. Government policies and initiatives for development of Ayurveda.

    Science.gov (United States)

    Katoch, Dinesh; Sharma, Jitendra S; Banerjee, Subhadip; Biswas, Rajarshi; Das, Bhaskar; Goswami, Debayan; Harwansh, Ranjit K; Katiyar, C K; Mukherjee, Pulok K

    2017-02-02

    Ayurveda (Sanskrit: Ayus - life +Veda - knowledge) means the "True knowledge of life". Ayurveda deals with a complete self-sustainable system of medicine. The Government of India through its Ministry of AYUSH is responsible for policy formulation, development and implementation of programs for the growth, development and propagation of Ayurveda. This review aimed to highlight the various aspects of government policies and initiatives for development of Ayurveda. We critically reviewed various books, annual reports, policy documents and various ancient Ayurvedic literatures. Besides the websites of Ministry of AYUSH, National Medicinal Plant Board, Central Council for Research on Ayurvedic Sciences (CCRAS) and AYUSH research portal have been searched and data was recorded. The vision of the ministry is to position AYUSH systems as the preferred systems of living and practice for attaining healthy nation. The ministry has identified its mission in terms of seven broad thematic functional areas of AYUSH activities. These are information, education and communication; drug administration, human resource development, medicinal plants, research and development, international collaborations, AYUSH services. Different programs have been taken up towards increasing visibility, acceptability and usage of Ayurveda vis-a vis its integration in the health system. Strategies to globalize and promote Ayurveda are being taken up through AYUSH clusters focusing its safety-efficacy-quality aspects and rational use of Ayurveda CONCLUSION: The government policies are taking firm steps towards promotion and development of Ayurveda. Research and development towards validation of Ayurveda is being projected as the thrust area. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Initial Development of Four Forest Species in Different Shading Conditions

    Directory of Open Access Journals (Sweden)

    C. C. Silva

    2013-07-01

    Full Text Available Abstract: Evaluated the initial development through destructive and non-destructive sampling, forest species Adenanthera pavonina, Cassia fistula, Parkia pendula and Hymenolobium petraeum, propagated by seeds at different levels of shading screens black poliefinas (0, 50 and 65% , in the region of Sinop, MT. There were no significant interactions between time and level of shading to any variable. Changes in fresh and dry weight at all levels of shading occurred from 30 DAT. The highest rates of growth were observed in 50% shading to A. pavonina, P. pendula and H. petraeum and 65% shading for C. fistula.Keywords: seedling, growth, physiology, climatic conditions.

  8. Relapsing Polychondritis Following Alopecia Areata

    Directory of Open Access Journals (Sweden)

    John C. Starr

    2010-01-01

    Full Text Available A case of alopecia areata followed by relapsing polychondritis is presented. Similar cases from the literature are reviewed and speculation about the relationship of these diseases is offered. Although the occurrence of these diseases together could be coincidental, an association seems immunologically plausible. Thus, relapsing polychondritis might be an unusual systemic manifestation of alopecia areata.

  9. Leadership Development Initiative: Growing Global Leaders… Advancing Palliative Care.

    Science.gov (United States)

    Ferris, Frank D; Moore, Shannon Y; Callaway, Mary V; Foley, Kathleen M

    2018-02-01

    The International Palliative Care Leadership Development Initiative (LDI) was a model demonstration project that aimed to expand the global network of palliative care leaders in low- and moderate-resource countries who are well positioned to apply their new leadership skills. Thirty-nine palliative medicine physicians from 25 countries successfully completed the two-year curriculum that included three thematic residential courses, mentorship, and site visits by senior global palliative care leaders and personal projects to apply their new leadership skills. The focus on self-reflection, leadership behaviors and practices, strategic planning, high-level communication, and teaching skills led to significant personal and professional transformation among the participants, mentors, and the LDI team. The resulting residential course curriculum and the personal leadership stories and biosketches of the leaders are now available open access at IPCRC.net. Already, within their first-year postgraduation, the leaders are using their new leadership skills to grow palliative care capacity through significant changes in policy, improved opioid/other medication availability, new and enhanced educational curricula and continuing education activities, and development/expansion of palliative care programs in their organizations and regions. We are not aware of another palliative care initiative that achieves the global reach and ripple effect that LDI has produced. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  10. Germination and initial development of aroeira (Myracrodruon urundeuva seedlings

    Directory of Open Access Journals (Sweden)

    Silvana de Paula Quintão Scalon

    2012-12-01

    Full Text Available Aroeira has great economic importance due to its wood useful, tannins extraction and use in the pharmacology. The aim of this work was to evaluate the germination aspects and initial seedlings development of aroeira, under gibberellins, substrata and shading effects, and for that two experiments were led out. In the first one, seeds were previously soaked for 24 hours in water and in 100 mg.L-1 gibberellin solution and were sowed directly in cells trays in the following substrata: land and sand (1:1 and 1:2 and Plantmax . In the second experiment, 15 cm length seedlings were transplanted to polyethylene sacks filled out land+sand+poultry manure (1:1:1 partly decomposed and they were maintained at greenhouse for 15 days. Soon after, seedlings were transferred for the following conditions: shading (50% and full sun and they were 50 mg.L-1 and 150 mg.L-1 gibberellins solutions pulverized, as control seedlings water pulverized. Aroeira seeds should not be previously water or gibberellins imbibed before being sowed. The best substrata for aroeira seeds germination was Plantmax without germinative treatments to reach higher than 80% of seedlings survival. The seedlings developed better at full sun light and the gibberellin. It was observed increment in height, diameter, foliar area and fresh and dry mass from aerial and root part when compared to shading situation. The gibberellins applications did not influence the aroeira seedlings initial growth characteristics.

  11. MRI diagnosis of bone marrow relapse in children with ALL

    International Nuclear Information System (INIS)

    Kan, J.H.; Hernanz-Schulman, Marta; Frangoul, Haydar A.; Connolly, Susan A.

    2008-01-01

    Diffuse marrow replacement in acute leukemia is well known, but there are few reports describing the MRI features of pediatric leukemic relapse. Our purpose was to describe the MRI appearance of pediatric leukemic relapse. A total of 53 consecutive children with a history of ALL were referred for musculoskeletal MRI from 1 January 1998 to 28 February 2007 at one center, and from 1 January 2000 to 2 May 2007 at a second center. From this group, 14 children seen at initial diagnosis of leukemia and 2 children who underwent MRI after therapy for relapse were excluded. The remaining 37 children, 8 with relapse and 29 in remission, were studied. Images of patients with relapse and in remission were reviewed for type and configuration of marrow infiltration; coexisting marrow alterations including osteonecrosis or stress reaction were also reviewed. All eight children with relapse demonstrated nodular lesions with well-defined margins. Coexisting osteonecrosis was present in three children (38%) and pathologic fracture in one. Among the 29 children in remission, 9 showed stress reaction/fracture, 14 showed osteonecrosis and 9 showed ill-defined nodules, and in 5 the marrow was completely normal. Well-defined nodules in all patients with leukemic relapse suggest that this appearance is characteristic and distinct from the published findings of diffuse marrow replacement in acute leukemia. (orig.)

  12. MRI diagnosis of bone marrow relapse in children with ALL

    Energy Technology Data Exchange (ETDEWEB)

    Kan, J.H.; Hernanz-Schulman, Marta [Vanderbilt University, Department of Radiology and Radiological Sciences, Vanderbilt Children' s Hospital, Nashville, TN (United States); Frangoul, Haydar A. [Vanderbilt University, Department of Pediatric Hematology-Oncology, Vanderbilt Children' s Hospital, Nashville, TN (United States); Connolly, Susan A. [Harvard Medical School, Department of Radiology, Boston Children' s Hospital, Boston, MA (United States)

    2008-01-15

    Diffuse marrow replacement in acute leukemia is well known, but there are few reports describing the MRI features of pediatric leukemic relapse. Our purpose was to describe the MRI appearance of pediatric leukemic relapse. A total of 53 consecutive children with a history of ALL were referred for musculoskeletal MRI from 1 January 1998 to 28 February 2007 at one center, and from 1 January 2000 to 2 May 2007 at a second center. From this group, 14 children seen at initial diagnosis of leukemia and 2 children who underwent MRI after therapy for relapse were excluded. The remaining 37 children, 8 with relapse and 29 in remission, were studied. Images of patients with relapse and in remission were reviewed for type and configuration of marrow infiltration; coexisting marrow alterations including osteonecrosis or stress reaction were also reviewed. All eight children with relapse demonstrated nodular lesions with well-defined margins. Coexisting osteonecrosis was present in three children (38%) and pathologic fracture in one. Among the 29 children in remission, 9 showed stress reaction/fracture, 14 showed osteonecrosis and 9 showed ill-defined nodules, and in 5 the marrow was completely normal. Well-defined nodules in all patients with leukemic relapse suggest that this appearance is characteristic and distinct from the published findings of diffuse marrow replacement in acute leukemia. (orig.)

  13. Smoking relapse situations among a community-recruited sample of Spanish daily smokers.

    Science.gov (United States)

    Piñeiro, Bárbara; López-Durán, Ana; Martínez-Vispo, Carmela; Fernández Del Río, Elena; Martínez, Úrsula; Rodríguez-Cano, Rubén; Míguez, M Carmen; Becoña, Elisardo

    2017-12-01

    Relapse is a common factor within the behavior change process. However, there is scarce and limited knowledge of smoking relapse situations in population-based samples. The aim of this study was to identify smoking relapse situations among a sample of Spanish relapsers from the general population. A sample of 775 relapsers was recruited among the general population using a snowball method. Participants completed a survey including sociodemographic, smoking-related and psychopathology variables. Smoking relapse situations were identified through specific questions assessing different aspects related to the last relapse episode. The majority of smoking relapse situations were attributed to positive affect (36.6%) and negative affect (34.3%), followed by lack of control (10.1%), smoking habit (6.7%), craving or nicotine withdrawal (6.3%), and social pressure (5.9%). Being unemployed and having a mental disorder in the past increased the likelihood of relapse in situations of negative affect. Being single and having quit smoking to save money were associated with an increased likelihood of relapse in situations of positive affect. Affect plays a significant role in smoking relapse among a community sample of unassisted Spanish smokers. Relapse may be much more of an affective and situational process than a habit, physiological or social pressure. Findings from this study may help develop tailored community smoking relapse prevention strategies or programs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. The United Nations development programme initiative for sustainable energy

    Energy Technology Data Exchange (ETDEWEB)

    Hurry, S.

    1997-12-01

    Energy is central to current concerns about sustainable human development, affecting economic and social development; economic growth, the local, national, regional, and global environment; the global climate; a host of social concerns, including poverty, population, and health, the balance of payments, and the prospects for peace. Energy is not an end in itself, but rather the means to achieve the goals of sustainable human development. The energy systems of most developing countries are in serious crisis involving insufficient levels of energy services, environmental degradation, inequity, poor technical and financial performance, and capital scarcity. Approximately 2.5 billion people in the developing countries have little access to commercial energy supplies. Yet the global demand for energy continues to grow: total primary energy is projected to grow from 378 exajoules (EJ) per year in 1990 to 571 EJ in 2020, and 832 EJ in 2050. If this increase occurs using conventional approaches and energy sources, already serious local (e.g., indoor and urban air pollution), regional (eg., acidification and land degradation), and global (e.g., climate change) environmental problems will be critically aggravated. There is likely to be inadequate capital available for the needed investments in conventional energy sources. Current approaches to energy are thus not sustainable and will, in fact, make energy a barrier to socio-economic development. What is needed now is a new approach in which energy becomes an instrument for sustainable development. The two major components of a sustainable energy strategy are (1) more efficient energy use, especially at the point of end-use, and (2) increased use of renewable sources of energy. The UNDP Initiative for Sustainable Energy (UNISE) is designed to harness opportunities in these areas to build upon UNDP`s existing energy activities to help move the world toward a more sustainable energy strategy by helping program countries.

  15. Geriatric medicine, Japanese Alzheimer's disease neuroimaging initiative and biomarker development

    International Nuclear Information System (INIS)

    Arai, Hiroyuki; Furukawa, Katsutoshi; Okamura, Nobuyuki; Kudo, Yukitsuka

    2010-01-01

    Due to a change in disease spectrum in aged countries, the primary role of geriatricians should be directed to an appropriate management and prevention of cognitive decline and dementia, swallowing and aspiration pneumonia and falls and fractures. Management of dementia constitutes a central part in the practice of geriatric medicine in order to support independence of life in elderly people. The current paradigm of cognitive function-based testing for the diagnosis and treatment of Alzheimer's disease (AD) is going to drastically shift to a biomarker-based test approach, a shift that will correspond to the emergence of disease-modifying drugs. In addition, a new molecular imaging technique that visualizes neuronal protein deposits or pathological features has been developed in Japan and the U.S.A. Based on these achievements, the Alzheimer's Disease Neuroimaging Initiative (ADNI) was proposed and initiated in 2005. The ADNI is a long-term observational study being conducted in the U.S.A., Europe, Australia, and Japan using identical protocols. The objectives of ADNI are: to establish methodology which will allow standard values related to long-term changes in imaging data, such as MRI and positron emission tomography (PET), in patients with AD and mild cognitive impairment and normal elderly persons; to obtain clinical indices, psychological test data, and blood/cerebrospinal fluid biomarkers to demonstrate the validity of image-based surrogate markers; and to establish optimum methods to monitor the therapeutic effects of disease-modifying drugs for AD. Patient enrollment in the Japanese ADNI has begun in July 2008. Imaging of AD pathology not only acts as a reliable biomarker with which to assay curative drug development by novel pharmaceutical companies, but it also helps health promotion toward AD prevention. (author)

  16. The Initial Development of a Computerized Operator Support System

    Energy Technology Data Exchange (ETDEWEB)

    Roger Lew; Ronald L Boring; Thomas A Ulrich; Ken Thomas

    2014-08-01

    A computerized operator support system (COSS) is a collection of resilient software technologies to assist operators in monitoring overall nuclear power plant performance and making timely, informed decisions on appropriate control actions for the projected plant condition. The COSS provides rapid assessments, computations, and recommendations to reduce workload and augment operator judgment and decision-making during fast- moving, complex events. A prototype COSS for a chemical volume control system at a nuclear power plant has been developed in order to demonstrate the concept and provide a test bed for further research. The development process identified four underlying elements necessary for the prototype, which consist of a digital alarm system, computer-based procedures, piping and instrumentation diagram system representations, and a recommender module for mitigation actions. An operational prototype resides at the Idaho National Laboratory (INL) using the U.S. Department of Energy’s (DOE) Light Water Reactor Sustainability (LWRS) Human Systems Simulation Laboratory (HSSL). Several human-machine interface (HMI) considerations are identified and incorporated in the prototype during this initial round of development.

  17. Developing a smoke free homes initiative in Kerala, India.

    Science.gov (United States)

    Nichter, Mimi; Padmajam, Sreedevi; Nichter, Mark; Sairu, P; Aswathy, S; Mini, G K; Bindu, V C; Pradeepkumar, A S; Thankappan, K R

    2015-05-10

    Results of the Global Adult Tobacco Survey in Kerala, India found that 42 % of adults were exposed to second hand smoke (SHS) inside the home. Formative research carried out in rural Kerala suggests that exposure may be much higher. Numerous studies have called for research and intervention on SHS exposure among women and children as an important component of maternal and child health activities. Community-based participatory research was carried out in Kerala. First, a survey was conducted to assess prevalence of SHS exposure in households. Next, a proof of concept study was conducted to develop and test the feasibility of a community-wide smoke free homes initiative. Educational materials were developed and pretested in focus groups. After feasibility was established, pilot studies were implemented in two other communities. Post intervention, surveys were conducted as a means of assessing changes in community support. At baseline, between 70 and 80 % of male smokers regularly smoked inside the home. Over 80 % of women had asked their husband not to do so. Most women felt powerless to change their husband's behavior. When women were asked about supporting a smoke free homes intervention, 88 % expressed support for the idea, but many expressed doubt that their husbands would comply. Educational meetings were held to discuss the harms of second hand smoke. Community leaders signed a declaration that their community was part of the smoke free homes initiative. Six months post intervention a survey was conducted in these communities; between 34 and 59 % of men who smoked no longer smoked in their home. The smoke free homes initiative is based on the principle of collective efficacy. Recognizing the difficulty for individual women to effect change in their household, the movement establishes a smoke free community mandate. Based on evaluation data from two pilot studies, we can project that between a 30 and 60 % reduction of smoking in the home may be achieved, the

  18. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... in RRMS; however, each person's experience with RRMS will be unique. Following a relapse, the new symptoms ... and worsening, you and your MS care provider will likely want to consider a more aggressive treatment ...

  19. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... course – is characterized by clearly defined attacks of new or increasing neurologic symptoms. These attacks – also called ... either active (with relapses and/or evidence of new MRI activity) or not active , as well as ...

  20. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... defined attacks of new or increasing neurologic symptoms. These attacks – also called relapses or exacerbations – are followed ... as well as the nerve fibers themselves. During these inflammatory attacks, activated immune cells cause small, localized ...

  1. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Treating MS Comprehensive Care Find an MS Care Provider Medications Managing Relapses Rehabilitation Complementary & Alternative Medicines For Clinicians Resources & Support Library & Education Programs Find Support Advanced Care ...

  2. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... without symptoms of which the person is aware. What happens in RRMS? Relapsing-remitting MS is defined ... a different mechanism of action in order to control the disease activity more effectively and help prevent ...

  3. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Rule Out For Clinicians Treating MS Comprehensive Care Find an MS Care Provider Medications Managing Relapses Rehabilitation ... Medicines For Clinicians Resources & Support Library & Education Programs Find Support Advanced Care Needs Resources for Specific Populations ...

  4. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... the periods of remission. At different points in time, RRMS can be further characterized as either active ( ... increase in disability over a specified period of time following a relapse) or not worsening . An increase ...

  5. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... attacks of inflammation (relapses) in the CNS, progressive forms of MS involve much less of this type ... and memory or information processing). People with progressive forms of MS are more likely to experience gradually ...

  6. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Team Make the Most of Your Doctor Visits Advance Medical Directives d Find an MS Care Provider ... in RRMS; however, each person's experience with RRMS will be unique. Following a relapse, the new symptoms ...

  7. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... as shown by the arrows, often occur as part of a relapse. However, new MRI lesions indicating ... course of your disease at different points in time helps you and your MS care provider discuss ...

  8. Relapse of nephrotic syndrome during post-rituximab peripheral blood B-lymphocyte depletion.

    Science.gov (United States)

    Sato, Mai; Kamei, Koichi; Ogura, Masao; Ishikura, Kenji; Ito, Shuichi

    2018-02-01

    Rituximab is effective against complicated childhood steroid-dependent nephrotic syndrome (SDNS). Peripheral blood B-lymphocyte (B-cell) depletion is strongly correlated with persistent remission, relapse rarely occurring during B-cell depletion; however, we have encountered several such patients. We retrospectively analyzed the characteristics and clinical course of 82 patients with SDNS treated with rituximab from January 2007 to December 2012 in our institution. Six of 82 patients (7.3%) had relapses during B-cell depletion after receiving rituximab (relapsed group). The remaining 76 patients did not have relapses during B-cell depletion (non-relapsed group). The median time to initial relapse during B-cell depletion was 85 days after receiving rituximab, which is significantly shorter than in the non-relapsed group (410 days, p = 0.0003). The median annual numbers of relapses after receiving rituximab were 2.5 and 0.9 in the relapsed and non-relapsed groups, respectively (p depletion did not differ between the two groups. Relapse during B-cell depletion after receiving rituximab suggests that various pathophysiological mechanisms play a part in childhood nephrotic syndrome.

  9. Initial Progress in Developing the New ICSU World Data System

    Science.gov (United States)

    Minster, J. H.; Capitaine, N.; Clark, D. M.; Mokrane, M.

    2009-12-01

    On October 24, 2008, at the 29th International Council for Science (ICSU) General Assembly in Maputo, Mozambique, a decision to form a new ICSU World Data System (WDS) was taken. The new ICSU World Data System (WDS) will replace the framework within which the current ICSU World Data Centers (WDCs) and services of the Federation of Astronomical and Geophysical data-analysis Services (FAGS) are currently organized. The transition from the old organizations to the new WDS was facilitated by the ICSU ad-hoc WDS Transition Team which developed a white paper with recommendations for the new WDS Scientific Committee (WDS-SC). The WDS-SC was appointed by ICSU and reports to the Executive Board and the General Assembly of ICSU. The WDSSC met for the first time in October 2009. WDS-SC shall be the governing body of WDS with the following tasks: 1) to ensure that the WDS clearly supports ICSU’s mission and objectives by ensuring the long-term stewardship and provision of quality-assessed data and data services to the international science community and other stakeholders; 2) to develop, and keep under continuous review, an implementation plan for the creation of the WDS by incorporating the ICSU WDCs, the Services of FAGS and a wide range of other data centers and services; 3) to define agreed standards, establish and oversee the procedures for the review and accreditation of existing and new facilities; 4) to monitor the geographic and disciplinary scope of the system and to develop strategies for the recruitment and establishment of new WDS facilities as necessary; 5) to consider resource issues and provide guidance on funding mechanisms for facilities within WDS when appropriate; 6) to develop strong cooperative links with the ICSU Strategic Coordinating Committee on Information and Data (SCCID);and 7) to cooperate closely with the ICSU Committee on Data for Science and Technology (CODATA). WDS development will proceed from these initial concepts: history and legacy of

  10. The initial development of the Pregnancy-related Anxiety Scale.

    Science.gov (United States)

    Brunton, Robyn J; Dryer, Rachel; Saliba, Anthony; Kohlhoff, Jane

    2018-05-30

    Pregnancy-related anxiety is a distinct anxiety characterised by pregnancy-specific concerns. This anxiety is consistently associated with adverse birth outcomes, and obstetric and paediatric risk factors, associations generally not seen with other anxieties. The need exists for a psychometrically sound scale for this anxiety type. This study, therefore, reports on the initial development of the Pregnancy-related Anxiety Scale. The item pool was developed following a literature review and the formulation of a definition for pregnancy-related anxiety. An Expert Review Panel reviewed the definition, item pool and test specifications. Pregnant women were recruited online (N=671). Using a subsample (N=262, M=27.94, SD=4.99), fourteen factors were extracted using Principal Components Analysis accounting for 63.18% of the variance. Further refinement resulted in 11 distinct factors. Confirmatory Factor Analysis further tested the model with a second subsample (N=369, M=26.59, SD=4.76). After additional refinement, the resulting model was a good fit with nine factors (childbirth, appearance, attitudes towards childbirth, motherhood, acceptance, anxiety, medical, avoidance, and baby concerns). Internal consistency reliability was good with the majority of subscales exceeding α=.80. The Pregnancy-related Anxiety Scale is easy to administer with higher scores indicative of greater pregnancy-related anxiety. The inclusion of reverse-scored items is a potential limitation with poorer reliability evident for these factors. Although still in its development stage, the Pregnancy-related Anxiety Scale will eventually be useful both clinically (affording early intervention) and in research settings. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  11. Tumor suppressors BTG1 and IKZF1 cooperate during mouse leukemia development and increase relapse risk in B-cell precursor acute lymphoblastic leukemia patients.

    Science.gov (United States)

    Scheijen, Blanca; Boer, Judith M; Marke, René; Tijchon, Esther; van Ingen Schenau, Dorette; Waanders, Esmé; van Emst, Liesbeth; van der Meer, Laurens T; Pieters, Rob; Escherich, Gabriele; Horstmann, Martin A; Sonneveld, Edwin; Venn, Nicola; Sutton, Rosemary; Dalla-Pozza, Luciano; Kuiper, Roland P; Hoogerbrugge, Peter M; den Boer, Monique L; van Leeuwen, Frank N

    2017-03-01

    Deletions and mutations affecting lymphoid transcription factor IKZF1 (IKAROS) are associated with an increased relapse risk and poor outcome in B-cell precursor acute lymphoblastic leukemia. However, additional genetic events may either enhance or negate the effects of IKZF1 deletions on prognosis. In a large discovery cohort of 533 childhood B-cell precursor acute lymphoblastic leukemia patients, we observed that single-copy losses of BTG1 were significantly enriched in IKZF1 -deleted B-cell precursor acute lymphoblastic leukemia ( P =0.007). While BTG1 deletions alone had no impact on prognosis, the combined presence of BTG1 and IKZF1 deletions was associated with a significantly lower 5-year event-free survival ( P =0.0003) and a higher 5-year cumulative incidence of relapse ( P =0.005), when compared with IKZF1 -deleted cases without BTG1 aberrations. In contrast, other copy number losses commonly observed in B-cell precursor acute lymphoblastic leukemia, such as CDKN2A/B, PAX5, EBF1 or RB1 , did not affect the outcome of IKZF1 -deleted acute lymphoblastic leukemia patients. To establish whether the combined loss of IKZF1 and BTG1 function cooperate in leukemogenesis, Btg1 -deficient mice were crossed onto an Ikzf1 heterozygous background. We observed that loss of Btg1 increased the tumor incidence of Ikzf1 +/- mice in a dose-dependent manner. Moreover, murine B cells deficient for Btg1 and Ikzf1 +/- displayed increased resistance to glucocorticoids, but not to other chemotherapeutic drugs. Together, our results identify BTG1 as a tumor suppressor in leukemia that, when deleted, strongly enhances the risk of relapse in IKZF1 -deleted B-cell precursor acute lymphoblastic leukemia, and augments the glucocorticoid resistance phenotype mediated by the loss of IKZF1 function. Copyright© Ferrata Storti Foundation.

  12. Glucocorticoids and relapse of major depression (dexamethasone/corticotropin-releasing hormone test in relation to relapse of major depression)

    NARCIS (Netherlands)

    Appelhof, Bente C.; Huyser, Jochanan; Verweij, Mijke; Brouwer, Jantien P.; van Dyck, Richard; Fliers, Eric; Hoogendijk, Witte J. G.; Tijssen, Jan G. P.; Wiersinga, Wilmar M.; Schene, Aart H.

    2006-01-01

    BACKGROUND: Knowledge of pathogenic mechanisms and predictors of relapse in major depressive disorder is still limited. Hypothalamic-pituitary-adrenocortical (HPA) axis dysregulation is thought to be related to the development and course of depression. METHODS: We investigated whether

  13. Environmental controls on pyrocumulus and pyrocumulonimbus initiation and development

    Directory of Open Access Journals (Sweden)

    N. P. Lareau

    2016-03-01

    Full Text Available In this paper we present the first direct observational evidence that the condensation level in pyrocumulus and pyrocumulonimbus clouds can be significantly higher than the ambient lifted condensation level. In addition, we show that the environmental thermodynamic profile, day-to-day variations in humidity, and ambient wind shear all exert significant influence over the onset and development of pyroconvective clouds. These findings are established using a scanning Doppler lidar and mobile radiosonde system during two large wildfires in northern California, the Bald Fire and the Rocky Fire. The lidar is used to distinguish liquid water from smoke backscatter during the plume rise, and thus provides a direct detection of plume condensations levels. Plume tops are subsequently determined from both the lidar and nearby radar observations. The radiosonde data, obtained adjacent to the fires, contextualize the lidar and radar observations, and enable estimates of the plume ascent, convective available potential energy, and equilibrium level. A noteworthy finding is that in these cases, the convective condensation level, not the lifted condensation level, provides the best estimate of the pyrocumulus initiation height.

  14. Development and initial evaluation of the SCI-FI/AT.

    Science.gov (United States)

    Jette, Alan M; Slavin, Mary D; Ni, Pengsheng; Kisala, Pamela A; Tulsky, David S; Heinemann, Allen W; Charlifue, Susie; Tate, Denise G; Fyffe, Denise; Morse, Leslie; Marino, Ralph; Smith, Ian; Williams, Steve

    2015-05-01

    To describe the domain structure and calibration of the Spinal Cord Injury Functional Index for samples using Assistive Technology (SCI-FI/AT) and report the initial psychometric properties of each domain. Cross sectional survey followed by computerized adaptive test (CAT) simulations. Inpatient and community settings. A sample of 460 adults with traumatic spinal cord injury (SCI) stratified by level of injury, completeness of injury, and time since injury. None SCI-FI/AT RESULTS: Confirmatory factor analysis (CFA) and Item response theory (IRT) analyses identified 4 unidimensional SCI-FI/AT domains: Basic Mobility (41 items) Self-care (71 items), Fine Motor Function (35 items), and Ambulation (29 items). High correlations of full item banks with 10-item simulated CATs indicated high accuracy of each CAT in estimating a person's function, and there was high measurement reliability for the simulated CAT scales compared with the full item bank. SCI-FI/AT item difficulties in the domains of Self-care, Fine Motor Function, and Ambulation were less difficult than the same items in the original SCI-FI item banks. With the development of the SCI-FI/AT, clinicians and investigators have available multidimensional assessment scales that evaluate function for users of AT to complement the scales available in the original SCI-FI.

  15. Development and initial validation of a caffeine craving questionnaire.

    Science.gov (United States)

    West, Oliver; Roderique-Davies, Gareth

    2008-01-01

    Craving for caffeine has received little empirical attention, despite considerable research into the potential for caffeine dependence. The main aim of this study was to develop, and initially validate, a multi-item, multidimensional instrument to measure cravings for caffeine. Participants were 189 caffeine consumers who completed the Questionnaire of Caffeine Cravings, which was based on the Questionnaire of Smoking Urges (QSU), in one of five naturally occurring periods of abstinence; 1-15 min; 16-120 mins; 3-7 h; 12-48 h and +48 h. Exploratory factor analysis suggested a three-factor solution best described the data; Factor 1 reflected strong desires, intentions and positive reinforcement; Factor 2 reflected mild/general positive and negative reinforcement and Factor 3 reflected functional/mood-based negative reinforcement. Significantly higher Factor 1 and Factor 2 scores were recorded for high frequency users; significantly higher Factor 1 and Factor 3 scores were recorded as a function of increased levels of dependence. Duration of abstinence did not significantly effect cravings across all three factors. Regression analyses suggested level of dependence best predicted both current cravings and frequency of daily use. These findings suggest caffeine cravings may be conceptualized multidimensionally and further validates the use of multidimensional, multi-item instruments. Cravings for caffeine may manifest and be detected across varying levels of dependence and, frequency of use and independently of duration of abstinence.

  16. Initial development of a blurry injector for biofuels

    Energy Technology Data Exchange (ETDEWEB)

    Azevedo, Claudia Goncalves de; Costa, Fernando de Souza [National Institute for Space Research (INPE) Cachoeira Paulista, SP (Brazil). Associated Lab. of Combustion and Propulsion], Emails: claudia@lcp.inpe.br, fernando@lcp.inpe.br; Couto, Heraldo da Silva [Vale Energy Solution, Sao Jose dos Campos, SP (Brazil)], E-mail: heraldo.couto@vsesa.com.br

    2010-07-01

    The increasing costs of fossil fuels, environmental concerns and stringent regulations on fuel emissions have caused a significant interest on biofuels, especially ethanol and biodiesel. The combustion of liquid fuels in diesel engines, turbines, rocket engines and industrial furnaces depends on the effective atomization to increase the surface area of the fuel and thus to achieve high rates of mixing and evaporation. In order to promote combustion with maximum efficiency and minimum emissions, an injector must create a fuel spray that evaporates and disperses quickly to produce a homogeneous mixture of vaporized fuel and air. Blurry injectors can produce a spray of small droplets of similar sizes, provide excellent vaporization and mixing of fuel with air, low emissions of NO{sub x} and CO, and high efficiency. This work describes the initial development of a blurry injector for biofuels. Theoretical droplet sizes are calculated in terms of feed pressures and mass flow rates of fuel and air. Droplet size distribution and average diameters are measured by a laser system using a diffraction technique. (author)

  17. The development and initial validation of the Countertransference Management Scale.

    Science.gov (United States)

    Pérez-Rojas, Andrés E; Palma, Beatriz; Bhatia, Avantika; Jackson, John; Norwood, Earta; Hayes, Jeffrey A; Gelso, Charles J

    2017-09-01

    Countertransference is an important aspect of the therapeutic relationship that exists in therapies of all theoretical orientations, and depending on how it is managed, it can either help or hinder treatment. Management of countertransference has been measured almost exclusively with the Countertransference Factors Inventory (Van Wagoner, Gelso, Hayes, & Diemer, 1991) and its variations, all of which focus on 5 therapist qualities theorized to facilitate management: self-insight, conceptualizing ability, empathy, self-integration, and anxiety management. Existing versions of the Countertransference Factors Inventory, however, possess certain psychometric limitations that appear to constrain how well they assess actual management of countertransference during a therapy session. We thus sought to develop a new measure that addressed these limitations and that captured the 5 therapist qualities as constituents (rather than correlates) of countertransference management that manifest in the treatment hour. The development and initial validation of the resulting 22-item Countertransference Management Scale (CMS) is described here. Exploratory factor analysis of ratings of 286 therapy supervisors of current supervisees indicated that the 5 constituents of countertransference management could be grouped into 2 correlated factors: "Understanding Self and Client" and "Self-Integration and Regulation." Evidence of convergent and criterion-related validity was supported by CMS total and subscale scores correlating as expected with measures of theoretically relevant constructs, namely, therapist countertransference behavior, theoretical framework, self-esteem, observing ego, empathic understanding, and tolerance of anxiety. Results also supported the internal consistency of the CMS and its subscales. Research, clinical, and training implications are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  18. Self-Organization in Integrated Conservation and Development Initiatives

    Directory of Open Access Journals (Sweden)

    Cristiana Simão Seixas

    2007-11-01

    Full Text Available This paper uses a cooking metaphor to explore key elements (i.e., ingredients for a great meal that contribute to self-organization processes in the context of successful community-based conservation (CBC or integrated conservation and development projects (ICDP. We pose two major questions: (1 What are the key factors that drive peoples' and/or organizations' willingness to take responsibilities and to act? (2 What contributes to community self-organization? In other words, how conservation-development projects originate, evolve, survive or disappear? In order to address these questions we examine trigger events and catalytic elements in several cases among the Equator Prize finalists and short-listed nominees, from both the 2002 and 2004 awards. The Prize recognizes efforts in integrating biodiversity conservation and poverty reduction. We use secondary data in our analysis, including data from several technical reports and scientific papers written about the Equator Prize finalists and short-listed nominees. We observed common ingredients in most projects including: (1 involvement and commitment of key players (including communities, (2 funding, (3 strong leadership, (4 capacity building, (5 partnership with supportive organizations and government, and (6 economic incentives (including alternative livelihood options. We also observed that CBC and ICDP initiatives opportunistically evolve in a multi-level world, in which local communities establish linkages with people and organizations at different political levels, across different geographical scales and for different purposes. We conclude that there is no right 'recipe' to promote community self-organization but often a mix of some of these six ingredients need to come together for 'success' and that one or two ingredients are not sufficient to ensure success. Also the existence of these six ingredients does not guarantee a great meal - the 'chef's' creativity also is critical. That is

  19. Outcome following late marrow relapse in childhood acute lymphoblastic leukemia

    International Nuclear Information System (INIS)

    Chessells, J.; Leiper, A.; Rogers, D.

    1984-01-01

    Thirty-four children with acute lymphoblastic leukemia, who developed bone marrow relapse after treatment was electively stopped, received reinduction, consolidation, continuing therapy, and intrathecal (IT) methotrexate (MTX). Sixteen children who relapsed within six months of stopping treatment had a median second-remission duration of 26 weeks; all next relapses occurred in the bone marrow. In 18 children who relapsed later, the median duration of second remission was in excess of two years, but after a minimum of four years follow-up, 16 patients have so far relapsed again (six in the CNS). CNS relapse occurred as a next event in four of 17 children who received five IT MTX injections only and in two of 14 children who received additional regular IT MTX. Although children with late marrow relapses may achieve long second remissions, their long-term out-look is poor, and regular IT MTX does not afford adequate CNS prophylaxis. It remains to be seen whether more intensive chemotherapy, including high-dose chemoradiotherapy and bone marrow transplantation, will improve the prognosis in this group of patients

  20. 77 FR 5044 - Announcement of Funding Awards for the Brownfields Economic Development Initiative (BEDI) Program...

    Science.gov (United States)

    2012-02-01

    ... Awards for the Brownfields Economic Development Initiative (BEDI) Program for Fiscal Year 2010 AGENCY...) for the Brownfield Economic Development Initiative (BEDI) program. This announcement contains the... CONTACT: David Kaminsky, Office of Economic Development Grants Management Division, Office of Community...

  1. 77 FR 5043 - Announcement of Funding Awards for the Brownfields Economic Development Initiative (BEDI) Program...

    Science.gov (United States)

    2012-02-01

    ... Awards for the Brownfields Economic Development Initiative (BEDI) Program for Fiscal Year 2009 AGENCY...) for the Brownfield Economic Development Initiative (BEDI) program. This announcement contains the... CONTACT: David Kaminsky, Office of Economic Development Grants Management Division, Office of Community...

  2. 76 FR 2405 - Notice of Proposed Information Collection: Brownfield Economic Development Initiative (BEDI)

    Science.gov (United States)

    2011-01-13

    ... Information Collection: Brownfield Economic Development Initiative (BEDI) AGENCY: Office of the Assistant... proposed use: The Brownfield Economic Development Initiative is authorized pursuant to Section 108(q... applicable: HUD 40123, Brownfields Economic Development Application; SF-LLL, Disclosure of Lobbying...

  3. Late Ebola virus relapse causing meningoencephalitis: a case report.

    Science.gov (United States)

    Jacobs, Michael; Rodger, Alison; Bell, David J; Bhagani, Sanjay; Cropley, Ian; Filipe, Ana; Gifford, Robert J; Hopkins, Susan; Hughes, Joseph; Jabeen, Farrah; Johannessen, Ingolfur; Karageorgopoulos, Drosos; Lackenby, Angie; Lester, Rebecca; Liu, Rebecca S N; MacConnachie, Alisdair; Mahungu, Tabitha; Martin, Daniel; Marshall, Neal; Mepham, Stephen; Orton, Richard; Palmarini, Massimo; Patel, Monika; Perry, Colin; Peters, S Erica; Porter, Duncan; Ritchie, David; Ritchie, Neil D; Seaton, R Andrew; Sreenu, Vattipally B; Templeton, Kate; Warren, Simon; Wilkie, Gavin S; Zambon, Maria; Gopal, Robin; Thomson, Emma C

    2016-07-30

    There are thousands of survivors of the 2014 Ebola outbreak in west Africa. Ebola virus can persist in survivors for months in immune-privileged sites; however, viral relapse causing life-threatening and potentially transmissible disease has not been described. We report a case of late relapse in a patient who had been treated for severe Ebola virus disease with high viral load (peak cycle threshold value 13.2). A 39-year-old female nurse from Scotland, who had assisted the humanitarian effort in Sierra Leone, had received intensive supportive treatment and experimental antiviral therapies, and had been discharged with undetectable Ebola virus RNA in peripheral blood. The patient was readmitted to hospital 9 months after discharge with symptoms of acute meningitis, and was found to have Ebola virus in cerebrospinal fluid (CSF). She was treated with supportive therapy and experimental antiviral drug GS-5734 (Gilead Sciences, San Francisco, Foster City, CA, USA). We monitored Ebola virus RNA in CSF and plasma, and sequenced the viral genome using an unbiased metagenomic approach. On admission, reverse transcriptase PCR identified Ebola virus RNA at a higher level in CSF (cycle threshold value 23.7) than plasma (31.3); infectious virus was only recovered from CSF. The patient developed progressive meningoencephalitis with cranial neuropathies and radiculopathy. Clinical recovery was associated with addition of high-dose corticosteroids during GS-5734 treatment. CSF Ebola virus RNA slowly declined and was undetectable following 14 days of treatment with GS-5734. Sequencing of plasma and CSF viral genome revealed only two non-coding changes compared with the original infecting virus. Our report shows that previously unanticipated, late, severe relapses of Ebola virus can occur, in this case in the CNS. This finding fundamentally redefines what is known about the natural history of Ebola virus infection. Vigilance should be maintained in the thousands of Ebola survivors

  4. Radiation dose and relapse are predictors for development of second malignant solid tumors after cancer in childhood and adolescence: A population-based case-control study in the five Nordic countries

    International Nuclear Information System (INIS)

    Svahn-Tapper, Gudrun; Garwicz, Stanislaw; Anderson, Harald

    2006-01-01

    The aim of the study was to assess the risk with radiation therapy and chemotherapy of the first cancer in childhood and adolescence for the development of a second malignant solid tumor (SMST). Also, the role of relapse of the primary tumor was studied. It is a nested case-control study within a Nordic cohort of patients less than 20 years of age at first diagnosis 1960-1987. SMSTs were diagnosed in 1960-1991. There were 196 cases and 567 controls. The risk was increased only for radiotherapy given more than five years before the development of the SMST. A significantly increased relative risk of 1.8 was found already at doses below 1 Gy. The risk increased rapidly up to a maximum of 18.3 for doses above 30 Gy. Chemotherapy alone did not increase the risk to develop an SMST. However, in combination with radiotherapy, chemotherapy showed a significant potentiating effect. Relapse was found to be an independent risk factor for development of an SMST, with a higher relative risk for females than for males

  5. Patterns of Relapse in High-Risk Neuroblastoma Patients Treated With and Without Total Body Irradiation

    International Nuclear Information System (INIS)

    Li, Richard; Polishchuk, Alexei; DuBois, Steven; Hawkins, Randall; Lee, Stephanie W.; Bagatell, Rochelle; Shusterman, Suzanne; Hill-Kayser, Christine; Al-Sayegh, Hasan; Diller, Lisa; Haas-Kogan, Daphne A.; Matthay, Katherine K.; London, Wendy B.

    2017-01-01

    Purpose: External beam radiation therapy to initial sites of disease may influence relapse patterns in high-risk neuroblastoma. However, the effect of systemic irradiation by use of total body irradiation (TBI) on anatomic patterns of relapse has not previously been investigated. Methods and Materials: We retrospectively analyzed patients receiving definitive treatment of high-risk neuroblastoma with subsequent relapse in bony metastatic sites, with a date of relapse between January 1, 1997, and December 31, 2012. Anatomic sites of disease, defined by metaiodobenzylguanidine (MIBG) avidity, were compared at diagnosis and at first relapse. The Fisher exact test was performed to compare relapse in initially involved sites between patients treated with and without TBI. Results: Seventy-four patients with a median age at diagnosis of 3.5 years (range, 0.3-15.3 years) had relapse in 227 sites of MIBG-avid metastatic disease, with a median time to relapse of 1.8 years. Of the 227 sites of first relapse, 154 sites (68%) were involved at diagnosis. When we compared relapse patterns in patients treated with and without TBI, 12 of 23 patients (52%) treated with TBI had relapse in ≥1 previously MIBG-avid site of disease whereas 40 of 51 patients (78%) treated without TBI had relapse in ≥1 previously MIBG-avid site of disease (P=.03). Conclusions: Patients treated with systemic irradiation in the form of TBI were significantly less likely to have relapse in prior sites of disease. These findings support further investigation into the role of radiopharmaceutical therapies in curative multimodality therapy.

  6. Patterns of Relapse in High-Risk Neuroblastoma Patients Treated With and Without Total Body Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Li, Richard [Harvard Medical School, Boston, Massachusetts (United States); Brigham and Women' s Hospital, Boston, Massachusetts (United States); Polishchuk, Alexei [School of Medicine, University of California San Francisco, San Francisco, California (United States); DuBois, Steven [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Hawkins, Randall [School of Medicine, University of California San Francisco, San Francisco, California (United States); Lee, Stephanie W. [Brigham and Women' s Hospital, Boston, Massachusetts (United States); Bagatell, Rochelle [Children' s Hospital of Philadelphia, Philadelphia, Pennsylvania (United States); Shusterman, Suzanne [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Hill-Kayser, Christine [Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Al-Sayegh, Hasan [Brigham and Women' s Hospital, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Diller, Lisa [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Haas-Kogan, Daphne A. [Harvard Medical School, Boston, Massachusetts (United States); Brigham and Women' s Hospital, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); Matthay, Katherine K. [School of Medicine, University of California San Francisco, San Francisco, California (United States); London, Wendy B. [Harvard Medical School, Boston, Massachusetts (United States); Dana-Farber/Boston Children' s Cancer and Blood Disorders Center, Boston, Massachusetts (United States); and others

    2017-02-01

    Purpose: External beam radiation therapy to initial sites of disease may influence relapse patterns in high-risk neuroblastoma. However, the effect of systemic irradiation by use of total body irradiation (TBI) on anatomic patterns of relapse has not previously been investigated. Methods and Materials: We retrospectively analyzed patients receiving definitive treatment of high-risk neuroblastoma with subsequent relapse in bony metastatic sites, with a date of relapse between January 1, 1997, and December 31, 2012. Anatomic sites of disease, defined by metaiodobenzylguanidine (MIBG) avidity, were compared at diagnosis and at first relapse. The Fisher exact test was performed to compare relapse in initially involved sites between patients treated with and without TBI. Results: Seventy-four patients with a median age at diagnosis of 3.5 years (range, 0.3-15.3 years) had relapse in 227 sites of MIBG-avid metastatic disease, with a median time to relapse of 1.8 years. Of the 227 sites of first relapse, 154 sites (68%) were involved at diagnosis. When we compared relapse patterns in patients treated with and without TBI, 12 of 23 patients (52%) treated with TBI had relapse in ≥1 previously MIBG-avid site of disease whereas 40 of 51 patients (78%) treated without TBI had relapse in ≥1 previously MIBG-avid site of disease (P=.03). Conclusions: Patients treated with systemic irradiation in the form of TBI were significantly less likely to have relapse in prior sites of disease. These findings support further investigation into the role of radiopharmaceutical therapies in curative multimodality therapy.

  7. Initial Development of an Electronic Testis Rigidity Tester

    Directory of Open Access Journals (Sweden)

    Petros Mirilas

    2011-01-01

    Full Text Available We aimed to develop our previously presented mechanical device, the Testis Rigidity Tester (TRT, into an electronic system (Electronic Testis Rigidity Tester, ETRT by applying tactile imaging, which has been used successfully with other solid organs. A measuring device, located at the front end of the ETRT incorporates a tactile sensor comprising an array of microsensors. By application of a predetermined deformation of 2 mm, increased pressure alters linearly the resistance of each microsensor, producing changes of voltage. These signals were amplified, filtered, and digitized, and then processed by an electronic collector system, which presented them as a color-filled contour plot of the area of the testis coming into contact with the sensor. Testis models of different rigidity served for initial evaluation of ETRT; their evacuated central spaces contained different, increasing glue masses. An independent method of rigidity measurement, using an electric weight scale and a micrometer, showed that the more the glue injected, the greater the force needed for a 2-mm deformation. In a preliminary test, a single sensor connected to a multimeter showed similar force measurement for the same deformation in these phantoms. For each of the testis models compressed in the same manner, the ETRT system offered a map of pressures, represented by a color scale within the contour plot of the contact area with the sensor. ETRT found certain differences in rigidity between models that had escaped detection by a blind observer. ETRT is easy to use and provides a color-coded “insight“ of the testis internal structure. After experimental testing, it could be valuable in intraoperative evaluation of testes, so that the surgeon can decide about orchectomy or orcheopexy.

  8. Engaging Parents Who Quit Smoking in Antismoking Socialization of Children: A Novel Approach to Relapse Prevention

    Science.gov (United States)

    Hayes, Kim A.; Dickinson, Denise M.

    2016-01-01

    Abstract Introduction: Data from a randomized controlled trial designed primarily to test the effect of an antismoking socialization parenting program on child initiation of smoking were used to test the subsidiary hypothesis that providing antismoking socialization to children would lower the odds of relapse within a sub-sample of parents who had recently quit smoking. Methods: Over 13 months, 11 state Quitlines provided contact information for callers who were parents of 8- to 10-year-old children. Of 1604 parents enrolled in the trial, 689 (344 treatment; 345 control) had quit smoking cigarettes for at least 24 hours after calling a Quitline. Their data were used to test for group differences in 30-day abstinence measured using telephone interviews conducted 7 and 12 months post-baseline. Analyses of parents with complete follow-up data and intent-to-treat analyses incorporating parents lost to follow-up are presented. Results: Among 465 parents with complete follow-up data, treatment group parents had twice the odds of being abstinent 12 months post-baseline (adjusted OR = 2.01; P = .001) relative to controls. Intent-to-treat analysis with all 689 parents, in which those lost to follow-up were coded as having relapsed, showed a smaller though significant treatment effect on 30-day abstinence at 12 months (adjusted OR = 1.58; P = .017). Conclusions: This study is the first to observe that engaging parents who have quit smoking in antismoking socialization of children can lower their odds of relapse. Additional research is needed to replicate this finding and to identify the psychological mechanisms underlying the observed effect. Implications: There is a clear the need for research to develop new relapse prevention strategies. This study is the first to observe that engaging parents who have quit smoking in antismoking socialization of children can lower their odds of relapse. PMID:26416824

  9. Center Planning and Development: Multi-User Spaceport Initiatives

    Science.gov (United States)

    Kennedy, Christopher John

    2015-01-01

    The Vehicle Assembly building at NASAs Kennedy Space Center has been used since 1966 to vertically assemble every launch vehicle, since the Apollo Program, launched from Launch Complex 39 (LC-39). After the cancellation of the Constellation Program in 2010 and the retirement of the Space Shuttle Program in 2011, the VAB faced an uncertain future. As the Space Launch System (SLS) gained a foothold as the future of American spaceflight to deep space, NASA was only using a portion of the VABs initial potential. With three high bays connected to the Crawler Way transportation system, the potential exists for up to three rockets to be simultaneously processed for launch. The Kennedy Space Center (KSC) Master plan, supported by the Center Planning and Development (CPD) Directorate, is guiding Kennedy toward a 21st century multi-user spaceport. This concept will maintain Kennedy as the United States premier gateway to space and provide multi-user operations through partnerships with the commercial aerospace industry. Commercial aerospace companies, now tasked with transporting cargo and, in the future, astronauts to the International Space Station (ISS) via the Commercial Resupply Service (CRS) and Commercial Crew Program (CCP), are a rapidly growing industry with increasing capabilities to make launch operations more economical for both private companies and the government. Commercial operations to Low Earth Orbit allow the government to focus on travel to farther destinations through the SLS Program. With LC-39B designated as a multi-use launch pad, companies seeking to use it will require an integration facility to assemble, integrate, and test their launch vehicle. An Announcement for Proposals (AFP) was released in June, beginning the process of finding a non-NASA user for High Bay 2 (HB2) and the Mobile Launcher Platforms (MLPs). An Industry Day, a business meeting and tour for interested companies and organizations, was also arranged to identify and answer any

  10. Novel therapeutic options for relapsed hairy cell leukemia.

    Science.gov (United States)

    Jain, Preetesh; Polliack, Aaron; Ravandi, Farhad

    2015-01-01

    The majority of patients with hairy cell leukemia (HCL) achieve a response to therapy with cladribine or pentostatin with or without rituximab. However, late relapses can occur. Treatment of relapsed HCL can be difficult due to a poor tolerance to chemotherapy, increased risk of infections and decreased responsiveness to chemotherapy. The identification of BRAFV600E mutations and the role of aberrant MEK kinase and Bruton's tyrosine kinase (BTK) pathways in the pathogenesis of HCL have helped to develop novel targeted therapies for these patients. Currently, the most promising therapeutic strategies for relapsed or refractory HCL include recombinant immunoconjugates targeting CD22 (e.g. moxetumomab pasudotox), BRAF inhibitors such as vemurafenib and B cell receptor signaling kinase inhibitors such as ibrutinib. Furthermore, the VH4-34 molecular variant of classic HCL has been identified to be less responsive to chemotherapy. Herein, we review the results of the ongoing clinical trials and potential future therapies for relapsed/refractory HCL.

  11. Children Develop Initial Orthographic Knowledge during Storybook Reading

    Science.gov (United States)

    Apel, Kenn; Brimo, Danielle; Wilson-Fowler, Elizabeth B.; Vorstius, Christian; Radach, Ralph

    2013-01-01

    We examined whether young children acquire orthographic knowledge during structured adult-led storybook reading even though minimal viewing time is devoted to print. Sixty-two kindergarten children were read 12 storybook "chapters" while their eye movements were tracked. Results indicated that the children quickly acquired initial mental…

  12. Developing Cooperative Learning in Initial Teacher Education: Indicators for Implementation

    Science.gov (United States)

    Jolliffe, Wendy; Snaith, Jessica

    2017-01-01

    This paper examines the impact of supporting pre-service teachers to use cooperative learning in one initial teacher education institution in England. In a context where the government requires all teacher education to be "school-led" and where school partners do not commonly use cooperative learning (Baines, Rubie-Davies, and Blatchford…

  13. Application of Neurolinguistic Programming for Treatment and Relapse Prevention of Addictive Behaviors.

    Science.gov (United States)

    Sandhu, Daya Singh

    The dilemma of relapse exists for a number of addictive behaviors, and mental health authorities agree that keeping addictive behaviors off permanently is much more difficult than treating the behaviors initially. Several relapse prevention models have been posited and environmental, physiological, behavioral, cognitive, and affective factors have…

  14. High-dose therapy and autologous bone marrow transplantation for Hodgkin's disease patients with relapses potentially treatable by radical radiation therapy

    International Nuclear Information System (INIS)

    Pezner, Richard D.; Nademanee, Auayporn; Forman, Stephen J.

    1995-01-01

    Purpose: A retrospective review evaluated the results of autologous bone marrow transplantation (A-BMT) for patients with relapsed Hodgkin's disease (HD) who were potentially treatable by radical radiation therapy (RRT). Methods and Materials: Evaluated patient cases met the following criteria: initial treatment with chemotherapy (with or without involved field radiation therapy 20 Gy to spinal cord); HD at time of salvage therapy limited to lymph nodes, Waldeyer's ring, liver, spleen, direct extension sites, and/or one lung. Results: There were 23 A-BMT patients treated between 1986 and 1991 who fulfilled the criteria. Three (13%) patients died from treatment-related complications and eight (35%) developed nonfatal Grade 3-4 complications. The 3-year actuarial disease-free survival rate was 61%. The 3-year disease-free survival rate was 55% for the nine patients with at least one prior disease-free interval (DFI) > 12 months, 67% for nine patients with DFI 0.10). These results are comparable to retrospective studies of RRT results in selected relapsed HD patients. Conclusions: Long-term disease-free survival is frequently possible with either A-BMT or RRT appropriately selected relapsed HD patients. In considering treatment options, important prognostic factors include initial stage of disease, number of prior relapses, DFI, and extent of relapsed disease

  15. Developing National Capacity to Initiate Nuclear Power Programme

    International Nuclear Information System (INIS)

    Ndontchueng, M.M.

    2014-01-01

    Conclusion: ⇒ Nuclear power is needed for Developing Countries in the long term development strategy; ⇒ Developing Countries are lack of man power for both the NPP projects and the long term nuclear power program; ⇒ A long term HRD program (strategy) is needed to be established, in cooperation with Developed countries; ⇒ Education and training abroad is essential to the technology transfer; ⇒ Establishment of adequate infrastructure supporting HRD (nuclear engineering faculties, research groups, technical support centers) is indispensible for Developing Countries

  16. Depression relapse and ethological measures

    NARCIS (Netherlands)

    Hale, WWH; Jansen, JHC; Bouhuys, AL; vandenHoofdakker, RH

    1997-01-01

    Within the framework of interactional theories on depression, the question is raised whether depression relapse can be predicted by observable behavior of remitted patients and their interviewer during an interaction (i.e. discharge interview). Thirty-four patients were interviewed at hospital

  17. Neurocognitive Predictors of Drug Relapse

    NARCIS (Netherlands)

    R. Marhe (Reshmi)

    2013-01-01

    textabstractWorldwide, about 35 million people, that is 0.8% of the world’s adult population, use heroin and/or cocaine and more than 10-13% of these drug users are or will become drug dependent (UNODC, World Drug Report, 2012). Drug dependency is characterized as a chronic relapsing disorder

  18. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Become an MS Activist Take Action Current Advocacy Issues Advocacy Results Advocacy News d Raise Awareness d ... MS are more likely to experience gradually worsening problems with walking and mobility, along with whatever other symptoms they may have. Diagnosing relapsing-remitting MS (RRMS) Learn More Learn More ... Room MS Prevalence ...

  19. A successful local economic development-urban renewal initiative ...

    African Journals Online (AJOL)

    Despite the urgent need for local economic development in South Africa, Local Economic Development (LED) as area of professional endeavour/activity has largely failed to live up to this need. In this article, an alternative approach to local economic development, which involved a 'bottom-up' approach to urban renewal is ...

  20. The neuropharmacology of relapse to food seeking: methodology, main findings, and comparison with relapse to drug seeking.

    Science.gov (United States)

    Nair, Sunila G; Adams-Deutsch, Tristan; Epstein, David H; Shaham, Yavin

    2009-09-01

    Relapse to old, unhealthy eating habits is a major problem in human dietary treatments. The mechanisms underlying this relapse are unknown. Surprisingly, until recently this clinical problem has not been systematically studied in animal models. Here, we review results from recent studies in which a reinstatement model (commonly used to study relapse to abused drugs) was employed to characterize the effect of pharmacological agents on relapse to food seeking induced by either food priming (non-contingent exposure to small amounts of food), cues previously associated with food, or injections of the pharmacological stressor yohimbine. We also address methodological issues related to the use of the reinstatement model to study relapse to food seeking, similarities and differences in mechanisms underlying reinstatement of food seeking versus drug seeking, and the degree to which the reinstatement procedure provides a suitable model for studying relapse in humans. We conclude by discussing implications for medication development and future research. We offer three tentative conclusions: (1)The neuronal mechanisms of food-priming- and cue-induced reinstatement are likely different from those of reinstatement induced by the pharmacological stressor yohimbine. (2)The neuronal mechanisms of reinstatement of food seeking are possibly different from those of ongoing food-reinforced operant responding. (3)The neuronal mechanisms underlying reinstatement of food seeking overlap to some degree with those of reinstatement of drug seeking.

  1. The Community Development Process: The Rediscovery of Local Initiative.

    Science.gov (United States)

    Biddle, William W.; Biddle, Loureide J.

    The development process in two communities, a mining county in rural Appalachia and a deteriorating neighborhood in a northern industrial city, is presented in case-study form. Concepts and commonly used terms are defined; a process of development is identified that can be used in groups small enough to permit attention to the growth of persons.…

  2. Kidney organ donation: developing family practice initiatives to reverse inertia

    Science.gov (United States)

    2010-01-01

    Background Kidney transplantation is associated with greater long term survival rates and improved quality of life compared with dialysis. Continuous growth in the number of patients with kidney failure has not been matched by an increase in the availability of kidneys for transplantation. This leads to long waiting lists, higher treatment costs and negative health outcomes. Discussion Misunderstandings, public uncertainty and issues of trust in the medical system, that limit willingness to be registered as a potential donor, could be addressed by community dissemination of information and new family practice initiatives that respond to individuals' personal beliefs and concerns regarding organ donation and transplantation. Summary Tackling both personal and public inertia on organ donation is important for any community oriented kidney donation campaign. PMID:20478042

  3. [Development and validation of an instrument for initial nursing assessment].

    Science.gov (United States)

    Fernández-Sola, Cayetano; Granero-Molina, José; Mollinedo-Mallea, Judith; de Gonzales, María Hilda Peredo; Aguilera-Manrique, Gabriel; Ponce, Mara Luna

    2012-12-01

    The objective of this study, conducted in Bolivia from April to July of 2008, is the design and validation of an initial nursing assessment instrument to be used in clinical and educational environments in Santa Cruz (Bolivia). Twelve Bolivian nurses participated; both document analysis as well as consensus techniques were used to determine the categories and criteria to be assessed. Categories included in the nursing assessment instrument are a physical assessment and the eleven Gordon's Functional Health Patterns. The nursing assessment instrument stands out as being concise, easy to complete and utilizing a nursing approach. It does not include items for advanced nursing assessment. However, it incorporates items regarding lifestyle and the patient's autonomy. The nursing assessment instrument contributes to improving the quality of clinical records, supports the nursing diagnosis and implementation of the nursing process, promotes the nurse's role and helps to standardize practice.

  4. Development and Initial Psychometric Assessment of the Plant Attitude Questionnaire

    Science.gov (United States)

    Fančovičová, Jana; Prokop, Pavol

    2010-10-01

    Plants are integral parts of ecosystems which determine life on Earth. People's attitudes toward them are however, largely overlooked. Here we present initial psychometric assessment of self-constructed Plant Attitude Scale (PAS) that was administered to a sample of 310 Slovakian students living in rural areas aged 10-15 years. The final version of PAS consists from 29 Likert-scale items that were loaded to four distinct dimensions (Interest, Importance, Urban trees and Utilization). Mean scores revealed that Slovakian students lack positive attitudes toward plants and that gender had no effect on their mean attitude scores. Living in a family with a garden was associated with a more positive attitude toward plants. Further correlative research on diverse samples containing urban children and experimental research examining the impact of gardening in schools on student attitudes toward plants is required.

  5. NAIRAS aircraft radiation model development, dose climatology, and initial validation

    Science.gov (United States)

    Mertens, Christopher J.; Meier, Matthias M.; Brown, Steven; Norman, Ryan B.; Xu, Xiaojing

    2013-10-01

    The Nowcast of Atmospheric Ionizing Radiation for Aviation Safety (NAIRAS) is a real-time, global, physics-based model used to assess radiation exposure to commercial aircrews and passengers. The model is a free-running physics-based model in the sense that there are no adjustment factors applied to nudge the model into agreement with measurements. The model predicts dosimetric quantities in the atmosphere from both galactic cosmic rays (GCR) and solar energetic particles, including the response of the geomagnetic field to interplanetary dynamical processes and its subsequent influence on atmospheric dose. The focus of this paper is on atmospheric GCR exposure during geomagnetically quiet conditions, with three main objectives. First, provide detailed descriptions of the NAIRAS GCR transport and dosimetry methodologies. Second, present a climatology of effective dose and ambient dose equivalent rates at typical commercial airline altitudes representative of solar cycle maximum and solar cycle minimum conditions and spanning the full range of geomagnetic cutoff rigidities. Third, conduct an initial validation of the NAIRAS model by comparing predictions of ambient dose equivalent rates with tabulated reference measurement data and recent aircraft radiation measurements taken in 2008 during the minimum between solar cycle 23 and solar cycle 24. By applying the criterion of the International Commission on Radiation Units and Measurements (ICRU) on acceptable levels of aircraft radiation dose uncertainty for ambient dose equivalent greater than or equal to an annual dose of 1 mSv, the NAIRAS model is within 25% of the measured data, which fall within the ICRU acceptable uncertainty limit of 30%. The NAIRAS model predictions of ambient dose equivalent rate are generally within 50% of the measured data for any single-point comparison. The largest differences occur at low latitudes and high cutoffs, where the radiation dose level is low. Nevertheless, analysis suggests

  6. Foresight studies and reform initiatives in construction: Lessons for developing countries

    CSIR Research Space (South Africa)

    Van Wyk, Llewellyn V

    2006-01-01

    Full Text Available This paper analyses construction foresight studies and construction reform initiatives with a view to identifying lessons for developing countries. It notes the number of construction reform initiatives over the last 60 years, mostly...

  7. NAIRAS aircraft radiation model development, dose climatology, and initial validation.

    Science.gov (United States)

    Mertens, Christopher J; Meier, Matthias M; Brown, Steven; Norman, Ryan B; Xu, Xiaojing

    2013-10-01

    [1] The Nowcast of Atmospheric Ionizing Radiation for Aviation Safety (NAIRAS) is a real-time, global, physics-based model used to assess radiation exposure to commercial aircrews and passengers. The model is a free-running physics-based model in the sense that there are no adjustment factors applied to nudge the model into agreement with measurements. The model predicts dosimetric quantities in the atmosphere from both galactic cosmic rays (GCR) and solar energetic particles, including the response of the geomagnetic field to interplanetary dynamical processes and its subsequent influence on atmospheric dose. The focus of this paper is on atmospheric GCR exposure during geomagnetically quiet conditions, with three main objectives. First, provide detailed descriptions of the NAIRAS GCR transport and dosimetry methodologies. Second, present a climatology of effective dose and ambient dose equivalent rates at typical commercial airline altitudes representative of solar cycle maximum and solar cycle minimum conditions and spanning the full range of geomagnetic cutoff rigidities. Third, conduct an initial validation of the NAIRAS model by comparing predictions of ambient dose equivalent rates with tabulated reference measurement data and recent aircraft radiation measurements taken in 2008 during the minimum between solar cycle 23 and solar cycle 24. By applying the criterion of the International Commission on Radiation Units and Measurements (ICRU) on acceptable levels of aircraft radiation dose uncertainty for ambient dose equivalent greater than or equal to an annual dose of 1 mSv, the NAIRAS model is within 25% of the measured data, which fall within the ICRU acceptable uncertainty limit of 30%. The NAIRAS model predictions of ambient dose equivalent rate are generally within 50% of the measured data for any single-point comparison. The largest differences occur at low latitudes and high cutoffs, where the radiation dose level is low. Nevertheless, analysis

  8. 78 FR 71635 - 60-Day Notice of Proposed Information Collection: Appalachia Economic Development Initiative and...

    Science.gov (United States)

    2013-11-29

    ... Information Collection: Appalachia Economic Development Initiative and Semi-Annual Reporting AGENCY: Office of... of Rural Housing & Economic Development, Department of Housing and Urban Development, 451 7th Street... application for the Appalachia Economic Development Initiative grant process. Information is required to rate...

  9. Proven Innovations and New Initiatives in Ground System Development

    Science.gov (United States)

    Gunn, Jody M.

    2006-01-01

    The state-of-the-practice for engineering and development of Ground Systems has evolved significantly over the past half decade. Missions that challenge ground system developers with significantly reduced budgets in spite of requirements for greater and previously unimagined functionality are now the norm. Making the right trades early in the mission lifecycle is one of the key factors to minimizing ground system costs. The Mission Operations Strategic Leadership Team at the Jet Propulsion Laboratory has spent the last year collecting and working through successes and failures in ground systems for application to future missions.

  10. University's Multi-Scale Initiatives for Redefining City Development

    Science.gov (United States)

    Ratajczyk, Natalia; Wagner, Iwona; Wolanska-Kaminska, Agnieszka; Jurczak, Tomasz; Zalewski, Maciej

    2017-01-01

    Purpose: The purpose of this paper is to present the varied roles played by the University of Lódz (UL) in maintaining and restoring the natural capital of a city as a driver for sustainable city development. The higher education institution can be perceived as visionary, originator and executor of natural capital projects.…

  11. Development and Initial Psychometrics of Counseling Supervisor's Behavior Questionnaire

    Science.gov (United States)

    Lee, Ahram; Park, Eun Hye; Byeon, Eunji; Lee, Sang Min

    2016-01-01

    This study describes the development and psychometric properties of the Counseling Supervisor's Behavior Questionnaire, designed to assess the specific behaviors of supervisors, which can be observed by supervisees during supervision sessions. Factor structure, construct and concurrent validity, and internal consistency reliability of the…

  12. New initiative to further global sustainable development goals in ...

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

    2016-03-17

    Mar 17, 2016 ... Representatives from some 60 think tanks met in November 2015 in Geneva to discuss how to further global objectives in health. ... Read the first submission, Accelerating achievement of the sustainable development goals, co-authored by the Graduate Institute, IDRC, the Harvard School of Public Health, ...

  13. The Juvenile Addiction Risk Rating: Development and Initial Psychometrics

    Science.gov (United States)

    Powell, Michael; Newgent, Rebecca A.

    2016-01-01

    This article describes the development and psychometrics of the Juvenile Addiction Risk Rating. The Juvenile Addiction Risk Rating is a brief screening of addiction potential based on 10 risk factors predictive of youth alcohol and drug-related problems that assists examiners in more accurate treatment planning when self-report information is…

  14. Initial Public Offering Market: Ways of Development in Ukraine

    Directory of Open Access Journals (Sweden)

    Gladchuk Kseniia Nikolaevna

    2013-10-01

    Full Text Available The article reveals preconditions for Ukrainian IPO market activization, as well as factors restraining its development at present. The history of Ukrainian IPOs on foreign stock exchanges was analyzed. As a result, key trends dominating the IPO market of Ukrainian companies abroad were specified. Practical guidelines of Ukrainian IPO market activization and the structural model of its functioning were suggested.

  15. Women's Participation in Development Initiatives and its Impact on ...

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

    In Afghanistan, as in other parts of the world, participation in local politics, community organizing and development projects is seen as key to women's empowerment, both as individuals and as a group. This project will ... IDRC's Board of Governors congratulates Jean Lebel on his appointment as President and CEO.

  16. The Pediatric Obesity Initiative: development, implementation, and evaluation.

    Science.gov (United States)

    Sample, Denise A; Carroll, Heather L; Barksdale, Debra J; Jessup, Ann

    2013-09-01

    Pediatric obesity rates have nearly tripled over the past three decades contributing to increased morbidity and mortality in the United States and around the world. Pediatric obesity is most prevalent in developed countries and affects all races, ethnicities, cultures, and age groups. To combat this epidemic locally, a team of dedicated providers developed a comprehensive evidenced-based toolkit and training program for clinical practices providing primary care services to children in a North Carolina county. The toolkit and training program were developed using the most current treatment guidelines for pediatric obesity and included resources developed by Healthy Carolinians. One unique feature of the training was a demonstration of motivational interviewing with additional resources included in the toolkit. Staff and providers in three pediatric practices and the local Health Department received the training. In a 3 months follow-up survey after the training, the providers indicated that the toolkit and training program were useful but that they still did not consistently use the guidelines or tools. Ensuring the use of available guidelines and resources by providers remains a challenge. Further study is needed on how to improve implementation of guidelines in primary care settings. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

  17. Mapping Civil Society Initiatives toward the Development and ...

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

    In addition to the mapping exercise, the project will result in an analytical paper on the nature, scope and scale of work being carried out, and an annotated directory of CSOs working on development issues with the Muslim community of India. The directory will be published and made available to the general public and ...

  18. "Initiate-build-operate-transfer"--a strategy for establishing sustainable telemedicine programs in developing countries: initial lessons from the balkans.

    Science.gov (United States)

    Latifi, Rifat; Merrell, Ronald C; Doarn, Charles R; Hadeed, George J; Bekteshi, Flamur; Lecaj, Ismet; Boucha, Kathe; Hajdari, Fatmir; Hoxha, Astrit; Koshi, Dashurije; de Leonni Stanonik, Mateja; Berisha, Blerim; Novoberdaliu, Kadri; Imeri, Arben; Weinstein, Ronald S

    2009-12-01

    Establishing sustainable telemedicine has become a goal of many developing countries around the world. Yet, despite initiatives from a select few individuals and on occasion from various governments, often these initiatives never mature to become sustainable programs. The introduction of telemedicine and e-learning in Kosova has been a pivotal step in advancing the quality and availability of medical services in a region whose infrastructure and resources have been decimated by wars, neglect, lack of funding, and poor management. The concept and establishment of the International Virtual e-Hospital (IVeH) has significantly impacted telemedicine and e-health services in the Balkans. The success of the IVeH in Kosova has led to the development of similar programs in other Balkan countries and other developing countries in the hope of modernizing and improving their healthcare infrastructure. A comprehensive, four-pronged strategy, "Initiate-Build-Operate-Transfer" (IBOT), may be a useful approach in establishing telemedicine and e-health educational services in developing countries. The development strategy, IBOT, used by the IVeH to establish and develop telemedicine programs, was discussed. IBOT includes assessment of healthcare needs of each country, the development of a curriculum and education program, the establishment of a nationwide telemedicine network, and the integration of the telemedicine program into the healthcare infrastructure. The endpoint is the transfer of a sustainable telehealth program to the nation involved. By applying IBOT, a sustainable telemedicine program of Kosova has been established as an effective prototype for telemedicine in the Balkans. Once fully matured, the program will be transitioned to the national Ministry of Health, which ensures the sustainability and ownership of the program. Similar programs are being established in Albania, Macedonia, and other countries around the world. The IBOT model has been effective in creating

  19. Supplier Value of Customer-Initiated Product Development

    DEFF Research Database (Denmark)

    Sommer, Anita Friis; Dukovska-Popovska, Iskra; Steger-Jensen, Kenn

    2013-01-01

    Increased market demand and shortened product life cycles generate industrial customer requests for collaborative product development. Manufacture-to-stock suppliers struggle to manage the request process to obtain profitability. The purpose of this paper is to investigate if request management...... is profitable for suppliers, and to examine possible relations between profitability of requests and the requesting customer. Through a case study, request management is identified as a profitable process due to long-term accumulated profit from developed products. Request profitability is not identified...... as related to profitability or turnover of existing customers, and thus profitability of requests cannot be predicted based on these customer data. Results from a coupled interview study indicate that request management has a large potential for future exploitation, and an outline of the supplier value...

  20. Development and Initial Testing of the Tiltrotor Test Rig

    Science.gov (United States)

    Acree, C. W., Jr.; Sheikman, A. L.

    2018-01-01

    The NASA Tiltrotor Test Rig (TTR) is a new, large-scale proprotor test system, developed jointly with the U.S. Army and Air Force, to develop a new, large-scale proprotor test system for the National Full-Scale Aerodynamics Complex (NFAC). The TTR is designed to test advanced proprotors up to 26 feet in diameter at speeds up to 300 knots, and even larger rotors at lower airspeeds. This combination of size and speed is unprecedented and is necessary for research into 21st-century tiltrotors and other advanced rotorcraft concepts. The TTR will provide critical data for validation of state-of-the-art design and analysis tools.

  1. Quality Initiatives in the Commercial Development of Reusable Launch Vehicles

    Science.gov (United States)

    2015-03-01

    projected that if the cost-escalation proceeds at the same trends, the budget allotted for the EELV program will consume most of the $7.06 billion...became necessary. Furthermore, with the emergence of the industrial society came freedom of choice for the consumer . Manufacturers now had to compete... Toyota Production System (TPS) developed by the Toyota Motor Company, where the goal of the system was to increase production efficiency by reducing

  2. The Cost of Relapse in Schizophrenia.

    Science.gov (United States)

    Pennington, Mark; McCrone, Paul

    2017-09-01

    Schizophrenia is a chronic and debilitating mental illness characterised by periods of relapse that require resource intensive management. Quantifying the cost of relapse is central to the evaluation of the cost effectiveness of treating schizophrenia. We aimed to undertake a comprehensive search of the available literature on the cost of relapse. We performed a search on multiple databases (MEDLINE, Embase, PsycINFO and Health Management Information Consortium) for any study reporting a cost of relapse or data from which such a cost could be calculated. Costs are reported in 2015 international dollars. We found 16 studies reporting costs associated with relapse over a defined period of time and identified a cost associated with hospitalisation for relapse in 43 studies. Eight clinical decision analyses also provided cost estimates. Studies from the US report excess costs of relapse of $6033-$32,753 (2015 Purchasing Power Parity dollars [PPP$]) over periods of 12-15 months. European studies report excess costs of $8665-$18,676 (2015 PPP$) over periods of 6-12 months. Estimates of the cost of hospitalisation for relapse are more diverse, and associated with marked differences in typical length of stay across jurisdictions. Wide ranges in the estimated cost of relapse may reflect differences in sample section and relapse definition as well as practice styles and differences in resource costs. Selection of the most appropriate cost estimate should be guided by the definition of relapse and the analysis setting.

  3. Development and initial standardization of Ayurveda child personality inventory

    Directory of Open Access Journals (Sweden)

    S P Suchitra

    2014-01-01

    Full Text Available Background: Ayurveda inventories for prakriti (constitution have been developed and validated for adults. Children, however, require different categories of quarter and questions, for example, to assess the intelligence, the questions can be related to their scholastic performances. Objective: To develop and standardize an inventory to assess the prakriti of the children, and to compare with Child Personality Questionnaire (CPQ. Materials and Methods: A 135-item  Ayurveda child personality inventory (ACPI scale was developed on the basis of translation of Sanskrit verses describing vataja (A, pittaja (B, and kaphaja prakriti (C characteristics and by taking the opinions of experts (ten Ayurveda experts and three psychologists. Study was carried out in Maxwell public school, Bangalore. The scale was administered on parents of children of the age group 6-12 years . CPQ was administered on children of the age group 8-12 years. Results: The ACPI was associated with excellent internal consistency. The Cronbach′s alpha for A, B, and C scales were 0.77, 0.55, and 0.84, respectively, and the Split-half reliability scores were 0.66.0.39 and 0.84, respectively. Factor validity coefficient scores on each items was above 0.5. Scores on vataja, pittaja and kaphaja scales were inversely correlated. Items of V, P, and K scales showed significant correlation (values ranging from 0.39 to 0.84 with subscales of CPQ, which indicates that Eastern and Western psychology concept have good correspondence. Conclusions: The prakrti of the children can be measured consistently by this instrument. Scores on V and P scale showed good correlation with the anxiety primary scale of CPQ.

  4. Development and initial standardization of Ayurveda child personality inventory.

    Science.gov (United States)

    Suchitra, S P; Jagan, Arati; Nagendra, H R

    2014-01-01

    Ayurveda inventories for prakriti (constitution) have been developed and validated for adults. Children, however, require different categories of quarter and questions, for example, to assess the intelligence, the questions can be related to their scholastic performances. To develop and standardize an inventory to assess the prakriti of the children, and to compare with Child Personality Questionnaire (CPQ). A 135-item Ayurveda child personality inventory (ACPI) scale was developed on the basis of translation of Sanskrit verses describing vataja (A), pittaja (B), and kaphaja prakriti (C) characteristics and by taking the opinions of experts (ten Ayurveda experts and three psychologists). Study was carried out in Maxwell public school, Bangalore. The scale was administered on parents of children of the age group 6-12 years. CPQ was administered on children of the age group 8-12 years. The ACPI was associated with excellent internal consistency. The Cronbach's alpha for A, B, and C scales were 0.77, 0.55, and 0.84, respectively, and the Split-half reliability scores were 0.66.0.39 and 0.84, respectively. Factor validity coefficient scores on each items was above 0.5. Scores on vataja, pittaja and kaphaja scales were inversely correlated. Items of V, P, and K scales showed significant correlation (values ranging from 0.39 to 0.84) with subscales of CPQ, which indicates that Eastern and Western psychology concept have good correspondence. The prakrti of the children can be measured consistently by this instrument. Scores on V and P scale showed good correlation with the anxiety primary scale of CPQ.

  5. Orifice jet brazing process development, qualification, and initial application

    International Nuclear Information System (INIS)

    1971-05-01

    Experiments were carried out to develop acceptable procedures for brazing molybdenum alloy orifices to fuel element channel inlets of the NERVA R-1 reactor core. Results achieved with various procedures are described, and qualification tests of the selected process are documented. The recommended procedure includes preplacing of Au-Ni-Cr alloy washers and induction heating to 1600 0 F, holding two minutes, heating further to 2400 0 F, holding one minute, and allowing to cool. Inert atmosphere is used, and fixturing maintains proper positioning of the orifices. Leak testing of the joints has demonstrated reproducibly satisfactory sealing. Repair brazing is feasible if needed. (auth)

  6. The Initial Development of Object Knowledge by a Learning Robot.

    Science.gov (United States)

    Modayil, Joseph; Kuipers, Benjamin

    2008-11-30

    We describe how a robot can develop knowledge of the objects in its environment directly from unsupervised sensorimotor experience. The object knowledge consists of multiple integrated representations: trackers that form spatio-temporal clusters of sensory experience, percepts that represent properties for the tracked objects, classes that support efficient generalization from past experience, and actions that reliably change object percepts. We evaluate how well this intrinsically acquired object knowledge can be used to solve externally specified tasks including object recognition and achieving goals that require both planning and continuous control.

  7. Initial Development of a Quadcopter Simulation Environment for Auralization

    Science.gov (United States)

    Christian, Andrew; Lawrence, Joseph

    2016-01-01

    This paper describes a recently created computer simulation of quadcopter flight dynamics for the NASA DELIVER project. The goal of this effort is to produce a simulation that includes a number of physical effects that are not usually found in other dynamics simulations (e.g., those used for flight controller development). These effects will be shown to have a significant impact on the fidelity of auralizations - entirely synthetic time-domain predictions of sound - based on this simulation when compared to a recording. High-fidelity auralizations are an important precursor to human subject tests that seek to understand the impact of vehicle configurations on noise and annoyance.

  8. Bringing the beneficiary closer: Explanations for volunteering time in Dutch private development initiatives

    NARCIS (Netherlands)

    Kinsbergen, S.; Tolsma, J.; Ruiter, S.

    2013-01-01

    In the Netherlands, charitable behavior for international development purposes is subject to important changes. Whereas established development organizations suffer from a declining support base, private development initiatives (PDIs) that execute concrete, small-scale projects within direct

  9. Prevention of relapsing backache

    Directory of Open Access Journals (Sweden)

    Raspe, Heiner

    2006-05-01

    Full Text Available Background: The condition of non-specific back pain is characterized by high prevalence, non satisfactory therapeutic options and severe socioeconomic consequences. Therefore prevention seems an attractive option to downsize the problem. However, the construction of effective preventive measures is complicated by the obscure aetiology of the condition, the multidimensionality of risk and prognostic factors (bio psychosocial model! and the variability of its natural as well as clinical course. This led to the development of a wide variety of preventive measures: e. g. exercise programs, educational measures (including back school, ergonomic modification of the work environment, mechanical supports (e. g. back belts as well as multidisciplinary interventions. For two reasons the workplace seems to be a suitable setting for prevention. First, because a number of strong risk factors are associated with working conditions and second, because it allows addressing a large proportion of the adult population. Against this background the assessment at hand sets out to answer the following questions: What is the amount and methodological quality of the available scientific literature on the effectiveness of back pain prevention in the workplace environment? What are effective measures for the prevention of back pain and its consequences in the workplace environment and how effective are they? Is back pain prevention in the workplace environment cost-effective? Is there a need for more research? As primary outcomes for effectiveness the assessment will focus on time lost from work and the frequency and duration of episodes with back pain. The preventive measures assessed belong to the following categories: exercise programs, educational and information measures, multidimensional interventions, back belts, lifting teams and ergonomic interventions. Methods: The assessment is based on a systematic review of the published literature according to the

  10. A simple risk scoring system for prediction of relapse after inpatient alcohol treatment.

    Science.gov (United States)

    Pedersen, Mads Uffe; Hesse, Morten

    2009-01-01

    Predicting relapse after alcoholism treatment can be useful in targeting patients for aftercare services. However, a valid and practical instrument for predicting relapse risk does not exist. Based on a prospective study of alcoholism treatment, we developed the Risk of Alcoholic Relapse Scale (RARS) using items taken from the Addiction Severity Index and some basic demographic information. The RARS was cross-validated using two non-overlapping samples, and tested for its ability to predict relapse across different models of treatment. The RARS predicted relapse to drinking within 6 months after alcoholism treatment in both the original and the validation sample, and in a second validation sample it predicted admission to new treatment 3 years after treatment. The RARS can identify patients at high risk of relapse who need extra aftercare and support after treatment.

  11. Relapse Prevention: An Overview of Marlatts Cognitive- Behavioral Model

    Directory of Open Access Journals (Sweden)

    2008-11-01

    Full Text Available Relapse prevention(RPis an important component of alcoholism treatment. The RP model proposed by Marlatt and Gordon suggests that both immediate determinants (e.g.,high- risk situations, coping skills, outcome expectancies, and the abstinence violation effect and covert antecedents (e.g., lifestyle factor and urges and cravings can contribute to relapse.The RP model also incorporates numerous specific and global intervention strategies that allow therapist and client to address each step of the relapse process. Specific interventions include identifying specific high-risk situations for each client and enhancing the client's skills for coping with those situations, increasing the client's self- efficacy, eliminating myths regarding alcohol's effects, managing lapses, and restructuring the client's perceptions of the relapse process. Global strategies comprise balancing the client's lifestyle and helping him or her develop positive addictions, employing stimulus control techniques and urgemanagement techniques, and developing relapse road maps. Several studies have provided theoretical and practical support for the RP model.

  12. Perceived Perfectionism from God Scale: Development and Initial Evidence.

    Science.gov (United States)

    Wang, Kenneth T; Allen, G E Kawika; Stokes, Hannah I; Suh, Han Na

    2017-05-03

    In this study, the Perceived Perfectionism from God Scale (PPGS) was developed with Latter-day Saints (Mormons) across two samples. Sample 1 (N = 421) was used for EFA to select items for the Perceived Standards from God (5 items) and the Perceived Discrepancy from God (5 items) subscales. Sample 2 (N = 420) was used for CFA and cross-validated the 2-factor oblique model as well as a bifactor model. Perceived Standards from God scores had Cronbach alphas ranging from .73 to .78, and Perceived Discrepancy from God scores had Cronbach alphas ranging from .82 to .84. Standards from God scores were positively correlated with positive affect, whereas Discrepancy from God scores was positively correlated with negative affect, shame and guilt. Moreover, these two PPGS subscale scores added significant incremental variances in predicting associated variables over and above corresponding personal perfectionism scores.

  13. INITIAL DEVELOPMENT OF AÇAÍ PLANTS UNDER SHADE GRADATION

    Directory of Open Access Journals (Sweden)

    ELEANDRO CANDIDO DAPONT

    2016-01-01

    Full Text Available ABSTRACT In order to evaluate the effect of different levels of shading on açai (Euterpe oleracea Mart. plants development, an experiment was conducted at the nursery of Floresta, Rio Branco, AC. The experiment was arranged in a completely randomized design with six treatments and four replications of 25 plants, set as full sunlight and 18%, 35%, 50%, 70%, and 80% shading. The evaluation occurred 125 days after transplantation and the variables were stem diameter, root length, length of the aerial part, total length, dry matter of root, dry matter of aerial part, and total dry matter. With exception of root length, there was significant difference between treatments for all variables. The production of açai plants should be performed using 40% shading.

  14. Development and initial validation of an Aviation Safety Climate Scale.

    Science.gov (United States)

    Evans, Bronwyn; Glendon, A Ian; Creed, Peter A

    2007-01-01

    A need was identified for a consistent set of safety climate factors to provide a basis for aviation industry benchmarking. Six broad safety climate themes were identified from the literature and consultations with industry safety experts. Items representing each of the themes were prepared and administered to 940 Australian commercial pilots. Data from half of the sample (N=468) were used in an exploratory factor analysis that produced a 3-factor model of Management commitment and communication, Safety training and equipment, and Maintenance. A confirmatory factor analysis on the remaining half of the sample showed the 3-factor model to be an adequate fit to the data. The results of this study have produced a scale of safety climate for aviation that is both reliable and valid. This study developed a tool to assess the level of perceived safety climate, specifically of pilots, but may also, with minor modifications, be used to assess other groups' perceptions of safety climate.

  15. Development and initial evaluation of a treatment decision dashboard.

    Science.gov (United States)

    Dolan, James G; Veazie, Peter J; Russ, Ann J

    2013-04-21

    For many healthcare decisions, multiple alternatives are available with different combinations of advantages and disadvantages across several important dimensions. The complexity of current healthcare decisions thus presents a significant barrier to informed decision making, a key element of patient-centered care.Interactive decision dashboards were developed to facilitate decision making in Management, a field marked by similarly complicated choices. These dashboards utilize data visualization techniques to reduce the cognitive effort needed to evaluate decision alternatives and a non-linear flow of information that enables users to review information in a self-directed fashion. Theoretically, both of these features should facilitate informed decision making by increasing user engagement with and understanding of the decision at hand. We sought to determine if the interactive decision dashboard format can be successfully adapted to create a clinically realistic prototype patient decision aid suitable for further evaluation and refinement. We created a computerized, interactive clinical decision dashboard and performed a pilot test of its clinical feasibility and acceptability using a multi-method analysis. The dashboard summarized information about the effectiveness, risks of side effects and drug-drug interactions, out-of-pocket costs, and ease of use of nine analgesic treatment options for knee osteoarthritis. Outcome evaluations included observations of how study participants utilized the dashboard, questionnaires to assess usability, acceptability, and decisional conflict, and an open-ended qualitative analysis. The study sample consisted of 25 volunteers - 7 men and 18 women - with an average age of 51 years. The mean time spent interacting with the dashboard was 4.6 minutes. Mean evaluation scores on scales ranging from 1 (low) to 7 (high) were: mechanical ease of use 6.1, cognitive ease of use 6.2, emotional difficulty 2.7, decision-aiding effectiveness 5

  16. The Thai Business Initiative in Rural Development (TBIRD): a new dimension in rural development.

    Science.gov (United States)

    Viravaidya, M

    1990-04-01

    The Population and Community Development Association (PDA) promotes family planning (FP) throughout Thailand through a community-based approach. The Thai government actively supports rural development. In 1986, 80% of Thailand's people who lived below the poverty line were in rural areas. The poverty line in rural areas is an annual per capita income of 3823 baht, or US $153; in urban areas, it is more. Since 1984, Thailand's gross domestic product (GDP) has increased by more than 50%. Per capita GDP has risen dramatically, also, with the success of FP efforts. This economic achievement, however, has not been shared by most of the Thai population. Incomes in the agriculture sector are far below those in the nonagricultural sector. The government and the nonprofit organizations, however, do not have skills. The corporate sector does have these skills. The Thailand Business Initiative in Rural Development (TBIRD) helps companies sponsor villages and aids them in developing business skills, whereupon income levels and local living standards are improved. Companies thus help in the employment transfer from agriculture to nonagriculture. There is a "one-company-one- village" formula. Company employees have the skills needed in the villages. They are directly involved. Since 1988, PDA has been working with companies in Thailand to help villages develop business skills. In Saraburi province, PDA and Volvo Swedish Motors have been aiding villagers to grow saplings and sell them to golf course and housing developers. In Ayutthaya Province, PDA and the same company are helping the residents with needlepoint and embroidery to supply a wedding dress manufacturing operation. These programs have succeeded. PDA wants to expand the program by September 1990, to include 50 companies. It is hoped that once the companies are comfortable with their relationship to the village, they will start associations with additional villages. PDA has established the "Ten Steps to Adopt a Village."

  17. Spiritual Well-Being and Associated Factors with Relapse in Opioid Addicts.

    Science.gov (United States)

    Noormohammadi, Mohammad-Reza; Nikfarjam, Masoud; Deris, Fatemeh; Parvin, Neda

    2017-03-01

    Opioid dependence relapse is a complex and multidimensional problem, and lack of spiritual well-being is a major concern in opioid addicts. This study was conducted to determine spiritual well-being and factors associated with relapse among opioid addicts. This cross-sectional study was conducted from April 2015 to September 2015. According to purposive sampling, 312 eligible addicted patients were enrolled in the study. The patients had at least an attempt of detoxification in the past six months and referred to an outpatient detoxification clinic in Shahrekord (Southwest, Iran). They completed Paloutzian and Ellison's Spiritual Well-being Scale. A researcher-developed questionnaire consisting of demographic characteristics and 20 questions about associated factors with relapse was administered. Data were analysed by version 16.0 (SPSS Inc.,Chicago, IL) using one-way ANOVA, Pearson's correlation test, chi-square, Friedman test, and student's t-test. The most important factors associated with opioid dependence relapse consist of relation with an addict friend, unemployment, living expenses, family conflicts, and somatic pain. In the present study, 157 patients had never experienced relapse while the mean of relapse in the rest participants was (3.25±1.53) times. Furthermore, the addicted patients with relapse had significantly lower scores of spiritual well-being and its subscales compared with non-relapse patients (pspiritual well-being, family and economical, personal, and occupational factors as crucial factors in opiate addiction relapse.

  18. Relapse of Neuromyelitis Optica Spectrum Disorder Associated with Intravenous Lidocaine

    Directory of Open Access Journals (Sweden)

    Akiyuki Uzawa

    2011-01-01

    Full Text Available Lidocaine unmasks silent symptoms and eases neuropathic pain in multiple sclerosis patients; however, the effects of lidocaine in neuromyelitis optica have never been reported. We describe the case of a 59-year-old Japanese woman with neuromyelitis optica spectrum disorder who developed optic neuritis 1 day after intravenous lidocaine injection for treating allodynia. Her symptom seemed to result from a relapse of neuromyelitis optica induced by lidocaine administration, and not because of the transient effects of intravenous lidocaine administration. The possibility that lidocaine administration results in relapse of neuromyelitis optica due to its immunomodulating effects cannot be ruled out.

  19. Connecticut State University System Initiative for Nanotechnology-Related Equipment, Faculty Development and Curriculum Development

    Energy Technology Data Exchange (ETDEWEB)

    Broadbridge, Christine C. [Southern Connecticut State University

    2013-03-28

    DOE grant used for partial fulfillment of necessary laboratory equipment for course enrichment and new graduate programs in nanotechnology at the four institutions of the Connecticut State University System (CSUS). Equipment in this initial phase included variable pressure scanning electron microscope with energy dispersive x-ray spectroscopy elemental analysis capability [at Southern Connecticut State University]; power x-ray diffractometer [at Central Connecticut State University]; a spectrophotometer and spectrofluorimeter [at Eastern Connecticut State University; and a Raman Spectrometer [at Western Connecticut State University]. DOE's funding was allocated for purchase and installation of this scientific equipment and instrumentation. Subsequently, DOE funding was allocated to fund the curriculum, faculty development and travel necessary to continue development and implementation of the System's Graduate Certificate in Nanotechnology (GCNT) program and the ConnSCU Nanotechnology Center (ConnSCU-NC) at Southern Connecticut State University. All of the established outcomes have been successfully achieved. The courses and structure of the GCNT program have been determined and the program will be completely implemented in the fall of 2013. The instrumentation has been purchased, installed and has been utilized at each campus for the implementation of the nanotechnology courses, CSUS GCNT and the ConnSCU-NC. Additional outcomes for this grant include curriculum development for non-majors as well as faculty and student research.

  20. [A case of relapsing iridocyclitis in tropical malaria].

    Science.gov (United States)

    Kravchinina, V V; Dushin, N V; Beliaev, V S; Barashkov, V I; Gonchar, P A; Frolov, M A

    1997-01-01

    An African student developed bilateral relapsing iridocyclitis with increased intraocular pressure. General examinations and parasitological studies revealed tropical malaria. Etiotropic and local therapy normalized intraocular pressure and improved vision acuity of both eyes. This case should be borne in mind by general practitioners as a possibility of transportation of various tropical diseases.

  1. Professional Development: Designing Initiatives to Meet the Needs of Online Faculty

    OpenAIRE

    Marquita Elliott; Nicole Rhoades; Christina M. Jackson; B. Jean Mandernach

    2015-01-01

    The increasing prevalence of online courses mandates an examination of the similarities – and differences – in the faculty training and development needs of those teaching online. With institutions facing increasingly limited resources, there is a need to prioritize faculty development initiatives that will encourage faculty participation. An examination of interest, attendance and completion rates of faculty development initiatives targeting online faculty revealed no distinct preferences in...

  2. Ibrutinib efficacy and tolerability in patients with relapsed chronic lymphocytic leukemia following allogeneic HCT.

    Science.gov (United States)

    Ryan, Christine E; Sahaf, Bita; Logan, Aaron C; O'Brien, Susan; Byrd, John C; Hillmen, Peter; Brown, Jennifer R; Dyer, Martin J S; Mato, Anthony R; Keating, Michael J; Jaglowski, Samantha; Clow, Fong; Rezvani, Andrew R; Styles, Lori; Coutre, Steven E; Miklos, David B

    2016-12-22

    Ibrutinib, a potent and irreversible small-molecule inhibitor of both Bruton's tyrosine kinase and interleukin-2 inducible kinase (ITK), has been used to treat relapsed/refractory chronic lymphocytic leukemia (CLL) with prolongation of progression-free and overall survival. Here, we present 27 patients with relapsed CLL following allogeneic hematopoietic cell transplant (HCT) who subsequently received ibrutinib salvage therapy. Sixteen of these patients were part of multi-institutional clinical trials and achieved an overall response rate of 87.5%. An additional 11 patients were treated at Stanford University following US Food and Drug Administration approval of ibrutinib; 7 (64%) achieved a complete response, and 3 (27%) achieved a partial response. Of the 9 patients treated at Stanford who had mixed chimerism-associated CLL relapse, 4 (44%) converted to full donor chimerism following ibrutinib initiation, in association with disease response. Four of 11 (36%) patients evaluated by ClonoSeq achieved minimal residual disease negativity with CLL ibrutinib was discontinued, in 1 case even after 26 months. None of the 27 patients developed graft-versus-host-disease (GVHD) following ibrutinib initiation. We postulate that ibrutinib augments the graft-versus-leukemia (GVL) benefit through a T-cell-mediated effect, most likely due to ITK inhibition. To investigate the immune modulatory effects of ibrutinib, we completed comprehensive immune phenotype characterization of peripheral B and T cells from treated patients. Our results show that ibrutinib selectively targets pre-germinal B cells and depletes Th2 helper cells. Furthermore, these effects persisted after drug discontinuation. In total, our results provide evidence that ibrutinib effectively augments GVL without causing GVHD. © 2016 by The American Society of Hematology.

  3. Self-help initiatives and rural development in Ibesikpo community of ...

    African Journals Online (AJOL)

    This study investigates the impact of self-help initiatives on rural development in Ibesikpo community of Akwa Ibom State, Nigeria. Self help initiatives were defined in terms of provision of employment, education and health-care. A sample size of 369 rural dwellers was drawn and data were analyzed using simple regression ...

  4. Development and Psychometric Evaluation of the Personal Growth Initiative Scale-II

    Science.gov (United States)

    Robitschek, Christine; Ashton, Matthew W.; Spering, Cynthia C.; Geiger, Nathaniel; Byers, Danielle; Schotts, G. Christian; Thoen, Megan A.

    2012-01-01

    The original Personal Growth Initiative Scale (PGIS; Robitschek, 1998) was unidimensional, despite theory identifying multiple components (e.g., cognition and behavior) of personal growth initiative (PGI). The present research developed a multidimensional measure of the complex process of PGI, while retaining the brief and psychometrically sound…

  5. Hodgkin's disease: internal mammary lymph nodes relapse diagnosed by Gallium-67 scintigraphy

    International Nuclear Information System (INIS)

    Ruiz Hernandez, G.; Ampudia, J.; Castillo, F.J.; Romero, C.; Pallardo, Y.; Garcia Conde, J.; Ramos, D.

    1999-01-01

    This article presents the case of a 62-year-old man with treated Hodgkin's disease who had internal mammary lymph nodes relapse after a complete initial response. These masses were gallium avid. These findings were explained by histologically documented Hodgkin's relapse, the first such case reported in that localization without chest wall involvement. The literature on mediastinal Hodgkin's disease and diagnostic procedures are reviewed. (orig.) [de

  6. The Promises and Challenges of Ecological Momentary Assessment in Schizophrenia: Development of an Initial Experimental Protocol

    Directory of Open Access Journals (Sweden)

    Brandon A. Gaudiano

    2015-07-01

    Full Text Available Severe mental illnesses, including schizophrenia and other psychotic-spectrum disorders, are a major cause of disability worldwide. Although efficacious pharmacological and psychosocial interventions have been developed for treating patients with schizophrenia, relapse rates are high and long-term recovery remains elusive for many individuals. Furthermore, little is still known about the underlying mechanisms of these illnesses. Thus, there is an urgent need to better understand the contextual factors that contribute to psychosis so that they can be better targeted in future interventions. Ecological Momentary Assessment (EMA is a dynamic procedure that permits the measurement of variables in natural settings in real-time through the use of brief assessments delivered via mobile electronic devices (i.e., smartphones. One advantage of EMA is that it is less subject to retrospective memory biases and highly sensitive to fluctuating environmental factors. In the current article, we describe the research-to-date using EMA to better understand fluctuating symptoms and functioning in patients with schizophrenia and other psychotic disorders and potential applications to treatment. In addition, we describe a novel EMA protocol that we have been employing to study the outcomes of patients with schizophrenia following a hospital discharge. We also report the lessons we have learned thus far using EMA methods in this challenging clinical population.

  7. Visceral leishmaniasis relapse hazard is linked to reduced miltefosine exposure in patients from Eastern Africa: a population pharmacokinetic/pharmacodynamic study.

    Science.gov (United States)

    Dorlo, Thomas P C; Kip, Anke E; Younis, Brima M; Ellis, Sally J; Alves, Fabiana; Beijnen, Jos H; Njenga, Simon; Kirigi, George; Hailu, Asrat; Olobo, Joseph; Musa, Ahmed M; Balasegaram, Manica; Wasunna, Monique; Karlsson, Mats O; Khalil, Eltahir A G

    2017-11-01

    Low efficacy of miltefosine in the treatment of visceral leishmaniasis was recently observed in Eastern Africa. To describe the pharmacokinetics and establish a pharmacokinetic/pharmacodynamic relationship for miltefosine in Eastern African patients with visceral leishmaniasis, using a time-to-event approach to model relapse of disease. Miltefosine plasma concentrations from 95 patients (48 monotherapy versus 47 combination therapy) were included in the population pharmacokinetic model using non-linear mixed effects modelling. Subsequently a time-to-event model was developed to model the time of clinical relapse. Various summary pharmacokinetic parameters (various AUCs, Time > EC50, Time > EC90), normalized within each treatment arm to allow simultaneous analysis, were evaluated as relapse hazard-changing covariates. A two-compartment population model with first-order absorption fitted the miltefosine pharmacokinetic data adequately. Relative bioavailability was reduced (-74%, relative standard error 4.7%) during the first week of treatment of the monotherapy arm but only the first day of the shorter combination regimen. Time to the relapse of infection could be described using a constant baseline hazard (baseline 1.8 relapses/year, relative standard error 72.7%). Miltefosine Time > EC90 improved the model significantly when added in a maximum effect function on the baseline hazard (half maximal effect with Time > EC90 6.97 days for monotherapy). Miltefosine drug exposure was found to be decreased in Eastern African patients with visceral leishmaniasis, due to a (transient) initial lower bioavailability. Relapse hazard was inversely linked to miltefosine exposure. Significantly lower miltefosine exposure was observed in children compared with adults, further urging the need for implementation of dose adaptations for children. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

  8. Tumor relapse present in oncologic nasal repair

    International Nuclear Information System (INIS)

    Galvez Chavez, Julio Cesar; Sanchez Wals, Lenia; Monzon Fernandez, Abel Nicolas; Morales Tirado, Roxana

    2009-01-01

    Tumor relapse is one of the more fearsome complications of the oncologic course and also to obscure the life prognosis, causing the loss of many reconstructions and of exhausting the repairing surgical possibilities. The aim of this study was to determine the relapse frequency, the repercussion on the repair and the subsequent medical course of patients operated on malign nasal tumors

  9. Initial Development Work for the Cloud-Aerosol Multi-Angle Lidar

    Data.gov (United States)

    National Aeronautics and Space Administration — Initiate development of a cost-effective off-nadir cloud-aerosol lidar instrument to enable data synergy with passive sensors (imagers, polarimeters) and models...

  10. Development of a MELCOR self-initialization algorithm for boiling water reactors

    International Nuclear Information System (INIS)

    Chien, C.S.; Wang, S.J.; Cheng, S.K.

    1996-01-01

    The MELCOR code, developed by Sandia National Laboratories, is suitable for calculating source terms and simulating severe accident phenomena of nuclear power plants. Prior to simulating a severe accident transient with MELCOR, the initial steady-state conditions must be generated in advance. The current MELCOR users' manuals do not provide a self-initialization procedure; this is the reason users have to adjust the initial conditions by themselves through a trial-and-error approach. A MELCOR self-initialization algorithm for boiling water reactor plants has been developed, which eliminates the tedious trial-and-error procedures and improves the simulation accuracy. This algorithm adjusts the important plant variable such as the dome pressure, downcomer level, and core flow rate to the desired conditions automatically. It is implemented through input with control functions provided in MELCOR. The reactor power and feedwater temperature are fed as input data. The initialization work of full-power conditions of the Kuosheng nuclear power station is cited as an example. These initial conditions are generated successfully with the developed algorithm. The generated initial conditions can be stored in a restart file and used for transient analysis. The methodology in this study improves the accuracy and consistency of transient calculations. Meanwhile, the algorithm provides all MELCOR users an easy and correct method for establishing the initial conditions

  11. The Alcohol Relapse Risk Assessment: a scoring system to predict the risk of relapse to any alcohol use after liver transplant.

    Science.gov (United States)

    Rodrigue, James R; Hanto, Douglas W; Curry, Michael P

    2013-12-01

    Alcohol relapse after liver transplant heightens concern about recurrent disease, nonadherence to the immunosuppression regimen, and death. To develop a scoring system to stratify risk of alcohol relapse after liver transplant. Retrospective medical record review. All adult liver transplants performed from May 2002 to February 2011 at a single center in the United States. The incidence of return to any alcohol consumption after liver transplant. Thirty-four percent (40/118) of patients with a history of alcohol abuse/dependency relapsed to use of any alcohol after liver transplant. Nine of 25 hypothesized risk factors were predictive of alcohol relapse after liver transplant: absence of hepatocellular carcinoma, tobacco dependence, continued alcohol use after liver disease diagnosis, low motivation for alcohol treatment, poor stress management skills, no rehabilitation relationship, limited social support, lack of nonmedical behavioral consequences, and continued engagement in social activities with alcohol present. Each independent predictor was assigned an Alcohol Relapse Risk Assessment (ARRA) risk value of 1 point, and patients were classified into 1 of 4 groups by ARRA score: ARRA I = 0, ARRA II = 1 to 3, ARRA III = 4 to 6, and ARRA IV = 7 to 9. Patients in the 2 higher ARRA classifications had significantly higher rates of alcohol relapse and were more likely to return to pretransplant levels of drinking. Alcohol relapse rates are moderately high after liver transplant. The ARRA is a valid and practical tool for identifying pretransplant patients with alcohol abuse or dependency at elevated risk of any alcohol use after liver transplant.

  12. High risk of postpartum relapses in neuromyelitis optica spectrum disorder.

    Science.gov (United States)

    Klawiter, Eric C; Bove, Riley; Elsone, Liene; Alvarez, Enrique; Borisow, Nadja; Cortez, Melissa; Mateen, Farrah; Mealy, Maureen A; Sorum, Jaime; Mutch, Kerry; Tobyne, Sean M; Ruprecht, Klemens; Buckle, Guy; Levy, Michael; Wingerchuk, Dean; Paul, Friedemann; Cross, Anne H; Jacobs, Anu; Chitnis, Tanuja; Weinshenker, Brian

    2017-11-28

    To study the effect of pregnancy on the frequency of neuromyelitis optica spectrum disorder (NMOSD) relapse and evaluate rates of pregnancy-related complications in an international multicenter setting. We administered a standardized survey to 217 women with NMOSD from 7 medical centers and reviewed their medical records. We compared the annualized relapse rate (ARR) during a baseline period 2 years prior to a participant's first pregnancy to that during pregnancy and to the 9 months postpartum. We also assessed pregnancy-related complications. There were 46 informative pregnancies following symptom onset in 31 women with NMOSD. Compared to baseline (0.17), ARR was increased both during pregnancy (0.44; p = 0.035) and during the postpartum period (0.69; p = 0.009). The highest ARR occurred during the first 3 months postpartum (ARR 1.33). A total of 8 of 76 (10.5%) with onset of NMOSD prior to age 40 experienced their initial symptom during the 3 months postpartum, 2.9 times higher than expected. The postpartum period is a particularly high-risk time for initial presentation of NMOSD. In contrast to published observations in multiple sclerosis, in neuromyelitis optica, relapse rate during pregnancy was also increased, although to a lesser extent than after delivery. © 2017 American Academy of Neurology.

  13. Second auto-SCT for treatment of relapsed multiple myeloma.

    Science.gov (United States)

    Gonsalves, W I; Gertz, M A; Lacy, M Q; Dispenzieri, A; Hayman, S R; Buadi, F K; Dingli, D; Hogan, W J; Kumar, S K

    2013-04-01

    High-dose therapy and auto-SCT remain integral in the initial treatment of multiple myeloma (MM), and are increasingly being applied for management of relapsed disease. We examined the outcomes in 98 patients undergoing salvage auto-SCT (auto-SCT2) for relapsed MM after receiving an initial transplant (auto-SCT1) between 1994 and 2009. The median age at auto-SCT2 was 60 years (range: 35-74). The median time between auto-SCT1 and auto-SCT2 was 46 months (range: 10-130). Treatment-related mortality was seen in 4%. The median PFS from auto-SCT2 was 10.3 (95% confidence interval (CI): 7-14) months and the median OS from auto-SCT2 was 33 months (95% CI: 28-51). In a multivariable analysis, shorter time to progression (TTP) after auto-SCT1, not achieving a CR after auto-SCT2, higher number of treatment regimens before auto-SCT2 and a higher plasma cell labeling index at auto-SCT2 predicted for shorter PFS. However, only a shorter TTP after auto-SCT1 predicted for a shorter OS post auto-SCT2. Hence, auto-SCT2 is an effective and feasible therapeutic option for MM patients relapsing after other treatments, especially in patients who had a TTP of at least 12 months after their auto-SCT1.

  14. Multimodal Hazard Rate for Relapse in Breast Cancer: Quality of Data and Calibration of Computer Simulation

    Directory of Open Access Journals (Sweden)

    Michael Retsky

    2014-11-01

    Full Text Available Much has occurred since our 2010 report in Cancers. In the past few years we published several extensive reviews of our research so a brief review is all that will be provided here. We proposed in the earlier reports that most relapses in breast cancer occur within 5 years of surgery and seem to be associated with some unspecified manner of surgery-induced metastatic initiation. These events can be identified in relapse data and are correlated with clinical data. In the last few years an unexpected mechanism has become apparent. Retrospective analysis of relapse events by a Brussels anesthesiology group reported that a perioperative NSAID analgesic seems to reduce early relapses five-fold. We then proposed that primary surgery produces a transient period of systemic inflammation. This has now been identified by inflammatory markers in serum post mastectomy. That could explain the early relapses. It is possible that an inexpensive and non-toxic NSAID can reduce breast cancer relapses significantly. We want to take this opportunity to discuss database quality issues and our relapse hazard data in some detail. We also present a demonstration that the computer simulation can be calibrated with Adjuvant-on-line, an often used clinical tool for prognosis in breast cancer.

  15. Distinctive clinical course and pattern of relapse in adolescents with medulloblastoma

    International Nuclear Information System (INIS)

    Tabori, Uri; Sung, Lillian; Hukin, Juliette; Laperriere, Normand; Crooks, Bruce; Carret, Anne-Sophie; Silva, Mariana; Odame, Isaac; Mpofu, Chris; Strother, Douglas; Wilson, Beverly; Samson, Yvan; Bouffet, Eric

    2006-01-01

    Purpose: To report the clinical course of adolescents with medulloblastoma, with specific emphasis on prognosis and pattern of relapse. Methods and Materials: We retrospectively studied the clinical course and outcomes of children aged 10-20 years with medulloblastoma, treated at centers throughout Canada between 1986 and 2003. To better assess time to relapse, a cohort of patients aged 3-20 years at diagnosis was generated. Results: A total of 72 adolescents were analyzed. Five-year overall survival and event-free survival rates were 78.3% ± 5.4% and 68.0% ± 6.2%, respectively. Late relapses occurred at a median of 3.0 years (range, 0.3-6.8 years). In univariate analysis, conventional risk stratification and the addition of chemotherapy to craniospinal radiation did not have prognostic significance. Female patients had improved overall survival (p = 0.007). Time to relapse increased with age in a linear fashion. After relapse, patients faired poorly regardless of treatment modality. Patients who did not receive chemotherapy initially had improved progression-free survival at relapse (p 0.05). Conclusions: Our study suggests that adolescents with medulloblastoma might have a unique prognosis and pattern of relapse, dissimilar to those in younger children. They might benefit from different risk stratifications and prolonged follow-up. These issues should be addressed in future prospective trials

  16. Multiple-clone activation of hypnozoites is the leading cause of relapse in Plasmodium vivax infection.

    Directory of Open Access Journals (Sweden)

    Flávia Carolina F de Araujo

    Full Text Available BACKGROUND: Plasmodium vivax infection is characterized by a dormant hepatic stage, the hypnozoite that is activated at varying periods of time after clearance of the primary acute blood-stage, resulting in relapse. Differentiation between treatment failure and new infections requires characterization of initial infections, relapses, and clone multiplicity in vivax malaria infections. METHODOLOGY/PRINCIPAL FINDINGS: Parasite DNA obtained from primary/relapse paired blood samples of 30 patients with P. vivax infection in Brazil was analyzed using 10 molecular markers (8 microsatellites and MSP-1 blocks 2 and 10. Cloning of PCR products and genotyping was used to identify low-frequency clones of parasites. We demonstrated a high frequency of multiple-clone infections in both primary and relapse infections. Few alleles were identified per locus, but the combination of these alleles produced many haplotypes. Consequently, the majority of parasites involved in relapse showed haplotypes that were distinct from those of primary infections. Plasmodium vivax relapse was characterized by temporal variations in the predominant parasite clones. CONCLUSIONS/SIGNIFICANCE: The high rate of low frequency alleles observed in both primary and relapse infections, along with temporal variation in the predominant alleles, might be the source of reported heterologous hypnozoite activation. Our findings complicate the concept of heterologous activation, suggesting the involvement of undetermined mechanisms based on host or environmental factors in the simultaneous activation of multiple clones of hypnozoites.

  17. Efficacy of Group Cognitive–behavioral Therapy in Maintenance Treatment and Relapse Prevention for Bipolar Adolescents

    Directory of Open Access Journals (Sweden)

    Soroor Arman

    2018-01-01

    Full Text Available Background: Despite conducting wide-ranging of pharmacotherapy for bipolar adolescents, many of them are showing a deficit in functioning with high relapse rate. The aim of the current study was to develop a manual and investigate the efficacy of group cognitive–behavioral therapy (G-CBT for female bipolar adolescents. Materials and Methods: During the first qualitative phase of a mixed-methods study, a manual of G-CBT was developed. Then, 32 female bipolar adolescents aged 12–19 years old, receiving usual maintenance medications (UMM, were selected. Participants were randomized to the control (UMM and intervention group (5, 2 h weekly sessions based on G-CBT manual with UMM. The parents in intervention group participated in three parallel sessions. All participants filled the following questionnaires before 1, 3, and 6 months after the initiation of the study: Young Mania Rating Scale, Children Depression Inventory and Global Assessment of Functioning. The results were analyzed using SPSS 21 software. The concurrent qualitative phase was analyzed through thematic analysis. Results: The results showed no significant differences in all questionnaires' scores through intervention and follow-up sessions (P > 0.05. However, using cutoff point of CDI, G-CBT was effective for intervention group (relapse rate: 25% vs. 44.4%. Two themes were extracted from the second qualitative phase: emotion recognition and emotion regulation, especially in anger control. Conclusions: The results showed that the addition of G-CBT to UMM leads to decrease in the depressive scores but has no effect on manic symptoms and relapse rate.

  18. Efficacy of Group Cognitive-behavioral Therapy in Maintenance Treatment and Relapse Prevention for Bipolar Adolescents.

    Science.gov (United States)

    Arman, Soroor; Golmohammadi, Farnaz; Maracy, Mohammadreza; Molaeinezhad, Mitra

    2018-01-01

    Despite conducting wide-ranging of pharmacotherapy for bipolar adolescents, many of them are showing a deficit in functioning with high relapse rate. The aim of the current study was to develop a manual and investigate the efficacy of group cognitive-behavioral therapy (G-CBT) for female bipolar adolescents. During the first qualitative phase of a mixed-methods study, a manual of G-CBT was developed. Then, 32 female bipolar adolescents aged 12-19 years old, receiving usual maintenance medications (UMM), were selected. Participants were randomized to the control (UMM) and intervention group (5, 2 h weekly sessions based on G-CBT manual with UMM). The parents in intervention group participated in three parallel sessions. All participants filled the following questionnaires before 1, 3, and 6 months after the initiation of the study: Young Mania Rating Scale, Children Depression Inventory and Global Assessment of Functioning. The results were analyzed using SPSS 21 software. The concurrent qualitative phase was analyzed through thematic analysis. The results showed no significant differences in all questionnaires' scores through intervention and follow-up sessions ( P > 0.05). However, using cutoff point of CDI, G-CBT was effective for intervention group (relapse rate: 25% vs. 44.4%). Two themes were extracted from the second qualitative phase: emotion recognition and emotion regulation, especially in anger control. The results showed that the addition of G-CBT to UMM leads to decrease in the depressive scores but has no effect on manic symptoms and relapse rate.

  19. Professional Development: Designing Initiatives to Meet the Needs of Online Faculty

    Directory of Open Access Journals (Sweden)

    Marquita Elliott

    2015-01-01

    Full Text Available The increasing prevalence of online courses mandates an examination of the similarities – and differences – in the faculty training and development needs of those teaching online. With institutions facing increasingly limited resources, there is a need to prioritize faculty development initiatives that will encourage faculty participation. An examination of interest, attendance and completion rates of faculty development initiatives targeting online faculty revealed no distinct preferences in relation to the focus or format of programs offered. The authors recommend offering flexibility and diversity in faculty development initiatives to accommodate the disparate needs of a remote, heterogeneous faculty population; as such, a sample needs assessment is offered to help guide faculty development programming to support online teaching.

  20. Clinical factors related to schizophrenia relapse.

    Science.gov (United States)

    Porcelli, Stefano; Bianchini, Oriana; De Girolamo, Giovanni; Aguglia, Eugenio; Crea, Luciana; Serretti, Alessandro

    2016-01-01

    Relapses represent one of the main problems of schizophrenia management. This article reviews the clinical factors associated with schizophrenia relapse. A research of the last 22 years of literature data was performed. Two-hundred nineteen studies have been included. Three main groups of factors are related to relapse: factors associated with pharmacological treatment, add-on psychotherapeutic treatments and general risk factors. Overall, the absence of a maintenance therapy and treatment with first generation antipsychotics has been associated with higher risk of relapse. Further, psychotherapy add-on, particularly with cognitive behaviour therapy and psycho-education for both patients and relatives, has shown a good efficacy for reducing the relapse rate. Among general risk factors, some could be modified, such as the duration of untreated psychosis or the substance misuse, while others could not be modified as male gender or low pre-morbid level of functioning. Several classes of risk factors have been proved to be relevant in the risk of relapse. Thus, a careful assessment of the risk factors here identified should be performed in daily clinical practice in order to individualise the relapse risk for each patient and to provide a targeted treatment in high-risk subjects.

  1. Role of routine imaging in detecting recurrent lymphoma; a review of 258 patients with relapsed aggressive non-Hodgkin and Hodgkin lymphoma

    DEFF Research Database (Denmark)

    El-Galaly, Tarec Christoffer; Mylam, Karen Juul; Bøgsted, Martin

    2014-01-01

    After first-line therapy, patients with Hodgkin and aggressive non-Hodgkin lymphomas are followed closely for early signs of relapse. The current follow-up practice with frequent use of surveillance imaging is highly controversial and warrants a critical evaluation. Therefore a retrospective...... multicenter study of relapsed Hodgkin and aggressive non-Hodgkin lymphomas (nodal T-cell and diffuse large B-cell lymphomas) was conducted. All included patients had been diagnosed during the period 2002-2011 and relapsed after achieving complete remission on first-line therapy. Characteristics and outcome...... of imaging-detected relapses were compared to other relapses. A total of 258 patients with recurrent lymphoma were included in the study. Relapse investigations were initiated outside preplanned visits in 52% of the patients. Relapse detection could be attributed to patient-reported symptoms alone...

  2. Metaplastic carcinoma. Breast. Relapse. Chemotherapy and Radiotherapy

    International Nuclear Information System (INIS)

    Marquez, A.; Terrasa, J.; Garcia, J.M.; Rifa, J.

    1996-01-01

    Metaplastic carcinoma of the breast is a rare tumor. The appearance of unexpected mesenchymal elements within the epithelial tumors is the squamous metaplasia. These tumors have a different clinical behaviour that classical breast carcinoma. We present a case of metaplastic mammary carcinoma with multiple relapses treated with a combination of chemotherapy and radiotherapy. The use of chemotherapy after local treatment has enhanced the relapse-free survival. The combined treatment modality seems to produce some benefit in the management of the local relapses of this neoplasms

  3. Changes in circulating peptide YY and ghrelin are associated with early smoking relapse.

    Science.gov (United States)

    Lemieux, Andrine M; al'Absi, Mustafa

    2018-01-01

    Ghrelin and peptide YY (PYY) during ad libitum smoking have been associated with decreased reported craving (ghrelin) and increased positive affect (PYY), and higher baseline ghrelin levels predicted subsequent increased risk of smoking relapse. The current study assessed PYY and ghrelin during ad libitum smoking and again after the initial 48h of a smoking cessation attempt. The data compared smokers who abstained for 28days (n=37), smokers who relapsed (n=54), and nonsmokers (n=37). Plasma samples and subjective measures assessing craving and mood were collected at the beginning of each session. Results showed that relapsers experienced greater levels of distress (ps <0.01). While nonsmokers and abstainers showed no change in ghrelin across the initial 48h, relapsers declined (p <0.01). With PYY, relapsers increased (p <0.05) across the early abstinent phase. PYY and ghrelin may be useful predictors of relapse, specifically in reference to early withdrawal. Copyright © 2017. Published by Elsevier B.V.

  4. A review for identification of initiating events in event tree development process on nuclear power plants

    International Nuclear Information System (INIS)

    Riyadi, Eko H.

    2014-01-01

    Initiating event is defined as any event either internal or external to the nuclear power plants (NPPs) that perturbs the steady state operation of the plant, if operating, thereby initiating an abnormal event such as transient or loss of coolant accident (LOCA) within the NPPs. These initiating events trigger sequences of events that challenge plant control and safety systems whose failure could potentially lead to core damage or large early release. Selection for initiating events consists of two steps i.e. first step, definition of possible events, such as by evaluating a comprehensive engineering, and by constructing a top level logic model. Then the second step, grouping of identified initiating event's by the safety function to be performed or combinations of systems responses. Therefore, the purpose of this paper is to discuss initiating events identification in event tree development process and to reviews other probabilistic safety assessments (PSA). The identification of initiating events also involves the past operating experience, review of other PSA, failure mode and effect analysis (FMEA), feedback from system modeling, and master logic diagram (special type of fault tree). By using the method of study for the condition of the traditional US PSA categorization in detail, could be obtained the important initiating events that are categorized into LOCA, transients and external events

  5. A review for identification of initiating events in event tree development process on nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Riyadi, Eko H., E-mail: e.riyadi@bapeten.go.id [Center for Regulatory Assessment of Nuclear Installation and Materials, Nuclear Energy Regulatory Agency (BAPETEN), Jl. Gajah Mada 8 Jakarta 10120 (Indonesia)

    2014-09-30

    Initiating event is defined as any event either internal or external to the nuclear power plants (NPPs) that perturbs the steady state operation of the plant, if operating, thereby initiating an abnormal event such as transient or loss of coolant accident (LOCA) within the NPPs. These initiating events trigger sequences of events that challenge plant control and safety systems whose failure could potentially lead to core damage or large early release. Selection for initiating events consists of two steps i.e. first step, definition of possible events, such as by evaluating a comprehensive engineering, and by constructing a top level logic model. Then the second step, grouping of identified initiating event's by the safety function to be performed or combinations of systems responses. Therefore, the purpose of this paper is to discuss initiating events identification in event tree development process and to reviews other probabilistic safety assessments (PSA). The identification of initiating events also involves the past operating experience, review of other PSA, failure mode and effect analysis (FMEA), feedback from system modeling, and master logic diagram (special type of fault tree). By using the method of study for the condition of the traditional US PSA categorization in detail, could be obtained the important initiating events that are categorized into LOCA, transients and external events.

  6. Transnational Higher Education and Sustainable Development: Current Initiatives and Future Prospects

    Science.gov (United States)

    Koehn, Peter H.

    2012-01-01

    Tertiary educational institutions increasingly are relied upon for sustainable development initiatives. This policy research note analyzes newly available data regarding seven key dimensions of 295 transnational sustainable development projects involving US universities. Comparative regional analysis of the projects profiled in the APLU/AAU…

  7. Professional Development: Designing Initiatives to Meet the Needs of Online Faculty

    Science.gov (United States)

    Elliott, Marquita; Rhoades, Nicole; Jackson, Christina M.; Mandernach, B. Jean

    2015-01-01

    The increasing prevalence of online courses mandates an examination of the similarities--and differences--in the faculty training and development needs of those teaching online. With institutions facing increasingly limited resources, there is a need to prioritize faculty development initiatives that will encourage faculty participation. An…

  8. 75 FR 64731 - Request for Information (RFI) for Consumer Health Initiative To Develop Collaborations That...

    Science.gov (United States)

    2010-10-20

    ... Initiative To Develop Collaborations That Produce Evidence-Based Informatics Resources and Products\\1\\ \\1... health. The overarching goal is to promote transparency, stimulate original development and partnerships..., Collaboration, & Quality was convened. This federally sponsored summit aimed to: (1) Convene leaders across...

  9. Civic initiatives in urban development : self-governance versus self-organisation in planning practice

    NARCIS (Netherlands)

    Rauws, Ward

    2016-01-01

    This paper discusses two distinct interpretations of self-organisation with regard to civic initiatives in urban development. One concerns urban developments in which citizens deliberately organise themselves in order to realise a collective ambition. This interpretation of self-organisation

  10. CSIR research, development and innovation initiatives for the medical device and diagnostic industry

    CSIR Research Space (South Africa)

    Vilakazi, Busisiwe

    2017-10-01

    Full Text Available This presentation is focused on development and innovation initiatives in the medical device and diagnostic industry. It is presented by Dr Busisiwe Vilakasi at The 6th CSIR Conference: Ideas that work for industrial development, 5-6 October 2017...

  11. 7. Annual seminar of the scientific initiation of the Center for Development of Nuclear Technology. Abstracts

    International Nuclear Information System (INIS)

    2012-01-01

    This seminar presents the Scientific Initiation Program developed at the CDTN - Brazilian Center for the Development of Nuclear Technology and focuses on activities of the sectors of: radiopharmaceutical production; radiation applied to health; waste management; structural integrity; environment; nanotechnology and nuclear materials; reactor technology; mineral technology; reactor and analytical techniques

  12. Developing a Curriculum for Initial Teacher Education Using a Situated Learning Perspective

    Science.gov (United States)

    Skinner, Nigel

    2010-01-01

    This paper argues that the implications of the concept of situated learning are important when developing a curriculum for initial teacher education (ITE). It describes and analyses the use of a model of ITE designed to stimulate discussions promoting the development of professional craft knowledge situated mainly in schools and to connect these…

  13. Gender and Women Development Initiatives in Bangladesh: A Study of Rural Mother Center.

    Science.gov (United States)

    Karim, K M Rabiul; Emmelin, Maria; Lindberg, Lene; Wamala, Sarah

    2016-01-01

    Women-focused development initiatives have become a controversial issue connected with women's health and welfare. Previous studies indicated that development initiatives might increase women's workload, family conflict, and marital violence. This study explored the gendered characteristics of a development initiative Rural Mother Center in Bangladesh. Data incorporated policy document and interviews of social workers working with the mother centers in two northwest subdistricts. The qualitative content analysis of data emerged a general theme of expanding women's responsibility while maintaining male privilege explaining gendered design and practice of the development initiative. The theme was supported by two gendered categories related to the design: (a) essentializing women's participation; (b) maintaining traditional gender, and four categories related to the practice; (c) inadequate gender knowledge and skills; (d) reinforcing traditional gender; (e) using women for improving office performance; and (f) upholding male privilege. The study suggests that though women-focused development initiatives need to be embraced with gender-redistributive policies, the social workers should be trained for attaining gender-transformative motivation and competencies.

  14. The development and initial evaluation of the Pornography-Use Avoidance Self-Efficacy Scale.

    Science.gov (United States)

    Kraus, Shane W; Rosenberg, Harold; Martino, Steve; Nich, Charla; Potenza, Marc N

    2017-09-01

    Background and aims This study employed a newly developed questionnaire to evaluate whether men's self-efficacy to avoid using pornography in each of 18 emotional, social, or sexually arousing situations was associated with either their typical frequency of pornography use or their hypersexuality. Methods Using an Internet-based data collection procedure, 229 male pornography users (M age  = 33.3 years, SD = 12.2) who had sought or considered seeking professional help for their use of pornography completed questionnaires assessing their situationally specific self-efficacy, history of pornography use, self-efficacy to employ specific pornography-reduction strategies, hypersexuality, and demographic characteristics. Results Frequency of pornography use was significantly negatively associated with level of confidence in 12 of the 18 situations. In addition, lower hypersexuality and higher confidence to employ pornography-use-reduction strategies were associated with higher confidence to avoid using pornography in each of the 18 situations. A principal axis factor analysis yielded three clusters of situations: (a) sexual arousal/boredom/opportunity, (b) intoxication/locations/easy access, and (c) negative emotions. Discussion and conclusions This questionnaire could be employed to identify specific high-risk situations for lapse or relapse and as a measure of treatment outcome among therapy clients, but we recommend further examination of the psychometric properties and clinical utility of the questionnaire in treatment samples. Because only one of the three clusters reflected a consistent theme, we do not recommend averaging self-efficacy within factors to create subscales.

  15. The development and initial evaluation of the Pornography-Use Avoidance Self-Efficacy Scale

    Science.gov (United States)

    Kraus, Shane W.; Rosenberg, Harold; Martino, Steve; Nich, Charla; Potenza, Marc N.

    2017-01-01

    Background and aims This study employed a newly developed questionnaire to evaluate whether men’s self-efficacy to avoid using pornography in each of 18 emotional, social, or sexually arousing situations was associated with either their typical frequency of pornography use or their hypersexuality. Methods Using an Internet-based data collection procedure, 229 male pornography users (Mage = 33.3 years, SD = 12.2) who had sought or considered seeking professional help for their use of pornography completed questionnaires assessing their situationally specific self-efficacy, history of pornography use, self-efficacy to employ specific pornography-reduction strategies, hypersexuality, and demographic characteristics. Results Frequency of pornography use was significantly negatively associated with level of confidence in 12 of the 18 situations. In addition, lower hypersexuality and higher confidence to employ pornography-use-reduction strategies were associated with higher confidence to avoid using pornography in each of the 18 situations. A principal axis factor analysis yielded three clusters of situations: (a) sexual arousal/boredom/opportunity, (b) intoxication/locations/easy access, and (c) negative emotions. Discussion and conclusions This questionnaire could be employed to identify specific high-risk situations for lapse or relapse and as a measure of treatment outcome among therapy clients, but we recommend further examination of the psychometric properties and clinical utility of the questionnaire in treatment samples. Because only one of the three clusters reflected a consistent theme, we do not recommend averaging self-efficacy within factors to create subscales. PMID:28889754

  16. Influence of chest radiotherapy in frequency and patterns of chest relapse in disseminated small cell lung carcinoma

    International Nuclear Information System (INIS)

    Mira, J.G.; Livingston, R.B.; Moore, T.N.

    1982-01-01

    The value of radiotherapy to the chest (RC) in disseminated small cell lung carcinoma (SCLC) has been questioned. Two protocols for disseminated SCLC from the Southwest Oncology Group (SWOG) have been compared. The first one included radiotherapy (RT), 3000 rad in two weeks, to the primary tumor, mediastinum and supraclavicular areas, while the second one deleted any RC. Multidrug chemotherapy (CT) and brain RT were used in both protocols. Nonresponders to CT were removed from the study. Our main findings are as follows: (1) Initial chest relapses (patients with no initial extrathoracic relapse) have increased from 24-55% when RC is not given (P = 0.0001). Overall chest relapse (adding those patients that relapsed simultaneously in the chest plus other sites) in the second protocol was 73%. (2) Amount of response to CT does not influence the chances for relapse. Even complete responders to CT have a high chance for chest relapse. (3) Sites of relapse without RC are mainly in the primary tumor, ipsilateral hilus and mediastinum. (4) With RC, relapses shift to the chest periphery, mostly to the lung outside the radiotherapy field and to the pleura. (5) The two very different CT regimens have produced similar percentages and duration of response. (6) CT schema with periodic reinductions prolongs duration of response and survival over schema with continuous maintenance. Hence, interruption of CT to allow RC does not seem to adversely influence CT efficacy

  17. Relapse after treatment of MAM: Should we be concerned? Are we using our resources well?

    International Nuclear Information System (INIS)

    Manary, Mark

    2014-01-01

    An estimated 5% of children less than five years old worldwide suffer from moderate acute malnutrition (MAM), defined as having a weight-for-height Z score (WHZ) between -2 and -3. Previous research has shown that outpatient treatment with supplementary feeding of fortified foods has the potential to treat children with MAM. These children continue to remain at a residual risk for potential deficits in cognitive development and suffer from numerous infectious complications. Experience and observation has also shown that after recovery from MAM, children are at an elevated risk for relapsing back into either moderate or severe acute malnutrition or to death. Recent work from our group indicates that one third of children who are discharged as recovered from MAM do not remain well-nourished after one year. In a study examining almost 2000 recovered children over a 12-month follow-up period, only 63% of children remained well-nourished, whereas 17% relapsed to MAM, 10% developed SAM, 4% died and 7% were lost to follow-up. Among the children who died, 79% of their caretakers reported the illness at the time of death to be fever, diarrhea, or malaria. Our primary conclusion and concern from those data is that children successfully treated for MAM remain at high risk for poor clinical outcomes. Operational practice is to either treat children with MAM to goal anthropometric criteria, such as WHZ>-2, or treat children for a fixed duration of time. Further research is needed to first examine if treating children for a set duration might be helpful and then determining what that set duration might be. Initial results of a 12 week treatment period indicate that those children treated for a longer duration will tend to do better (73% recovery), and relapse might be reduced, as only 4% developed SAM. Surviving children treated for 12 weeks were also shown to have greater anthropometric indices one year after treatment for MAM. An intervention package has been designed to

  18. The development of clinical activity in relapsing-remitting MS is associated with a decrease of FasL mRNA and an increase of Fas mRNA in peripheral blood

    NARCIS (Netherlands)

    Lopatinskaya, L.; Boxel van-Dezaire, A.H.H.; Barkhof, F.; Polman, C.H.; Lucas, C.J.; Nagelkerken, L.

    2003-01-01

    In this longitudinal study, we examined the expression of Fas, FasL, CCR3, CCR5 and CXCR3 mRNA in peripheral blood mononuclear cells (PBMCs) of secondary progressive (SP) and relapsing-remitting (RR) multiple sclerosis (MS) patients. In RR patients, FasL, CCR3 and CCR5 mRNA levels were increased

  19. Pharmacological interventions for alcohol relapse prevention

    African Journals Online (AJOL)

    Arun Kumar Agnihotri

    Health NHS Foundation Trust, Birmingham, UK ... ABSTRACT: Alcohol dependence is a chronic, debilitating disorder that is an important .... hours, or as long as alcohol remains in the blood. ... term and slightly improving days to relapse.

  20. Factors associated with relapse in schizophrenia

    African Journals Online (AJOL)

    increases the economic burden on health care systems because of its associated morbidity .... Depression in schizophrenia has been associated with higher rates of relapse ... The researchers approached the psychiatric nursing staff of mental.

  1. Relapsing polychondritis and airway involvement.

    Science.gov (United States)

    Ernst, Armin; Rafeq, Samaan; Boiselle, Phillip; Sung, Arthur; Reddy, Chakravarthy; Michaud, Gaetane; Majid, Adnan; Herth, Felix J F; Trentham, David

    2009-04-01

    To assess the prevalence and characteristics of airway involvement in relapsing polychondritis (RP). Retrospective chart review and data analysis of RP patients seen in the Rheumatology Clinic and the Complex Airway Center at Beth Israel Deaconess Medical Center from January 2004 through February 2008. RP was diagnosed in 145 patients. Thirty-one patients had airway involvement, a prevalence of 21%. Twenty-two patients were women (70%), and they were between 11 and 61 years of age (median age, 42 years) at the time of first symptoms. Airway symptoms were the first manifestation of disease in 17 patients (54%). Dyspnea was the most common symptom in 20 patients (64%), followed by cough, stridor, and hoarseness. Airway problems included the following: subglottic stenosis (n = 8; 26%); focal and diffuse malacia (n = 15; 48%); and focal stenosis in different areas of the bronchial tree in the rest of the patients. Twelve patients (40%) required and underwent intervention including balloon dilatation, stent placement, tracheotomy, or a combination of the above with good success. The majority of patients experienced improvement in airway symptoms after intervention. One patient died during the follow-up period from the progression of airway disease. The rest of the patients continue to undergo periodic evaluation and intervention. In this largest cohort described in the English language literature, we found symptomatic airway involvement in RP to be common and at times severe. The nature of airway problems is diverse, with tracheomalacia being the most common. Airway intervention is frequently required and in experienced hands results in symptom improvement.

  2. Prevention and treatment of relapse after stem cell transplantation by cellular therapies.

    Science.gov (United States)

    Falkenburg, Fred; Ruggiero, Eliana; Bonini, Chaira; Porter, David; Miller, Jeff; Malard, Floran; Mohty, Mohamad; Kröger, Nicolaus; Kolb, Hans Jochem

    2018-05-24

    Despite recent advances in reducing therapy-related mortality after allogeneic stem cell transplantation (alloSCT) relapse remains the major cause of treatment failure and little progress has been achieved in the last decades. At the 3rd International Workshop on Biology, Prevention, and Treatment of Relapse held in Hamburg/Germany in November 2016 international experts presented and discussed recent developments in the field. Here, the potential of cellular therapies including unspecific and specific T cells, genetically modified T cells, CAR-T cells, NK-cells, and second allografting in prevention and treatment of relapse after alloSCT are summarized.

  3. Corporate Initiatives and Strategies to Meet the Environmental Challenges – Contributions Towards a Green Economic Development

    Directory of Open Access Journals (Sweden)

    Claudia Ogrean

    2015-12-01

    Full Text Available The paper aims to emphasize, based on an interdisciplinary and multi-level approach, on the actual and potential contributions of businesses towards a green economic development - through the positive integration of the environmental challenges within their initiatives and strategies. The main objectives that the paper will target in order to accomplish this mission are: (1. to outline the general framework of the green economic development; (2. to identify the specific environmental challenges businesses could and have to address in order to support the green economic development; (3. to analyze particular initiatives and strategies which have been successfully developed by companies aiming at internalizing the environmental imperative - and to argue in favor of a new business model, able to end, through the green economic development, a virtuous circle of co-evolution between businesses and the environment.

  4. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... An increase in disability is confirmed when the person exhibits the same level of disability at the ... to 12 months later. Approximately 85 percent of people with MS are initially diagnosed with RRMS. This ...

  5. Effects of ocean initial perturbation on developing phase of ENSO in a coupled seasonal prediction model

    Science.gov (United States)

    Lee, Hyun-Chul; Kumar, Arun; Wang, Wanqiu

    2018-03-01

    Coupled prediction systems for seasonal and inter-annual variability in the tropical Pacific are initialized from ocean analyses. In ocean initial states, small scale perturbations are inevitably smoothed or distorted by the observational limits and data assimilation procedures, which tends to induce potential ocean initial errors for the El Nino-Southern Oscillation (ENSO) prediction. Here, the evolution and effects of ocean initial errors from the small scale perturbation on the developing phase of ENSO are investigated by an ensemble of coupled model predictions. Results show that the ocean initial errors at the thermocline in the western tropical Pacific grow rapidly to project on the first mode of equatorial Kelvin wave and propagate to the east along the thermocline. In boreal spring when the surface buoyancy flux weakens in the eastern tropical Pacific, the subsurface errors influence sea surface temperature variability and would account for the seasonal dependence of prediction skill in the NINO3 region. It is concluded that the ENSO prediction in the eastern tropical Pacific after boreal spring can be improved by increasing the observational accuracy of subsurface ocean initial states in the western tropical Pacific.

  6. The Ties that Bind: Presidential Involvement with the Development of NCAA Division I Initial Eligibility Legislation.

    Science.gov (United States)

    Covell, Dan; Barr, Carol A.

    2001-01-01

    Provides a chronology of college presidential efforts to deal with conflicts related to reconciliation of academic mission and athletic success through development of National Collegiate Athletic Association (NCAA) initial eligibility academic legislation. Analyzes these efforts in terms of maintaining congruence within the constituency-based…

  7. Development and Initial Examination of the School Psychology Multicultural Competence Scale

    Science.gov (United States)

    Malone, Celeste M.; Briggs, Candyce; Ricks, Elizabeth; Middleton, Kyndra; Fisher, Sycarah; Connell, James

    2016-01-01

    This study reports on the initial development and examination of the School Psychology Multicultural Competence Scale (SPMCS), a 45-item self-report measure for evaluating school psychologists' multicultural competence in the primary domains of school psychology practice (i.e., assessment, consultation, intervention). A sample of 312 school…

  8. Evaluating Teachers' Professional Development Initiatives: Towards an Extended Evaluative Framework

    Science.gov (United States)

    Merchie, Emmelien; Tuytens, Melissa; Devos, Geert; Vanderlinde, Ruben

    2018-01-01

    Evaluating teachers' professional development initiatives (PDI) is one of the main challenges for the teacher professionalisation field. Although different studies have focused on the effectiveness of PDI, the obtained effects and evaluative methods have been found to be widely divergent. By means of a narrative review, this study provides an…

  9. 78 FR 58546 - State System Development Initiative (SSDI) Grant Program; Single-Case Deviation From Competition...

    Science.gov (United States)

    2013-09-24

    ... Development Initiative (SSDI) Grant Program; Single- Case Deviation From Competition Requirements AGENCY...). ACTION: Notice of Single-Case Deviation from Competition Requirements for the Maternal and Child Health... and quality data that is timely. SUPPLEMENTARY INFORMATION: Intended Recipient of the Award...

  10. Developing Effluent Analysis Technologies to Support Nonproliferation Initiatives, Arms Control and Nonproliferation Technologies, Third quarter 1995

    Energy Technology Data Exchange (ETDEWEB)

    Schubert, S A; Staehle, G; Alonzo, G M [eds.

    1995-01-01

    This issue provides an overview of the Effluent Research Program of the DOE Office of Research and Development, highlighting a number of representative projects within this program in support of nonproliferation initiatives. Technologies reported include portable instruments for on-site inspections, standoff detectors, fieldable, real-time instruments, field collection techniques, and ultrasensitive laboratory techniques.

  11. The Adolescent-Parent Career Congruence Scale: Development and Initial Validation

    Science.gov (United States)

    Sawitri, Dian R.; Creed, Peter A.; Zimmer-Gembeck, Melanie J.

    2013-01-01

    Although there is a growing interest in the discrepancy between parents and their adolescent children in relation to career expectations, there is no existing, psychometrically sound scale that directly measures adolescent-parent career congruence or incongruence. This study reports the development and initial validation of the Adolescent-Parent…

  12. Biofuel Development Initiatives in Sub-Saharan Africa: Opportunities and Challenges

    Directory of Open Access Journals (Sweden)

    Patrick T. Sekoai

    2016-06-01

    Full Text Available In recent years, biofuels have emerged as a suitable alternative to hydrocarbon fuel due to their foreseen potential of being a future energy resource. Biofuel development initiatives have been successfully implemented in countries like Brazil, United States of America, European Union, Canada, Australia, and Japan. However, such programmes have been stagnant in Africa due to various constraints, such as financial barriers, technical expertise, land availability, and government policies. Nonetheless, some countries within the continent have realized the potential of biofuels and have started to introduce similar programmes and initiatives for their development. These include the bioethanol production initiatives and the plantation of jatropha oil seeds in most Sub-Saharan African countries for biodiesel production. Therefore, this paper examines the biofuel development initiatives that have been implemented in several countries across Sub-Saharan Africa over the past few years. It also discusses the opportunities and challenges of having biofuel industries in the continent. Finally, it proposes some recommendations that could be applied to accelerate their development in these Sub-Saharan African countries.

  13. Climate Change Professional Development: Design, Implementation, and Initial Outcomes on Teacher Learning, Practice, and Student Beliefs

    Science.gov (United States)

    Shea, Nicole A.; Mouza, Chrystalla; Drewes, Andrea

    2016-01-01

    In this work, we present the design, implementation, and initial outcomes of the Climate Academy, a hybrid professional development program delivered through a combination of face-to-face and online interactions, intended to prepare formal and informal science teachers (grades 5-16) in teaching about climate change. The Climate Academy was…

  14. Social capital, agricultural innovation and the evaluation of agricultural development initiatives

    NARCIS (Netherlands)

    Rijn, van F.C.

    2014-01-01

    In this thesis, I show that social capital has an important role in the evaluation of development initiatives targeting agricultural innovation. Social capital and agricultural innovation are naturally linked from an innovation system perspective in which innovations result from the integration

  15. 75 FR 37756 - Request for Public Comment To Inform Development of National Export Initiative Plan

    Science.gov (United States)

    2010-06-30

    ... with financing, and in general by pursuing a government-wide approach to export advocacy abroad, among other steps. General information concerning the NEI and government programs that help U.S. businesses... To Inform Development of National Export Initiative Plan AGENCY: International Trade Administration...

  16. Software Development Initiatives to Identify and Mitigate Security Threats - Two Systematic Mapping Studies

    Directory of Open Access Journals (Sweden)

    Paulina Silva

    2016-12-01

    Full Text Available Software Security and development experts have addressed the problem of building secure software systems. There are several processes and initiatives to achieve secure software systems. However, most of these lack empirical evidence of its application and impact in building secure software systems. Two systematic mapping studies (SM have been conducted to cover the existent initiatives for identification and mitigation of security threats. The SMs created were executed in two steps, first in 2015 July, and complemented through a backward snowballing in 2016 July. Integrated results of these two SM studies show a total of 30 relevant sources were identified; 17 different initiatives covering threats identification and 14 covering the mitigation of threats were found. All the initiatives were associated to at least one activity of the Software Development Lifecycle (SDLC; while 6 showed signs of being applied in industrial settings, only 3 initiatives presented experimental evidence of its results through controlled experiments, some of the other selected studies presented case studies or proposals.

  17. The Value of Fecal Markers in Predicting Relapse in Inflammatory Bowel Diseases

    Directory of Open Access Journals (Sweden)

    Bianca J. Galgut

    2018-01-01

    Full Text Available The inflammatory bowel diseases (IBDs are lifelong chronic illnesses that place an immense burden on patients. The primary aim of therapy is to reduce disease burden and prevent relapse. However, the occurrence of relapses is often unpredictable. Current disease monitoring is primarily by way of clinical indices, with relapses often only recognized once the inflammatory episode is established with subsequent symptoms and gut damage. The window between initial upregulation of the inflammatory response and the recognition of symptoms may provide an opportunity to prevent the relapse and associated morbidity. This review will describe the existing literature surrounding predictive indicators of relapse of IBD with a specific focus on fecal biomarkers. Fecal biomarkers offer promise as a convenient, non-invasive, low cost option for disease monitoring that is predictive of subsequent relapse. To exploit the potential of fecal biomarkers in this role, further research is now required. This research needs to assess multiple fecal markers in context with demographics, disease phenotype, genetics, and intestinal microbiome composition, to build disease behavior models that can provide the clinician with sufficient confidence to intervene and change the long-term disease course.

  18. Market development of organic products in Europe: conditions and role of Organic Marketing Initiatives

    OpenAIRE

    Schmit, Otto; Fontguyon, Guy de; Sans, Pierre

    2007-01-01

    The contribution presents some of the main results of a European program of investigation (titled Organic Marketing Initiatives – OMIs – and Rural Development). Firstly, consumer behavior, as well as attitudes, expectations, motives and buying barriers concerning organic food are explored. Then, authors give a brief overview of the organic market analysis of 18 European countries, based on a Delphi inquiry. Finally, the third part highlights the role of OMIs in the organic market development ...

  19. Prognosis and treatment after relapse of acute lymphoblastic leukemia and non-Hodgkin's lymphoma: 1985. A report from the Childrens Cancer Study Group

    International Nuclear Information System (INIS)

    Bleyer, W.A.; Sather, H.; Hammond, G.D.

    1986-01-01

    Acute lymphoblastic leukemia and non-Hodgkin's lymphoma constitute 42% to 45% of the cancers in infants, children, and adolescents: In 1985, an estimated 2025 children were newly diagnosed with these two cancers and 900 (43%) of the pediatric cancer deaths in the United States have been projected to be due to these diseases. The single most important obstacle to preventing these deaths is relapse, and prevention of relapse or salvage of the patient who has had a relapse continues to be a major therapeutic challenge. The most important initial step in the treatment of the child whose disease has relapsed is to determine, to the extent possible, the prognosis. In a child with non-Hodgkin's lymphoma, a relapse confers an extremely poor prognosis, regardless of site of relapse, tumor histology, or other original prognostic factors, prior therapy, or time to relapse. In the child with acute lymphoblastic leukemia in relapse, the prognosis depends on multiple factors. The primary therapy is chemotherapy or chemoradiotherapy with marrow grafting. Other options exist, including no therapy, or investigational therapy. The therapy selected should be predicated on the prognosis. In the child with an isolated central nervous system (CNS) relapse off therapy, minimum therapy should be administered, particularly if the relapse occurred without prior cranial irradiation. In the child whose relapse is more than 6 months off therapy, conventional therapy should be considered. Also, a patient with an isolated CNS relapse on therapy after prior cranial irradiation should be given moderate therapy. Bone marrow transplantation or high-dose chemoradiotherapy with autologous marrow rescue should be reserved in children with a second or subsequent extramedullary relapse, and possibly for those with a first isolated overt testicular relapse on therapy

  20. Handling e-waste in developed and developing countries: Initiatives, practices, and consequences

    Energy Technology Data Exchange (ETDEWEB)

    Sthiannopkao, Suthipong, E-mail: suthisuthi@gmail.com [Department of Environmental Engineering, College of Engineering, Dong-A University, 37 Nakdong-Daero 550 beon-gil Saha-gu, Busan (Korea, Republic of); Wong, Ming Hung [Croucher Institute for Environmental Sciences, Hong Kong Baptist University, Hong Kong (China)

    2013-10-01

    Discarded electronic goods contain a range of toxic materials requiring special handling. Developed countries have conventions, directives, and laws to regulate their disposal, most based on extended producer responsibility. Manufacturers take back items collected by retailers and local governments for safe destruction or recovery of materials. Compliance, however, is difficult to assure, and frequently runs against economic incentives. The expense of proper disposal leads to the shipment of large amounts of e-waste to China, India, Pakistan, Nigeria, and other developing countries. Shipment is often through middlemen, and under tariff classifications that make quantities difficult to assess. There, despite the intents of national regulations and hazardous waste laws, most e-waste is treated as general refuse, or crudely processed, often by burning or acid baths, with recovery of only a few materials of value. As dioxins, furans, and heavy metals are released, harm to the environment, workers, and area residents is inevitable. The faster growth of e-waste generated in the developing than in the developed world presages continued expansion of a pervasive and inexpensive informal processing sector, efficient in its own way, but inherently hazard-ridden. - Highlights: ► Much e-waste, expensive to process safely, illegally goes to developing countries. ► E-waste processing in developing countries pollutes with heavy metals and dioxins. ► Well-conceived developing world waste regulations lack enforceability. ► Crude e-waste processing cannot recover several rare materials. ► The amount of e-waste unsafely processed will continue to grow.

  1. Handling e-waste in developed and developing countries: Initiatives, practices, and consequences

    International Nuclear Information System (INIS)

    Sthiannopkao, Suthipong; Wong, Ming Hung

    2013-01-01

    Discarded electronic goods contain a range of toxic materials requiring special handling. Developed countries have conventions, directives, and laws to regulate their disposal, most based on extended producer responsibility. Manufacturers take back items collected by retailers and local governments for safe destruction or recovery of materials. Compliance, however, is difficult to assure, and frequently runs against economic incentives. The expense of proper disposal leads to the shipment of large amounts of e-waste to China, India, Pakistan, Nigeria, and other developing countries. Shipment is often through middlemen, and under tariff classifications that make quantities difficult to assess. There, despite the intents of national regulations and hazardous waste laws, most e-waste is treated as general refuse, or crudely processed, often by burning or acid baths, with recovery of only a few materials of value. As dioxins, furans, and heavy metals are released, harm to the environment, workers, and area residents is inevitable. The faster growth of e-waste generated in the developing than in the developed world presages continued expansion of a pervasive and inexpensive informal processing sector, efficient in its own way, but inherently hazard-ridden. - Highlights: ► Much e-waste, expensive to process safely, illegally goes to developing countries. ► E-waste processing in developing countries pollutes with heavy metals and dioxins. ► Well-conceived developing world waste regulations lack enforceability. ► Crude e-waste processing cannot recover several rare materials. ► The amount of e-waste unsafely processed will continue to grow

  2. Pemphigus erythematosus relapse associated with atorvastatin intake

    Directory of Open Access Journals (Sweden)

    Lo Schiavo A

    2014-09-01

    Full Text Available Ada Lo Schiavo,1 Rosa Valentina Puca,1 Francesca Romano,1 Roberto Cozzi2 1Department of Dermatology, Second University of Naples, Naples, Italy; 2Department of Dermatology, AORN "A Cardarelli", Naples, Italy Abstract: Statins, also known as 3-hydroxy-3-methylglutaril-CoA reductase inhibitors, are well-tolerated drugs used for prevention of atherosclerosis and cardiovascular events. Although they are generally considered safe, some serious adverse effects, such as myositis, myopathy, and rhabdomyolysis can rarely occur. Furthermore, recent data from long-term follow-up on patients who have been taking statins for a long period of time suggest that prolonged exposure to statins may trigger autoimmune reactions. The exact mechanism of statin-induced autoimmune reactions is unclear. Statins, as proapoptotic agents, release nuclear antigen into the circulation and may induce the production of pathogenic autoantibodies. Herein we report the case of a 70 year-old man who developed a relapse of pemphigus erythematosus, a syndrome with features of both lupus erythematosus and pemphigus, after atorvastatin intake. Keywords: pemphigus erythematosus, autoimmune disease, treatment, pathogenesis, statins

  3. Developing a statewide public health initiative to reduce infant mortality in Oklahoma.

    Science.gov (United States)

    Dooley, Suzanna; Patrick, Paul; Lincoln, Alicia; Cline, Janette

    2014-01-01

    The Preparing for a Lifetime, It's Everyone's Responsibility initiative was developed to improve the health and well- being of Oklahoma's mothers and infants. The development phase included systematic data collection, extensive data analysis, and multi-disciplinary partnership development. In total, seven issues (preconception/interconception health, tobacco use, postpartum depression, breastfeeding, infant safe sleep, preterm birth, and infant injury prevention) were identified as crucial to addressing infant mortality in Oklahoma. Workgroups were created to focus on each issue. Data and media communications workgroups were added to further partner commitment and support for policy and programmatic changes across multiple agencies and programs. Leadership support, partnership, evaluation, and celebrating small successes were important factors that lead to large scale adoption and support for the state-wide initiative to reduce infant mortality.

  4. Trichurs suis ova theraphy in relapsing multiple sclerosis is safe but without signals of beneficial effect

    DEFF Research Database (Denmark)

    Voldsgaard, A.; Bager, P.; Garde, E.

    2015-01-01

    revealed 6 new or enlarged T2 lesions in the run-in period, 7 lesions in the early period and 21 lesions in the late treatment period. Two patients suffered a relapse before treatment and two during treatment. Eight patients developed eosinophilia. The expression of cytokines and transcription factors did...... not change. CONCLUSIONS: In a small group of relapsing multiple sclerosis patients, Trichuris suis oral therapy was well tolerated but without beneficial effect....

  5. Clinical Trials and Tribulations: Lessons Learned from Recruiting Pregnant Ex-Smokers for Relapse Prevention

    OpenAIRE

    Lopez, Elena N.; Simmons, Vani Nath; Quinn, Gwendolyn P.; Meade, Cathy D.; Chirikos, Thomas N.; Brandon, Thomas H.

    2008-01-01

    The development of smoking cessation and relapse-prevention interventions for pregnant and postpartum women is a public health priority. However, researchers have consistently reported substantial difficulty in accruing this population into clinical trials. The problem is particularly acute for relapse-prevention studies, which must recruit women who have already quit smoking because of their pregnancy. Although an important target for tobacco control efforts, these individuals represent an e...

  6. Building sustainable policy framework for transport development: A review of national transport policy initiatives in Nigeria

    Directory of Open Access Journals (Sweden)

    Sumaila A.F.

    2013-06-01

    Full Text Available This paper is concerned with building a sustainable policy framework for transport development in Nigeria. Its objective is to review the country’s transport policy initiatives in order to understand the extent to which it addresses Nigeria’s mobility and transportation problems. From published materials and official government documents and files, the study identifies four national policy initiatives which are reviewed and analysed with regard to their context, contents, and consequences. The study reveals that while the policy initiatives could be said to be adequate and comprehensive in terms of their context and contents, the major challenge is implementation of recommended solutions. The study therefore provides a general checklist to guide policy direction, while advocating for policy-based researches and empirical studies in order to provide the data base for formulation of a sustainable national transport policy for Nigeria.

  7. Handling e-waste in developed and developing countries: initiatives, practices, and consequences.

    Science.gov (United States)

    Sthiannopkao, Suthipong; Wong, Ming Hung

    2013-10-01

    Discarded electronic goods contain a range of toxic materials requiring special handling. Developed countries have conventions, directives, and laws to regulate their disposal, most based on extended producer responsibility. Manufacturers take back items collected by retailers and local governments for safe destruction or recovery of materials. Compliance, however, is difficult to assure, and frequently runs against economic incentives. The expense of proper disposal leads to the shipment of large amounts of e-waste to China, India, Pakistan, Nigeria, and other developing countries. Shipment is often through middlemen, and under tariff classifications that make quantities difficult to assess. There, despite the intents of national regulations and hazardous waste laws, most e-waste is treated as general refuse, or crudely processed, often by burning or acid baths, with recovery of only a few materials of value. As dioxins, furans, and heavy metals are released, harm to the environment, workers, and area residents is inevitable. The faster growth of e-waste generated in the developing than in the developed world presages continued expansion of a pervasive and inexpensive informal processing sector, efficient in its own way, but inherently hazard-ridden. Copyright © 2012 Elsevier B.V. All rights reserved.

  8. Relapsing tubulointerstitial nephritis in an adolescent with inflammatory bowel disease without aminosalicylate exposure.

    LENUS (Irish Health Repository)

    Shahrani Muhammad, H S

    2012-01-31

    A 14-year-old boy presented with ongoing constipation as a manifestation of newly diagnosed Crohn\\'s disease (CD) and a concomitant decline in renal function with biopsy-proven interstitial nephritis. Initiation of steroid therapy and mesalazine was associated with an improvement in symptoms and renal function. We describe a rare case of a 5-aminosalicylic acid (5-ASA)-naive patient who developed interstitial nephritis in association with CD with no evidence of other primary glomerulopathy. A unique feature of the case being a profound systemic inflammatory response at the time of diagnosis and a relapse in nephritis 2 months after cessation of mesalazine in the absence of any macroscopic colitis.

  9. Lean and leadership practices: development of an initial realist program theory.

    Science.gov (United States)

    Goodridge, Donna; Westhorp, Gill; Rotter, Thomas; Dobson, Roy; Bath, Brenna

    2015-09-07

    Lean as a management system has been increasingly adopted in health care settings in an effort to enhance quality, capacity and safety, while simultaneously containing or reducing costs. The Ministry of Health in the province of Saskatchewan, Canada has made a multi-million dollar investment in Lean initiatives to create "better health, better value, better care, and better teams", affording a unique opportunity to advance our understanding of the way in which Lean philosophy, principles and tools work in health care. In order to address the questions, "What changes in leadership practices are associated with the implementation of Lean?" and "When leadership practices change, how do the changed practices contribute to subsequent outcomes?", we used a qualitative, multi-stage approach to work towards developing an initial realist program theory. We describe the implications of realist assumptions for evaluation of this Lean initiative. Formal theories including Normalization Process Theory, Theories of Double Loop and Organization Leaning and the Theory of Cognitive Dissonance help understand this initial rough program theory. Data collection included: key informant consultation; a stakeholder workshop; documentary review; 26 audiotaped and transcribed interviews with health region personnel; and team discussions. A set of seven initial hypotheses regarding the manner in which Lean changes leadership practices were developed from our data. We hypothesized that Lean, as implemented in this particular setting, changes leadership practices in the following ways. Lean: a) aligns the aims and objectives of health regions; b) authorizes attention and resources to quality improvement and change management c) provides an integrated set of tools for particular tasks; d) changes leaders' attitudes or beliefs about appropriate leadership and management styles and behaviors; e) demands increased levels of expertise, accountability and commitment from leaders; f) measures and

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

    Science.gov (United States)

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

    2016-01-01

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

  11. Assessing personal initiative among vocational training students: development and validation of a new measure.

    Science.gov (United States)

    Balluerka, Nekane; Gorostiaga, Arantxa; Ulacia, Imanol

    2014-11-14

    Personal initiative characterizes people who are proactive, persistent and self-starting when facing the difficulties that arise in achieving goals. Despite its importance in the educational field there is a scarcity of measures to assess students' personal initiative. Thus, the aim of the present study was to develop a questionnaire to assess this variable in the academic environment and to validate it for adolescents and young adults. The sample comprised 244 vocational training students. The questionnaire showed a factor structure including three factors (Proactivity-Prosocial behavior, Persistence and Self-Starting) with acceptable indices of internal consistency (ranging between α = .57 and α =.73) and good convergent validity with respect to the Self-Reported Initiative scale. Evidence of external validity was also obtained based on the relationships between personal initiative and variables such as self-efficacy, enterprising attitude, responsibility and control aspirations, conscientiousness, and academic achievement. The results indicate that this new measure is very useful for assessing personal initiative among vocational training students.

  12. Daily corticosteroids reduce infection-associated relapses in frequently relapsing nephrotic syndrome: a randomized controlled trial.

    Science.gov (United States)

    Gulati, Ashima; Sinha, Aditi; Sreenivas, Vishnubhatla; Math, Aparna; Hari, Pankaj; Bagga, Arvind

    2011-01-01

    Relapses of nephrotic syndrome often follow minor infections, commonly of the upper respiratory tract. Daily administration of maintenance prednisolone during intercurrent infections was examined to determine whether the treatment reduces relapse rates in children with frequently relapsing nephrotic syndrome. In a randomized controlled trial (nonblind, parallel group, tertiary-care hospital), 100 patients with idiopathic, frequently relapsing nephrotic syndrome eligible for therapy with prolonged low-dose, alternate-day prednisolone with or without levamisole were randomized to either receive their usual dose of alternate-day prednisolone daily for 7 days during intercurrent infections (intervention group) or continue alternate-day prednisolone (controls). Primary outcome was assessed by comparing the rates of infection-associated relapses at 12-month follow-up. Secondary outcomes were the frequency of infections and the cumulative amount of prednisolone received in both groups. Patients in the intervention group showed significantly lower infection-associated (rate difference, 0.7 episodes/patient per year; 95% confidence intervals [CI] 0.3, 1.1) and lower total relapse rates (0.9 episodes/patient per year, 95% CI 0.4, 1.4) without increase in steroid toxicity. Poisson regression, adjusted for occurrence of infections, showed that daily administration of prednisolone during infections independently resulted in 59% reduction in frequency of relapses (rate ratio, 0.41; 95% CI 0.3, 0.6). For every six patients receiving this intervention, one showed a reduction of relapse frequency to less than three per year. Daily administration of maintenance doses of prednisolone, during intercurrent infections, significantly reduces relapse rates and the proportion of children with frequently relapsing nephrotic syndrome.

  13. TOWARDS DEVELOPING A SUSTAINABLE FACULTY DEVELOPMENT PROGRAM: An Initiative of an American Medical School in Lebanon.

    Science.gov (United States)

    Rahal, Boushra; Mansour, Nabil; Zaatari, Ghazi

    2015-01-01

    The American University of Beirut Faculty of Medicine (AUB-FM) strategy is to develop faculty members (fm) skills by sponsoring local and international scientific activities has been in place for over three decades, and remains dependent on individuals' efforts. In 2011-2012, Faculty Development Program (FDP) was introduced to develop faculty leadership, business skills in medicine, fulfill personal and professional goals, followed by a five-year plan to cover five themes: Management/Leadership, Marketing, Finance, Strategic Planning and Communications with the purpose of integrating these themes in medical practice. A survey was sent to all departments at AUB-FM in 2011 to assess needs and determine themes. Nine workshops were conducted, followed by post-workshop evaluation. 117 fm responded to needs assessment surveys. Respondents had on average 15 years in clinical practice, 50% with extensive to moderate administrative experience; 71% assumed administrative responsibilities at least once, 56% in leadership positions. Faculty attendance dropped midway from 69 to 19, although workshops were rated very good to excellent. Although faculty were interested in FDP, the drop in attendance might be attributed to: challenges to achieve personal and professional goals while struggling to fulfill their roles, satisfy promotion requirements and generate their income. FDP has to be aligned with FM strategic goals and faculty objectives, be complimentary to a faculty mentoring program, provide rewards, and be supported by a faculty progression tool.

  14. Developability studies before initiation of process development: improving manufacturability of monoclonal antibodies.

    Science.gov (United States)

    Yang, Xiaoyu; Xu, Wei; Dukleska, Svetlana; Benchaar, Sabrina; Mengisen, Selina; Antochshuk, Valentyn; Cheung, Jason; Mann, Leslie; Babadjanova, Zulfia; Rowand, Jason; Gunawan, Rico; McCampbell, Alexander; Beaumont, Maribel; Meininger, David; Richardson, Daisy; Ambrogelly, Alexandre

    2013-01-01

    Monoclonal antibodies constitute a robust class of therapeutic proteins. Their stability, resistance to stress conditions and high solubility have allowed the successful development and commercialization of over 40 antibody-based drugs. Although mAbs enjoy a relatively high probability of success compared with other therapeutic proteins, examples of projects that are suspended due to the instability of the molecule are not uncommon. Developability assessment studies have therefore been devised to identify early during process development problems associated with stability, solubility that is insufficient to meet expected dosing or sensitivity to stress. This set of experiments includes short-term stability studies at 2-8 þC, 25 þC and 40 þC, freeze-thaw studies, limited forced degradation studies and determination of the viscosity of high concentration samples. We present here three case studies reflecting three typical outcomes: (1) no major or unexpected degradation is found and the study results are used to inform early identification of degradation pathways and potential critical quality attributes within the Quality by Design framework defined by US Food and Drug Administration guidance documents; (2) identification of specific degradation pathway(s) that do not affect potency of the molecule, with subsequent definition of proper process control and formulation strategies; and (3) identification of degradation that affects potency, resulting in program termination and reallocation of resources.

  15. Application of the principle of Open Initiatives in developing Trakai tourism infrastructure

    Directory of Open Access Journals (Sweden)

    Eugenijus Nazelskis

    2013-01-01

    Full Text Available This article aims to identify the principle of open initiatives, launched by Trakai resort municipality, which is focused on infrastructure development in order to open the way for widespread participation of natural and legal persons in infrastructure projects and to define the strategic directions in tourism development and infrastructure projects that apply this principle. In addition, it aims to assess the effectiveness of this principle as well as its practical benefits to the expansion of tourism infrastructure and the development of new tourism products.

  16. “Aid for Trade” initiative in order to achieve the development objectives

    Directory of Open Access Journals (Sweden)

    Diana Popa

    2013-03-01

    Full Text Available This paper addresses the “aid for trade” initiative as a key source of economic growth and prosperity, so necessary in developing countries and especially, least developed ones. Based on a deductive analysis, the research purpose is to observe, as much as possible, the involvement of international organizations to support this foreign aid and its effects on poor nations.Assuming that developing countries need foreign aid to get out of poverty and to fully benefit from the advantages of international trade, but not only, the paper shows that from the XXI century, donor countries have considerably increased the amounts allocated for this purpose.

  17. Characteristics of specific immunological indicators in patients with postoperative relapse of Graves’ disease

    Directory of Open Access Journals (Sweden)

    Yu.V. Buldigina

    2018-02-01

    Full Text Available Background. Activity of autoimmune processes had a leading role in the development of relapse of hyperthyroidism. Level of thyroid-stimulating hormone (TSH receptor antibodies is a basic factor that predetermines the relapse and can be used as a criterion to evaluate its development. A research aim was to study the structural and functional state of the thyroid gland, levels of thyroid peroxidase antibodies and TSH receptor antibodies in patients with postoperative relapse of Graves’ disease during antithyroid therapy. Mate­rials and methods. The group of patients consisted of 25 wo­men aged 23 to 73 years (an average of 53.56 ± 2.31 years. The period from the first surgical treatment to the development of relapse of thyrotoxicosis ranged from 1 to 29 years and avera­ged 13.33 ± 1.66 years. Results. It was found that the le­vels of TSH receptor antibodies, which are the main factors in the pathogenesis of Graves’ disease, are not decreased on the background of drug treatment that indicates a lack of perspective of conservative therapy for the post-operative relapse of this disease. Conclusions. When the state of medication compensation for thyrotoxicosis is achieved, it is recommended to conduct the therapy with I131 or surgical treatment of the relapse of Graves’ disease.

  18. Targeting the eIF4F translation initiation complex: a critical nexus for cancer development.

    Science.gov (United States)

    Pelletier, Jerry; Graff, Jeremy; Ruggero, Davide; Sonenberg, Nahum

    2015-01-15

    Elevated protein synthesis is an important feature of many cancer cells and often arises as a consequence of increased signaling flux channeled to eukaryotic initiation factor 4F (eIF4F), the key regulator of the mRNA-ribosome recruitment phase of translation initiation. In many cellular and preclinical models of cancer, eIF4F deregulation results in changes in translational efficiency of specific mRNA classes. Importantly, many of these mRNAs code for proteins that potently regulate critical cellular processes, such as cell growth and proliferation, enhanced cell survival and cell migration that ultimately impinge on several hallmarks of cancer, including increased angiogenesis, deregulated growth control, enhanced cellular survival, epithelial-to-mesenchymal transition, invasion, and metastasis. By being positioned as the molecular nexus downstream of key oncogenic signaling pathways (e.g., Ras, PI3K/AKT/TOR, and MYC), eIF4F serves as a direct link between important steps in cancer development and translation initiation. Identification of mRNAs particularly responsive to elevated eIF4F activity that typifies tumorigenesis underscores the critical role of eIF4F in cancer and raises the exciting possibility of developing new-in-class small molecules targeting translation initiation as antineoplastic agents. ©2014 American Association for Cancer Research.

  19. Factors of risk for relapse of pulmonary tuberculosis in-patient of the Hospital Santa Clara from Bogota 1992/2000

    International Nuclear Information System (INIS)

    Hidalgo Martinez, Patricia; Awad Garcia, Carlos; Pavia Albor, Jacqueline

    2002-01-01

    Pulmonary tuberculosis relapse is defined as these patients that make recurrence of tuberculosis after complete an adequate treatment, and these patients are again diagnosed bacteriologically with tuberculosis. We tried to identify the risk factors for relapse among adults, through an analytical study of cases and controls, with eighty patients among the tuberculosis programmed of Santa Clara Hospital between 1992-2000 with relapse diagnosis which meet criterion of case and eighty patients which meet criterion of control. We did a bivariate analysis with confidence intervals and univariate calculation with logistic regression analysis to predict the development of relapse for the different variables. Diabetes mellitus, chronic renal failure, silicosis are associated with relapse, but in our study we found another factors which are joined to relapse and we suggest that if we find these factors among tuberculosis patients would indicate the chance of relapse and this would create the necessity of use a larger number of doses of antituberculosis medicaments

  20. Men’s Perceptions of Women’s Participation in Development Initiatives in Rural Bangladesh

    Science.gov (United States)

    Karim, Rabiul; Lindberg, Lene; Wamala, Sarah; Emmelin, Maria

    2017-01-01

    Without taking masculine issues into account, women’s participation in development initiatives does not always guarantee their empowerment, health, and welfare in a male-dominated society. This study aimed to explore men’s perceptions of women’s participation in development (WPD) in rural Bangladesh. In adopting a qualitative approach, the study examined 48 purposively selected married and unmarried men aged 20–76 years in three northwest villages. Data collection was accomplished through four focus group discussions (FGDs) with 43 men clustered into four groups and through individual interviews with five other men. A qualitative content analysis of the data revealed an overall theme of “feeling challenged by fears and hopes,” indicating variations in men’s views on women’s participation in development initiatives as represented by three main categories: (a) fearing the loss of male authority, (b) recognizing women’s roles in enhancing family welfare, and (c) valuing women’s independence. In the context of dominant patriarchal traditions in Bangladesh, these findings provide new insight into dynamics and variations of men’s views, suggesting a need to better engage men during different stages of women-focused development initiatives. PMID:29025358

  1. Men's Perceptions of Women's Participation in Development Initiatives in Rural Bangladesh.

    Science.gov (United States)

    Karim, Rabiul; Lindberg, Lene; Wamala, Sarah; Emmelin, Maria

    2018-03-01

    Without taking masculine issues into account, women's participation in development initiatives does not always guarantee their empowerment, health, and welfare in a male-dominated society. This study aimed to explore men's perceptions of women's participation in development (WPD) in rural Bangladesh. In adopting a qualitative approach, the study examined 48 purposively selected married and unmarried men aged 20-76 years in three northwest villages. Data collection was accomplished through four focus group discussions (FGDs) with 43 men clustered into four groups and through individual interviews with five other men. A qualitative content analysis of the data revealed an overall theme of "feeling challenged by fears and hopes," indicating variations in men's views on women's participation in development initiatives as represented by three main categories: (a) fearing the loss of male authority, (b) recognizing women's roles in enhancing family welfare, and (c) valuing women's independence. In the context of dominant patriarchal traditions in Bangladesh, these findings provide new insight into dynamics and variations of men's views, suggesting a need to better engage men during different stages of women-focused development initiatives.

  2. Site of relapse after chemotherapy alone for stage I and II Hodgkin's disease

    International Nuclear Information System (INIS)

    Shahidi, Mehdi; Kamangari, Nahid; Ashley, Sue; Cunningham, David; Horwich, Alan

    2006-01-01

    Background: Short course chemotherapy followed by radiotherapy is a standard treatment for early Hodgkin's disease. There is yet no consensus regarding the appropriate radiotherapy portal following chemotherapy. A good guide to the adjuvant radiotherapy field is the site of relapse in patients treated with chemotherapy alone. Patients and methods: From 1980 to 1996, 61 patients with stage I and II supradiaphragmatic Hodgkin's disease were treated with chemotherapy alone at the Royal Marsden Hospital. We undertook a retrospective review and failure analysis to define the pattern of recurrence. Results: After a median follow-up of 6.5 years, 24 patients had relapsed giving a 5-year relapse rate of 40%. The 5 and 10-year actuarial survival rates were 94 and 89%, respectively with cause-sepecific survival being 94% at 5 and 10 years. Two-thirds of the relapses were nodal and supradiaphragmatic. Twenty patients (83%) relapsed in the initially involved sites of disease and this was the sole site of recurrence in 11 (45%) of patients. In retrospect, it appeared that at least 12 recurrences could have been prevented by involved field radiotherapy. Review of detailed imaging data (available in 9 out of 11 patients with recurrences in initial sites of disease) showed that the relapses were always in the initially involved nodes. Conclusion: After chemotherapy alone in early stage HD most initial recurrences are nodal. Loco-regional recurrences are in the originally involved nodes. Based on limited data it appears that involved nodal RT is equivalent to involved field radiotherapy and may halve the risk of recurrence

  3. Spanish version of the Talent Development Environment Questionnaire for sport: Cultural adaptation and initial validation

    Science.gov (United States)

    Olivares, Pedro R.; Andronikos, Georgios; Martindale, Russell J. J.

    2017-01-01

    This study aimed to translate the Talent Development Environment Questionnaire into Spanish and provide an initial validation. A recommended methodology for translation and cultural adaptation of questionnaires was applied. Once this had been completed, three hundred and thirty-two young athletes completed the Talent Development Environment Questionnaire. The results revealed that the five factor solution Talent Development Environment Questionnaire was confirmed. With the exclusion of one item due to low factor loading, the Talent Development Environment Questionnaire-5 had robust statistical support for its factor structure (χ2 (df = 305) = 499.64, pTalent Development Environment Questionnaire-5 had a Cronbach α score of .877, and the reliability scores for individual factors 1–5 were .622; .761; .658; .605; .602 respectively. As such, it is recommended that the Spanish Talent Development Environment Questionnaire-5 can be used with confidence in Spain in both applied and research settings. PMID:28582387

  4. Spanish version of the Talent Development Environment Questionnaire for sport: Cultural adaptation and initial validation.

    Science.gov (United States)

    Brazo-Sayavera, Javier; Olivares, Pedro R; Andronikos, Georgios; Martindale, Russell J J

    2017-01-01

    This study aimed to translate the Talent Development Environment Questionnaire into Spanish and provide an initial validation. A recommended methodology for translation and cultural adaptation of questionnaires was applied. Once this had been completed, three hundred and thirty-two young athletes completed the Talent Development Environment Questionnaire. The results revealed that the five factor solution Talent Development Environment Questionnaire was confirmed. With the exclusion of one item due to low factor loading, the Talent Development Environment Questionnaire-5 had robust statistical support for its factor structure (χ2 (df = 305) = 499.64, pTalent Development Environment Questionnaire-5 had a Cronbach α score of .877, and the reliability scores for individual factors 1-5 were .622; .761; .658; .605; .602 respectively. As such, it is recommended that the Spanish Talent Development Environment Questionnaire-5 can be used with confidence in Spain in both applied and research settings.

  5. Gender differences in alcohol and substance use relapse.

    Science.gov (United States)

    Walitzer, Kimberly S; Dearing, Ronda L

    2006-03-01

    This review explores gender differences in relapse and characteristics of relapse events in alcohol and substance use. For alcohol, relapse rates were similar across gender. Although negative mood, childhood sexual abuse, alcohol-related self-efficacy, and poorer coping strategies predicted alcohol relapse, gender did not moderate these effects. Gender did moderate the association between marriage and alcohol relapse. For women, marriage and marital stress were risk factors for alcohol relapse; among men, marriage lowered relapse risk. This gender difference in the role of marriage in relapse may be a result of partner differences in problem drinking. Alcoholic women are more likely to be married to heavy drinking partners than are alcoholic men; thus, alcoholic women may be put at risk of relapse by marriage and alcoholic men may be protected by marriage. There are fewer studies documenting gender differences in substance abuse relapse so conclusions are limited and tentative. In contrast to the lack of gender differences in alcohol relapse rates, women appear less likely to experience relapse to substance use, relative to men. Women relapsing to substance use appear to be more sensitive to negative affect and interpersonal problems. Men, in contrast, may be more likely to have positive experiences prior to relapse.

  6. The modified Puestow procedure for chronic relapsing pancreatitis in children.

    Science.gov (United States)

    Crombleholme, T M; deLorimier, A A; Way, L W; Adzick, N S; Longaker, M T; Harrison, M R

    1990-07-01

    Chronic relapsing pancreatitis in children is an unusual condition that often goes undiagnosed and untreated for years. In light of recent reports in adults that endocrine and exocrine function may be preserved by early pancreaticojejunostomy, we reviewed our experience with this procedure (one Duval, 10 Puestows) in 10 children between 1969 and 1989. The underlying etiology was familial pancreatitis in four patients, one case of unknown etiology, congenital ductal anomalies in four (one pancreas divisum, one annular pancreas, one choledochal cyst, and one ductal stenosis), and posttraumatic in one. All 10 had intractable recurrent abdominal pain. Preoperatively, only three patients evidenced exocrine insufficiency and none had endocrine insufficiency. There was complete resolution of pain in eight patients and improvement in two during a mean observation period of 4 years (range, 7 months to 19.75 years). Exocrine insufficiency resolved in two patients but has persisted in the third patient now on Viokase. Endocrine insufficiency has developed during follow-up in one patient. Pancreaticojejunostomy provides excellent relief of recurrent pain in chronic relapsing pancreatitis in children. Endoscopic retrograde cholangiopancreatography (ERCP) is indicated when the diagnosis of chronic relapsing pancreatitis is suspected to define the ductal anatomy. Pancreaticojejunostomy may prevent the progression of exocrine and endocrine insufficiency if performed early in the course of the disease.

  7. Implications of human trafficking in Asia: a scoping review of aftercare initiatives centered on economic development.

    Science.gov (United States)

    Camp, Meghan A; Barner, John R; Okech, David

    2018-01-01

    The trafficking of persons is one of the most egregious violations of human rights in modern society. Given the disproportionate effects across demographic categories of age and gender, as well as concentrated impacts within the developing world, there is a strong need for research and literature on program effectiveness and appropriate aftercare efforts for those persons whose lives and livelihoods have been impacted by trafficking. The purpose of this article is to provide a scoping review of what is known about effectively helping survivors of human trafficking experiencing lack of economic opportunity and the implications for practice and future research regarding the absence of literature. From over 14,000 initial search results, this article focuses on those initiatives (N = 16) that support economic development of the individual or family after being trafficked. Implications arising from the review for trafficking policy, areas for further research, and implications for practitioners are highlighted and discussed.

  8. A new funding model for nursing education through business development initiatives.

    Science.gov (United States)

    Broome, Marion E; Bowersox, Dave; Relf, Michael

    Public and private higher education funding models are shifting from traditional funding of schools and departments to a model in which schools increasingly rely on revenue other than tuition to fulfill and supplement activities related to their core missions. In this paper we discuss what nursing deans need to know about non tuition funding in this contemporary paradigm. We focus on how the Duke University School of Nursing created a Business Development Initiative (BDI) that provides additional revenue to help meets the financial needs of its' programs while nurturing the entrepreneurial spirit of faculty and staff. This BDI holds promise as a model that can be adapted by other schools seeking to support education, research and professional development initiatives without relying solely on tuition, tax dollars, endowments and/or grants. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Addressing Gaps in Mental Health and Addictions Nursing Leadership: An Innovative Professional Development Initiative.

    Science.gov (United States)

    Gehrs, Margaret; Strudwick, Gillian; Ling, Sara; Reisdorfer, Emilene; Cleverley, Kristin

    2017-01-01

    Mental health and addictions services are integral to Canada's healthcare system, and yet it is difficult to recruit experienced nurse leaders with advanced practice, management or clinical informatics expertise in this field. Master's-level graduates, aspiring to be mental health nurse leaders, often lack the confidence and experience required to lead quality improvement, advancements in clinical care, service design and technology innovations for improved patient care. This paper describes an initiative that develops nursing leaders through a unique scholarship, internship and mentorship model, which aims to foster confidence, critical thinking and leadership competency development in the mental health and addictions context. The "Mutual Benefits Model" framework was applied in the design and evaluation of the initiative. It outlines how mentee, mentor and organizational needs can drive strategic planning of resource investment, mentorship networks and relevant leadership competency-based learning plans to optimize outcomes. Five-year individual and organizational outcomes are described. © 2017 Longwoods Publishing.

  10. Very Late Local Relapse of Ewing's Sarcoma of the Head and Neck treated with Aggressive Multimodal Therapy

    Directory of Open Access Journals (Sweden)

    J. Thariat

    2008-01-01

    Full Text Available Ewing's sarcoma's relapse rarely occurs more than two years after the initial diagnosis. We report the case of a 26-year-old man with a history of Ewing's sarcoma of the left maxillary sinus at the age of 10 who presented with a very late local relapse, 16 years after the first occurrence of disease. Ultimate control was achieved after multimodal therapy including surgery, high-dose chemotherapy, and radiotherapy. This report indicates that local relapses of Ewing's sarcoma can be treated with curative intent in selected cases.

  11. Fiscal Year 2014 Annual Report on BNLs Next Generation Safeguards Initiative Human Capital Development Activities

    Energy Technology Data Exchange (ETDEWEB)

    Pepper, Susan E. [Brookhaven National Lab. (BNL), Upton, NY (United States)

    2014-10-10

    Brookhaven National Laboratory’s (BNL’s) Nonproliferation and National Security Department contributes to the National Nuclear Security Administration Office of Nonproliferation and International Security Next Generation Safeguards Initiative (NGSI) through university engagement, safeguards internships, safeguards courses, professional development, recruitment, and other activities aimed at ensuring the next generation of international safeguards professionals is adequately prepared to support the U.S. safeguards mission. This report is a summary of BNL s work under the NGSI program in Fiscal Year 2014.

  12. Organic marketing initiatives and rural development - lessons learned for the organic industry

    DEFF Research Database (Denmark)

    Kristensen, Niels Heine; Kujala, Jouni

    2005-01-01

    Kujala J, Kristensen NH, (2005): Organic marketing initiatives and rural development - lessons learned for the organic industry. Article in "Organic farming for a new millennium - status and future challenges". Published by Nordic Association of Agricultural Scientists (NJF). Swedish University...... of Agricultural Sciences Alnarp, Sweden. NJF-Seminar 369, June 15-17, 2005. Electronic version available at www.njf.nu. ISSN 1653-2015...

  13. Developer Initiation and Social Interactions in OSS: A Case Study of the Apache Software Foundation

    Science.gov (United States)

    2014-08-01

    pp. 201–215, 2003. 2. K. Crowston, K. Wei, J. Howison, and A. Wiggins, “Free/ libre open-source software devel- opment: What we know and what we do not...Understanding the process of participating in open source communities,” in International Workshop on Emerging Trends in Free/ Libre /Open Source Software ...Noname manuscript No. (will be inserted by the editor) Developer Initiation and Social Interactions in OSS: A Case Study of the Apache Software

  14. Initiatives driving accelerated access to medicines in Europe: Review of recent concepts and developments

    Directory of Open Access Journals (Sweden)

    Mia Gannedahl

    2018-03-01

    Full Text Available Improving timely patient access to new medicines, particularly in areas with high unmet need, has been a healthcare priority during the past 5–10 years, with several new regulatory initiatives from the European Medicines Agency, as well as on national level within the European Union. Nevertheless, evidence suggests that medicines going through these regulatory initiatives experience variable reimbursement outcomes due to uncertainties in the clinical or economic evidence base. New initiatives, including the adaptive pathways concept, have therefore been introduced that embrace a holistic view of a medicine’s route to patient access. These involve expanded clusters of stakeholders working together to prospectively influence and design evidence generation strategies, including use of real-world evidence, to ensure that development plans meet the needs of multiple stakeholders including regulatory agencies and health technology assessment bodies. Multi-stakeholder dialogues, provided through scientific advice, are already available for medicines in Europe in various forms and are important tools for regulators, health technology assessment bodies and pharmaceutical companies to develop evidence generation plans optimised to support decision-making on marketing authorisation and reimbursement of new medicines. Multiple stakeholder groups have been actively engaged in advancing developments of initiatives driving timely access and it is likely to continue due to the need to balance this with affordability. The aim of this article is to provide a review of the latest, as well as a future perspective on, developments with respect to accelerated access of medicines in the European Union with a particular focus on procedures for formal scientific advice.

  15. Relapses in Multiple Sclerosis: Definition, Pathophysiology, Features, Imitators, and Treatment

    Directory of Open Access Journals (Sweden)

    Serhan Sevim

    2016-09-01

    Full Text Available Relapse in multiple sclerosis (MS is defined as a neurologic deficit associated with an acute inflammatory demyelinating event that lasts at least 24 hours in the absence of fever and infection. Myelinoclasis and axonal transection occur in relapses. Diagnosis, prognosis, treatment, and many other features of the disease are directly related to the relapses. MS starts as the relapsing-remitting (RRMS form in 85% of patients. A large number of relapses in the first years, polysymptomatic relapses, and pyramidal system, brain stem, and spinal cord involvement are signs of a poor outcome. The average frequency of relapses is approximately one per year during the first years of RRMS. The frequency of relapses increases during systemic infections, psychological stress, and in the postpartum first 3 months. Seventy-five percent of relapses are monosymptomatic. Pseudo-relapses and paroxysmal symptoms are distinguished from relapses by their sudden onset, sudden termination, and shorter duration. Contrast enhancement is valuable in imaging, but undetectable in most relapses. The regression in the first few weeks of relapses is explained by reduction of the edema, and by remyelination in the following months. Relapses and their features are also among the main determinants of treatment. High-dose methylprednisolone and early treatment with adrenocorticotropic hormone reduce post-relapse disability and shorten the duration of relapses. Plasmapheresis is a good option for patients who do not respond to steroid treatment. Identification of relapses by patients and physicians, distinguishing them from imitators, proper evaluation, treatment when necessary, and monitoring the results are of great importance for patients with MS. The educational levels of patients and physicians regarding these parameters should be increased. Well-designed studies that evaluate the long-term effect of relapse treatment on disability are needed.

  16. PARATHYROID CANCER OCCURRING IN RELAPSING SECONDARY HYPERPARATHYROIDISM

    Directory of Open Access Journals (Sweden)

    I. V. Kotova

    2016-01-01

    Full Text Available We present a clinical case of parathyroid cancer in a patient with relapsing secondary hyperparathyroidism at 4 years after subtotal parathyroidectomy. Its unique character is related to the combination of relapsing secondary hyperparathyroidism, parathyromatosis, ectopic of an adenomatous hyperplastic parathyroid gland into the thyroid gland, and parathyroid cancer. Several most complicated aspects of parathyroid surgery are disclosed, such as the choice of strategy for surgical intervention in secondary hyperparathyroidism, complexity of morphological and cytological diagnostics of this disorder.

  17. Track treeing mechanism and plastic zone in solid Part 1: Initial development of plastic zone

    International Nuclear Information System (INIS)

    Li Boyang

    2008-01-01

    After neutron exposure and chemical etching in advance, latent tracks of recoil nucleon develop into pits on CR39 surface. During electrochemical etching, plastic zone is formed at top of pits. Some pits develop into tree cracks in the initial stage of plastic zone development. Physical and mathematical model of crack and plastic zone is proposed; parameter of development free path of plastic zone is presented. Based on integration of elementary theories the stress analysis is build up; based on analyses of measured parameters, a set of common relations between parameters is obtained. Integrate parameter analysis and stress analysis, depth of plastic zone development, law and phenomenon in experimental data can be interpreted completely

  18. Relapse Risk Assessment for Schizophrenia Patients (RASP): A New Self-Report Screening Tool.

    Science.gov (United States)

    Velligan, Dawn; Carpenter, William; Waters, Heidi C; Gerlanc, Nicole M; Legacy, Susan N; Ruetsch, Charles

    2018-01-01

    The Relapse Assessment for Schizophrenia Patients (RASP) was developed as a six-question self-report screener that measures indicators of Increased Anxiety and Social Isolation to assess patient stability and predict imminent relapse. This paper describes the development and psychometric characteristics of the RASP. The RASP and Positive and Negative Syndrome Scale (PANSS) were administered to patients with schizophrenia (n=166) three separate times. Chart data were collected on a subsample of patients (n=81). Psychometric analyses of RASP included tests of reliability, construct validity, and concurrent validity of items. Factors from RASP were correlated with subscales from PANSS (sensitivity to change and criterion validity [agreement between RASP and evidence of relapse]). Test-retest reliability returned modest to strong agreement at the item level and strong agreement at the questionnaire level. RASP showed good item response curves and internal consistency for the total instrument and within each of the two subscales (Increased Anxiety and Social Isolation). RASP Total Score and subscales showed good concurrent validity when correlated with PANSS Total Score, Positive, Excitement, and Anxiety subscales. RASP correctly predicted relapse in 67% of cases, with good specificity and negative predictive power and acceptable positive predictive power and sensitivity. The reliability and validity data presented support the use of RASP in settings where addition of a brief self-report assessment of relapse risk among patients with schizophrenia may be of benefit. Ease of use and scoring, and the ability to administer without clinical supervision allows for routine administration and assessment of relapse risk.

  19. Risk factors for tuberculosis treatment failure, default, or relapse and outcomes of retreatment in Morocco.

    Science.gov (United States)

    Dooley, Kelly E; Lahlou, Ouafae; Ghali, Iraqi; Knudsen, Janine; Elmessaoudi, My Driss; Cherkaoui, Imad; El Aouad, Rajae

    2011-02-28

    Patients with tuberculosis require retreatment if they fail or default from initial treatment or if they relapse following initial treatment success. Outcomes among patients receiving a standard World Health Organization Category II retreatment regimen are suboptimal, resulting in increased risk of morbidity, drug resistance, and transmission.. In this study, we evaluated the risk factors for initial treatment failure, default, or early relapse leading to the need for tuberculosis retreatment in Morocco. We also assessed retreatment outcomes and drug susceptibility testing use for retreatment patients in urban centers in Morocco, where tuberculosis incidence is stubbornly high. Patients with smear- or culture-positive pulmonary tuberculosis presenting for retreatment were identified using clinic registries in nine urban public clinics in Morocco. Demographic and outcomes data were collected from clinical charts and reference laboratories. To identify factors that had put these individuals at risk for failure, default, or early relapse in the first place, initial treatment records were also abstracted (if retreatment began within two years of initial treatment), and patient characteristics were compared with controls who successfully completed initial treatment without early relapse. 291 patients presenting for retreatment were included; 93% received a standard Category II regimen. Retreatment was successful in 74% of relapse patients, 48% of failure patients, and 41% of default patients. 25% of retreatment patients defaulted, higher than previous estimates. Retreatment failure was most common among patients who had failed initial treatment (24%), and default from retreatment was most frequent among patients with initial treatment default (57%). Drug susceptibility testing was performed in only 10% of retreatment patients. Independent risk factors for failure, default, or early relapse after initial treatment included male gender (aOR = 2.29, 95% CI 1

  20. Development and Initial Validation of the Five-Factor Model Adolescent Personality Questionnaire (FFM-APQ).

    Science.gov (United States)

    Rogers, Mary E; Glendon, A Ian

    2018-01-01

    This research reports on the 4-phase development of the 25-item Five-Factor Model Adolescent Personality Questionnaire (FFM-APQ). The purpose was to develop and determine initial evidence for validity of a brief adolescent personality inventory using a vocabulary that could be understood by adolescents up to 18 years old. Phase 1 (N = 48) consisted of item generation and expert (N = 5) review of items; Phase 2 (N = 179) involved item analyses; in Phase 3 (N = 496) exploratory factor analysis assessed the underlying structure; in Phase 4 (N = 405) confirmatory factor analyses resulted in a 25-item inventory with 5 subscales.

  1. INL Human Resource Development and the Next-Generation Safeguards Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Gouveia, Fernando; Metcalf, Richard Royce Madison

    2010-07-01

    It is the stated goal of the Next Generation Safeguards Initiative (NGSI) to promote the development of a strengthened nuclear safeguards base, one with the potential to advance the secure and peaceful implementation of nuclear energy world-wide. To meet this goal, the initiative, among other things, has sought to develop a revitalized effort to ensure the continued availability of next generation safeguards professionals. Accordingly, this paper serves to outline the human capital building strategies taken by Idaho National Laboratory (INL) in line with the NGSI. Various components are presented in detail, including INL’s efforts directed at university outreach, in particular the laboratory’s summer internship program, along with the development of various innovative training programs and long-term oriented strategies for student professional development. Special highlights include a video training series, developed by INL in cooperation with LLNL and other laboratories, which sought to expose students and entry-level professionals to the concept and practice of international nuclear safeguards.

  2. Extending prednisolone treatment does not reduce relapses in childhood nephrotic syndrome

    NARCIS (Netherlands)

    Teeninga, N.; Kist-van Holthe, J.E.; Rijswijk, N. van; Mos, N.I. de; Hop, W.C.J.; Wetzels, J.F.M.; Heijden, A.J. van der; Nauta, J.

    2013-01-01

    Prolonged prednisolone treatment for the initial episode of childhood nephrotic syndrome may reduce relapse rate, but whether this results from the increased duration of treatment or a higher cumulative dose remains unclear. We conducted a randomized, double-blind, placebo-controlled trial in 69

  3. Development and validation of the measure of initial attraction- Short Interest Scale (MIA-I

    Directory of Open Access Journals (Sweden)

    David Rodrigues

    2015-06-01

    Full Text Available Unilateral initial attraction (UIA is a positive affective reaction following a unilateral perception of an unknown target, defining the first stage in developing a new interpersonal relationship. Although little attention is given to this construct, literature suggests it has a physiological activation component as well as an interpersonal interest component. However, this interest component emerges as necessary to willingly approach another person and eventually initiate interaction. Based on these evidences, we developed and validated the Measure of Initial Attraction - Interest Short Scale (MIA-I in a sample of Portuguese-speaking individuals (Study 1, N = 544. Results suggest the MIA-I is a valid and reliable instrument (Study 1; Study 2a, and show its capacity to discriminate UIA across different relationships (Study 1 and to differentiate UIA from passion and love (Study 1. Towards an unknown target, the MIA-I also distinguished UIA from liking (Study 2b. These results show that the MIA-I assesses a specific construct, differentiated from liking, passion and love, and suggest its importance to understand the UIA phenomenon.

  4. Heavy-Section Steel Technology Program: Recent developments in crack initiation and arrest research

    International Nuclear Information System (INIS)

    Pennell, W.E.

    1991-01-01

    Technology for the analysis of crack initiation and arrest is central to the reactor pressure vessel fracture-margin-assessment process. Regulatory procedures for nuclear plants utilize this technology to assure the retention of adequate fracture-prevention margins throughout the plant operating license period. As nuclear plants age and regulatory procedures dictate that fracture-margin assessments be performed, interest in the fracture-mechanics technology incorporated into those procedures has heightened. This has led to proposals from a number of sources for development and refinement of the underlying crack-initiation and arrest-analysis technology. An important element of the Heavy-Section Steel Technology (HSST) Program is devoted to the investigation and evaluation of these proposals. This paper presents the technological bases and fracture-margin assessment objectives for some of the recently proposed crack-initiation and arrest-technology developments. The HSST Program approach to the evaluation of the proposals is described and the results and conclusions obtained to date are presented

  5. The Development of a Strategic Prioritisation Method for Green Supply Chain Initiatives.

    Science.gov (United States)

    Masoumik, S Maryam; Abdul-Rashid, Salwa Hanim; Olugu, Ezutah Udoncy

    2015-01-01

    To maintain a competitive position, companies are increasingly required to integrate their proactive environmental strategies into their business strategies. The shift from reactive and compliance-based to proactive and strategic environmental management has driven companies to consider the strategic factors while identifying the areas in which they should focus their green initiatives. In previous studies little attention was given to providing the managers with a basis from which they could strategically prioritise these green initiatives across their companies' supply chains. Considering this lacuna in the literature, we present a decision-making method for prioritising green supply chain initiatives aligned with the preferred green strategies alternatives for the manufacturing companies. To develop this method, the study considered a position between determinism and the voluntarism orientation of environmental management involving both external pressures and internal competitive drivers and key resources as decision factors. This decision-making method was developed using the analytic network process (ANP) technique. The elements of the decision model were derived from the literature. The causal relationships among the multiple decision variables were validated based on the results of structural equation modelling (SEM) using a dataset collected from a survey of the ISO 14001-certified manufacturers in Malaysia. A portion of the relative weights required for computation in ANP was also calculated using the SEM results. A case study is presented to demonstrate the applicability of the method.

  6. Developing and Implementing a Food Insecurity Screening Initiative for Adult Patients Living With Type 2 Diabetes.

    Science.gov (United States)

    Thomas, Brittany; Fitzpatrick, Sandra; Sidani, Souraya; Gucciardi, Enza

    2018-06-01

    Routine food insecurity screening is recommended in diabetes care to inform more tailored interventions that better support diabetes self-management among food-insecure patients. This pilot study explored the acceptability and feasibility of a food insecurity screening initiative within a diabetes care setting in Toronto. A systematic literature review informed the development of a food insecurity screening initiative to help health-care providers tailor diabetes management plans and better support food-insecure patients with type 2 diabetes. Interviews with 10 patients and a focus group with 15 care providers elicited feedback on the relevance and acceptance of the food insecurity screening questions and a care algorithm. Subsequently, 5 care providers at 4 sites implemented the screening initiative over 2 weeks, screening 33 patients. After implementation, 7 patients and 5 care providers were interviewed to assess the acceptability and feasibility of the screening initiative. Our findings demonstrate that patients are willing to share their experiences of food insecurity, despite the sensitivity of this topic. Screening elicited information about how patients cope with food insecurity and how this affects their ability to self-manage diabetes. Care providers found this information helpful in directing their care and support for patients. Using a standardized, respectful method of assessing food insecurity can better equip health-care providers to support food-insecure patients with diabetes self-management. Further evaluation of this initiative is needed to determine how food insecurity screening can affect patients' self-management and related health outcomes. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Developing a service improvement initiative for people with learning disabilities in hospice settings.

    Science.gov (United States)

    Springall, Fiona

    2018-03-21

    People with learning disabilities are often marginalised in healthcare, including in hospice settings, and as a result may not receive effective end of life care. Research in hospice settings has identified that many staff lack confidence, skills and knowledge in caring for people with learning disabilities, which can have a negative effect on the care these individuals receive. To address these issues, the author has proposed a service improvement initiative, which she developed as part of her learning disability nursing degree programme. This proposed initiative aimed to enhance end of life care for people with learning disabilities through the implementation of a community learning disability link nurse in the hospice setting. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  8. Heavy-Section Steel Technology Program: Recent developments in crack initiation and arrest research

    International Nuclear Information System (INIS)

    Pennell, W.E.

    1991-01-01

    Technology for the analysis of crack initiation and arrest is central to the reactor pressure vessel fracture-margin-assessment process. Regulatory procedures for nuclear plants utilize this technology to assure the retention of adequate fracture-prevention margins throughout the plant operating license period. As nuclear plants age and regulatory procedures dictate that fracture-margin assessments be performed, interest in the fracture-mechanics technology incorporated into those procedures has heightened. This has led to proposals from a number of sources for development and refinement of the underlying crack-initiation and arrest-analysis technology. This paper presents an overview of ongoing Heavy-Section Steel Technology (HSST) Program research aimed at refining the fracture toughness data used in the analysis of fracture margins under pressurized-thermal-shock loading conditions. 33 refs., 13 figs

  9. Relapse to cocaine seeking in an invertebrate.

    Science.gov (United States)

    Amaning-Kwarteng, Akua O; Asif-Malik, Aman; Pei, Yue; Canales, Juan J

    2017-06-01

    Addiction is characterised by cycles of compulsive drug taking, periods of abstinence and episodes of relapse. The extinction/reinstatement paradigm has been extensively used in rodents to model human relapse and explore underlying mechanisms and therapeutics. However, relapse to drug seeking behaviour has not been previously demonstrated in invertebrates. Here, we used a cocaine conditioned place preference (CPP) paradigm in the flatworm, planarian, followed by extinction and reinstatement of drug seeking. Once baseline preference was established for one of two distinctly textured environments (i.e. compartments with a coarse or smooth surface), planarian received pairings of cocaine (5μM) in the non-preferred, and vehicle in the most preferred, environment, and were tested for conditioning thereafter. Cocaine produced robust CPP, measured as a significant increase in the time spent in the cocaine-paired compartment. Subsequently, planarian underwent extinction training, reverting back to their original preference within three sessions. Brief exposure to cocaine (5μM) or methamphetamine (5μM) reinstated cocaine-seeking behaviour. By contrast, the high affinity dopamine transporter inhibitor, (N-(n-butyl)-3α-[bis (4-fluorophenyl) methoxy]-tropane) (JHW007), which in rodents exhibits a neurochemical and behavioural profile distinct from cocaine, was ineffective. The present findings demonstrate for the first time reinstatement of extinguished cocaine seeking in an invertebrate model and suggest that the long-term adaptations underlying drug conditioning and relapse are highly conserved through evolution. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Relapsing/remitting type 1 diabetes

    NARCIS (Netherlands)

    van Megen, Kayleigh M.; Spindler, Matthew P.; Keij, Fleur M.; Bosch, Ineke; Sprangers, Fleur; van Royen-Kerkhof, Annet; Nikolic, Tatjana; Roep, Bart O.

    2017-01-01

    Aims/hypothesis: Type 1 diabetes is believed to be an autoimmune disease associated with irreversible loss of insulin secretory function that follows a chronic progressive course. However, it has been speculated that relapsing/remitting disease progression may occur in type 1 diabetes. Methods: We

  11. Recurrence and Relapse in Bipolar Mood Disorder

    Directory of Open Access Journals (Sweden)

    S Gh Mousavi

    2004-06-01

    Full Text Available Background: Despite the effectiveness of pharmacotherapy in acute phase of bipolar mood disorder, patients often experience relapses or recurrent episodes. Hospitalization of patients need a great deal of financial and humanistic resources which can be saved through understanding more about the rate of relapse and factors affecting this rate. Methods: In a descriptive analytical study, 380 patients with bipolar disorder who were hospitalized in psychiatric emergency ward of Noor hospital, Isfahan, Iran, were followed. Each patient was considered for; the frequency of relapse and recurrence, kind of pharmachotherapy, presence of psychotherapeutic treatments, frequency of visits by psychiatrist and the rank of present episode. Results: The overall prevalence of recurrence was 42.2%. Recurrence was lower in patients using lithium carbonate or sodium valproate or combined therapy (about 40%, compared to those using carbamazepine (80%. Recurrence was higher in patients treated with only pharmacotherapy (44.5% compared to those treated with both pharmacotherapy and psychotherapy (22.2%. Patients who were visited monthy by psychiatrist had lower rate of recurrence compared to those who had irregular visits. Conclusion: The higher rate of recurrence observed in carbamazepine therapy may be due to its adverse reactions and consequently poor compliance to this drug. Lower rates of recurrence with psychotherapy and regular visits may be related to the preventive effects of these procedures and especially to the effective management of stress. Keywords: Bipolar Mood Disorder, Recurrence, Relapse.

  12. Resistance to Change and Relapse of Observing

    Science.gov (United States)

    Thrailkill, Eric A.; Shahan, Timothy A.

    2012-01-01

    Four experiments examined relapse of extinguished observing behavior of pigeons using a two-component multiple schedule of observing-response procedures. In both components, unsignaled periods of variable-interval (VI) food reinforcement alternated with extinction and observing responses produced stimuli associated with the availability of the VI…

  13. High rates of relapse in adolescents crack users after inpatient clinic discharge

    Directory of Open Access Journals (Sweden)

    Rosemeri Siqueira Pedroso

    Full Text Available ABSTRACT Objective The objective of the present study was to evaluate 88 adolescent crack users referred to hospitalization and to follow them up after discharge to investigate relapse and factors associated with treatment. Methods Cohort (30 and 90 days after discharge from a psychiatric hospital and a rehab clinic for treatment for chemical dependency in Porto Alegre between 2011 and 2012. Instruments: Semi-structured interview, conducted to evaluate the sociodemographic profile of the sample and describe the pattern of psychoactive substance use; Crack Use Relapse Scale/CURS; Questionnaire Tracking Users to Crack/QTUC; K-SADS-PL. Results In the first follow-up period (30 days after discharge, 65.9% of participants had relapsed. In the second follow-up period (90 days after discharge, 86.4% of participants had relapsed. Conclusion This is one of the first studies that show the extremely high prevalence of early relapse in adolescent crack users after discharge, questioning the cost/benefit of inpatient treatment for this population. Moreover, these results corroborate studies which suggested, young psychostimulants users might need tailored intensive outpatient treatment with contingency management and other behavioral strategies, in order to increase compliance and reduce drug or crime relapse, but this specific therapeutic modality is still scarce and must be developed in Brazil.

  14. Multiple sclerosis, relapses, and the mechanism of action of adrenocorticotropic hormone (ACTH

    Directory of Open Access Journals (Sweden)

    Amy ePerrin Ross

    2013-03-01

    Full Text Available Relapses in multiple sclerosis (MS are disruptive and frequently disabling for patients, and their treatment is often a challenge to clinicians. Despite progress in the understanding of the pathophysiology of MS and development of new treatments for long-term management of MS, options for treating relapses have not changed substantially over the past few decades. Corticosteroids, a component of the HPA axis that modulate immune responses and reduce inflammation, are currently the mainstay of relapse treatment. Adrenocorticotropic hormone (ACTH gel is another treatment option. Although it has long been assumed that the efficacy of ACTH in treating relapses depends on the peptide’s ability to increase endogenous corticosteroid production, evidence from research on the melanocortin system suggests that steroidogenesis may only partly account for ACTH influences. Indeed, the melanocortin peptides (ACTH and α-, β-, γ-melanocyte-stimulating hormones [MSH] and their receptors (MCRs exert multiple actions, including modulation of inflammatory and immune mediator production. Melanocortin receptors are widely distributed within the central nervous system and in peripheral tissues including immune cells (eg, macrophages. This suggests that the mechanism of action of ACTH includes not only steroid-mediated indirect effects, but also direct anti-inflammatory and immune-modulating actions via the melanocortin system. An increased understanding of the role of the melanocortin system, particularly ACTH, in the immune and inflammatory processes underlying relapses may help to improve relapse management.

  15. Development and initial feedback about a human papillomavirus (HPV) vaccine comic book for adolescents.

    Science.gov (United States)

    Katz, Mira L; Oldach, Benjamin R; Goodwin, Jennifer; Reiter, Paul L; Ruffin, Mack T; Paskett, Electra D

    2014-06-01

    Human papillomavirus (HPV) vaccination rates do not meet the Healthy People 2020 objective of 80% coverage among adolescent females. We describe the development and initial feedback about an HPV vaccine comic book for young adolescents. The comic book is one component of a multilevel intervention to improve HPV vaccination rates among adolescents. Parents suggested and provided input into the development of a HPV vaccine comic book. Following the development of the comic book, we conducted a pilot study to obtain initial feedback about the comic book among parents (n = 20) and their adolescents ages 9 to 14 (n = 17) recruited from a community-based organization. Parents completed a pre-post test including items addressing HPV knowledge, HPV vaccine attitudes, and about the content of the comic book. Adolescents completed a brief interview after reading the comic book. After reading the comic book, HPV knowledge improved (2.7 to 4.6 correct answers on a 0-5 scale; p book's content was acceptable and adolescents liked the story, found it easy to read, and thought the comic book was a good way to learn about being healthy. Parents provided valuable information in the development of a theoretically-based comic book and the comic book appears to be an acceptable format for providing HPV vaccine information to adolescents. Future research will include the comic book in an intervention study to improve HPV vaccination rates.

  16. Development of the Indigenous Child-Initiated Pretend Play Assessment: Selection of play materials and administration.

    Science.gov (United States)

    Dender, Alma; Stagnitti, Karen

    2011-02-01

    There is a need for culturally appropriate assessments for Australian Indigenous children. This article reports the selection of culturally appropriate and gender-neutral play materials, and changes in administration identified to develop further the Indigenous Child-Initiated Pretend Play Assessment (I-ChIPPA). Twenty-three typically developing children aged four to six years from the Pilbara region in Western Australia participated in the study. Children were presented with four sets of play materials and frequency counts were recorded for each time the child used one of the play materials in a pretend play action. Twelve of the 23 children came to play in pairs. Both boys and girls used the Pilbara toy set including the dark coloured dolls and Pilbara region animals, more frequently than the standardised play materials from the Child-Initiated Pretend Play Assessment (ChIPPA). This study reports the first steps in the development of the I-ChIPPA. Future development will include the refinement of the administration and scoring with pairs of children, and then validity testing the assessment. © 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.

  17. PREDICTION OF RELAPSE FROM HYPERTHYROIDISM FOLLOWING ANTITHYROID MEDICATION WITHDRAWAL USING TECHNETIUM THYROID UPTAKE SCANNING.

    Science.gov (United States)

    Nakhjavani, Manouchehr; Abdollahi, Soraya; Farzanefar, Saeed; Abousaidi, Mohammadtagi; Esteghamati, Alireza; Naseri, Maryam; Eftekhari, Mohamad; Abbasi, Mehrshad

    2017-04-02

    Technetium thyroid uptake (TTU) is not inhibited by antithyroid drugs (ATD) and reflects the degree of thyroid stimulation. We intended to predict the relapse rate from hyperthyroidism based on TTU measurement. Out of 44 initially enrolled subjects, 38 patients aged 41.6 ± 14.6 with Graves disease (duration: 84 ± 78 months) completed the study. TTU was performed with 40-second imaging of the neck and mediastinum 20 minutes after injection of 1 mCi technetium-99m pertechnetate. TTU was measured as the percentage of the count of activity accumulated in the thyroidal region minus the mediastinal background uptake to the count of 1 mCi technetium-99m under the same acquisition conditions. Then methimazole was stopped and patients were followed. The optimal TTU cutoff value for Graves relapse prediction was calculated using Youden's J statistic. Hyperthyroidism relapsed in 11 (28.9%) patients 122 ± 96 (range: 15-290) days post-ATD withdrawal. The subjects in remission were followed for 209 ± 81 days (range: 88-390). TTU was significantly higher in patients with forthcoming relapse (12.0 ± 8.0 vs. 3.9 ± 2.0, P = .007). The difference was significant after adjustment for age, sex, history of previous relapse, disease duration, and thyroid-stimulating hormone (TSH) levels before withdrawal. The area under the receiver operative characteristic (ROC) curve was 0.87. The optimal TTU cutoff value for classification of subjects with relapse and remission was 8.7 with sensitivity, specificity, and positive and negative predictive value of 73%, 100%, 100%, and 90%, respectively (odds ratio [OR] = 10.0; 95% confidence interval [CI]: 3.4-29.3). TTU evaluation in hyperthyroid patients receiving antithyroid medication is an accurate and practical method for predicting relapse after ATD withdrawal. ATD = antithyroid drugs RIU = radio-iodine uptake TSH = thyroid-stimulating hormone TSI = thyroid-stimulating immunoglobulin TTU = technetium thyroid uptake.

  18. Initial Development and Pilot Study Design of Interactive Lecture Demonstrations for ASTRO 101

    Science.gov (United States)

    Schwortz, Andria C.; French, D. A; Gutierrez, Joseph V; Sanchez, Richard L; Slater, Timothy F.; Tatge, Coty

    2014-06-01

    Interactive lecture demonstrations (ILDs) have repeatedly shown to be effective tools for improving student achievement in the context of learning physics. As a first step toward systematic development of interactive lecture demonstrations in ASTRO 101, the introductory astronomy survey course, a systematic review of education research, describing educational computer simulations (ECSs) reveals that initial development requires a targeted study of how ASTRO 101 students respond to ECSs in the non-science majoring undergraduate lecture setting. In this project we have adopted the process by which ILDs were designed, pilot-tested, and successfully implemented in the context of physics teaching (Sokoloff & Thornton, 1997; Sokoloff & Thornton, 2004). We have designed the initial pilot-test set of ASTRO 101 ILD instructional materials relying heavily on ECSs. Both an instructor’s manual and a preliminary classroom-ready student workbook have been developed, and we are implementing a pilot study to explore their effectiveness in communicating scientific content, and the extent to which they might enhance students’ knowledge of and perception about astronomy and science in general. The study design uses a pre-/post-test quasi-experimental study design measuring students’ normalized gain scores, calculated as per Hake (1998) and Prather (2009), using a slightly modified version of S. Slater’s (2011) Test Of Astronomy STandards TOAST combined with other instruments. The results of this initial study will guide the iterative development of ASTRO 101 ILDs that are intended to both be effective at enhancing student achievement and easy for instructors to successfully implement.

  19. Learning service and development of emotional competencies in initial teacher training

    Directory of Open Access Journals (Sweden)

    Mayka García García

    2017-02-01

    Full Text Available This work has as main objective to make visible and analyze awareness of the emotional development of students Grade Early Childhood Education at the University of Cádiz, which are involved in Service Leaning experiences done within a pathway chasing curriculum institutionalization of it. For it, we use a qualitative methodology approach, where the personal accounts of students –as tools for gathering information– were analyzed through a previous category system. The results show, illustrated through the voice of the students, develop their emotional skills, which allows us to conclude that the scaffold ApS allows this dimension in the context of initial teacher favoring their intrapersonal and interpersonal development.

  20. Initiating the Pathway to Increase the Region's Income by Developing Tourism Village of Panglipuran Bali

    Directory of Open Access Journals (Sweden)

    M. Bashori Imron

    2015-12-01

    Full Text Available The head of regencies and cities needs to develop their imagination and inspiration in order to present the goal of region development and deliver the positive economic growth for the public. Initiating the tourism village program for the potential area may serve as a creative alternative. The aim of this research is to develop the idea of tourism village to improve the income of the region. In depth participation in the community and intensive interview with the tourism stakeholders have been chosen as the method of this study. The result of the research shows that the tourism village of Penglipuran has seven potentials as the main attractions as represented by the traditional architecture, artistic spatial arrangement, the bamboo forest, heroes cemetery, the beauty of Pura Panataran, remarkable village landscape, and Karang Memadu. The participation of local government may contribute the positive impact for the economic growth and improve the income of local community.

  1. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Comprehensive Care Developing a Healthcare Team Make the Most of Your Doctor Visits Advance Medical Directives d ... Text Print In this article Overview RRMS – the most common disease course – is characterized by clearly defined ...

  2. Relapsing-Remitting MS (RRMS)

    Medline Plus

    Full Text Available ... Conditions to Rule Out For Clinicians Treating MS Comprehensive Care Find an MS Care Provider Medications Managing ... ADEM) d For Clinicians d Treating MS d Comprehensive Care Developing a Healthcare Team Make the Most ...

  3. Potential risk factors associated with risk for drop-out and relapse during and following withdrawal of opioid prescription medication.

    Science.gov (United States)

    Heiwe, Susanne; Lönnquist, Ingeborg; Källmén, Håkan

    2011-10-01

    Withdrawal of opioid medication in patients with chronic pain has a drop-out and relapse problem. To evaluate if depressive symptoms, anxiety and pain intensity are potential risk factors for drop-out or relapse during the withdrawal process. Further, to assess internal consistency of scales for assessment of these potential risk factors. Twenty-nine patients were included. After 2 years 28 of these were followed-up. Those with depressive symptoms at baseline had a significant risk for drop-out from the withdrawal program (odds ratio 1.37) and relapse into use of opioids at follow-up (odds ratio 1.44). Drop-outs rated depressive symptoms significantly higher before detoxification. Those who relapsed rated significantly higher for pain intensity, depressive symptoms and abstinence prior to withdrawal. All scales had high reliability. To avoid drop-out and relapse clinical practice need to screen for depressive symptoms, pain intensity, and abstinence. This article presents significant reliability of scales useful within dependency centers. They can be used to identify these risk factors for drop-out and relapse, respectively, when initiating the withdrawal process. Taking these risk factors into consideration could improve the outcome of the withdrawal process by preventing drop-out and relapse. Copyright © 2011 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.

  4. Current Approaches in the Treatment of Relapsed and Refractory Acute Myeloid Leukemia

    Science.gov (United States)

    Ramos, Nestor R.; Mo, Clifton C.; Karp, Judith E.; Hourigan, Christopher S.

    2015-01-01

    The limited sensitivity of the historical treatment response criteria for acute myeloid leukemia (AML) has resulted in a different paradigm for treatment compared with most other cancers presenting with widely disseminated disease. Initial cytotoxic induction chemotherapy is often able to reduce tumor burden to a level sufficient to meet the current criteria for “complete” remission. Nevertheless, most AML patients ultimately die from their disease, most commonly as clinically evident relapsed AML. Despite a variety of available salvage therapy options, prognosis in patients with relapsed or refractory AML is generally poor. In this review, we outline the commonly utilized salvage cytotoxic therapy interventions and then highlight novel investigational efforts currently in clinical trials using both pathway-targeted agents and immunotherapy based approaches. We conclude that there is no current standard of care for adult relapsed or refractory AML other than offering referral to an appropriate clinical trial. PMID:25932335

  5. Initial closed operation of the CELSS Test Facility Engineering Development Unit

    Science.gov (United States)

    Kliss, M.; Blackwell, C.; Zografos, A.; Drews, M.; MacElroy, R.; McKenna, R.; Heyenga, A. G.

    2003-01-01

    As part of the NASA Advanced Life Support Flight Program, a Controlled Ecological Life Support System (CELSS) Test Facility Engineering Development Unit has been constructed and is undergoing initial operational testing at NASA Ames Research Center. The Engineering Development Unit (EDU) is a tightly closed, stringently controlled, ground-based testbed which provides a broad range of environmental conditions under which a variety of CELSS higher plant crops can be grown. Although the EDU was developed primarily to provide near-term engineering data and a realistic determination of the subsystem and system requirements necessary for the fabrication of a comparable flight unit, the EDU has also provided a means to evaluate plant crop productivity and physiology under controlled conditions. This paper describes the initial closed operational testing of the EDU, with emphasis on the hardware performance capabilities. Measured performance data during a 28-day closed operation period are compared with the specified functional requirements, and an example of inferring crop growth parameters from the test data is presented. Plans for future science and technology testing are also discussed. Published by Elsevier Science Ltd on behalf of COSPAR.

  6. Development and initial evaluation of Transdiagnostic Behavior Therapy (TBT) for veterans with affective disorders.

    Science.gov (United States)

    Gros, Daniel F

    2014-12-15

    Considerable attention has focused on the growing need for evidence-based psychotherapy for veterans with affective disorders within the Department of Veteran Affairs. Despite, and possibly due to, the large number of evidence-based protocols available, several obstacles remain in their widespread delivery within Veterans Affairs Medical Centers. In part as an effort to address these concerns, newer transdiagnostic approaches to psychotherapy have been developed to provide a single treatment that is capable of addressing several, related disorders. The goal of the present investigation was to develop and evaluate a transdiagnostic psychotherapy, Transdiagnostic Behavior Therapy (TBT), in veterans with affective disorders. Study 1 provided initial support for transdiagnostic presentation of evidence-based psychotherapy components in veterans with principal diagnoses of affective disorders (n=15). These findings were used to inform the development of the TBT protocol. In Study 2, an initial evaluation of TBT was completed in a second sample of veterans with principal diagnoses of affective disorders (n=29). The findings of Study 2 demonstrated significant improvements in symptoms of depression, anxiety, stress, posttraumatic stress, and related impairment across participants with various principal diagnoses. Together, the investigation provided preliminary support for effectiveness of TBT in veterans with affective disorders. Published by Elsevier Ireland Ltd.

  7. The development of the Teaching Professional Identity in the initial training of secondary teachers

    Directory of Open Access Journals (Sweden)

    Rocío SERRANO RODRÍGUEZ

    2016-06-01

    Full Text Available We present a study that aims to know how the students of the Master’s Degree in Secondary Teacher Training begin to build their Teaching Professional Identity, as well as what the main implications of this identification process are, in order to improve their training. Through an open questionnaire, a total of 355 opinions of students from the University of Córdoba have been analysed. The conclusions obtained highlight: a the students show a professional identity that is significantly less developed than in other professional groups; b it is important to develop activities to reflect on the nature of the teaching profession by improving the identification of students with the characteristics of the teaching profession. Some of the implications from this research point to the need to take into consideration the results obtained when designing the process of initial training of future secondary teachers. Particularly, it would be necessary to include the issue of Teaching Professional Identity more specifically in the curriculum of the new model of initial training. This, moreover, should be linked to the pedagogical knowledge of the contents and the acquisition of real teaching skills according to the development of the educational curriculum for each subject. 

  8. Relationship between sustainable development initiatives and improved company financial performance: A South African perspective

    Directory of Open Access Journals (Sweden)

    Darelle Groenewald

    2016-05-01

    Research purpose: The study analysed the relationship between sustainability performance and FP in South African listed companies. Motivation for the study: Some South African listed companies acknowledge in their sustainability reports that there is a link between sustainability development and long-term shareholder value. This implies that FP is linked to sustainable development performance. This relationship has not been researched for South African listed companies and therefore needs to be investigated. Research design, approach and method: A similar research method was used as for an international study. Forty-five listed South African companies were selected as the sample. Their sustainable development reports were used for analysis. Data were analysed with the use of content and a canonical correlation analysis. Main findings: The results of the study revealed that an overall positive relationship exists between sustainability performance and FP. Practical implications: South African companies that have a high involvement and focus on specific sustainable development initiatives that are integrated into overall sustainable development strategy can deliver improved FP for the organisation and deliver long-term value to its shareholders. Contribution: Six sustainable development aspects were found to be significantly correlated with improved FP and if incorporated into a company’s sustainable development strategy can lead to increased successes.

  9. Developing and initiating a public engagement process for a nuclear decommissioning and waste management program

    International Nuclear Information System (INIS)

    Badke, C.; Johnson, C.; Brooks, S.; MacCafferty, M.

    2011-01-01

    Public consultation is key to any major nuclear initiative, but how do you engage the public in a complex multi-site nuclear decommissioning and environmental restoration program that will last 70 years? A clear message of sound environmental stewardship throughout the process is critical to building the trust required to attract public interest and support. The Nuclear Legacy Liabilities Program (NLLP) manages Canada's nuclear legacy liabilities at Atomic Energy of Canada Limited (AECL) sites and is funded by the Government of Canada through Natural Resources Canada (NRCan). The objective of the NLLP is to safely and cost-effectively reduce the federal legacy liabilities and associated risks, based on sound waste management and environmental principles, in the best interest of Canadians. An important area of focus for the NLLP in both the short- and long-term is to inform the public, stakeholders and Aboriginal people about the Program, and to gather input on the long-term strategy for site restoration and waste management. This paper describes progress made to date on developing and initiating a public engagement process for the NLLP in the initial phase of the Program. Furthermore, it examines general best practices for public participation, specific challenges and opportunities which have been identified, as well as the next steps for communications activities related to the Program. (author)

  10. Preventing Relapse to Cigarette Smoking by Behavioral Skill Training.

    Science.gov (United States)

    Hall, Sharon M.; And Others

    1984-01-01

    Crossed two relapse prevention conditions (skills training-vs-discussion control) with two levels of aversive smoking in volunteer subjects (N=123). Results indicated that relapse-prevention skill training did prevent relapse among cigarette smokers. Lighter smokers were more favorably influenced. (LLL)

  11. A classification framework for drug relapse prediction | Salleh ...

    African Journals Online (AJOL)

    mining algorithms, Artificial Intelligence Neural Network (ANN) is one of the best algorithms to predict relapse among drug addicts. This may help the rehabilitation center to predict relapse individually and the prediction result is hoped to prevent drug addicts from relapse. Keywords: classification; artificial neural network; ...

  12. Pubertal development among girls with classical congenital adrenal hyperplasia initiated on treatment at different ages

    Directory of Open Access Journals (Sweden)

    Bindu Kulshreshtha

    2012-01-01

    Full Text Available Introduction: Children with congenital adrenal hyperplasia (CAH provide us an opportunity to study the clinical effects of androgen excess in humans. We studied the sequence of pubertal development in girls with congenital adrenal hyperplasia initiated on treatment at different ages, to assess the effects of androgen exposure on the Hypothalamic-Pituitary-Ovarian (HPO axis. Materials and Methods: Girls more than 18 years of age, with CAH, on follow-up at this hospital were the subjects for this study. Details of history, physical findings, laboratory evaluation, and medication were noted from their case records and verified from the patients and their / parents, in addition to assessment of their present health status. Result: We studied 24 patients of classical CAH (SW-2, SV-22, average age - 24.5 ± 6.6 years. All had varying degrees of genital ambiguity (Prader stage 3 (n = 13, Prader stage 2 (n = 10, Prader stage 1 (n = 1. Among them were13 girls, who were started on steroids after eight years of age. Girls who received treatment from infancy and early childhood had normal pubertal development (mean age at menarche 11.4 ± 1.7 years. Hirsutism was not a problem among them. Untreated children had progressive clitoral enlargement throughout childhood, developed pubic hair at around three to six years of age, and facial hair between nine and eleven years. Plasma testosterone ranged from 3 to 6 ng / ml prior to treatment. Six of the 13 untreated CAH girls had subtle breast development starting at ages 11 - 16 years and three had spontaneous infrequent vaginal bleeding starting at ages 11 - 17. Steroid supplementation initiated pubertal changes in older girls in two-to-six months′ time. Conclusion: There was a delay in HPO axis maturation (as evidenced by delayed pubertal development in the absence of treatment in girls with CAH. This could be corrected with steroid supplementation.

  13. Parental Guidance and Children’s Development of Collaborative Initiative: Cultural Contexts of Children’s Prosocial Development

    OpenAIRE

    Coppens, Andrew Dee

    2015-01-01

    Two studies examined how mothers of 2- to 3-year-olds and 6- to 7-year-olds from a US Mexican-heritage community and a middle-class European American community support children’s prosocial helping and development of collaborative initiative in work at home. Together, the studies aim to explain a ‘developmental puzzle’ suggested by taking into account separate literatures on young children’s household work contributions: Toddlers in many communities seem to be interested in helping and taking ...

  14. Spanish version of the Talent Development Environment Questionnaire for sport: Cultural adaptation and initial validation.

    Directory of Open Access Journals (Sweden)

    Javier Brazo-Sayavera

    Full Text Available This study aimed to translate the Talent Development Environment Questionnaire into Spanish and provide an initial validation. A recommended methodology for translation and cultural adaptation of questionnaires was applied. Once this had been completed, three hundred and thirty-two young athletes completed the Talent Development Environment Questionnaire. The results revealed that the five factor solution Talent Development Environment Questionnaire was confirmed. With the exclusion of one item due to low factor loading, the Talent Development Environment Questionnaire-5 had robust statistical support for its factor structure (χ2 (df = 305 = 499.64, p<0.01, CFI = 0.90, RMSEA = 0.045, SRMR = 0.055. It also demonstrated adequate convergent and discriminant validity. While the internal reliability was lower than in previous studies, it revealed acceptable levels. Specifically the overall 27 item Talent Development Environment Questionnaire-5 had a Cronbach α score of .877, and the reliability scores for individual factors 1-5 were .622; .761; .658; .605; .602 respectively. As such, it is recommended that the Spanish Talent Development Environment Questionnaire-5 can be used with confidence in Spain in both applied and research settings.

  15. Challenges and Changes: Developing Teachers' and Initial Teacher Education Students' Understandings of the Nature of Science

    Science.gov (United States)

    Ward, Gillian; Haigh, Mavis

    2017-12-01

    Teachers need an understanding of the nature of science (NOS) to enable them to incorporate NOS into their teaching of science. The current study examines the usefulness of a strategy for challenging or changing teachers' understandings of NOS. The teachers who participated in this study were 10 initial teacher education chemistry students and six experienced teachers from secondary and primary schools who were introduced to an explicit and reflective activity, a dramatic reading about a historical scientific development. Concept maps were used before and after the activity to assess teachers' knowledge of NOS. The participants also took part in a focus group interview to establish whether they perceived the activity as useful in developing their own understanding of NOS. Initial analysis led us to ask another group, comprising seven initial teacher education chemistry students, to take part in a modified study. These participants not only completed the same tasks as the previous participants but also completed a written reflection commenting on whether the activity and focus group discussion enhanced their understanding of NOS. Both Lederman et al.'s (Journal of Research in Science Teaching, 39(6), 497-521, 2002) concepts of NOS and notions of "naive" and "informed" understandings of NOS and Hay's (Studies in Higher Education, 32(1), 39-57, 2007) notions of "surface" and "deep" learning were used as frameworks to examine the participants' specific understandings of NOS and the depth of their learning. The ways in which participants' understandings of NOS were broadened or changed by taking part in the dramatic reading are presented. The impact of the data-gathering tools on the participants' professional learning is also discussed.

  16. Development of transient initiating event frequencies for use in probabilistic risk assessments

    International Nuclear Information System (INIS)

    Mackowiak, D.P.; Gentillon, C.D.; Smith, K.L.

    1985-05-01

    Transient initiating event frequencies are an essential input to the analysis process of a nuclear power plant probabilistic risk assessment. These frequencies describe events causing or requiring scrams. This report documents an effort to validate and update from other sources a computer-based data file developed by the Electric Power Research Institute (EPRI) describing such events at 52 United States commercial nuclear power plants. Operating information from the United States Nuclear Regulatory Commission on 24 additional plants from their date of commercial operation has been combined with the EPRI data, and the entire data base has been updated to add 1980 through 1983 events for all 76 plants. The validity of the EPRI data and data analysis methodology and the adequacy of the EPRI transient categories are examined. New transient initiating event frequencies are derived from the expanded data base using the EPRI transient categories and data display methods. Upper bounds for these frequencies are also provided. Additional analyses explore changes in the dominant transients, changes in transient outage times and their impact on plant operation, and the effects of power level and scheduled scrams on transient event frequencies. A more rigorous data analysis methodology is developed to encourage further refinement of the transient initiating event frequencies derived herein. Updating the transient event data base resulted in approx.2400 events being added to EPRI's approx.3000-event data file. The resulting frequency estimates were in most cases lower than those reported by EPRI, but no significant order-of-magnitude changes were noted. The average number of transients per year for the combined data base is 8.5 for pressurized water reactors and 7.4 for boiling water reactors

  17. Development of transient initiating event frequencies for use in probabilistic risk assessments

    Energy Technology Data Exchange (ETDEWEB)

    Mackowiak, D.P.; Gentillon, C.D.; Smith, K.L.

    1985-05-01

    Transient initiating event frequencies are an essential input to the analysis process of a nuclear power plant probabilistic risk assessment. These frequencies describe events causing or requiring scrams. This report documents an effort to validate and update from other sources a computer-based data file developed by the Electric Power Research Institute (EPRI) describing such events at 52 United States commercial nuclear power plants. Operating information from the United States Nuclear Regulatory Commission on 24 additional plants from their date of commercial operation has been combined with the EPRI data, and the entire data base has been updated to add 1980 through 1983 events for all 76 plants. The validity of the EPRI data and data analysis methodology and the adequacy of the EPRI transient categories are examined. New transient initiating event frequencies are derived from the expanded data base using the EPRI transient categories and data display methods. Upper bounds for these frequencies are also provided. Additional analyses explore changes in the dominant transients, changes in transient outage times and their impact on plant operation, and the effects of power level and scheduled scrams on transient event frequencies. A more rigorous data analysis methodology is developed to encourage further refinement of the transient initiating event frequencies derived herein. Updating the transient event data base resulted in approx.2400 events being added to EPRI's approx.3000-event data file. The resulting frequency estimates were in most cases lower than those reported by EPRI, but no significant order-of-magnitude changes were noted. The average number of transients per year for the combined data base is 8.5 for pressurized water reactors and 7.4 for boiling water reactors.

  18. The Western Energy Corridor Initiative: Unconventional Fuel Development Issues, Impacts, and Management Assessment

    Science.gov (United States)

    Wolfsberg, A.; Hagood, M.; Pasqualini, D.; Wood, T.; Wilson, C.; Witkowski, M.; Levitt, D.; Pawar, R.; Keating, G.; Ziock, H.

    2008-12-01

    The United States is increasingly dependent on imported oil and gas; commodities for which other nations are competing and for which future supply may be inadequate to support our transportation fuel needs. Therefore, a renewed interest in 'harder-to-get' unconventional fuels has emerged in both industry and government with directed focus on world class hydrocarbon resources within a corridor extending from Canada southward through the Rocky Mountain States. Within this Western Energy Corridor, co-located with significant conventional hydrocarbon and renewable energy resources, lie some of the world's richest unconventional hydrocarbon resources in oil shales, oil sands and coal for coal-to-liquid conversion. However, development of these resources poses substantial environmental concerns as well as increasing competition for limited resources of water and habitat. With large-scale energy development in the predominantly rural region, local communities, infrastructures, and economies will face increasing demands for roads, electricity, law enforcement, labor, and other support services. The Western Energy Corridor Initiative (WECI) seeks to develop an integrated assessment of the impacts of unconventional fuel development, the interrelationships of planned energy developments in different basins, and the resultant demands placed on the region. This initial WECI study focuses on two of the most important current issues for industry, regulators, and stakeholders -- the assessment of carbon and water resources issues, impacts, and management strategies. Through scenario analyses using coupled systems and process level models, this study investigates the viability of integrated development of multiple energy resources in a carbon neutral and environmentally acceptable manner, and the interrelationships of various energy resource development plans. The modeling framework is designed to extend to include infrastructure, employment, training, fiscal and economic demands

  19. NATIONAL TECHNOLOGICAL INITIATIVE AS THE STRATEGIC DIRECTION OF THE TECHNOLOGICAL DEVELOPMENT OF RUSSIA

    Directory of Open Access Journals (Sweden)

    E. V. Sibirskaya

    2018-01-01

    Full Text Available Russia, having lost a significant part of a high-tech industrial complex during the reforms (1993–2000, sharply reducing the state support of scientific research and development, has turned into a power dependent on the conjuncture in the hydrocarbon energy market and from foreign sup-plies of technologies, consumption goods, including those necessary for life support, thus being on the "technological needle". The main factor of development was the resource-producing complex. This situation had a negative impact on the pace of the country's development, on its defense capability and created real prerequisites for the loss of technological, economic, and, in the long run, political sovereignty and disintegration of the state. Nevertheless, the availability of natural resources along with human capi-tal and geographic location is a global competitive advantage of theRussian Federation, and the task is to use this advantage maximally as one of the first echelon countries in the emerging world order. One of the most important tasks was the search for such a direction of technological devel-opment that allows, on the one hand, to preserve Russia's position in the world market of traditional products; on the other – to strengthen positions in the markets of products with a higher degree of processing of Russian raw materials (oil and gas complex and agro-industrial complex; and finally – to master new "growth points" (services, new markets, talents, technologies in the world market of high-tech products and services. The set tasks assume several solutions. First, scientific and technological development should be based on the strategy of scientific and technological development of theRussian Federationand the national technological initiative, as it sets both resource constraints and priorities in the needs of the economy in new products and new technological solutions. Secondly,Russiashould take into account existing and emerging trends in the

  20. Description and evaluation of an initiative to develop advanced practice nurses in mainland China.

    Science.gov (United States)

    Wong, Frances Kam Yuet; Peng, Gangyi; Kan, Eva C; Li, Yajie; Lau, Ada T; Zhang, Liying; Leung, Annie F; Liu, Xueqin; Leung, Vilna O; Chen, Weiju; Li, Ming

    2010-05-01

    This paper describes an initiative to develop Advanced Practice Nurses (APNs) in mainland China and evaluation of the outcomes of the described programme. The pioneer project was an APN postgraduate programme involving 38 students conducted in Guangzhou, China during 2004-2005. Data related to curriculum content and process, student performance, self-reported competence and programme effects were collected. Quantitative data such as demographic data, student performance were analysed using descriptive statistics and the pre and post self-reported practice of competence was compared using chi-square test. Qualitative data such as case reports and interviews were examined using thematic analyses. Reflective journals and case studies revealed the attributes of APNs in managing clinical cases at advanced level, applying theory into practice and exercising evidence-based practice. The relatively modest self-reported practice of competence suggested that the graduates were novice APNs and needed continued development after the completion of the programme. This study reports the experience of an initiative in China and suggests a useful curriculum framework for educating APNs. Copyright 2009 Elsevier Ltd. All rights reserved.

  1. Teachers’ dialogue in a learner centered professional development initiative In a us urban high school

    Directory of Open Access Journals (Sweden)

    Leticia Alvarez Gutiérrez

    2014-06-01

    Full Text Available Using paradigms emerging from Learner Centered Professional Development (LCPD, dialogic education and Transformative Pedagogical Practices (TPPs, this research study examined pedagogies that ignited a revitalization of shared values as a community of learners, challenged assumptions about learning while invigorating professional identities and cultivating possibilities for transforming praxis of a group of female teachers and female administrators in an urban high school. The LCPD initiative engaged teachers (13 and administrators (3 in dialogue, self-examination, and reflection, while also chipping away dearth perceptions of Latina/o student as learners and nourish possibilities for their successes. The data for this study is part of a larger corpus of data exploring teacher professional development initiatives in a large urban city in the southwestern region of Texas. Narrative analysis was the methodological tool used to code and analyze the data. The authors highlight the pedagogies that served to renew teachers and administrators’ sense of community, professional identities and modifications of teachers’ attitudes and pedagogies regarding themselves and Latina/o students. Our research findings underscore the urgency of educational reform to include on-going LCPD in order to transform and encourage professional enrichment, teacher agency and revive pedagogies that support all students’ academic and social successes.

  2. LOCAL INITIATIVES FOR SUSTAINABLE DEVELOPMENT IN RURAL HOKKAIDO: A CASE STUDY OF SAMANI

    Directory of Open Access Journals (Sweden)

    Devon Dublin

    2013-01-01

    Full Text Available The paper presents the results of a field investigation about sustainable development of Samani town—a rural area in Hidaka region, Hokkaido, Japan. Local activities, business, environmental, social and economic challenges that affect the town as well as the advantages were investigated. The research was done by means of field visits, questionnaires and interviews involving the local people and government. The main economic sectors: olivine industry, fishery, agriculture and tourism were targeted as well as the government sector and the local high school with a particular focus on rural-urban migration. Samani has quite unique natural features on hand but a few strong comprehensive challenges on the other hand. The authors focused on the citizens opinions and positions which were based on the uniqueness of Samani and their own local activities and initiatives for the sustainable development of the town in the future which can be replicated in other rural communities around the world.

  3. Development and verification of an efficient spatial neutron kinetics method for reactivity-initiated event analyses

    International Nuclear Information System (INIS)

    Ikeda, Hideaki; Takeda, Toshikazu

    2001-01-01

    A space/time nodal diffusion code based on the nodal expansion method (NEM), EPISODE, was developed in order to evaluate transient neutron behavior in light water reactor cores. The present code employs the improved quasistatic (IQS) method for spatial neutron kinetics, and neutron flux distribution is numerically obtained by solving the neutron diffusion equation with the nonlinear iteration scheme to achieve fast computation. A predictor-corrector (PC) method developed in the present study enabled to apply a coarse time mesh to the transient spatial neutron calculation than that applicable in the conventional IQS model, which improved computational efficiency further. Its computational advantage was demonstrated by applying to the numerical benchmark problems that simulate reactivity-initiated events, showing reduction of computational times up to a factor of three than the conventional IQS. The thermohydraulics model was also incorporated in EPISODE, and the capability of realistic reactivity event analyses was verified using the SPERT-III/E-Core experimental data. (author)

  4. Diaspora-led development through the corporate social responsibility initiatives of talented migrants

    Directory of Open Access Journals (Sweden)

    Gutiérrez-Chávez, Juan Enrique

    2012-12-01

    Full Text Available In this paper we explore the idea that talented migrants can assist in the development andgrowth of their economies of origin through brain-circulation dynamics, linking the developedworld where they live and developing homelands they (or their ancestors in the case of latergenerationdiasporans left behind. Depending on the roles these talented people play in theorganizational (and institutional environment at both ends of the migratory trail, differentalternatives of diaspora-led initiatives are available to them. When these roles are attached tothe private sector, the introduction of Corporate Social Responsibility (CSR initiativespiggybacking preexisting diaspora tools (such as talent networks, open migration chains,diaspora-oriented institutions, etc. might be the more appropriate and efficient channels.

  5. Health behavior in persons with spinal cord injury: development and initial validation of an outcome measure.

    Science.gov (United States)

    Pruitt, S D; Wahlgren, D R; Epping-Jordan, J E; Rossi, A L

    1998-10-01

    To describe the development and initial psychometric properties of a new outcome measure for health behaviors that delay or prevent secondary impairments associated with spinal cord injury (SCI). Persons with SCI were surveyed during routine annual physical evaluations. Veterans Affairs Medical Center Spinal Cord Injury Unit, which specializes in primary care for persons with SCI. Forty-nine persons with SCI, aged 19-73 years, 1-50 years post-SCI. The newly developed Spinal Cord Injury Lifestyle Scale (SCILS). Internal consistency is high (alpha = 0.81). Correlations between clinicians' ratings of participants' health behavior and the new SCILS provide preliminary support for construct validity. The SCILS is a brief, self-report measure of health-related behavior in persons with SCI. It is a promising new outcome measure to evaluate the effectiveness of clinical and educational efforts for health maintenance and prevention of secondary impairments associated with SCI.

  6. Initial operating experience and recent development on the TRIUMF optically pumped polarized H- ion source

    International Nuclear Information System (INIS)

    Schmor, P.W.; Law, W.M.; Levy, C.D.P.; McDonald, M.

    1988-01-01

    A polarized H - ion source using optical pumping techniques has been developed at TRIUMF. This source was used to demonstrate (on an ion source test stand) the feasibility of producing 10- μA of ∼ 60% polarized H - ion beam in a dc mode suitable for injection into the TRIUMF cyclotron. The source has been installed in a 300 kV high voltage terminal connected to the cyclotron via a recently constructed beam transport line. A polarization of 80% is anticipated near the end of 1988 after the installation of a superconducting solenoid to the source. In this paper the authors describe the initial operating experience, recent developments, and the future plans for the TRIUMF optically pumped polarized ion source

  7. Development and initial validation of an instrument to assess stressors among South African sports coaches.

    Science.gov (United States)

    Kubayi, Alliance; Toriola, Abel; Didymus, Faye

    2018-06-01

    The aim of this series of studies was to develop and initially validate an instrument to assess stressors among South African sports coaches. In study one, a preliminary pool of 45 items was developed based on existing literature and an expert panel was employed to assess the content validity and applicability of these items. In study two, the 32 items that were retained after study one were analysed using principal component analysis (PCA). The resultant factorial structure comprised four components: environmental stressors, performance stressors, task-related stressors, and athlete stressors. These four components were made up of 26 items and, together, the components and items comprised the provisional Stressors in Sports Coaching Questionnaire (SSCQ). The results show that the SSCQ demonstrates acceptable internal consistency (.73-.89). The findings provide preliminary evidence that SSCQ is a valid tool to assess stressors among South African sports coaches.

  8. Method of development force at the young gymnasts on the stages of initial and specialized preparation

    Directory of Open Access Journals (Sweden)

    Khudolii O.N.

    2010-08-01

    Full Text Available The terms of effective development of force are considered for young gymnasts on the stages of initial and specialized preparation. The models of urgent and moved aside training effect of the power loadings are certain for young gymnasts 7-13 years. It is set that the process of power preparation of young gymnasts can be separate on two stages. On the first stage by means of the concentrated power loadings the expressed decline of force of group of muscles is arrived at. On the second stage by means of favourable a display maximal efforts of loadings the increase of force of group of muscles is arrived at. Application of the power loadings of different orientation is given by possibility during 10-12 employments on 30-60% to increase force of group of muscles, shorten time of training on development of force in two times.

  9. Development and participant assessment of a practical quality improvement educational initiative for surgical residents.

    Science.gov (United States)

    Sellers, Morgan M; Hanson, Kristi; Schuller, Mary; Sherman, Karen; Kelz, Rachel R; Fryer, Jonathan; DaRosa, Debra; Bilimoria, Karl Y

    2013-06-01

    As patient-safety and quality efforts spread throughout health care, the need for physician involvement is critical, yet structured training programs during surgical residency are still uncommon. Our objective was to develop an extended quality-improvement curriculum for surgical residents that included formal didactics and structured practical experience. Surgical trainees completed an 8-hour didactic program in quality-improvement methodology at the start of PGY3. Small teams developed practical quality-improvement projects based on needs identified during clinical experience. With the assistance of the hospital's process-improvement team and surgical faculty, residents worked through their selected projects during the following year. Residents were anonymously surveyed after their participation to assess the experience. During the first 3 years of the program, 17 residents participated, with 100% survey completion. Seven quality-improvement projects were developed, with 57% completing all DMAIC (Define, Measure, Analyze, Improve, Control) phases. Initial projects involved issues of clinical efficiency and later projects increasingly focused on clinical care questions. Residents found the experience educationally important (65%) and believed they were well equipped to lead similar initiatives in the future (70%). Based on feedback, the timeline was expanded from 12 to 24 months and changed to start in PGY2. Developing an extended curriculum using both didactic sessions and applied projects to teach residents the theory and implementation of quality improvement is possible and effective. It addresses the ACGME competencies of practice-based improvement and learning and systems-based practice. Our iterative experience during the past 3 years can serve as a guide for other programs. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Hungarian Economic Development Prospects – in the Light of the One Belt and One Road Initiative

    Directory of Open Access Journals (Sweden)

    Tamás Novák

    2018-04-01

    Full Text Available This paper attempts to delineate the most important aspects of the historical Hungarian economic development path, while shedding light on long-term Chinese investment and trade opportunities in Hungary. In order to make the One Belt and One Road Initiative a success, China needs proper knowledge of the Central European countries’ long-term development needs and goals. This analysis delivers a first assessment of the basic long-term questions of Hungarian economic development. The paper reviews milestones of economic progress after 1990 until the present, and shortly looks into the effects of the economic transformation of the 90s, and the main repercussions of the Global Financial Crisis (2008-2009. At the end of the paper a short glimpse is given on how the Hungarian economy could develop, and what are the possible development models to be utilized by Hungarian decision-makers. At the same time, it will be clear where Hungarian and Chinese need can intersect each other.

  11. An energy-saving development initiative increases birth rate and childhood malnutrition in rural Ethiopia.

    Directory of Open Access Journals (Sweden)

    Mhairi A Gibson

    2006-04-01

    Full Text Available Evolutionary life history theory predicts that, in the absence of contraception, any enhancement of maternal condition can increase human fertility. Energetic trade-offs are likely to be resolved in favour of maximizing reproductive success rather than health or longevity. Here we find support for the hypothesis that development initiatives designed to improve maternal and child welfare may also incur costs associated with increased family sizes if they do not include a family planning component.Demographic and anthropometric data were collected in a rural Ethiopian community benefiting from a recent labour-saving development technology that reduces women's energetic expenditure (n = 1,976 households. Using logistic hazards models and general linear modelling techniques, we found that whilst infant mortality has declined, the birth rate has increased, causing greater scarcity of resources within households.This study is, to our knowledge, the first to demonstrate a link between a technological development intervention and an increase in both birth rate and childhood malnutrition. Women's nutritional status was not improved by the energy-saving technology, because energy was diverted into higher birth rates. We argue that the contribution of biological processes to increased birth rates in areas of the developing world without access to modern contraception has been overlooked. This highlights the continued need for development programmes to be multisectoral, including access to and promotion of contraception.

  12. Disrupted coupling of large-scale networks is associated with relapse behaviour in heroin-dependent men

    Science.gov (United States)

    Li, Qiang; Liu, Jierong; Wang, Wei; Wang, Yarong; Li, Wei; Chen, Jiajie; Zhu, Jia; Yan, Xuejiao; Li, Yongbin; Li, Zhe; Ye, Jianjun; Wang, Wei

    2018-01-01

    Background It is unknown whether impaired coupling among 3 core large-scale brain networks (salience [SN], default mode [DMN] and executive control networks [ECN]) is associated with relapse behaviour in treated heroin-dependent patients. Methods We conducted a prospective resting-state functional MRI study comparing the functional connectivity strength among healthy controls and heroin-dependent men who had either relapsed or were in early remission. Men were considered to be either relapsed or in early remission based on urine drug screens during a 3-month follow-up period. We also examined how the coupling of large-scale networks correlated with relapse behaviour among heroin-dependent men. Results We included 20 controls and 50 heroin-dependent men (26 relapsed and 24 early remission) in our analyses. The relapsed men showed greater connectivity than the early remission and control groups between the dorsal anterior cingulate cortex (key node of the SN) and the dorsomedial prefrontal cortex (included in the DMN). The relapsed men and controls showed lower connectivity than the early remission group between the left dorsolateral prefrontal cortex (key node of the left ECN) and the dorsomedial prefrontal cortex. The percentage of positive urine drug screens positively correlated with the coupling between the dorsal anterior cingulate cortex and dorsomedial prefrontal cortex, but negatively correlated with the coupling between the left dorsolateral prefrontal cortex and dorsomedial prefrontal cortex. Limitations We examined deficits in only 3 core networks leading to relapse behaviour. Other networks may also contribute to relapse. Conclusion Greater coupling between the SN and DMN and lower coupling between the left ECN and DMN is associated with relapse behaviour. These findings may shed light on the development of new treatments for heroin addiction. PMID:29252165

  13. Cost-effectiveness of natalizumab vs fingolimod for the treatment of relapsing-remitting multiple sclerosis: analyses in Sweden.

    Science.gov (United States)

    O'Day, Ken; Meyer, Kellie; Stafkey-Mailey, Dana; Watson, Crystal

    2015-04-01

    To assess the cost-effectiveness of natalizumab vs fingolimod over 2 years in relapsing-remitting multiple sclerosis (RRMS) patients and patients with rapidly evolving severe disease in Sweden. A decision analytic model was developed to estimate the incremental cost per relapse avoided of natalizumab and fingolimod from the perspective of the Swedish healthcare system. Modeled 2-year costs in Swedish kronor of treating RRMS patients included drug acquisition costs, administration and monitoring costs, and costs of treating MS relapses. Effectiveness was measured in terms of MS relapses avoided using data from the AFFIRM and FREEDOMS trials for all patients with RRMS and from post-hoc sub-group analyses for patients with rapidly evolving severe disease. Probabilistic sensitivity analyses were conducted to assess uncertainty. The analysis showed that, in all patients with MS, treatment with fingolimod costs less (440,463 Kr vs 444,324 Kr), but treatment with natalizumab results in more relapses avoided (0.74 vs 0.59), resulting in an incremental cost-effectiveness ratio (ICER) of 25,448 Kr per relapse avoided. In patients with rapidly evolving severe disease, natalizumab dominated fingolimod. Results of the sensitivity analysis demonstrate the robustness of the model results. At a willingness-to-pay (WTP) threshold of 500,000 Kr per relapse avoided, natalizumab is cost-effective in >80% of simulations in both patient populations. Limitations include absence of data from direct head-to-head studies comparing natalizumab and fingolimod, use of relapse rate reduction rather than sustained disability progression as the primary model outcome, assumption of 100% adherence to MS treatment, and exclusion of adverse event costs in the model. Natalizumab remains a cost-effective treatment option for patients with MS in Sweden. In the RRMS patient population, the incremental cost per relapse avoided is well below a 500,000 Kr WTP threshold per relapse avoided. In the rapidly

  14. Longitudinal fluorescence in situ hybridization reveals cytogenetic evolution in myeloma relapsing after autologous transplantation

    Science.gov (United States)

    Merz, Maximilian; Jauch, Anna; Hielscher, Thomas; Mai, Elias K.; Seckinger, Anja; Hose, Dirk; Bertsch, Uta; Neben, Kai; Raab, Marc S.; Salwender, Hans; Blau, Igor W.; Lindemann, Hans-Walter; Schmidt-Wolf, Ingo; Scheid, Christof; Haenel, Mathias; Weisel, Katja; Goldschmidt, Hartmut; Hillengass, Jens

    2017-01-01

    To investigate cytogenetic evolution after upfront autologous stem cell transplantation for newly diagnosed myeloma we retrospectively analyzed fluorescence in situ hybridization results of 128 patients with paired bone marrow samples from the time of primary diagnosis and at relapse. High-risk cytogenetic abnormalities (deletion 17p and/or gain 1q21) occurred more frequently after relapse (odds ratio: 6.33; 95% confidence interval: 1.86–33.42; P<0.001). No significant changes were observed for defined IGH translocations [t(4;14); t(11;14); t(14;16)] or hyperdiploid karyotypes between primary diagnosis and relapse. IGH translocations with unknown partners occurred more frequently at relapse. New deletion 17p and/or gain 1q21 were associated with cytogenetic heterogeneity, since some de novo lesions with different copy numbers were present only in subclones. No distinct baseline characteristics were associated with the occurrence of new high-risk cytogenetic abnormalities after progression. Patients who relapsed after novel agent-based induction therapy had an increased risk of developing high-risk aberrations (odds ratio 10.82; 95% confidence interval: 1.65–127.66; P=0.03) compared to those who were treated with conventional chemotherapy. Survival analysis revealed dismal outcomes regardless of whether high-risk aberrations were present at baseline (hazard ratio, 3.53; 95% confidence interval: 1.53–8.14; P=0.003) or developed at relapse only (hazard ratio, 3.06; 95% confidence interval: 1.09–8.59; P=0.03). Our results demonstrate cytogenetic evolution towards high-risk disease after autologous transplantation and underline the importance of repeated genetic testing in relapsed myeloma (EudraCT number of the HD4 trial: 2004-000944-26). PMID:28495913

  15. Developing and implementing a data acquisition strategy for global agricultural monitoring: an inter-agency initiative

    Science.gov (United States)

    Justice, C. O.; Whitcraft, A. K.; Becker-Reshef, I.; Killough, B.

    2013-12-01

    In 2011, in response to global food crises, the G20 Agricultural Ministers launched a satellite-based global agricultural monitoring initiative to develop the Group on Earth Observations Global Agriculture Monitoring (GEOGLAM) system. The GEO is aimed at enhancing the availability and use of both satellite and in situ data for societal benefit. This initiative builds on the observation requirements developed by the GEO Agricultural Community of Practice, the understanding that no one satellite system can currently provide all the data needed for agricultural monitoring and the resulting recommendation for improved acquisition and availability of data by the World's space agencies. Implicit in this recommendation is the fact that certain regions of the Earth are imagery rich while others are imagery poor, leaving knowledge gaps about agricultural processes and food supply for certain areas of the World. In order to respond to these knowledge gaps and to strengthen national, regional, and global agricultural monitoring networks, GEOGLAM is working with the Committee on Earth Observations (CEOS), the space arm of GEO, to develop a coordinated global acquisition strategy. A key component of GEOGLAM is an effort to articulate the temporal and spatial Earth Observation (EO) requirements for monitoring; second, the identification of current and planned missions which are capable of fulfilling these EO requirements; and third, the development of a multi-agency, multi-mission image acquisition strategy for agricultural monitoring. CEOS engineers and GEOGLAM scientists have been collaborating on the EO requirements since 2012, and are now beginning the first implementation phase of the acquisition strategy. The goal is to put in place an operational system of systems using a virtual constellation of satellite-based sensors acquiring data to meet the needs for monitoring and early warning of shortfalls in agricultural production, a goal that was articulated in the 1970's

  16. Received View of Addiction, Relapse and Treatment.

    Science.gov (United States)

    Ndasauka, Yamikani; Wei, Zhengde; Zhang, Xiaochu

    2017-01-01

    It is important to highlight that attempts at understanding and explaining addiction have been made for centuries. It is, however, just five decades ago, with the growth of science and technology that more interest has been observed in this field. This chapter examines different views and theories that have been posited to understand and explain addiction. More attention will be given to prominent views that seem to draw consensus among researchers and medical practitioners. The first section of the chapter introduces the addiction debate, the different theories that have been provided to explain it from different perspectives and disciplines such as neurosciences, philosophy and psychology. Then, the chapter discusses different views on the role of relapse and what it entails in understanding addiction. The second section discusses different proposed and used forms of treating addiction. Thus, the chapter discusses the received view of addiction, the understanding of relapse as a critical element in addiction and treatments.

  17. Integration of genetic and clinical risk factors improves prognostication in relapsed childhood B-cell precursor acute lymphoblastic leukemia

    NARCIS (Netherlands)

    Irving, J.A.; Enshaei, A.; Parker, C.A.; Sutton, R.; Kuiper, R.P.; Erhorn, A.; Minto, L.; Venn, N.C.; Law, T.; Yu, J.; Schwab, C.; Davies, R.; Matheson, E.; Davies, A.; Sonneveld, E.; Boer, M.L. Den; Love, S.B.; Harrison, C.J.; Hoogerbrugge, P.M.; Revesz, T.; Saha, V.; Moorman, A.V.

    2016-01-01

    Somatic genetic abnormalities are initiators and drivers of disease and have proven clinical utility at initial diagnosis. However, the genetic landscape and its clinical utility at relapse are less well understood and have not been studied comprehensively. We analyzed cytogenetic data from 427

  18. Integration of genetic and clinical risk factors improves prognostication in relapsed childhood B-cell precursor acute lymphoblastic leukemia

    NARCIS (Netherlands)

    J. Irving (Julie); A. Enshaei; Parker, C.A. (Catriona A.); R. Sutton; R. Kuiper (Ruud); Erhorn, A. (Amy); L. Minto (L.); N. Venn; T. Law (T.); Yu, J. (Jiangyan); C. Schwab (Claire); Davies, R. (Rosanna); Matheson, E. (Elizabeth); Davies, A. (Alysia); E. Sonneveld (Edwin); M.L. den Boer (Monique); Love, S.B. (Sharon B.); C.J. Harrison (Christine); P.M. Hoogerbrugge (Peter); T. Revesz (Tamas); V. Saha (Vaskar); A.V. Moorman (Anthony)

    2016-01-01

    textabstractSomatic genetic abnormalities are initiators and drivers of disease and have proven clinical utility at initial diagnosis. However, the genetic landscape and its clinical utility at relapse are less well understood and have not been studied comprehensively. We analyzed cytogenetic data

  19. Initiatives and strategies for development of nanotechnology in nations: a lesson for Africa and other least developed countries

    Science.gov (United States)

    Ezema, Ikechukwu C.; Ogbobe, Peter O.; Omah, Augustine D.

    2014-03-01

    It is a known fact that the progress and development of different nations of the world is strongly connected with the type of materials under their use. This paper highlighted the development of nanotechnology in some selected countries of the world through a careful review of their road maps by way of public and private initiatives, funding/investment profile, human resources development, industrial potentials, and focus in order to draw inferences. The peculiar challenges and opportunities for some African nations and other least developed countries (LDC) were drawn for their economic and technological developments. This investigation was simply based on open access literatures. The review showed that although nanotechnology is new globally, most countries of the world have had growing public and private investments aimed at bringing about new materials and systems that can impact positively on their economy and ensure their global competitiveness and sustainability. The global scenario suggests the crucial role of cooperation in a multidisciplinary collaboration/partnership between government ministries, agencies, institutions, and private sector/donor agencies in order to pool enough resource capital required for activities in nanotechnology.

  20. Initiatives and strategies for development of nanotechnology in nations: a lesson for Africa and other least developed countries

    Science.gov (United States)

    2014-01-01

    It is a known fact that the progress and development of different nations of the world is strongly connected with the type of materials under their use. This paper highlighted the development of nanotechnology in some selected countries of the world through a careful review of their road maps by way of public and private initiatives, funding/investment profile, human resources development, industrial potentials, and focus in order to draw inferences. The peculiar challenges and opportunities for some African nations and other least developed countries (LDC) were drawn for their economic and technological developments. This investigation was simply based on open access literatures. The review showed that although nanotechnology is new globally, most countries of the world have had growing public and private investments aimed at bringing about new materials and systems that can impact positively on their economy and ensure their global competitiveness and sustainability. The global scenario suggests the crucial role of cooperation in a multidisciplinary collaboration/partnership between government ministries, agencies, institutions, and private sector/donor agencies in order to pool enough resource capital required for activities in nanotechnology. PMID:24650295

  1. Economic costs associated with an MS relapse

    LENUS (Irish Health Repository)

    O'Connell, K.

    2014-09-01

    This was an prospective audit composed of medical chart review and patient questionnaire. Relapses were stratified into 3 groups: low, moderate and high intensity. Age, gender, MS subtype, disease duration, expanded disability status scale (EDSS) score, disease modifying therapy (DMT) use and employment status were recorded. Direct costs included GP visits, investigations, clinic visit, consultations with medical staff, medication and admission costs. Indirect costs assessed loss of earnings, partner\\'s loss of earnings, childcare, meals and travel costs.

  2. Climate Change Professional Development: Design, Implementation, and Initial Outcomes on Teacher Learning, Practice, and Student Beliefs

    Science.gov (United States)

    Shea, Nicole A.; Mouza, Chrystalla; Drewes, Andrea

    2016-04-01

    In this work, we present the design, implementation, and initial outcomes of the Climate Academy, a hybrid professional development program delivered through a combination of face-to-face and online interactions, intended to prepare formal and informal science teachers (grades 5-16) in teaching about climate change. The Climate Academy was designed around core elements of successful environmental professional development programs and aligned with practices advocated in benchmarked science standards. Data were collected from multiple sources including observations of professional development events, participants' reflections on their learning, and collection of instructional units designed during the Academy. Data were also collected from a focal case study teacher in a middle school setting. Case study data included classroom observations, teacher interviews, and student beliefs toward climate change. Results indicated that the Climate Academy fostered increased learning among participants of both climate science content and pedagogical strategies for teaching about climate change. Additionally, results indicated that participants applied their new learning in the design of climate change instructional units. Finally, results from the case study indicated positive impacts on student beliefs and greater awareness about climate change. Results have implications for the design of professional development programs on climate change, a topic included for the first time in national standards.

  3. PlasmaPy: initial development of a Python package for plasma physics

    Science.gov (United States)

    Murphy, Nicholas; Leonard, Andrew J.; Stańczak, Dominik; Haggerty, Colby C.; Parashar, Tulasi N.; Huang, Yu-Min; PlasmaPy Community

    2017-10-01

    We report on initial development of PlasmaPy: an open source community-driven Python package for plasma physics. PlasmaPy seeks to provide core functionality that is needed for the formation of a fully open source Python ecosystem for plasma physics. PlasmaPy prioritizes code readability, consistency, and maintainability while using best practices for scientific computing such as version control, continuous integration testing, embedding documentation in code, and code review. We discuss our current and planned capabilities, including features presently under development. The development roadmap includes features such as fluid and particle simulation capabilities, a Grad-Shafranov solver, a dispersion relation solver, atomic data retrieval methods, and tools to analyze simulations and experiments. We describe several ways to contribute to PlasmaPy. PlasmaPy has a code of conduct and is being developed under a BSD license, with a version 0.1 release planned for 2018. The success of PlasmaPy depends on active community involvement, so anyone interested in contributing to this project should contact the authors. This work was partially supported by the U.S. Department of Energy.

  4. Genomic profiling of pediatric acute myeloid leukemia reveals a changing mutational landscape from disease diagnosis to relapse | Office of Cancer Genomics

    Science.gov (United States)

    The genomic and clinical information used to develop and implement therapeutic approaches for AML originated primarily from adult patients and has been generalized to patients with pediatric AML. However, age-specific molecular alterations are becoming more evident and may signify the need to age-stratify treatment regimens. The NCI/COG TARGET-AML initiative employed whole exome capture sequencing (WXS) to interrogate the genomic landscape of matched trios representing specimens collected upon diagnosis, remission, and relapse from 20 cases of de novo childhood AML.

  5. TBI parameters and relapse of acute leukemia

    International Nuclear Information System (INIS)

    Sugawara, Tadashi; Inoue, Toshihiko; Mori, Tomoyuki.

    1994-01-01

    The purpose of this study, which involved 240 acute leukemia patients (ALL: 115, ANL: 125) who received an allogeneic bone marrow transplantation (BMT) with preconditioning by total body irradiation (TBI) and chemotherapy, was to examine retrospectively the TBI factors that may have influenced a leukemic relapse. The patients were divided into two groups: 124 patients who had received their BMT within a diagnosis-transplantation period of 9 months or less (DTP9 group), and 116 patients who had received their BMT within a diagnosis-transplantation period of 10 months or more (DTP10 group). It was concluded that: (1) the higher the TBI dose, the fewer the relapse rates in DTP9 group; (2) the longer the TBI period, the greater the increase in the relapse rate in DTP10 group. It was thus speculated that an effective TBI regimen for acute leukemia patients may vary depending on the length of time that has elapsed from the diagnosis of leukemia to the BMT. (author)

  6. California's tobacco tax initiative: the development and passage of Proposition 99.

    Science.gov (United States)

    Traynor, M P; Glantz, S A

    1996-01-01

    In this case study, we describe and analyze the development and passage of California's tobacco tax initiative, Proposition 99, the Tobacco Tax and Health Promotion Act of 1988. We gathered information from published reports, public documents, personal correspondence, internal memorandums, polling data, and interviews with representatives from organizations that participated in the Proposition 99 campaign. Proposition 99 passed as a result of the efforts of a coalition of voluntary health agencies, medical organizations, and environmental groups. They organized a long-term effort by conducting essential polling, planning strategies, gaining media exposure, developing a coalition, and running a successful campaign to enact the tax by shifting the venue from legislative to initiative politics. To build the coalition that was needed to pass Proposition 99, public health proponents enlisted the help of medical organizations in exchange for additional revenue to be allocated to medical services. By shifting the venue from the legislature to the general public, advocates capitalized on public concern about tobacco and for youth and took advantage of the tobacco industry's low credibility. The passage of Proposition 99, despite a massive campaign against it by the tobacco industry, represents a milestone in the tobacco control and public health fields. From its passage in 1988 through 1993, tobacco use in California declined by 27 percent, which is three times faster than the United States average. As a result, Proposition 99 has served as a national model for other states and the federal government. Although allocation of tobacco tax revenues specifically to health education and prevention was a primary goal during the development and passage of Proposition 99, when the venue shifted back to the legislature for implementation, medical organizations successfully advocated illegal diversions of Proposition 99 tobacco control and research funds to medical services

  7. Factors affecting the initial literacy development of urban and rural learners in the Iganga district, Uganda

    Directory of Open Access Journals (Sweden)

    Banda, Felix

    2005-12-01

    Full Text Available The initial motivation for the study was data from the Ministry of Education in Uganda that suggests that in terms of academic performance, urban learners continually outperform rural schools at primary and secondary school levels (Ministry of Education 2002. At present all government examinations are written in English. However, the language in education policy in Uganda differentially stipulates the use English as medium of instruction in urban schools and the use of the mother tongue in rural schools (cf. Kyeyune 2004. Other factors which mitigate against rural learners’ successful academic performance are untrained educators, poor infrastructure and school management practices in rural schools, poverty, lack of supportive academic discourse practices, and a general lack of enthusiasm among rural parents (most of whom have very little formal education for their children’s education. Using data from observations of selected urban and rural homes and schools in The Iganga district and field notes in the form of diary entries, the study draws on New Literacy Studies (NLS particularly the notion of literacy as social practice (Street 2001; Gee 2000; Baynham 2000, 2001, to explore the differential effect of urban and rural-based acculturation processes on the initial literacy development of learners. Finally, since 88% of Ugandans live in rural areas (Uganda Bureau of Statistics 2002, the pedagogical implications for primary schools are discussed and suggestions are made on how to establish an inclusive education system.

  8. A Mechanically Proved and an Incremental Development of the Session Initiation Protocol INVITE Transaction

    Directory of Open Access Journals (Sweden)

    Rajaa Filali

    2014-01-01

    Full Text Available The Session Initiation Protocol (SIP is an application layer signaling protocol used to create, manage, and terminate sessions in an IP based network. SIP is considered as a transactional protocol. There are two main SIP transactions, the INVITE transaction and the non-INVITE transaction. The SIP INVITE transaction specification is described in an informal way in Request for Comments (RFC 3261 and modified in RFC 6026. In this paper we focus on the INVITE transaction of SIP, over reliable and unreliable transport mediums, which is used to initiate a session. In order to ensure the correctness of SIP, the INVITE transaction is modeled and verified using event-B method and its Rodin platform. The Event-B refinement concept allows an incremental development by defining the studied system at different levels of abstraction, and Rodin discharges almost all proof obligations at each level. This interaction between modeling and proving reduces the complexity and helps in assuring that the INVITE transaction SIP specification is correct, unambiguous, and easy to understand.

  9. Illinois Cleantech Ecosystem Consortium (ICE) for the Department of Energy Innovation Ecosystem Development Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Zielke, Jason [Clean Energy Trust, Chicago, IL (United States)

    2014-01-31

    The DoE Innovation Ecosystem Initiative was a gamechanger for Clean Energy Trust. The grant accelerated our development from a concept to a real company in 2010, seeding us with the capital to begin our mission to “accelerate the growth of clean energy businesses in the Midwest”. Now three years later, we have scores and scores of partners which fund us through sponsorship donations to our programs, and we have played a key role in launching several new companies, and helping them acquire funding and reach their milestones. In three years we have grown from two people to nine, now with an annual budget of over $3M. We started with the following simple plan (verbatim from our original submission): “The short-term objective of ICE is to fortify and enhance the platform for collaboration necessary to create a robust ecosystem for clean energy innovation. This includes launching a number of initiatives designed to source, evaluate, and launch new clean energy businesses derived from university research.

  10. STATE CONTROL OF THE REPUBLIC OF BELARUS: INITIAL STAGE OF ORGANIZATION AND DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    V. A. Sakovich

    2013-01-01

    Full Text Available  The paper considers  the initial stage of organization and development of the first State control organ of the independent Belarus – Control Chamber of the Republic of Belarus on the basis of scientific grounds of control theory of economic systems. Scientific and methodologically considered organizational and coordination approaches to the activity of the Control Chamber have promoted to  higher intensity and efficiency of financial and economic control in the initial period of the activity of new control organ and  the activity of all control organs of the Republic has taken systemized and perfectly oriented character. Such approaches have made it possible to stabilize macro-economic situation in the Republic and strengthen its economic security. The Control Chamber through highly-qualified personal, created and practically introduced methodological principles of control activity, international cooperation experience and finally high efficiency of practical control activity has made its historical contribution in formation of fundamentals of  the State Control in Belarus.13th of March 1992 is the day when the Law “About Control Chamber of the Republic of Belarus” has been enacted by the Supreme Council of the Republic of Belarus and this day is to considered as the Day of State Control foundation in the Republic of Belarus.  

  11. Case report: partial relapse of Bell's palsy following superficial radiotherapy to a basal cell carcinoma in the temple

    International Nuclear Information System (INIS)

    Brincat, Stephen; Mantell, B.S.

    1986-01-01

    A patient who developed a partial relapse of Bell's palsy following superficial radiotherapy to a basal cell carcinoma in the temple is reported. Nerves injured by Bell's palsy may be more susceptible to radiation induced damage. (author)

  12. Recurrent bleeding after arterial embolization in patients with hemoptysis : Comparison of angiographic findings and relapsing period

    International Nuclear Information System (INIS)

    Park, Sung Keun; Choi, Seok Jin; Choi, Gi Bok; Kim, Hae Yeon; Park, Auh Whan; Juhn, Jae Ryang; Cha, Seong Sook

    2001-01-01

    To describe the angiographic findings of patients with recurrent hemoptysis after bronchial artery embolization (BAE) according to the point at which relapse occurred. From 125 patients who underwent BAE due to hemoptysis between 1996 and 2000, we selected 18 of 23 who underwent additional BAE due to recurrent bleeding after initial BAE. Depending on the point at which relapse occurred, they were divided into two groups (I and ll, according to whether additional BAE was performed within two weeks of initial BAE or more than two weeks after this) We retrospectively compared the two groups in terms of angiographic findings, number of embolized arteries, and character of feeding arteries at initial and additional BAE. Nine patients in group I (additional BAE: n=10) and nine in group ll (additional BAE: n=13) were admitted for recurrent hemoptysis within two weeks of initial BAE and more than two weeks after this, respectively. In group I (n=29) and ll(n=31), angiography demonstrated two direct and 27 indirect, and two direct and 29 indirect signs of hemorrhage, respectiveIy. No statistically significant differences were observed (x 2 =0.005, ρ=0.945). Among the embolized feeder ressels in group I (n=30) there were 20 bronchial artery and 10 non bronchial systemic collaterals, while for group ll (n=35), the corresponding totals were 21 and 14. Again, no statistically significant differences were encountered(x 2 =0.308; ρ=0.579). In group I, feeders were newly developed in one case(10%), previously embolized in five(50%), and missed in four(40%), while in group two the corresponding figures were none, twelve(92.3%), and one(7.7%) No significant differences were noted, though the incidence of previously embolized feeders in Group ll was very high (x 2 =5.383, ρ=0.068). Among patients in whom hemoptysis after BAE recurred at different times, the angiographic findings and number of embolized arteries were not significantly different, but differences in the nature of the

  13. Communication Ambassadors-an Australian Social Media Initiative to Develop Communication Skills in Early Career Scientists.

    Science.gov (United States)

    Wang, Jack T H; Power, Cheryl J; Kahler, Charlene M; Lyras, Dena; Young, Paul R; Iredell, Jonathan; Robins-Browne, Roy

    2018-01-01

    Science communication is a skill set to be developed through ongoing interactions with different stakeholders across a variety of platforms. Opportunities to engage the general public are typically reserved for senior scientists, but the use of social media in science communication allows all scientists to instantaneously disseminate their findings and interact with online users. The Communication Ambassador program is a social media initiative launched by the Australian Society for Microbiology to expand the online presence and science communication portfolios of early-career scientists. Through their participation in the program, a rotating roster of Australian microbiologists have broadened the online reach of the Society's social media channels as well as their own professional networks by attending and live-tweeting microbiology events throughout the year. We present the Communication Ambassador program as a case study of coordinated social media activity in science communication to the general public, and describe the potential for its applications in science education and training.

  14. The development and initial validation of a new measure of male body dissatisfaction.

    Science.gov (United States)

    Ochner, Christopher N; Gray, James A; Brickner, Katrina

    2009-12-01

    The purpose of this research was to develop, and establish the initial psychometric properties of, the Male Body Dissatisfaction Scale (MBDS). Ninety-five male students were recruited over three phases. An item-remainder analysis was performed in phase I, convergent and discriminant validity assessed in phase II, and test-retest reliability and factor structure assessed in phase III. The MBDS achieved an alpha level of 0.93 and was inversely related to body esteem (p=0.02) and self-esteem (p=0.03), and positively related to how much participants' opinion of themselves was based on their body shape and weight (pbody shape and weight concerns (pbody dissatisfaction that allows men to weight particular aspects of their body image according to personal importance.

  15. Pore Formation and Mobility Investigation (PFMI): Concept, Hardware Development and Initial Analysis of Experiments

    Science.gov (United States)

    Grugel, Richard N.

    2004-01-01

    Porosity in the form of "bubbles and pipes" can occur during controlled directional solidification processing of metal alloys. This is a consequence that 1) precludes obtaining any meaningful scientific results and 2) is detrimental to desired material properties. Unfortunately, several Microgravity experiments have been compromised by porosity. The intent of the PFMI investigation is to conduct a systematic effort directed towards understanding porosity formation and mobility during controlled directional solidification (DS) in a microgravity environment. PFMI uses a pure transparent material, succinonitrile (SCN), as well as SCN "alloyed" with water, in conjunction with a translating temperature gradient stage so that direct observation and recording of pore generation and mobility can be made. PFMI is investigating the role of thermocapillary forces and temperature gradients in affecting bubble dynamics as well as other solidification processes in a microgravity Environment. This presentation will cover the concept, hardware development, operations, and the initial results from experiments conducted aboard the International Space Station. .

  16. Initial color development in radiochromic dye films after a short intense pulse of accelerated electrons

    International Nuclear Information System (INIS)

    Uribe, R.M.; Barcelo, M.; Rios, J.; McLaughlin, W.L.; Buenfil, A.E.

    1990-01-01

    The radiation response of different dye precursors in several host plastics has been investigated after a single short-pulse irradiation with 2.5-MeV electrons. It was observed that in most films the radiation-initiated color development proceeds mainly during the first 300 seconds, after such high dose-rate irradiation (∼ 10 12 Gy/s). Absorption spectra show that the main absorption band increases at the expense of a shorter-wavelength precursor absorption band, showing an isosbestic point approximately midway bwetwen the two absorption bands. It was found that a certain combination of dye precursor and host plastic (namely a polyamide containing an aromatic group) constitutes a film which shows a very fast increase in optical density of the main absorption band, making it suitable for immediate dosimetric analysis in very high dose-rate installations. (author)

  17. Development and initial validation of the ibadan knee/hip osteoarthritis outcome measure

    Directory of Open Access Journals (Sweden)

    A. O. Akinpelu

    2007-01-01

    was developed from other measures found in literature, as well as complaints of attending patients. Forty nine patients with pain from knee and/or hip osteoarthritis, the OA group (OAG and 49 individuals without knee or hip pain, the pain-free group (PFG were assessed, using the IKHOAM. The OAG was assessed on IKHOAM and the Visual Analogue Scale (VAS before and after a 6-week physiotherapy programme. Results: Significant differences between IKHOAM scores of the OAG and PFG and between IKHOAM scores of OAG pre and post 6-week physiotherapy programme, as well as the significant negative correlations between changes in IKHOAM and VAS scores of OAG before and after the 6-week physiotherapy programme were demonstrated. Conclusion: IKHOAM demonstrated initial criteria towards validity and responsiveness and may be used in a Nigerian population of OA knee/hip individuals and similar environments.

  18. Development of A 32P-Postlabeling Technic for Detection of the Initiation of Cancer

    International Nuclear Information System (INIS)

    Budiawan

    2000-01-01

    It is well know that the interaction between exogenous and also endogenous subs-trances with macromolecular biology (Protein or DNA) in human with in sublethal or lethal level can lead to the initiation of cancer (Auerbach, 1946, Phillips, 1981). In the assessment of carcinogen exposure (exo genus or endo genus), bio markers are chosen based on a knowledge of the internal interactions of carcinogen molecules/metabolites with cellular macromolecules such as DNA, i.e. formation DNA adduct. The 32 P-postlabeling assay is most sensitive, fast and applicability methods to structurally diverse classes of chemical. It has been developed to detect DNA adduct (Randerath at. All, 1993, Reddy, 1986). The 32 P-Postlabeling technic has emerged as the method of choice for qualitative detection and quantitation of carcinogen-DNA adducts in human. The result of detection of the Adduct will lead the understand of the mechanism reaction of the substance in human organ. The assay of the 32 P-Postlabeling involves a stepwise sequence of biochemical reaction entailing: Isolation DNA and following with cleavage by enzymatic hydrolyzed of intact DNA (Nucleotide) with phosphate in 3 position. Attachment of a 32 P- label to the 5-hydroxyl end of DNA (Nucleotide) creating a 3,5-biphosphate; following by separation and detection of adducts by high-regulation TLC and autoradiography respectively and quantitation of adducts by measurement of radioactivity. The 32 P-Postlabeling was used to detection of DNA adduct of Polycyclic aromatic and alpha, beta unsaturated carbonyl compound such crotonaldehyde, which is in this paper to discussed. We have investigated and developed the 32 P-Postlabeling for detection of modified DNA of crotonaldehyde in vitro and in vivo as markers for initiation of cancer. From the result of study were found the adduct the adduct in several organs of F-344 rast after gavage and persisted to a certain extent (Eder dan Budiawan, 1997)

  19. Radiation protection survey of research and development activities initiated after the Chernobyl accident. Review report

    International Nuclear Information System (INIS)

    Burkart, W.

    1989-01-01

    The compilation of research and development activities in the various fields of radiation protection in OECD Member countries which have been undertaken or planned specifically to address open questions arising from the Chernobyl reactor accident experience shows a potential for international cooperative arrangements and/or coordination between national programmes. Both the preliminary review of the answers, which only cover a part of the relevant activities in OECD Member countries, and a computerized literature search indicate that the multidisciplinarity of the research area under consideration will call for special efforts to efficiently implement new models and new quantitative findings from the different fields of activity to provide an improved basis for emergency management and risk assessment. Further improvements could also be achieved by efforts to initiate new activities to close gaps in the programmes under way, to enhance international cooperation, and to coordinate the evaluation of the results. This preliminary review of the answers of 17 Member countries to the questionnaire on research and development activities initiated after the Chernobyl accident is not sufficient as a basis for a balanced decision on those research areas most in need for international cooperation and coordination. It may however serve as a guide for the exploration of the potential for international cooperative arrangements and/or coordination between national programmes by the CRPPH. Even at this preliminary stage, several specific activities are proposed to the NEA/OECD by Member countries. Whole body counting and the intercomparison of national data bases on the behaviour of radionuclides in the environment did attract most calls for international cooperation sponsored by the NEA

  20. Inculcating the ergonomic culture in developing countries: national healthy schoolbag initiative in Sri Lanka.

    Science.gov (United States)

    Jayaratne, Kapila

    2012-12-01

    The aim of this article is to describe a survey on ergonomic factors of classroom environments of school children, their influence on health, and use of research outcomes to launch a healthy schoolbag initiative. Ergonomics have not yet well penetrated relevant fields in industrially developing countries, such as Sri Lanka. One of the crucial parameters of the school environment is ergonomics. Available evidence suggests ergonomic mismatches in classroom settings. Good practice examples in child ergonomic interventions are few in resource-poor contexts. A school-based cross-sectional study was conducted in a district in Sri Lanka with a sample of 1,607 children in Grades 6 to 8 with the use of a stratified multistage cluster sampling method. Many children did experience discomfort related to substandard seating arrangements in the classroom. A significant proportion had to turn their necks to see the blackboard. For many children, seating locations were not changed. There were widespread incompatibilities of classroom furniture with anthropometric dimensions of children. A majority of children perceived discomfort contributed by mismatched classroom furniture. Carriage of school materials was not healthy. Deficiencies were noted in weight, model, ergonomic features, and carrying behavior of bags. Children experienced several negative effects, in part attributable to mismatched ergonomic factors. The schoolbag was considered a priority issue. Findings were disseminated to stakeholders and to media. Solutions were contemplated on bag weight reduction, healthy schoolbag introduction, and behavior change in a collaborative initiative with the Education Ministry. Political, administrative, and business stakeholders were successfully engaged to inculcate an ergonomic culture in an industrially developing country.

  1. Building the field of population health intervention research: The development and use of an initial set of competencies

    Directory of Open Access Journals (Sweden)

    Barbara Riley

    2015-01-01

    This initial set of competencies, released in 2013, may be used to develop graduate student curriculum, recruit trainees and faculty to academic institutions, plan non-degree professional development, and develop job descriptions for PHIR-related research and professional positions. The competencies provide some initial guideposts for the field and will need to be adapted as the PHIR field matures and to meet unique needs of different jurisdictions.

  2. Initial development and testing of a novel foam-based pressure sensor for wearable sensing

    Directory of Open Access Journals (Sweden)

    Smyth Barry

    2005-03-01

    Full Text Available Abstract Background This paper provides an overview of initial research conducted in the development of pressure-sensitive foam and its application in wearable sensing. The foam sensor is composed of polypyrrole-coated polyurethane foam, which exhibits a piezo-resistive reaction when exposed to electrical current. The use of this polymer-coated foam is attractive for wearable sensing due to the sensor's retention of desirable mechanical properties similar to those exhibited by textile structures. Methods The development of the foam sensor is described, as well as the development of a prototype sensing garment with sensors in several areas on the torso to measure breathing, shoulder movement, neck movement, and scapula pressure. Sensor properties were characterized, and data from pilot tests was examined visually. Results The foam exhibits a positive linear conductance response to increased pressure. Torso tests show that it responds in a predictable and measurable manner to breathing, shoulder movement, neck movement, and scapula pressure. Conclusion The polypyrrole foam shows considerable promise as a sensor for medical, wearable, and ubiquitous computing applications. Further investigation of the foam's consistency of response, durability over time, and specificity of response is necessary.

  3. Leading Communities: Community-led Development in England’s Small Towns: the Market Towns Initiative

    Directory of Open Access Journals (Sweden)

    Gordon Morris

    2012-12-01

    Full Text Available The Market Towns Initiative (MTI, a UK community-led development programme, operated throughout rural England from 2000 until 2005/6. It was designed to help local people, with professional support, identify – and then capitalize on – the economic, environmental and social strengths and weaknesses of small country towns. This paper explains the origins and ways of working of the MTI. Examples of the topics explored and participants’ views are given, and conclusions drawn. The opportunity is also taken to explain how interest in the roles of England’s small country towns grew in the years following the Second World War, and how this led to the development of the MTI. Evidence suggests that the programme worked well. It demonstrated that local people have the enthusiasm, skills and knowledge to take a lead in the development of the places in which they live; something which, until local government reforms changed roles and structures, was largely taken for granted.

  4. Initial vesicular-arbuscular mycorrhizal development of slender wheatgrass on two amended mine spoils

    Energy Technology Data Exchange (ETDEWEB)

    Zak, J.C.; Parkinson, D. (University of Calgary, Calgary, AB (Canada). Dept. of Biology)

    1982-01-01

    The initial vesicular-arbuscular (VA) mycorrhizal development of slender wheatgrass on extracted oil-sands and subalpine coal-mine spoils, amended with either fertilizer, peat, or liquid sewage sludge, was examined. Plants were sampled at 2,6 and 10 weeks after plant emergence and the level of infection was expressed as length of mycorrhizal root per plant and length of root which contained arbuscules, vesicles, or only hyphae. Mycorrhizal infection of slender wheatgrass on the oil sands was limited to plants on the peat-amended spoil. Infection of plants on the peat-amended oil-sands spoil was detected by 2 weeks. Plants on the subalpine spoil were infected at 2 weeks only on the peat-amended spoil. While slender wheatgrass on the control and fertilizer-amended spoil developed mycorrhizae by 6 weeks, infection was not observed in plants on the sewage-amended spoil until 10 weeks. At 10 weeks, there were no significant differences in lengths of mycorrhizal root per plant among the amendments. Increased P levels in the fertilizer- and sewage-amended subalpine spoil did not suppress VA mycorrhizal development. 43 refs., 6 tabs.

  5. Merkel Cell Polyomavirus Small T Antigen Initiates Merkel Cell Carcinoma-like Tumor Development in Mice.

    Science.gov (United States)

    Verhaegen, Monique E; Mangelberger, Doris; Harms, Paul W; Eberl, Markus; Wilbert, Dawn M; Meireles, Julia; Bichakjian, Christopher K; Saunders, Thomas L; Wong, Sunny Y; Dlugosz, Andrzej A

    2017-06-15

    Merkel cell carcinoma (MCC) tumor cells express several markers detected in normal Merkel cells, a nonproliferative population of neuroendocrine cells that arise from epidermis. MCCs frequently contain Merkel cell polyomavirus (MCPyV) DNA and express viral transforming antigens, sT and tLT, but the role of these putative oncogenes in MCC development, and this tumor's cell of origin, are unknown. Using a panel of preterm transgenic mice, we show that epidermis-targeted coexpression of sT and the cell fate-determinant atonal bHLH transcription factor 1 (ATOH1) leads to development of widespread cellular aggregates, with histology and marker expression mimicking that of human intraepidermal MCC. The MCC-like tumor phenotype was dependent on the FBXW7-binding domain of sT, but not the sT-PP2A binding domain. Coexpression of MCPyV tLT did not appreciably alter the phenotype driven by either sT or sT combined with ATOH1. MCPyV sT, when coexpressed with ATOH1, is thus sufficient to initiate development of epidermis-derived MCC-like tumors in mice. Cancer Res; 77(12); 3151-7. ©2017 AACR . ©2017 American Association for Cancer Research.

  6. Proceedings from the National Cancer Institute's Second International Workshop on the Biology, Prevention, and Treatment of Relapse after Hematopoietic Stem Cell Transplantation: Part I. Biology of relapse after transplantation.

    Science.gov (United States)

    Gress, Ronald E; Miller, Jeffrey S; Battiwalla, Minoo; Bishop, Michael R; Giralt, Sergio A; Hardy, Nancy M; Kröger, Nicolaus; Wayne, Alan S; Landau, Dan A; Wu, Catherine J

    2013-11-01

    In the National Cancer Institute's Second Workshop on the Biology, Prevention, and Treatment of Relapse after Hematopoietic Stem Cell Transplantation, the Scientific/Educational Session on the Biology of Relapse discussed recent advances in understanding some of the host-, disease-, and transplantation-related contributions to relapse, emphasizing concepts with potential therapeutic implications. Relapse after hematopoietic stem cell transplantation (HSCT) represents tumor escape, from the cytotoxic effects of the conditioning regimen and from immunologic control mediated by reconstituted lymphocyte populations. Factors influencing the biology of the therapeutic graft-versus-malignancy (GVM) effect-and relapse-include conditioning regimen effects on lymphocyte populations and homeostasis, immunologic niches, and the tumor microenvironment; reconstitution of lymphocyte populations and establishment of functional immune competence; and genetic heterogeneity within the malignancy defining potential for clonal escape. Recent developments in T cell and natural killer cell homeostasis and reconstitution are reviewed, with implications for prevention and treatment of relapse, as is the application of modern genome sequencing to defining the biologic basis of GVM, clonal escape, and relapse after HSCT. Published by Elsevier Inc.

  7. From Family Based to Industrial Based Production: Local Economic Development Initiatives and the HELIX Model

    Directory of Open Access Journals (Sweden)

    Bartjan W Pennink

    2013-01-01

    Full Text Available To build a strong local economy, good practice tells us that each community should undertake a collaborative, strategically planned process to understand and then act upon its own strengths, weaknesses, opportunities and threats. From this perspective we start with the local communities but how is this related to the perspective from the Helix model in which three actors are explicitly introduced: the Government, the Industry and the Universities? The purpose of local economic development (LED is to build up the economic capacity of a local area to improve its economic future and the quality of life for all. To support  the Local Economic Development in remote areas,   a program  has been developed based on the LED frame work of the world bank. This approach and  the experiences over  the past years with this program are  described in the first part.  In the second part of the paper, We analyse work done with that program with the help of the social capital concept and the triple helix model.  In all cases it is important to pay attention to who is taken the initiative after the first move (and it is not always the governance as actor and for the triple helix we suggest  that the concepts of (national Government, Industry and University need a translation to Local Governance Agency, Cooperation or other ways of cooperation of local communities and Local Universities. Although a push from outside might help  a local region in development the endogenous factors are  also needed. Keywords: Triple Helix model, Local Economic Development, Local Actors, Double Triangle within the Helix Model

  8. Psychotic relapse and associated factors among patients attending health services in Southwest Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Fikreyesus, Mahlet; Soboka, Matiwos; Feyissa, Garumma Tolu

    2016-10-20

    Psychotic relapse leads to repeated hospitalization and negatively affects the clinical prognosis of the patients. Information on prevalence of relapse among patients with psychotic disorders in Ethiopian setting is scarce. This study aimed to assess the prevalence of relapse among patients with psychotic disorders attending services in Jimma University Specialized Hospital (JUSH). Data were collected using interviewer administered questionnaire. We used medication adherence rating scale (MARS) to assess compliance to medication and abnormal involuntary movement scale (AIMS) to detect medication side effects. Logistic regression analysis was used to identify independent predictors of psychotic relapse. All variables with P-value value higher when compared to those who have never experienced medication side effects (aOR = 1.83, 95 % CI = 1.01, 3.31). The high prevalence of relapse among patients with psychotic disorder needs special attention. Clinicians need to pay attention to medication side effects the patient faces. Intervening noncompliance to medication and appropriately managing medication side effects may help in preventing psychotic relapse that may result because of non-compliance. The provision of counseling, psycho education, psycho social support may help patients in improving compliance to medication and reducing psychotic relapse. Developing and strengthening community based rehabilitation services should be emphasized as part of mental healthcare services.

  9. University of Idaho Water of the West Initiative: Development of a sustainable, interdisciplinary water resources program

    Science.gov (United States)

    Boll, J.; Cosens, B.; Fiedler, F.; Link, T.; Wilson, P.; Harris, C.; Tuller, M.; Johnson, G.; Kennedy, B.

    2006-12-01

    Recently, an interdisciplinary group of faculty from the University of Idaho was awarded a major internal grant for their project "Water of the West (WoW)" to launch an interdisciplinary Water Resources Graduate Education Program. This Water Resources program will facilitate research and education to influence both the scientific understanding of the resource and how it is managed, and advance the decision-making processes that are the means to address competing societal values. By educating students to integrate environmental sciences, socio-economic, and political issues, the WoW project advances the University's land grant mission to promote economic and social development in the state of Idaho. This will be accomplished through novel experiential interdisciplinary education activities; creation of interdisciplinary research efforts among water resources faculty; and focusing on urgent regional problems with an approach that will involve and provide information to local communities. The Water Resources Program will integrate physical and biological sciences, social science, law, policy and engineering to address problems associated with stewardship of our scarce water resources. As part of the WoW project, faculty will: (1) develop an integrative problem-solving framework; (2) develop activities to broaden WR education; (3) collaborate with the College of Law to offer a concurrent J.D. degree, (4) develop a virtual system of watersheds for teaching and research, and (5) attract graduate students for team-based education. The new program involves 50 faculty from six colleges and thirteen departments across the university. This university-wide initiative is strengthened by collaboration with the Idaho Water Resources Research Institute, and participation from off-campus Centers in Idaho Falls, Boise, Twin Falls, and Coeur d'Alene. We hope this presentation will attract university faculty, water resources professionals, and others for stimulating discussions on

  10. The Healthy Migrant Families Initiative: development of a culturally competent obesity prevention intervention for African migrants.

    Science.gov (United States)

    Renzaho, Andre M N; Halliday, Jennifer A; Mellor, David; Green, Julie

    2015-03-19

    Although obesity among immigrants remains an important area of study given the increasing migrant population in Australia and other developed countries, research on factors amenable to intervention is sparse. The aim of the study was to develop a culturally-competent obesity prevention program for sub-Saharan African (SSA) families with children aged 12-17 years using a community-partnered participatory approach. A community-partnered participatory approach that allowed the intervention to be developed in collaborative partnership with communities was used. Three pilot studies were carried out in 2008 and 2009 which included focus groups, interviews, and workshops with SSA parents, teenagers and health professionals, and emerging themes were used to inform the intervention content. A cultural competence framework containing 10 strategies was developed to inform the development of the program. Using findings from our scoping research, together with community consultations through the African Review Panel, a draft program outline (skeleton) was developed and presented in two separate community forums with SSA community members and health professionals working with SSA communities in Melbourne. The 'Healthy Migrant Families Initiative (HMFI): Challenges and Choices' program was developed and designed to assist African families in their transition to life in a new country. The program consists of nine sessions, each approximately 1 1/2 hours in length, which are divided into two modules based on the topic. The first module 'Healthy lifestyles in a new culture' (5 sessions) focuses on healthy eating, active living and healthy body weight. The second module 'Healthy families in a new culture' (4 sessions) focuses on parenting, communication and problem solving. The sessions are designed for a group setting (6-12 people per group), as many of the program activities are discussion-based, supported by session materials and program resources. Strong partnerships and

  11. The long view of nanotechnology development: the National Nanotechnology Initiative at 10 years

    International Nuclear Information System (INIS)

    Roco, Mihail C.

    2011-01-01

    A global scientific and societal endeavor was set in motion by the nanotechnology vision formulated in 1999 that inspired the National Nanotechnology Initiative (NNI) and other national and international R and D programs. Establishing foundational knowledge at the nanoscale has been the main focus of the nanotechnology research community in the first decade. As of 2009, this new knowledge underpinned about a quarter of a trillion dollars worldwide market, of which about $91 billion was in US products that incorporate nanoscale components. Nanotechnology is already evolving toward becoming a general-purpose technology by 2020, encompassing four generations of products with increasing structural and dynamic complexity: (1) passive nanostructures, (2) active nanostructures, (3) nanosystems, and (4) molecular nanosystems. By 2020, the increasing integration of nanoscale science and engineering knowledge and of nanosystems promises mass applications of nanotechnology in industry, medicine, and computing, and in better comprehension and conservation of nature. Nanotechnology’s rapid development worldwide is a testimony to the transformative power of identifying a concept or trend and laying out a vision at the synergistic confluence of diverse scientific research areas. This chapter provides a brief perspective on the development of the NNI since 2000 in the international context, the main outcomes of the R and D programs after 10 years, the governance aspects specific to this emerging field, lessons learned, and most importantly, how the nanotechnology community should prepare for the future.

  12. Initial development of the Psychopathic Processing and Personality Assessment (PAPA) across populations.

    Science.gov (United States)

    Lewis, Michael; Ireland, Jane L; Abbott, Janice; Ireland, Carol A

    Three studies describe development of the Psychopathic Processing and Personality Assessment (PAPA). Study one outlines a literature review and Expert Delphi (n=32) to develop the initial PAPA. Study two validates the PAPA with 431 participants (121 male prisoners and 310 university students: 154 men, 156 women), also using the Levenson Self Report Psychopathy scale and a measure of cognitive schema and affect. Study three refined the PAPA, employing it with 50 male students and 40 male forensic psychiatric patients using clinical (interview) assessments of psychopathy: the Psychopathy Checklist - Screening Version and the Affect, Cognitive and Lifestyle assessment. The PAPA comprised four factors; dissocial tendencies; emotional detachment; disregard for others; and lack of sensitivity to emotion. It positively correlated with existing psychopathy measures. Variations across PAPA subscales were noted across samples when associated with clinical measures of psychopathy. Support for the validity of the PAPA was indicated across samples. Directions for research and application are outlined. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Using fish communities to assess streams in Romania: Initial development of an index of biotic integrity

    Science.gov (United States)

    Angermeier, P.L.; Davideanu, G.

    2004-01-01

    Multimetric biotic indices increasingly are used to complement physicochemical data in assessments of stream quality. We initiated development of multimetric indices, based on fish communities, to assess biotic integrity of streams in two physiographic regions of central Romania. Unlike previous efforts to develop such indices for European streams, our metrics and scoring criteria were selected largely on the basis of empirical relations in the regions of interest. We categorised 54 fish species with respect to ten natural-history attributes, then used this information to compute 32 candidate metrics of five types (taxonomic, tolerance, abundance, reproductive, and feeding) for each of 35 sites. We assessed the utility of candidate metrics for detecting anthropogenic impact based on three criteria: (a) range of values taken, (b) relation to a site-quality index (SQI), which incorporated information on hydrologic alteration, channel alteration, land-use intensity, and water chemistry, and (c) metric redundancy. We chose seven metrics from each region to include in preliminary multimetric indices (PMIs). Both PMIs included taxonomic, tolerance, and feeding metrics, but only two metrics were common to both PMIs. Although we could not validate our PMIs, their strong association with the SQI in each region suggests that such indices would be valuable tools for assessing stream quality and could provide more comprehensive assessments than the traditional approaches based solely on water chemistry.

  14. The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures.

    Science.gov (United States)

    Rutter, Matthew D; Senore, Carlo; Bisschops, Raf; Domagk, Dirk; Valori, Roland; Kaminski, Michal F; Spada, Cristiano; Bretthauer, Michael; Bennett, Cathy; Bellisario, Cristina; Minozzi, Silvia; Hassan, Cesare; Rees, Colin; Dinis-Ribeiro, Mário; Hucl, Tomas; Ponchon, Thierry; Aabakken, Lars; Fockens, Paul

    2016-02-01

    The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) have a vision to create a thriving community of endoscopy services across Europe, collaborating with each other to provide high quality, safe, accurate, patient-centered and accessible endoscopic care. Whilst the boundaries of what can be achieved by advanced endoscopy are continually expanding, we believe that one of the most fundamental steps to achieving our goal is to raise the quality of everyday endoscopy. The development of robust, consensus- and evidence-based key performance measures is the first step in this vision. ESGE and UEG have identified quality of endoscopy as a major priority. This paper explains the rationale behind the ESGE Quality Improvement Initiative and describes the processes that were followed. We recommend that all units develop mechanisms for audit and feedback of endoscopist and service performance using the ESGE performance measures that will be published in future issues of this journal over the next year. We urge all endoscopists and endoscopy services to prioritize quality and to ensure that these performance measures are implemented and monitored at a local level, so that we can provide the highest possible care for our patients.

  15. Creating a new rural pharmacy workforce: Development and implementation of the Rural Pharmacy Health Initiative.

    Science.gov (United States)

    Scott, Mollie Ashe; Kiser, Stephanie; Park, Irene; Grandy, Rebecca; Joyner, Pamela U

    2017-12-01

    An innovative certificate program aimed at expanding the rural pharmacy workforce, increasing the number of pharmacists with expertise in rural practice, and improving healthcare outcomes in rural North Carolina is described. Predicted shortages of primary care physicians and closures of critical access hospitals are expected to worsen existing health disparities. Experiential education in schools and colleges of pharmacy primarily takes place in academic medical centers and, unlike experiential education in medical schools, rarely emphasizes the provision of patient care in rural U.S. communities, where chronic diseases are prevalent and many residents struggle with poverty and poor access to healthcare. To help address these issues, UNC Eshelman School of Pharmacy developed the 3-year Rural Pharmacy Health Certificate program. The program curriculum includes 4 seminar courses, interprofessional education and interaction with medical students, embedding of each pharmacy student into a specific rural community for the duration of training, longitudinal ambulatory care practice experiences, community engagement initiatives, leadership training, development and implementation of a population health project, and 5 pharmacy practice experiences in rural settings. The Rural Pharmacy Health Certificate program at UNC Eshelman School of Pharmacy seeks to transform rural pharmacy practice by creating a pipeline of rural pharmacy leaders and teaching a unique skillset that will be beneficial to healthcare systems, communities, and patients. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  16. Enhancing the quality of aged latent fingerprints developed by superglue fuming: loss and replenishment of initiator.

    Science.gov (United States)

    Wargacki, Stephen P; Lewis, Linda A; Dadmun, Mark D

    2008-09-01

    The recovery and identification of latent fingerprints from a crime scene are crucial to many investigations. The cyanoacrylate (superglue) fuming method (CFM), which develops fingerprints by growing a polymer coating over the print residue, is a powerful method but encounters severe limitations when prints are aged or exposed to harsh environmental conditions. We examine the aging process and how the changes that occur to a fingerprint residue over time influence the growth of polymer during development. We identify loss of initiator by erosion and degradation that, when coupled with a loss of water from the print residue, result in a decreased ability to polymerize ethylcyanoacrylate. Then, we present a methodology by which the ability of aged latent fingerprints to polymerize ethylcyanoacrylate is recovered. Two print enhancement agents, acetic acid and ammonia, are demonstrated to improve the growth of polymer from the print ridges by over an order of magnitude, while retaining the integrity of the print structure. Comparison between the two enhancement agents indicate that the enhancement occurs due to ridge coating by the ammonia or acetic acid and pH control of the latent print.

  17. The development and initial assessment of the strategy and leadership systems capability evaluation survey.

    Science.gov (United States)

    Coon, Cheryl D; Bokowy, Kay L; Horblyuk, Ruslan; Zisman, Robert S; McLeod, Lori D; Brown, T Michelle

    2012-01-01

    Hospital management and leadership systems are associated with organizational success and quality care. The Strategy and Leadership Systems Capability Evaluation (CE) survey was developed by GE Healthcare to assess management and leadership systems at health care institutions, serve as a benchmark for improvement, and measure progress. To assess the psychometric properties of the 29-item CE survey, including the factor structure, scoring algorithm, reliability, and discriminant validity, an online survey was completed by 3450 employees at 15 US hospitals. Of these employees, 609 worked at a hospital where a leadership and management intervention occurred after the initial survey administration. Data were also collected on job level, number of hospital beds, hospital ownership, location, community type, and the implementation of hospital interventions. Item response frequencies showed no floor or ceiling effects and limited missing data. Interitem correlations were strong without obvious redundancies, and factor analysis suggested a unidimensional scale. The resulting scale had strong internal consistency and was able to discriminate among known groups. The CE survey was developed to evaluate management and leadership systems at health care institutions. This study provides psychometric evidence in support of the reliability, validity, and scoring structure of this survey.

  18. Word-initial /r/-clusters in Swedish speaking children with typical versus protracted phonological development.

    Science.gov (United States)

    Lundeborg Hammarström, Inger

    2018-01-01

    The present study investigated word-initial (WI) /r/-clusters in Central Swedish-speaking children with and without protracted phonological development (PPD). Data for WI singleton /r/ and singleton and cluster /l/ served as comparisons. Participants were twelve 4-year-olds with PPD and twelve age- and gender-matched typically developing (TD) controls. Native speakers audio-recorded and transcribed 109 target single words using a Swedish phonology test with 12 WI C+/r/-clusters and three WI CC+/r/-clusters. The results showed significantly higher match scores for the TD children, a lower match proportion for the /r/ targets and for singletons compared with clusters, and differences in mismatch patterns between the groups. There were no matches for /r/-cluster targets in the PPD group, with all children except two in that group showing deletions for both /r/-cluster types. The differences in mismatch proportions and types between the PPD group and controls suggests new directions for future clinical practice.

  19. Development and initial validation of a measure of work, family, and school conflict.

    Science.gov (United States)

    Olson, Kristine J

    2014-01-01

    This study reports the development and initial validation of a theoretically based measure of conflict between work, family, and college student roles. The measure was developed through the assessment of construct definitions and an assessment of measurement items by subject matter experts. Then, the measurement items were assessed with data from 500 college students who were engaged in work and family responsibilities. The results indicate that conflict between work, family, and school are effectively measured by 12 factors assessing the direction of conflict (e.g., work-to-school conflict, and school-to-work conflict) as well as the form of conflict (i.e., time, strain, and behavior based conflict). Sets of exploratory and confirmatory factor analyses demonstrated that the 12 factors of the new measure are distinct from the 6 factors of the Carlson, Kacmar, and Williams (2000) work-family conflict measure. Criterion validity of the measure was established through a series of regression analyses testing hypothesized relationships between antecedent and outcome variables with role conflict. Results indicate that role demand was a robust predictor of role conflict. To extend the literature, core self-evaluations and emotional stability were established as predictors of role conflict. Further, work, family, and school role satisfaction were significantly impacted with the presence of role conflict between work, family, and school. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  20. Epistemology and expectations survey about experimental physics: Development and initial results

    Directory of Open Access Journals (Sweden)

    Benjamin M. Zwickl

    2014-06-01

    Full Text Available In response to national calls to better align physics laboratory courses with the way physicists engage in research, we have developed an epistemology and expectations survey to assess how students perceive the nature of physics experiments in the contexts of laboratory courses and the professional research laboratory. The Colorado Learning Attitudes about Science Survey for Experimental Physics (E-CLASS evaluates students’ epistemology at the beginning and end of a semester. Students respond to paired questions about how they personally perceive doing experiments in laboratory courses and how they perceive an experimental physicist might respond regarding their research. Also, at the end of the semester, the E-CLASS assesses a third dimension of laboratory instruction, students’ reflections on their course’s expectations for earning a good grade. By basing survey statements on widely embraced learning goals and common critiques of teaching labs, the E-CLASS serves as an assessment tool for lab courses across the undergraduate curriculum and as a tool for physics education research. We present the development, evidence of validation, and initial formative assessment results from a sample that includes 45 classes at 20 institutions. We also discuss feedback from instructors and reflect on the challenges of large-scale online administration and distribution of results.

  1. Initial phase of the development of sunspot groups and their forecast

    International Nuclear Information System (INIS)

    Berlyand, B.O.; Burov, V.A.; Stepanyan, N.N.

    1979-01-01

    Some characteristics of the initial phase of sunspot groups and their forecast have been considered. Experimental data on 340 sunspot groups were obtained in 1967-1969. It was found that oscillations of the magnetic flux in the groups indicate the possibility of the existence of typical periods (2 and 4 days) of the magnetic field development. Most of the groups appears in young plages. The probability of the protons injection from the young groups is very small. The typical time of the development of the proton centre is 10-30 days. The characteristics of the group on the first day of its existence are vaguely connected with the lifetime of the group. On the second and third days the magnetic characteristics (the summary magnetic flux and the number of the unipolar regions) have the highest correlation coefficient (approximately 70%) with the lifetime of the group. The problem of the group lifetime forecast was being solved with the pattern recognition technique. On the base of the second day observation of the existence of the group verification of the received forecast 14% exceeds the verification of the climatological forecast. The forecast of the Zurich class with the same technique is effective beginning with the fifth day of the group existence and the forecast of the flare activity of the group since the day of its appearance. The exceeding of the verification as compared with the climatological forecasts in these problems is 10% and 8% accordingly

  2. Multiple Sclerosis Relapses: Epidemiology, Outcomes and Management. A Systematic Review.

    Science.gov (United States)

    Kalincik, Tomas

    2015-01-01

    Relapses (episodic exacerbations of neurological signs or symptoms) are a defining feature of relapsing-remitting multiple sclerosis (MS), the most prevalent MS phenotype. While their diagnostic value relates predominantly to the definition of clinically definite MS, their prognostic value is determined by their relatively high associated risk of incomplete remission resulting in residual disability. The mechanisms governing a relapse incidence are unknown, but numerous modifiers of relapse risk have been described, including demographic and clinical characteristics, many of which represent opportunities for improved disease management. Also relapse phenotypes have been associated with patient and disease characteristics and an individual predisposition to certain phenotypic presentations may imply individual neuroanatomical disease patterns. While immunomodulatory therapies and corticosteroids represent the mainstay of relapse prevention and acute management, respectively, their effect has only been partial and further search for more efficient relapse therapies is warranted. Other areas of research include pathophysiology and determinants of relapse incidence, recurrence and phenotypes, including the characteristics of the relapsing and non-relapsing multiple sclerosis variants and their responsiveness to therapies. © 2015 S. Karger AG, Basel.

  3. Psychosocial factors related to gambling abstinence and relapse in members of gamblers anonymous.

    Science.gov (United States)

    Oei, Tian P S; Gordon, Leon M

    2008-03-01

    Problem gamblers account for almost one-third of the industry's total revenue with the adverse effects of problem gambling including significant financial loss, legal and occupational difficulties, family problems, psychological distress and suicide. As such, it is important to understand the influential factors in gambling abstinence and relapse, which will assist in the development of relapse prevention methods in therapeutic treatment regimes. This paper reported the role of a set of seven predictors in distinguishing between abstinent and relapsed gamblers among 75 Gambling Anonymous (GA) members (55 males; 20 females; Mean age 45 years) in Southeast Queensland. The measures taken were meeting Attendance and Participation, Social Support, God Belief, Belief in a Higher Power, Working the 12-steps of Recovery, Gambling Urges and Erroneous Cognitions. Discriminant analysis revealed that the variables separating the two groups were significant, suggesting that GA members achieving abstinence could be distinguished from those who relapsed, with Attendance and Participation, and Social Support contributing the greatest influence on member's ability to abstain from gambling. The findings suggested that GA member's involvement in meetings, and support from family and friends had significant impact on their gambling abstinence. In contrast, increased gambling urges and erroneous cognitions increased the chance of relapse.

  4. Pioglitazone attenuates the opioid withdrawal and vulnerability to relapse to heroin seeking in rodents.

    Science.gov (United States)

    de Guglielmo, Giordano; Kallupi, Marsida; Scuppa, Giulia; Demopulos, Gregory; Gaitanaris, George; Ciccocioppo, Roberto

    2017-01-01

    Relapse to opioids is often driven by the avoidance of the aversive states of opioid withdrawal. We recently demonstrated that activation of peroxisome proliferator-activated receptor gamma (PPARγ) by pioglitazone reduces the motivation for heroin and attenuates its rewarding properties. However, the role of PPARγ in withdrawal and other forms of relapse to heroin is unknown. To further address this issue, we investigated the role of PPARγ on the development and expression of morphine withdrawal in mice and the effect of pioglitazone on several forms of heroin relapse in rats. We induced physical dependence to morphine in mice by injecting morphine twice daily for 6 days. Withdrawal syndrome was precipitated on day 6 with an injection of naloxone. In addition, different groups of rats were trained to self-administer heroin and, after the extinction, the relapse was elicited by cues, priming, or stress. The effect of different doses of pioglitazone was tested on these different paradigms. Data show that chronic and acute administration of pioglitazone attenuates morphine withdrawal symptoms, and these effects are mediated by activation of PPARγ receptors. Activation of PPARγ by pioglitazone also abolishes yohimbine-induced reinstatement of heroin seeking and reduces heroin-induced reinstatement, while it does not affect cue-induced relapse. These findings provide new insights on the role of PPARγ on opioid dependence and suggest that pioglitazone may be useful for the treatment of opioid withdrawal in opioid-addicted individuals.

  5. How to Initiate and Develop the Market of DME - With Focus on Bio-DME?

    Energy Technology Data Exchange (ETDEWEB)

    Baudin, Anders; Nordvall, Hans-Olof (School of Engineering, Linnaeus Univ., Vaexjoe (Sweden))

    2010-01-15

    The theme of this study is how to initiate and develop the market for DME with focus on Bio-DME. In particular, the view considered is that DME can replace diesel and LPG. Initiating and market development for other application is not included here. Regional diesel prices are highly correlated. One can even argue that there seems to be a world market price. Furthermore, they are strongly volatile, which can be traced to the relationship to crude oil. The volatility in diesel - and oil - prices is taken care of in a well developed market for financial instruments (e.g. futures, options). Similar financial risk handling is not yet available for the unit price of DME. A considerable amount of structured information exists in companies, also with consultants and researchers, on how different end-use sectors are expected to react to variation in diesel prices. Knowledge of the end-use sectors' likely reaction to the introduction of DME prices in comparison to diesel prices is generally unknown and is thus only subject to discussion. Obtaining information on this process is, however, the crucial point in the introduction of the market for (bio-)DME. In the short term the introduction phase might be shorter if DME could be mixed with diesel (cf. DME in LPG). This would imply unaltered infrastructure. The advantage of leaving aside adaptation of engines and changing infrastructure would imply that the thresholds for introduction of DME are reduced - the consequence would be that larger production volumes of DME would be obtained quicker. The business risk would also be reduced. But is it possible to mix DME (fossil and bio) with diesel? One standpoint is that this is impossible. Other researchers argue that mix is possible up to 25 per cent - some claim even higher. The problem is that viscosity tends to be too low. Further studies will cast light on this problem. Parallel efforts should be initiated to introduce systems with 100 per cent DME. This requires adaptation

  6. Why do employees take more initiatives to improve their performance after co-developing performance measures? A field study

    NARCIS (Netherlands)

    Groen, B.A.C.; Wouters, M.J.F.; Wilderom, C.P.M.

    2012-01-01

    Performance measurements may stimulate employee initiatives to improve operational performance, especially when employees themselves participate in the development of their own departmental performance measures. Using the theory of planned behavior, we examine why this occurs in a beverage

  7. Why do employees take more initiatives to improve their performance after co-developing performance measures? A field study.

    NARCIS (Netherlands)

    Groen, B.A.C.; Wouters, Marc; Wilderom, Celeste P.M.

    2012-01-01

    Performance measurements may stimulate employee initiatives to improve operational performance, especially when employees themselves participate in the development of their own departmental performance measures. Using the theory of planned behavior, we examine why this occurs in a beverage

  8. Study of the variation of the nuclear transcriptional map during de initial development of Drosophyla melanogaster embryos

    International Nuclear Information System (INIS)

    Alonso, C.E.V.

    1987-01-01

    The variation of nuclear transcriptional map during the initial development of Drosophyla melanogaster embryos were studied. Thermic treatment, chromatographic techniques and liquid scintilation in embryos inoculated with radioactive uridine were used. (L.J.C.)

  9. Development of a Physically-Based Methodology for Predicting Material Variability in Fatigue Crack Initiation and Growth Response

    National Research Council Canada - National Science Library

    Chan, Kwai

    2004-01-01

    ... of aerospace structural alloys. In this three-year program, physics-based fatigue crack initiation and growth models were developed and integrated into a probabilistic micromechanical code for treating fatigue life variability...

  10. The EGF receptor and notch signaling pathways control the initiation of the morphogenetic furrow during Drosophila eye development.

    Science.gov (United States)

    Kumar, J P; Moses, K

    2001-07-01

    The onset of pattern formation in the developing Drosophila retina begins with the initiation of the morphogenetic furrow, the leading edge of a wave of retinal development that transforms a uniform epithelium, the eye imaginal disc into a near crystalline array of ommatidial elements. The initiation of this wave of morphogenesis is under the control of the secreted morphogens Hedgehog (Hh), Decapentaplegic (Dpp) and Wingless (Wg). We show that the Epidermal Growth Factor Receptor and Notch signaling cascades are crucial components that are also required to initiate retinal development. We also show that the initiation of the morphogenetic furrow is the sum of two genetically separable processes: (1) the 'birth' of pattern formation at the posterior margin of the eye imaginal disc; and (2) the subsequent 'reincarnation' of retinal development across the epithelium.

  11. Development of a comprehensive hospital-based elder abuse intervention: an initial systematic scoping review.

    Directory of Open Access Journals (Sweden)

    Janice Du Mont

    Full Text Available Elder abuse, a universal human rights problem, is associated with many negative consequences. In most jurisdictions, however, there are no comprehensive hospital-based interventions for elder abuse that address the totality of needs of abused older adults: psychological, physical, legal, and social. As the first step towards the development of such an intervention, we undertook a systematic scoping review.Our primary objective was to systematically extract and synthesize actionable and applicable recommendations for components of a multidisciplinary intersectoral hospital-based elder abuse intervention. A secondary objective was to summarize the characteristics of the responses reviewed, including methods of development and validation.The grey and scholarly literatures were systematically searched, with two independent reviewers conducting the title, abstract and full text screening. Documents were considered eligible for inclusion if they: 1 addressed a response (e.g., an intervention to elder abuse, 2 contained recommendations for responding to abused older adults with potential relevance to a multidisciplinary and intersectoral hospital-based elder abuse intervention; and 3 were available in English.The extracted recommendations for care were collated, coded, categorized into themes, and further reviewed for relevancy to a comprehensive hospital-based response. Characteristics of the responses were summarized using descriptive statistics.649 recommendations were extracted from 68 distinct elder abuse responses, 149 of which were deemed relevant and were categorized into 5 themes: Initial contact; Capacity and consent; Interview with older adult, caregiver, collateral contacts, and/or suspected abuser;physical/forensic, mental, psychosocial, and environmental/functional; and care plan. Only 6 responses had been evaluated, suggesting a significant gap between development and implementation of recommendations.To address the lack of evidence to

  12. Initial development of a practical safety audit tool to assess fleet safety management practices.

    Science.gov (United States)

    Mitchell, Rebecca; Friswell, Rena; Mooren, Lori

    2012-07-01

    Work-related vehicle crashes are a common cause of occupational injury. Yet, there are few studies that investigate management practices used for light vehicle fleets (i.e. vehicles less than 4.5 tonnes). One of the impediments to obtaining and sharing information on effective fleet safety management is the lack of an evidence-based, standardised measurement tool. This article describes the initial development of an audit tool to assess fleet safety management practices in light vehicle fleets. The audit tool was developed by triangulating information from a review of the literature on fleet safety management practices and from semi-structured interviews with 15 fleet managers and 21 fleet drivers. A preliminary useability assessment was conducted with 5 organisations. The audit tool assesses the management of fleet safety against five core categories: (1) management, systems and processes; (2) monitoring and assessment; (3) employee recruitment, training and education; (4) vehicle technology, selection and maintenance; and (5) vehicle journeys. Each of these core categories has between 1 and 3 sub-categories. Organisations are rated at one of 4 levels on each sub-category. The fleet safety management audit tool is designed to identify the extent to which fleet safety is managed in an organisation against best practice. It is intended that the audit tool be used to conduct audits within an organisation to provide an indicator of progress in managing fleet safety and to consistently benchmark performance against other organisations. Application of the tool by fleet safety researchers is now needed to inform its further development and refinement and to permit psychometric evaluation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  13. Development of a Comprehensive Hospital-Based Elder Abuse Intervention: An Initial Systematic Scoping Review

    Science.gov (United States)

    Du Mont, Janice; Macdonald, Sheila; Kosa, Daisy; Elliot, Shannon; Spencer, Charmaine; Yaffe, Mark

    2015-01-01

    Introduction Elder abuse, a universal human rights problem, is associated with many negative consequences. In most jurisdictions, however, there are no comprehensive hospital-based interventions for elder abuse that address the totality of needs of abused older adults: psychological, physical, legal, and social. As the first step towards the development of such an intervention, we undertook a systematic scoping review. Objectives Our primary objective was to systematically extract and synthesize actionable and applicable recommendations for components of a multidisciplinary intersectoral hospital-based elder abuse intervention. A secondary objective was to summarize the characteristics of the responses reviewed, including methods of development and validation. Methods The grey and scholarly literatures were systematically searched, with two independent reviewers conducting the title, abstract and full text screening. Documents were considered eligible for inclusion if they: 1) addressed a response (e.g., an intervention) to elder abuse, 2) contained recommendations for responding to abused older adults with potential relevance to a multidisciplinary and intersectoral hospital-based elder abuse intervention; and 3) were available in English. Analysis The extracted recommendations for care were collated, coded, categorized into themes, and further reviewed for relevancy to a comprehensive hospital-based response. Characteristics of the responses were summarized using descriptive statistics. Results 649 recommendations were extracted from 68 distinct elder abuse responses, 149 of which were deemed relevant and were categorized into 5 themes: Initial contact; Capacity and consent; Interview with older adult, caregiver, collateral contacts, and/or suspected abuser; Assessment: physical/forensic, mental, psychosocial, and environmental/functional; and care plan. Only 6 responses had been evaluated, suggesting a significant gap between development and implementation of

  14. The IGAC activity for the development of global emissions inventories: Description and initial results

    International Nuclear Information System (INIS)

    Benkovitz, C.M.; Graedel, T.E.

    1992-02-01

    Modeling assessments of the atmospheric chemistry, air quality and climatic conditions of the past, present and future require as input inventories of emissions of the appropriate chemical species constructed on appropriate spatial and temporal scales. The task of the Global Emissions Inventories Activity (GEIA) of the International Global Atmospheric Chemistry Project (IGAC) is the production of global inventories suitable for a range of research applications. Current GEIA programs are generally based on addressing emissions by species; these include CO 2 , NH 3 /N 2 O, SO 2 /NO x , CFC, volatile organic compounds and radioisotopes. In addition a separate program to inventory emissions from biomass burning is also being structured, plus an additional program to address data management issues for all the developing inventories. Program priorities are based on current knowledge and tasks needed to produce the desired inventories. This paper will discuss the different types of global inventories to be developed by the GEIA programs, their key characteristics, and areas to be addressed in the compilation of such inventories. Results of the first GEIA task, a survey of existing inventories and auxiliary data, will be presented. The survey included status assessments for the available inventory information for nineteen different atmospheric species or groups of species on global and regional scales and over time. Of this entire body of information, the only inventory regarded as satisfactory was that for the global emissions of CFCs. An implication of the results of these assessments is that properly gridded emissions inventories are badly needed to support atmospheric modeling calculations on a variety of spatial and temporal scales. Initial studies in the development of global inventories of sulfur dioxide, currently the most advanced GEIA program, will be presented and discussed

  15. Electric Power Infrastructure Reliability And Security Research And Development Initiative. Final report

    International Nuclear Information System (INIS)

    Dale, S.; Meeker, R.; Steurer, M.; Li, H.; Pamidi, S.; Rodrigo, H.; Suryanarayanan, S.; Cartes, D.; Ordonez, J.; Domijan, A.; Liu, W.; Cox, D.; McLaren, P.; Hovsapian, R.; Edwards, D.; Simmons, S.; Wilde, N.; Woodruff, S.; Kopriva, D.; Hussaini, Y.; Mohammed, O.; Zheng, J.; Baldwin, T.L.

    2008-01-01

    This is the final scientific/technical report for the Electric Power Infrastructure Reliability and Security R and D Initiative sponsored by the U.S. Department of Energy, Office of Electricity Delivery and Energy Reliability, under award number DE-FG02-05CH11292. This report covers results from the FSU-led, multi-institution effort conducted over the period 8/15/05 to 10/14/2007. Building upon existing infrastructure for power systems research, modeling, and simulation, the Center for Advanced Power Systems (CAPS) at Florida State University (FSU) is developing world-class programs in electric power systems research and education to support future electric power system needs and challenges. With U.S. Department of Energy Support, FSU CAPS has engaged in a multi-faceted effort to conduct basic and applied research towards understanding, developing, and deploying technologies and approaches that can lead to improved reliability and security of the North American electric power generation and delivery infrastructure. This wide-reaching project, through a number of carefully selected thrusts cutting across several research disciplines, set out to address key terrestrial electric utility power system issues and challenges. The challenges and the thrusts to address them were arrived at through analysis of a number of national reports and recommendations combined with input from an experienced multi-disciplined team of power systems research staff and faculty at FSU CAPS. The resulting project effort can be grouped into four major areas: - Power Systems and New Technology Insertion - Controls, Protection, and Security - Simulation Development - High Temperature Superconductivity (HTS)

  16. From Abstinence to Relapse: A Preliminary Qualitative Study of Drug Users in a Compulsory Drug Rehabilitation Center in Changsha, China.

    Directory of Open Access Journals (Sweden)

    Mei Yang

    Full Text Available Relapse among abstinent drug users is normal. Several factors are related to relapse, but it remains unclear what individuals' actual life circumstances are during periods of abstinence, and how these circumstances facilitate or prevent relapse.To illuminate drug users' experiences during abstinence periods and explore the real-life catalysts and inhibitors contributing to drug use relapse.Qualitative in-depth interviews were conducted with 20 drug users recruited from a compulsory isolated drug rehabilitation center in Changsha. The interviews were guided by open-ended questions on individuals' experiences in drug use initiation, getting addicted, treatment history, social environment, abstinence, and relapse. Participants were also encouraged to share their own stories. Interviews were digitally recorded and fully transcribed. The data of 18 participants who reported abstinence experiences before admission were included in the analyses. The data were analyzed using a thematic analysis with inductive hand coding to derive themes.Most drug users were able to successfully abstain from drugs. During abstinence, their lives were congested with challenges, such as adverse socioeconomic conditions, poor family/social support, interpersonal conflicts, and stigma and discrimination, all of which kept them excluded from mainstream society. Furthermore, the police's system of ID card registration, which identifies individuals as drug users, worsened already grave situations. Relapse triggers reported by the participants focused mainly on negative feelings, interpersonal conflicts, and stressful events. Craving was experienced but not perceived as a relapse trigger by most participants.This study of in-depth interview with drug users found evidence of situations and environments they live during abstinence appear rather disadvantaged, making it extremely difficult for them to remain abstinent. Comprehensive programs on relapse prevention that acknowledge

  17. Remitting - Relapsing Polyneuropathy In Juvenile Metachromatic Leukodystrophy

    Directory of Open Access Journals (Sweden)

    Taly AB

    2004-01-01

    Full Text Available A five-year-old girl manifested with acute relapsing polyradiculo-neuropathy. Elevated cerebrospinal fluid proteins, electro-physiological evidence of conduction block and remitting course suggested possible acquired demyelinating radiculoneuropathy. However, intellectual deterioration during follow up, evidence of extensive, symmetrical and periventricular demyelination on MRI of brain and metachromatic on sural nerve biopsy led to the diagnosis of metachromatic leukodystrophy (MLD. Inherited neuropathies such as MLD may occasionally present atypically in the early stages. Recognition of this variation has considerable therapeutic and prognostic significance.

  18. Breast cancer relapse stage I and II

    International Nuclear Information System (INIS)

    Perez Braojos, Ines; Diaz Gestoso, Yadira; Franco Odio, Sonia; Samuel Gonzalez, Victor

    2009-01-01

    Breast cancer has always been the most common malignancy in women and is the leading cause of death in women, study relapses Stages I and II therapeutic guidelines applied in the service Mastology the 1985 - 1989, was our first objective, the database used was Clinical history, which gave us all the material necessary, treatments were: In tumors up to 3 cm node-conserving surgery plus treatment N0 with ionizing radiation on the breast tangential C0G0 in tumors greater than 3 cm or less with N1 was modified radical mastectomy according to node status for the study of the part and the receiver adjuvant treatment conducted. (Author)

  19. Cost effectiveness and budget impact of natalizumab in patients with relapsing multiple sclerosis.

    Science.gov (United States)

    Chiao, Evelyn; Meyer, Kellie

    2009-06-01

    Disease-modifying therapy (DMT) is the largest single-cost item that contributes to the total per-patient cost of multiple sclerosis (MS), a disabling disorder of the central nervous system. Natalizumab is the most recent DMT to be approved for the treatment of relapsing MS and may be an attractive alternative to interferon beta and glatiramer acetate (GA). To determine from the perspective of a United States payer (1) the incremental cost effectiveness of natalizumab compared with other DMTs and (2) the budgetary impact of utilization of natalizumab for the treatment of relapsing MS. A combined cost effectiveness and budget impact model was developed. Model inputs were drug acquisition costs (wholesale acquisition cost), costs of drug administration and monitoring, costs of treating relapses, anticipated reduction in relapse rates after 2 years of therapy, and estimated market utilization of natalizumab. Outcomes included total 2-year costs of therapy per patient, costs per relapse avoided for each treatment, and overall 2-year costs to the health plan and per member per month (PMPM) costs. Drug acquisition costs are in 2008 US dollars, and all other costs were inflated to 2008 US dollars when necessary. Univariate sensitivity analyses were performed to determine the model inputs with the greatest influence on the cost per relapse avoided for natalizumab. The overall 2-year cost of therapy per patient was $72,120 for natalizumab, $56,790 for intramuscular (IM) interferon beta-1a (IFNbeta-1a), $56,773 for IFNbeta-1b, $57,180 for GA, and $58,538 for subcutaneous (SC) IFNbeta-1a. The cost per relapse avoided was lowest for natalizumab at $56,594, followed by $87,791 for IFNbeta-1b, $93,306 for IM IFNbeta-1a, $96,178 for SC IFNbeta-1a, and $103,665 for GA. The incremental cost-effectiveness ratios of natalizumab relative to IM IFNbeta-1a, IFNbeta-1b, GA, and SC IFNbeta-1a were $23,029, $24,452, $20,671, and $20,403 per additional relapse avoided, respectively. An

  20. Prolonged Survival of Acute Lymphoblastic Leukemia with Intrathecal Treatments for Isolated Central Nervous System Relapse

    Directory of Open Access Journals (Sweden)

    Elan Gorshein

    2018-01-01

    Full Text Available Acute lymphoblastic leukemia is commonly cured when diagnosed in the pediatric population. It portends a poorer prognosis if present in adult patients. Although adults frequently achieve complete remission, relapse rates are substantial, particularly among the elderly and high-risk populations. In the absence of prophylactic intrathecal chemotherapy, more than half of patients may develop CNS involvement or relapse, which is associated with significant risk for systemic illness. This report describes a patient with acute lymphoblastic leukemia with repeated isolated CNS relapses. This case should remind clinicians that isolated CNS disease in the absence of systemic recurrence could successfully respond to intrathecal therapy and offer patients a favorable quality of life.

  1. Hematologic Response to Vorinostat Treatment in Relapsed Myeloid Leukemia of Down Syndrome.

    Science.gov (United States)

    Scheer, Carina; Kratz, Christian; Witt, Olaf; Creutzig, Ursula; Reinhardt, Dirk; Klusmann, Jan-Henning

    2016-09-01

    Children with Down syndrome are at high risk to develop myeloid leukemia (ML-DS). Despite their excellent prognosis, children with ML-DS particularly suffer from severe therapy-related toxicities and for relapsed ML-DS the cure rates are very poor. Here we report the clinical course of one child with ML-DS treated with the histone deacetylase (HDAC) inhibitor vorinostat (suberoylanilide hydroxamic acid) after second relapse. The child had previously received conventional chemotherapy and stem cell transplantation, yet showed a remarkable clinical and hematologic response. Thus, HDAC inhibitor may represent an effective class of drugs for the treatment of ML-DS. © 2016 Wiley Periodicals, Inc.

  2. Developing the "120 by 20" goal for the Global FP2020 Initiative.

    Science.gov (United States)

    Brown, Win; Druce, Nel; Bunting, Julia; Radloff, Scott; Koroma, Desmond; Gupta, Srishti; Siems, Brian; Kerrigan, Monica; Kress, Dan; Darmstadt, Gary L

    2014-03-01

    This report describes the purpose for developing a quantitative goal for the London Summit on Family Planning held in July 2012, the methodology behind its formulation, and the lessons learned in the process. The London Summit has evolved into the global initiative known as FP2020, and the goal has become "120 by 20," or reaching 120 million additional users of modern contraceptive methods by 2020 in the world's poorest countries. The success of FP2020 will first be evaluated on the basis of quantitative verification to determine that the "120 by 20" goal was reached. More important, however, is the extent to which the goal today serves as a global rallying cry to mobilize resources and leadership around current family planning programs, with a focus on voluntary family planning and quality of care, and with an emphasis on meeting girls' and women's unmet needs and their right to practice contraception. We hope this article provides greater transparency and understanding of the FP2020 goal, and that the global goal spurs annual monitoring of progress toward national goals in the world's poorest countries. © 2014 The Population Council, Inc.

  3. Training initiatives for essential obstetric care in developing countries: a 'state of the art' review.

    Science.gov (United States)

    Penny, S; Murray, S F

    2000-12-01

    Increased international awareness of the need to provide accessible essential or emergency obstetric and newborn care in developing countries has resulted in the recognition of new training needs and in a number of new initiatives to meet those needs. This paper reviews experience in this area so far. The first section deals with some of the different educational approaches and teaching methods that have now been employed, ranging from the traditional untheorized 'chalk and talk', to competency-based training, to theories of adult learning, problem solving and transferable skills. The second section describes a range of different types of indicators and data sources (learner assessments, user and community assessments, trainer assessments and institutional data) that have been used in the assessment of the effectiveness of such training. The final section of the paper draws together some of the lessons. It considers evaluation design issues such as the inclusion of medium and long term evaluation, the importance of methods that allow for the detection of iatrogenic effects of training, and the roles of community randomized trials and 'before, during and after' studies. Issues identified for the future include comparative work, how to keep training affordable, and where training ought to lie on the continuum between straightforward technical skills acquisition and the more complex learning processes required for demanding professional work.

  4. Restoring the capacity for initiative to local authorities for the development of ENR

    International Nuclear Information System (INIS)

    Gouvello, Ch. de; Nadaud, F.

    2001-01-01

    The decree of June 8. 2001 concerning wind powered electricity purchase prices as a sign of public support in terms of industrial policy. The recent debates have given the local authorities a key role in the development of ENR systems although concrete achievements so far remain quite limited We will demonstrate that this is essentially explained by the fact that the skills of local authorities chiefly lie in the discrete framework of the Rural Electrification scheme. Based on examples of thermal ENR systems in housing and of electrical production via ENR systems connected to the network, we will show that the Rural Electrification scheme has the effect of focusing the technical choices of local authorities on the traditional technology of the distribution networks. A minor modification to the Rural Electrification scheme would make it possible to give the capacity for initiative back to local authorities with regard to ENR systems, while at the same time making it possible to contribute to resolving the question of the reinforcement of transportation and distribution networks in order to incorporate production obtained from ENR systems. (authors)

  5. Genetic resources as initial material for developing new soft winter wheat varieties

    Directory of Open Access Journals (Sweden)

    В. М. Кір’ян

    2016-12-01

    Full Text Available Purpose. To estimate genetic resources collection of soft winter wheat plants (new collection accessions of Ustymivka Experimental Station for Plant Production and select initial material for breeding of adaptive, productive and qualitative soft winter wheat varieties. Methods. Field experiment, laboratory testing. Results. The authors pre- sented results of study of over 1000 samples of gene pool of soft winter wheat from 25 countries during 2001–2005 in Ustymivka Experimental Station for Plant Production of Plant Production Institute nd. a. V. Ya. Yuriev, NAAS of Ukraine for a complex of economic traits. More than 400 new sources with high adaptive properties were selected that combine traits of high productivity and high quality of grain, early ripening, resistance to biotic and abiotic fac- tors (the assessment of samples for 16 valuable traits is given. The selected material comes from various agro-cli- matic zones, including zones of unsustainable agriculture. Conclusions. Recommended sources of traits that have breeding value will allow to enrich high-quality assortment of wheat and considerably accelerate breeding process du- ring development of new soft winter wheat varieties.

  6. Status on development and verification of reactivity initiated accident analysis code for PWR (NODAL3)

    International Nuclear Information System (INIS)

    Peng Hong Liem; Surian Pinem; Tagor Malem Sembiring; Tran Hoai Nam

    2015-01-01

    A coupled neutronics thermal-hydraulics code NODAL3 has been developed based on the nodal few-group neutron diffusion theory in 3-dimensional Cartesian geometry for a typical pressurized water reactor (PWR) static and transient analyses, especially for reactivity initiated accidents (RIA). The spatial variables are treated by using a polynomial nodal method (PNM) while for the neutron dynamic solver the adiabatic and improved quasi-static methods are adopted. A simple single channel thermal-hydraulics module and its steam table is implemented into the code. Verification works on static and transient benchmarks are being conducting to assess the accuracy of the code. For the static benchmark verification, the IAEA-2D, IAEA-3D, BIBLIS and KOEBERG light water reactor (LWR) benchmark problems were selected, while for the transient benchmark verification, the OECD NEACRP 3-D LWR Core Transient Benchmark and NEA-NSC 3-D/1-D PWR Core Transient Benchmark (Uncontrolled Withdrawal of Control Rods at Zero Power). Excellent agreement of the NODAL3 results with the reference solutions and other validated nodal codes was confirmed. (author)

  7. Development of a new compact intraoperative magnetic resonance imaging system: concept and initial experience.

    Science.gov (United States)

    Morita, Akio; Sameshima, Tetsuro; Sora, Shigeo; Kimura, Toshikazu; Nishimura, Kengo; Itoh, Hirotaka; Shibahashi, Keita; Shono, Naoyuki; Machida, Toru; Hara, Naoko; Mikami, Nozomi; Harihara, Yasushi; Kawate, Ryoichi; Ochiai, Chikayuki; Wang, Weimin; Oguro, Toshiki

    2014-06-01

    Magnetic resonance imaging (MRI) during surgery has been shown to improve surgical outcomes, but the current intraoperative MRI systems are too large to install in standard operating suites. Although 1 compact system is available, its imaging quality is not ideal. We developed a new compact intraoperative MRI system and evaluated its use for safety and efficacy. This new system has a magnetic gantry: a permanent magnet of 0.23 T and an interpolar distance of 32 cm. The gantry system weighs 2.8 tons and the 5-G line is within the circle of 2.6 m. We created a new field-of-view head coil and a canopy-style radiofrequency shield for this system. A clinical trial was initiated, and the system has been used in 44 patients. This system is significantly smaller than previous intraoperative MRI systems. High-quality T2 images could discriminate tumor from normal brain tissue and identify anatomic landmarks for accurate surgery. The average imaging time was 45.5 minutes, and no clinical complications or MRI system failures occurred. Floating organisms or particles were minimal (1/200 L maximum). This intraoperative, compact, low-magnetic-field MRI system can be installed in standard operating suites to provide relatively high-quality images without sacrificing safety. We believe that such a system facilitates the introduction of the intraoperative MRI.

  8. Discover Science Initiative, outreach and professional development at the University of California, Irvine

    Science.gov (United States)

    Pestana, Jill; Earthman, James

    Discover Science Initiative (DSI) is an unprecedented success in the Southern Californian community by reaching out to over 5,000 participants through eight hands-on workshops on topics from fungi to the physics of light, and two large events in the past year. The DSI vision is to provide an avenue for University of California, Irvine (UCI) students and faculty from all departments to engage with the local community through workshops and presentations on interdisciplinary, state-of-the-art STEM research unique to UCI. DSI provides professional development opportunities for diverse students at UCI, while providing outreach at one of the most popular educational centers in Southern California, the Discovery Cube, which hosts over 400,000 guests each year. In DSI, students engage in peer-to-peer mentoring with guidance from the UCI School of Education in designing workshops, leading meetings, and managing teams. Also, students practice science communication, coached by certified communications trainers. Students involved in DSI learn important skills to complement their academic degrees, and stay motivated to pursue their career goals. Support for DSI is from Diverse Educational and Doctoral Experience (DECADE) at UCI.

  9. Development and initial validation of a cognitive-based work-nonwork conflict scale.

    Science.gov (United States)

    Ezzedeen, Souha R; Swiercz, Paul M

    2007-06-01

    Current research related to work and life outside work specifies three types of work-nonwork conflict: time, strain, and behavior-based. Overlooked in these models is a cognitive-based type of conflict whereby individuals experience work-nonwork conflict from cognitive preoccupation with work. Four studies on six different groups (N=549) were undertaken to develop and validate an initial measure of this construct. Structural equation modeling confirmed a two-factor, nine-item scale. Hypotheses regarding cognitive-based conflict's relationship with life satisfaction, work involvement, work-nonwork conflict, and work hours were supported. The relationship with knowledge work was partially supported in that only the cognitive dimension of cognitive-based conflict was related to extent of knowledge work. Hypotheses regarding cognitive-based conflict's relationship with family demands were rejected in that the cognitive dimension correlated positively rather than negatively with number of dependent children and perceived family demands. The study provides encouraging preliminary evidence of scale validity.

  10. A web-based application for initial screening of living kidney donors: development, implementation and evaluation.

    Science.gov (United States)

    Moore, D R; Feurer, I D; Zavala, E Y; Shaffer, D; Karp, S; Hoy, H; Moore, D E

    2013-02-01

    Most centers utilize phone or written surveys to screen candidates who self-refer to be living kidney donors. To increase efficiency and reduce resource utilization, we developed a web-based application to screen kidney donor candidates. The aim of this study was to evaluate the use of this web-based application. Method and time of referral were tabulated and descriptive statistics summarized demographic characteristics. Time series analyses evaluated use over time. Between January 1, 2011 and March 31, 2012, 1200 candidates self-referred to be living kidney donors at our center. Eight hundred one candidates (67%) completed the web-based survey and 399 (33%) completed a phone survey. Thirty-nine percent of donors accessed the application on nights and weekends. Postimplementation of the web-based application, there was a statistically significant increase (p web-based application as opposed to telephone contact. Also, there was a significant increase (p = 0.025) in the total number of self-referrals post-implementation from 61 to 116 per month. An interactive web-based application is an effective strategy for the initial screening of donor candidates. The web-based application increased the ability to interface with donors, process them efficiently and ultimately increased donor self-referral at our center. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

  11. Development of a process for continuous, radiation-chemically initiated, catalytic hydrocarboxylation

    International Nuclear Information System (INIS)

    Laege, J.

    1980-01-01

    In the general part are treated technical preparation of aliphatic carboxylic acids and their economical importance, the hydrocarboxylation reaction and general aspects of radiation chemistry. The chapter on results of discontinuous experiments contains experiments of radiochemically initiated catalytical hydroesterification of oct-1-ene and buteneoxide. The chapter on development and arrangement of the continuously working hydrocarboxylation plant deals with the disposition of process flow sheet, single elements of and description of the plant. The chapter on results of continuous experiments describes residence time behaviour of the tube reactor, investigations on the mixing behaviour of educts, influence of residence time and reaction pressure on continuous thermal and thermal-radiochemical hydrocarboxylation. The next chapter proposes a procedure of continuous hydrobarboxylation and esterification at high pressure on an industrial scale. The experimental part presents starting materials, preparation on catalysts and reference substances, performance of discontinuous autoclave experiments, work up and investigation of reaction products, performance of continuous high pressure experiments, Co-60-source, Fricke-dosimetry and analytics. (SPI)

  12. The GEDEON program. An R and D initiative in support of the ADS development in France

    International Nuclear Information System (INIS)

    Salvatores, M.; Schapira, J.P.; Mouney, H.; Carluec, B.

    1999-01-01

    The GEDEON initiative: R and D on basic physics issues of ADS. Also: R and D in the perspective of a 'demo' experiment. The context in France: R and D for waste management; R and D organisations have collaboration agreements with industrial partners; the French Ministry for Research has promoted a study on the relevance of an ADS 'demo'. The context in Europe: The 5th Framework Program; A tri-country initiative towards an 'ASAP demo' (at present being enlarged to other countries). GEDEON is coordinating and supporting R and D activities in this context. Four organisations are presently supporting financially GEDEON: CEA, CNRS, EdF, FRAMATOME. Workshop help to focus on issues and to start cooperative projects nuclear data, pyrochemistry, and materials for target and window. Also: some joint projects, such as the MUSE program at MASURCA. Links with ongoing R and D activities such as High Intensity Accelerators. Present R and D fields: Spallation Target physics: double differential data (analysis of SATURNE experiments), neutron multiplicities (GANIL), spallation product distribution (GSI). Nuclear Data Np-237 and Tc-99 σ c in the resonance region (GEEL), Am-242 σ f at thermal energy (ILL). Nuclear data validation with integral experiments: MA sample irradiation and Irradiated Fuel Analysis. Spallation physics and particle transport modeling: the SPARTE code. Neutronics and control of subcritical cores: the MUSE Program at MASURCA; MUSE-1, MUSE-2 (1995-96) with Cf-252 external source, MUSE-3 with commercial 14 eV n source. Future program: MASURCA cores coupling to a performing deuteron accelerator (GENEPI). System studies: scenario studies (e.g. double strata fuel cycle); use of thorium. Also reduced radiotoxicity 'at the origin'. Potential of pyrochemistry to handle highly active fuel and supports not compatible with PUREX (heterogeneous recycling targets, dedicated MA-based fuels); also: potential of the IFR concept revisited (homogeneous recycling). Potential of

  13. Differences in depression severity and frequency of relapses in opiate addicts treated with methadone or opiate blocker after detoxification

    OpenAIRE

    Jovanović Tatjana; Lazarević Dušan; Nikolić Gordana

    2012-01-01

    Background/Aim. Relapse of opiate dependence is a common occurrence after detoxification and introduction of opiate addicts in abstinence from opiates. Clinical evaluation showed that over 90% of opiate addicts exhibit depressive manifestations during detoxification, or develop post-detoxification depression. The aim of this study was to determine differences in the frequency of relapses, severity and course of depression during a of 6-month period, and previous patterns of use of opioi...

  14. U.S. next generation safeguards initiative: the human capital development program

    International Nuclear Information System (INIS)

    Scholz, M.A.

    2013-01-01

    The Human Capital Development (HCD) subprogram of the U.S. Next Generation Safeguards Initiative (NGSI) is developing sustainable academic and technical programs that support the recruitment, education, training, and retention of the next generation of international safeguards professionals. This wide-ranging HCD effort endeavors to develop additional human resources to address current shortfalls, encourage U.S. experts to seek employment at the IAEA, and identify and train a new cadre of safeguards experts to meet the needs of both the United States and the IAEA for decades to come. In recent years, a convergence of factors has challenged the IAEA's ability to carry out its safeguards mission effectively. A staffing study shows that less than 20% of the international safeguards specialists in the U.S. workforce are 44 years of age or younger and that over 80% of the international safeguards specialists at the National Laboratories will be retired or otherwise resigned within 15 years. An aging workforce nearing retirement and growing workload, coupled with a safeguards budget that has remained essentially flat in real terms for nearly two decades, have posed particular challenges to the IAEA's Department of Safeguards. Recognizing the trends, the National Nuclear Security Administration's (NNSA) Office of Nonproliferation and International Security (NIS) launched NGSI in the fall of 2007. Since that time, the HCD subprogram of NGSI has sponsored over 300 safeguards internships at U.S. National Labs, organized eight annual short safeguards policy and technical courses, worked with ten universities to develop new undergraduate and graduate course-work on international safeguards and nonproliferation, established a highly competitive graduate fellowship program, and completed a human capital requirements study that closely examined the safeguards workforce within the U.S. National Lab complex. Of past NGSI students and interns, nearly four in ten pursue multiple NGSI

  15. eSACP - a new Nordic initiative towards developing statistical climate services

    Science.gov (United States)

    Thorarinsdottir, Thordis; Thejll, Peter; Drews, Martin; Guttorp, Peter; Venälainen, Ari; Uotila, Petteri; Benestad, Rasmus; Mesquita, Michel d. S.; Madsen, Henrik; Fox Maule, Cathrine

    2015-04-01

    The Nordic research council NordForsk has recently announced its support for a new 3-year research initiative on "statistical analysis of climate projections" (eSACP). eSACP will focus on developing e-science tools and services based on statistical analysis of climate projections for the purpose of helping decision-makers and planners in the face of expected future challenges in regional climate change. The motivation behind the project is the growing recognition in our society that forecasts of future climate change is associated with various sources of uncertainty, and that any long-term planning and decision-making dependent on a changing climate must account for this. At the same time there is an obvious gap between scientists from different fields and between practitioners in terms of understanding how climate information relates to different parts of the "uncertainty cascade". In eSACP we will develop generic e-science tools and statistical climate services to facilitate the use of climate projections by decision-makers and scientists from all fields for climate impact analyses and for the development of robust adaptation strategies, which properly (in a statistical sense) account for the inherent uncertainty. The new tool will be publically available and include functionality to utilize the extensive and dynamically growing repositories of data and use state-of-the-art statistical techniques to quantify the uncertainty and innovative approaches to visualize the results. Such a tool will not only be valuable for future assessments and underpin the development of dedicated climate services, but will also assist the scientific community in making more clearly its case on the consequences of our changing climate to policy makers and the general public. The eSACP project is led by Thordis Thorarinsdottir, Norwegian Computing Center, and also includes the Finnish Meteorological Institute, the Norwegian Meteorological Institute, the Technical University of Denmark

  16. Electric Power Infrastructure Reliability and Security (EPIRS) Reseach and Development Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Rick Meeker; L. Baldwin; Steinar Dale; Alexander Domijan; Davild Larbalestier; Hui Li; Peter McLaren; Sastry Pamidi; Horatio Rodrigo; Michael Steurer

    2010-03-31

    Power systems have become increasingly complex and face unprecedented challenges posed by population growth, climate change, national security issues, foreign energy dependence and an aging power infrastructure. Increased demand combined with increased economic and environmental constraints is forcing state, regional and national power grids to expand supply without the large safety and stability margins in generation and transmission capacity that have been the rule in the past. Deregulation, distributed generation, natural and man-made catastrophes and other causes serve to further challenge and complicate management of the electric power grid. To meet the challenges of the 21st century while also maintaining system reliability, the electric power grid must effectively integrate new and advanced technologies both in the actual equipment for energy conversion, transfer and use, and in the command, control, and communication systems by which effective and efficient operation of the system is orchestrated - in essence, the 'smart grid'. This evolution calls for advances in development, integration, analysis, and deployment approaches that ultimately seek to take into account, every step of the way, the dynamic behavior of the system, capturing critical effects due to interdependencies and interaction. This approach is necessary to better mitigate the risk of blackouts and other disruptions and to improve the flexibility and capacity of the grid. Building on prior Navy and Department of Energy investments in infrastructure and resources for electric power systems research, testing, modeling, and simulation at the Florida State University (FSU) Center for Advanced Power Systems (CAPS), this project has continued an initiative aimed at assuring reliable and secure grid operation through a more complete understanding and characterization of some of the key technologies that will be important in a modern electric system, while also fulfilling an education and

  17. Developing Public Health Initiatives through Understanding Motivations of the Audience at Mass-Gathering Events.

    Science.gov (United States)

    Hutton, Alison; Ranse, Jamie; Munn, Matthew Brendan

    2018-04-01

    . Through understanding the motivations of the audience, event planners and designers, event risk managers, and emergency medical personnel may be better able to understand the motivation of the audience and how this might impact on audience behavior at the event. Hutton A , Ranse J , Munn MB . Developing public health initiatives through understanding motivations of the audience at mass-gathering events. Prehosp Disaster Med. 2018;33(2):191-196.

  18. Hodgkin`s disease: internal mammary lymph nodes relapse diagnosed by Gallium-67 scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz Hernandez, G.; Ampudia, J.; Castillo, F.J.; Romero, C. [Hospital Clinico Univ., Valencia (Spain). Servicio de Medicina Nuclear; Pallardo, Y. [Hospital Clinico Univ., Valencia (Spain). Servicio de Radiologia; Garcia Conde, J. [Hospital Clinico Univ., Valencia (Spain). Servicio de Hematologia y Oncologia Medica; Ramos, D. [Hospital Clinico Univ., Valencia (Spain). Servicio de Anatomia Patologica

    1999-04-01

    This article presents the case of a 62-year-old man with treated Hodgkin`s disease who had internal mammary lymph nodes relapse after a complete initial response. These masses were gallium avid. These findings were explained by histologically documented Hodgkin`s relapse, the first such case reported in that localization without chest wall involvement. The literature on mediastinal Hodgkin`s disease and diagnostic procedures are reviewed. (orig.) [Deutsch] Beschrieben wird der Fall eines 62jaehrigen Mannes, der nach initial erfolgreicher Therapie eines Morbus Hodgkin ein Lymphknotenrezidiv im Bereich der Brust aufweist. Die Lymphknoten reicherten Gallium an. Histologisch wurde das Hodgkinrezidiv gesichert. Es handelt sich um den ersten in diesem Bereich beschriebenen Fall ohne Infiltration der Brustwand. Die Literatur ueber mediastinalen Morbus Hodgkin und diagnostisches Vorgehen wurde ueberprueft. (orig.)

  19. Surface-initiated Atom Transfer Radical Polymerization - a Technique to Develop Biofunctional Coatings

    DEFF Research Database (Denmark)

    Fristrup, Charlotte Juel; Jankova Atanasova, Katja; Hvilsted, Søren

    2009-01-01

    The initial formation of initiating sites for atom transfer radical polymerization (ATRP) on various polymer surfaces and numerous inorganic and metallic surfaces is elaborated. The subsequent ATRP grafting of a multitude of monomers from such surfaces to generate thin covalently linked polymer...

  20. Manifestation of interplanetary medium parameters in development of a geomagnetic storm initial phase

    International Nuclear Information System (INIS)

    Chkhetiya, A.M.

    1988-01-01

    The role of solar wind plasma parameters in formation of a geomagnetic storm initial phase is refined. On the basis of statistical analysis an empirical formula relating the interplanetary medium parameters (components of interplanetary magnetic field, proton velocity and concentration) and D st -index during the geomagnetic storm initial phase is proposed

  1. Evaluation of the effect of initial texture on the development of deformation texture

    DEFF Research Database (Denmark)

    Leffers, Torben; Juul Jensen, Dorte

    1986-01-01

    The authors describe a computer procedure which allows them to introduce experimental initial textures as starting conditions for texture simulation (instead of a theoretical random texture). They apply the procedure on two batches of copper with weak initial textures and on fine-grained and coarse......-grained aluminium with moderately strong initial textures. In copper the initial texture turns out to be too weak to have any significant effect. In aluminium the initial texture has a very significant effect on the simulated textures-similar to the effect it has on the experimental textures. However......, there are differences between the simulated and the experimental aluminium textures that can only be explained as a grain-size effect. Possible future applications of the procedure are discussed...

  2. Second allogeneic hematopoietic SCT for relapsed ALL in children.

    Science.gov (United States)

    Kato, M; Horikoshi, Y; Okamoto, Y; Takahashi, Y; Hasegawa, D; Koh, K; Takita, J; Inoue, M; Kigasawa, H; Ogawa, A; Sasahara, Y; Kawa, K; Yabe, H; Sakamaki, H; Suzuki, R; Kato, K

    2012-10-01

    A second SCT is generally accepted as the only potentially curative approach for ALL patients that relapse after SCT, but the role of second SCT for pediatric ALL is not fully understood. We performed a retrospective analysis of 171 pediatric patients who received a second allo-SCT for relapsed ALL after allo-SCT. OS at 2 years was 29.4 ± 3.7%, the cumulative incidence of relapse was 44.1 ± 4.0% and non-relapse mortality was 18.8 ± 3.5%. Relapse occurred faster after the second SCT than after the first SCT (117 days vs 164 days, P=0.04). Younger age (9 years or less), late relapse (180 days or more after first SCT), CR at the second SCT, and myeloablative conditioning were found to be related to longer survival. Neither acute GVHD nor the type of donor influenced the outcome of second SCT. Multivariate analysis showed that younger age and late relapse were associated with better outcomes. Our analysis suggests that second SCT for relapsed pediatric ALL is an appropriate treatment option for patients that have achieved CR, which is associated with late relapse after the first SCT.

  3. Acquisition, Maintenance and Relapse-Like Alcohol Drinking: Lessons from the UChB Rat Line

    OpenAIRE

    Israel, Yedy; Karahanian, Eduardo; Ezquer, Fernando; Morales, Paola; Ezquer, Marcelo; Rivera-Meza, Mario; Herrera-Marschitz, Mario; Quintanilla, María E.

    2017-01-01

    This review article addresses the biological factors that influence: (i) the acquisition of alcohol intake; (ii) the maintenance of chronic alcohol intake; and (iii) alcohol relapse-like drinking behavior in animals bred for their high-ethanol intake. Data from several rat strains/lines strongly suggest that catalase-mediated brain oxidation of ethanol into acetaldehyde is an absolute requirement (up 80%?95%) for rats to display ethanol?s reinforcing effects and to initiate chronic ethanol in...

  4. THE DEVELOPMENT OF A MODEL INITIATION OF PROJECT IN A FORM OF MARKOV CHAIN

    Directory of Open Access Journals (Sweden)

    Катерина Вікторівна КОЛЕСНІКОВА

    2017-03-01

    Full Text Available The model of the initiation of projects which reproduces a fragment of the general scheme of interaction between the main entities in the project initiation phase is created. Determined that the project initiation through communication links between the four main entities: projects team, environment, the project itself and the customer. The result of the initiation of projects in the emerging communications referred to objects in the design phase through consistency requirements of stakeholders and the adoption of the basic concepts of projects, goal-projects, project planning, evaluation requirements of specialization and competence required for the formation of the project team. This Markov chain is part of the control circuit that includes elements such as the temporary organizational structure of the project design, project team, customer, and environment project. It is shown that the Markov model of interaction between project participants in their initiation phase, taking into account the role of a key player in the project ‑ the customer can determine changes of state and generate recommendations for initiating projects. Results of the study can serve as a basis for creating models of control objects that contain its organizational structure and reflect the parametric properties of the system to obtain information needed for decision making to initiate projects

  5. Gemtuzumab ozogamicin (Mylotarg) in children with refractory or relapsed acute myeloid leukemia.

    NARCIS (Netherlands)

    Reinhardt, D; Diekamp, S; Fleischhack, G; Corbacioglu, C; Jurgens, H; Dworzak, M; Kaspers, G.J.L.; Creutzig, U.; Zwaan, C.M.

    2004-01-01

    BACKGROUND: Gemtuzumab ozogamicin (GO) is an immunoconjugate consisting of the CD33 antibody and calicheamicin, a potent cytotoxic agent. Developed for targeted treatment of CD33-positive AML, studies in adults showed its efficacy in relapsed and refractory AML. PATIENTS AND METHOD: We report 12

  6. Combined MYC and P53 defects emerge at medulloblastoma relapse and define rapidly progressive, therapeutically targetable disease.

    Science.gov (United States)

    Hill, Rebecca M; Kuijper, Sanne; Lindsey, Janet C; Petrie, Kevin; Schwalbe, Ed C; Barker, Karen; Boult, Jessica K R; Williamson, Daniel; Ahmad, Zai; Hallsworth, Albert; Ryan, Sarra L; Poon, Evon; Robinson, Simon P; Ruddle, Ruth; Raynaud, Florence I; Howell, Louise; Kwok, Colin; Joshi, Abhijit; Nicholson, Sarah Leigh; Crosier, Stephen; Ellison, David W; Wharton, Stephen B; Robson, Keith; Michalski, Antony; Hargrave, Darren; Jacques, Thomas S; Pizer, Barry; Bailey, Simon; Swartling, Fredrik J; Weiss, William A; Chesler, Louis; Clifford, Steven C

    2015-01-12

    We undertook a comprehensive clinical and biological investigation of serial medulloblastoma biopsies obtained at diagnosis and relapse. Combined MYC family amplifications and P53 pathway defects commonly emerged at relapse, and all patients in this group died of rapidly progressive disease postrelapse. To study this interaction, we investigated a transgenic model of MYCN-driven medulloblastoma and found spontaneous development of Trp53 inactivating mutations. Abrogation of p53 function in this model produced aggressive tumors that mimicked characteristics of relapsed human tumors with combined P53-MYC dysfunction. Restoration of p53 activity and genetic and therapeutic suppression of MYCN all reduced tumor growth and prolonged survival. Our findings identify P53-MYC interactions at medulloblastoma relapse as biomarkers of clinically aggressive disease that may be targeted therapeutically. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Polio eradication initiative in Africa: influence on other infectious disease surveillance development

    Directory of Open Access Journals (Sweden)

    Cochi Stephen

    2002-12-01

    Full Text Available Abstract Background The World Health Organization (WHO and partners are collaborating to eradicate poliomyelitis. To monitor progress, countries perform surveillance for acute flaccid paralysis (AFP. The WHO African Regional Office (WHO-AFRO and the U.S Centers for Disease Control and Prevention are also involved in strengthening infectious disease surveillance and response in Africa. We assessed whether polio-eradication initiative resources are used in the surveillance for and response to other infectious diseases in Africa. Methods During October 1999-March 2000, we developed and administered a survey questionnaire to at least one key informant from the 38 countries that regularly report on polio activities to WHO. The key informants included WHO-AFRO staff assigned to the countries and Ministry of Health personnel. Results We obtained responses from 32 (84% of the 38 countries. Thirty-one (97% of the 32 countries had designated surveillance officers for AFP surveillance, and 25 (78% used the AFP resources for the surveillance and response to other infectious diseases. In 28 (87% countries, AFP program staff combined detection for AFP and other infectious diseases. Fourteen countries (44% had used the AFP laboratory specimen transportation system to transport specimens to confirm other infectious disease outbreaks. The majority of the countries that performed AFP surveillance adequately (i.e., non polio AFP rate = 1/100,000 children aged Conclusions Despite concerns regarding the targeted nature of AFP surveillance, it is partially integrated into existing surveillance and response systems in multiple African countries. Resources provided for polio eradication should be used to improve surveillance for and response to other priority infectious diseases in Africa.

  8. Development and initial validation of a damage index (DIAPS) in patients with thrombotic antiphospholipid syndrome (APS).

    Science.gov (United States)

    Amigo, M-C; Goycochea-Robles, M V; Espinosa-Cuervo, G; Medina, G; Barragán-Garfias, J A; Vargas, A; Jara, L Javier

    2015-08-01

    In antiphospholipid syndrome (APS), certain principal manifestations are associated with a worse prognosis and organ damage. The objective of this paper is to describe the development and initial content, criterion and construct validity of a disease-specific cumulative damage index in patients with thrombotic APS (DIAPS). Through expert panel agreement, 47 items were considered to reflect damage in APS. This preliminary version of the DIAPS was submitted to four local and international clinical and research experts in APS who ranked each item according to severity. A Delphi exercise resulted in a final 37 item instrument. In the second phase, a cross-sectional study was conducted applying the DIAPS in patients included in a multicenter electronic registry of patients with APS. Quality of life related to health status was evaluated with the EuroQol for construct validation. An α Cronbach and correlation with the EuroQol scale were calculated with SPSS 20.0 (p APS. Common comorbidities included obesity, depression and dyslipidemia. The most frequent manifestations resulting in sequelae were deep venous thrombosis and ischemic stroke. Blindness, retinal occlusive vessel disease, myocardial infarction, cardiac valve requiring replacement, mesenteric thrombosis, and renal insufficiency also occurred. Homogeneity: α Cronbach 0.619. DIAPS items correlated with EuroQol domains with the exception of pulmonary, renal, gastrointestinal, and endocrine systems. This study demonstrates content, criterion and construct validity of a new physician-reported instrument to assess the DIAPS. In addition, the DIAPS correlated with the EuroQol. © The Author(s) 2015.

  9. PAH growth initiated by propargyl addition: Mechanism development and computational kinetics

    KAUST Repository

    Raj, Abhijeet Dhayal

    2014-04-24

    Polycyclic aromatic hydrocarbon (PAH) growth is known to be the principal pathway to soot formation during fuel combustion, as such, a physical understanding of the PAH growth mechanism is needed to effectively assess, predict, and control soot formation in flames. Although the hydrogen abstraction C2H2 addition (HACA) mechanism is believed to be the main contributor to PAH growth, it has been shown to under-predict some of the experimental data on PAHs and soot concentrations in flames. This article presents a submechanism of PAH growth that is initiated by propargyl (C 3H3) addition onto naphthalene (A2) and the naphthyl radical. C3H3 has been chosen since it is known to be a precursor of benzene in combustion and has appreciable concentrations in flames. This mechanism has been developed up to the formation of pyrene (A4), and the temperature-dependent kinetics of each elementary reaction has been determined using density functional theory (DFT) computations at the B3LYP/6-311++G(d,p) level of theory and transition state theory (TST). H-abstraction, H-addition, H-migration, β-scission, and intramolecular addition reactions have been taken into account. The energy barriers of the two main pathways (H-abstraction and H-addition) were found to be relatively small if not negative, whereas the energy barriers of the other pathways were in the range of (6-89 kcal·mol-1). The rates reported in this study may be extrapolated to larger PAH molecules that have a zigzag site similar to that in naphthalene, and the mechanism presented herein may be used as a complement to the HACA mechanism to improve prediction of PAH and soot formation. © 2014 American Chemical Society.

  10. Bortezomib-related neuropathy may mask CNS relapse in multiple myeloma: A call for diligence.

    Science.gov (United States)

    Abid, Muhammad Bilal; De Mel, Sanjay; Abid, Muhammad Abbas; Tan, Kong Bing; Chng, Wee Joo

    2016-07-02

    Neuropathy is a common adverse effect of bortezomib. Isolated central nervous system (CNS) relapse in MM remains exceedingly rare and carries a dismal prognosis. We present an unusual case of bortezomib related neuropathy masking a CNS relapse of MM. A 57-year-old female was diagnosed with standard-risk MM with clinical and cytogenetic features not typically associated with CNS involvement. She was treated with 4 cycles of bortezomib/cyclophosphamide/dexamethasone (VCD) and achieved a VGPR, after which she underwent an autologous stem cell transplant (ASCT) followed by bortezomib maintenance. Six months after ASCT she developed symptoms suggestive of peripheral neuropathy which was attributed to bortezomib. However the symptoms persisted despite discontinuation of bortezomib. Imaging and cerebrospinal fluid analysis subsequently confirmed a CNS relapse. CNS involvement in MM (CNS-MM) is uncommon and is considered an aggressive disease. Recently published literature has reported biomarkers with prognostic potential. However, isolated CNS relapse is even less common; an event which carries a very poor prognosis. Given the heterogeneous neurologic manifestations associated with MM, clinical suspicion may be masked by confounding factors such as bortezomib-based therapy. The disease may further remain incognito if the patient does not exhibit any of the high risk features and biomarkers associated with CNS involvement. In the era of proteasome inhibitor (PtdIns)/immunomodulator (IMID)-based therapy for MM which carries neurologic adverse effects, it is prudent to consider CNS relapse early. This case further highlights the need for more robust biomarkers to predict CNS relapse and use of newer novel agents which demonstrate potential for CNS penetration.

  11. Game method application efficiency for speed and power capability development of trampoline athletes at the initial training stage

    Directory of Open Access Journals (Sweden)

    Alfia Deineko

    2017-06-01

    Full Text Available Purpose: to prove the effectiveness of using the game method for speed and power capability development of trampoline athletes at the initial training stage. Material & Methods: in the article the materials of the research that was carried out with the help of pedagogical testing of trampoliners of 7–8 years on the basis of the Children and Youth Sports School No. 7, Trampoline Department of Kharkov. Results: conducted pedagogical experiment showed the effectiveness of the developed methodology for the development of speed-strength abilities of trampoline athletes at the initial training stage using the game method. Conclusion: results of the experiment confirm the importance of the use of the game method for the development of speed-strength abilities in the initial training of young trampolines, which further affects the level of their technical preparedness and the effectiveness of competition activities.

  12. 78 FR 50410 - Black Bear Development Holdings, LLC; Supplemental Notice that Initial Market-Based Rate Filing...

    Science.gov (United States)

    2013-08-19

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. ER13-2143-000] Black Bear Development Holdings, LLC; Supplemental Notice that Initial Market-Based Rate Filing Includes Request for... Black Bear Development Holdings, LLC's application for market-based rate authority, with an accompanying...

  13. The African Capacity Building Initiative: Toward Improved Policy Analysis and Development Management in Sub-Saharan Africa.

    Science.gov (United States)

    World Bank, Washington, DC.

    The objective of the African Capacity Building Initiative is to build and strengthen local capabilities for policy analysis and development management in Sub-Saharan Africa. This report examines the nature and magnitude of the problem, which basically consists of a shortage of development management skills combined with weakness in the area of…

  14. The DOE fellows program-a workforce development initiative for the US department of energy

    Energy Technology Data Exchange (ETDEWEB)

    Lagos, Leonel E. [Applied Research Center, Florida International University, 10555 West Flagler St, EC2100, Miami, Florida (United States)

    2013-07-01

    The US Department of Energy Office of Environmental Management (DOE-EM) oversees one of the largest and most technically challenging cleanup programs in the world. The mission of DOE-EM is to complete the safe cleanup of the environmental legacy from five decades of nuclear weapons development and government-sponsored nuclear energy research. Since 1995, Florida International University's Applied Research Center (FIU-ARC) has supported the DOE-EM mission and provided unique research capabilities to address some of these highly technical and difficult challenges. This partnership has allowed FIU-ARC to create a unique infrastructure that is critical for the training and mentoring of science, technology, engineering, and math (STEM) students and has exposed many STEM students to 'hands-on' DOE-EM applied research, supervised by the scientists and engineers at ARC. As a result of this successful partnership between DOE and FIU, DOE requested FIU-ARC to create the DOE-FIU Science and Technology Workforce Development Initiative in 2007. This innovative program was established to create a 'pipeline' of minority STEM students trained and mentored to enter DOE's environmental cleanup workforce. The program was designed to help address DOE's future workforce needs by partnering with academic, government and private companies (DOE contractors) to mentor future minority scientists and engineers in the research, development, and deployment of new technologies and processes addressing DOE's environmental cleanup challenges. Since its inception in 2007, the program has trained and mentored 78 FIU STEM minority students. Although, the program has been in existence for only six years, a total of 75 internships have been conducted at DOE National Laboratories, DOE sites, DOE Headquarters and field offices, and DOE contractors. Over 100 DOE Fellows have participated in the Waste Management (WM) Symposia since 2008 with a total of 84 student

  15. The DOE fellows program-a workforce development initiative for the US department of energy

    International Nuclear Information System (INIS)

    Lagos, Leonel E.

    2013-01-01

    The US Department of Energy Office of Environmental Management (DOE-EM) oversees one of the largest and most technically challenging cleanup programs in the world. The mission of DOE-EM is to complete the safe cleanup of the environmental legacy from five decades of nuclear weapons development and government-sponsored nuclear energy research. Since 1995, Florida International University's Applied Research Center (FIU-ARC) has supported the DOE-EM mission and provided unique research capabilities to address some of these highly technical and difficult challenges. This partnership has allowed FIU-ARC to create a unique infrastructure that is critical for the training and mentoring of science, technology, engineering, and math (STEM) students and has exposed many STEM students to 'hands-on' DOE-EM applied research, supervised by the scientists and engineers at ARC. As a result of this successful partnership between DOE and FIU, DOE requested FIU-ARC to create the DOE-FIU Science and Technology Workforce Development Initiative in 2007. This innovative program was established to create a 'pipeline' of minority STEM students trained and mentored to enter DOE's environmental cleanup workforce. The program was designed to help address DOE's future workforce needs by partnering with academic, government and private companies (DOE contractors) to mentor future minority scientists and engineers in the research, development, and deployment of new technologies and processes addressing DOE's environmental cleanup challenges. Since its inception in 2007, the program has trained and mentored 78 FIU STEM minority students. Although, the program has been in existence for only six years, a total of 75 internships have been conducted at DOE National Laboratories, DOE sites, DOE Headquarters and field offices, and DOE contractors. Over 100 DOE Fellows have participated in the Waste Management (WM) Symposia since 2008 with a total of 84 student

  16. The effect of coronae on leader initiation and development under thunderstorm conditions and in long air gaps

    International Nuclear Information System (INIS)

    Aleksandrov, N.L.; Bazelyan, E.M.; Carpenter Jr, R.B.; Drabkin, M.M.; Raizer, Yu P.

    2001-01-01

    The initiation and development of a leader is theoretically studied by considering an electrode which is embedded in a cloud of space charge injected by a corona discharge. The focus is on the initiation of upward lightning from a stationary grounded object in a thundercloud electric field. The main results are also applicable to the leader process in long laboratory air gaps at direct voltage. Simple physical models of non-stationary coronae developing in free space near a solitary stressed sphere and of a leader propagating in the space charge cloud of coronae are suggested. It is shown that the electric field redistribution due to the space charge released by the long corona discharge near the top of a high object hinders the initiation and development of an upward leader from the object in a thundercloud electric field. The conditions for the formation of corona streamers that are required to initiate a leader are derived. The criteria are obtained for a leader to be initiated and propagate in the space charge cloud. A hypothesis is proposed that the streamers are never initiated near the top of a high object under thunderstorm conditions if at ground level there is only a slowly-varying electric field of the thundercloud. The streamers may be induced by the fast-rising electric field of distant downward leaders or intracloud discharges. (author)

  17. [Relapse prevention group therapy for paedophiles: French adaptation].

    Science.gov (United States)

    Smith, J; Petibon, C

    2005-01-01

    Psychotherapy for sex offenders has only very recently started to develop in France. The French law on compulsory treatment for sex offenders was voted in 1998, and many mental health practitioners are not trained to treat such patients yet. In our ambulatory forensic consultation, sex offenders have been treated since 1992 and group psychotherapy has been offered to them since 1994. Our first therapeutic models were the North-American behavioural-cognitive therapy and Pithers' relapse prevention model. Behavioural-cognitive theory describes paedophilia as an acquired sexual preference maintained by positive reinforcement. Pithers (1990) considered that relapse only occurs in high-risk situations, and that high-risk situations always come after offence precursors. In North America, relapse prevention consists in helping paedophiles spot their high-risk situations and offence precursors, and enhance their skills to cope with such situations or to prevent them. Therapy programs were developed according to these models, aiming to help offenders develop such skills, ie empathy, social skills, cognitive restructuring, self-esteem, etc. Trying to apply these therapy programs in France, our team quickly realised that we would have to adapt them to French culture. On the one hand, behavioural-cognitive theory did not seem satisfactory enough in explaining paedophilic behaviour and paedophilic preference. On the other hand, behavioural-cognitive therapy made patients into children too much and increased resistance. Therapy based on programs seemed too rigid for French patients and therapists, and we often felt we were working on an issue that would have been much more accurate to work on a few sessions earlier, when this issue was spontaneously brought up by a patient. We believe change occurs all the more as issues are worked on at the right moment for the patient. Moreover, on a cultural point of view, we also realised the use of programs in psychotherapy was difficult to

  18. Mycophenolate mofetil combined with systemic corticosteroids prevents progression to chronic recurrent inflammation and development of 'sunset glow fundus' in initial-onset acute uveitis associated with Vogt-Koyanagi-Harada disease.

    Science.gov (United States)

    Abu El-Asrar, Ahmed M; Dosari, Mona; Hemachandran, Suhail; Gikandi, Priscilla W; Al-Muammar, Abdulrahman

    2017-02-01

    To evaluate the effectiveness and safety of mycophenolate mofetil (MMF) as first-line therapy combined with systemic corticosteroids in initial-onset acute uveitis associated with Vogt-Koyanagi-Harada (VKH) disease. This prospective study included 38 patients (76 eyes). The main outcome measures were final visual acuity, corticosteroid-sparing effect, progression to chronic recurrent granulomatous uveitis and development of complications, particularly 'sunset glow fundus'. The mean follow-up period was 37.0 ± 29.3 (range 9-120 months). Visual acuity of 20/20 was achieved by 93.4% of the eyes. Corticosteroid-sparing effect was achieved in all patients. The mean interval between starting treatment and tapering to 10 mg or less daily was 3.8 ± 1.3 months (range 3-7 months). Twenty-two patients (57.9%) discontinued treatment without relapse of inflammation. The mean time observed off of treatment was 28.1 ± 19.6 months (range 1-60 months). None of the eyes progressed to chronic recurrent granulomatous uveitis. The ocular complications encountered were glaucoma in two eyes (2.6%) and cataract in five eyes (6.6%). None of the eyes developed 'sunset glow fundus', and none of the patients developed any systemic adverse events associated with the treatment. Use of MMF as first-line therapy combined with systemic corticosteroids in patients with initial-onset acute VKH disease prevents progression to chronic recurrent granulomatous inflammation and development of 'sunset glow fundus'. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  19. Fingolimod for the Treatment of Relapsing-Remitting Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Burcu Altunrende

    2017-12-01

    Full Text Available Multiple sclerosis (MS is a chronic autoimmune disease of the central nervous system and is characterized by inflammation, demyelination, and axonal loss. Fingolimod is the first oral drug for the treatment of MS approved by the United States Food and Drug Administration, European Union countries, and various other countries. The compound exerts its effect via interaction with lysophospholipid receptors known as sphingosine-1 phosphate receptors. Although fingolimod has a very convenient daily oral dosing, it may cause development of bradycardia at the first dose, macular edema, infection, all of which require attention. Randomized double-blind clinical trials have shown that fingolimod significantly reduces relapse rates and is beneficial in brain magnetic resonance imaging measures when compared with both placebo and intramuscular interferon β-1a. This review describes the characteristics of fingolimod concerning its efficacy, safety, and tolerability in the clinical context of the management of MS

  20. Treatment of relapsing polychondritis in the era of biological agents.

    LENUS (Irish Health Repository)

    McCarthy, Eoghan M

    2012-02-01

    Relapsing polychondritis (RP) is a rare disorder, often requiring high doses of immunosuppressive therapy to control its potentially life-threatening consequences. The advent of biological agents has added to the armamentarium available to treat RP, but the lack of controlled trials, along with the small numbers of patients and disease heterogeneity means that new therapies are prescribed without the benefits of rigorous clinical research. Thus, information on individual cases is of value in expanding our knowledge of the use of biologic agents in rare conditions. We report on the use of rituximab in a patient who subsequently developed catastrophic aortic incompetence, and we review the literature in relation to the use of this drug in RP.

  1. Mathematical Models of Tuberculosis Reactivation and Relapse

    Directory of Open Access Journals (Sweden)

    Robert Steven Wallis

    2016-05-01

    Full Text Available The natural history of human infection with Mycobacterium tuberculosis (Mtb is highly variable, as is the response to treatment of active tuberculosis. There is presently no direct means to identify individuals in whom Mtb infection has been eradicated, whether by a bactericidal immune response or sterilizing antimicrobial chemotherapy. Mathematical models can assist in such circumstances by measuring or predicting events that cannot be directly observed. The 3 models discussed in this review illustrate instances in which mathematical models were used to identify individuals with innate resistance to Mtb infection, determine the etiology of tuberculosis in patients treated with tumor necrosis factor antagonists, and predict the risk of relapse in persons undergoing tuberculosis treatment. These examples illustrate the power of various types of mathematic models to increase knowledge and thereby inform interventions in the present global tuberculosis epidemic.

  2. Natalizumab plus interferon beta-1a for relapsing multiple sclerosis.

    NARCIS (Netherlands)

    Rudick, R.A.; Stuart, W.H.; Calabresi, P.A.; Confavreux, C.; Galetta, S.L.; Radue, E.W.; Lublin, F.D.; Weinstock-Guttman, B.; Wynn, D.R.; Lynn, F.; Panzara, M.A.; Sandrock, A.W.

    2006-01-01

    BACKGROUND: Interferon beta is used to modify the course of relapsing multiple sclerosis. Despite interferon beta therapy, many patients have relapses. Natalizumab, an alpha4 integrin antagonist, appeared to be safe and effective alone and when added to interferon beta-1a in preliminary studies.

  3. Anca associated vasculitis : occurrence, prediction, prevention, and outcome of relapses

    NARCIS (Netherlands)

    Boomsma, Maarten Michiel

    2001-01-01

    During follow-up, relapses of disease activity occur in the majority of patients with ANCA associated vasculitis. The general objective brought together in this thesis was to further elucidate the characteristics and consequences of these relapses. Investigated items are the occurrence, the

  4. Frequency of relapse among Nigerian children with steroid‑sensitive ...

    African Journals Online (AJOL)

    Background: The clinical course of steroid‑sensitive nephrotic syndrome (SSNS) among Nigerian children has rarely been reported; this makes prognostication difficult. Objectives: The objective was to determine the frequency of relapses including frequent relapses (FR) and steroid‑dependence (SD) in a cohort of Nigerian ...

  5. Predictors of Exercise Relapse in a College Population.

    Science.gov (United States)

    Sullum, Julie; Clark, Matthew M.; King, Teresa K.

    2000-01-01

    Investigated factors that predicted exercise relapse among college students. Physically active undergraduates completed questionnaires measuring Prochaska's 10 processes for change of exercise, self-efficacy, and decisional balance. Exercise levels were assessed at baseline and 8 weeks later. At baseline, relapsers had significantly lower…

  6. Symptomatic relapse of HIV-associated cryptococcal meningitis in ...

    African Journals Online (AJOL)

    Objectives. Cryptococcal meningitis is the most common cause of adult meningitis in southern Africa. Much of this disease burden is thought to be due to symptomatic relapse of previously treated infection. We studied the contribution of inadequate secondary fluconazole prophylaxis to symptomatic relapses of cryptococcal ...

  7. Power2: Relapse Management with Adolescents Who Stutter.

    Science.gov (United States)

    Blood, Gordon W.

    1995-01-01

    This article describes a cognitive-behavioral treatment package for relapse management in adolescents who stutter. The package includes game-based training techniques in problem solving, communication skills, and assertiveness; coping responses for stuttering episodes; and realistic expectations for fluency and relapse. Follow-up results with…

  8. Factors associated with relapse in schizophrenia | Kazadi | South ...

    African Journals Online (AJOL)

    Aim. Early identification and prevention of relapse in patients with schizophrenia has significant therapeutic and socioeconomic implications. The aim of this study was to determine the factors, if any, that may be associated with relapse in a group of patients in Johannesburg. Method. Patients were recruited from mental ...

  9. An Integrative Ambient Agent Model for Unipolar Depression Relapse Prevention

    NARCIS (Netherlands)

    Aziz, A.A.; Klein, M.C.A.; Treur, J.

    2010-01-01

    One of the challenges for persons with a history of unipolar depression is to stay healthy throughout their lifetime. In principle, having more severe prior onset cases escalates the risk to fall into a relapse. In this article, first a domain model of the process of depression, recovery and relapse

  10. Relapse and craving in alcohol-dependent individuals

    NARCIS (Netherlands)

    van de Mheen, H,; Snelleman, M.; Schoenmakers, T.M.

    2018-01-01

    Background: Negative affective states and alcohol-related stimuli increase risk of relapse in alcohol dependence. In research and in clinical practice, craving is often used as another important indicator of relapse, but this lacks a firm empirical foundation. Objectives: The goal of the present

  11. Bortezomib or high-dose dexamethasone for relapsed multiple myeloma

    NARCIS (Netherlands)

    P.G. Richardson (Paul Gerard); P. Sonneveld (Pieter); M.W. Schuster (Michael); D. Irwin (David); E.A. Stadtmauer (Edward); T. Facon (Thierry); J-L. Harousseau (Jean-Luc); D. Ben-Yehuda (Dina); S. Lonial (Sagar); H. Goldschmidt (Hartmut); D. Reece (Donna); J.F. San Miguel (Jesús Fernando); J. Bladé (Joan); M. Boccadoro (Mario); J. Cavenagh (Jamie); W. Dalton (William); A.L. Boral (Anthony); D.-L. Esseltine (Dixie-Lee); J.B. Porter (Jane); D. Schenkein (David); K.C. Anderson (Kenneth)

    2005-01-01

    textabstractBACKGROUND: This study compared bortezomib with high-dose dexamethasone in patients with relapsed multiple myeloma who had received one to three previous therapies. METHODS: We randomly assigned 669 patients with relapsed myeloma to receive either an intravenous bolus of bortezomib (1.3

  12. An intervention study to prevent relapse in patients with schizophrenia

    NARCIS (Netherlands)

    van Meijel, B.; Kruitwagen, C.; van der Gaag, M.; Kahn, R.S.; Grypdonck, M.H.E.

    2006-01-01

    Purpose: To determine whether the use of relapse prevention plans (RPPs) in nursing practice is an effective intervention in reducing relapse rates among patients with schizophrenia. Design and Methods: Experimental design. Patients with schizophrenia (or a related psychotic disorder) and nurses

  13. Perception, understanding and initiatives with regard to sustainable development: A profile of Québec tourism organizations

    OpenAIRE

    Auger, Denis; Bélanger, Vincent

    2011-01-01

    The concept of sustainable development is not new. However, its application in the field of tourism in Québec needs to be clarified. This way, this study is aimed at drawing the profile of Québec tourist organizations, at comparing the initiatives developed according to various perspectives (environmental, social and economic) and finally, to verify the coherence between the level of importance these organizations give to the concepts of sustainable development and the application of these wi...

  14. Prefrontal gamma-aminobutyric acid type A receptor insertion controls cue-induced relapse to nicotine seeking.

    Science.gov (United States)

    Lubbers, Bart R; van Mourik, Yvar; Schetters, Dustin; Smit, August B; De Vries, Taco J; Spijker, Sabine

    2014-11-01

    Current smoking cessation therapies offer limited success, as relapse rates remain high. Nicotine, which is the major component of tobacco smoke, is thought to be primarily responsible for the addictive properties of tobacco. However, little is known about the molecular mechanisms underlying nicotine relapse, hampering development of more effective therapies. The objective of this study was to elucidate the role of medial prefrontal cortex (mPFC) glutamatergic and gamma-aminobutyric acid (GABA)ergic receptors in controlling relapse to nicotine seeking. Using an intravenous self-administration model, we studied glutamate and gamma-aminobutyric acid receptor regulation in the synaptic membrane fraction of the rat mPFC following extinction and cue-induced relapse to nicotine seeking. Subsequently, we locally intervened at the level of GABAergic signaling by using a mimetic peptide of the GABA receptor associated protein-interacting domain of GABA type A (GABAA) receptor subunit γ2 (TAT-GABAγ2) and muscimol, a GABAA receptor agonist. Alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid and N-methyl-D-aspartate receptors were not regulated after the 30-min relapse test. However, GABAA receptor subunits α1 and γ2 were upregulated, and interference with GABAA receptor insertion in the cell membrane using the TAT-GABAγ2 peptide in the dorsal mPFC, but not the ventral mPFC, significantly increased responding during relapse. Increasing GABAA transmission with muscimol in the dorsal and ventral mPFC attenuated relapse. These data indicate that cue-induced relapse entails a GABAergic plasticity mechanism that limits nicotine seeking by restoring inhibitory control in the dorsal mPFC. GABAA receptor-mediated neurotransmission in the dorsal mPFC constitutes a possible future therapeutic target for maintaining smoking abstinence. Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  15. Cortical thickness, surface area, and volume of the brain reward system in alcohol dependence: relationships to relapse and extended abstinence.

    Science.gov (United States)

    Durazzo, Timothy C; Tosun, Duygu; Buckley, Shannon; Gazdzinski, Stefan; Mon, Anderson; Fryer, Susanna L; Meyerhoff, Dieter J

    2011-06-01

    At least 60% of those treated for an alcohol use disorder will relapse. Empirical study of the integrity of the brain reward system (BRS) is critical to understanding the mechanisms of relapse as this collection of circuits is implicated in the development and maintenance of all forms of addictive disorders. This study compared thickness, surface area, and volume in neocortical components of the BRS among nonsmoking light-drinking controls (controls), individuals who remained abstinent and those who relapsed after treatment. Seventy-five treatment-seeking alcohol-dependent individuals (abstinent for 7±3 days) and 43 controls completed 1.5T proton magnetic resonance imaging studies. Parcellated morphological data were obtained for following bilateral components of the BRS: rostral and caudal anterior cingulate cortex, insula, medial and lateral orbitofrontal cortex (OFC), rostral and caudal middle and superior frontal gyri, amygdala and hippocampus as well as for 26 other bilateral neocortical regions. Alcohol-dependent participants were followed over 12-months after baseline study and were classified as abstainers (no alcohol consumption; n=24) and relapsers (any alcohol consumption; n=51) at follow-up. Relapsers and abstainers demonstrated lower cortical thickness in the vast majority of BRS regions as well as lower global thickness compared to controls. Relapsers had lower total BRS surface area than both controls and abstainers, but abstainers were not significantly different from controls on any surface area measure. Relapsers demonstrated lower volumes than controls in the majority of regions, while abstainers showed lower volumes than controls in the superior frontal gyrus, insula, amygdala, and hippocampus, bilaterally. Relapsers exhibited smaller volumes than abstainers in the right rostral middle and caudal middle frontal gyri and the lateral OFC, bilaterally. In relapsers, lower baseline volumes and surface areas in multiple regions were associated with

  16. Relapse prevention in anorexia nervosa: Experiences of patients and parents.

    Science.gov (United States)

    Berends, Tamara; van de Lagemaat, Marleen; van Meijel, Berno; Coenen, Jasmijn; Hoek, Hans W; van Elburg, Annemarie A

    2018-03-24

    One of the main aims of treatment after successful recovery from anorexia nervosa (AN) is to prevent a relapse. The Guideline Relapse Prevention (GRP) Anorexia Nervosa offers a structured approach to relapse prevention. This study explores how patients and their parents experience working with the guideline. It also describes the factors that support or hinder successful application of the guideline. A descriptive qualitative research design was chosen involving in-depth interviews with seventeen patients with anorexia nervosa and six sets of parents. Patients and family members were generally satisfied with the support provided by the GRP. It contributed significantly to a better understanding of the personal process of relapse. Patients and families valued being able to keep in touch with their professional during the aftercare programme. The GRP supports the patient's use of self-management strategies for relapse prevention. © 2018 Australian College of Mental Health Nurses Inc.

  17. Improved outcome after relapse in children with acute myeloid leukaemia

    DEFF Research Database (Denmark)

    Abrahamsson, Jonas; Clausen, Niels; Gustafsson, Göran

    2007-01-01

    investigated. The study included all 146 children in the Nordic countries diagnosed with AML between 1988 and 2003, who relapsed. Data on disease characteristics and relapse treatment were related to outcome. Sixty-six percentage achieved remission with survival after relapse (5 years) 34 +/- 4%. Of 122......In the Nordic Society for Paediatric Haematology and Oncology paediatric study acute myeloid leukaemia (AML) 93, event-free survival was 50% and overall survival was 66%, indicating that many patients were cured following relapse. Factors influencing outcome in children with relapsed AML were...... patients who received re-induction therapy, 77% entered remission with 40 +/- 5% survival. Remission rates were similar for different re-induction regimens but fludarabine, cytarabine, granulocyte colony-stimulating factor-based therapy had low treatment-related mortality. Prognostic factors for survival...

  18. Increased multiple sclerosis relapses related to lower prevalence of pain

    Directory of Open Access Journals (Sweden)

    José Vinícius Martins da Silva

    2015-07-01

    Full Text Available Objective The study aims to investigate the presence of pain amongst multiple sclerosis (MS patients. Method One hundred MS patients responded to questionnaires evaluating neuropathic and nociceptive pain, depression and anxiety. Statistical analysis was performed using the Mann–Whitney U, Chi-Square and two-tailed Fisher’s exact tests and multivariate logistic regression. Results Women had a statistically higher prevalence of pain (p = 0.037, and chances of having pain after the age of 50 reduced. Women with pain had a statistically significant lower number of relapses (p = 0.003, restricting analysis to those patients with more than one relapse. After the second relapse, each relapse reduced the chance of having pain by 46%. Presence of pain was independent of Expanded Disability Status Scale (EDSS anxiety, and depression. Conclusion Our findings suggest a strong inverse association between relapses and pain indicating a possible protective role of focal inflammation in the control of pain.

  19. Predictive factors for relapse in patients on buprenorphine maintenance.

    Science.gov (United States)

    Ferri, Michael; Finlayson, Alistair J Reid; Wang, Li; Martin, Peter R

    2014-01-01

    Despite the dramatic increase in the use of buprenorphine for the treatment of opioid dependence, clinical outcomes of this treatment approach continue to need evaluation. This study examines factors associated with relapse and retention during buprenorphine treatment in a sample of opioid dependent outpatients. In a retrospective chart review of 62 patients with opioid dependence, relapse was determined by self-report, urine toxicology screens, and by checking the state controlled substance monitoring database. Data was analyzed using two-way tests of association and logistic regression. Patients with comorbid anxiety disorders, active benzodiazepine use (contrary to clinic policy), or active alcohol abuse, were significantly more likely to relapse. Patients who relapsed were also more likely to be on a higher buprenorphine maintenance dose. This study identifies relapse risk factors during buprenorphine treatment for opioid dependence. Future research is needed to determine whether modifying these factors may lead to improved treatment outcomes. © American Academy of Addiction Psychiatry.

  20. Investigating the Impacts of Design Heuristics on Idea Initiation and Development

    Science.gov (United States)

    Kramer, Julia; Daly, Shanna R.; Yilmaz, Seda; Seifert, Colleen M.; Gonzalez, Richard

    2015-01-01

    This paper presents an analysis of engineering students' use of Design Heuristics as part of a team project in an undergraduate engineering design course. Design Heuristics are an empirically derived set of cognitive "rules of thumb" for use in concept generation. We investigated heuristic use in the initial concept generation phase,…

  1. Learning from Simulation Design to Develop Better Experiential Learning Initiatives: An Integrative Approach

    Science.gov (United States)

    Canhoto, Ana Isabel; Murphy, Jamie

    2016-01-01

    Simulations offer engaging learning experiences, via the provision of feedback or the opportunities for experimentation. However, they lack important attributes valued by marketing educators and employers. This article proposes a "back to basics" look at what constitutes an effective experiential learning initiative. Drawing on the…

  2. Development and Initial Validation of the Counseling Center Assessment of Psychological Symptoms-34

    Science.gov (United States)

    Locke, Benjamin D.; McAleavey, Andrew A.; Zhao, Yu; Lei, Pui-Wa; Hayes, Jeffrey A.; Castonguay, Louis G.; Li, Hongli; Tate, Robin; Lin, Yu-Chu

    2012-01-01

    A short version of the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62) was created via three studies. The final short version (CCAPS-34), which contains 34 items and 7 subscales, demonstrated good discrimination power, support for the proposed factor structure, strong initial convergent validity, and adequate test-retest…

  3. The development on the methodology of the initiating event frequencies for liquid metal reactor KALIMER

    International Nuclear Information System (INIS)

    Jeong, K. S.; Yang, Z. A.; Ah, Y. B.; Jang, W. P.; Jeong, H. Y.; Ha, K. S.; Han, D. H.

    2002-01-01

    In this paper, the PSA methodology of PRISM,Light Water Reactor, Pressurized Heavy Water Reactor are analyzed and the methodology of Initiating Events for KALIMER are suggested. Also,the reliability assessment of assumptions for Pipes Corrosion Frequency is set up. The reliability assessment of Passive Safety System, one of Main Safety System of KALIMER, are discussed and analyzed

  4. Ontogeny of axillary buds and shoots in roses: Leaf initiation and pith development.

    NARCIS (Netherlands)

    Marcelis-van Acker, C.A.M.

    1994-01-01

    The ontogeny of an axillary bud (in the middle region of a shoot) from initiation up to flowering of the subsequent shoot was studied. The first secondary buds appeared in the axillary bud (primary bud) when the leaf subtending the primary bud unfolded. By that time, the primary bud contained seven

  5. Double hemibody irradiation (DHBI) in the management of relapsed and primary chemoresistant multiple myeloma

    Energy Technology Data Exchange (ETDEWEB)

    McSweeney, E.N.; Tobias, J.S.; Goldstone, A.H.; Richards, J.D.M. (University Coll. Hospital, London (United Kingdom)); Blackman, G. (Middlesex Hospital, London (United Kingdom))

    1993-01-01

    Fifty-five patients with multiple myeloma were treated with both upper and lower hemibody irradiation between January 1985 and January 1991; 42 had relapsed post-plateau and 13 were chemo-resistant to initial therapy. Fifteen patients received [alpha]IFN-2b maintenance therapy post-DHBI, at a dose of 3 Mu three times per week. Ninety-five per cent of patients experienced symptomatic improvement in bone pain post-DHBI, 21% of whom discontinued opiate analgesics altogether; 63% had a minor biochemical response and 38% had a partial biochemical response. The overall survival (OS) and progression free survivals (PFS) in all patients were 11 months and 8 months respectively. No significant difference was noted in either OS or PFS, according to whether patients were chemoresistant or had relapsed post-plateau. [alpha]IFN did not appear to prolong survival (OS or PFS) post-DHBI. We conclude that DHBI is an effective treatment in patients with relapsed multiple myeloma and in those who are chemoresistant to initial therapy. Cytopenia was a significant problem post-DHBI, such that the role of maintenance [alpha]IFN therapy could not be fully evaluated. (author).

  6. Double hemibody irradiation (DHBI) in the management of relapsed and primary chemoresistant multiple myeloma

    International Nuclear Information System (INIS)

    McSweeney, E.N.; Tobias, J.S.; Goldstone, A.H.; Richards, J.D.M.; Blackman, G.

    1993-01-01

    Fifty-five patients with multiple myeloma were treated with both upper and lower hemibody irradiation between January 1985 and January 1991; 42 had relapsed post-plateau and 13 were chemo-resistant to initial therapy. Fifteen patients received αIFN-2b maintenance therapy post-DHBI, at a dose of 3 Mu three times per week. Ninety-five per cent of patients experienced symptomatic improvement in bone pain post-DHBI, 21% of whom discontinued opiate analgesics altogether; 63% had a minor biochemical response and 38% had a partial biochemical response. The overall survival (OS) and progression free survivals (PFS) in all patients were 11 months and 8 months respectively. No significant difference was noted in either OS or PFS, according to whether patients were chemoresistant or had relapsed post-plateau. αIFN did not appear to prolong survival (OS or PFS) post-DHBI. We conclude that DHBI is an effective treatment in patients with relapsed multiple myeloma and in those who are chemoresistant to initial therapy. Cytopenia was a significant problem post-DHBI, such that the role of maintenance αIFN therapy could not be fully evaluated. (author)

  7. Metachronous contralateral breast cancer as first event of relapse

    International Nuclear Information System (INIS)

    La Rochefordiere, Anne de; Mouret-Fourme, Emmanuelle; Asselain, Bernard; Scholl, Susan M.; Campana, Francois; Broeet, Philippe; Fourquet, Alain

    1996-01-01

    Purpose: To determine which clinical, biological, or treatment-related factors of the first and second primary breast cancers influenced the outcome following contralateral breast carcinoma (CBC). Methods and Materials: By August 1994, 319 of 6406 patients with clinical Stage 0 to III breast carcinoma treated between 1981 and 1987 at Institut Curie had developed a second breast cancer that was diagnosed more than 6 months following ipsilateral breast cancer. Of these 319 patients, 235 had a CBC as the first recurrent event and constitute the study population. Comparisons of first and second breast tumor characteristics were done using Fisher's exact test. Survival distributions from the date of CBC were compared by the log-rank test. Prognostic factors for local relapses, distant relapses, and survival after CBC were assessed by univariate and multivariate analysis using the Cox proportional hazards model. Results: The diagnosis of CBC was more frequently guided by mammographies than for ipsilateral tumors (p 5 years) had no influence on survival. Cox model analysis showed that the risk factors for distant metastases were stage and progesterone receptor levels of the contralateral tumor. The risk of distant failure in CBC was not influenced by the extent of surgery. Conclusions: In this selected population of CBCs as first recurrent events, a follow-up policy based on clinical examination and annual mammography enabled the detection of CBCs at an earlier stage than the primary ipsilateral cancer. The outcome after CBC was determined only by the characteristics of the contralateral tumor. Breast-conserving treatment should be recommended when it is feasible. Adjuvant chemotherapy should be delivered according to the same criteria as the primary tumor

  8. Ibrutinib for previously untreated and relapsed or refractory chronic lymphocytic leukaemia with TP53 aberrations

    DEFF Research Database (Denmark)

    Farooqui, Mohammed Z H; Valdez, Janet; Martyr, Sabrina

    2015-01-01

    BACKGROUND: Patients with chronic lymphocytic leukaemia (CLL) with TP53 aberrations respond poorly to first-line chemoimmunotherapy, resulting in early relapse and short survival. We investigated the safety and activity of ibrutinib in previously untreated and relapsed or refractory CLL with TP53...... aberrations. METHODS: In this investigator-initiated, single-arm phase 2 study, we enrolled eligible adult patients with active CLL with TP53 aberrations at the National Institutes of Health Clinical Center (Bethesda, MD, USA). Patients received 28-day cycles of ibrutinib 420 mg orally once daily until...... in one (2%) patient. INTERPRETATION: The activity and safety profile of single-agent ibrutinib in CLL with TP53 aberrations is encouraging and supports its consideration as a novel treatment option for patients with this high-risk disease in both first-line and second-line settings. FUNDING: Intramural...

  9. Very late relapse in breast cancer survivors: a report of 6 cases.

    Science.gov (United States)

    Omidvari, Shapour; Hamedi, Seyed Hasan; Mohammadianpanah, Mohammad; Nasrolahi, Hamid; Mosalaei, Ahmad; Talei, Abdolrasoul; Ahmadloo, Niloofar; Ansari, Mansour

    2013-01-01

    Breast cancer is the most common cancer and the leading cause of cancer death among the women worldwide. The risk of local and distant recurrence is the highest during the first two years following the initial treatment. Very late relapse (after 12 years) is uncommon in breast cancer survivors. Herein, we report the characteristics and outcomes of 6 such cases of breast cancer. The mean age of the patients was 40.1 years (range 30-57) and the mean disease free survival was 19.6 years. Late relapse is not so common in breast cancer but can occur in any stage. Therefore, we suggest life-time follow up for every patient with breast cancer.

  10. Ibrutinib Treatment of Mantle Cell Lymphoma Relapsing at Central Nervous System: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Donato Mannina

    2017-01-01

    Full Text Available Mantle cell lymphoma (MCL accounts for about 5% of all lymphomas. Its clinical and histological features are heterogeneous. After a frequently good initial response, the disease generally and repeatedly relapses and finally the outcome is poor. Particularly severe is the prognosis of the rare occurrence of CNSi (Central Nervous System involvement. Ibrutinib, an oral inhibitor of Bruton tyrosine kinase (BTK, has shown strong activity in relapsing patients with Chronic Lymphocytic Leukemia (CLL and MCL. Few reports are available about treatment with ibrutinib of patients presenting CNSi by lymphoproliferative diseases (LPD. In all of them, ibrutinib, at the dosage between 420 and 560 mg/day, showed an impressive effectiveness. Here we describe a case of MCL with CNS relapse showing an excellent response to ibrutinib administered at the unusual dose of 280 mg/day because of concomitant treatment of cardiological disease.

  11. Chinese Fine Art of the 3rd Century: On the Initial Stage of Development of Painting

    Directory of Open Access Journals (Sweden)

    Marina Prasolova

    2011-12-01

    Full Text Available The paper summarizes the extant written data on Chinese painting on silk in the initial century of the Period of Disunion (Six Dynasties, Liu chao, III–VI A.D., known as the Sanguo (220–280 and the Western Jin (265–317 epochs. While it is scattered among diverse sources, it is mainly in the Lidai minghua ji treatise of Zhang Yanyuan (ca. 810–ca. 990. An analysis of accounts of individual masters and their creative activities attempts to reconstruct the probable artistic and essential features of pieces of art lost afterwards, offering a novel explanation of the initial stage of the formative process of an important genre of composition in Chinese painting and culture.

  12. Learning to Be Sustainable in ICT for Development: A Citizen Engagement Initiative in South Africa

    OpenAIRE

    Pade-Khene , Caroline; Lannon , John

    2017-01-01

    Part 11: Sustainability in ICT4D; International audience; The uncertainty and complexity of ICT4D projects call into question the suitability of conventional approaches to project management that are imposed exogenously, particularly in relation to the challenge of supporting sustainability and resilience. Attempts to transfer knowledge or ownership to local stakeholders or other responsible bodies fail, and consequently many worthwhile initiatives become unsustainable. The problem is particu...

  13. Initial development of a treatment adherence measure for cognitive-behavioral therapy for child anxiety

    OpenAIRE

    Southam-Gerow, MA; McLeod, BD; Arnold, CC; Rodríguez, A; Cox, JR; Reise, SP; Bonifay, WE; Weisz, JR; Kendall, PC

    2016-01-01

    © 2015 American Psychological Association.The measurement of treatment adherence (a component of treatment integrity defined as the extent to which a treatment is delivered as intended) is a critical element in treatment evaluation research. This article presents initial psychometric data for scores on the Cognitive-Behavioral Therapy Adherence Scale for Youth Anxiety (CBAY-A), an observational measure designed to be sensitive to common practice elements found in individual cognitive- behavio...

  14. Developing agricultural opportunities on mine tailings : the Green Mines green energy initiative

    Energy Technology Data Exchange (ETDEWEB)

    Tisch, B.; Spiers, G.; Beckett, P.; Lock, A. [Natural Resources Canada, Ottawa, ON (Canada). CANMET Mining and Mineral Sciences Laboratories

    2009-02-15

    The goal of the Green Mines green energy initiative is to advance mine reclamation through the beneficial use of organic residuals for the sustainable establishment of bioenergy crops and other productive land uses. Target organic residuals include: source separated organic compost; papermill biosolids; leaf and yard waste compost; and municipal wastewater biosolids. This presentation discussed the Green Mines green energy initiative with particular reference to potential uses; current participants; scope of the initiative; and progress to date. The presentation also discussed a column study that involved adding filter, filter fabric, silica sand and polyethylene beads to the base of columns. Unoxidized tailings were slurried and pumped into columns and then the oxidized tailings were dried and homogenized. The results of acidic copper/nickel tailings with lime and no lime were also discussed. A summary of findings from the column study was offered. It was found that nutrient management must be considered and organic covers appear to increase metal and arsenic leaching from unlimed tailings. The presentation also made reference to demonstration field plots; biosolids delivery; tilling; monitoring; biomass sampling; and harvesting. The presentation concluded with a discussion of next steps which involve completing construction of the current suite of field plots and implementing full monitoring. figs.

  15. Acceleration of Intended Pozzolanic Reaction under Initial Thermal Treatment for Developing Cementless Fly Ash Based Mortar

    Directory of Open Access Journals (Sweden)

    Yang-Hee Kwon

    2017-02-01

    Full Text Available Without using strong alkaline solution or ordinary Portland cement, a new structural binder consisting of fly ash and hydrated lime was hardened through an intensified pozzolanic reaction. The main experimental variables are the addition of silica fume and initial thermal treatment (60 °C for 3 days. A series of experiments consisting of mechanical testing (compressive and flexural strength, modulus of elasticity, X-ray diffraction, and measurements of the heat of hydration, pore structure, and shrinkage were conducted. These tests show that this new fly ash-based mortar has a compressive strength of 15 MPa at 91 days without any silica fume addition or initial thermal treatment. The strength increased to over 50 MPa based on the acceleration of the intensified pozzolanic reaction from the silica fume addition and initial thermal treatment. This is explained by a significant synergistic effect induced by the silica fume. It intensifies the pozzolanic reaction under thermal treatment and provides a space filling effect. This improved material performance can open a new pathway to utilize the industrial by-product of fly ash in cementless construction materials.

  16. New-onset ascites as a manifestation of virologic relapse in patients with hepatitis C cirrhosis

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    Chua DL

    2014-01-01

    Full Text Available Deborah Lim Chua, Thomas Hahambis, Samuel H SigalDivision of Gastroenterology, Department of Medicine, New York University School of Medicine, New York, NY, USABackground: Chronic hepatitis C is the most common cause of cirrhosis in industrialized countries. Successful treatment of chronic hepatitis C in patients with advanced fibrosis or cirrhosis has significant benefits, including improvements in inflammation, fibrosis, and portal hypertension, with prevention of esophageal varices and clinical decompensation.Case: In this report, we present two patients with well-compensated hepatitis C cirrhosis who achieved an end-of-treatment response on a direct-acting antiviral therapy-based triple regimen for hepatitis C virus, but subsequently presented with new-onset ascites associated with virologic relapse.Conclusion: We propose that the development of ascites in this setting is due to the adverse impact of inflammation of the virologic relapse on portal hypertension. Our observation that ascites formation can be a manifestation of virologic relapse has potentially important clinical implications, as it highlights not only the importance of close monitoring of cirrhotic patients after achieving end-of-treatment response but also the impact of active inflammation on the severity of portal hypertension.Keywords: chronic hepatitis C, cirrhosis, virologic relapse, portal hypertension, ascites

  17. Review of interferon beta-1b in the treatment of early and relapsing multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Damiano Paolicelli

    2009-07-01

    Full Text Available Damiano Paolicelli, Vita Direnzo, Maria TrojanoDepartment of Neurological and Psychiatric Sciences, University of Bari, Bari, ItalyAbstract: Multiple sclerosis (MS is the most common autoimmune illness of the central nervous system. For many years the inflammatory manifestations of MS were treated using only corticosteroids. Since the 1990s the results of several clinical trials with immunomodulatory agents have changed the therapeutic approach to this disease. Interferon beta (IFNβ-1b represents the pioneer of those therapies. There is growing evidence from clinical trials on relapsing-remitting MS and clinically isolated syndromes suggestive of MS that IFNβ-1b reduces the frequency and severity of relapses and the development of new and active brain lesions as assessed by magnetic resonance imaging. Long-term data suggest a persistent efficacy of IFNβ-1b on disease activity and a positive effect in slowing disability worsening. Furthermore a reduction of relapse rate and a slight positive effect on the progression were demonstrated when IFNβ-1b was administered to still-active secondary progressive MS. IFNβ-1b therapy is well tolerated and relatively free of long-term side effects. In spite of the emergence of new agents for the treatment of MS, IFNβ-1b still remains a first-line therapy with a fundamental role in all stages of the disease.Keywords: interferon beta-1b, relapsing-remitting multiple sclerosis, clinically isolated syndromes, efficacy, safety, neutralizing antibodies

  18. Expression changes in the stroma of prostate cancer predict subsequent relapse.

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    Zhenyu Jia

    Full Text Available Biomarkers are needed to address overtreatment that occurs for the majority of prostate cancer patients that would not die of the disease but receive radical treatment. A possible barrier to biomarker discovery may be the polyclonal/multifocal nature of prostate tumors as well as cell-type heterogeneity between patient samples. Tumor-adjacent stroma (tumor microenvironment is less affected by genetic alteration and might therefore yield more consistent biomarkers in response to tumor aggressiveness. To this end we compared Affymetrix gene expression profiles in stroma near tumor and identified a set of 115 probe sets for which the expression levels were significantly correlated with time-to-relapse. We also compared patients that chemically relapsed shortly after prostatectomy (<1 year, and patients that did not relapse in the first four years after prostatectomy. We identified 131 differentially expressed microarray probe sets between these two categories. 19 probe sets (15 genes overlapped between the two gene lists with p<0.0001. We developed a PAM-based classifier by training on samples containing stroma near tumor: 9 rapid relapse patient samples and 9 indolent patient samples. We then tested the classifier on 47 different samples, containing 90% or more stroma. The classifier predicted the risk status of patients with an average accuracy of 87%. This is the first general tumor microenvironment-based prognostic classifier. These results indicate that the prostate cancer microenvironment exhibits reproducible changes useful for predicting outcomes for patients.

  19. Ensuring New Zealand's Future Prosperity: A Professional Learning Development Initiative to Bridge the Gap between Theory and Practice

    Science.gov (United States)

    Kennedy, I.; Smith, P.; Sexton, S. S.

    2015-01-01

    This paper reports on a study investigating the effectiveness of a new professional learning development (PLD) initiative in New Zealand, The Sir Paul Callaghan Science Academy (The Academy). The Academy is designed to provide primary and intermediate (students aged 5 to 13) classroom teachers with the knowledge, materials and support needed for…

  20. Initial Development and Psychometric Properties of the Adolescent Perceptions of Parental Pro-Educational Attitudes and Behaviors Scale

    Science.gov (United States)

    Herlickson, Allison B.; Wettersten, Kara B.; Herrick, Christen G.; Kim, Grace Y.; Hunter, Patricia J.; Guilmino, Adam; Faul, Kiri; Jagow-France, Desiree; Mach, Barbara; Napton, Sean; Beecher, Timothy; Holzer, Kendra; Rudolph, Susan E.

    2009-01-01

    The Initial development and psychometric properties of the Adolescent Perceptions of Parental Pro-Educational Attitudes and Behaviors Scale (APPEABS) are reviewed. Evidence of content convergent, and construct validity are reported. The APPEABS demonstrated usefulness as a scale of predicting the role of adolescents' perceptions of parents'…