Science.gov

Sample records for change empiric treatment

  1. The Common Factors, Empirically Validated Treatments, and Recovery Models of Therapeutic Change

    ERIC Educational Resources Information Center

    Reisner, Andrew D.

    2005-01-01

    I review the Common Factors Model, the Empirically Validated Therapy Model, and the Recovery Model of therapeutic change and effectiveness. In general, psychotherapy appears to be effective and common factors account for more of the variance than do specific techniques. However, in some areas, particularly in the treatment of anxiety disorders,…

  2. [Empiric treatment of pyelonephritis].

    PubMed

    Iarovoĭ, S K; Shimanovskiĭ, N L; Kareva, E N

    2011-01-01

    The article analyses the most typical clinical situations in empirical treatment of pyelonephritis including situations with comorbid severe diseases: decompensated diabetes mellitus, chronic renal failure, HIV-infection. Choice of antibacterial medicines for empiric treatment of pyelonephritis is based on the results of the latest studies of antibioticoresistance of pyelonephritis pathogens as well as on specific features of pharmacokinetics and pharmacodynamics of antibacterial drugs. PMID:21815461

  3. Empirical Bayes MCMC Estimation for Modeling Treatment Processes, Mechanisms of Change, and Clinical Outcomes in Small Samples

    PubMed Central

    Ozechowski, Timothy J.

    2015-01-01

    Objective The current analysis demonstrates of the use of empirical Bayes estimation methods with data-derived prior parameters for studying clinically intricate process-mechanism-outcome linkages using structural equation modeling (SEM) with small samples. Method The data were obtained from a small subsample of 23 families receiving Functional Family Therapy (FFT) for adolescent substance abuse during a completed randomized clinical trial. Two or three video recorded FFT sessions were randomly selected for each family. The middle 20-minute portion of each session was observed and coded. A SEM was specified examining the influence of a select set of observed therapist behaviors on pre- to post-treatment change in mother-reports of family functioning and, in turn, pre- to post-treatment change in adolescent reports of adolescent marijuana use and delinquent behavior. The SEM was implemented using empirical Bayes estimation with data-derived maximum likelihood (ML) prior parameters and Markov Chain Monte Carlo (MCMC) estimation of the joint posterior distribution. Results The EB SEM results indicated that a relatively high proportion of individually focused general interventions (i.e., seek information, acknowledge) as well as relationally focused meaning change interventions by therapists during sessions of FFT were predictive of pre- to post-treatment increases in levels of family functioning as reported by mothers in families of substance abusing adolescents. In turn, increases in mother-reported family functioning were predictive of reductions in levels of adolescent-reported delinquent behavior. Conclusions EB MCMC methods produced more stable results than ML, especially regarding the variances on the change factors in the SEM. EB MCMC estimation is a viable alternative to ML estimation of SEMs in clinical research with prohibitively small samples. PMID:24512127

  4. Validating Culturally Relevant Treatment Interventions: What Are We Trying To Change? or Challenges to the Development of Culturally Relevant or Specific Empirically Validated Treatment.

    ERIC Educational Resources Information Center

    Coleman, Hardin L. K.

    This paper presents an example of a patient treated in a school-based clinic. The counselor used traditional diagnostic perspectives to come up with a diagnosis that would be understood by the patient's Health Maintenance Organization. This diagnosis reflects traditional understanding of mental health and psychological treatment, which promotes…

  5. Empirical treatment of acute cystitis in women.

    PubMed

    Nicolle, Lindsay E

    2003-07-01

    Empirical antimicrobial treatment for acute cystitis in women requires continuing reassessment as the antimicrobial susceptibility of community isolates of Escherichia coli evolves. Current recommendations for 3 days trimethoprim or trimethoprim/sulphamethoxazole are compromised by increasing resistance of community E. coli to these agents. Fluoroquinolones are an alternate 3-day therapy, but increasing resistance is being reported from some countries, and widespread community use may promote resistance, limiting effectiveness of these agents for more serious infections. Alternate regimens supported by recent clinical trials suggest pivmecillinam given twice daily for 7 days is as effective as 3 days of quinolone therapy, while microbiological cure is 80% with 3 days therapy twice daily, and 90% with 3 days therapy thrice daily. Nitrofurantoin given for 7 days has a cure rate of 80-85%. Fosfomycin trometamol as a single dose has cure rates of 75-85%. All these agents are effective, but a compromise in efficacy or duration of therapy compared with current 3-day regimens may have to be considered. PMID:12842322

  6. Treatments for Sleep Changes

    MedlinePlus

    ... Contributing medical factors Non-drug strategies Medications Common sleep changes Many people with Alzheimer’s experience changes in ... at night. Subscribe now Non-drug treatments for sleep changes Non-drug treatments aim to improve sleep ...

  7. Empirical Treatment Effectiveness Models for Binary Outcomes.

    PubMed

    Dalton, Jarrod E; Dawson, Neal V; Sessler, Daniel I; Schold, Jesse D; Love, Thomas E; Kattan, Michael W

    2016-01-01

    Randomized trials provide strong evidence regarding efficacy of interventions but are limited in their capacity to address potential heterogeneity in effectiveness within broad clinical populations. For example, a treatment that on average is superior may be distinctly worse in certain patients. We propose a technique for using large electronic health registries to develop and validate decision models that measure-for distinct combinations of covariate values-the difference in predicted outcomes among 2 alternative treatments. We demonstrate the methodology in a prototype analysis of in-hospital mortality under alternative revascularization treatments. First, we developed prediction models for a binary outcome of interest for each treatment. Decision criteria were then defined based on the treatment-specific model predictions. Patients were then classified as receiving concordant or discordant care (in relation to the model recommendation), and the association between discordance and outcomes was evaluated. We then present alternative decision criteria and validation methodologies, as well as sensitivity analyses that investigate 1) the imbalance between treatments on observed covariates and 2) the aggregate impact of unobserved covariates. Our methodology supplements population-average clinical trial results by modeling heterogeneity in outcomes according to specific covariate values. It thus allows for assessment of current practice, from which cogent hypotheses for improved care can be derived. Newly emerging large population registries will allow for accurate predictions of outcome risk under competing treatments, as complex functions of predictor variables. Whether or not the models might be used to inform decision making depends on the extent to which important predictors are available. Further work is needed to understand the strengths and limitations of this approach, particularly in relation to those based on randomized trials. PMID:25852080

  8. Empirically Supported Treatment Endeavour: A Successful Future or Inevitable Debacle?

    ERIC Educational Resources Information Center

    Foley, Jessica M.

    2004-01-01

    The Empirically Supported Treatment (EST) endeavour began with and has persisted through prodigious skepticism among practising clinical psychologists. Despite such criticism, however, the advent of managed care guidelines, growing emphasis on biological psychiatry, promotion of scientific interests, and the need for better patient care have…

  9. Empirically Supported Treatment's Impact on Organizational Culture and Climate

    ERIC Educational Resources Information Center

    Patterson-Silver Wolf, David A.; Dulmus, Catherine N.; Maguin, Eugene

    2012-01-01

    Objectives: With the continued push to implement empirically supported treatments (ESTs) into community-based organizations, it is important to investigate whether working condition disruptions occur during this process. While there are many studies investigating best practices and how to adopt them, the literature lacks studies investigating the…

  10. An Exploration of Students' Perceptions of Empirically Supported Treatments: The Significance of Gender and Ethnicity

    ERIC Educational Resources Information Center

    Simons, Lori; Giorgio, Tina; Houston, Hank; Jacobucci, Ray

    2007-01-01

    A secondary analysis of a quasi-experimental study was conducted to evaluate differences in students 'perceptions of empirically supported treatments (ESTS) randomized to experimental (n= 10) and attention-control (n= 10) manual-based therapy interventions. The results indicated that attitudinal changes took place for both groups. The results…

  11. Tailored Therapy Versus Empiric Chosen Treatment for Helicobacter pylori Eradication

    PubMed Central

    Chen, Han; Dang, Yini; Zhou, Xiaoying; Liu, Bingtuan; Liu, Shiyu; Zhang, Guoxin

    2016-01-01

    Abstract Although various regimens are empirically accepted for Helicobacter pylori eradication, the efficacy might be declined by multiple individual factors. The necessity of a personalized eradication therapy still remains controversial. The aim of the study was to compare tailored therapy with empiric chosen regimens. Databases of PUBMED, EMBASE, and MEDLINE were searched for eligible studies, published up to October 2015. All relevant controlled clinical trials were included. A random-effect model was applied to compare pooled relative risk (RR) with related 95% confidence intervals (CIs). Thirteen controlled clinical trials integrating 3512 participants were assessed. Overall, the pooled eradication rates of tailored groups were higher than those of empiric ones (intention-to-treat: RR = 1.16, 95% CI 1.10–1.22; preprotocol: RR = 1.14, 95% CI 1.08–1.21). In subgroup analysis, tailored therapy was superior to 7-day standard triple therapy (RR = 1.22, 95% CI 1.16–1.29) and bismuth-quadruple therapy (RR = 1.14, 95% CI 1.07–1.22) on eradication rates; first-line tailored therapy achieved higher eradication rates than first-line empirical regimens (pooled RR = 1.18, 95%CI 1.14–1.22), whereas tailored rescue regimen showed no difference with empirical ones (pooled RR = 1.16, 95% CI 0.96–1.39). Moreover, among different tailored designs, susceptibility-guided tailored therapy obtained higher eradication rates than empiric groups, independent of CYP2C19 genotype detection (with CYP: RR = 1.16, 95% CI 1.09–1.23; without CYP: RR = 1.14, 95% CI 1.01–1.28). Both molecular test-based and culture-based tailored groups were better on eradication rates than empiric groups (molecular: RR = 1.23, 95% CI 1.11–1.35; culture: RR = 1.13, 95% CI 1.06–1.20). Compared with empiric chosen treatments, tailored therapy is a better alternative for H pylori eradication. PMID:26886617

  12. Empiric treatment of neonatal sepsis in developing countries.

    PubMed

    Obiero, Christina W; Seale, Anna C; Berkley, James A

    2015-06-01

    Infections are among the leading causes of neonatal mortality, and about 75% of the burden occurs in developing countries. Diagnosis of neonatal sepsis in these countries is dependent on the recognition of a set of nonspecific clinical signs that maximize sensitivity because staff making initial assessments may not have specialist pediatric training. Accurate diagnosis is usually limited by the unavailability of reliable microbiological investigation. The World Health Organization recommends ampicillin (or penicillin; cloxacillin if staphylococcal infection is suspected) plus gentamicin for empiric treatment of neonates with suspected clinical sepsis or meningitis. However, there is a lack of comprehensive data on the causes of infection and antimicrobial susceptibility in developing countries to support these recommendations, especially in rural settings. Bacterial pathogens (predominantly Gram negative) with reduced susceptibility to empiric medication have been reported, with variations both between and within regions. Nosocomial infections with resistant organisms and high case fatality challenge the first-line use of cephalosporins. Improving local surveillance data using standardized antimicrobial susceptibility testing methods and validation of diagnostic algorithms against microbial findings are essential. Standardized reporting of treatment outcomes is required to evaluate practice, provide guidance on second-line regimes and for studies of new approaches, such as simplified community-based regimens, and to determine the appropriate duration of empiric treatment for apparently low-risk neonates with early resolution of clinical signs, or where available, negative blood cultures. Thus, a multifaceted approach, with attention to microbiological quality assurance, is needed to better guide antimicrobial use and reduce mortality and long-term impairments. PMID:25806843

  13. Empirically supported psychological treatments: the challenge of evaluating clinical innovations.

    PubMed

    Church, Dawson; Feinstein, David; Palmer-Hoffman, Julie; Stein, Phyllis K; Tranguch, Anthony

    2014-10-01

    Clear and transparent standards are required to establish whether a therapeutic method is "evidence based." Even when research demonstrates a method to be efficacious, it may not become available to patients who could benefit from it, a phenomenon known as the "translational gap." Only 30% of therapies cross the gap, and the lag between empirical validation and clinical implementation averages 17 years. To address these problems, Division 12 of the American Psychological Association published a set of standards for "empirically supported treatments" in the mid-1990s that allows the assessment of clinical modalities. This article reviews these criteria, identifies their strengths, and discusses their impact on the translational gap, using the development of a clinical innovation called Emotional Freedom Techniques (EFT) as a case study. Twelve specific recommendations for updates of the Division 12 criteria are made based on lessons garnered from the adoption of EFT within the clinical community. These recommendations would shorten the cycle from the research setting to clinical practice, increase transparency, incorporate recent scientific advances, and enhance the capacity for succinct comparisons among treatments. PMID:25265265

  14. Familiarizing Students with the Empirically Supported Treatment Approaches for Childhood Problems.

    ERIC Educational Resources Information Center

    Wilkins, Victoria; Chambliss, Catherine

    The clinical research literature exploring the efficacy of particular treatment approaches is reviewed with the intent to facilitate the training of counseling students. Empirically supported treatments (ESTs) is defined operationally as evidence-based treatments following the listing of empirically validated psychological treatments reported by…

  15. Flood risk changes over centuries in Rome: an empirical study

    NASA Astrophysics Data System (ADS)

    Di Baldassarre, Giuliano; Saccà, Smeralda; Tito Aronica, Giuseppe; Grimaldi, Salvatore; Crisci, Massimiliano

    2015-04-01

    Over centuries, the development of the historical city of Rome -close to one of the largest Italian rivers, the Tiber- has been intertwined with the magnitude and frequency of flooding events. The ancient Rome mostly developed on the (seven) hills, while the Tiber's floodplain was mainly exploited for agricultural purposes. A few small communities did settle in the riparian areas of the Tiber, but they had a relatively peaceful relationships with the frequent occurrence of flooding events. Nowadays, numerous people live in modern districts in the Tiber's floodplain, unaware of their exposure to potentially catastrophic flooding. The main goal of this research is to explore the dynamics of changing flood risk over the centuries between these two extreme pictures of the ancient and contemporary Rome. To this end, we carried out a socio-hydrological study by exploiting long time series of physical (flooding, river morphology) and social (urbanization, population dynamics) processes together with information about human interactions with the environment (flood defense structures). This empirical analysis showed how human and physical systems have been co-evolving over time, while being abruptly altered by the occurrence of extreme events. For instance, a large flooding event occurred in 1870 and contributed to the constructions of levees, which in turn facilitated the development of new urban areas in the Tiber's floodplain, while changed the societal memory of floods as well as the communities' perception of risk. This research work was also used to test the hypotheses of recent-developed models conceptualizing the interplay between floods and societies and simulating the long-term behavior of coupled human-water systems. The outcomes of this test provided interesting insights about the dynamics of flood risk, which are expected to support a better anticipation of future changes.

  16. Patterns of Empiric Treatment of Chlamydia Trachomatis Infections in an Underserved Population

    PubMed Central

    Faricy, Lauren; Page, Tanya; Ronick, Mischa; Rdesinski, Rebecca; DeVoe, Jennifer

    2016-01-01

    BACKGROUND AND OBJECTIVES Appropriate treatment of chlamydia trachomatis (CT) sexually transmitted infections (STIs) is important. Much of this treatment is empiric, and most research on treatment patterns has been conducted in emergency department settings. Few studies have focused on CT treatment in outpatient primary care settings, especially among underserved populations. We aimed to study patterns of empiric CT treatment in an urban safety net clinic. METHODS We examined electronic health records from all patients in whom a CT lab test was completed between January 1 and December 31, 2007 (n=1,222). We manually reviewed charts to confirm patient demographics, CT testing, STI symptoms, known exposure, empiric treatment, test results, and follow-up. We then conducted univariate and multivariate analyses to study patterns of and characteristics associated with receiving empiric treatment. We also assessed follow-up for non-treated patients with positive tests. RESULTS Among 488 patients who presented with STI symptoms and who were tested, 181 (37.1%) were empirically treated. In multivariate analyses, women with symptoms had significantly lower odds of receiving empiric treatment, as compared with men. Of the 1,222 patients tested, 75 had a positive CT laboratory test; seven (9.3%) of these patients did not receive empiric treatment and had no documented posttest treatment. CONCLUSIONS A minority of patients with STI symptoms were empirically treated. Outpatient clinicians should consider whether a patient meets guidelines for empiric STI treatment; this decision should take into account the feasibility of prompt follow-up. This may be especially important in women presenting with STI symptoms. PMID:22733418

  17. Empirical risk factors for delinquency and best treatments: where do we go from here?

    PubMed

    Zagar, Robert John; Busch, Kenneth G; Hughes, John Russell

    2009-02-01

    Youth development and prevention of violence are two sides of the same public policy issue. A great deal of theoretical and empirical effort has focused on identification of risk factors for delinquency and development of interventions for general risks. Recent calls for changes in public policy are evaluated here--and challenged--in light of new comprehensive, longitudinal empirical data on urban violent delinquency. Treatments such as prenatal care, home visitation, prevention of bullying, prevention of alcohol and/or drug abuse, promotion of alternative thinking, mentoring, life skills training, rewards for graduation and employment, functional family therapy, and multidimensional foster care are effective because they prevent or ameliorate risks for delinquency occurring during development. At present, the best treatments yield 10 to 40% reductions in delinquent recidivism. Better controlled application of developmentally appropriate treatments in higher doses, with narrow targeting of the highest-risk youth based on actuarial testing--rather than less accurate clinical judgment--should result in higher effectiveness. Such a focused approach in a geographical area with high homicide rates should be cost-effective. A prediction of cost-benefit outcomes for a carefully constructed example of a large-scale program is presented. PMID:19480217

  18. Empiric treatment of children with gastroesophageal reflux-like symptoms: Effect of proton pump inhibitors.

    PubMed

    Gündüz, Mehmet; Yamaç, Pınar; Baysoy, Gökhan

    2015-01-01

    Gastroesophageal reflux disease is an important cause of morbidity in childhood. Although various diagnostic methods are available, short course of empiric treatment with a proton pump inhibitor is widely used in adults as a diagnostic test. Data about empiric treatment is scarce in children. The aim of this study is to evaluate the effectiveness of empiric treatment of reflux-like symptoms in children. Pediatric gastroenterology outpatient files were searched and patients with a diagnosis of gastroesophageal reflux were found. Patient complaints, history and the treatments provided were recorded. Treatment naive patients older than 2 years of age with symptoms suggestive of gastroesophageal reflux were selected and included if they were given empiric treatment with a proton pump inhibitor. Empiric treatment was found to be effective in 78% of patients. Treatment response tended to be better in children older than 5 years of age. Of the 22 non-responders 9 underwent endoscopy and pathological findings were discovered in 7 of them. Treatment of children with gastroesophageal reflux symptoms with a proton pump inhibitor might significantly decrease the need for extensive evaluations. However it is important to investigate non-responders to empiric therapy, as it seems there might be high probability of pathological findings. PMID:27411415

  19. Has the DOTS Strategy Improved Case Finding or Treatment Success? An Empirical Assessment

    PubMed Central

    Obermeyer, Ziad; Abbott-Klafter, Jesse; Murray, Christopher J. L.

    2008-01-01

    Background Nearly fifteen years after the start of WHO's DOTS strategy, tuberculosis remains a major global health problem. Given the lack of empirical evidence that DOTS reduces tuberculosis burden, considerable debate has arisen about its place in the future of global tuberculosis control efforts. An independent evaluation of DOTS, one of the most widely-implemented and longest-running interventions in global health, is a prerequisite for meaningful improvements to tuberculosis control efforts, including WHO's new Stop TB Strategy. We investigate the impact of the expansion of the DOTS strategy on tuberculosis case finding and treatment success, using only empirical data. Methods and Findings We study the effect of DOTS using time-series cross-sectional methods. We first estimate the impact of DOTS expansion on case detection, using reported case notification data and controlling for other determinants of change in notifications, including HIV prevalence, GDP, and country-specific effects. We then estimate the effect of DOTS expansion on treatment success. DOTS programme variables had no statistically significant impact on case detection in a wide range of models and specifications. DOTS population coverage had a significant effect on overall treatment success rates, such that countries with full DOTS coverage benefit from at least an 18% increase in treatment success (95% CI: 5–31%). Conclusions The DOTS technical package improved overall treatment success. By contrast, DOTS expansion had no effect on case detection. This finding is less optimistic than previous analyses. Better epidemiological and programme data would facilitate future monitoring and evaluation efforts. PMID:18320042

  20. Familiarizing Students with the Empirically Supported Treatment Approaches for Substance Abuse Problems.

    ERIC Educational Resources Information Center

    Wilkins, Victoria; Chambliss, Catherine

    When training counseling students, it is important to familiarize them with the clinical research literature exploring the efficacy of particular treatments. The bulk of the document is comprised of a review of empirically supported treatments (ESTs). ESTs or evidence-based treatments are grounded in studies recommended by the American…

  1. Empirically Supported Treatments (ESTs) in Perspective: Implications for Counseling Psychology Training.

    ERIC Educational Resources Information Center

    Waehler, Charles A.; Kalodner, Cynthia R.; Wampold, Bruce E.; Lichtenberg, James W.

    2000-01-01

    Discusses the movement toward employing only evidence-based treatments or empirically validated treatments (EVTs) in psychological services. Examines the adoption of EVTs and how efficacious treatments must respond successfully to practicing psychologists' applications, scientific certainty, and marketplace demand. Reviews both the merits and…

  2. Hypnosis Treatment of Gastrointestinal Disorders: A Comprehensive Review of the Empirical Evidence.

    PubMed

    Palsson, Olafur S

    2015-10-01

    Hypnotherapy has been investigated for 30 years as a treatment for gastrointestinal (GI) disorders. There are presently 35 studies in the published empirical literature, including 17 randomized controlled trials (RCTs) that have assessed clinical outcomes of such treatment. This body of research is reviewed comprehensively in this article. Twenty-four of the studies have tested hypnotherapy for adult irritable bowel syndrome (IBS) and 5 have focused on IBS or abdominal pain in children. All IBS hypnotherapy studies have reported significant improvement in gastrointestinal symptoms, and 7 out of 10 RCTs in adults and all 3 RCTs in pediatric patient samples found superior outcomes for hypnosis compared to control groups. Collectively this body of research shows unequivocally that for both adults and children with IBS, hypnosis treatment is highly efficacious in reducing bowel symptoms and can offer lasting and substantial symptom relief for a large proportion of patients who do not respond adequately to usual medical treatment approaches. For other GI disorders the evidence is more limited, but preliminary indications of therapeutic potential can be seen in the single randomized controlled trials published to date on hypnotherapy for functional dyspepsia, functional chest pain, and ulcerative colitis. Further controlled hypnotherapy trials in those three disorders should be a high priority. The mechanisms underlying the impact of hypnosis on GI problems are still unclear, but findings from a number of studies suggest that they involve both modulation of gut functioning and changes in the brain's handling of sensory signals from the GI tract. PMID:26264539

  3. Impact of three empirical tuberculosis treatment strategies for people initiating antiretroviral therapy

    PubMed Central

    Van Rie, Annelies; Westreich, Daniel; Sanne, Ian

    2016-01-01

    Background Early mortality in people initiating antiretroviral treatment (ART) in Africa remains high. Empiric TB treatment strategies aim to reduce early mortality by initiating TB treatment in individuals without clinical suspicion of TB who are at high-risk of death from undiagnosed TB. Methods Using data from 16,913 individuals starting ART under programmatic conditions, we simulated the impact of three empiric treatment strategies on mortality and incident TB: two randomized clinical trials (REMEMBER and PrOMPT) and a pragmatic approach. The main analysis assumed that 50% of early deaths and 100% of incident TB is averted in those eligible and ignored outcomes in those lost to follow up. Results The increase in individuals eligible for TB treatment under empirical TB treatment strategies ranged from 4.4% to 31.4% as compared to those started on clinical or mycobacteriological grounds. The proportion of deaths averted by empiric treatment strategies ranged from 5.5% to 25.4%. The proportion of incident TB cases averted ranged from 10.9% to 57.3%. The proportion receiving any TB treatment during the first six months of ART increased from the observed 24.0% to an estimated 27.5%, 40.4% and 51.3% under the PrOMPT, REMEMBER and pragmatic approach, respectively. Conclusion The impact of empiric TB treatment strategies depends greatly on the eligibility criteria chosen. The additional strain placed on TB treatment facilities and the relatively limited impact of some empirical TB strategies raise the question whether the benefits will outweigh the risks at population level. PMID:25299868

  4. Urban and regional change in Australia: an empirical introduction.

    PubMed

    O'connor, K

    1984-08-01

    Recent changes in the spatial distribution of the population in Australia are examined. In particular, changes in population by state are analyzed for the period 1971-1981. The relationship of these changes to shifts in economic activity, private investment, and banking activity is considered. "Results show there have been only small shifts toward population growth areas. These results are interpreted in part as a consequence of nonlocal multipliers and linkages back to established areas, but also as a reflection of the unique features of the Australian urban and regional system." PMID:12266112

  5. Why are empirically supported treatments for bulimia nervosa underutilized and what can we do about it?

    PubMed

    Arnow, B A

    1999-06-01

    Empirically supported therapies for bulimia nervosa, as well as for other disorders, are rarely utilized. Underutilization is frequently attributed to doubts among psychotherapists about the value of randomized controlled trials and professional resistance to the perceived constraints of manualized therapy. However, controversies about the usefulness of empirically supported therapies have been shaped by lack of access to adequate training and inexperience in delivering these treatments. A proposal for expanding training opportunities is presented along with discussion about how more intensive training for the practicing therapist would affect current controversies regarding the value and relevance of empirically supported therapies for bulimia nervosa and other disorders. PMID:10445866

  6. Familiarizing Students with the Empirically Supported Treatment Approaches for Psychophysiological Disorders and Chronic Pain.

    ERIC Educational Resources Information Center

    Wilkins, Victoria; Chambliss, Catherine

    In training counseling students, it is increasingly important to acquaint them with the clinical research literature exploring the efficacy of particular treatments. This review of empirically supported treatments (EST's) concerning psychophysiological disorders and chronic pain is intended to facilitate the educational process. EST's, or…

  7. Identifying Empirically Supported Treatments for Pica in Individuals with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Hagopian, Louis P.; Rooker, Griffin W.; Rolider, Natalie U.

    2011-01-01

    The purpose of the current study was to critically examine the existing literature on the treatment of pica displayed by individuals with intellectual disabilities. Criteria for empirically supported treatments as described by Divisions 12 and 16 of APA, and adapted for studies employing single-case designs were used to review this body of…

  8. Familiarizing Students with the Empirically Supported Treatment Approaches for Eating Disorders.

    ERIC Educational Resources Information Center

    Wilkins, Victoria; Urban, Greg; Zanotti, Mary; Chambliss, Catherine

    In recent years, bulimia nervosa has plagued young women and become a major issue in mental health care. Strategies for training counseling students so as to acquaint them with clinical research on treatments for bulimia are presented in this report. It reviews empirically supported treatments (ESTs) concerning eating disorders in order to…

  9. An empiric treatment for idiopathic oligozoospermia revisited: a 20-year investigative saga.

    PubMed

    Koukkou, E; Billa, E; Kapolla, N; Pappa, A; Venaki, E; Andreou, L; Nicopoulou, S C; Adamopoulos, D A

    2012-10-01

    A series of studies aiming at introducing an effective treatment for idiopathic oligozoospermia was conducted in a step-wise fashion spanning over a 20-year period. The concept was that co-administration of an accessory gland-stimulating androgen, testosterone undecanoate (40 mg t.i.d.) and the FSH raising anti-oestrogen tamoxifen citrate (10 mg b.i.d.) may improve sperm parameters. A prerequisite for such an effect was the demonstration that testosterone undecanoate had no suppressing action on pituitary-testicular axis. In this context, initial studies demonstrated no change in basal or stimulated gonadotrophin and testosterone secretion in short- or long-term protocols. Two subsequent trials with this combination showed a marked improvement of sperm parameters and pregnancy incidence, with a seasonal variation noted in response to treatment, this being higher during the cold seasons of autumn and winter. Regarding the mechanism of testosterone undecanoate's action, a recent study from our unit showed that its administration resulted in a marked rise of serum DHT levels. Because this steroid is an epididymal function promoter, it appears that its contribution in the combination is mediated mainly through its DHT raising effect. By and large, this empiric approach for the treatment of idiopathic oligozoospermia was satisfactorily documented after a 20-year investigative saga. PMID:22946848

  10. Empiric validation of a process for behavior change.

    PubMed

    Elliot, Diane L; Goldberg, Linn; MacKinnon, David P; Ranby, Krista W; Kuehl, Kerry S; Moe, Esther L

    2016-09-01

    Most behavior change trials focus on outcomes rather than deconstructing how those outcomes related to programmatic theoretical underpinnings and intervention components. In this report, the process of change is compared for three evidence-based programs' that shared theories, intervention elements and potential mediating variables. Each investigation was a randomized trial that assessed pre- and post- intervention variables using survey constructs with established reliability. Each also used mediation analyses to define relationships. The findings were combined using a pattern matching approach. Surprisingly, knowledge was a significant mediator in each program (a and b path effects [p<0.01]). Norms, perceived control abilities, and self-monitoring were confirmed in at least two studies (p<0.01 for each). Replication of findings across studies with a common design but varied populations provides a robust validation of the theory and processes of an effective intervention. Combined findings also demonstrate a means to substantiate process aspects and theoretical models to advance understanding of behavior change. PMID:27528533

  11. High Feasibility of Empiric HIV Treatment for Patients With Suspected Acute HIV in an Emergency Department.

    PubMed

    Jacobson, Kathleen R; Arora, Sanjay; Walsh, Kristin B; Lora, Meredith; Merjavy, Stephen; Livermore, Shanna; Menchine, Michael

    2016-07-01

    Earlier intervention in acute HIV infection limits HIV reservoirs and may decrease HIV transmission. We developed criteria for empiric antiretroviral therapy (ART) in an emergency department (ED) routine HIV screening program. We assessed the feasibility and willingness of patients with suspected acute HIV infection in the ED to begin ART. A suspected acute HIV infection was defined as a positive HIV antigen antibody combination immunoassay with pending HIV-antibody differentiation test results and HIV RNA viral load. During the study period, there were 16 confirmed cases of acute HIV infection: 11 met our criteria for empiric ART and agreed to treatment, 10 were prescribed ART, and 1 left the ED against medical advice without a prescription for ART. Eight patients completed at least one follow-up visit. Empiric HIV treatment in an ED is feasible, well received by patients, and offers a unique entry point into the HIV care continuum. PMID:27028498

  12. A Survey of Graduate Training in Empirically Supported and Manualized Treatments: A Preliminary Report

    ERIC Educational Resources Information Center

    Karekla, Maria; Lundgren, Jennifer D.; Forsyth, John P.

    2004-01-01

    The promotion and dissemination of empirically supported (ESTs) and manualized therapies are important, albeit controversial, developments within clinical science and practice. To date, studies evaluating training opportunities and attitudes about such treatments at the graduate, predoctoral internship, and postdoctoral levels have focused on the…

  13. The Science and Theory of Empirically Supported Treatments: A Response to Hughes.

    ERIC Educational Resources Information Center

    Sheridan, Susan M.

    2000-01-01

    Refocuses Hughes arguments, in target article, away from empirically supported treatments (ESTs) and back to science-practice links to services. Discusses the importance of theory in school psychology practice and research. Argues that theory alone is insufficient when considering services for children and families. Suggests the EST movement helps…

  14. An Empirical Investigation of Group Treatment for a Clinical Population of Adult Female Incest Survivors.

    ERIC Educational Resources Information Center

    Saxe, Brenda J.; Johnson, Susan M.

    1999-01-01

    Empirically assesses the effectiveness of a group treatment program on intrapersonal symptomatology and interpersonal difficulties in a clinical population of women with a history of incest. Results indicate that a time-limited group, which focuses on the original trauma, is effective in reducing intrapersonal symptomatology for women with a…

  15. Identifying Empirically Supported Treatments for Phobic Avoidance in Individuals with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Jennett, Heather K.; Hagopian, Louis P.

    2008-01-01

    This paper reviews the literature regarding the treatment of phobic avoidance in individuals with intellectual disabilities. Criteria for classifying interventions as empirically supported, developed by the American Psychological Association (APA) Division 12 Task Force on Promotion and Dissemination of Psychological Procedures, were used. For…

  16. An Empirical Study Comparing the Effect of Feedback, Training and Executive Coaching on Leadership Behavior Change

    ERIC Educational Resources Information Center

    Saling, Nona

    2005-01-01

    Despite the phenomenal growth of executive coaching in recent years, there has been little empirical research on its effectiveness. Executive coaching is typically delivered with 360 degree feedback and training. This study tests whether there are significant differences in leadership behavior change for participants who: received feedback alone;…

  17. An Empirical Study of the Relative Error Magnitude in Three Measures of Change.

    ERIC Educational Resources Information Center

    Williams, Richard H.; And Others

    1984-01-01

    This paper describes the procedures and results of two studies designed to yield empirical comparisons of the error magnitude in three change measures: the simple gain score, the residualized difference score, and the base free measure (Tucker et al). Residualized scores possessed smaller standard errors of measurement. (Author/BS)

  18. Changes in Anatomy Instruction and USMLE Performance: Empirical Evidence on the Absence of a Relationship

    ERIC Educational Resources Information Center

    Cuddy, Monica M.; Swanson, David B.; Drake, Richard L.; Pawlina, Wojciech

    2013-01-01

    Anatomy instruction has evolved over the past two decades as many medical schools have undergone various types of curricular reform. To provide empirical evidence about whether or not curricular changes impact the acquisition and retention of anatomy knowledge, this study investigated the effect of variation in gross anatomy course hours,…

  19. A simple empirical model for the clarification-thickening process in wastewater treatment plants.

    PubMed

    Zhang, Y K; Wang, H C; Qi, L; Liu, G H; He, Z J; Fan, H T

    2015-01-01

    In wastewater treatment plants (WWTPs), activated sludge is thickened in secondary settling tanks and recycled into the biological reactor to maintain enough biomass for wastewater treatment. Accurately estimating the activated sludge concentration in the lower portion of the secondary clarifiers is of great importance for evaluating and controlling the sludge recycled ratio, ensuring smooth and efficient operation of the WWTP. By dividing the overall activated sludge-thickening curve into a hindered zone and a compression zone, an empirical model describing activated sludge thickening in the compression zone was obtained by empirical regression. This empirical model was developed through experiments conducted using sludge from five WWTPs, and validated by the measured data from a sixth WWTP, which fit the model well (R² = 0.98, p < 0.001). The model requires application of only one parameter, the sludge volume index (SVI), which is readily incorporated into routine analysis. By combining this model with the conservation of mass equation, an empirical model for compression settling was also developed. Finally, the effects of denitrification and addition of a polymer were also analysed because of their effect on sludge thickening, which can be useful for WWTP operation, e.g., improving wastewater treatment or the proper use of the polymer. PMID:25714635

  20. Training and Consultation to Promote Implementation of an Empirically Supported Treatment: A Randomized Trial

    PubMed Central

    Beidas, Rinad S.; Edmunds, Julie M.; Marcus, Steven C.; Kendall, Philip C.

    2012-01-01

    Objective The study evaluated the efficacy of three training modalities and the impact of ongoing consultation after training. Cognitive-behavioral therapy (CBT) for anxiety among youths, an empirically supported treatment, was used as the exemplar. Participants were randomly assigned to one of three one-day workshops to examine the efficacy of training modality: routine training (training as usual), computer training (computerized version of training as usual), and augmented training (training that emphasized active learning). After training, all participants received three months of ongoing consultation that included case consultation, didactics, and problem solving. Methods Participants were 115 community therapists (mean age of 35.9 years; 90% were women). Outcome measures included the Adherence and Skill Checklist, used to rate a performance-based role-play; a knowledge test; and the Training Satisfaction Rating Scale. Results All three training modalities resulted in limited gains in therapist adherence, skill, and knowledge. There was no significant effect of modality on adherence, skill, or knowledge from pretraining to posttraining. Participants were more satisfied with augmented and routine training than with computer training. Most important, number of consultation hours after training significantly predicted higher therapist adherence and skill at the three-month follow-up. Conclusions The findings suggest that training alone did not result in therapist behavior change. The inclusion of ongoing consultation was critical to influencing therapist adherence and skill. Implications for implementation science and mental health services research are discussed. PMID:22549401

  1. Moving Clinical Deliberations on Administrative Discharge in Drug Addiction Treatment Beyond Moral Rhetoric to Empirical Ethics.

    PubMed

    Williams, Izaak L

    2016-01-01

    Patients' admission to modern substance use disorder treatment comes with the attendant risk of being discharged from treatment-a widespread practice. This article describes the three mainstream theories of addiction that operate as a reference point for clinicians in reasoning about a decision to discharge a patient from treatment. The extant literature is reviewed to highlight the pathways that patients follow after administrative discharge. Little scientific research has been done to investigate claims and hypotheses about the therapeutic function of AD, which points to the need for empirical ethics to inform clinical addictions practice. PMID:27045311

  2. Perspectives on empirical approaches for ocean color remote sensing of chlorophyll in a changing climate

    PubMed Central

    Dierssen, Heidi M.

    2010-01-01

    Phytoplankton biomass and productivity have been continuously monitored from ocean color satellites for over a decade. Yet, the most widely used empirical approach for estimating chlorophyll a (Chl) from satellites can be in error by a factor of 5 or more. Such variability is due to differences in absorption and backscattering properties of phytoplankton and related concentrations of colored-dissolved organic matter (CDOM) and minerals. The empirical algorithms have built-in assumptions that follow the basic precept of biological oceanography—namely, oligotrophic regions with low phytoplankton biomass are populated with small phytoplankton, whereas more productive regions contain larger bloom-forming phytoplankton. With a changing world ocean, phytoplankton composition may shift in response to altered environmental forcing, and CDOM and mineral concentrations may become uncoupled from phytoplankton stocks, creating further uncertainty and error in the empirical approaches. Hence, caution is warranted when using empirically derived Chl to infer climate-related changes in ocean biology. The Southern Ocean is already experiencing climatic shifts and shows substantial errors in satellite-derived Chl for different phytoplankton assemblages. Accurate global assessments of phytoplankton will require improved technology and modeling, enhanced field observations, and ongoing validation of our “eyes in space.” PMID:20861445

  3. Tailored Therapy Versus Empiric Chosen Treatment for Helicobacter pylori Eradication: A Meta-Analysis.

    PubMed

    Chen, Han; Dang, Yini; Zhou, Xiaoying; Liu, Bingtuan; Liu, Shiyu; Zhang, Guoxin

    2016-02-01

    Although various regimens are empirically accepted for Helicobacter pylori eradication, the efficacy might be declined by multiple individual factors. The necessity of a personalized eradication therapy still remains controversial. The aim of the study was to compare tailored therapy with empiric chosen regimens. Databases of PUBMED, EMBASE, and MEDLINE were searched for eligible studies, published up to October 2015. All relevant controlled clinical trials were included. A random-effect model was applied to compare pooled relative risk (RR) with related 95% confidence intervals (CIs).Thirteen controlled clinical trials integrating 3512 participants were assessed. Overall, the pooled eradication rates of tailored groups were higher than those of empiric ones (intention-to-treat: RR = 1.16, 95% CI 1.10-1.22; preprotocol: RR = 1.14, 95% CI 1.08-1.21). In subgroup analysis, tailored therapy was superior to 7-day standard triple therapy (RR = 1.22, 95% CI 1.16-1.29) and bismuth-quadruple therapy (RR = 1.14, 95% CI 1.07-1.22) on eradication rates; first-line tailored therapy achieved higher eradication rates than first-line empirical regimens (pooled RR = 1.18, 95%CI 1.14-1.22), whereas tailored rescue regimen showed no difference with empirical ones (pooled RR = 1.16, 95% CI 0.96-1.39). Moreover, among different tailored designs, susceptibility-guided tailored therapy obtained higher eradication rates than empiric groups, independent of CYP2C19 genotype detection (with CYP: RR = 1.16, 95% CI 1.09-1.23; without CYP: RR = 1.14, 95% CI 1.01-1.28). Both molecular test-based and culture-based tailored groups were better on eradication rates than empiric groups (molecular: RR = 1.23, 95% CI 1.11-1.35; culture: RR = 1.13, 95% CI 1.06-1.20). Compared with empiric chosen treatments, tailored therapy is a better alternative for H pylori eradication. PMID:26886617

  4. Different recommendations for empiric first-choice antibiotic treatment of uncomplicated urinary tract infections in Europe

    PubMed Central

    2013-01-01

    Abstract Objective Uncomplicated urinary tract infection (uUTI) is a common reason for antibiotic treatment in primary health care. Due to the increasing prevalence of antibiotic-resistant uropathogens it is crucial to use the most appropriate antibiotics for first-choice empiric treatment of uUTI. Particularly, it is important to avoid antibiotics associated with a high rate of antimicrobial resistance. This study compares national recommendations from six European countries, investigating recommendations for first-choice antibiotic therapy of uUTI. Setting General practice in six European countries. Method Searches were undertaken on PubMed, the Cochrane Library databases, Google, and Google Scholar. Recommendations from different geographical regions in Europe were investigated: Northern Europe (Denmark, Sweden), Western Europe (Scotland), Central Europe (Germany), Southern Europe (Spain), and Eastern Europe (Croatia). Results The six countries recommended seven different antibiotics. Five countries recommended more than one antibiotic as first-choice treatment. Half of the countries recommended antibiotics associated with a high rate (> 10–20%) of resistant E. coli. All countries recommended at least one antibiotic associated with a low (< 5%) resistance rate. Discussion The differences in first-choice treatment of uUTI could not be explained by differences in local bacterial aetiology or by different patterns of antimicrobial resistance. Despite resistance rates exceeding 10–20%, sulphamethizole, trimethoprim. or fluoroquinolones were recommended in half of the countries. Conclusion Within the European countries there are considerable differences in recommendations for empiric first-choice antibiotic treatment of uUTI. In order to reduce the increasing antimicrobial resistance in Europe, it is important to agree on the most appropriate antibiotics for empiric treatment of uUTI. PMID:24102498

  5. Motivation Change in Therapeutic Community Residential Treatment

    ERIC Educational Resources Information Center

    Morgen, Keith; Kressel, David

    2010-01-01

    Latent growth curve analysis was used to assess motivation change across 3 time points for 120 therapeutic community residents. Models included the time-invariant predictor of readiness for treatment, which significantly predicted initial treatment motivation but not the rate of motivation change over time. (Contains 1 figure and 2 tables.)

  6. EMPIRICAL TECHNIQUES FOR ANALYZING AIR QUALITY AND METEOROLOGICAL DATA. PART III. SHORT-TERM CHANGES IN GROUND-LEVEL OZONE CONCENTRATIONS: AN EMPIRICAL ANALYSIS

    EPA Science Inventory

    An empirical analysis of ambient air quality data for the Los Angeles Basin is used to relate the one- and two-hour changes in oxidant levels in the urban environment to the preceding levels of precursor pollutants and to meteorological variables. The intent was to demonstrate th...

  7. Comprehensive versus matched psychosocial treatment in the MTA study: conceptual and empirical issues.

    PubMed

    Wells, K C

    2001-03-01

    Addressed some factual inaccuracies and presented alternative positions on key issues raised in the article by Greene and Ablon (this issue) on the question, "What does the Multimodal Treatment Study (MTA) tell us about effective psychosocial treatment for attention deficit hyperactivity disorder (ADHD)?" The Greene and Ablon critique does not present for the reader's consideration the full range of findings from the MTA study, notably those most relevant to psychosocial treatment, and articulates a theoretical position that effective treatment requires matching treatment to children's assessed needs, an approach not taken in the MTA study. In this article, I present the full range of findings from the MTA study related to psychosocial treatment effects, correct the misperceptions that exist about the study based on limited reviews such as Greene and Ablon's, and review the empirical and experimental design issues that produced the decision by the MTA investigative team to study the effects of intensive, comprehensive psychosocial treatment. I argue that the questions asked by the MTA study about psychosocial treatment were important, relevant, and were addressed well in the MTA study design. PMID:11294072

  8. Estimating the Importance of Private Adaptation to Climate Change in Agriculture: A Review of Empirical Methods

    NASA Astrophysics Data System (ADS)

    Moore, F.; Burke, M.

    2015-12-01

    A wide range of studies using a variety of methods strongly suggest that climate change will have a negative impact on agricultural production in many areas. Farmers though should be able to learn about a changing climate and to adjust what they grow and how they grow it in order to reduce these negative impacts. However, it remains unclear how effective these private (autonomous) adaptations will be, or how quickly they will be adopted. Constraining the uncertainty on this adaptation is important for understanding the impacts of climate change on agriculture. Here we review a number of empirical methods that have been proposed for understanding the rate and effectiveness of private adaptation to climate change. We compare these methods using data on agricultural yields in the United States and western Europe.

  9. National Trainers’ Perspectives on Challenges to Implementation of an Empirically-Supported Mental Health Treatment

    PubMed Central

    Hanson, Rochelle F.; Gros, Kirstin Stauffacher; Davidson, Tatiana M.; Barr, Simone; Cohen, Judith; Deblinger, Esther; Mannarino, Anthony P.; Ruggiero, Kenneth J.

    2013-01-01

    This study examined perceived challenges to implementation of an empirically supported mental health treatment for youth (Trauma-Focused Cognitive Behavioral Therapy; TF-CBT) and explored the potential use of technology-based resources in treatment delivery. Thematic interviews were conducted with 19 approved national TF-CBT trainers to assess their perspectives about challenges to implementation of TF-CBT and to explore their perceptions about the potential value of innovative, technology-based solutions to enhance provider fidelity and improve quality of care. These data offer some important insights and implications for training in evidence-based treatments, provider fidelity and competence, and patient engagement, particularly for those interventions targeting trauma-related symptoms among youth. PMID:23605292

  10. A content analysis of advertisements for psychotherapy workshops: implications for disseminating empirically supported treatments.

    PubMed

    Cook, Joan M; Weingardt, Kenneth R; Jaszka, Jacqueline; Wiesner, Michael

    2008-03-01

    This study involved a content analysis of 261 unique advertisements for psychotherapy workshops that appeared in two bimonthly clinical magazines, Psychotherapy Networker and Counselor, during a 2-year period. Two independent judges coded each advertisement and documented the type and prevalence of advertising appeals used. From the seminal diffusion of innovations model, Rogers' (2003) five perceived characteristics of innovations found to influence adoption in diverse fields were not well represented in these workshops appeals, appearing less than 10% each. Few advertisements cited specific empirically supported treatments or presented any evidence of treatment effectiveness beyond expert testimonials. The most frequently noted appeals were to benefit the clinician (e.g., earning education credit or developing skills), characteristics that enhance credibility of the workshop (e.g., reference to storied history or mention of faculty), and features of the advertisements itself (e.g., use of superlatives and exclamation points). Promotional strategies to advertise psychotherapy workshops can be used to inform the dissemination of empirically supported treatments. PMID:18271002

  11. Impact of climate change on human infectious diseases: Empirical evidence and human adaptation.

    PubMed

    Wu, Xiaoxu; Lu, Yongmei; Zhou, Sen; Chen, Lifan; Xu, Bing

    2016-01-01

    Climate change refers to long-term shifts in weather conditions and patterns of extreme weather events. It may lead to changes in health threat to human beings, multiplying existing health problems. This review examines the scientific evidences on the impact of climate change on human infectious diseases. It identifies research progress and gaps on how human society may respond to, adapt to, and prepare for the related changes. Based on a survey of related publications between 1990 and 2015, the terms used for literature selection reflect three aspects--the components of infectious diseases, climate variables, and selected infectious diseases. Humans' vulnerability to the potential health impacts by climate change is evident in literature. As an active agent, human beings may control the related health effects that may be effectively controlled through adopting proactive measures, including better understanding of the climate change patterns and of the compound disease-specific health effects, and effective allocation of technologies and resources to promote healthy lifestyles and public awareness. The following adaptation measures are recommended: 1) to go beyond empirical observations of the association between climate change and infectious diseases and develop more scientific explanations, 2) to improve the prediction of spatial-temporal process of climate change and the associated shifts in infectious diseases at various spatial and temporal scales, and 3) to establish locally effective early warning systems for the health effects of predicated climate change. PMID:26479830

  12. Colour in insect thermoregulation: empirical and theoretical tests in the colour-changing grasshopper, Kosciuscola tristis.

    PubMed

    Umbers, K D L; Herberstein, M E; Madin, J S

    2013-01-01

    Body colours can result in different internal body temperatures, but evidence for the biological significance of colour-induced temperature differences is inconsistent. We investigated the relationship between body colour and temperature in a model insect species that rapidly changes colour. We used an empirical approach and constructed a heat budget model to quantify whether a colour change from black to turquoise has a role in thermoregulation for the chameleon grasshopper (Kosciuscola tristis). Our study shows that colour change in K. tristis provides relatively small temperature differences that vary greatly with wind speed (0.55 °C at ms(-1) to 0.05 °C at 10 ms(-1)). The biological significance of this difference is unclear and we discuss the requirement for more studies that directly test hypotheses regarding the fitness effects of colour in manipulating body temperature. PMID:23108152

  13. Rape treatment outcome research: empirical findings and state of the literature.

    PubMed

    Vickerman, Katrina A; Margolin, Gayla

    2009-07-01

    This article reviews empirical support for treatments targeting women sexually assaulted during adolescence or adulthood. Thirty-two articles were located using data from 20 separate samples. Of the 20 samples, 12 targeted victims with chronic symptoms, three focused on the acute period post-assault, two included women with chronic and acute symptoms, and three were secondary prevention programs. The majority of studies focus on posttraumatic stress disorder (PTSD), depression, and/or anxiety as treatment targets. Cognitive Processing Therapy and Prolonged Exposure have garnered the most support with this population. Stress Inoculation Training and Eye Movement Desensitization and Reprocessing also show some efficacy. Of the four studies that compared active treatments, few differences were found. Overall, cognitive behavioral interventions lead to better PTSD outcomes than supportive counseling does. However, even in the strongest treatments more than one-third of women retain a PTSD diagnosis at post-treatment or drop out of treatment. Discussion highlights the paucity of research in this area, methodological limitations of examined studies, generalizability of findings, and important directions for future research at various stages of trauma recovery. PMID:19442425

  14. Rape Treatment Outcome Research: Empirical Findings and State of the Literature

    PubMed Central

    Vickerman, Katrina A.; Margolin, Gayla

    2009-01-01

    This article reviews empirical support for treatments targeting women sexually assaulted during adolescence or adulthood. Thirty-two articles were located using data from 20 separate samples. Of the 20 samples, 12 targeted victims with chronic symptoms, three focused on the acute period post-assault, two included women with chronic and acute symptoms, and three were secondary prevention programs. The majority of studies focus on posttraumatic stress disorder (PTSD), depression, and/or anxiety as treatment targets. Cognitive Processing Therapy and Prolonged Exposure have garnered the most support with this population. Stress Inoculation Training and Eye Movement Desensitization and Reprocessing also show some efficacy. Of the four studies that compared active treatments, few differences were found. Overall, cognitive behavioral interventions lead to better PTSD outcomes than supportive counseling does. However, even in the strongest treatments more than one-third of women retain a PTSD diagnosis at post-treatment or drop out of treatment. Discussion highlights the paucity of research in this area, methodological limitations of examined studies, generalizability of findings, and important directions for future research at various stages of trauma recovery. PMID:19442425

  15. An Empirical Approach to Predicting Effects of Climate Change on Stream Water Chemistry

    NASA Astrophysics Data System (ADS)

    Olson, J. R.; Hawkins, C. P.

    2014-12-01

    Climate change may affect stream solute concentrations by three mechanisms: dilution associated with increased precipitation, evaporative concentration associated with increased temperature, and changes in solute inputs associated with changes in climate-driven weathering. We developed empirical models predicting base-flow water chemistry from watershed geology, soils, and climate for 1975 individual stream sites across the conterminous USA. We then predicted future solute concentrations (2065 and 2099) by applying down-scaled global climate model predictions to these models. The electrical conductivity model (EC, model R2 = 0.78) predicted mean increases in EC of 19 μS/cm by 2065 and 40 μS/cm by 2099. However predicted responses for individual streams ranged from a 43% decrease to a 4x increase. Streams with the greatest predicted decreases occurred in the southern Rocky Mountains and Mid-West, whereas southern California and Sierra Nevada streams showed the greatest increases. Generally, streams in dry areas underlain by non-calcareous rocks were predicted to be the most vulnerable to increases in EC associated with climate change. Predicted changes in other water chemistry parameters (e.g., Acid Neutralization Capacity (ANC), SO4, and Ca) were similar to EC, although the magnitude of ANC and SO4 change was greater. Predicted changes in ANC and SO4 are in general agreement with those changes already observed in seven locations with long term records.

  16. WHITE CLOVER MORPHOLOGY CHANGES WITH STRESS TREATMENTS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The plasticity of white clover (Trifolium repens L.) results in morphological changes in plant habit in response to different environmental stresses. This research characterized morphological changes in white clover clones derived either from two cultivars and a germplasm exposed to treatments in 2-...

  17. Clinical Feedback About Empirically Supported Treatments for Obsessive-Compulsive Disorder.

    PubMed

    Jacobson, Nicholas C; Newman, Michelle G; Goldfried, Marvin R

    2016-01-01

    Previous evidence for the treatment of obsessive-compulsive disorder (OCD) has been derived principally from randomized controlled trials. As such, evidence about the treatment of OCD has unilaterally flowed from researchers to clinicians. Despite often having decades of experience treating OCD, clinicians' feedback on their clinical observations in using these treatments has not been solicited. The current study contacted clinicians for their clinical observations on empirically supported treatments for OCD to identify commonly used cognitive-behavioral techniques and their limitations in their practices. One hundred eighty-one psychotherapists completed an online survey. The average participant practiced psychotherapy for 15 years, worked in private practice, held a doctorate, and treated an average of 25 clients with OCD in their lifetime. In regard to the most common techniques, behavioral strategies involving exposure to a feared outcome and prevention of a compulsive ritual were the most frequent group of interventions, followed by techniques that attempted to identify and challenge irrational thoughts. However, the majority of participants also reported incorporating mindfulness or acceptance-based methods. Based on therapists' reports, the most common barriers to the efficacy of cognitive-behavioral interventions included limited premorbid functioning, chaotic lifestyles, controlling and critical families, OCD symptom severity, OCD symptom chronicity, and comorbidities. This study provides insight into common practices and limitations in clinical practice to inform future clinically relevant treatment research. PMID:26763499

  18. Climate change and the collapse of the Akkadian empire: Evidence from the deep sea

    NASA Astrophysics Data System (ADS)

    Cullen, H. M.; Demenocal, P. B.; Hemming, S.; Hemming, G.; Brown, F. H.; Guilderson, T.; Sirocko, F.

    2000-04-01

    The Akkadian empire ruled Mesopotamia from the headwaters of the Tigris-Euphrates Rivers to the Persian Gulf during the late third millennium B.C. Archeological evidence has shown that this highly developed civilization collapsed abruptly near 4170 ± 150 calendar yr B.P., perhaps related to a shift to more arid conditions. Detailed paleoclimate records to test this assertion from Mesopotamia are rare, but changes in regional aridity are preserved in adjacent ocean basins. We document Holocene changes in regional aridity using mineralogic and geochemical analyses of a marine sediment core from the Gulf of Oman, which is directly downwind of Mesopotamian dust source areas and archeological sites. Our results document a very abrupt increase in eolian dust and Mesopotamian aridity, accelerator mass spectrometer radiocarbon dated to 4025 ± 125 calendar yr B.P., which persisted for ˜300 yr. Radiogenic (Nd and Sr) isotope analyses confirm that the observed increase in mineral dust was derived from Mesopotamian source areas. Geochemical correlation of volcanic ash shards between the archeological site and marine sediment record establishes a direct temporal link between Mesopotamian aridification and social collapse, implicating a sudden shift to more arid conditions as a key factor contributing to the collapse of the Akkadian empire.

  19. Climate change and the collapse of the Akkadian empire: Evidence from the deep sea

    SciTech Connect

    Cullen, H.M.; Menocal, P.B. de; Hemming, S.; Hemming, G.; Brown, F.H.; Guilderson, T.; Sirocko, F.

    2000-04-01

    The Akkadian empire ruled Mesopotamia from the headwaters of the Tigris-Euphrates Rivers to the Persian Gulf during the late third millennium B.C. Archeological evidence has shown that this highly developed civilization collapsed abruptly near 4,170 {+-} 150 calendar yr B.P., perhaps related to a shift to more arid conditions. Detailed paleoclimate records to test this assertion from Mesopotamia are rare, but changes in regional aridity are preserved in adjacent ocean basins. The authors document Holocene changes in regional aridity using mineralogic and geochemical analyses of a marine sediment core from the Gulf of Oman, which is directly downwind of Mesopotamian dust source areas and archeological sites. Results document a very abrupt increase in eolian dust and Mesopotamian aridity, accelerator mass spectrometer radiocarbon dates to 4,025 {+-} 125 calendar yr B.P., which persisted for {approximately} 300 yr. Radiogenic (Nd and Sr) isotope analyses confirm that the observed increase in mineral dust was derived from Mesopotamian source areas. Geochemical correlation of volcanic ash shards between the archeological site and marine sediment record establishes a direct temporal link between Mesopotamian aridification and social collapse, implicating a sudden shift to more arid conditions as a key factor contributing to the collapse of the Akkadian empire.

  20. Body Composition Changes Associated With Methadone Treatment

    PubMed Central

    Sadek, Gamal E.; Chiu, Simon; Cernovsky, Zack Z.

    2016-01-01

    Background: Methadone is associated with a statistically significant increase in BMI in the first 2 years of treatment. Objectives: To evaluate the changes of body composition (bone mass, % fat, % muscle mass, % water, and basal metabolic rate) related to this increase. Patients and Methods: Changes in body composition were monitored, via bioelectrical impedance, in 29 patients in methadone treatment for opiate dependency (age 18 to 44, mean = 29.3, SD = 7.0, 13 men, 16 women). Results: Within one year from admission to treatment, a statistically significant (t-tests, P < 0.05) increase was noted in their body mass index (BMI), % of body fat, average body mass, and average basal metabolic rate, and relative decrease in their % of muscle mass and % of bone mass. Neither absolute bone mass nor muscle mass changed significantly. Conclusions: Physicians involved in care of methadone patients should recommend dietary and lifestyle changes to improve their overall health. PMID:27162765

  1. Empirical likelihood based detection procedure for change point in mean residual life functions under random censorship.

    PubMed

    Chen, Ying-Ju; Ning, Wei; Gupta, Arjun K

    2016-05-01

    The mean residual life (MRL) function is one of the basic parameters of interest in survival analysis that describes the expected remaining time of an individual after a certain age. The study of changes in the MRL function is practical and interesting because it may help us to identify some factors such as age and gender that may influence the remaining lifetimes of patients after receiving a certain surgery. In this paper, we propose a detection procedure based on the empirical likelihood for the changes in MRL functions with right censored data. Two real examples are also given: Veterans' administration lung cancer study and Stanford heart transplant to illustrate the detecting procedure. Copyright © 2016 John Wiley & Sons, Ltd. PMID:26936529

  2. Moxifloxacin Pharmacokinetic Profile and Efficacy Evaluation in Empiric Treatment of Community-Acquired Pneumonia

    PubMed Central

    Hardlei, Tore Forsingdal; Brock, Birgitte; Jensen-Fangel, Søren; Kragh Thomsen, Marianne; Petersen, Eskild; Kreilgaard, Mads

    2015-01-01

    When antimicrobials are used empirically, pathogen MICs equal to clinical breakpoints or epidemiological cutoff values must be considered. This is to ensure that the most resistant pathogen subpopulation is appropriately targeted to prevent emergence of resistance. Accordingly, we determined the pharmacokinetic (PK) profile of moxifloxacin at 400 mg/day in 18 patients treated empirically for community-acquired pneumonia. We developed a population pharmacokinetic model to assess the potential efficacy of moxifloxacin and to simulate the maximal MICs for which recommended pharmacokinetic-pharmacodynamic (PK-PD) estimates are obtained. Moxifloxacin plasma concentrations were determined the day after therapy initiation using ultra-high-performance liquid chromatography. Peak drug concentrations (Cmax) and area under the free drug concentration-time curve from 0 to 24 h (fAUC0–24) values predicted for each patient were evaluated against epidemiological cutoff MIC values for Streptococcus pneumoniae, Haemophilus influenzae, and Legionella pneumophila. PK-PD targets adopted were a Cmax/MIC of ≥12.2 for all pathogens, an fAUC0–24/MIC of >34 for S. pneumoniae, and an fAUC0–24/MIC of >75 for H. influenzae and L. pneumophila. Individual predicted estimates for Cmax/MIC and fAUC0–24/MIC as well as simulated maximal MICs resulting in target attainment for oral and intravenous administration of the drug were suitable for S. pneumoniae and H. influenzae but not for L. pneumophila. These results indicate that caution must be taken when moxifloxacin is used as monotherapy to treat community-acquired pneumonia caused by L. pneumophila. In conclusion, this report reveals key information relevant to the empirical treatment of community-acquired pneumonia while highlighting the robust and flexible nature of this population pharmacokinetic model to predict therapeutic success. (Clinical Trials Registration no. NCT01983839.) PMID:25666151

  3. An Analysis of Functional Communication Training as an Empirically Supported Treatment for Problem Behavior Displayed by Individuals with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Kurtz, Patricia F.; Boelter, Eric W.; Jarmolowicz, David P.; Chin, Michelle D.; Hagopian, Louis P.

    2011-01-01

    This paper examines the literature on the use of functional communication training (FCT) as a treatment for problem behavior displayed by individuals with intellectual disabilities (ID). Criteria for empirically supported treatments developed by Divisions 12 and 16 of the American Psychological Association (Kratochwill & Stoiber, 2002; Task Force,…

  4. Good outcome with early empiric treatment of neural larva migrans due to Baylisascaris procyonis.

    PubMed

    Peters, Jurriaan M; Madhavan, Vandana L; Kazacos, Kevin R; Husson, Robert N; Dangoudoubiyam, Sriveny; Soul, Janet S

    2012-03-01

    We report a remarkably good outcome in a 14-month-old boy with early clinical diagnosis and aggressive empirical treatment of neural larva migrans caused by the raccoon roundworm Baylisascaris procyonis. He presented with fever, meningismus, lethargy, irritability and asymmetric spastic extremity weakness. Early findings of marked blood and cerebrospinal fluid eosinophilia and of diffuse white matter signal abnormality in the brain and spinal cord on MRI suggested a parasitic encephalomyelitis. Rapid presumptive treatment with albendazole and high-dose steroids halted progression of clinical signs. The diagnosis was confirmed by 2 sequential enzyme-linked immunosorbent assay studies positive for B procyonis serum immunoglobulin G and by Western blot. Field examination with soil sampling yielded infective Baylisascaris eggs. Repeat MRI 3 months later showed atrophy and diffuse, chronic white matter abnormalities, discordant with the marked clinical improvement in this interval. At 10 months, residual neurologic deficits included subtle paraparesis and moderate language delay. This case is the first in which spinal involvement in human Baylisascaris infection was clinically suspected and confirmed by neuroimaging. Importantly, early diagnosis and aggressive treatment of Baylisascaris meningo-encephalitis and myelitis with albendazole and high-dose steroids likely contributed to the good outcome in this patient, in contrast with previous reports. PMID:22311989

  5. Treatments for Autism: Parental Choices and Perceptions of Change

    ERIC Educational Resources Information Center

    Bowker, Anne; D'Angelo, Nadia M.; Hicks, Robin; Wells, Kerry

    2011-01-01

    Empirically conducted studies of the efficacy of various treatments for autism are limited, which leaves parents with little evidence on which to base their treatment decisions (Kasari, "Journal of Autism and Developmental Disorders," 32: 447-461, 2002). The purpose of this study was to examine the types of treatments in current use by families of…

  6. "Empires Overseas" and "Empires at Home": Postcolonial and Transnational Perspectives on Social Change in the History of Education

    ERIC Educational Resources Information Center

    Goodman, Joyce; McCulloch, Gary; Richardson, William

    2009-01-01

    This article presents a collection of work that grew out of an international symposium sponsored by the History of Education Society UK and held in Hamburg in 2007. The symposium aimed to contribute to understandings of different approaches to researching the extent to which education has contributed historically to social change in respect of…

  7. Empirically supported treatments for panic disorder with agoraphobia in a Spanish psychology clinic.

    PubMed

    Ballesteros, Francisco; Labrador, Francisco J

    2014-01-01

    The aim of this work is to study the sociodemographic and clinical characteristics of patients diagnosed with Panic Disorder with Agoraphobia (PD/Ag), as well as the characteristics of the treatment and its results and cost in a University Psychology Clinic. Fifty patients demanded psychological assistance for PD/Ag; 80% were women, with an average age of 29.22 years (SD = 9.03). Mean number of evaluation sessions was 3.26 (SD = 1.03), and of treatment sessions, 13.39 (SD = 9.237). Of the patients, 83.33% were discharged (that is, questionnaire scores were below the cut-off point indicated by the authors, and no PD/Ag was observed at readministration of the semistructured interview), 5.5% refused treatment, and 11% were dropouts. The average number of treatment sessions of patients who achieved therapeutic success was 15.13 (SD = 8.98). Effect sizes (d) greater than 1 were obtained in all the scales. Changes in all scales were significant (p < .05). The estimated cost of treatment for patients who achieved therapeutic success was 945.12€. The treatment results are at least similar to those of studies of efficacy and effectiveness for PD/Ag. The utility of generalizing treatments developed in research settings to a welfare clinic is discussed. PMID:26054491

  8. A Model of Therapist Competencies for the Empirically Supported Cognitive Behavioral Treatment of Child and Adolescent Anxiety and Depressive Disorders

    ERIC Educational Resources Information Center

    Sburlati, Elizabeth S.; Schniering, Carolyn A.; Lyneham, Heidi J.; Rapee, Ronald M.

    2011-01-01

    While a plethora of cognitive behavioral empirically supported treatments (ESTs) are available for treating child and adolescent anxiety and depressive disorders, research has shown that these are not as effective when implemented in routine practice settings. Research is now indicating that is partly due to ineffective EST training methods,…

  9. Use of Evidence-Based Practice Resources and Empirically Supported Treatments for Posttraumatic Stress Disorder among University Counseling Center Psychologists

    ERIC Educational Resources Information Center

    Juel, Morgen Joray

    2012-01-01

    In the present study, an attempt was made to determine the degree to which psychologists at college and university counseling centers (UCCs) utilized empirically supported treatments with their posttraumatic stress disorder (PTSD) clients. In addition, an attempt was made to determine how frequently UCC psychologists utilized a number of…

  10. Consensus between GCM climate change projections with empirical downscaling: precipitation downscaling over South Africa

    NASA Astrophysics Data System (ADS)

    Hewitson, B. C.; Crane, R. G.

    2006-08-01

    This paper discusses issues that surround the development of empirical downscaling techniques as context for presenting a new approach based on self-organizing maps (SOMs). The technique is applied to the downscaling of daily precipitation over South Africa. SOMs are used to characterize the state of the atmosphere on a localized domain surrounding each target location on the basis of NCEP 6-hourly reanalysis data from 1979 to 2002, and using surface and 700-hPa u and v wind vectors, specific and relative humidities, and surface temperature. Each unique atmospheric state is associated with an observed precipitation probability density function (PDF). Future climate states are derived from three global climate models (GCMs): HadAM3, ECHAM4.5, CSIRO Mk2. In each case, the GCM data are mapped to the NCEP SOMs for each target location and a precipitation value is drawn at random from the associated precipitation PDF. The downscaling approach combines the advantages of a direct transfer function and a stochastic weather generator, and provides an indication of the strength of the regional versus stochastic forcing, as well as a measure of stationarity in the atmosphere-precipitation relationship.The methodology is applied to South Africa. The downscaling reveals a similarity in the projected climate change between the models. Each GCM projects similar changes in atmospheric state and they converge on a downscaled solution that points to increased summer rainfall in the interior and the eastern part of the country, and a decrease in winter rainfall in the Western Cape. The actual GCM precipitation projections from the three models show large areas of intermodel disagreement, suggesting that the model differences may be due to their precipitation parameterization schemes, rather than to basic disagreements in their projections of the changing atmospheric state over South Africa.

  11. Empirically Supported Family-Based Treatments for Conduct Disorder and Delinquency in Adolescents

    PubMed Central

    Henggeler, Scott W.; Sheidow, Ashli J.

    2011-01-01

    Several family-based treatments of conduct disorder and delinquency in adolescents have emerged as evidence-based and, in recent years, have been transported to more than 800 community practice settings. These models include multisystemic therapy, functional family therapy, multidimensional treatment foster care, and, to a lesser extent, brief strategic family therapy. In addition to summarizing the theoretical and clinical bases of these treatments, their results in efficacy and effectiveness trials are examined with particular emphasis on any demonstrated capacity to achieve favorable outcomes when implemented by real world practitioners in community practice settings. Special attention is also devoted to research on purported mechanisms of change as well as the long-term sustainability of outcomes achieved by these treatment models. Importantly, we note that the developers of each of the models have developed quality assurance systems to support treatment fidelity and youth and family outcomes; and the developers have formed purveyor organizations to facilitate the large scale transport of their respective treatments to community settings nationally and internationally. PMID:22283380

  12. Organizational Readiness for Change and Opinions toward Treatment Innovations

    PubMed Central

    Fuller, Bret E.; Rieckmann, Traci; Nunes, Edward V.; Miller, Michael; Arfken, Cynthia; Edmundson, Eldon; McCarty, Dennis

    2007-01-01

    Program administrators and staff in treatment programs participating in the National Drug Abuse Treatment Clinical Trials Network (CTN) completed surveys to characterize participating programs and practitioners. A two-level random effects regression model assessed the influence of Organizational Readiness for Change (ORC) and organizational attributes on opinions toward the use of four evidence-based practices (manualized treatments, medication, integrated mental health services, and motivational incentives) and practices with less empirical support (confrontation and noncompliance discharge). The ORC Scales suggested greater support for evidence-based practices in programs where staff perceived more program need for improvement, better Internet access, higher levels of peer influence, more opportunities for professional growth, a stronger sense of organizational mission and more organizational stress. Support for confrontation and noncompliance discharge, in contrast, was strong when staff saw less opportunity for professional growth, weaker peer influence, less Internet access, and perceived less organizational stress. The analysis provides evidence of the ORC’s utility in assessing agency strengths and needs during the implementation of evidence-based practices. PMID:17434708

  13. Colonialism, Education and Social Change in the British Empire: The Cases of Australia, Papua New Guinea and Ireland

    ERIC Educational Resources Information Center

    O'Donoghue, Tom

    2009-01-01

    This paper focuses on the history of relations between colonialism, schooling and social change in Australia, Papua New Guinea and Ireland, countries that were once part of the British Empire. It indicates that responses to schooling ranged from acceptance and tolerance, to modification and rejection, depending on the country, the issue, and the…

  14. Changing Healthcare Providers’ Behavior during Pediatric Inductions with an Empirically-based Intervention

    PubMed Central

    Martin, Sarah R.; Chorney, Jill MacLaren; Tan, Edwin T.; Fortier, Michelle A.; Blount, Ronald L.; Wald, Samuel H.; Shapiro, Nina L.; Strom, Suzanne L.; Patel, Swati; Kain, Zeev N.

    2011-01-01

    Background Each year over 4 million children experience significant levels of preoperative anxiety, which has been linked to poor recovery outcomes. Healthcare providers (HCP) and parents represent key resources for children to help them manage their preoperative anxiety. The present study reports on the development and preliminary feasibility testing of a new intervention designed to change HCP and parent perioperative behaviors that have been previously reported to be associated with children’s coping and stress behaviors before surgery. Methods An empirically-derived intervention, Provider-Tailored Intervention for Perioperative Stress, was developed to train HCPs to increase behaviors that promote children’s coping and decrease behaviors that may exacerbate children’s distress. Rates of HCP behaviors were coded and compared between pre-intervention and post-intervention. Additionally, rates of parents’ behaviors were compared between those that interacted with HCPs before training to those interacting with HCPs post-intervention. Results Effect sizes indicated that HCPs that underwent training demonstrated increases in rates of desired behaviors (range: 0.22 to 1.49) and decreases in rates of undesired behaviors (range: 0.15 to 2.15). Additionally, parents, who were indirectly trained, also demonstrated changes to their rates of desired (range: 0.30 to 0.60) and undesired behaviors (range: 0.16 to 0.61). Conclusions The intervention successfully modified HCP and parent behaviors. It represents a potentially new clinical way to decrease anxiety in children. A recently National Institute of Child Health and Development funded multi-site randomized control trial will examine the efficacy of this intervention in reducing children’s preoperative anxiety and improving children’s postoperative recovery is about to start. PMID:21606826

  15. Developing empirically supported theories of change for housing investment and health.

    PubMed

    Thomson, Hilary; Thomas, Sian

    2015-01-01

    The assumption that improving housing conditions can lead to improved health may seem a self-evident hypothesis. Yet evidence from intervention studies suggests small or unclear health improvements, indicating that further thought is required to refine this hypothesis. Articulation of a theory can help avoid a black box approach to research and practice and has been advocated as especially valuable for those evaluating complex social interventions like housing. This paper presents a preliminary theory of housing improvement and health based on a systematic review conducted by the authors. Following extraction of health outcomes, data on all socio-economic impacts were extracted by two independent reviewers from both qualitative and quantitative studies. Health and socio-economic outcome data from the better quality studies (n = 23/34) were mapped onto a one page logic models by two independent reviewers and a final model reflecting reviewer agreement was prepared. Where there was supporting evidence of links between outcomes these were indicated in the model. Two models of specific improvements (warmth & energy efficiency; and housing led renewal), and a final overall model were prepared. The models provide a visual map of the best available evidence on the health and socio-economic impacts of housing improvement. The use of a logic model design helps to elucidate the possible pathways between housing improvement and health and as such might be described as an empirically based theory. Changes in housing factors were linked to changes in socio-economic determinants of health. This points to the potential for longer term health impacts which could not be detected within the lifespan of the evaluations. The developed theories are limited by the available data and need to be tested and refined. However, in addition to providing one page summaries for evidence users, the theory may usefully inform future research on housing and health. PMID:25461878

  16. Developing empirically supported theories of change for housing investment and health

    PubMed Central

    Thomson, Hilary; Thomas, Sian

    2015-01-01

    The assumption that improving housing conditions can lead to improved health may seem a self-evident hypothesis. Yet evidence from intervention studies suggests small or unclear health improvements, indicating that further thought is required to refine this hypothesis. Articulation of a theory can help avoid a black box approach to research and practice and has been advocated as especially valuable for those evaluating complex social interventions like housing. This paper presents a preliminary theory of housing improvement and health based on a systematic review conducted by the authors. Following extraction of health outcomes, data on all socio-economic impacts were extracted by two independent reviewers from both qualitative and quantitative studies. Health and socio-economic outcome data from the better quality studies (n = 23/34) were mapped onto a one page logic models by two independent reviewers and a final model reflecting reviewer agreement was prepared. Where there was supporting evidence of links between outcomes these were indicated in the model. Two models of specific improvements (warmth & energy efficiency; and housing led renewal), and a final overall model were prepared. The models provide a visual map of the best available evidence on the health and socio-economic impacts of housing improvement. The use of a logic model design helps to elucidate the possible pathways between housing improvement and health and as such might be described as an empirically based theory. Changes in housing factors were linked to changes in socio-economic determinants of health. This points to the potential for longer term health impacts which could not be detected within the lifespan of the evaluations. The developed theories are limited by the available data and need to be tested and refined. However, in addition to providing one page summaries for evidence users, the theory may usefully inform future research on housing and health. PMID:25461878

  17. Mindfulness Meditation Training for Attention-Deficit/Hyperactivity Disorder in Adulthood: Current Empirical Support, Treatment Overview, and Future Directions

    PubMed Central

    Mitchell, John T.; Zylowska, Lidia; Kollins, Scott H.

    2015-01-01

    Research examining nonpharmacological interventions for adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) has expanded in recent years and provides patients with more treatment options. Mindfulness-based training is an example of an intervention that is gaining promising preliminary empirical support and is increasingly administered in clinical settings. The aim of this review is to provide a rationale for the application of mindfulness to individuals diagnosed with ADHD, describe the current state of the empirical basis for mindfulness training in ADHD, and summarize a treatment approach specific to adults diagnosed with ADHD: the Mindful Awareness Practices (MAPs) for ADHD Program. Two case study examples are provided to demonstrate relevant clinical issues for practitioners interested in this approach. Directions for future research, including mindfulness meditation as a standalone treatment and as a complementary approach to cognitive-behavioral therapy, are provided. PMID:25908900

  18. Amoxicillin plus temocillin as an alternative empiric therapy for the treatment of severe hospital-acquired pneumonia: results from a retrospective audit.

    PubMed

    Habayeb, H; Sajin, B; Patel, K; Grundy, C; Al-Dujaili, A; Van de Velde, S

    2015-08-01

    A formulary decision was made at a large provider of acute hospital services in Surrey to replace piperacillin/tazobactam with amoxicillin+temocillin for the empiric treatment of severe hospital-acquired pneumonia. This decision was made because the use of broad-spectrum-β-lactam antibiotics is a known risk factor for Clostridium difficile infection (CDI) and for the selection of resistance. After the antibiotic formulary was changed, a retrospective audit was conducted to assess the effect of this change. Data from patients hospitalised between January 2011 and July 2012 for severe hospital-acquired pneumonia and treated empirically with piperacillin/tazobactam or amoxicillin+temocillin were reviewed retrospectively. Clinical characteristics of patients, data related to the episode of pneumonia, clinical success and incidence of significant diarrhoea and CDI were analysed. One hundred ninety-two episodes of severe hospital-acquired pneumonia in 188 patients were identified from hospital records. Ninety-eight patients received piperacillin/tazobactam and 94 amoxicillin+temocillin. At baseline, the two treatment groups were comparable, except that more patients with renal insufficiency were treated with piperacillin/tazobactam. Clinical success was comparable (80 versus 82 %; P = 0.86), but differences were observed between piperacillin/tazobactam and amoxicillin+temocillin for the rates of significant diarrhoea (34 versus 4 %, respectively; P < 0.0001) and for CDI (7 versus 0 %, respectively; P < 0.0028). This preliminary study suggests that the combination amoxicillin+temocillin is a viable alternative to piperacillin/tazobactam for the treatment of severe hospital-acquired pneumonia. This combination appears to be associated with fewer gastrointestinal adverse events. Further studies are needed to evaluate the place of amoxicillin+temocillin as empiric treatment of severe hospital-acquired pneumonia. PMID:25987247

  19. Empirical treatment for TB in HIV: lessons from a cohort study of people living with HIV treated in Recife, Brazil

    PubMed Central

    2014-01-01

    Background Tuberculosis (TB) is the leading cause of death related to HIV worldwide. This study analyzes the survival of People Living with HIV (PLHIV) reporting cough without bacteriological confirmation of TB and identify factors associated with death. Methods Prospective cohort with a consecutive sample of PLHIV, aged ≥ 18 years. Patient inclusion criteria were complaint of current cough of any duration at the time of the first study interview or during their subsequent routine visits to health services and for whom AFB sputum smear was either negative or not performed during the whole follow-up period. Kaplan-Meier method was used to calculate the probability of survival. We estimated the Hazard Ratio (HR) in bivariate and multivariate Cox regression analyses. Results Mortality was 4.6 per 100 py; 73% were receiving HAART at recruitment. Average time from the first recorded date of cough until empirical treatment for tuberculosis was six months. Mortality was higher when the CD4 count was low (HR = 5.3; CI 95%: 3.2-9.0; p = 0.000), in those with anemia (HR = 3.0; CI 95%: 1.6-5.6; p = 0.001) and with abnormal chest X-rays (HR = 2.4; CI 95%: 1.4-4.0; p = 0.001). Mortality was higher in those receiving empirical TB treatment (HR = 2.4; CI 95%: 1.4-4.0; p = 0.002), but only in those with normal X-rays, no history of tuberculosis and no bacteriology requests. Empirical treatment for TB was more frequent in PLHIV with low CD4 counts, anemia, history of opportunistic infections, weight loss, previous tuberculosis, negative bacteriology test (as opposed to not having a test) and abnormal chest X-ray. Conclusions Higher mortality in PLHIV reporting a current cough without bacteriological confirmation of tuberculosis was identified for those with a CD4 cell count <200, abnormal chest X-ray, anemia and empirical treatment for tuberculosis. Mortality was not significantly higher in those empirically treated for TB, who had three

  20. Can empirical hypertonic saline or sodium bicarbonate treatment prevent the development of cardiotoxicity during serious amitriptyline poisoning? Experimental research

    PubMed Central

    Sukru Paksu, Muhammet; Zengin, Halit; Uzun, Adem; Ilkaya, Fatih; Guzel, Hasan; Paksu, Sule; Ucar, Durmus; Alacam, Hasan; Duran, Latif; Murat, Naci; Guzel, Ahmet

    2015-01-01

    Summary Objective The aim of this experimental study was to investigate whether hypertonic saline or sodium bicarbonate administration prevented the development of cardiotoxicity in rats that received toxic doses of amitriptyline. Method Thirty-six Sprague Dawley rats were used in the study. The animals were divided into six groups. Group 1 received toxic doses of i.p. amitriptyline. Groups 2 and 3 toxic doses of i.p. amitriptyline, plus i.v. sodium bicarbonate and i.v. hypertonic saline, respectively. Group 4 received only i.v. sodium bicarbonate, group 5 received only i.v. hypertonic saline, and group 6 was the control. Electrocardiography was recorded in all rats for a maximum of 60 minutes. Blood samples were obtained to measure the serum levels of sodium and ionised calcium. Results The survival time was shorter in group 1. In this group, the animals’ heart rates also decreased over time, and their QRS and QTc intervals were significantly prolonged. Groups 2 and 3 showed less severe changes in their ECGs and the rats survived for a longer period. The effects of sodium bicarbonate or hypertonic saline treatments on reducing the development of cardiotoxicity were similar. The serum sodium levels decreased in all the amitriptyline-applied groups. Reduction of serum sodium level was most pronounced in group 1. Conclusion Empirical treatment with sodium bicarbonate or hypertonic saline can reduce the development of cardiotoxicity during amitriptyline intoxication. As hypertonic saline has no adverse effects on drug elimination, it should be considered as an alternative to sodium bicarbonate therapy. PMID:25939777

  1. Upscaling Empirically Based Conceptualisations to Model Tropical Dominant Hydrological Processes for Historical Land Use Change

    NASA Astrophysics Data System (ADS)

    Toohey, R.; Boll, J.; Brooks, E.; Jones, J.

    2009-12-01

    Surface runoff and percolation to ground water are two hydrological processes of concern to the Atlantic slope of Costa Rica because of their impacts on flooding and drinking water contamination. As per legislation, the Costa Rican Government funds land use management from the farm to the regional scale to improve or conserve hydrological ecosystem services. In this study, we examined how land use (e.g., forest, coffee, sugar cane, and pasture) affects hydrological response at the point, plot (1 m2), and the field scale (1-6ha) to empirically conceptualize the dominant hydrological processes in each land use. Using our field data, we upscaled these conceptual processes into a physically-based distributed hydrological model at the field, watershed (130 km2), and regional (1500 km2) scales. At the point and plot scales, the presence of macropores and large roots promoted greater vertical percolation and subsurface connectivity in the forest and coffee field sites. The lack of macropores and large roots, plus the addition of management artifacts (e.g., surface compaction and a plough layer), altered the dominant hydrological processes by increasing lateral flow and surface runoff in the pasture and sugar cane field sites. Macropores and topography were major influences on runoff generation at the field scale. Also at the field scale, antecedent moisture conditions suggest a threshold behavior as a temporal control on surface runoff generation. However, in this tropical climate with very intense rainstorms, annual surface runoff was less than 10% of annual precipitation at the field scale. Significant differences in soil and hydrological characteristics observed at the point and plot scales appear to have less significance when upscaled to the field scale. At the point and plot scales, percolation acted as the dominant hydrological process in this tropical environment. However, at the field scale for sugar cane and pasture sites, saturation-excess runoff increased as

  2. An Empirical Assessment of an Activity to Teach Sensory Change in Aging

    ERIC Educational Resources Information Center

    Dickinson, Paige E.; Schwarzmueller, April; Martin, Bret

    2014-01-01

    This study empirically tested the effectiveness of a brief, inexpensive aging simulation activity to educate traditional-aged students about sensory declines and their potential causes in older adulthood development. Students in a life-span development course wore specific props (e.g., thick gloves, earplugs, and obscured glasses) to simulate…

  3. Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections

    PubMed Central

    Strymish, Judith; Gupta, Kalpana

    2015-01-01

    The emergence of multidrug-resistant (MDR) uropathogens is making the treatment of urinary tract infections (UTIs) more challenging. We sought to evaluate the accuracy of empiric therapy for MDR UTIs and the utility of prior culture data in improving the accuracy of the therapy chosen. The electronic health records from three U.S. Department of Veterans Affairs facilities were retrospectively reviewed for the treatments used for MDR UTIs over 4 years. An MDR UTI was defined as an infection caused by a uropathogen resistant to three or more classes of drugs and identified by a clinician to require therapy. Previous data on culture results, antimicrobial use, and outcomes were captured from records from inpatient and outpatient settings. Among 126 patient episodes of MDR UTIs, the choices of empiric therapy against the index pathogen were accurate in 66 (52%) episodes. For the 95 patient episodes for which prior microbiologic data were available, when empiric therapy was concordant with the prior microbiologic data, the rate of accuracy of the treatment against the uropathogen improved from 32% to 76% (odds ratio, 6.9; 95% confidence interval, 2.7 to 17.1; P < 0.001). Genitourinary tract (GU)-directed agents (nitrofurantoin or sulfa agents) were equally as likely as broad-spectrum agents to be accurate (P = 0.3). Choosing an agent concordant with previous microbiologic data significantly increased the chance of accuracy of therapy for MDR UTIs, even if the previous uropathogen was a different species. Also, GU-directed or broad-spectrum therapy choices were equally likely to be accurate. The accuracy of empiric therapy could be improved by the use of these simple rules. PMID:26416859

  4. Treatment Utility of Functional versus Empiric Assessment within Consultation for Reading Problems

    ERIC Educational Resources Information Center

    Beavers, Karen F.; Kratochwill, Thomas R.; Braden, Jeffery P.

    2004-01-01

    In this study, 18 teachers and 32 of their students who had reading difficulties were randomly assigned to one of two assessment conditions. In the functional assessment condition, consultants identified functional relationships among environmental events and targeted reading behaviors to develop an intervention plan. In the empiric condition,…

  5. Naturalistic Developmental Behavioral Interventions: Empirically Validated Treatments for Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Schreibman, Laura; Dawson, Geraldine; Stahmer, Aubyn C.; Landa, Rebecca; Rogers, Sally J.; McGee, Gail G.; Kasari, Connie; Ingersoll, Brooke; Kaiser, Ann P.; Bruinsma, Yvonne; McNerney, Erin; Wetherby, Amy; Halladay, Alycia

    2015-01-01

    Earlier autism diagnosis, the importance of early intervention, and development of specific interventions for young children have contributed to the emergence of similar, empirically supported, autism interventions that represent the merging of applied behavioral and developmental sciences. "Naturalistic Developmental Behavioral Interventions…

  6. Evaluating the Validity of Systematic Reviews to Identify Empirically Supported Treatments

    ERIC Educational Resources Information Center

    Slocum, Timothy A.; Detrich, Ronnie; Spencer, Trina D.

    2012-01-01

    The "best available evidence" is one of the three basic inputs into evidence-based practice. This paper sets out a framework for evaluating the quality of systematic reviews that are intended to identify empirically supported interventions as a way of summarizing the best available evidence. The premise of this paper is that the process of…

  7. Behavior Change Outcomes of Marathon Group Treatment

    ERIC Educational Resources Information Center

    Uhlemann, Max R.; Weigel, Richard G.

    1977-01-01

    This study evaluated behavior change occurring after a marathon group experience, with a focus on individualized rather than shared behavioral change criteria. The individualization of behavior change criteria is based on the assertion that few, if any, single change criteria are appropriate or realistic for assessing change in all individuals.…

  8. Naturalistic Developmental Behavioral Interventions: Empirically Validated Treatments for Autism Spectrum Disorder.

    PubMed

    Schreibman, Laura; Dawson, Geraldine; Stahmer, Aubyn C; Landa, Rebecca; Rogers, Sally J; McGee, Gail G; Kasari, Connie; Ingersoll, Brooke; Kaiser, Ann P; Bruinsma, Yvonne; McNerney, Erin; Wetherby, Amy; Halladay, Alycia

    2015-08-01

    Earlier autism diagnosis, the importance of early intervention, and development of specific interventions for young children have contributed to the emergence of similar, empirically supported, autism interventions that represent the merging of applied behavioral and developmental sciences. "Naturalistic Developmental Behavioral Interventions (NDBI)" are implemented in natural settings, involve shared control between child and therapist, utilize natural contingencies, and use a variety of behavioral strategies to teach developmentally appropriate and prerequisite skills. We describe the development of NDBIs, their theoretical bases, empirical support, requisite characteristics, common features, and suggest future research needs. We wish to bring parsimony to a field that includes interventions with different names but common features thus improving understanding and choice-making among families, service providers and referring agencies. PMID:25737021

  9. Identification of sudden stiffness changes in the acceleration response of a bridge to moving loads using ensemble empirical mode decomposition

    NASA Astrophysics Data System (ADS)

    Aied, H.; González, A.; Cantero, D.

    2016-01-01

    The growth of heavy traffic together with aggressive environmental loads poses a threat to the safety of an aging bridge stock. Often, damage is only detected via visual inspection at a point when repairing costs can be quite significant. Ideally, bridge managers would want to identify a stiffness change as soon as possible, i.e., as it is occurring, to plan for prompt measures before reaching a prohibitive cost. Recent developments in signal processing techniques such as wavelet analysis and empirical mode decomposition (EMD) have aimed to address this need by identifying a stiffness change from a localised feature in the structural response to traffic. However, the effectiveness of these techniques is limited by the roughness of the road profile, the vehicle speed and the noise level. In this paper, ensemble empirical mode decomposition (EEMD) is applied by the first time to the acceleration response of a bridge model to a moving load with the purpose of capturing sudden stiffness changes. EEMD is more adaptive and appears to be better suited to non-linear signals than wavelets, and it reduces the mode mixing problem present in EMD. EEMD is tested in a variety of theoretical 3D vehicle-bridge interaction scenarios. Stiffness changes are successfully identified, even for small affected regions, relatively poor profiles, high vehicle speeds and significant noise. The latter is due to the ability of EEMD to separate high frequency components associated to sudden stiffness changes from other frequency components associated to the vehicle-bridge interaction system.

  10. Treating Pediatric Obesity Using an Empirically Supported Treatment: A Case Report

    ERIC Educational Resources Information Center

    Cunningham, Phillippe B.; Ellis, Deborah A.; Naar-King, Sylvie

    2010-01-01

    Overweight and obesity are increasing dramatically in the United States of America, especially among children. Effective treatment of the multiple risk factors that promote youth obesity requires treatment approaches that are flexible and comprehensive enough to address each of these factors. One such treatment approach is Multisystemic Therapy…

  11. An Empirical Study on the Role of Context Factors in Employees' Commitment to Change

    ERIC Educational Resources Information Center

    Soumyaja, Devi; Kamlanabhan, T. J.; Bhattacharyya, Sanghamitra

    2011-01-01

    The study attempts to address the gap of exploring the possible antecedents of employees' commitment to change and its three dimensions. The role of context factors--participation in decision making, quality of communication, trust in management and history of change--are tested on overall commitment to change and also on its three…

  12. Moving empirically-supported treatment to the workplace: Recruiting addiction program supervisors to help in technology transfer

    PubMed Central

    Amodeo, Maryann; Storti, Susan A.; Larson, Mary Jo

    2013-01-01

    Federal and state funding agencies are encouraging or mandating the use of empirically supported treatments in addiction programs, yet many programs have not moved in this direction (Forman, Bovasso, and Woody, 2001; Roman and Johnson, 2002; Willenbring et al., 2004). To improve the skills of counselors in community addiction programs, the authors developed an innovative Web-based course on Cognitive Behavioral Therapy (CBT), a widely accepted empirically-supported treatment (EST) for addiction. Federal funding supports this Web course and a randomized controlled trial to evaluate its effectiveness. Since supervisors often play a pivotal role in helping clinicians transfer learned skills from training courses to the workplace, the authors recruited supervisor-counselor teams, engaging 54 supervisors and 120 counselors. Lessons learned focus on supervisor recruitment and involvement, supervisors’ perceptions of CBT, their own CBT skills and their roles in the study, and implications for technology transfer for the addiction field as a whole. Recruiting supervisors proved difficult because programs lacked clinical supervisors. Recruiting counselors proved difficult because programs were concerned about loss of third-party reimbursement. Across the addiction field, technology transfer will be severely hampered unless such infrastructure problems can be solved. Areas for further investigation are identified. PMID:20397880

  13. Antimicrobial sensitivity patterns of cerebrospinal fluid (CSF) isolates in Namibia: implications for empirical antibiotic treatment of meningitis

    PubMed Central

    2013-01-01

    Objective Bacterial meningitis is a medical emergency associated with high mortality rates. Cerebrospinal fluid (CSF) culture is the “gold standard” for diagnosis of meningitis and it is important to establish the susceptibility of the causative microorganism to rationalize treatment. The Namibia Standard Treatment Guidelines (STGs) recommends initiation of empirical antibiotic treatment in patients with signs and symptoms of meningitis after taking a CSF sample for culture and sensitivity. The objective of this study was to assess the antimicrobial sensitivity patterns of microorganisms isolated from CSF to antibiotics commonly used in the empirical treatment of suspected bacterial meningitis in Namibia. Methods This was a cross-sectional descriptive study of routinely collected antibiotic susceptibility data from the Namibia Institute of Pathology (NIP) database. Results of CSF culture and sensitivity from January 1, 2009 to May 31, 2012, from 33 state hospitals throughout Namibia were analysed. Results The most common pathogens isolated were Streptococcus species, Neisseria meningitidis, Haemophilus influenzae, Staphylococcus, and Escherichia coli. The common isolates from CSF showed high resistance (34.3% –73.5%) to penicillin. Over one third (34.3%) of Streptococcus were resistance to penicillin which was higher than 24.8% resistance in the United States. Meningococci were susceptible to several antimicrobial agents including penicillin. The sensitivity to cephalosporins remained high for Streptococcus, Neisseria, E. coli and Haemophilus. The highest percentage of resistance to cephalosporins was seen among ESBL K. pneumoniae (n = 7, 71%–100%), other Klebsiella species (n = 7, 28%–80%), and Staphylococcus (n = 36, 25%–40%). Conclusions The common organisms isolated from CSF were Streptococcus Pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Staphylococcus, and E. coli. All common organisms isolated from CSF showed high

  14. Empirically Supported Treatments in Psychotherapy: Towards an Evidence-Based or Evidence-Biased Psychology in Clinical Settings?

    PubMed Central

    Castelnuovo, Gianluca

    2010-01-01

    The field of research and practice in psychotherapy has been deeply influenced by two different approaches: the empirically supported treatments (ESTs) movement, linked with the evidence-based medicine (EBM) perspective and the “Common Factors” approach, typically connected with the “Dodo Bird Verdict”. About the first perspective, since 1998 a list of ESTs has been established in mental health field. Criterions for “well-established” and “probably efficacious” treatments have arisen. The development of these kinds of paradigms was motivated by the emergence of a “managerial” approach and related systems for remuneration also for mental health providers and for insurance companies. In this article ESTs will be presented underlining also some possible criticisms. Finally complementary approaches, that could add different evidence in the psychotherapy research in comparison with traditional EBM approach, are presented. PMID:21833197

  15. Empirically Supported Family-Based Treatments for Conduct Disorder and Delinquency in Adolescents

    ERIC Educational Resources Information Center

    Henggeler, Scott W.; Sheidow, Ashli J.

    2012-01-01

    Several family-based treatments of conduct disorder and delinquency in adolescents have emerged as evidence-based and, in recent years, have been transported to more than 800 community practice settings. These models include multisystemic therapy, functional family therapy, multidimensional treatment foster care, and, to a lesser extent, brief…

  16. The Current State of Empirical Support for the Pharmacological Treatment of Selective Mutism

    ERIC Educational Resources Information Center

    Carlson, John S.; Mitchell, Angela D.; Segool, Natasha

    2008-01-01

    This article reviews the current state of evidence for the psychopharmacological treatment of children diagnosed with selective mutism within the context of its link to social anxiety disorder. An increased focus on potential medication treatment for this disorder has resulted from significant monetary and resource limitations in typical practice,…

  17. Meta-analysis of prophylactic or empirical antifungal treatment versus placebo or no treatment in patients with cancer complicated by neutropenia.

    PubMed Central

    Gøtzsche, P. C.; Johansen, H. K.

    1997-01-01

    OBJECTIVE: To determine whether antifungal agents given prophylactically or empirically decrease morbidity and mortality in patients with cancer complicated by neutropenia. DESIGN: Meta-analysis of randomised trials of amphotericin B, various lipid soluble formulations of amphotericin B (for example, AmBisome), fluconazole, ketoconazole, miconazole, or itraconazole compared with placebo or no treatment. SETTING: Trials conducted anywhere in the world. SUBJECTS: Patients with cancer complicated by neutropenia. MAIN OUTCOME MEASURES: Mortality, invasive fungal infection (defined as positive blood culture, oesophageal candidiasis, or lung or deep tissue infection), and colonisation. RESULTS: 24 trials with 2758 randomised patients were reviewed; the total number of deaths was 434. Prophylactic or empirical treatment with antifungals as a group bad no effect on mortality (odds ratio 0.92; 95% confidence interval 0.74 to 1.14). Amphotericin B decreased mortality significantly (0.58; 0.37 to 0.93) but the studies were small and the difference in number of deaths was only 15. Antifungal treatment decreased the incidence of invasive fungal infection (0.47; 0.35 to 0.64) and fungal colonisation (0.45; 0.30 to 0.69). For every 73 patients treated (95% confidence interval to 48 to 158) one case of fungal invasion was prevented in surviving patients. CONCLUSIONS: There seems to be no survival benefit of antifungal agents given prophylactically or empirically to patients with cancer complicated by neutropenia. These agents should be restricted to patients with proved infection and those in randomised trials. A large, definitive placebo controlled trial of amphotericin B is needed. PMID:9154027

  18. Soil carbon sequestration and land use change associated with biofuel production: Empirical evidence

    SciTech Connect

    Qin, Zhangcai; Dunn, Jennifer B.; Kwon, Hoyoung; Mueller, Steffen; Wander, Michelle M.

    2016-01-01

    Soil organic carbon (SOC) change can be a major impact of land use change (LUC) associated with biofuel feedstock production. By collecting and analyzing data from worldwide field observations with major LUCs from cropland, grassland and forest to lands producing biofuel crops (i.e., corn, switchgrass, Miscanthus, poplar and willow), we were able to estimate SOC response ratios and sequestration rates and evaluate the effects of soil depth and time scale on SOC change. Both the amount and rate of SOC change were highly dependent on the specific land transition. Irrespective of soil depth or time horizon, cropland conversions resulted in an overall SOC gain of 6-14% relative to initial SOC level, while conversion from grassland or forest to corn (without residue removal) or poplar caused significant carbon loss (9-35%). No significant SOC changes were observed in land converted from grasslands or forests to switchgrass, Miscanthus or willow. The SOC response ratios were similar in both 0-30 and 0-100 cm soil depths in most cases, suggesting SOC changes in deep soil and that use of top soil only for SOC accounting in biofuel life cycle analysis (LCA) might underestimate total SOC changes. Soil carbon sequestration rates varied greatly among studies and land transition types. Generally, the rates of SOC change tended to be the greatest during the 10 years following land conversion, and had declined to approach 0 within about 20 years for most LUCs. Observed trends in SOC change were generally consistent with previous reports. Soil depth and duration of study significantly influence SOC change rates and so should be considered in carbon emission accounting in biofuel LCA. High uncertainty remains for many perennial systems, field trials and modeling efforts are needed to determine the site- and system-specific rates and direction of change associated with their production.

  19. Changing Hot Pursuit Policy: An Empirical Assessment of the Impact on Pursuit Behavior.

    ERIC Educational Resources Information Center

    Crew, Robert E., Jr.; And Others

    1994-01-01

    Using a two-year time series, the impact on law enforcement pursuit behavior of two changes in pursuit policy in a police department was studied using the ARIMA computer program and Tobit analysis. Each policy change produced significant reductions in pursuits engaged in by police officers. (SLD)

  20. Language Change in the Wake of Empire: Syriac in Its Greco-Roman Context

    ERIC Educational Resources Information Center

    Butts, Aaron Michael

    2013-01-01

    Greek-Aramaic bilingualism was wide-spread throughout Late Antique Syria and Mesopotamia. Among the various Aramaic dialects, Syriac underwent a particularly intense and prolonged period of contact with Greek. This contact led to changes in both languages. The present study provides a new analysis of contact-induced changes in Syriac due to Greek,…

  1. Melting empires? Climate change and politics in Antarctica since the International Geophysical Year.

    PubMed

    Howkins, Adrian

    2011-01-01

    This article examines the relationship between climate change and politics in Antarctica since the International Geophysical Year of 1957-8, paying particular attention to the work of the British Antarctic Survey. Research conducted in Antarctica has played an important role in the understanding of climate change on a global scale. In turn, fears about the consequences of global climate change have radically changed perceptions of Antarctica and profoundly shaped scientific research agendas: a continent that until fifty years ago was perceived largely as an inhospitable wilderness has come to be seen as a dangerously vulnerable environment. This radical shift in perception contrasts with a fundamental continuity in the political power structures of the continent. This article argues that the severity of the threat of climate change has reinforced the privileged political position of the "insider" nations within the Antarctic Treaty System. PMID:21936193

  2. An empirical examination of women's empowerment and transformative change in the context of international development.

    PubMed

    Grabe, Shelly

    2012-03-01

    This paper responds to calls from social scientists in the area of globalization and women's empowerment to test a model that investigates both structural and individual components of women's empowerment in the context of globalization. The investigation uses a liberation psychology framework by taking into account the effects of globalization, human rights discourse, and women's activism within social movements to identify how structural inequities may be related to empowerment. Surveys conducted in rural Nicaragua revealed that land ownership and organizational participation among women were related to more progressive gender ideology, and in turn, women's power and control within the marital relationship, individual levels of agency, and subjective well-being. The study demonstrates that psychology can bridge the theoretical arguments surrounding human rights with the practical implementation of development interventions, and provide empirical support that has yet to be demonstrated elsewhere. The findings have important implications for strategies and interventions that can improve conditions for women and contribute to the aims of social justice articulated in the Beijing Platform for Action. PMID:21671108

  3. Fringes of the empire: Diet and cultural change at the Roman to post-Roman transition in NW Iberia.

    PubMed

    López-Costas, Olalla; Müldner, Gundula

    2016-09-01

    A growing number of paleodiet investigations over recent years have begun to reveal the stark dietary differences that existed between regions of the Roman Empire, as well as significant changes in subsistence strategies after its fall. The present study explores the dietary changes at the Roman to post-Roman (Germanic) transition in the Northwest Iberian Peninsula, in order to improve our understanding of the changes that occurred at end of the Roman Empire in different regions across Europe and to also consider the influence of climate had on them. The carbon and nitrogen stable isotope investigation in bone collagen from A Lanzada, NW Spain (100-700 AD), which was an important commercial, coastal settlement has been presented. A human sample of 59 individuals, 6 of them subadults, is compared with 31 faunal specimens, which include a number of marine fish. Isotope data for the terrestrial fauna reveal the influence of the sea on the local isotope baseline. Analysis of the human samples indicates a mixed marine-terrestrial diet. A shift in mean human δ(13) C values from -16.7‰ to -14.3‰ provides clear evidence for a significant change in diet in the post-Roman period, probably through the intensification of both marine resources exploitation and C4 -plant consumption (presumably millet). A deterioration of paleoenvironmental conditions, together with a poor socioeconomic situation and the arrival of new people, the Sueves, who brought a new political and socioeconomic system have been discussed as the main causes for the dietary modification in post-Roman times. PMID:27311883

  4. Economic valuation of environmental benefits from wastewater treatment processes: an empirical approach for Spain.

    PubMed

    Hernández-Sancho, Francesc; Molinos-Senante, María; Sala-Garrido, Ramón

    2010-01-15

    Economic research into the design and implementation of policies for the efficient management of water resources has been emphasized by the European Water Framework Directive (Directive 2000/60/EC). The efficient implementation of policies to prevent the degradation and depletion of water resources requires determining their value in social and economic terms and incorporating this information into the decision-making process. A process of wastewater treatment has many associated environmental benefits. However, these benefits are often not calculated because they are not set by the market, due to inadequate property rights, the presence of externalities, and the lack of perfect information. Nevertheless, the valuation of these benefits is necessary to justify a suitable investment policy and a limited number of studies exist on the subject of the economic valuation of environmental benefits. In this paper, we propose a methodology based on the estimation of shadow prices for the pollutants removed in a treatment process. This value represents the environmental benefit (avoided cost) associated with undischarged pollution. This is a pioneering approach to the economic valuation of wastewater treatment. The comparison of these benefits with the internal costs of the treatment process will provide a useful indicator for the feasibility of wastewater treatment projects. PMID:19903571

  5. Empirically Estimating the Potential for Farm-Level Adaptation to Climate Change in Western European Agriculture

    NASA Astrophysics Data System (ADS)

    Moore, F. C.; Lobell, D. B.

    2013-12-01

    Agriculture is one of the economic sectors most exposed to climate change and estimating the sensitivity of food production to these changes is critical for determining the severity of climate change impacts and for informing both adaptation and mitigation policy. While climate change might have adverse effects in many areas, it has long been recognized that farmers have a suite of adaptation options at their disposal including, inter alia, changing planting date, varieties, crops, or the mix and quantity of inputs applied. These adaptations may significantly reduce the adverse impacts of climate change but the potential effectiveness of these options and the speed with which farmers will adopt them remain uncertain. We estimate the sensitivity of crop yields and farm profits in western Europe to climate change with and without the adoption of on-farm adaptations. We use cross-sectional variation across farms to define the long-run response function that includes adaptation and inter-annual variation within farms to define the short-run response function without adaptation. The difference between these can be interpreted as the potential for adaptation. We find that future warming will have a large adverse impact on wheat and barley yields and that adaptation will only be able to mitigate a small fraction of this. Maize, oilseed and sugarbeet yields are more modestly affected and adaptation is more effective for these crops. Farm profits could increase slightly under moderate amounts of warming if adaptations are adopted but will decline in the absence of adaptation. A decomposition of variance gives the relative importance of different sources of uncertainty in projections of climate change impacts. We find that in most cases uncertainty over future adaptation pathways (whether farmers will or will not adopt beneficial adaptations) is the most important source of uncertainty in projecting the effect of temperature changes on crop yields and farm profits. This

  6. Empirical Models of Transitions between Coral Reef States: Effects of Region, Protection, and Environmental Change

    PubMed Central

    Lowe, Phillip K.; Bruno, John F.; Selig, Elizabeth R.; Spencer, Matthew

    2011-01-01

    There has been substantial recent change in coral reef communities. To date, most analyses have focussed on static patterns or changes in single variables such as coral cover. However, little is known about how community-level changes occur at large spatial scales. Here, we develop Markov models of annual changes in coral and macroalgal cover in the Caribbean and Great Barrier Reef (GBR) regions. We analyzed reef surveys from the Caribbean and GBR (1996–2006). We defined a set of reef states distinguished by coral and macroalgal cover, and obtained Bayesian estimates of the annual probabilities of transitions between these states. The Caribbean and GBR had different transition probabilities, and therefore different rates of change in reef condition. This could be due to differences in species composition, management or the nature and extent of disturbances between these regions. We then estimated equilibrium probability distributions for reef states, and coral and macroalgal cover under constant environmental conditions. In both regions, the current distributions are close to equilibrium. In the Caribbean, coral cover is much lower and macroalgal cover is higher at equilibrium than in the GBR. We found no evidence for differences in transition probabilities between the first and second halves of our survey period, or between Caribbean reefs inside and outside marine protected areas. However, our power to detect such differences may have been low. We also examined the effects of altering transition probabilities on the community state equilibrium, along a continuum from unfavourable (e.g., increased sea surface temperature) to favourable (e.g., improved management) conditions. Both regions showed similar qualitative responses, but different patterns of uncertainty. In the Caribbean, uncertainty was greatest about effects of favourable changes, while in the GBR, we are most uncertain about effects of unfavourable changes. Our approach could be extended to provide

  7. Empirical support for global integrated assessment modeling: Productivity trends and technological change in developing countries' agriculture and electric power sectors

    SciTech Connect

    Sathaye, Jayant A.

    2000-04-01

    Integrated assessment (IA) modeling of climate policy is increasingly global in nature, with models incorporating regional disaggregation. The existing empirical basis for IA modeling, however, largely arises from research on industrialized economies. Given the growing importance of developing countries in determining long-term global energy and carbon emissions trends, filling this gap with improved statistical information on developing countries' energy and carbon-emissions characteristics is an important priority for enhancing IA modeling. Earlier research at LBNL on this topic has focused on assembling and analyzing statistical data on productivity trends and technological change in the energy-intensive manufacturing sectors of five developing countries, India, Brazil, Mexico, Indonesia, and South Korea. The proposed work will extend this analysis to the agriculture and electric power sectors in India, South Korea, and two other developing countries. They will also examine the impact of alternative model specifications on estimates of productivity growth and technological change for each of the three sectors, and estimate the contribution of various capital inputs--imported vs. indigenous, rigid vs. malleable-- in contributing to productivity growth and technological change. The project has already produced a data resource on the manufacturing sector which is being shared with IA modelers. This will be extended to the agriculture and electric power sectors, which would also be made accessible to IA modeling groups seeking to enhance the empirical descriptions of developing country characteristics. The project will entail basic statistical and econometric analysis of productivity and energy trends in these developing country sectors, with parameter estimates also made available to modeling groups. The parameter estimates will be developed using alternative model specifications that could be directly utilized by the existing IAMs for the manufacturing

  8. Empirically and Clinically Useful Decision Making in Psychotherapy: Differential Predictions with Treatment Response Models

    ERIC Educational Resources Information Center

    Lutz, Wolfgang; Saunders, Stephen M.; Leon, Scott C.; Martinovich, Zoran; Kosfelder, Joachim; Schulte, Dietmar; Grawe, Klaus; Tholen, Sven

    2006-01-01

    In the delivery of clinical services, outcomes monitoring (i.e., repeated assessments of a patient's response to treatment) can be used to support clinical decision making (i.e., recurrent revisions of outcome expectations on the basis of that response). Outcomes monitoring can be particularly useful in the context of established practice research…

  9. The Differential Treatment Model: Empirical Evidence from a Personality Typology of Adult Offenders.

    ERIC Educational Resources Information Center

    Annis, Helen M.; Chan, David

    1983-01-01

    Interaction of offender type by treatment program was examined for 100 adult offenders with alcohol and drug problems assigned to a group therapy program and 50 to routine care. Offenders who were classified high in self-image showed greater improvement in the group therapy program. (Author/HLM)

  10. Noncontingent Reinforcement Is an Empirically Supported Treatment for Problem Behavior Exhibited by Individuals with Developmental Disabilities

    ERIC Educational Resources Information Center

    Carr, James E.; Severtson, Jamie M.; Lepper, Tracy L.

    2009-01-01

    Noncontingent reinforcement (NCR) is a function-based treatment for problem behavior that has produced robust effects across a variety of response topographies and reinforcement functions among individuals with developmental disabilities. Several narrative reviews have adequately described this literature. The purpose of the present article was to…

  11. An Investigation of Different Treatment Strategies for Item Category Collapsing in Calibration: An Empirical Study

    ERIC Educational Resources Information Center

    Tay-lim, Brenda Siok-Hoon; Zhang, Jinming

    2015-01-01

    To ensure the statistical result validity, model-data fit must be evaluated for each item. In practice, certain actions or treatments are needed for misfit items. If all misfit items are treated, much item information would be lost during calibration. On the other hand, if only severely misfit items are treated, the inclusion of misfit items may…

  12. An Empirical "Real World" Comparison of Two Treatments with Aggressive Adolescent Males

    ERIC Educational Resources Information Center

    Apsche, Jack A.; Bass, Christopher K.; Siv, Alexander M.; Matteson, Susan C.

    2005-01-01

    This research study compares the efficacy of Mode Deactivation Therapy (MDT), an advanced form of Cognitive Behavioral Therapy based on Beck's theory of modes, and standard Cognitive Behavioral Therapy (CBT) for adolescent males in residential treatment. The results showed MDT was superior to CBT in reducing both physical and sexual aggression and…

  13. Empirical model for the volume-change behavior of debris flows

    USGS Publications Warehouse

    Cannon, S.H.

    1993-01-01

    The potential travel down hillsides; movement stops where the volume-change behavior of flows as they travel down hillsides ; movement stops where the volume of actively flowing debris becomes negligible. The average change in volume over distance for 26 recent debris flows in the Honolulu area was assumed to be a function of the slope over which the debris flow traveled, the degree of flow confinement by the channel, and an assigned value for the type of vegetation through which the debris flow traveled. Analysis of the data yielded a relation that can be incorporated into digital elevation models to characterize debris-flow travel on Oahu.

  14. Valuing Climate Change Impacts on Human Health: Empirical Evidence from the Literature

    PubMed Central

    Markandya, Anil; Chiabai, Aline

    2009-01-01

    There is a broad consensus that climate change will increase the costs arising from diseases such as malaria and diarrhea and, furthermore, that the largest increases will be in developing countries. One of the problems is the lack of studies measuring these costs systematically and in detail. This paper critically reviews a number of studies about the costs of planned adaptation in the health context, and compares current health expenditures with MDGs which are felt to be inadequate when considering climate change impacts. The analysis serves also as a critical investigation of the methodologies used and aims at identifying research weaknesses and gaps. PMID:19440414

  15. Parent-child interaction therapy: application of an empirically supported treatment to maltreated children in foster care.

    PubMed

    Timmer, Susan G; Urquiza, Anthony J; Herschell, Amy D; McGrath, Jean M; Zebell, Nancy M; Porter, Alissa L; Vargas, Eric C

    2006-01-01

    One of the more serious problems faced by child welfare services involves the management of children with serious behavioral and mental health problems. Aggressive and defiant foster children are more likely to have multiple foster care placements, require extraordinary social services resources, and have poor short- and long-term mental health outcomes. Interventions that work with challenging foster children and enhance foster parents' skills in managing problem behaviors are necessary. This article presents the successful results of a single case study examining the application of Parent-Child Interaction Therapy (PCIT) with an aggressive young boy and his foster-adoptive parent. PCIT is a dyadic intervention that has been identified as an empirically supported treatment for abused children and for children with different types of behavioral disruption. The application of PCIT to assist foster parents is a promising direction for child welfare services. PMID:17305042

  16. Why Do Firms Train? Empirical Evidence on the Relationship between Training and Technological and Organizational Change

    ERIC Educational Resources Information Center

    Neirotti, Paolo; Paolucci, Emilio

    2013-01-01

    We explore the relationship between training and innovation using key insights from the resource-based approach, organizational learning and labour studies. By using data from 304 large enterprises in Italy, the study highlights a twofold role of training in favouring technological and organizational changes. First, training plays a role in…

  17. An Empirical Study of the Range of Marital Complaints Found in the Areas of Change Questionnaire.

    ERIC Educational Resources Information Center

    Mead, D. Eugene; Vatcher, Gary

    1985-01-01

    Describes a study to determine if the Areas of Change Questionnaire (AC) items represent commonly occurring problems seen by marital therapists and identified by Geiss and O'Leary (1981). Results suggest that AC Questionnaire, containing 13 of Geiss and O'Leary's 29 marital problem categories, is limited in the range of clinical marital problems…

  18. Instructional Change in Preschool Classrooms: A Study of Empirically-Based Teacher Support

    ERIC Educational Resources Information Center

    Boat, Mary B.; Carr, Victoria; Barnett, David; Macmann, Gregg; Moomaw, Sally; Pan, Wei; Nichols, Angela

    2009-01-01

    This study examined the effects of staff development and support on Head Start teachers' use of instructional and managerial strategies. Specific research questions were (a) What variables were selected by teachers? and (b) What changes were indicated by the method of support? Observations were conducted for teachers randomly assigned to…

  19. Adaptability: Conceptual and Empirical Perspectives on Responses to Change, Novelty and Uncertainty

    ERIC Educational Resources Information Center

    Martin, Andrew J.; Nejad, Harry; Colmar, Susan; Liem, Gregory Arief D.

    2012-01-01

    Adaptability is proposed as individuals' capacity to constructively regulate psycho-behavioral functions in response to new, changing, and/or uncertain circumstances, conditions and situations. The present investigation explored the internal and external validity of an hypothesised adaptability scale. The sample comprised 2,731 high school…

  20. An empirical assessment of social structural and cultural change in clinical directorates.

    PubMed

    Braithwaite, Jeffrey

    2006-12-01

    The results of two observational studies of clinical directorates (CDs) are presented. The paper exposes fresh perspectives about the management of hospitals and CDs, and suggests that the most important axis on which hospital decision-making rests continues to be profession rather than the CD, even though CDs are designed at least in part to mitigate professional tribalism and bridge professional divides. In empiricising social structural and cultural theories it seems clear that changes to the prescribed organisational framework, which CDs represent, have had negligible effects on behaviour. This being the case, the paper questions the benefits alleged to have accrued from establishing CDs and calls for more effective, micro-behavioural change strategies than merely altering the structure. PMID:17214253

  1. Changing environmental strategies over time: an empirical study of the steel industry in the United States.

    PubMed

    Clemens, B

    2001-06-01

    This study investigates how environmental strategies change over time. We submit evidence from the US steel industry that firms have modified their strategies over time. We offer that US industry passed through three stages--cost minimization, cost-effective compliance, and beneficial environmental controls. We compare typologies of environmental strategies and choose that of C. Oliver as the most appropriate. We investigate how environmental strategies in the steel industry changed over time a 4-year period. We offer that a further understanding of Oliver's strategies may increase understanding of the relationship between business and government on environmental issues. One over-arching problem in our field is the need to adequately operationalize how firms change strategies and pass through different stages. We hope that our study will help future researchers and practitioners better articulate the concepts of environmental strategies over time. Our study focused on the steel industry in the United States. We chose the US steel industry as one of the major environmental actors in the United States. The United States Environmental Protection Agency ranks the iron and steel industry as the largest industrial source of toxic environmental contamination. We encourage researchers to evaluate and test our methodology and findings in other contexts--both in other nations and different industries. PMID:11434033

  2. Anaemia and cancer treatment: a conceptual change.

    PubMed

    Khan, F A; Shukla, A N; Joshi, S C

    2008-10-01

    Anaemia is the most common haematological abnormality in cancer patients, and unfortunately, it is often under-recognised and undertreated. The aetiopathology of anaemia in cancer patients is complex and is usually multifactorial. There is enough evidence suggesting that tumour hypoxia in anaemic patients has a negative impact on the treatment outcomes in cancer patients. The use of recombinant human erythropoietin is becoming a new standard of care in cancer patients. Various well-controlled studies have shown that the use of erythropoietin (EPO) increases the haemoglobin level, thereby decreasing the need for frequent transfusions and improving the tumour responses, cancer-free survival and quality-of-life parameters in cancer patients. However, a few recent clinical trials failed to replicate the survival benefit. Hence, a free unrestricted use of EPO is to be avoided. The past belief that anaemia does not matter in cancer patients is now considered invalid and is being seriously challenged. This article aims to present some recent findings on the impact of anaemia on outcomes, with discussion on the possible causes and effects. The benefits of the use of EPO analogues in cancer-related anaemia are also presented. PMID:18946607

  3. A Propensity Score Analysis Shows that Empirical Treatment with Linezolid Does Not Increase the Thirty-Day Mortality Rate in Patients with Gram-Negative Bacteremia

    PubMed Central

    Ternavasio-de la Vega, Hugo-Guillermo; Mateos-Díaz, Ana-María; Martinez, Jose-Antonio; Almela, Manel; Cobos-Trigueros, Nazaret; Morata, Laura; De-la-Calle, Cristina; Sala, Marta; Mensa, Josep; Soriano, Alex

    2014-01-01

    The role of linezolid in empirical therapy of suspected bacteremia remains unclear. The aim of this study was to evaluate the influence of empirical use of linezolid or glycopeptides in addition to other antibiotics on the 30-day mortality rates in patients with Gram-negative bacteremia. For this purpose, 1,126 patients with Gram-negative bacteremia in the Hospital Clinic of Barcelona from 2000 to 2012 were included in this study. In order to compare the mortality rates between patients who received linezolid or glycopeptides, the propensity scores on baseline variables were used to balance the treatment groups, and both propensity score matching and propensity-adjusted logistic regression were used to compare the 30-day mortality rates between the groups. The overall 30-day mortality rate was 16.0% during the study period. Sixty-eight patients received empirical treatment with linezolid, and 1,058 received glycopeptides. The propensity score matching included 64 patients in each treatment group. After matching, the mortality rates were 14.1% (9/64) in patients who received glycopeptides and 21.9% (14/64) in those who received linezolid, and a nonsignificant association between empirical linezolid treatment and mortality rate (odds ratio [OR], 1.63; 95% confidence interval [CI], 0.69 to 3.82; P = 0.275, McNemar's test) was found. This association remained nonsignificant when variables that remained unbalanced after matching were included in a conditional logistic regression model. Further, the stratified propensity score analysis did not show any significant relationship between empirical linezolid treatment and the mortality rate after adjustment by propensity score quintiles or other variables potentially associated with mortality. In conclusion, the propensity score analysis showed that empirical treatment with linezolid compared with that with glycopeptides was not associated with 30-day mortality rates in patients with Gram-negative bacteremia. PMID:25199780

  4. Three empirical essays on consumer behavior related to climate change and energy

    NASA Astrophysics Data System (ADS)

    Jacobsen, Grant Douglas

    This dissertation consists of three essays. All of the chapters address a topic in the area of household and consumer behavior related to climate change or energy. The first chapter is titled "The Al Gore Effect: An Inconvenient Truth and Voluntary Carbon Offsets". This chapter examines the relationship between climate change awareness and household behavior by testing whether Al Gore's documentary An Inconvenient Truth caused an increase in the purchase of voluntary carbon offsets. The analysis shows that in the two months following the film's release, zip codes within a 10-mile radius of a zip code where the film was shown experienced a 50 percent relative increase in the purchase of voluntary carbon offsets. The second chapter is titled "Are Building Codes Effective at Saving Energy? Evidence from Residential Billing Data in Florida". The analysis shows that Florida's energy-code change that took effect in 2002 is associated with a 4-percent decrease in electricity consumption and a 6-percent decrease in natural-gas consumption in Gainesville, FL. The estimated private payback period for the average residence is 6.4 years and the social payback period ranges between 3.5 and 5.3 years. The third chapter in this dissertation is titled "Do Environmental Offsets Increase Demand for Dirty Goods? Evidence from Residential Electricity Demand". This study evaluates the relationship between green products and existing patterns of consumer behavior by examining the relationship between household enrollment in a green electricity program and consumption of residential electricity. The results suggest there are two different types of green consumers. One type makes a small monthly donation and partially views the donation as a substitute for a previously existing pattern of green behavior, in this case, energy conservation. The other type makes a larger monthly donation and views the donation as a way to make strictly additional improvements in environmental quality.

  5. Empirical investigation of SET seasoning effects in Phase Change Memory arrays

    NASA Astrophysics Data System (ADS)

    Zambelli, C.; Chimenton, A.; Olivo, P.

    2011-04-01

    In this work we have investigated the seasoning effect in SET state occurring during cycling of multimegabit Phase Change Memory arrays. The impact of the erasing waveform on this phenomenon has been experimentally evaluated. The physical nature of the phenomenon has been discussed in relation to the electro-thermal characteristics of the active material. The study of such phenomenon is also important to comprehend the transition dynamics of the GST material towards its crystalline state and to develop accurate models allowing an estimate of the PCM cells behavior as a function of the operative cycles.

  6. Empirical study on impact of demographic and economic changes on pension cost

    NASA Astrophysics Data System (ADS)

    Yusof, Shaira; Ibrahim, Rose Irnawaty

    2014-06-01

    A continuation of the same financial standard of living after retirement as before is very importance to retired person. The pension provider has a responsibility to ensure their employees receive the sufficient benefit after retirement and regularly monitor the factors that cause insufficient funds to pay benefit to retirees. Insufficient funds may be due to increased in pension cost. Some of the factors that increase the cost of pensions are changes in mortality rates and interest rates. This study will used these two factors to determine their sensitivity to pension cost. Two methods which are Accrued Benefit Cost Method and Projected Benefit Cost Method will be used to estimate pension cost. Interest rates has a inversely related to pension cost while mortality rates has a directly related to pension cost.

  7. Latent change score modeling of psychophysiological data: an empirical instantiation using electrodermal responding.

    PubMed

    Keller, Peggy S; El-Sheikh, Mona

    2011-11-01

    We examined latent change score (LCS) modeling as an approach to the analysis of children's skin conductance level (SCL) throughout a stressful task-a simulated interadult argument-as it relates to externalizing and internalizing symptoms. LCS is an extension of traditional multilevel modeling (MLM), which allows estimation of proportional growth terms. Children (age 6-12 years; N=150) were from two-parent families. Mothers reported on children's internalizing and externalizing symptoms. Results indicated that the LCS models outperformed the traditional MLM. The use of LCS yielded important novel information regarding profile and pattern of responding for various children and is likely to advance understanding of relations between children's physiological responses and psychopathology symptoms. PMID:21707644

  8. Temporal variability of forest communities: empirical estimates of population change in 4000 tree species.

    PubMed

    Chisholm, Ryan A; Condit, Richard; Rahman, K Abd; Baker, Patrick J; Bunyavejchewin, Sarayudh; Chen, Yu-Yun; Chuyong, George; Dattaraja, H S; Davies, Stuart; Ewango, Corneille E N; Gunatilleke, C V S; Nimal Gunatilleke, I A U; Hubbell, Stephen; Kenfack, David; Kiratiprayoon, Somboon; Lin, Yiching; Makana, Jean-Remy; Pongpattananurak, Nantachai; Pulla, Sandeep; Punchi-Manage, Ruwan; Sukumar, Raman; Su, Sheng-Hsin; Sun, I-Fang; Suresh, H S; Tan, Sylvester; Thomas, Duncan; Yap, Sandra

    2014-07-01

    Long-term surveys of entire communities of species are needed to measure fluctuations in natural populations and elucidate the mechanisms driving population dynamics and community assembly. We analysed changes in abundance of over 4000 tree species in 12 forests across the world over periods of 6-28 years. Abundance fluctuations in all forests are large and consistent with population dynamics models in which temporal environmental variance plays a central role. At some sites we identify clear environmental drivers, such as fire and drought, that could underlie these patterns, but at other sites there is a need for further research to identify drivers. In addition, cross-site comparisons showed that abundance fluctuations were smaller at species-rich sites, consistent with the idea that stable environmental conditions promote higher diversity. Much community ecology theory emphasises demographic variance and niche stabilisation; we encourage the development of theory in which temporal environmental variance plays a central role. PMID:24805976

  9. Empirical Records of Environmental Change across the Archean-Proterozoic Transition

    NASA Astrophysics Data System (ADS)

    Kaufman, A. J.

    2011-12-01

    Time-series geochemical analyses of scientific drill cores intersecting the Archean-Proterozoic transition suggest a coupling of environmental and biological change that culminated in the pervasive oxygenation of Earth's atmosphere and oceans. Elemental and multiple isotope measurements of sedimentary archives, including carbonate, shale, and banded iron-formation from Western Australia, South Africa, Brazil, and southern Canada, indicate important changes in the carbon, sulfur, and nitrogen cycles that monitor the redox state of the oceans and the cyanobacterial buildup of atmospheric oxygen and ozone. In response, continental weathering would have increased, resulting in the enhanced delivery of sulfate and nutrients to seawater, further stimulating photoautotrophic fluxes of oxygen to surface environments. The positive feedback may additionally be responsible for the decline of atmospheric methane and surface refrigeration, represented by a series of discrete ice ages beginning around 2.4 billion years ago, due to the loss of greenhouse capacity during a time of lower solar luminosity. While speculative, the linkage of surface oxidation with enhanced nutrient supply and development of stratospheric sunscreen soon after the Archean-Proterozoic boundary suggests that the earliest perturbation in the carbon cycle may be associated with the rapid expansion of single-celled eukaryotes. Both sterol synthesis in eukaryotes and aerobic respiration require significant levels of oxygen in the ambient environment. Hence, Earth's earliest ice age(s) and onset of a modern and far more energetic carbon cycle may have been directly related to the global expansion of cyanobacteria that released oxygen to the environment, and of eukaryotes that respired it.

  10. How do psychological treatments work? Investigating mediators of change

    PubMed Central

    Murphy, Rebecca; Cooper, Zafra; Hollon, Steven D.; Fairburn, Christopher G.

    2009-01-01

    Little is known about how psychological treatments work. Research on treatment-induced mediators of change may be of help in identifying potential causal mechanisms through which they operate. Outcome-focused randomised controlled trials provide an excellent opportunity for such work. However, certain conceptual and practical difficulties arise when studying psychological treatments, most especially deciding how best to conceptualise the treatment concerned and how to accommodate the fact that most psychological treatments are implemented flexibly. In this paper, these difficulties are discussed, and strategies and procedures for overcoming them are described. PMID:19010459

  11. Guiding Empiric Treatment for Serious Bacterial Infections via Point of Care [Formula: see text]-Lactamase Characterization.

    PubMed

    Palanisami, Akilan; Khan, Shazia; Erdem, Sultan Sibel; Hasan, Tayyaba

    2016-01-01

    Fever is one of the most common symptoms of illness in infants and represents a clinical challenge due to the potential for serious bacterial infection. As delayed treatment for these infections has been correlated with increased morbidity and mortality, broad-spectrum [Formula: see text]-lactam antibiotics are often prescribed while waiting for microbiological lab results (1-3 days). However, the spread of antibiotic resistance via the [Formula: see text]-lactamase enzyme, which can destroy [Formula: see text]-lactam antibiotics, has confounded this paradigm; empiric antibiotic regimens are increasingly unable to cover all potential bacterial pathogens, leaving some infants effectively untreated until the pathogen is characterized. This can lead to lifelong sequela or death. Here, we introduce a fluorescent, microfluidic assay that can characterize [Formula: see text]-lactamase derived antibiotic susceptibility in 20 min with a sensitivity suitable for direct human specimens. The protocol is extensible, and the antibiotic spectrum investigated can be feasibly adapted for the pathogens of regional relevance. This new assay fills an important need by providing the clinician with hitherto unavailable point of care information for treatment guidance in an inexpensive and simple diagnostic format. PMID:27602307

  12. The Dimensions of Change in Therapeutic Community Treatment Instrument

    ERIC Educational Resources Information Center

    Orlando, Maria; Wenzel, Suzanne L.; Ebener, Pat; Edwards, Michael C.; Mandell, Wallace; Becker, Kirsten

    2006-01-01

    In this article, the authors describe the refinement and preliminary evaluation of the Dimensions of Change in Therapeutic Community Treatment Instrument (DCI), a measure of treatment process. In Study 1, a 99-item DCI, administered to a cross-sectional sample of substance abuse clients (N = 990), was shortened to 54 items on the basis of results…

  13. Adolescent Substance Abuse Treatment: Organizational Change and Quality of Care

    ERIC Educational Resources Information Center

    Rieckmann, Traci; Fussell, Holly; Doyle, Kevin; Ford, Jay; Riley, Katherine J.; Henderson, Stuart

    2011-01-01

    Substance abuse treatment agencies serving youth face unique barriers to providing quality care. Interviews with 17 adolescent programs found that family engagement, community involvement, and gender and diversity issues affected treatment delivery. Programs report organizational change efforts with implications for future process improvement…

  14. Family Transitions Following the Birth of a Sibling: An Empirical Review of Changes in the Firstborn’s Adjustment

    PubMed Central

    Volling, Brenda L.

    2012-01-01

    Nearly 80% of children in the U.S. have at least one sibling, indicating that the birth of a baby sibling is a normative ecological transition for most children. Many clinicians and theoreticians believe the transition is stressful, constituting a developmental crisis for most children. Yet, a comprehensive review of the empirical literature on children’s adjustment over the transition to siblinghood (TTS) has not been done for several decades. The current review summarized research examining change in firstborns’ adjustment to determine whether there was evidence that the TTS was disruptive for most children. Thirty studies addressing the transition to siblinghood were found and of those studies, the evidence did not support a crisis model of developmental transitions, nor was there overwhelming evidence of consistent changes in firstborn adjustment. Although there were decreases in children’s affection and responsiveness toward mothers, the results were more equivocal for many other behaviors (e.g., sleep problems, anxiety, aggression, regression). An inspection of the scientific literature indicated there are large individual differences in children’s adjustment and that the TTS can be a time of disruption, an occasion for developmental advances, or a period of quiescence with no noticeable changes. The TTS may be a developmental turning point for some children that portends future psychopathology or growth depending on the transactions between children and the changes in the ecological context over time. A developmental ecological systems framework guided the discussion of how child, parent, and contextual factors may contribute to the prediction of firstborn children’s successful adaptation to the birth of a sibling. PMID:22289107

  15. [Analysis of empirical treatment for newly diagnosed acute promyelocytic leukemia combined with disseminated intravascular coagulation].

    PubMed

    Yang, Hua; Zhu, Cheng-Ying; Wang, Quan-Shun; Niu, Jian-Hua; Zhang, Qi; Zhu, Hai-Yan; Yao, Zi-Long; Xu, Yuan-Yuan; Jing, Yu; Yu, Li

    2014-04-01

    This study was aimed to explore the clinical characteristics and optimal therapeutic methods for newly diagnosed acute promyelocytic leukemia (APL) combined with disseminated intravascular coagulation (DIC) so as to guide the clinical therapy. The clinical date and therapeutic outcome of 25 cases of APL combined with DIC treated from January 2008 to March 2013 in our department were analysed retrospectively. The 25 patients were given ATRA 20 mg orally twice a day and arsenic trioxide (ATO) 10 mg intravenously once a day to induce differentiation therapy, the chemotherapy was added after degranulation of promyelocytes. At the same time the platelets, fresh frozen plasma, fibrinogen, cryoprecipitate,prothrombin complex and amino methylbenzoic acid, low molecular weight heparin were given to treat DIC. According to the laboratorial examination of coagulation and fibrinolysis, the medication was adjusted.The white blood cell count, platelet level, prothrombin time (PT), partial thromboplastin time of plasma (APTT), fibrinogen level were detected, and the relation of those factors and age with bleeding severity was analyzed by multivariate manner. The results showed that among 25 patients with APL (low-risk 5 cases, intermediate risk 13 cases and high risk 7 cases), 22 cases combined with DIC, incidence of DIC was 88%. Out of 22 patients with DIC 21 patients (95.5%) were corrected, except 1 case death. After the first course of treatment, 23 cases (92%) gained complete remission (CR) with average CR time 31.8 ± 7.2 days. During the induction of CR, the average platelet transfusion level was 75.68 ± 55.88 U, the RBC level was 8.90 ± 5.69 U, the average level of fresh frozen plasma transfusion of APL patients with DIC was 21.92 ± 19.32 U. The recovery time of platelet level to normal was 29.3 ± 9.3 days, the recovery time of PT, APTT, FDP and fibrinogen to normal were 12.7 ± 9.5 days, 11.6 ± 8.6 days, 16.0 ± 9.3 days and 125.3 ± 85.3 days respectively. The

  16. Balancing Fidelity and Adaptation in the Dissemination of Empirically-Supported Treatments: The Promise of Transdiagnostic Interventions

    PubMed Central

    McHugh, R. Kathryn; Murray, Heather W.; Barlow, David H.

    2009-01-01

    Assessing treatment fidelity is a core methodological consideration in the study of treatment outcome; it influences both the degree to which changes can be attributed to the intervention and the ability to replicate and disseminate the intervention. Efforts to increase access to evidence-based psychological treatments are receiving unprecedented support; but pressures exist to adapt treatments to service settings, running the risk of compromising fidelity. However, little evidence is available to inform the necessary conditions for the transportation of interventions to service provision settings, and the degree to which fidelity is even evaluated or emphasized in dissemination and implementation programs varies dramatically. Moreover, adaptation is associated with several benefits for dissemination efforts and may address relevant barriers to adoption. A particularly promising strategy for maximizing the benefits of both fidelity and adaptation is the use of transdiagnostic interventions. Such treatments allow for greater flexibility of the pacing and content of treatment, while still providing structure to facilitate testing and replication. Preliminary evidence supports the efficacy of this strategy, which may be particularly conducive to dissemination into service provision settings. At this time, further research is needed to evaluate the relationships among fidelity, adaptation, and outcome, and to determine the potential for transdiagnostic treatments to facilitate dissemination. PMID:19643395

  17. Comparing Child, Parent, and Family Characteristics in Usual Care and Empirically Supported Treatment Research Samples for Children with Disruptive Behavior Disorders

    ERIC Educational Resources Information Center

    Baker-Ericzen, Mary J.; Hurlburt, Michael S.; Brookman-Frazee, Lauren; Jenkins, Melissa M.; Hough, Richard L.

    2010-01-01

    This study compared data from 34 research trials of five empirically supported treatments (ESTs) with one large usual care (UC) sample on child, parent, and family characteristics for children with Disruptive Behavior Disorders. Large variations were found within and across ESTs on sample characteristics during the past two decades. Most parent…

  18. Electrocortical changes associated with minocycline treatment in fragile X syndrome

    PubMed Central

    Andrea, Schneider; Jacena, Leigh Mary; Patrick, Adams; Rawi, Nanakul; Tasleem, Chechi; John, Olichney; Randi, Hagerman; David, Hessl

    2016-01-01

    Minocycline normalizes synaptic connections and behavior in the knockout mouse model of fragile X syndrome (FXS). Human-targeted treatment trials with minocycline have shown benefits in behavioral measures and parent reports. Event-related potentials (ERPs) may provide a sensitive method of monitoring treatment response and changes in coordinated brain activity. Measurement of electrocortical changes due to minocycline was done in a double-blind, placebo-controlled crossover treatment trial in children with FXS. Children with FXS (Meanage 10.5 years) were randomized to minocycline or placebo treatment for 3 months then changed to the other treatment for 3 months. The minocycline dosage ranged from 25–100 mg daily, based on weight. Twelve individuals with FXS (eight male, four female) completed ERP studies using a passive auditory oddball paradigm. Current source density (CSD) and ERP analysis at baseline showed high-amplitude, long-latency components over temporal regions. After 3 months of treatment with minocycline, the temporal N1 and P2 amplitudes were significantly reduced compared with placebo. There was a significant amplitude increase of the central P2 component on minocycline. Electrocortical habituation to auditory stimuli improved with minocycline treatment. Our study demonstrated improvements of the ERP in children with FXS treated with minocycline, and the potential feasibility and sensitivity of ERPs as a cognitive biomarker in FXS treatment trials. PMID:23981511

  19. Impact of empirical treatment in extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. bacteremia. A multicentric cohort study

    PubMed Central

    2012-01-01

    Background The objective of this study is to analyze the factors that are associated with the adequacy of empirical antibiotic therapy and its impact in mortality in a large cohort of patients with extended-spectrum β-lactamase (ESBL) - producing Escherichia coli and Klebsiella spp. bacteremia. Methods Cases of ESBL producing Enterobacteriaceae (ESBL-E) bacteremia collected from 2003 through 2008 in 19 hospitals in Spain. Statistical analysis was performed using multivariate logistic regression. Results We analyzed 387 cases ESBL-E bloodstream infections. The main sources of bacteremia were urinary tract (55.3%), biliary tract (12.7%), intra-abdominal (8.8%) and unknown origin (9.6%). Among all the 387 episodes, E. coli was isolated from blood cultures in 343 and in 45.71% the ESBL-E was multidrug resistant. Empirical antibiotic treatment was adequate in 48.8% of the cases and the in hospital mortality was 20.9%. In a multivariate analysis adequacy was a risk factor for death [adjusted OR (95% CI): 0.39 (0.31-0.97); P = 0.04], but not in patients without severe sepsis or shock. The class of antibiotic used empirically was not associated with prognosis in adequately treated patients. Conclusion ESBL-E bacteremia has a relatively high mortality that is partly related with a low adequacy of empirical antibiotic treatment. In selected subgroups the relevance of the adequacy of empirical therapy is limited. PMID:23038999

  20. Empirical model of ionospheric storm effects on the F2 layer peak height associated with changes of peak electron density

    NASA Astrophysics Data System (ADS)

    Gulyaeva, T. L.

    2012-02-01

    An empirical model of storm-time behavior of the ionospheric peak height hmF2 associated with changes of peak electron density NmF2 is inferred from the topside true-height profiles provided by ISIS 1, ISIS 2, IK-19, and Cosmos-1809 satellites for the period of 1969-1987. The topside-derived quiet-time models of the ionospheric peak height hqF2 and peak electron density NqF2 are used as a frame of reference. To harmonize the model with storm and substorm effects induced by large-scale traveling ionospheric disturbances (LSTIDs), constraints are applied to the topside data, excluding their changes deviating above LSTID extreme limits. The degree of disturbance is estimated by the ionospheric weather W index; then, the least squares fitting is applied to the median of log(hm/hq) versus log(Nm/Nq). Anticorrelation between instant changes of hmF2 and NmF2 has a particular seasonal-magnetic latitude structure varying with solar activity that is used for the buildup of the analytical model. The model allows the deduction of the instantaneous hmF2 associated with the assessment or forecast of the respective NmF2. The model is validated with the data of five ground-based ionosondes during severe space weather storms at times of high solar activity (2000) and low solar activity (2006), and results agree reasonably well with the peak parameters derived from an ionogram. The model is incorporated into the coupled International Reference Ionosphere-Plasmasphere (IRI-Plas) code, used in the assimilative mode as the three-dimensional (3-D) interpolator of the GPS-derived total electron content, TECgps.

  1. The Effect of Inadequate Initial Empiric Antimicrobial Treatment on Mortality in Critically Ill Patients with Bloodstream Infections: A Multi-Centre Retrospective Cohort Study

    PubMed Central

    Savage, Rachel D.; Fowler, Robert A.; Rishu, Asgar H.; Bagshaw, Sean M.; Cook, Deborah; Dodek, Peter; Hall, Richard; Kumar, Anand; Lamontagne, François; Lauzier, François; Marshall, John; Martin, Claudio M.; McIntyre, Lauralyn; Muscedere, John; Reynolds, Steven; Stelfox, Henry T.; Daneman, Nick

    2016-01-01

    Hospital mortality rates are elevated in critically ill patients with bloodstream infections. Given that mortality may be even higher if appropriate treatment is delayed, we sought to determine the effect of inadequate initial empiric treatment on mortality in these patients. A retrospective cohort study was conducted across 13 intensive care units in Canada. We defined inadequate initial empiric treatment as not receiving at least one dose of an antimicrobial to which the causative pathogen(s) was susceptible within one day of initial blood culture. We evaluated the association between inadequate initial treatment and hospital mortality using a random effects multivariable logistic regression model. Among 1,190 patients (1,097 had bacteremia and 93 had candidemia), 476 (40%) died and 266 (22%) received inadequate initial treatment. Candidemic patients more often had inadequate initial empiric therapy (64.5% versus 18.8%), as well as longer delays to final culture results (4 vs 3 days) and appropriate therapy (2 vs 0 days). After adjustment, there was no detectable association between inadequate initial treatment and mortality among bacteremic patients (Odds Ratio (OR): 1.02, 95% Confidence Interval (CI) 0.70–1.48); however, candidemic patients receiving inadequate treatment had nearly three times the odds of death (OR: 2.89, 95% CI: 1.05–7.99). Inadequate initial empiric antimicrobial treatment was not associated with increased mortality in bacteremic patients, but was an important risk factor in the subgroup of candidemic patients. Further research is warranted to improve early diagnostic and risk prediction methods in candidemic patients. PMID:27152615

  2. Oral Hygiene Behaviour Change During the Nonsurgical Periodontal Treatment Phase

    PubMed Central

    Shamani, Saeed; Jansson, Leif

    2012-01-01

    The purpose of the present study was to investigate the frequency of smoking cessation and the use of proximal tooth cleaning routines after a nonsurgical periodontal treatment phase in a Specialist clinic of Periodontology and to evaluate if these behaviour changes had any influence on the periodontal healing results. The investigation was conducted as a retrospective longitudinal study on a randomly selected population of 100 patients referred for periodontal treatment. The variables were registered from the dental records and the radiographs. Forty-six individuals declared that they were smokers at baseline and one individual of those quitted smoking during the nonsurgical treatment period. The percentage of individuals who performed proximal tooth cleaning daily was significantly increased from 56% to 72% during the treatment period. The patients practising proximal tooth cleaning daily had significantly lower Plaque index before as well as after the nonsurgical periodontal treatment phase compared to those without the routine. The subjects who did not perform tooth cleaning daily before the treatment and who did not introduce this routine had significantly deeper periodontal pockets compared to those who performed inter-dental cleaning daily before treatment or who had adopted the routine during the treatment phase. However, there were no significant differences according to number of deepened periodontal pockets after nonsurgical treatment irrespective of proximal cleaning routines. In the future, motivational interviewing may be a more effective method to achieve a behaviour change if an extended education of dental hygienists within this area will be implemented. PMID:23284591

  3. Changes in Anger in Relationship to Responsivity to PTSD Treatment

    PubMed Central

    Galovski, Tara E.; Elwood, Lisa S.; Blain, Leah M.; Resick, Patricia A.

    2014-01-01

    This study examined the clinical course of different dimensions of anger and their relationship to change in posttraumatic stress disorder (PTSD) in a sample of 139 female survivors of interpersonal violence suffering from PTSD. Specifically, this study evaluated differences in the rates of change in anger dimensions by responsivity to treatment status (responders, non-responders, and drop-outs). Responders and non-responders did not differ in rate of change on state anger and anger directed inward, suggesting that treatment led to improvements in these dimensions of anger regardless of final PTSD diagnosis. Responders did evidence statistically significantly more change in trait anger and control over one’s anger than did the non-responders, suggesting that changes in these dimensions of anger may be related to recovery from PTSD. Individuals who terminated therapy prematurely did not experience the same gains in state anger, trait anger, or anger-in as those who completed treatment. Differences in rates of change (linear versus quadratic growth patterns), particularly with respect to continued improvement in anger following treatment completion are discussed. PMID:25045416

  4. On the gap between an empirical distribution and an exponential distribution of waiting times for price changes in a financial market

    NASA Astrophysics Data System (ADS)

    Sazuka, Naoya

    2007-03-01

    We analyze waiting times for price changes in a foreign currency exchange rate. Recent empirical studies of high-frequency financial data support that trades in financial markets do not follow a Poisson process and the waiting times between trades are not exponentially distributed. Here we show that our data is well approximated by a Weibull distribution rather than an exponential distribution in the non-asymptotic regime. Moreover, we quantitatively evaluate how much an empirical data is far from an exponential distribution using a Weibull fit. Finally, we discuss a transition between a Weibull-law and a power-law in the long time asymptotic regime.

  5. Final Technical Report for "Collaborative Research. Regional climate-change projections through next-generation empirical and dynamical models"

    SciTech Connect

    Kravtsov, S.; Robertson, Andrew W.; Ghil, Michael; Smyth, Padhraic J.

    2011-04-08

    This project was a continuation of previous work under DOE CCPP funding in which we developed a twin approach of non-homogeneous hidden Markov models (NHMMs) and coupled ocean-atmosphere (O-A) intermediate-complexity models (ICMs) to identify the potentially predictable modes of climate variability, and to investigate their impacts on the regional-scale. We have developed a family of latent-variable NHMMs to simulate historical records of daily rainfall, and used them to downscale seasonal predictions. We have also developed empirical mode reduction (EMR) models for gaining insight into the underlying dynamics in observational data and general circulation model (GCM) simulations. Using coupled O-A ICMs, we have identified a new mechanism of interdecadal climate variability, involving the midlatitude oceans mesoscale eddy field and nonlinear, persistent atmospheric response to the oceanic anomalies. A related decadal mode is also identified, associated with the oceans thermohaline circulation. The goal of the continuation was to build on these ICM results and NHMM/EMR model developments and software to strengthen two key pillars of support for the development and application of climate models for climate change projections on time scales of decades to centuries, namely: (a) dynamical and theoretical understanding of decadal-to-interdecadal oscillations and their predictability; and (b) an interface from climate models to applications, in order to inform societal adaptation strategies to climate change at the regional scale, including model calibration, correction, downscaling and, most importantly, assessment and interpretation of spread and uncertainties in multi-model ensembles. Our main results from the grant consist of extensive further development of the hidden Markov models for rainfall simulation and downscaling specifically within the non-stationary climate change context together with the development of parallelized software; application of NHMMs to

  6. Final Technical Report for "Collaborative Research: Regional climate-change projections through next-generation empirical and dynamical models"

    SciTech Connect

    Robertson, A.W.; Ghil, M.; Kravtsov, K.; Smyth, P.J.

    2011-04-08

    This project was a continuation of previous work under DOE CCPP funding in which we developed a twin approach of non-homogeneous hidden Markov models (NHMMs) and coupled ocean-atmosphere (O-A) intermediate-complexity models (ICMs) to identify the potentially predictable modes of climate variability, and to investigate their impacts on the regional-scale. We have developed a family of latent-variable NHMMs to simulate historical records of daily rainfall, and used them to downscale seasonal predictions. We have also developed empirical mode reduction (EMR) models for gaining insight into the underlying dynamics in observational data and general circulation model (GCM) simulations. Using coupled O-A ICMs, we have identified a new mechanism of interdecadal climate variability, involving the midlatitude oceans mesoscale eddy field and nonlinear, persistent atmospheric response to the oceanic anomalies. A related decadal mode is also identified, associated with the oceans thermohaline circulation. The goal of the continuation was to build on these ICM results and NHMM/EMR model developments and software to strengthen two key pillars of support for the development and application of climate models for climate change projections on time scales of decades to centuries, namely: (a) dynamical and theoretical understanding of decadal-to-interdecadal oscillations and their predictability; and (b) an interface from climate models to applications, in order to inform societal adaptation strategies to climate change at the regional scale, including model calibration, correction, downscaling and, most importantly, assessment and interpretation of spread and uncertainties in multi-model ensembles. Our main results from the grant consist of extensive further development of the hidden Markov models for rainfall simulation and downscaling specifically within the non-stationary climate change context together with the development of parallelized software; application of NHMMs to

  7. Enhancing Motivation for Change in Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series 35.

    ERIC Educational Resources Information Center

    CDM Group, Inc.

    This TIP on the guidelines for treatment of substance use disorders is based on a fundamental rethinking of the concept of motivation. It suggests that the cognitive-behavioral approach to treatment requires a different perspective on the problem and on the prerequisites for change, while placing greater responsibility on the counselor whose job…

  8. NEW INSIGHTS INTO LEAD CORROSION CONTROL AND TREATMENT CHANGE IMPACTS

    EPA Science Inventory

    This presentation will summarize recent research into the chemistry of lead corrosion control, and focus on five different areas that could impact the prediction of whether or not particular treatment changes are likely to either disturb existing lead corrosion scales, or to actu...

  9. Changes in Coping Following Treatment for Child Molesters

    ERIC Educational Resources Information Center

    Serran, Geris A.; Moulden, Heather; Firestone, Philip; Marshall, W. L.

    2007-01-01

    Relapse prevention theory assumes that specific coping skills deficits contribute to sexual reoffending. Recent research suggests that the general coping style of sexual offenders is also ineffective. In this study changes were examined in specific and general coping deficits following a treatment program that incorporated specific skills training…

  10. Change in Suicidal Ideation Following Interdisciplinary Treatment of Chronic Pain

    PubMed Central

    Kowal, John; Wilson, Keith G.; Henderson, Peter R.; McWilliams, Lachlan A.

    2014-01-01

    Objectives To examine suicidal ideation in individuals with chronic pain, especially change in suicidal thinking following interdisciplinary treatment. Methods Consecutive patients (n = 250) admitted to a 4-week, group-based chronic pain management program completed measures of pain intensity, functional limitations, depressive symptoms, overall distress, pain catastrophizing, self-perceived burden, and suicidal ideation at pre- and post-treatment. Results Before treatment, 30 (12.0%) participants were classified as having a high level of suicidal ideation, 56 (22.4%) had a low level of suicidal ideation, and 164 (65.6%) reported none. Following treatment, there was a significant reduction in suicidal ideation and improvements in all other outcomes, but there were still some individuals with high (n = 22, 8.8%) or low (n = 28, 11.2%) levels at discharge. Patients with high suicidal ideation at baseline differed from those with no suicidal thinking on pre- and post-treatment measures of depression, distress, catastrophizing, and self-perceived burden, but not on pain intensity or functional limitations. Patients high in suicidal ideation endorsed greater pain catastrophizing and self-perceived burden than those low in suicidal thinking. Sustained suicidal ideation after treatment was associated with higher baseline levels of suicidal thinking and self-perceived burden to others, as well as a more limited overall response to treatment. Discussion Suicidal ideation was common in individuals with chronic pain, although mostly at a low level. Interdisciplinary treatment may result in reduced suicidal thinking; however, some patients continue to express thoughts of self-harm. Future studies could examine processes of change and interventions for treatment-resistant suicidal concerns. PMID:24281291

  11. Assessing changes to South African maize production areas in 2055 using empirical and process-based crop models

    NASA Astrophysics Data System (ADS)

    Estes, L.; Bradley, B.; Oppenheimer, M.; Beukes, H.; Schulze, R. E.; Tadross, M.

    2010-12-01

    Rising temperatures and altered precipitation patterns associated with climate change pose a significant threat to crop production, particularly in developing countries. In South Africa, a semi-arid country with a diverse agricultural sector, anthropogenic climate change is likely to affect staple crops and decrease food security. Here, we focus on maize production, South Africa’s most widely grown crop and one with high socio-economic value. We build on previous coarser-scaled studies by working at a finer spatial resolution and by employing two different modeling approaches: the process-based DSSAT Cropping System Model (CSM, version 4.5), and an empirical distribution model (Maxent). For climate projections, we use an ensemble of 10 general circulation models (GCMs) run under both high and low CO2 emissions scenarios (SRES A2 and B1). The models were down-scaled to historical climate records for 5838 quinary-scale catchments covering South Africa (mean area = 164.8 km2), using a technique based on self-organizing maps (SOMs) that generates precipitation patterns more consistent with observed gradients than those produced by the parent GCMs. Soil hydrological and mechanical properties were derived from textural and compositional data linked to a map of 26422 land forms (mean area = 46 km2), while organic carbon from 3377 soil profiles was mapped using regression kriging with 8 spatial predictors. CSM was run using typical management parameters for the several major dryland maize production regions, and with projected CO2 values. The Maxent distribution model was trained using maize locations identified using annual phenology derived from satellite images coupled with airborne crop sampling observations. Temperature and precipitation projections were based on GCM output, with an additional 10% increase in precipitation to simulate higher water-use efficiency under future CO2 concentrations. The two modeling approaches provide spatially explicit projections of

  12. Rapid treatment-induced brain changes in pediatric CRPS.

    PubMed

    Erpelding, Nathalie; Simons, Laura; Lebel, Alyssa; Serrano, Paul; Pielech, Melissa; Prabhu, Sanjay; Becerra, Lino; Borsook, David

    2016-03-01

    To date, brain structure and function changes in children with complex regional pain syndrome (CRPS) as a result of disease and treatment remain unknown. Here, we investigated (a) gray matter (GM) differences between patients with CRPS and healthy controls and (b) GM and functional connectivity (FC) changes in patients following intensive interdisciplinary psychophysical pain treatment. Twenty-three patients (13 females, 9 males; average age ± SD = 13.3 ± 2.5 years) and 21 healthy sex- and age-matched controls underwent magnetic resonance imaging. Compared to controls, patients had reduced GM in the primary motor cortex, premotor cortex, supplementary motor area, midcingulate cortex, orbitofrontal cortex, dorsolateral prefrontal cortex (dlPFC), posterior cingulate cortex, precuneus, basal ganglia, thalamus, and hippocampus. Following treatment, patients had increased GM in the dlPFC, thalamus, basal ganglia, amygdala, and hippocampus, and enhanced FC between the dlPFC and the periaqueductal gray, two regions involved in descending pain modulation. Accordingly, our results provide novel evidence for GM abnormalities in sensory, motor, emotional, cognitive, and pain modulatory regions in children with CRPS. Furthermore, this is the first study to demonstrate rapid treatment-induced GM and FC changes in areas implicated in sensation, emotion, cognition, and pain modulation. PMID:25515312

  13. Shape of the self-concept clarity change during group psychotherapy predicts the outcome: an empirical validation of the theoretical model of the self-concept change

    PubMed Central

    Styła, Rafał

    2015-01-01

    Background: Self-Concept Clarity (SCC) describes the extent to which the schemas of the self are internally integrated, well defined, and temporally stable. This article presents a theoretical model that describes how different shapes of SCC change (especially stable increase and “V” shape) observed in the course of psychotherapy are related to the therapy outcome. Linking the concept of Jean Piaget and the dynamic systems theory, the study postulates that a stable SCC increase is needed for the participants with a rather healthy personality structure, while SCC change characterized by a “V” shape or fluctuations is optimal for more disturbed patients. Method: Correlational study in a naturalistic setting with repeated measurements (M = 5.8) was conducted on the sample of 85 patients diagnosed with neurosis and personality disorders receiving intensive eclectic group psychotherapy under routine inpatient conditions. Participants filled in the Self-Concept Clarity Scale (SCCS), Symptoms' Questionnaire KS-II, and Neurotic Personality Questionnaire KON-2006 at the beginning and at the end of the course of psychotherapy. The SCCS was also administered every 2 weeks during psychotherapy. Results: As hypothesized, among the relatively healthiest group of patients the stable SCC increase was related to positive treatment outcome, while more disturbed patients benefited from the fluctuations and “V” shape of SCC change. Conclusions: The findings support the idea that for different personality dispositions either a monotonic increase or transient destabilization of SCC is a sign of a good treatment prognosis. PMID:26579001

  14. Changing Donor Funding and the Challenges of Integrated HIV Treatment.

    PubMed

    Nattrass, Nicoli; Hodes, Rebecca; Cluver, Lucie

    2016-01-01

    Donor financing for HIV prevention and treatment has shifted from supporting disease-specific ("vertical") programs to health systems strengthening ("horizontal") programs intended to integrate all aspects of care. We examine the consequences of shifting resources from three perspectives: first, through a broad analysis of the changing policy context of health care financing; second, through an account of changing priorities for HIV treatment in South Africa; and third, through a description of some clinical consequences that the authors observed in a research study examining adherence to antiretroviral therapy (ART) and sexual health among adolescents. We note that AIDS responses are neither completely vertical nor horizontal but rather increasingly diagonal, as disease-specific protocols operate alongside integrated supply chain management, human resource development, and preventive screening. We conclude that health care programs are better conceived of as networks of policies requiring different degrees of integration into communities. PMID:27437818

  15. "The Worst School I've Ever Been To:" Empirical Evaluations of a Restorative School and Treatment Milieu

    ERIC Educational Resources Information Center

    Mirsky, Laura; Wachtel, Ted

    2007-01-01

    While anecdotal reports have strongly supported restorative practices, there is a need to expand the evidence base through empirical studies of the efficacy of these interventions. This article highlights such emerging findings reported by Paul McCold of the Institute for Restorative Practices in collaboration with researchers from Temple…

  16. Mandibular arch perimeter changes with lip bumper treatment.

    PubMed

    Osborn, W S; Nanda, R S; Currier, G F

    1991-06-01

    The effects of lip bumper treatment on the mandibular arch were observed in 32 patients with late transitional and early permanent dentitions. Dental cast measurements were made for arch perimeter, arch length, and arch width. Cephalometric radiographs were used to determine labial tipping of the incisors and distal movement of the molars. Arch circumference increased in all patients, ranging from 0.7 mm to 8.8 mm, with an average of 4.1 mm. The mean increase in arch length was 1.2 mm and was largely attributed to anterior tipping of the mandibular incisors. Change in arch length was the most predictive variable for the increase in arch circumference. Passive changes in arch width were recorded, with a mean increase of 2.0 mm in the intercanine distance and 2.5 mm in the first premolar distance. Arch width increments contributed to the increase in arch circumference, but the increases in arch width were not found to be predictive of the change in arch circumference. Changes in either arch circumference or arch length were not related to the duration of treatment, age and sex of the patient, or the eruption status of the permanent second molars. PMID:2038972

  17. Change from inverse to normal magnetic fabrics through thermal treatment

    NASA Astrophysics Data System (ADS)

    Kim, H.; Cho, H.; Jeong, J. O.; Son, M.; Sohn, Y. K.

    2014-12-01

    The Gusandong Tuff is an extensive rhyolitic ignimbrite that has been used as an excellent key bed in the Cretaceous Gyeongsang Basin, SE Korea. Magnetic fabric analysis in the tuff, using AMS (Anisotropy of Magnetic Susceptibility) technique, shows an anomalous fabric which has horizontal k3 and vertical k1 axes in several sites. The fabric is interpreted to be an inverse one attributed to single-domain magnetites. We attempted a stepwise thermal treatment to investigate the changes of AMS axes and parameters (T, PJ) in four sites (KT11B, KT11M, KT18B, KT18M). All these sites dominantly include the specimens showing the anomalous fabric. Rock magnetism shows that magnetites are the main carrier of the AMS fabric. The changing patterns of magnetic fabric during heating are classified into 4 types: (1) Type-0 is characterized by unchanged three principal axes (k1, k2, k3) over all heating steps. (2) Type-I shows the exchange of k1 and k2 axes each other. (3) Type-II is characterized by the exchange of k2 and k3 axes each other. (4) Type-III shows that three principal axes switch their positions with one another. Except for Type-0, most of the magnetic fabrics are transformed gradually. The directional changes of the axes begin between 450-580°C and then terminate near 670°C. After the thermal treatment, all the fabrics become geologically normal as vertical k3 and horizontal k1 axes. It is also notable that the beginning temperatures are nearly equal to those of inflection points in the T-PJ plots. In the sites KT18B and KT18M which showed girdle-distributed and vertical k1 axes, respectively, before the treatment, all the k1 axes become horizontally and co-directionally clustered after the treatment. This result indicates that the thermal treatment can be a strongly useful tool for eliminating the inverse AMS magnetic fabric of natural rocks. The changes of axis orientation and magnitude observed in this study can be reasonably explained with the theoretical

  18. Structural changes of synthetic opal by heat treatment

    NASA Astrophysics Data System (ADS)

    Arasuna, Akane; Okuno, Masayuki; Okudera, Hiroki; Mizukami, Tomoyuki; Arai, Shoji; Katayama, Shin'ichi; Koyano, Mikio; Ito, Nobuaki

    2013-10-01

    The structural changes of synthetic opal by heat treatment up to 1,400 °C were investigated using scanning electron microscopy, X-ray diffraction, and Fourier transform infrared and Raman spectroscopies. The results indicate that the dehydration and condensation of silanol in opal are very important factors in the structural evolution of heat-treated synthetic opal. Synthetic opal releases water molecules and silanols by heat treatment up to 400 °C, where the dehydration of silanol may lead to the condensation of a new Si-O-Si network comprising a four-membered ring structure of SiO4 tetrahedra, even at 400 °C. Above 600 °C, water molecules are lost and the opal surface and internal silanol molecules are completely dehydrated by heat effect, and the medium-temperature range structure of opal may begin to thermally reconstruct to six-membered rings of SiO4 tetrahedra. Above 1,000 °C, the opal structure almost approaches that of silica glass with an average structure of six-membered rings. Above 1,200 °C, the opal changes to low-cristobalite; however, minor evidence of low-tridymite stacking was evident after heat treatment at 1,400 °C.

  19. Epigenetic changes in the rat livers induced by pyrazinamide treatment

    SciTech Connect

    Kovalenko, V.M.; Bagnyukova, T.V.; Sergienko, O.V.; Bondarenko, L.B.; Shayakhmetova, G.M.; Matvienko, A.V.; Pogribny, I.P.

    2007-12-15

    Drug-induced liver injury, including drug-induced hepatotoxicity during the treatment of tuberculosis infection, is a major health problem with increasingly significant challenges to modern hepatology. Therefore, the assessment and monitoring of the hepatotoxicity of antituberculosis drugs for prevention of liver injury are great concerns during disease treatment. The recently emerged data showing the ability of toxicants, including pharmaceutical agents, to alter cellular epigenetic status, open a unique opportunity for early detection of drug hepatotoxicity. Here we report that treatment of male Wistar rats with antituberculosis drug pyrazinamide at doses of 250, 500 or 1000 mg/kg/day body weight for 45 days leads to an early and sustained decrease in cytosine DNA methylation, progressive hypomethylation of long interspersed nucleotide elements (LINE-1), and aberrant promoter hypermethylation of placental form glutathione-S-transferase (GSTP) and p16{sup INK4A} genes in livers of pyrazinamide-treated rats, while serum levels of bilirubin and activity of aminotransferases changed modestly. The early occurrence of these epigenetic alterations and their association with progression of liver injury specific pathological changes indicate that alterations in DNA methylation may be useful predictive markers for the assessment of drug hepatotoxicity.

  20. Changes in Quality of Life following Buprenorphine Treatment: Relationship with Treatment Retention and Illicit Opioid Use

    PubMed Central

    Mitchell, Shannon Gwin; Gryczynski, Jan; Schwartz, Robert P.; Myers, C. Patrick; O’Grady, Kevin E.; Olsen, Yngvild K.; Jaffe, Jerome H.

    2015-01-01

    Studies of substance abuse treatment outcomes that give priority to cessation of all drug use may obscure other tangible benefits of treatment that are important to patients. The aim of this study was to examine the association between changes in quality of life (QoL) and: (a) retention in treatment and (b) opioid use as measured by self-report and urine testing. Participants were 300 African American men and women starting outpatient buprenorphine treatment. Participants completed assessments at baseline, 3- and 6-months consisting of the World Health Organization’s Quality of Life brief scale, Addiction Severity Index, and urine testing for opioids. There were statistically significant increases over time across all four QoL domains: physical, psychological, environmental, and social. Self-reported frequency of opioid use was negatively associated with psychological QoL, but opioid urine test results were not significantly associated with any QoL domains. Continued treatment enrollment was significantly associated with higher psychological QoL and environmental QoL. Patients entering buprenorphine treatment experience improvements in QoL, which are amplified for patients who remain in treatment. Point-prevalence opiate urine test results obtained at each assessment were not associated with any of the QoL domains and may not accurately reflect improvements perceived by patients receiving buprenorphine treatment. PMID:25950595

  1. Changes in Quality of Life following Buprenorphine Treatment: Relationship with Treatment Retention and Illicit Opioid Use.

    PubMed

    Mitchell, Shannon Gwin; Gryczynski, Jan; Schwartz, Robert P; Myers, C Patrick; O'Grady, Kevin E; Olsen, Yngvild K; Jaffe, Jerome H

    2015-01-01

    Studies of substance abuse treatment outcomes that give priority to cessation of all drug use may obscure other tangible benefits of treatment that are important to patients. The aim of this study was to examine the association between changes in quality of life (QoL) and: (1) retention in treatment; and (2) opioid use as measured by self-report and urine testing. Participants were 300 African American men and women starting outpatient buprenorphine treatment. Participants completed assessments at baseline, three and six months consisting of the World Health Organization's Quality of Life brief scale, Addiction Severity Index, and urine testing for opioids. There were statistically significant increases over time across all four QoL domains: physical, psychological, environmental, and social. Self-reported frequency of opioid use was negatively associated with psychological QoL, but opioid urine test results were not significantly associated with any QoL domains. Continued treatment enrollment was significantly associated with higher psychological QoL and environmental QoL. Patients entering buprenorphine treatment experience improvements in QoL, which are amplified for patients who remain in treatment. Point-prevalence opiate urine test results obtained at each assessment were not associated with any of the QoL domains and may not accurately reflect improvements perceived by patients receiving buprenorphine treatment. PMID:25950595

  2. Assessing treatment effects through changes in perceptions and cognitive organization.

    PubMed

    Szalay, L; Bovasso, G; Vilov, S; Williams, R E

    1992-01-01

    This investigation tested the Associative Group Analysis (AGA) for its analytic sensitivity in assessing perceptions and attitudes and in mapping changes in cognitive organization indicative of substance abuse. Based on inferences drawn from the distributions of thousands of spontaneous, free associations elicited by strategically selected stimulus themes, AGA offers an unstructured approach to assess images and meanings, and to map systems of mental representation evasive to the more direct methods of using questions or scales. This article compares pretreatment and posttreatment samples, tracing the psychosocial effects of treatment. The investigations focus on variables related to substance abuse such as self-image, social nexus, and perceptions of illicit substances. The results indicate a sensitive approach, useful in treatment evaluation. PMID:1449123

  3. Non-basic azolotriazinone MCHR1 antagonists for the treatment of obesity: An empirical brain-exposures-driven candidate selection for in vivo efficacy studies.

    PubMed

    Devasthale, Pratik; Wang, Wei; Mignone, James; Renduchintala, Kishore; Radhakrishnan, Sridhar; Dhanapal, Jayanthi; Selvaraj, Jagannath; Kuppusamy, Rajesh; Pelleymounter, Mary Ann; Longhi, Daniel; Huang, Ning; Flynn, Neil; Azzara, Anthony V; Rohrbach, Kenneth; Devenny, James; Rooney, Suzanne; Thomas, Michael; Glick, Susan; Godonis, Helen; Harvey, Susan; Cullen, Mary Jane; Zhang, Hongwei; Caporuscio, Christian; Stetsko, Paul; Grubb, Mary; Huang, Christine; Zhang, Lisa; Freeden, Chris; Murphy, Brian J; Robl, Jeffrey A; Washburn, William N

    2015-10-15

    Non-basic azolotriazinones were explored using an empirical free brain exposures-driven approach to identify potent MCHR1 antagonists for evaluation in in vivo efficacy studies. An optimized lead from this series, 1j (rMCHR1 Ki=1.8 nM), demonstrated a 6.9% reduction in weight gain relative to vehicle in a rat model at 30 mg/kg after 4 days of once-daily oral treatment as a glycine prodrug. Despite a promising efficacy profile, an assessment of the biliary toxicity risk of this compound rendered this compound non-progressible. PMID:26386604

  4. Changes in optical behaviour of iron pyritohedron upon microwave treatment

    NASA Astrophysics Data System (ADS)

    Arvind, Hemant K.; Choudhary, B. L.; Dolia, S. N.; Dalela, S.; Jakhar, S. R.; Kumar, Sudhish

    2016-05-01

    We have utilized the volumetric heating of materials by microwave energy absorption for investigating the changes in the optical behavior of a well characterized natural crystal of iron pyritohedron (FeS2). For microwave treatment virgin central core pieces of the FeS2 crystal were ground to fine powder and then heated in a microwave oven for half an hour. Powder XRD measurements confirmed that the microwave treatment on FeS2 does not affect the face centered cubic structure of FeS2. The UV-Visible optical spectrum of the microwave treated FeS2 display a narrow optical absorption peak at ˜315 nm, on the other hand in the UV-Vis spectrum of pure FeS2 a broad absorption band with a maximum centered ˜310-330 nm was observed. The band gap energies for pure and microwave treated FeS2 are estimated to be 1.09 eV and 1.35 eV respectively. This study clearly indicates that microwave treatment results in a blue shift in the absorption edge and enhancement in the band gap energy.

  5. Volume changes of human endothelial cells induced by photodynamic treatment

    NASA Astrophysics Data System (ADS)

    Leunig, Andreas; Staub, Frank; Plesnila, Nick; Peters, Jurgen; Feyh, Jens; Gutmann, Ralph; Goetz, Alwin E.

    1996-01-01

    Photodynamic therapy (PDT) has shown promising results in treatment of malignant tumors. However, the mechanisms leading to tumor destruction during PDT are still not completely understood. In addition to effects on the microcirculation, damage to cellular structures has been observed following exposure of cells to PDT. A phenomenon preceding these events might possibly be cell swelling. We therefore studied the influence of treatment with Photofrin (PF) and laser light on volume changes and cell viability of endothelial cells. Endothelial cells were obtained from human umbilical cord veins (HUVEC) by an adaption of the method of Maruyama (1963). After subcultivation the cells were harvested and transferred as a cell suspension into a specially designed incubation chamber. Cells received either PF in concentrations of 1.5 or 3.0 (mu) g/ml and laser illumination (630 nm; 40 mW/cm2, 4 Joule), PF alone, or laser treatment only. Following start of PF incubation and after phototreatment cell samples were taken for volume measurements using flow cytometry and for studies of cellular morphology using scanning electron microscopy. Simultaneously, cell viability was monitored by the trypan blue exclusion test and colorimetric MTT assay. (abstract truncated)

  6. Changing times and the treatment of liver injury.

    PubMed

    Lucas, C E; Ledgerwood, A M

    2000-04-01

    We hypothesized that the frequency, diagnosis and treatment of liver injury have changed dramatically in the past 30 years. Patients with liver injuries treated in an urban level I trauma center were analyzed for three separate time periods, namely, 1969-1970, 1981-1982, and 1997-1998. The injuries were categorized by etiology; Abbreviated Injury Score severity, and type of treatment, including observation (Ob), laparotomy without treatment of liver injury (OR No Rx), suture repair (Sut), tractotomy with intraperipheral hemostasis (Tr), dearterialization (HAL), and resection (Re) (See Table, below). There were 249 patients in 1969-1970, 70, 79 in 1981-1982, and 116 in 1997-1998. Stab wounds and gunshot wounds decreased from 235 patients in 1969-1970 to 61 patients in 1997-1998. Blunt injuries increased from 14 patients in 1969-1970 to 55 patients in 1997-1998. Major injuries (Abbreviated Injury Score 4-5) fell from 104 to 25 to 20 during the decade. Laparotomy was done in all patients in 1969-1970 and 1981-1982, whereas most blunt injuries were observed in 1997-1998; only 9 of 65 blunt injuries in 1997-1998 required hemostasis. [table in text] We conclude the following: 1) Central urban depopulation reduces experience with liver trauma, 2) abdominal CT increases the diagnosis of liver injury, and 3) observation of stable patients with blunt liver injury is now the standard. PMID:10776869

  7. Algorithm changes in treatment of submandibular gland sialolithiasis.

    PubMed

    Kopeć, Tomasz; Wierzbicka, Małgorzata; Szyfter, Witold; Leszczyńska, Małgorzata

    2013-07-01

    Our research was conducted to determine the algorithm changes during the treatment of submandibular sialolithiasis. Two time periods were compared between 2004-2008 and 2009-2012. The turning point was December 2008, when sialendoscopy procedure was introduced. In the first period, 48 patients were treated: 31 outpatient duct incisions with stone evacuation and 17 surgical excision of submandibular gland. In the second period, 207 sialendoscopy procedures were performed on 197 patients. Out of this particular group, 158 patients were diagnosed with pathological obstruction of salivary glands and 64 of them were confirmed to have sialolithiasis of submandibular gland. Deposits of calcifications in 40 individuals (62.5 %) affected by sialolithiasis were removed endoscopically; however, in 21 patients, due to the increased circumference of the stone, the intimate association of deposits within the wall of the duct along with its presence inside the deep portions of the gland, double approach (incision of the floor of the mouth in hilar area and sialendoscopy) was performed. Three individuals had their salivary glands totally removed due to the presence of calcified deposits within the glandular parenchyma. Our results allow us to affirm that sialendoscopy is the current treatment of choice for submandibular glands affected by sialoliths. Indication for a complete removal of the gland is becoming uncommon as a first line treatment although still indispensable in chosen cases. PMID:23568038

  8. Subtypes of batterers in treatment: empirical support for a distinction between type I, type II and type III.

    PubMed

    Graña, José Luis; Redondo, Natalia; Muñoz-Rivas, Marina J; Cantos, Arthur L

    2014-01-01

    This study explores the existence of different types of batterers in a sample of 266 men who had been court referred for intimate partner violence. The data collected in the assessment that have been used to perform a hierarchical and a two-step cluster analysis fall into three areas: aggression towards the partner, general aggression and presence of psychopathology and personality traits, more specifically, alcohol use, borderline and antisocial personality traits, psychopathy traits, state anger and trait anger, anger expression and control, anger, hostility, and, finally, impulsivity. The results show a typology consisting of 3 types of batterers on the basis of violence level and psychopathology: low (65%), moderate (27.8%) and high (7.1%). This study provides empirical support for the development of batterer typologies. These typologies will help achieve early detection of different types of batterers, allowing us to tailor interventions on the basis of the needs of each of the types. PMID:25329828

  9. Subtypes of Batterers in Treatment: Empirical Support for a Distinction between Type I, Type II and Type III

    PubMed Central

    Graña, José Luis; Redondo, Natalia; Muñoz-Rivas, Marina J.; Cantos, Arthur L.

    2014-01-01

    This study explores the existence of different types of batterers in a sample of 266 men who had been court referred for intimate partner violence. The data collected in the assessment that have been used to perform a hierarchical and a two-step cluster analysis fall into three areas: aggression towards the partner, general aggression and presence of psychopathology and personality traits, more specifically, alcohol use, borderline and antisocial personality traits, psychopathy traits, state anger and trait anger, anger expression and control, anger, hostility, and, finally, impulsivity. The results show a typology consisting of 3 types of batterers on the basis of violence level and psychopathology: low (65%), moderate (27.8%) and high (7.1%). This study provides empirical support for the development of batterer typologies. These typologies will help achieve early detection of different types of batterers, allowing us to tailor interventions on the basis of the needs of each of the types. PMID:25329828

  10. The Changing Landscape of Lung Cancer Research and Treatment

    Cancer.gov

    Along with the Lung Cancer Social Media (#LCSM) community, the National Cancer Institute will be co-hosting a lively and interactive Google Hangout on Air about the changing landscape of lung cancer research and treatment. During the chat, viewers will have the opportunity to pose questions to a panel of lung cancer experts including NCI's Dr. Shakun Malik, the head of thoracic oncology therapeutics, Roy S. Herbst, MD, PhD, Chief of Medical Oncology, Yale Cancer Center and Smilow Cancer Hospital at Yale-New Haven and David Tom Cooke MD FACS, Head, Section of General Thoracic Surgery University of California, Davis. You can also learn more and follow along on the #LCSM Chat page. The chat will be moderated by lung cancer advocate and #LCSM co-founder, Janet Freeman-Daily. To ask questions of our experts, simply use the #LCSM hashtag during the chat.

  11. Treatment of the mentally ill in the Chola Empire in 11th -12th centuries AD: A study of epigraphs

    PubMed Central

    Raghavan, D. Vijaya; Tejus Murthy, A. G.; Somasundaram, O.

    2014-01-01

    The paper deals with the epigraphs of the Chola emperors Veera Rajendra Deva (1063-1069 AD) and Raja Raja III (1216-1256 AD), found at the temples of Thirumukkudal and Vedaranyam, with emphasis on the treatment given to the residents of the attached hospitals with special reference to treatment of mental disorders. PMID:24891715

  12. Capacity to Consent to Treatment: Empirical Comparison of Three Instruments in Older Adults with and without Dementia

    ERIC Educational Resources Information Center

    Moye, Jennifer; Karel, Michele J.; Azar, Armin R.; Gurrera, Ronald J.

    2004-01-01

    Purpose: The purpose of this study was to compare adults with and without dementia on capacities to consent to treatment as assessed by three instruments. Design and Methods: Eighty-eight older adults with mild to moderate dementia were compared with 88 matched controls on four indices of legal competency to consent to medical treatment as…

  13. Changes in rhizosphere bacterial gene expression following glyphosate treatment.

    PubMed

    Newman, Molli M; Lorenz, Nicola; Hoilett, Nigel; Lee, Nathan R; Dick, Richard P; Liles, Mark R; Ramsier, Cliff; Kloepper, Joseph W

    2016-05-15

    In commercial agriculture, populations and interactions of rhizosphere microflora are potentially affected by the use of specific agrichemicals, possibly by affecting gene expression in these organisms. To investigate this, we examined changes in bacterial gene expression within the rhizosphere of glyphosate-tolerant corn (Zea mays) and soybean (Glycine max) in response to long-term glyphosate (PowerMAX™, Monsanto Company, MO, USA) treatment. A long-term glyphosate application study was carried out using rhizoboxes under greenhouse conditions with soil previously having no history of glyphosate exposure. Rhizosphere soil was collected from the rhizoboxes after four growing periods. Soil microbial community composition was analyzed using microbial phospholipid fatty acid (PLFA) analysis. Total RNA was extracted from rhizosphere soil, and samples were analyzed using RNA-Seq analysis. A total of 20-28 million bacterial sequences were obtained for each sample. Transcript abundance was compared between control and glyphosate-treated samples using edgeR. Overall rhizosphere bacterial metatranscriptomes were dominated by transcripts related to RNA and carbohydrate metabolism. We identified 67 differentially expressed bacterial transcripts from the rhizosphere. Transcripts downregulated following glyphosate treatment involved carbohydrate and amino acid metabolism, and upregulated transcripts involved protein metabolism and respiration. Additionally, bacterial transcripts involving nutrients, including iron, nitrogen, phosphorus, and potassium, were also affected by long-term glyphosate application. Overall, most bacterial and all fungal PLFA biomarkers decreased after glyphosate treatment compared to the control. These results demonstrate that long-term glyphosate use can affect rhizosphere bacterial activities and potentially shift bacterial community composition favoring more glyphosate-tolerant bacteria. PMID:26901800

  14. Changes in soft tissue profile following treatment with the bionator.

    PubMed

    Lange, D W; Kalra, V; Broadbent, B H; Powers, M; Nelson, S

    1995-01-01

    The purpose of this study was to determine the changes in the soft tissue profile in patients treated in the mixed dentition with a bionator. Two groups of 30 individuals, between 9 and 12 years old and with Class II, Division 1, malocclusion were matched for age, sex, observation time, and dentofacial characteristics. Patients in the first group were treated with a bionator for an average of 18.7 months, resulting in a Class I molar relationship and reduction of overjet. The second group acted as a control and individuals did not receive any form of orthodontic treatment. Pretreatment and posttreatment cephalograms were analyzed and paired t-tests were used to compare the significance of changes between the two groups. Compared with the control group, the treated group demonstrated 1.97 degrees decrease in ANB, a 3.35 mm increase in anterior facial height, 2.22 degrees decrease in soft tissue profile convexity, and 17.4 degrees increase in mentolabial angle. PMID:8702068

  15. Land Use Change Impacts to Flows and Hydropower at the Southern Fringe of the Brazilian Amazon: A Regional, Empirical Study of Land-Water-Energy Nexus Dynamics

    NASA Astrophysics Data System (ADS)

    Levy, M. C.; Thompson, S. E.; Cohn, A.

    2014-12-01

    Land use/cover change (LUCC) has occurred extensively in the Brazilian Amazon rainforest-savanna transition. Agricultural development-driven LUCC at regional scales can alter surface energy budgets, evapotranspiration (ET) and rainfall; these hydroclimatic changes impact streamflows, and thus hydropower. To date, there is only limited empirical understanding of these complex land-water-energy nexus dynamics, yet understanding is important to developing countries where both agriculture and hydropower are expanding and intensifying. To observe these changes and their interconnections, we synthesize a novel combination of ground network, remotely sensed, and empirically modeled data for LUCC, rainfall, flows, and hydropower potential. We connect the extensive temporal and spatial trends in LUCC occurring from 2000-2012 (and thus observable in the satellite record) to long-term historical flow records and run-of-river hydropower generation potential estimates. Changes in hydrologic condition are observed in terms of dry and wet season moments, extremes, and flow duration curves. Run-of-river hydropower generation potential is modeled at basin gauge points using equation models parameterized with literature-based low-head turbine efficiencies, and simple algorithms establishing optimal head and capacity from elevation and flows, respectively. Regression analyses are used to demonstrate a preliminary causal analysis of LUCC impacts to flow and energy, and discuss extension of the analysis to ungauged basins. The results are transferable to tropical and transitional forest regions worldwide where simultaneous agricultural and hydropower development potentially compete for coupled components of regional water cycles, and where policy makers and planners require an understanding of LUCC impacts to hydroclimate-dependent industries and ecosystems.

  16. Potential utility of empirical tuberculosis treatment for HIV-infected patients with advanced immunodeficiency in high TB-HIV burden settings.

    PubMed

    Lawn, S D; Ayles, H; Egwaga, S; Williams, B; Mukadi, Y D; Santos Filho, E D; Godfrey-Faussett, P; Granich, R M; Harries, A D

    2011-03-01

    The human immunodeficiency virus (HIV) and HIV-associated tuberculosis (TB-HIV) epidemics remain uncontrolled in many resource-limited regions, especially in sub-Saharan Africa. The scale of these epidemics requires the consideration of innovative bold interventions and 'out-of-the-box' thinking. To this end, a symposium entitled 'Controversies in HIV' was held at the 40th Union World Conference on Lung Health in Cancun, Mexico, in December 2009. The first topic debated, entitled 'Annual HIV testing and immediate start of antiretroviral therapy for all HIV-infected persons', received much attention at international conferences and in the literature in 2009. The second topic forms the subject of this article. The rationale for the use of empirical TB treatment is premised on the hypothesis that in settings worst affected by the TB-HIV epidemic, a subset of HIV-infected patients have such a high risk of undiagnosed TB and of associated mortality that their prognosis may be improved by immediate initiation of empirical TB treatment used in conjunction with antiretroviral therapy. In addition to morbidity and mortality reduction, additional benefits may include prevention of nosocomial TB transmission and TB preventive effect. Potential adverse consequences, however, may include failure to consider other non-TB diagnoses, drug co-toxicity, compromised treatment adherence, and logistical and resource challenges. There may also be general reluctance among national TB programmes to endorse such a strategy. Following fruitful debate, the conclusion that this strategy should be carefully evaluated in randomised controlled trials was strongly supported. This paper provides an in-depth consideration of this proposed intervention. PMID:21333094

  17. Comparative Case Study of Diffusion of Eye Movement Desensitization and Reprocessing in Two Clinical Settings: Empirically Supported Treatment Status Is Not Enough

    PubMed Central

    Cook, Joan M.; Biyanova, Tatyana; Coyne, James C.

    2013-01-01

    An in-depth comparative case study was conducted of two attempts at diffusion of an empirically supported, but controversial, psychotherapy: eye movement desensitization and reprocessing (EMDR). One Department of Veterans Affairs (VA) treatment setting in which there was substantial uptake was compared with a second VA setting in which it was not adopted. Qualitative interviews were conducted with 10 mental health clinicians at the first site, and 19 at the second. Critical selling points for EMDR were a highly regarded champion, the observability of effects with patients, and personally experiencing its effects during a role training session. Compatibility with existing psychotherapist practices and values further allowed the therapy to become embedded in the organizational culture. At the second site, a sense that EMDR was not theoretically coherent or compelling overwhelmed other considerations, including its empirical status. Comparative studies contrasting settings in which innovative therapies are implemented versus those in which they were rejected may aid in refining theories of and strategies for dissemination. PMID:25360060

  18. Economic evaluation of test-and-treat and empirical treatment strategies in the eradication of Helicobacter pylori infection; A Markov model in an Iranian adult population

    PubMed Central

    Mazdaki, Alireza; Ghiasvand, Hesam; Sarabi Asiabar, Ali; Naghdi, Seyran; Aryankhesal, Aidin

    2016-01-01

    Background: Helicobacter pylori may cause many gastrointestinal problems in developing countries such as Iran. We aimed to analyze the cost- effectiveness and cost- utility of the test-and-treat and empirical treatment strategies in managing Helicobacter pylori infection. Methods: This was a Markov based economic evaluation. Effectiveness was defined as the symptoms free numbers and QALYs in 100,000 hypothetical adults. The sensitivity analysis was based on Monte Carlo approach. Results: In the test- and- treat strategy, if the serology is the first diagnostic test vs. histology, the cost per symptoms free number would be 291,736.1 Rials while the cost per QALYs would be 339,226.1 Rials. The cost per symptoms free number and cost per QALYs when the 13 C-UBT was used as the first diagnostic test vs. serology was 1,283,200 and 1,492,103 Rials, respectively. In the empirical strategy, if histology is used as the first diagnostic test vs. 13 CUBT, the cost per symptoms free numbers and cost per QALYs would be 793,234 and 955,698 Rials, respectively. If serology were used as the first diagnostic test vs. histology, the cost per symptoms free and QALYs would be 793,234 and 368941 Rials, respectively. Conclusion: There was no significant and considerable dominancy between the alternatives and the diagnostic tests. PMID:27390697

  19. Impact of farm level adaptation to climate change on agricultural productivity and farmers' wellbeing: Empirical evidence from Pakistan

    NASA Astrophysics Data System (ADS)

    Abid, Muhammad; Scheffran, Jürgen

    2016-04-01

    Climate change is projected to adversely affect the agricultural sector and attached rural livelihoods, particularly in the developing countries. Hence adaptation to climate change is crucial to support agricultural productivity and rural livelihoods. The current study is based on comprehensive cross sectional data collected through 450 face-to-face interviews with farmers from three agro-ecological zones of Punjab province, Pakistan. This paper aims to examine the factors that influence the farmers' adaptation decisions and to assess the impact of farm level adaptation on crop productivity and farmers' wellbeing. The paper uses correlation analysis, binary logistic regression and propensity score matching techniques in order to explore the study objectives. The results of the study indicate that education, age, land holdings, farmer-to-farmer interaction, access to weather forecasting information and location in agro-ecological zone does have significant impact on farmers' decision to adapt to climate change. Major adaptation measures adopted by farmers were changing planting dates, changing cropping varieties, planting shaded trees and changing input-mix. Moreover the study found a positive and significant impact of adaptation on productivity of all major crops (wheat, sugarcane, maize and rice) and on farmers' wellbeing in term of farm income. Furthermore, the study also found that the extent of adaptation benefits increases with the number of adaptation measures. The findings of the study suggest to focus on farmers' education and easy access to climate-specific information for better adaptation at farm level and improved farm wellbeing. Key words: Climate change; Farm level adaptation; crop productivity; farmers' wellbeing; Pakistan

  20. Translating Empirically Supported Strategies into Accessible Interventions: The Potential Utility of Exercise for the Treatment of Panic Disorder

    ERIC Educational Resources Information Center

    Smits, Jasper A. J.; Powers, Mark B.; Berry, Angela C.; Otto, Michael W.

    2007-01-01

    Many patients suffering from panic disorder do not receive adequate care. Advances in the conceptualization and treatment of panic disorder encourage innovative strategies for targeting core fears (fears of anxiety sensations) that underlie this disorder. In this article, we discuss the use of exercise as a potential strategy for therapeutic…

  1. Clients' Expected Number of Counseling Sessions, Treatment Effectiveness, and Termination Status: Using Empirical Evidence to Inform Session Limit Policies

    ERIC Educational Resources Information Center

    Owen, Jesse; Smith, Amanda; Rodolfa, Emil

    2009-01-01

    Many counseling centers have session limits to accommodate the increasing number of clients who seek treatment. The current study explored clients' expectations for the number of sessions over the course of one year at a large university counseling center. In contrast to previous research that has suggested clients want ten or fewer sessions, our…

  2. Changes in Transformational Leadership and Empirical Quality Outcomes in a Finnish Hospital over a Two-Year Period: A Longitudinal Study

    PubMed Central

    Mäntynen, Raija; Vehviläinen-Julkunen, Katri; Partanen, Pirjo; Turunen, Hannele; Miettinen, Merja; Kvist, Tarja

    2014-01-01

    This paper describes the changes in transformational leadership and quality outcomes that occurred between 2008 and 2011 in a Finnish university hospital that is aiming to meet the Magnet standards. Measurements were conducted in 2008-2009 and subsequently in 2010-2011 by surveying nursing staff and patients. Nursing staff were surveyed using web-based surveys to collect data on transformational leadership (n1 = 499, n2 = 498) and patient safety culture (n1 = 234, n2 = 512) and using both postal and web-based surveys to gather information on job satisfaction (n1 = 1176, n2 = 779). Questionnaires were used to collect data on care satisfaction from patients (n1 = 678, n2 = 867). Transformational leadership was measured using the 54-item TLS, job satisfaction with the 37-item KUHJSS, patient safety culture with the 42-item HSPSC, and patient satisfaction using the 42-item RHCS questionnaire. Transformational leadership, which was the weakest area, was at the same level between the two measurement occasions. Job satisfaction scores increased between 2008 and 2010, although they were generally excellent in 2008. The scores for nonpunitive responses to errors and events reported were also higher in the 2010-2011 surveys. The highest empirical outcome scores related to patient satisfaction. The project and the development initiatives undertaken since 2008 seem to have had positive effects on empirical quality outcomes. PMID:25009744

  3. Changing Bilingual Self-Perceptions from Early Adolescence to Early Adulthood: Empirical Evidence from a Mixed-Methods Case Study

    ERIC Educational Resources Information Center

    Caldas, Stephen J.

    2008-01-01

    In the emerging tradition of language socialization research, this study examines the changing bilingual self-perceptions of three children, identical twin girls and their older brother, from early adolescence through early adulthood. The children were reared in a predominantly French-speaking home in south Louisiana by French/English bilingual…

  4. Evidence for Adverse Phonatory Change Following an Inhaled Combination Treatment

    ERIC Educational Resources Information Center

    Erickson, Elizabeth; Sivasankar, Mahalakshmi

    2010-01-01

    Purpose: Voice problems are reported as a frequent side effect of inhaled combination (IC) treatments. The purpose of this experimental study was to investigate whether IC treatments are detrimental to phonation. We hypothesized that IC treatment would significantly increase phonation threshold pressure (PTP) and perceived phonatory effort (PPE),…

  5. Lipid changes due to fenofibrate treatment are not associated with changes in DNA methylation patterns in the GOLDN study

    PubMed Central

    Das, Mithun; Irvin, M. Ryan; Sha, Jin; Aslibekyan, Stella; Hidalgo, Bertha; Perry, Rodney T.; Zhi, Degui; Tiwari, Hemant K.; Absher, Devin; Ordovas, Jose M.; Arnett, Donna K.

    2015-01-01

    Fenofibrate lowers triglycerides (TG) and raises high density lipoprotein cholesterol (HDLc) in dyslipidemic individuals. Several studies have shown genetic variability in lipid responses to fenofibrate treatment. It is, however, not known whether epigenetic patterns are also correlated with the changes in lipids due to fenofibrate treatment. The present study was therefore undertaken to examine the changes in DNA methylation among the participants of Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) study. A total of 443 individuals were studied for epigenome-wide changes in DNA methylation, assessed using the Illumina Infinium HumanMethylation450 array, before and after a 3-week daily treatment with 160 mg of fenofibrate. The association between the change in DNA methylation and changes in TG, HDLc, and low-density lipoprotein cholesterol (LDLc) were assessed using linear mixed models adjusted for age, sex, baseline lipids, and study center as fixed effects and family as a random effect. Changes in DNA methylation were not significantly associated with changes in TG, HDLc, or LDLc after 3 weeks of fenofibrate for any CpG. CpG changes in genes known to be involved in fenofibrate response, e.g., PPAR-α, APOA1, LPL, APOA5, APOC3, CETP, and APOB, also did not show evidence of association. In conclusion, changes in lipids in response to 3-week treatment with fenofibrate were not associated with changes in DNA methylation. Studies of longer duration may be required to detect treatment-induced changes in methylation. PMID:26483836

  6. Clarithromycin vs. Gemifloxacin in Quadruple Therapy Regimens for Empiric Primary Treatment of Helicobacter pylori Infection: A Randomized Clinical Trial

    PubMed Central

    Masoodi, Mohsen; Talebi-Taher, Mahshid; Tabatabaie, Khadijeh; Khaleghi, Siamak; Faghihi, Amir-Hossein; Agah, Shahram; Asadi, Reyhaneh

    2015-01-01

    BACKGROUND Eradication of Helicobacter pylori infection plays a crucial role in the treatment of peptic ulcer. Clarithromycin resistance is a major cause of treatment failure. This randomized clinical trial aimed at evaluating the efficacy of a clarithromycin versus gemifloxacin containing quadruple therapy regimen in eradication of H.pylori infection. METHODS In this randomized double blind clinical trial (RCT 2012102011054N2), a total of 120 patients were randomized to two groups of 60 patients each. Patients with proven H.pylori infection were consecutively assigned into two groups to receive OBAG or OBAC in gastroenterology clinic in Rasoul-e- Akram General Hospital in Tehran, Iran. The patients in the OBAG group received omeprazole (20 mg) twice daily, bismuth subcitrate (240 mg) twice daily, amoxicillin (1 gr) twice daily, and gemifloxacin (320 mg) once daily, and those in the OBAC group received omeprazole (20 mg) twice daily, 240 mg of bismuth subcitrate twice daily, amoxicillin (1 gr) twice daily, and clarithromycin (500 mg) twice daily for 10 days. RESULTS Five patients from each group were excluded from the study because of poor compliance, so 110 patients completed the study. The intention-to-treat eradication rate was 61.6% and 66.6% for the OBAC and OBAG groups, respectively. According to the per protocol analysis, the success rates of eradication of H.pylori infection were 67.2% and 72.7% for OBAC and OBAG groups, respectively (p=0.568). CONCLUSION The results of this study suggest that gemifloxacin containing regimen is at least as effective as clarithromycin regimen; hence, this new treatment could be considered as an alternative for the patients who cannot tolerate clarithromycin. PMID:26106468

  7. An Empirical Approach to the Diagnosis and Treatment of Cerebrospinal Fluid Rhinorrhoea: An Optimised Method for Developing Countries

    PubMed Central

    SAFAVI, Ali; Safavi, Amir Ali; Jafari, Rozita

    2014-01-01

    Background: We aimed to test a new approach for repairing cerebrospinal fluid (CSF) leaks and to determine the demographic, diagnostic, and treatment factors associated with the successful management of intracranial complication. Owing to the high frequency of endoscopic surgeries and the low cost of medical care in Iran, we decided to report our experience of reconstruction after CSF leaks. Methods: We retrospectively reviewed our experience in the diagnosis and management of CSF rhinorrhoea in Iran between 2005 and 2012. The locations of all pre-repair leaks were identified using simple, readily available methods. The follow-up time ranged from 2 to 72 months. Results: Of the 37 participants, 59.5% were men and the mean age was 33 years. The success rate was 86.1%, and the most common aetiological factor was trauma (57%). The most common location was the ethmoidal fovea (45.9%), followed by the sphenoid sinus (24.3%), the cribriform plate (13.5%), and the posterior table of the frontal sinus (5.4%). Conclusion: Medical care in Iran has considerable budget restrictions. This study advocates a practical method of treatment for patients in similar circumstances, with a success rate of 86.1% when compared to the 90.6% achieved with other techniques. Keywords: cerebrospinal fluid leak, endoscopic, intracranial pressure ICP PMID:25977632

  8. Identifying significant covariates for anti-HIV treatment response: mechanism-based differential equation models and empirical semiparametric regression models.

    PubMed

    Huang, Yangxin; Liang, Hua; Wu, Hulin

    2008-10-15

    In this paper, the mechanism-based ordinary differential equation (ODE) model and the flexible semiparametric regression model are employed to identify the significant covariates for antiretroviral response in AIDS clinical trials. We consider the treatment effect as a function of three factors (or covariates) including pharmacokinetics, drug adherence and susceptibility. Both clinical and simulated data examples are given to illustrate these two different kinds of modeling approaches. We found that the ODE model is more powerful to model the mechanism-based nonlinear relationship between treatment effects and virological response biomarkers. The ODE model is also better in identifying the significant factors for virological response, although it is slightly liberal and there is a trend to include more factors (or covariates) in the model. The semiparametric mixed-effects regression model is very flexible to fit the virological response data, but it is too liberal to identify correct factors for the virological response; sometimes it may miss the correct factors. The ODE model is also biologically justifiable and good for predictions and simulations for various biological scenarios. The limitations of the ODE models include the high cost of computation and the requirement of biological assumptions that sometimes may not be easy to validate. The methodologies reviewed in this paper are also generally applicable to studies of other viruses such as hepatitis B virus or hepatitis C virus. PMID:18407583

  9. Fluctuating Arctic Sea ice thickness changes estimated by an in situ learned and empirically forced neural network model

    USGS Publications Warehouse

    Belchansky, G.I.; Douglas, D.C.; Platonov, N.G.

    2008-01-01

    Sea ice thickness (SIT) is a key parameter of scientific interest because understanding the natural spatiotemporal variability of ice thickness is critical for improving global climate models. In this paper, changes in Arctic SIT during 1982-2003 are examined using a neural network (NN) algorithm trained with in situ submarine ice draft and surface drilling data. For each month of the study period, the NN individually estimated SIT of each ice-covered pixel (25-km resolution) based on seven geophysical parameters (four shortwave and longwave radiative fluxes, surface air temperature, ice drift velocity, and ice divergence/convergence) that were cumulatively summed at each monthly position along the pixel's previous 3-yr drift track (or less if the ice was <3 yr old). Average January SIT increased during 1982-88 in most regions of the Arctic (+7.6 ?? 0.9 cm yr-1), decreased through 1996 Arctic-wide (-6.1 ?? 1.2 cm yr-1), then modestly increased through 2003 mostly in the central Arctic (+2.1 ?? 0.6 cm yr-1). Net ice volume change in the Arctic Ocean from 1982 to 2003 was negligible, indicating that cumulative ice growth had largely replaced the estimated 45 000 km3 of ice lost by cumulative export. Above 65??N, total annual ice volume and interannual volume changes were correlated with the Arctic Oscillation (AO) at decadal and annual time scales, respectively. Late-summer ice thickness and total volume varied proportionally until the mid-1990s, but volume did not increase commensurate with the thickening during 1996-2002. The authors speculate that decoupling of the ice thickness-volume relationship resulted from two opposing mechanisms with different latitudinal expressions: a recent quasi-decadal shift in atmospheric circulation patterns associated with the AO's neutral state facilitated ice thickening at high latitudes while anomalously warm thermal forcing thinned and melted the ice cap at its periphery. ?? 2008 American Meteorological Society.

  10. Multimodality treatment strategies have changed prognosis of peritoneal metastases.

    PubMed

    Lungoci, Corneliu; Mironiuc, Aurel Ion; Muntean, Valentin; Oniu, Traian; Leebmann, Hubert; Mayr, Max; Piso, Pompiliu

    2016-01-15

    For a long time, treatment of peritoneal metastases (PM) was mostly palliative and thus, this status was link with "terminal status/despair". The current multimodal treatment strategy, consisting of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), has been strenuously achieved over time, but seems to be the best treatment option for PM patients. As we reviewed the literature data, we could emphasize some milestones and also, controversies in the history of proposed multimodal treatment and thus, outline the philosophy of this approach, which seems to be an unusual one indeed. Initially marked by nihilism and fear, but benefiting from a remarkable joint effort of human and material resources (multi-center and -institutional research), over a period of 30 years, CRS and HIPEC found their place in the treatment of PM. The next 4 years were dedicated to the refinement of the multimodal treatment, by launching research pathways. In selected patients, with requires training, it demonstrated a significant survival results (similar to the Hepatic Metastases treatment), with acceptable risks and costs. The main debates regarding CRS and HIPEC treatment were based on the oncologists' perspective and the small number of randomized clinical trials. It is important to statement the PM patient has the right to be informed of the existence of CRS and HIPEC, as a real treatment resource, the decision being made by multidisciplinary teams. PMID:26798438

  11. Multimodality treatment strategies have changed prognosis of peritoneal metastases

    PubMed Central

    Lungoci, Corneliu; Mironiuc, Aurel Ion; Muntean, Valentin; Oniu, Traian; Leebmann, Hubert; Mayr, Max; Piso, Pompiliu

    2016-01-01

    For a long time, treatment of peritoneal metastases (PM) was mostly palliative and thus, this status was link with “terminal status/despair”. The current multimodal treatment strategy, consisting of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), has been strenuously achieved over time, but seems to be the best treatment option for PM patients. As we reviewed the literature data, we could emphasize some milestones and also, controversies in the history of proposed multimodal treatment and thus, outline the philosophy of this approach, which seems to be an unusual one indeed. Initially marked by nihilism and fear, but benefiting from a remarkable joint effort of human and material resources (multi-center and -institutional research), over a period of 30 years, CRS and HIPEC found their place in the treatment of PM. The next 4 years were dedicated to the refinement of the multimodal treatment, by launching research pathways. In selected patients, with requires training, it demonstrated a significant survival results (similar to the Hepatic Metastases treatment), with acceptable risks and costs. The main debates regarding CRS and HIPEC treatment were based on the oncologists’ perspective and the small number of randomized clinical trials. It is important to statement the PM patient has the right to be informed of the existence of CRS and HIPEC, as a real treatment resource, the decision being made by multidisciplinary teams. PMID:26798438

  12. The Essence of Residential Treatment: III. Change and Adaptation

    ERIC Educational Resources Information Center

    Leichtman, Martin

    2008-01-01

    This paper examines four challenges facing residential treatment programs: Providing short-term treatment, increasing family involvement, preparing children for life in the community, and offering a "hospital level of care." It shows that past problems in these areas have arisen from the social conditions and historical circumstances in which…

  13. Advanced Wastewater Treatment Engineering-Investigating Membrane Fouling in both Rotational and Static Membrane Bioreactor Systems Using Empirical Modelling.

    PubMed

    Paul, Parneet; Jones, Franck Anderson

    2016-01-01

    Advanced wastewater treatment using membranes are popular environmental system processes since they allow reuse and recycling. However, fouling is a key limiting factor and so proprietary systems such as Avanti's RPU-185 Flexidisks membrane bioreactor (MBR) use novel rotating membranes to assist in ameliorating it. In earlier research, this rotating process was studied by creating a simulation model based on first principles and traditional fouling mechanisms. In order to directly compare the potential benefits of this rotational system, this follow-up study was carried out using Avanti's newly developed static (non-rotating) Flexidisks MBR system. The results from operating the static pilot unit were simulated and modelled using the rotational fouling model developed earlier however with rotational switching functions turned off and rotational parameters set to a static mode. The study concluded that a rotating MBR system could increase flux throughput when compared against a similar static system. It is thought that although the slowly rotating spindle induces a weak crossflow shear, it is still able to even out cake build up across the membrane surface, thus reducing the likelihood of localised critical flux being exceeded at the micro level and lessening the potential of rapid trans-membrane pressure increases at the macro level. PMID:26742053

  14. Advanced Wastewater Treatment Engineering—Investigating Membrane Fouling in both Rotational and Static Membrane Bioreactor Systems Using Empirical Modelling

    PubMed Central

    Paul, Parneet; Jones, Franck Anderson

    2016-01-01

    Advanced wastewater treatment using membranes are popular environmental system processes since they allow reuse and recycling. However, fouling is a key limiting factor and so proprietary systems such as Avanti’s RPU-185 Flexidisks membrane bioreactor (MBR) use novel rotating membranes to assist in ameliorating it. In earlier research, this rotating process was studied by creating a simulation model based on first principles and traditional fouling mechanisms. In order to directly compare the potential benefits of this rotational system, this follow-up study was carried out using Avanti’s newly developed static (non-rotating) Flexidisks MBR system. The results from operating the static pilot unit were simulated and modelled using the rotational fouling model developed earlier however with rotational switching functions turned off and rotational parameters set to a static mode. The study concluded that a rotating MBR system could increase flux throughput when compared against a similar static system. It is thought that although the slowly rotating spindle induces a weak crossflow shear, it is still able to even out cake build up across the membrane surface, thus reducing the likelihood of localised critical flux being exceeded at the micro level and lessening the potential of rapid trans-membrane pressure increases at the macro level. PMID:26742053

  15. Hormonal effects on Tetrahymena: change in case of combined treatment.

    PubMed

    Csaba, G; Lajkó, Eszter; Pállinger, Eva

    2010-12-01

    In order to approach their natural conditions, populations of Tetrahymena were kept in Losina-Losinky's salt solution for 1 h, than in the tryptone+yeast medium. During this time they were treated with histamine, serotonin or insulin, or with the combinations of these hormones. Effect of the combined treatments on the production of serotonin (5HT), or adrenocorticotropic hormone (ACTH) or triiodothyronine (T₃) by the cells was compared to the effect of single-hormone treatments. Significant differences were seen between the results obtained following the single or combined treatments. There was no summation of the effects, however an elevation or diminution of the hormone production was observed after the combined treatment, as compared with the untreated controls or with the use of one of the hormones in the samples. The experiments demonstrate that there is a hormonal regulation between the Tetrahymena cells and the hormones influence each other's effect. PMID:21183424

  16. [Personality changes of neurotic patients as outcome of the treatment].

    PubMed

    Jodzio, K

    1993-01-01

    The present article attempted to assess the importance of outcomes which appeared during the treatment of 30 neurotic patients. This study specially concentrates on measures of emotional empathy, self-confidence and introspection. There were two surveys in the clinical group: before and after the treatment was completed. Data were compared with a control group, also consisting of 30 persons (15 male and 15 female) matched for age and education. All patients attending group psychotherapy were also treated by pharmacotherapy. As it appeared from the analysis before treatment high empathy in patients was found, but this declined after therapy, however it was still significantly higher than in the control group. The first survey revealed also that patients demonstrated lower levels of self-confidence and introspection. After treatment there were no important differences between the groups. Relationships between the studied qualities were not statistically significant. PMID:8134493

  17. Assessing the Impacts of Climate Change on Drinking Water Treatment

    EPA Science Inventory

    Climate change may affect both surface water and ground water quality. Increases (or decreases) in precipitation and related changes in flow can result in problematic turbidity levels, increased levels of organic matter, high levels of bacteria, virus and parasites and increased...

  18. Sofosbuvir, a Significant Paradigm Change in HCV Treatment.

    PubMed

    McQuaid, Thomas; Savini, Carolyn; Seyedkazemi, Star

    2015-03-01

    Nucleotide compounds like sofosbuvir, acyclovir, and tenofovir have proven to be amongst the most potent orally available antiviral treatments. These drugs exhibit high efficacy and a wide therapeutic index, with demonstrated utility in a number of chronic viral infections. The approval of Sovaldi™, brand name for sofosbuvir, by the U.S. Food and Drug Administration heralded improvements in chronic hepatitis C virus (HCV) treatment. Sofosbuvir was originally discovered by Pharmasset Corporation and named PSI-7977. It was subsequently acquired and advanced through phase 3 development by Gilead Sciences, Inc. In Sofosbuvir both a unique pharmacology and a high specificity for the HCV ribonucleic acid polymerase are present in a molecule that is well tolerated and highly efficacious. Phase 2 and 3 clinical trials have consistently demonstrated durable and high rates of sustained virologic response (SVR), curing patients in excess of 80% in all genotypes and >90% in treatment-naïve subjects being administered combination therapy with other agents. Harvoni(®) is the combination of sofosbuvir and the NS5A inhibitor ledipasvir in a fixed-dose oral tablet, and it has demonstrated high SVR rates in patients infected with HCV genotype 1, without the need for exogenous interferon and/or ribavirin. Here, we discuss the discovery, development, pharmacologic characterization, and results from the phase 3 trials of sofosbuvir. Hepatitis C is a chronic disease, for which most patients have been undiagnosed, are unwilling to start treatment, or are ineligible for treatment because of the high toxicity and low efficacy of interferon and ribavirin-based therapy. Clinical studies with sofosbuvir have demonstrated significant improvement over the prior standard of care, thus ushering in a new paradigm of HCV treatment and an update of treatment guidelines. PMID:26357632

  19. Physiological Changes in Older Adults and Their Effect on Diabetes Treatment

    PubMed Central

    Gates, Brian J.; Walker, Kevin M.

    2014-01-01

    In Brief Physiological changes associated with aging have the potential to affect the treatment of diabetes. However, evidence regarding treatment of diabetes in geriatric patients has been limited, especially for “oldest-old” patients. Recent research has provided greater insight into the risks and benefits of treatment, and new guidelines provide more specific information regarding treatment goals in older people with diabetes and encourage greater individualization of treatment. PMID:26246752

  20. [Perinatal clomiphene citrate treatment changes sexual orientations of male mice].

    PubMed

    He, Feng-Qin; Zhang, Heng-Rui

    2013-10-01

    Perinatal period and adolescence are critical for brain development, which is the biological basis of an individual's sexual orientation and sexual behavior. In this study, animals were divided into two groups and their sexual orientations were observed: one group experienced drug treatments during the perinatal period, and the other group was castrated at puberty. The results showed that estradiol treatment had no effect on mature male offspring's sexual orientations, but 9 days and 14 days of clomiphene citrate treatment significantly increased the chance of homosexuality and effeminized behavior. In addition, the sexual orientation of mature normal male offspring, which were castrated when they were 21 days old,was not significant different from the control animals. These findings suggest that the inhibition of perinatal estrogen activities could suppress individual male-typical responses, enhance female-typical responses and induce homosexual orientations. Moreover, the masculinizing effects of estrogen were more obvious during perinatal period than adolescence. PMID:24115661

  1. Ultrasonic verification of microstructural changes due to heat treatment

    NASA Technical Reports Server (NTRS)

    Generazio, E. R.

    1986-01-01

    Ultrasonic attenuation was measured for polycrystalline samples of nickel and copper with various grain-size distributions produced by heat treatment. Attenuation as a function of frequency was determined for a sample having a known mean grain diameter. Once this function was determined, it could be scaled to determine the mean grain size of other samples of the same material with different mean grain diameters. These results were obtained by using broadband pulse-echo ultrasound in the 25 to 100 MHz frequency range. The results suggest an ultrasonic, nondestructive approach for verifying heat treatment of metals.

  2. Starting, Choosing, Changing, and Discontinuing Drug Treatment for Epilepsy Patients.

    PubMed

    Schmidt, Dieter

    2016-05-01

    Epilepsy is a serious brain disease with seizures as the main symptom, which can be successfully treated with antiepileptic drugs (AEDs). AEDs are usually started as soon as the epilepsy diagnosis has been established. About 80% of adults with new-onset epilepsy will achieve lasting seizure remission on AEDs. However, 20% continue to have seizures despite treatment (drug-resistant epilepsy). AEDs can be safely discontinued after several years of seizure remission during early treatment. Remarkably, 60% of all treated patients remain in remission off AEDs, making epilepsy one of the best treatable among chronic brain diseases. PMID:27086984

  3. Lifestyle changes and surgical treatment for hypertension in the elderly.

    PubMed

    Duran-Salgado, Montserrat B; Rubio-Guerra, Alberto F

    2015-01-01

    Hypertension is a major cardiovascular risk factor that increases morbidity and mortality in the elderly because, numerous factors contribute to development and progression of hypertension in elderly patients, including excessive salt intakes, obesity, physical inactivity and stress. Hypertension treatment usually results in a combination of both, pharmacologic and non-pharmacologic measures. These latter are an essential part of treatment and cannot be replaced by the medication. Non pharmacologic management known as lifestyle modifications has a pivotal role in non-hypertensive and hypertensive individuals. In case of non-hypertensive or pre-hypertensive patients it can prevent hypertension development and in hypertensive people it has the capacity to lower blood pressure levels as well as modify cardiovascular complications. Older people tend more often to treatment resistance so it is increasingly necessary to have other therapeutic resources for patients with difficult control of disease. Minimally invasive techniques are developing that might improve the course of the disease and prevent its complications by a more extended time.In this chapter, we will review components of nonpharmacological treatment of hypertension focusing on the geriatric patient. PMID:25761105

  4. Length of Group Treatment and Changes in Women with Bulimia.

    ERIC Educational Resources Information Center

    Gerstein, Lawrence H.; Hotelling, Kathy

    1987-01-01

    Examined effects of 4-month or 9-month multidimensional therapy group on bulimic women. Results suggest that participants altered behaviors, attitudes, feelings, and thoughts related to bingeing, purging, and physical appearance and developed more adaptive life skills. Decreases in bingeing and purging were maintained after treatment; no…

  5. Cognitive Mediation of Treatment Change in Social Phobia

    ERIC Educational Resources Information Center

    Hofmann, Stefan G.

    2004-01-01

    Ninety individuals with social phobia (social anxiety disorder) participated in a randomized controlled trial and completed cognitive-behavioral group therapy, exposure group therapy without explicit cognitive interventions, or a wait-list control condition. Both treatments were superior to the wait-list group in reducing social anxiety but did…

  6. Changes in wheat kernel proteins induced by microwave treatment.

    PubMed

    Lamacchia, Carmela; Landriscina, Loretta; D'Agnello, Paola

    2016-04-15

    Wheat kernels were subjected to microwave treatment, and the proteins were characterized by size exclusion high-performance liquid chromatography (SE-HPLC) and sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). Using this process, the proteins polymerize, forming intermolecular bonds among the same classes of proteins. Furthermore, the polymerization occurs only through disulphide bonds. Although SDS-PAGE did not show any differences for either the number or intensity of protein bands between flour samples before and after microwave treatment, gliadins from treated flours showed significantly reduced cross-reactivity with the R5 antibody. Moreover, the gluten became soluble in an aqueous saline solution, and it was not possible to isolate it using the Glutomatic apparatus. However, the treated flour, in the presence of water, was able to form dough and leaven and produce bread. PMID:26616997

  7. Electrical conductivity changes during irreversible electroporation treatment of brain cancer.

    PubMed

    Garcia, Paulo A; Rossmeisl, John H; Davalos, Rafael V

    2011-01-01

    Irreversible electroporation (IRE) is a new minimally invasive technique to kill tumors and other undesirable tissue in a non-thermal manner. During an IRE treatment, a series of short and intense electric pulses are delivered to the region of interest to destabilize the cell membranes in the tissue and achieve spontaneous cell death. The alteration of the cellular membrane results in a dramatic increase in electrical conductivity during IRE as in other electroporation-based-therapies. In this study, we performed the planning and execution of an IRE brain cancer treatment using MRI reconstructions of the tumor and a multichannel array that served as a stereotactic fiducial and electrode guide. Using the tumor reconstructions within our numerical simulations, we developed equations relating the increase in tumor conductivity to calculated currents and volumes of tumor treated with IRE. We also correlated the experimental current measured during the procedure to an increase in tumor conductivity ranging between 3.42-3.67 times the baseline conductivity, confirming the physical phenomenon that has been detected in other tissues undergoing similar electroporation-based treatments. PMID:22254416

  8. Metabolic changes in psoriatic skin under topical corticosteroid treatment

    PubMed Central

    2013-01-01

    Background MR spectroscopy of intact biopsies can provide a metabolic snapshot of the investigated tissue. The aim of the present study was to explore the metabolic pattern of uninvolved skin, psoriatic skin and corticosteroid treated psoriatic skin. Methods The three types of skin biopsy samples were excised from patients with psoriasis (N = 10). Lesions were evaluated clinically, and tissue biopsies were excised and analyzed by one-dimensional 1H MR spectroscopy. Relative levels were calculated for nine tissue metabolites. Subsequently, relative amounts of epidermis, dermis and subcutaneous tissue were scored by histopathological evaluation of HES stained sections. Results Seven out of 10 patients experienced at least 40% reduction in clinical score after corticosteroid treatment. Tissue biopsies from psoriatic skin contained lower levels of the metabolites myo-inositol and glucose, and higher levels of choline and taurine compared to uninvolved skin. In corticosteroid treated psoriatic skin, tissue levels of glucose, myo-inositol, GPC and glycine were increased, whereas choline was reduced, in patients with good therapeutic effect. These tissue levels are becoming more similar to metabolite levels in uninvolved skin. Conclusion This MR method demonstrates that metabolism in psoriatic skin becomes similar to that of uninvolved skin after effective corticosteroid treatment. MR profiling of skin lesions reflect metabolic alterations related to pathogenesis and treatment effects. PMID:23945194

  9. Respiratory and Cognitive Mediators of Treatment Change in Panic Disorder: Evidence for Intervention Specificity

    ERIC Educational Resources Information Center

    Meuret, Alicia E.; Rosenfield, David; Seidel, Anke; Bhaskara, Lavanya; Hofmann, Stefan G.

    2010-01-01

    Objective: There are numerous theories of panic disorder, each proposing a unique pathway of change leading to treatment success. However, little is known about whether improvements in proposed mediators are indeed associated with treatment outcomes and whether these mediators are specific to particular treatment modalities. Our purpose in this…

  10. Changes in vitamin D metabolites during teriparatide treatment

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective was to assess changes in serum 1,25(OH)2D and 25(OH)D concentrations during teriparatide 20 g/day (teriparatide) therapy in the double-blind Fracture Prevention Trial of postmenopausal women with osteoporosis and male study of men with osteoporosis. Patients were randomized to teripara...

  11. Changing Needle Practices in Community Outreach and Methadone Treatment.

    ERIC Educational Resources Information Center

    Wechsberg, Wendee M.; And Others

    1994-01-01

    This pretest/posttest study used two samples of injecting drug users (184 from street outreach and 103 from a methadone program) to assess drug use and human immunodeficiency virus risk practices. The improvement in risk behaviors at posttest suggests that intervention programs were agents of change. (SLD)

  12. Neoadjuvant-intensified treatment for rectal cancer: Time to change?

    PubMed Central

    Musio, Daniela; De Felice, Francesca; Bulzonetti, Nadia; Guarnaccia, Roberta; Caiazzo, Rossella; Bangrazi, Caterina; Raffetto, Nicola; Tombolini, Vincenzo

    2013-01-01

    AIM: To investigate whether neoadjuvant-intensified radiochemotherapy improved overall and disease-free survival in patients with locally advanced rectal cancer. METHODS: Between January 2007 and December 2011, 80 patients with histologically confirmed rectal adenocarcinoma were enrolled. Tumors were clinically classified as either T3 or T4 and by the N stage based on the presence or absence of positive regional lymph nodes. Patients received intensified combined modality treatment, consisting of neoadjuvant radiation therapy (50.4-54.0 Gy) and infusional chemotherapy (oxaliplatin 50 mg/m2) on the first day of each week, plus five daily continuous infusions of fluorouracil (200 mg/m2 per die) from the first day of radiation therapy until radiotherapy completion. Patients received five or six cycles of oxaliplatin based on performance status, clinical lymph node involvement, and potential risk of a non-sphincter-conserving surgical procedure. Surgery was planned 7 to 9 wk after the end of radiochemotherapy treatment; adjuvant chemotherapy treatment was left to the oncologist’s discretion and was recommended in patients with positive lymph nodes. After treatment, all patients were monitored every three months for the first year and every six months for the subsequent years. RESULTS: Of the 80 patients enrolled, 75 patients completed the programmed neoadjuvant radiochemotherapy treatment. All patients received the radiotherapy prescribed total dose; five patients suspended chemotherapy indefinitely because of chemotherapy-related toxicity. At least five cycles of oxaliplatin were administered to 73 patients. Treatment was well tolerated with high compliance and a good level of toxicity. Most of the acute toxic effects observed were classified as grades 1-2. Proctitis grade 2 was the most common symptom (63.75%) and the earliest manifestation of acute toxicity. Acute toxicity grades 3-4 was reported in 30% of patients and grade 3 or 4 diarrhoea reported in just three

  13. Identifying Patients Who Need a Change in Depression Treatment and Implementing That Change.

    PubMed

    Papakostas, George I

    2016-08-01

    For patients whose depression is difficult to treat or treatment-resistant, physicians must make an educated choice to switch, augment, or combine therapies to help patients adequately respond after initial treatment selections fail. Uncover some of the complexities of this challenging diagnosis by following the case of Robert, a 55-year-old accountant whose inadequate response to treatment by his primary care doctor has prompted a referral to a specialist. PMID:27561146

  14. Treatment Outcome Package: Measuring and facilitating multidimensional change.

    PubMed

    Boswell, James F; Kraus, David R; Castonguay, Louis G; Youn, Soo Jeong

    2015-12-01

    The Treatment Outcome Package (TOP; D. R. Kraus, Seligman, & Jordan, 2005) is a multidimensional routine progress and outcome measure developed for use in diverse naturalistic practice settings. In this article, we (a) provide a brief review and summary of the extant psychometric and research support for the TOP, (b) provide examples of the TOP's use in clinical training and practice, and (c) discuss the implications of the TOP for future psychotherapy training, research, and practice. In particular, we focus on the implications of risk-adjusted progress monitoring for systems of care and mental health care decision making. PMID:26641372

  15. Changes in personal networks of women in residential and outpatient substance abuse treatment.

    PubMed

    Min, Meeyoung O; Tracy, Elizabeth M; Kim, Hyunsoo; Park, Hyunyong; Jun, Minkyoung; Brown, Suzanne; McCarty, Christopher; Laudet, Alexandre

    2013-10-01

    Changes in personal network composition, support and structure over 12 months were examined in 377 women from residential (n=119) and intensive outpatient substance abuse treatment (n=258) through face-to-face interviews utilizing computer based data collection. Personal networks of women who entered residential treatment had more substance users, more people with whom they had used alcohol and/or drugs, and fewer people from treatment programs or self- help groups than personal networks of women who entered intensive outpatient treatment. By 12 months post treatment intake, network composition improved for women in residential treatment; however, concrete support was still lower and substance users are still more prevalent in their networks. Network composition of women in outpatient treatment remained largely the same over time. Both groups increased cohesiveness within the network over 12 months. Targeting interventions that support positive changes in personal networks may heighten positive long term outcomes for women entering treatment. PMID:23755971

  16. Changes in Personal Networks of Women in Residential and Outpatient Substance Abuse Treatment

    PubMed Central

    Min, Meeyoung O.; Tracy, Elizabeth M.; Kim, Hyunsoo; Park, Hyunyong; Jun, MinKyong; Brown, Suzanne; McCarty, Christopher; Laudet, Alexandre

    2013-01-01

    Changes in personal network composition, support and structure over 12 months were examined in 377 women from residential (n=119) and intensive outpatient substance abuse treatment (n=258) through face-to-face interviews utilizing computer based data collection. Personal networks of women who entered residential treatment had more substance users, more people with whom they had used alcohol and/or drugs, and fewer people from treatment programs or self- help groups than personal networks of women who entered intensive outpatient treatment. By 12 months post treatment intake, network composition improved for women in residential treatment; however, concrete support was still lower and substance users still more prevalent in their networks. Network composition of women in outpatient treatment remained largely the same over time. Both groups increased cohesiveness within the network over 12 months. Targeting interventions that support positive changes in personal networks may heighten positive long term outcomes for women entering treatment. PMID:23755971

  17. Morphological changes of V-79 cells after equinatoxin II treatment.

    PubMed

    Batista, U; Jezernik, K

    1992-02-01

    Morphological observations on the V-79-379 A cells after treatment with equinatoxin II (EqT II), isolated from the sea anemone Actina equina L., and fetal calf serum (FCS) treated toxin were examined by transmission electron microscopy. Our results showed that the cells incubated with FCS treated EqT II were almost ultrastructurally unaltered. When the cells were treated with low concentrations of EqT II alone cell ultrastructure was altered with the evidence of numerous blebs and decreased microvilli number on the cell surface and appearance of numerous vesicles in the Golgi regions. High concentrations of EqT II caused disintegration of plasmalemma and intracellular membranes as well as degradation of cytosol. PMID:1348018

  18. Fleet Fatality Risk and its Sensitivity to Vehicle Mass Change in Frontal Vehicle-to-Vehicle Crashes, Using a Combined Empirical and Theoretical Model.

    PubMed

    Shi, Yibing; Nusholtz, Guy S

    2015-11-01

    The objective of this study is to analytically model the fatality risk in frontal vehicle-to-vehicle crashes of the current vehicle fleet, and its sensitivity to vehicle mass change. A model is built upon an empirical risk ratio-mass ratio relationship from field data and a theoretical mass ratio-velocity change ratio relationship dictated by conservation of momentum. The fatality risk of each vehicle is averaged over the closing velocity distribution to arrive at the mean fatality risks. The risks of the two vehicles are summed and averaged over all possible crash partners to find the societal mean fatality risk associated with a subject vehicle of a given mass from a fleet specified by a mass distribution function. Based on risk exponent and mass distribution from a recent fleet, the subject vehicle mean fatality risk is shown to increase, while at the same time that for the partner vehicles decreases, as the mass of the subject vehicle decreases. The societal mean fatality risk, the sum of these, incurs a penalty with respect to a fleet with complete mass equality. This penalty reaches its minimum (~8% for the example fleet) for crashes with a subject vehicle whose mass is close to the fleet mean mass. The sensitivity, i.e., the rate of change of the societal mean fatality risk with respect to the mass of the subject vehicle is assessed. Results from two sets of fully regression-based analyses, Kahane (2012) and Van Auken and Zellner (2013), are approximately compared with the current result. The general magnitudes of the results are comparable, but differences exist at a more detailed level. The subject vehicle-oriented societal mean fatality risk is averaged over all possible subject vehicle masses of a given fleet to obtain the overall mean fatality risk of the fleet. It is found to increase approximately linearly at a rate of about 0.8% for each 100 lb decrease in mass of all vehicles in the fleet. PMID:26660748

  19. Proton magnetic resonance spectroscopy changes after antipsychotic treatment.

    PubMed

    Szulc, Agata; Galinska-Skok, Beata; Waszkiewicz, Napoleon; Bibulowicz, Daniel; Konarzewska, Beata; Tarasow, Eugeniusz

    2013-01-01

    Proton magnetic resonance spectroscopy ((1)H MRS) enables the observation of brain function in vivo. Several brain metabolites can be measured by the means of (1)H MRS: N-acetylaspartate (NAA), choline containing compounds (Cho), myo-inositol (mI) and glutamate (Glu), glutamine (Gln) and GABA (together as Glx complex or separately). (1)H MRS measures have been found to be abnormal in psychotic disorders such as schizophrenia. Here we specifically review the influence exerted by antipsychotic drugs on brain metabolism, as detected by (1)H MRS. We systematically reviewed the available literature and uncovered 27 studies, 16 before-after treatment and 11 cross-sectional. Most of them addressed the effects of antipsychotics in schizophrenia and mainly focusing on NAA alterations. Follow up studies indicated antipsychotic drugs may act by increasing NAA levels in selected brain areas (the frontal lobe and thalamus), especially during the short-time observation. This phenomenon seems to vanish after longer observation. Other studies indicated that glutamate measures are decreasing along with the duration of the disease, suggesting both a neurodegenerative process present in schizophrenic brain as well as an influence of antipsychotics. The above results were reviewed according to the most recent theories in the field accounting for the impact of antipsychotics (1)HMRS measures. PMID:23157634

  20. Changes in some physical properties induced by vacuum heat treatment

    NASA Technical Reports Server (NTRS)

    Hultquist, A. E.

    1972-01-01

    A method is proposed for reducing or eliminating outgassing of materials by heat treating them in vacuum prior to use. This may be performed on the raw material prior to manufacturing and installation or after fabrication of parts. Processing of a fabricated part can be performed only on relatively small parts and on assemblies containing no components which are affected by the required temperatures and pressures. Processing conditions of temperature and time are dependent on the particular application and the materials involved. Silicone-coated fiber glass cloth was vacuum-heat treated for 100 hrs at 400 + or - 25 F at pressures of 0.001 torr or less. The materials were tested in terms of tensile strength and tear properties in both the smooth and several creased configurations. Data obtained on one side silicone coated fiber glass showed large reductions in these properties as a result of the vacuum-heat treatment. The problem was alleviated by coating both sides of the fiber glass.

  1. A scoping study to identify opportunities to advance the ethical implementation and scale-up of HIV treatment as prevention: priorities for empirical research

    PubMed Central

    2014-01-01

    Background Despite the evidence showing the promise of HIV treatment as prevention (TasP) in reducing HIV incidence, a variety of ethical questions surrounding the implementation and “scaling up” of TasP have been articulated by a variety of stakeholders including scientists, community activists and government officials. Given the high profile and potential promise of TasP in combatting the global HIV epidemic, an explicit and transparent research priority-setting process is critical to inform ongoing ethical discussions pertaining to TasP. Methods We drew on the Arksey and O’Malley framework for conducting scoping review studies as well as systematic approaches to identifying empirical and theoretical gaps within ethical discussions pertaining to population-level intervention implementation and scale up. We searched the health science database PubMed to identify relevant peer-reviewed articles on ethical and implementation issues pertaining to TasP. We included English language articles that were published after 2009 (i.e., after the emergence of causal evidence within this field) by using search terms related to TasP. Given the tendency for much of the criticism and support of TasP to occur outside the peer-reviewed literature, we also included grey literature in order to provide a more exhaustive representation of how the ethical discussions pertaining to TasP have and are currently taking place. To identify the grey literature, we systematically searched a set of search engines, databases, and related webpages for keywords pertaining to TasP. Results Three dominant themes emerged in our analysis with respect to the ethical questions pertaining to TasP implementation and scale-up: (a) balancing individual- and population-level interests; (b) power relations within clinical practice and competing resource demands within health care systems; (c) effectiveness considerations and socio-structural contexts of HIV treatment experiences within broader

  2. Neural and behavioural changes in male periadolescent mice after prolonged nicotine-MDMA treatment.

    PubMed

    Adeniyi, Philip A; Ishola, Azeez O; Laoye, Babafemi J; Olatunji, Babawale P; Bankole, Oluwamolakun O; Shallie, Philemon D; Ogundele, Olalekan M

    2016-02-01

    The interaction between MDMA and Nicotine affects multiple brain centres and neurotransmitter systems (serotonin, dopamine and glutamate) involved in motor coordination and cognition. In this study, we have elucidated the effect of prolonged (10 days) MDMA, Nicotine and a combined Nicotine-MDMA treatment on motor-cognitive neural functions. In addition, we have shown the correlation between the observed behavioural change and neural structural changes induced by these treatments in BALB/c mice. We observed that MDMA (2 mg/Kg body weight; subcutaneous) induced a decline in motor function, while Nicotine (2 mg/Kg body weight; subcutaneous) improved motor function in male periadolescent mice. In combined treatment, Nicotine reduced the motor function decline observed in MDMA treatment, thus no significant change in motor function for the combined treatment versus the control. Nicotine or MDMA treatment reduced memory function and altered hippocampal structure. Similarly, a combined Nicotine-MDMA treatment reduced memory function when compared with the control. Ultimately, the metabolic and structural changes in these neural systems were seen to vary for the various forms of treatment. It is noteworthy to mention that a combined treatment increased the rate of lipid peroxidation in brain tissue. PMID:26088184

  3. [Changes in the surgical treatment of breast cancer].

    PubMed

    Taguchi, T

    1988-01-01

    The principle in surgery for breast cancer is to clean out and remove en masse the primary lesion within the breast as well as the lymph nodes (metastases) in the vicinity. This fundamental approach to surgical intervention was established by Halsted and Meyer at the close of the nineteenth century. This has been termed typical mastectomy to this day and standard radical mastectomy has been the method used. Later, a more expanded type of radical surgery was performed on somewhat more advanced cases, but a less radical approach then came about. Since 1960, the excision of nodes in the cerebrum and cerebellum was not used for early cancer, and in some cases a more conservative approach in which only part of the breasts was removed resulted, as Europe and the United States were heavily toward reduced operations. Thus, it was considered that axillary expurgation was needed, but that excision of nodes in the cerebrum and cerebellum was not essential in every case. One approach is less aggressive, whether as to the expurgation or excision of the surrounding area of the breast; in certain cases, treatment may be combined with radiation and the surgery minimized. The above-mentioned operative procedure which leaves brain nodes intact has been called modified radical mastectomy. This is subdivided into the Auchincloss method, in which modes in the cerebellum are extirpated, and the Patey method, in which the cerebral nodes are preserved. In Japan this approach has been used for breast cancer in Stage I and Stage II, with surgery gradually becoming the mainstream. Conservative breast operation procedures such as tumor extirpation, partial breast removal or segmental resection are still rare in Japan but very common in Europe and the United States. Since remote metastases frequently occur through the circulation in breast cancer, in recent years it has generally been regarded as a whole-body disease and, in terms of the advance of the cancer in each case, the method of

  4. Empiric Piperacillin-Tazobactam versus Carbapenems in the Treatment of Bacteraemia Due to Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae

    PubMed Central

    Harris, Patrick N. A.; De, Partha P.; Chow, Angela; Tambyah, Paul A.; Lye, David C.

    2016-01-01

    Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae are a common cause of bacteraemia in endemic countries and may be associated with high mortality; carbapenems are considered the drug of choice. Limited data suggest piperacillin-tazobactam could be equally effective. We aimed to compare 30-day mortality of patients treated empirically with piperacillin-tazobactam versus a carbapenem in a multi-centre retrospective cohort study in Singapore. Only patients with active empiric monotherapy with piperacillin-tazobactam or a carbapenem were included. A propensity score for empiric carbapenem therapy was derived and an adjusted multivariate analysis of mortality was conducted. A total of 394 patients had ESBL-Escherichia.coli and ESBL-Klebsiella pneumoniae bacteraemia of which 23.1% were community acquired cases. One hundred and fifty-one received initial active monotherapy comprising piperacillin-tazobactam (n = 94) or a carbapenem (n = 57). Patients who received carbapenems were less likely to have health-care associated risk factors and have an unknown source of bacteraemia, but were more likely to have a urinary source. Thirty-day mortality was comparable between those who received empiric piperacillin-tazobactam and a carbapenem (29 [30.9%] vs. 17 [29.8%]), P = 0.89). Those who received empiric piperacillin-tazobactam had a lower 30-day acquisition of multi-drug resistant and fungal infections (7 [7.4%] vs. 14 [24.6%]), P<0.01). After adjusting for confounders, use of empiric piperacillin-tazobactam was not associated with increased 30-day mortality (OR 1.00, 95% CI; 0.45–2.17). Empiric piperacillin-tazobactam was not associated with increased 30-day mortality and may result in fewer multi-drug resistant and fungal infections when compared with a carbapenem. PMID:27104951

  5. Predictors and moderators of psychological changes during the treatment of adolescent bulimia nervosa

    PubMed Central

    Ciao, Anna C.; Accurso, Erin C.; Fitzsimmons-Craft, Ellen E.; Le Grange, Daniel

    2015-01-01

    This study examined predictors of psychological change among 80 adolescents with bulimia nervosa (BN) participating in a randomized-controlled trial comparing family-based treatment (FBT) to supportive psychotherapy (SPT). Psychological outcomes (cognitive eating disorder pathology, depression, and self-esteem) were explored at baseline, post-treatment, and 6-month follow-up. Multi-level growth models examined predictors of rate of change in psychological outcomes and moderators of treatment effects. All psychological outcomes improved through 6-month follow-up (moderate to large effect sizes) across both treatments. Overall, few significant predictors were identified. Older adolescents had faster change in self-esteem relative to younger adolescents (p=.03). Adolescents taking psychotropic medication at baseline had faster change in eating concerns relative to adolescents not taking medication (p=.02). Age (p=.02) and baseline purging severity (p=.03) moderated the relationship between treatment condition and change in eating concerns, where younger adolescents and individuals with high baseline purging had greater change when treated with FBT relative to SPT. Age and purging did not significantly moderate change in other psychological outcomes. Bulimic symptom improvement did not predict change in psychological symptoms. Generally, FBT and SPT were equally efficacious with respect to psychological improvement, although FBT may be more efficacious in younger adolescents and those with more frequent purging. PMID:25874955

  6. Predictors and moderators of psychological changes during the treatment of adolescent bulimia nervosa.

    PubMed

    Ciao, Anna C; Accurso, Erin C; Fitzsimmons-Craft, Ellen E; Le Grange, Daniel

    2015-06-01

    This study examined predictors of psychological change among 80 adolescents with bulimia nervosa (BN) participating in a randomized-controlled trial comparing family-based treatment (FBT) to supportive psychotherapy (SPT). Psychological outcomes (cognitive eating disorder pathology, depression, and self-esteem) were explored at baseline, post-treatment, and 6-month follow-up. Multi-level growth models examined predictors of rate of change in psychological outcomes and moderators of treatment effects. All psychological outcomes improved through 6-month follow-up (moderate to large effect sizes) across both treatments. Overall, few significant predictors were identified. Older adolescents had faster change in self-esteem relative to younger adolescents (p = 0.03). Adolescents taking psychotropic medication at baseline had faster change in eating concerns relative to adolescents not taking medication (p = 0.02). Age (p = 0.02) and baseline purging severity (p = 0.03) moderated the relationship between treatment condition and change in eating concerns, where younger adolescents and individuals with high baseline purging had greater change when treated with FBT relative to SPT. Age and purging did not significantly moderate change in other psychological outcomes. Bulimic symptom improvement did not predict change in psychological symptoms. Generally, FBT and SPT were equally efficacious with respect to psychological improvement, although FBT may be more efficacious in younger adolescents and those with more frequent purging. PMID:25874955

  7. Assessing Change Readiness and Treatment Eagerness among Psychoactive Substance Users in Northern Nigeria.

    PubMed

    Abiola, Tajudeen; Udofia, Owoidoho; Sheikh, Taiwo L; Sanni, Kamaldeen

    2015-11-01

    Studies on psychoactive substance use in Nigeria had focused on prevalence and rarely on treatment implication(s) of large rates reported. Further challenge was to find suitable instruments to monitor change readiness as well as predict treatment outcomes along motivation continuum and according to resilience characteristics. Such ability will not only help to match treatment strategy with stage of change but also come with a more satisfactory outcome. This study therefore provided psychometric properties of one of such measuring scales: Stage of Change Readiness and Treatment Eagerness Scale version 8 (SOCRATES-8) and the accompanying change in resilience among Nigerians using psychoactive substances. Participants were 111 psychoactive substance dependent users in three treatment centers in Northern Nigeria. All respondents filled sociodemographic questionnaire, SOCRATES-8 and 14-item Resilience Scale. The study found overall motivation for change among participants to be medium on the three subscales of SOCRATES-8: ambivalence (median=14.00; range=7-20); recognition (median=31.00; range=7-35); and taking steps (median=35.00; range=12-40). More than half (61.3%) scored moderately on resilience. The Internal reliability of SOCRATES-8's subscales fell into acceptable range (ambivalence=0.54; recognition=0.87; taking steps=0.84). Pearson correlation coefficients of subscales with resilience are positive and in moderate range except for ambivalence with very low coefficient. Hierarchical cluster analysis based on participants' resilience characteristics yields five distinct profiles corresponding to five stages of motivational change. ANOVA of these five profiles based on SOCRATES' 3 subscales was significant. The study demonstrates utility of SOCRATES-8 to assess change readiness and treatment eagerness of psychoactive substance abusers according to stages of change and their resilience characteristics. This will aid treatment planning and can also measure treatment

  8. Predicting Change in Emotional and Behavioural Problems during Inpatient Treatment in Clients with Mild Intellectual Disability

    ERIC Educational Resources Information Center

    Tenneij, Nienke; Didden, Robert; Koot, Hans M.

    2011-01-01

    Background: Little is known about client characteristics that are related to outcome during inpatient treatment of adults with mild intellectual disability (ID) and severe behavioural problems. Method: We explored variables that were related to a change in behavioural problems in 87 individuals with mild ID during inpatient treatment in facilities…

  9. The Role of Readiness to Change in Response to Treatment of Adolescent Depression

    ERIC Educational Resources Information Center

    Lewis, Cara C.; Simons, Anne D.; Silva, Susan G.; Rohde, Paul; Small, David M.; Murakami, Jessica L.; High, Robin R.; March, John S.

    2009-01-01

    The effect of readiness to change on treatment outcome was examined among 332 adolescents (46% male, 74% Caucasian), ages 12 through 17 years (M = 14.6, SD = 1.5), with major depressive disorder who were participating in the Treatment for Adolescents With Depression Study (TADS). TADS is a randomized clinical trial comparing the effectiveness of…

  10. Family Involvement and Changes in Child Behavior during Residential Mental Health Treatment

    ERIC Educational Resources Information Center

    Robst, John; Rohrer, Lodi; Armstrong, Mary; Dollard, Norin; Sharrock, Patty; Batsche, Catherine; Reader, Steven

    2013-01-01

    Background: Family involvement is viewed as an important component of the treatment process for children in residential treatment centers, but little is known about the impact of contact with family members on changes in youth functioning. Objective: The goal of this study was to use administrative data to examine the association between family…

  11. Change in Depressive Symptoms among Treatment-Seeking College Students Who Are Sexual Minorities

    ERIC Educational Resources Information Center

    Effrig, Jessica C.; Maloch, Janelle K.; McAleavey, Andrew; Locke, Benjamin D.; Bieschke, Kathleen J.

    2014-01-01

    Changes in students' depressive symptoms during the course of treatment at college counseling centers were examined by sexual orientation. In Study 1, results showed that depressive symptoms decreased similarly across sexual orientation groups during the course of treatment. In Study 2, family support did not moderate the relationship between…

  12. Automatic Associations and Panic Disorder: Trajectories of Change over the Course of Treatment

    ERIC Educational Resources Information Center

    Teachman, Bethany A.; Marker, Craig D.; Smith-Janik, Shannan B.

    2008-01-01

    Cognitive models of anxiety and panic suggest that symptom reduction during treatment should be preceded by changes in cognitive processing, including modifying the anxious schema. The current study tested these hypotheses by using a repeated measures design to evaluate whether the trajectory of change in automatic panic associations over a…

  13. Comparative assessment of organic and conventional production of row crops under climate change: Empirical and simulated yield variation in the Chippewa River Watershed, MN

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The long-term provision of ecosystem services, including stable temporal crop yields, provided by the traditional corn-soybean cropping system in the Chippewa River Watershed (CRW) in west-central Minnesota are being threatened by several anthropogenic and climatic factors. We conducted an empirical...

  14. Measurements of Nb3Sn conductor dimension changes during heat treatment

    SciTech Connect

    Bocian, D.; Ambrosio, G.; Whitson, G.M.; /Fermilab

    2011-06-01

    During the heat treatment of Nb{sub 3}Sn coils the conductor material properties change significantly. These effects together with the changes of the conductor dimensions during heat treatment may introduce large strain in the coils for accelerator magnets. The US LHC Accelerator Research Program (LARP) has initiated a study aiming at understanding the thermal expansion and contraction of Nb3Sn strands, cables and coils during heat treatment. Several measurements on strands and cables were performed in order to have sufficient inputs for finite element simulation of the dimensional changes during heat treatment. In this paper the results of measurements of OST-RRP Nb{sub 3}Sn conductor used in the LARP magnet program are discussed.

  15. SU-E-J-267: Change in Mean CT Intensity of Lung Tumors During Radiation Treatment

    SciTech Connect

    Mahon, R; Tennyson, N; Weiss, E; Hugo, G

    2015-06-15

    Purpose: To evaluate CT intensity change of lung tumors during radiation therapy. Methods: Repeated 4D CT images were acquired on a CT simulator during the course of therapy for 27 lung cancer patients on IRB approved protocols. All subjects received definitive radiation treatment ± chemotherapy. CT scans were completed prior to treatment, and 2–7 times during the treatment course. Primary tumor was delineated by an experienced Radiation Oncologist. Contours were thresholded between −100 HU and 200 HU to remove airways and bone. Correlations between the change in the mean tumor intensity and initial tumor intensity, SUVmax, and tumor volume change rate were investigated. Reproducibility was assessed by evaluating the variation in mean intensity over all phases in 4DCT, for a subgroup of 19 subjects. Results: Reproducibility of tumor intensity between phases as characterized by the root mean square of standard deviation across 19 subjects was 1.8 HU. Subjects had a mean initial tumor intensity of 16.5 ± 11.6 HU and an overall reduction in HU by 10.3 ± 8.5 HU. Evaluation of the changes in tumor intensity during treatment showed a decrease of 0.3 ± 0.3 HU/day for all subjects, except three. No significant correlation was found between change in HU/day and initial HU intensity (p=0.53), initial PET SUVmax (p=0.69), or initial tumor volume (p=0.70). The rate of tumor volume change was weakly correlated (R{sup 2}=0.05) with HU change (p=0.01). Conclusion: Most lung cancer subjects showed a marked trend of decreasing mean tumor CT intensity throughout radiotherapy, including early in the treatment course. Change in HU/day is not correlated with other potential early predictors for response, such as SUV and tumor volume change. This Result supports future studies to evaluate change in tumor intensity on CT as an early predictor of response.

  16. Moving Innovations into Treatment: A Stage-based Approach to Program Change

    PubMed Central

    Simpson, D. Dwayne; Flynn, Patrick M.

    2007-01-01

    Treatment programs are expected to change their clients. To adopt evidence-based practices to improve their therapeutic effectiveness in dealing with drug-related problems of clients, they also are expected to change themselves. The process of innovation adoption and implementation is the focus of studies included in this special journal issue. Collectively, this volume examines staff perceptions of program needs, organizational readiness for change (based on pressures, resources, staff attributes, and organizational climate), quality of workshop training, subsequent utilization of training materials, and client self-report of treatment engagement. Approximately 800 treatment programs nationwide contributed data for these studies. A standardized assessment of organizational functioning captured attributes that describe environments, settings, and staffs, and the findings are interpreted in the context of a stage-based approach to program changes. A conceptual model is used to help organize and summarize longitudinal results within the organizational context and according to implementation influences related to qualities of the innovations. PMID:17434704

  17. A changing industry -- A need for new market-based environmental regulatory treatments

    SciTech Connect

    Gildea, M.

    1995-12-31

    As deregulation occurs in the electric utility industry, ratemaking treatments must correctly and economically handle all economic costs and revenues. This paper briefly examines the ratemaking treatment given to sulfur dioxide emissions allowances (EAs) by state public utility commissions (PUCs) prior to 1995. The paper then overviews a new market-based ratemaking treatment recently approved by the Federal Energy Regulatory Commission (FERC) for wholesale coordination transactions and identifies important virtues of this regulatory treatment. The paper concludes with arguments supporting the hypothesis that changes currently underway in the electric utility industry are compatible and may enhance the operational effectiveness of Title IV`s implementation.

  18. Patterns of early change and their relationship to outcome and early treatment termination in patients with panic disorder

    PubMed Central

    Lutz, Wolfgang; Hofmann, Stefan G.; Rubel, Julian; Boswell, James F.; Shear, M. Katherine; Gorman, Jack M.; Woods, Scott W.; Barlow, David H.

    2014-01-01

    Objective Recently, innovative statistical tools have been used to model patterns of change in psychological treatments. These tools can detect patterns of change in patient progress early in treatment and allow for the prediction of treatment outcomes and treatment length. Method We used Growth Mixture Modeling to identify different latent classes of early change in patients with panic disorder (N = 326) who underwent a manualized cognitive-behavioral treatment. Results Four latent subgroups were identified, showing clusters of change trajectories over the first five sessions. One of the subgroups consisted of patients whose symptoms rapidly decreased and also showed the best outcomes. This information improved treatment prediction by 16.1% over patient intake characteristics. Early change patterns also significantly predicted patients’ early treatment termination. Patient intake characteristics that significantly predicted class membership included functional impairment and separation anxiety. Conclusions These findings suggest that early treatment changes are uniquely predictive of treatment outcome. PMID:24447004

  19. Systematic review of behavior change research on point-of-use water treatment interventions in countries categorized as low- to medium-development on the human development index.

    PubMed

    Fiebelkorn, Amy Parker; Person, Bobbie; Quick, Robert E; Vindigni, Stephen M; Jhung, Michael; Bowen, Anna; Riley, Patricia L

    2012-08-01

    Point-of-use water treatment (i.e., water purification at the point of consumption) has proven effective in preventing diarrhea in developing countries. However, widespread adoption has not occurred, suggesting that implementation strategies have not motivated sustained behavior change. We conducted a systematic literature review of published behavioral research on factors influencing adoption of point-of-use water treatment in countries categorized as low- to medium-development on the United Nations Development Programme Human Development Index. We used 22 key words to search peer-reviewed literature from 1950 to 2010 from OVID Medline, CINAHL, and PsycINFO. Twenty-six (1.7%) of 1551 papers met our four inclusion criteria: 1) implemented a point-of-use water treatment intervention, 2) applied a behavioral intervention, 3) evaluated behavior change as the outcome, and 4) occurred in a low- or medium-development country. We reviewed these 26 publications for detailed descriptions of the water treatment intervention, theoretical rationales for the behavioral intervention, and descriptions of the evaluation. In 5 (19%) papers, details of the behavioral intervention were fully specified. Seven (27%) papers reported using a behavioral theory in the design of the intervention and evaluation of its impact. Ten (38%) studies used a comparison or control group; 5 provided detailed descriptions. Seven (27%) papers reported high sustained use of point-of-use water treatment with rates >50% at the last recorded follow-up. Despite documented health benefits of point-of-use water treatment interventions in reducing diarrheal diseases, we found limited peer-reviewed behavioral research on the topic. In addition, we found the existing literature often lacked detailed descriptions of the intervention for replication, seldom described the theoretical and empirical rationale for the implementation and evaluation of the intervention, and often had limitations in the evaluation

  20. Changes in Body Composition in Anorexia Nervosa: Predictors of Recovery and Treatment Outcome

    PubMed Central

    Arcelus, Jon; Sánchez, Isabel; Riesco, Nadine; Jiménez-Murcia, Susana; González-Gómez, Jana; Granero, Roser; Custal, Nuria; Montserrat-Gil de Bernabé, Monica; Tárrega, Salomé; Baños, Rosa M.; Botella, Cristina; de la Torre, Rafael; Fernández-García, José C.; Fernández-Real, José M.; Frühbeck, Gema; Gómez-Ambrosi, Javier; Tinahones, Francisco J.; Crujeiras, Ana B.; Casanueva, Felipe F.; Menchón, José M.; Fernández-Aranda, Fernando

    2015-01-01

    The restoration of body composition (BC) parameters is considered to be one of the most important goals in the treatment of patients with anorexia nervosa (AN). However, little is known about differences between AN diagnostic subtypes [restricting (AN-R) and binge/purging (AN-BP)] and weekly changes in BC during refeeding treatment. Therefore, the main objectives of our study were twofold: 1) to assess the changes in BC throughout nutritional treatment in an AN sample and 2) to analyze predictors of BC changes during treatment, as well as predictors of treatment outcome. The whole sample comprised 261 participants [118 adult females with AN (70 AN-R vs. 48 AN-BP), and 143 healthy controls]. BC was measured weekly during 15 weeks of day-hospital treatment using bioelectrical impedance analysis (BIA). Assessment measures also included the Eating Disorders Inventory-2, as well as a number of other clinical indices. Overall, the results showed that AN-R and AN-BP patients statistically differed in all BC measures at admission. However, no significant time×group interaction was found for almost all BC parameters. Significant time×group interactions were only found for basal metabolic rate (p = .041) and body mass index (BMI) (p = .035). Multiple regression models showed that the best predictors of pre-post changes in BC parameters (namely fat-free mass, muscular mass, total body water and BMI) were the baseline values of BC parameters. Stepwise predictive logistic regressions showed that only BMI and age were significantly associated with outcome, but not with the percentage of body fat. In conclusion, these data suggest that although AN patients tended to restore all BC parameters during nutritional treatment, only AN-BP patients obtained the same fat mass values as healthy controls. Put succinctly, the best predictors of changes in BC were baseline BC values, which did not, however, seem to influence treatment outcome. PMID:26600309

  1. In vivo electrical conductivity measurements during and after tumor electroporation: conductivity changes reflect the treatment outcome

    NASA Astrophysics Data System (ADS)

    Ivorra, Antoni; Al-Sakere, Bassim; Rubinsky, Boris; Mir, Lluis M.

    2009-10-01

    Electroporation is the phenomenon in which cell membrane permeability is increased by exposing the cell to short high-electric-field pulses. Reversible electroporation treatments are used in vivo for gene therapy and drug therapy while irreversible electroporation is used for tissue ablation. Tissue conductivity changes induced by electroporation could provide real-time feedback of the treatment outcome. Here we describe the results from a study in which fibrosarcomas (n = 39) inoculated in mice were treated according to different electroporation protocols, some of them known to cause irreversible damage. Conductivity was measured before, within the pulses, in between the pulses and for up to 30 min after treatment. Conductivity increased pulse after pulse. Depending on the applied electroporation protocol, the conductivity increase after treatment ranged from 10% to 180%. The most significant conclusion from this study is the fact that post-treatment conductivity seems to be correlated with treatment outcome in terms of reversibility.

  2. Secondary structure and conformational change of mushroom polyphenol oxidase during thermosonication treatment by using FTIR spectroscopy.

    PubMed

    Baltacıoğlu, Hande; Bayındırlı, Alev; Severcan, Feride

    2017-01-01

    To understand the conformational changes of mushroom PPO, the secondary structural change of the enzyme during thermosonication treatment at different power (60, 80 and 100%), temperature (20-60°C) and time (0-30min) combinations was investigated by using FTIR spectroscopy and compared with the change in enzyme activity. The enzyme inactivation higher than 99% was obtained at 100% amplitude at 60°C for 10min. FTIR studies showed that marked spectral changes were noted after ultrasound treatment at 20°C. The α-helix and β-sheet contents decreased, while aggregated β-sheet, turns and random coil contents increased as temperature increased up to 60°C during thermosonication treatment for 10min indicating protein denaturation. Aggregated bands located at 1683 and 1616cm(-1) became evident after ultrasound treatment at 40°C. When temperature was lowered back to 25°C, from ultrasound treatment at 60°C, these bands were still observed, indicating the irreversible change in the structure. PMID:27507504

  3. The Practitioner Proposes a Treatment Change and the Patient Declines: What to do Next?

    PubMed Central

    Falzer, Paul R.; Leventhal, Howard L.; Peters, Ellen; Fried, Terri R.; Kerns, Robert; Michalski, Marion; Fraenkel, Liana

    2013-01-01

    Objective This study describes how pain practitioners can elicit the beliefs that are responsible for patients’ judgments against considering a treatment change and activate collaborative decision making. Methods Beliefs of 139 chronic pain patients who are in treatment but continue to experience significant pain were reduced to seven items about the significance of pain on the patient’s life. The items were aggregated into four decision models that predict which patients are actually considering a change in their current treatment. Results While only 34% of study participants were considering a treatment change overall, the percentage ranged from 20 to 70, depending on their ratings about current consequences of pain, emotional influence, and long-term impact. Generalized linear model analysis confirmed that a simple additive model of these three beliefs is the best predictor. Conclusion Initial opposition to a treatment change is a conditional judgment and subject to change as specific beliefs become incompatible with patients’ current conditions. These beliefs can be elicited through dialog by asking three questions. PMID:23462141

  4. Dietary changes and food intake in the first year after breast cancer treatment.

    PubMed

    Vance, Vivienne; Campbell, Sharon; McCargar, Linda; Mourtzakis, Marina; Hanning, Rhona

    2014-06-01

    Understanding dietary habits of women after breast cancer is a critical first step in developing nutrition guidelines that will support weight management and optimal health in survivorship; however, limited data are available. The objective of this study was to describe changes in diet among breast cancer survivors in the first year after treatment, and to evaluate these changes in the context of current dietary intake. Changes in diet were assessed in 28 early stage breast cancer survivors, using a self-reported survey in which women identified changes in food intake since their diagnosis. Current dietary intake was estimated from 3-day food records and described relative to current recommendations. The majority of women reported changes in diet after diagnosis, most common being an increase in vegetables/fruit and fish, lower intake of red meat, and reduced alcohol. Many women reported that these changes were initiated during active treatment. Dietary changes were largely consistent with current recommendations for cancer prevention; however, some women were still above the guidelines for total and saturated fat, and many were below recommendations for vegetables/fruit, milk/alternatives, calcium, and vitamin D. Evidence that some women are willing and able to initiate positive changes in diet early in the treatment trajectory suggests that early intervention may be effective in promoting dietary habits that will assist with weight management and overall health. Data on current dietary intake highlights several possible targets for dietary intervention in this population. PMID:24869974

  5. Changes in the temporomandibular joint space after functional treatment of disk displacement with reduction.

    PubMed

    Ma, ZhiGui; Xie, QianYang; Yang, Chi; Zhang, ShanYong; Shen, YuQing; Cai, XieYi

    2015-03-01

    This study aimed to evaluate the changes of temporomandibularjoint (TMJ) space in the treatment of disk displacement with reduction (DDWR) for class II cases. Forty-two adolescent patients with unilateral DDWR, who were successfully treated by functional appliance, were selected in this study. Magnetic resonance imaging scans were used before treatment (T1), at the start of treatment (T2), and after functional treatment (T3). Compared with the normal joint, the change of joint space index was calculated. The anterior, posterior, and superior joint spaces were analyzed on the largest sagittal plane among T1, T2, and T3. Student's t-test was used for statistical analysis. The mean treatment period was 10 months (6-16 mo). Functional appliance was effective in eliminating pain and clicking. During the phase of T1, the value of the joint space index of DDWR was significantly higher than that of the control (P < 0.05). There was a significant decrease in the anterior space and an increase in the postsuperior space at T2 (P < 0.01), and then the contrary changes occurred at T3. However, there was a significant increase in the postsuperior space and no significant decrease in the anterior space when T1 and T3 were compared. This study indicates that the TMJ space is well distributed after disk repositioning with functional treatment of DDWR. It is also suggested that the adaptive remodeling in TMJ occurs via functional treatment. PMID:25759936

  6. Determinants for changing the treatment of COPD: a regression analysis from a clinical audit

    PubMed Central

    López-Campos, Jose Luis; Abad Arranz, María; Calero Acuña, Carmen; Romero Valero, Fernando; Ayerbe García, Ruth; Hidalgo Molina, Antonio; Aguilar Perez-Grovas, Ricardo I; García Gil, Francisco; Casas Maldonado, Francisco; Caballero Ballesteros, Laura; Sánchez Palop, María; Pérez-Tejero, Dolores; Segado, Alejandro; Calvo Bonachera, Jose; Hernández Sierra, Bárbara; Doménech, Adolfo; Arroyo Varela, Macarena; González Vargas, Francisco; Cruz Rueda, Juan J

    2016-01-01

    Introduction This study is an analysis of a pilot COPD clinical audit that evaluated adherence to guidelines for patients with COPD in a stable disease phase during a routine visit in specialized secondary care outpatient clinics in order to identify the variables associated with the decision to step-up or step-down pharmacological treatment. Methods This study was a pilot clinical audit performed at hospital outpatient respiratory clinics in the region of Andalusia, Spain (eight provinces with over eight million inhabitants), in which 20% of centers in the area (catchment population 3,143,086 inhabitants) were invited to participate. Treatment changes were evaluated in terms of the number of prescribed medications and were classified as step-up, step-down, or no change. Three backward stepwise binominal multivariate logistic regression analyses were conducted to evaluate variables associated with stepping up, stepping down, and inhaled corticosteroids discontinuation. Results The present analysis evaluated 565 clinical records (91%) of the complete audit. Of those records, 366 (64.8%) cases saw no change in pharmacological treatment, while 99 patients (17.5%) had an increase in the number of drugs, 55 (9.7%) had a decrease in the number of drugs, and 45 (8.0%) noted a change to other medication for a similar therapeutic scheme. Exacerbations were the main factor in stepping up treatment, as were the symptoms themselves. In contrast, rather than symptoms, doctors used forced expiratory volume in 1 second and previous treatment with long-term antibiotics or inhaled corticosteroids as the key determinants to stepping down treatment. Conclusion The majority of doctors did not change the prescription. When changes were made, a number of related factors were noted. Future trials must evaluate whether these therapeutic changes impact clinically relevant outcomes at follow-up. PMID:27330285

  7. Orthodontic treatment effects on inflammatory marker profiles in saliva before and after 2 archwire changes

    NASA Astrophysics Data System (ADS)

    Yamamoto, Zulham; Jaafar, Ikmal Mohamad; Rohaya, M. A. W.; Abidin, Intan Zarina Zainol; Senafi, Sahidan; Ariffin, Zaidah Zainal; Ariffin, Shahrul Hisham Zainal

    2013-11-01

    Periodontal tissue changes exerted by external forces in orthodontic treatment allow tooth movement. The changes in periodontal tissues i.e. inflammation can be monitored using gingival crevicular fluid (GCF). GCF is a component of saliva. Saliva could be used to monitor periodontal disease progression. The use of saliva to monitor periodontal tissues changes during orthodontic treatment is still unknown. Therefore, we observed the profiles of inflammatory markers namely creatine kinase ('CK), nitric oxide (NO), lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) in saliva of orthodontic patients to evaluate their importance in orthodontic treatment. A total of 21 subjects (13 female and 8 male) participated in this study. Samples were collected from gingival crevicular fluid at three period of archwire changes: baseline (M0), 2 weeks after 0.014" NiTi archwire (M1), and 2 weeks after 0.018" NiTi archwire (M2). All enzyme activities i.e. CK, LDH and AST were measured spectrophotometrically at 340 nm. Griess assay was used to measure nitric oxide level. CK activity, NO level, LDH activity and AST activity in saliva samples did not show significant differences among period of archwire changes. The use of inflammatory marker profiles in saliva may not represent the changes in periodontal tissues during orthodontic treatment.

  8. Changing global essential medicines norms to improve access to AIDS treatment: lessons from Brazil.

    PubMed

    Nunn, A; Fonseca, E Da; Gruskin, S

    2009-01-01

    Brazil's large-scale, successful HIV/AIDS treatment programme is considered by many to be a model for other developing countries aiming to improve access to AIDS treatment. Far less is known about Brazil's important role in changing global norms related to international pharmaceutical policy, particularly international human rights, health and trade policies governing access to essential medicines. Prompted by Brazil's interest in preserving its national AIDS treatment policies during World Trade Organisation trade disputes with the USA, these efforts to change global essential medicines norms have had important implications for other countries, particularly those scaling up AIDS treatment. This paper analyses Brazil's contributions to global essential medicines policy and explains the relevance of Brazil's contributions to global health policy today. PMID:19333805

  9. Changing global essential medicines norms to improve access to AIDS treatment: Lessons from Brazil

    PubMed Central

    Nunn, A.; Fonseca, E. Da; Gruskin, S.

    2009-01-01

    Brazil's large-scale, successful HIV/AIDS treatment programme is considered by many to be a model for other developing countries aiming to improve access to AIDS treatment. Far less is known about Brazil's important role in changing global norms related to international pharmaceutical policy, particularly international human rights, health and trade policies governing access to essential medicines. Prompted by Brazil's interest in preserving its national AIDS treatment policies during World Trade Organisation trade disputes with the USA, these efforts to change global essential medicines norms have had important implications for other countries, particularly those scaling up AIDS treatment. This paper analyses Brazil's contributions to global essential medicines policy and explains the relevance of Brazil's contributions to global health policy today. PMID:19333805

  10. Changes in Diarrheal Disease and Treatment Among Brazilian Children from 1986 to 1996

    PubMed Central

    Sastry, Narayan; Burgard, Sarah

    2010-01-01

    We examined changes in diarrhea prevalence and treatment in Brazil between 1986 and 1996. Over this 10-year period there was a small decline in diarrhea prevalence but treatment with oral rehydration therapy (ORT) increased greatly. Deaths due to dehydration were thus averted, although the costly burden of morbidity remained high. The decline in diarrhea prevalence was largely due to changes in the effects of several key covariates, such as breastfeeding, with only a modest role played by socioeconomic change, infrastructure improvements, and other behavioral factors. ORT treatment of diarrhea was essentially unrelated to child and family characteristics, suggesting that the large increase was due to the success of public health efforts to promote its use widely. Our results suggest that the most effective policies for reducing diarrhea prevalence are likely to be further increases in education and the promotion of breastfeeding. Persistent disparities in diarrhea prevalence mean that policies to prevent the disease should be targeted at disadvantaged socioeconomic groups. PMID:21359099

  11. Problem Internet Overuse Behaviors in College Students: Readiness-to-Change and Receptivity to Treatment.

    PubMed

    O'Brien, Jennifer E; Li, Wen; Snyder, Susan M; Howard, Matthew O

    2016-01-01

    This mixed methods study explores college students' readiness-to-change and receptivity to treatment for problem Internet overuse behaviors. Focus groups were conducted with 27 college students who self-identified as Internet over-users, and had experienced biopsychosocial problems related to Internet overuse. Participants completed standardized questionnaires assessing their Internet use and sociodemographic forms. Focus groups explored readiness to change problem Internet overuse behaviors and receptivity to treatment. Similar to college students with other addictive behaviors, students with problem Internet overuse fall along a continuum vis-à-vis readiness-to-change their behaviors. Over half of the participants were receptive to treatment for their problem Internet overuse behaviors. PMID:26963733

  12. Treatment of changes on male sex organs with CO2 and Nd:YAG laser

    NASA Astrophysics Data System (ADS)

    Wozniak, Jakub; Rzymski, Pawel; Opala, Tomasz; Wilczak, Maciej; Sajdak, Stefan

    2003-10-01

    The aim of our study was to evaluate treatment of changes on male sex organs with CO2 and Nd:YAG lasers. Material consisted of 34 male patients of Diagnostic and Observational Department of Gynecologic and Obstetrical University Hospital in Poznan, Poland treated between 1998 and 2002. Results of treatment with both lasers were similar when comparing therapeutic effect and side effects. No complication was noticed and the observed differences were not statistically significant.

  13. [Training model for integral treatment of patients with eating disorders resistant to change].

    PubMed

    Calvo Sagardoy, R; Gallego Morales, L T; García de Lorenzo y Mateos, A

    2012-01-01

    The need to find effective treatments for patients with Anorexia or Bulimia nervosa has led to the professionals who care for them to develop new forms of treatment that take into account the variables that cause resistance to change. Patients in this study (2006-2009) have the following characteristics: 340 patients who have 7 or more years of evolution and/or have tried numerous previous treatments without having succeeded in starting and / or maintaining the desired changes, that allowed them to recover steadily. As the proposed treatment, the patient-treatment team is based on the principles of the training model. It considers the patient holistically, it informs and provides him with resources to increase its commitment to change. Teaches the patient to take care physically and mentally as a way to regain their health and leave the disorder in a stable way. Includes family members as essential support in the recovery of their closest. Therapists require extensive experience in the treatment of ED, flexibility, ability to integrate with other team members even if they use different theoretical models, skills for group sessions, ability to handle negative emotions and frustration tolerance. Finally, the model presented below has been implemented, recovered patients whose stay in the disorder exceeded 15 years of development and led to permanent occupational disability. PMID:23114941

  14. Trends and predictors of changes in pulmonary function after treatment for pulmonary tuberculosis

    PubMed Central

    Chung, Kuei-Pin; Chen, Jung-Yueh; Lee, Chih-Hsin; Wu, Huey-Dong; Wang, Jann-Yuan; Lee, Li-Na; Yu, Chong-Jen; Yang, Pan-Chyr

    2011-01-01

    OBJECTIVES: The present study aimed to investigate the trends in changes in pulmonary function and the risk factors for pulmonary function deterioration in patients with pulmonary tuberculosis after completing treatment. INTRODUCTION: Patients usually have pulmonary function abnormalities after completing treatment for pulmonary tuberculosis. The time course for changes in pulmonary function and the risk factors for deterioration have not been well studied. METHODS: A total of 115 patients with 162 pulmonary function results were analyzed. We retrieved demographic and clinical data, radiographic scores, bacteriological data, and pulmonary function data. A generalized additive model with a locally weighted scatterplot smoothing technique was used to evaluate the trends in changes in pulmonary function. A generalized estimating equation model was used to determine the risk factors associated with deterioration of pulmonary function. RESULTS: The median interval between the end of anti-tuberculosis treatment and the pulmonary function test was 16 months (range: 0 to 112 months). The nadir of pulmonary function occurred approximately 18 months after the completion of the treatment. The risk factors associated with pulmonary function deterioration included smear-positive disease, extensive pulmonary involvement prior to anti-tuberculosis treatment, prolonged anti-tuberculosis treatment, and reduced radiographic improvement after treatment. CONCLUSIONS: After the completion of anti-tuberculosis TB treatment, several risk factors predicted pulmonary function deterioration. For patients with significant respiratory symptoms and multiple risk factors, the pulmonary function test should be followed up to monitor the progression of functional impairment, especially within the first 18 months after the completion of anti-tuberculosis treatment. PMID:21655745

  15. On the Importance of Prompt Oxygen Changes for Hypofractionated Radiation Treatments

    PubMed Central

    Kissick, Michael; Campos, David; van der Kogel, Albert; Kimple, Randall

    2013-01-01

    This discussion is motivated by observations of prompt oxygen changes occurring prior to significant number of cancer cells dying (permanently stopping their metabolic activity) from therapeutic agents like large doses of ionizing radiation. Such changes must be from changes in the vasculature that supplies the tissue or from the metabolic changes in the tissue itself. An adapted linear-quadratic treatment is used to estimate the cell survival variation magnitudes from repair and reoxygenation from a two-fraction treatment in which the second fraction would happen prior to significant cell death from the first fraction, in the large fraction limit. It is clear the effects of oxygen changes are likely to be the most significant factor for hypofractionation because of large radiation doses. It is a larger effect than repair. Optimal dose timing should be determined by the peak oxygen timing. A call is made to prioritize near real time measurements of oxygen dynamics in tumors undergoing hypofractionated treatments in order to make these treatments adaptable and patient-specific. PMID:24061351

  16. On the importance of prompt oxygen changes for hypofractionated radiation treatments.

    PubMed

    Kissick, Michael; Campos, David; van der Kogel, Albert; Kimple, Randall

    2013-10-21

    This discussion is motivated by observations of prompt oxygen changes occurring prior to a significant number of cancer cells dying (permanently stopping their metabolic activity) from therapeutic agents like large doses of ionizing radiation. Such changes must be from changes in the vasculature that supplies the tissue or from the metabolic changes in the tissue itself. An adapted linear-quadratic treatment is used to estimate the cell survival variation magnitudes from repair and reoxygenation from a two-fraction treatment in which the second fraction would happen prior to significant cell death from the first fraction, in the large fraction limit. It is clear the effects of oxygen changes are likely to be the most significant factor for hypofractionation because of large radiation doses. It is a larger effect than repair. Optimal dose timing should be determined by the peak oxygen timing. A call is made to prioritize near real time measurements of oxygen dynamics in tumors undergoing hypofractionated treatments in order to make these treatments adaptable and patient-specific. PMID:24061351

  17. A retrospective analysis of the change in anti-malarial treatment policy: Peru

    PubMed Central

    Williams, Holly Ann; Vincent-Mark, Arlene; Herrera, Yenni; Chang, O Jaime

    2009-01-01

    Background National malaria control programmes must deal with the complex process of changing national malaria treatment guidelines, often without guidance on the process of change. Selecting a replacement drug is only one issue in this process. There is a paucity of literature describing successful malaria treatment policy changes to help guide control programs through this process. Objectives To understand the wider context in which national malaria treatment guidelines were formulated in a specific country (Peru). Methods Using qualitative methods (individual and focus group interviews, stakeholder analysis and a review of documents), a retrospective analysis of the process of change in Peru's anti-malarial treatment policy from the early 1990's to 2003 was completed. Results The decision to change Peru's policies resulted from increasing levels of anti-malarial drug resistance, as well as complaints from providers that the drugs were no longer working. The context of the change occurred in a time in which Peru was changing national governments, which created extreme challenges in moving the change process forward. Peru utilized a number of key strategies successfully to ensure that policy change would occur. This included a) having the process directed by a group who shared a common interest in malaria and who had long-established social and professional networks among themselves, b) engaging in collaborative teamwork among nationals and between nationals and international collaborators, c) respect for and inclusion of district-level staff in all phases of the process, d) reliance on high levels of technical and scientific knowledge, e) use of standardized protocols to collect data, and f) transparency. Conclusion Although not perfectly or fully implemented by 2003, the change in malaria treatment policy in Peru occurred very quickly, as compared to other countries. They identified a problem, collected the data necessary to justify the change, utilized

  18. Guided self-help CBT treatment for bulimic disorders: effectiveness and clinically significant change.

    PubMed

    Vaz, Ana Rita; Conceição, Eva; Machado, Paulo P P

    2013-01-01

    The aim of this study was to test the effectiveness of a cognitive-behavioral guided self-help treatment program for bulimia nervosa and similar disorders. Participants were assessed at the beginning and end of treatment, and at 6 months follow-up, using the Eating Disorder Examination Questionnaire (EDE-Q), the Outcome-Questionnaire-45 (OQ-45), and the Beck Depression Inventory (BDI). Forty-two participants from an eating disorders treatment service participated in this study. This study followed a one-group repeated measures naturalistic design with no control group. Results showed a significant reduction in EDE scores, OQ-45 and BDI. Clinically significant change occurred for the majority of participants. Cognitive-behavioral self-help treatment may be of value as an initial treatment for bulimia nervosa and similar disorders such as binge eating disorder. PMID:23701428

  19. Orthodontic and orthopaedic changes associated with treatment in subjects with Class III malocclusions.

    PubMed

    Kama, Jalen Devecioğlu; Ozer, Törün; Baran, Sedat

    2006-10-01

    The aim of this study was to determine the cephalometric changes in subjects with Class III malocclusions after rapid palatal expansion (RPE) and facemask treatment. The 30 subjects presented with developing Class III malocclusions. The treatment group comprised 15 patients (eight girls and seven boys, mean age 11 years 6 months) who had undergone RPE and facemask therapy. The control group consisted of nine girls and six boys with a mean age of 11 years 8 months. Radiographs were take at the same time intervals for both groups, and the average treatment time was 15 months. A Wilcoxon test was used to determine significant differences before and after treatment, and a Mann-Whitney U-test to analyse differences between the treatment and control groups. In the sagittal plane, significant changes were observed in both groups. In the treatment group, the following dimensions increased significantly: A perpendicular to FHp (P < 0.001), ANS-PNS (P < 0.01), 6 perpendicular to FHp (P < 0.05); in the control group Go-Gn (P < 0.05) increased significantly. In the treatment group, SN/Go-Gn and SN/ANS-PNS had higher values and this finding was significant (P < 0.05). Managing developing Class III malocclusions with RPE and maxillary protraction presents favourable results, such as vertical and sagittal displacement of point A. PMID:16772318

  20. Changes in Distress Intolerance and Treatment Outcome in a Partial Hospital Setting

    PubMed Central

    McHugh, R. Kathryn; Kertz, Sarah J.; Weiss, Rachel B.; Baskin-Sommers, Arielle R.; Hearon, Bridget A.; Björgvinsson, Thröstur

    2014-01-01

    Despite the well-established role of distress intolerance (DI) in a wide range of psychological disorders, few studies have examined whether DI improves during treatment and whether these changes are associated with symptom outcomes. Patients (N = 626) enrolled in a brief cognitive-behavioral partial hospital program completed pre- and post-treatment measures of DI. Results indicated that DI decreased significantly during treatment, with more than 30% of the sample exhibiting a reduction of more than 2 standard deviations from the mean. Women reported higher DI than men at baseline; however, there were no gender differences in changes in DI over time. Participants also completed a pre- and post-treatment measure of depression and a sub-set completed a measure of anxiety (n = 167). DI was associated with more severe depression and anxiety at pre- and post-treatment, with participants who reported a decrease in DI also reporting lower depression and anxiety symptoms at post-treatment. These results further highlight the transdiagnostic relevance of DI and suggest that DI may be a relevant factor in treatment outcome for depression and anxiety. PMID:24491198

  1. Changes in Adult, Child, and Family Functioning among Participants in a Family Treatment Drug Court.

    PubMed

    Cosden, Merith; Koch, Lauren M

    2015-01-01

    Behavioral changes for 76 adults and 115 children from 62 families participating in a Family Treatment Drug Court (FTDC), in either residential or outpatient settings, were studied. Improvements in psychosocial functioning were calculated using a reliable change index (RCI) for family, adult, and child measures. Among outcomes, significant improvements in family functioning were noted and associated with improvements in child development and the likelihood of reunification. Support for FTDCs and implications for future practice and research are discussed. PMID:26827466

  2. Changes induced in spice paprika powder by treatment with ionizing radiation and saturated steam

    NASA Astrophysics Data System (ADS)

    Kispéter, J.; Bajúsz-Kabók, K.; Fekete, M.; Szabó, G.; Fodor, E.; Páli, T.

    2003-12-01

    The changes in spice paprika powder induced by ionizing radiation, saturated steam (SS) and their combination were studied as a function of the absorbed radiation dose and the storage time. The SS treatment lead to a decrease in color content (lightening) after 12 weeks of storage, together with the persistence of free radicals and viscosity changes for a longer period. The results suggest that ionizing radiation is a more advantageous method as concerns preservation of the quality of spice paprika.

  3. Law of Empires.

    ERIC Educational Resources Information Center

    Martz, Carlton

    2001-01-01

    This issue of "Bill of Rights in Action" explores issues raised by empires and imperial law. The first article, "Clash of Empires: The Fight for North America," looks at the clash of empires and the fight for North America during the 18th century. The second article, "When Roman Law Ruled the Western World," examines Roman Law, which helped hold…

  4. Parent Predictors of Child Weight Change in Family Based Behavioral Obesity Treatment

    PubMed Central

    Boutelle, Kerri N.; Cafri, Guy; Crow, Scott J.

    2015-01-01

    Family based behavioral treatment for overweight and obese children includes parenting skills targeting the modification of child eating and activity change. The purpose of this study was to examine parenting skills and parent weight change as predictors of child weight change in a sample of 80 parent/child dyads who were enrolled in a family based behavioral weight loss program for childhood obesity. Eighty overweight and obese children and their parents who enrolled in treatment in two sites were included in the study. Variables included those related to parent modeling (parent BMI), home food environment, parenting (parent and child report), and demographics. Results suggested that parent BMI change was a significant predictor of child weight, in that a reduction of 1 BMI unit in the parent was associated with a 0.255 reduction in child BMI. None of the other variables were significant in the final model. This study is consistent with other research showing that parent weight change is a key contributor to child weight change in behavioral treatment for childhood obesity. Researchers and clinicians should focus on encouraging parents to lose weight to assist their overweight and obese child in weight management. PMID:22421896

  5. Changes in Temporal Attention Inhibition Following Prolonged Exposure and Sertraline in the Treatment of PTSD

    PubMed Central

    Echiverri-Cohen, Aileen; Zoellner, Lori A.; Gallop, Robert; Feeny, Norah; Jaeger, Jeffrey; Bedard-Gilligan, Michele

    2016-01-01

    Objective Attentional inhibitory deficits expressed as difficulty ignoring irrelevant stimuli in the pursuit of goal-directed behavior may serve as a fundamental mechanism of posttraumatic stress disorder (PTSD). Evidence of inhibitory processes as central to extinction suggests that exposure-based treatments may act more directly on the inhibitory deficits implicated in PTSD, whereas, in facilitating serotonergic neurotransmission, selective serotonin reuptake inhibitors (SSRIs) may be less direct and bring about general neurochemical changes in the fear circuitry. If these inhibitory deficits underlie PTSD, then inhibition should improve with successful treatment, with those treated with prolonged exposure (PE) potentially resulting in greater changes in inhibition than those treated with sertraline. Method Changes in temporal attentional inhibition, using an attentional blink (AB) paradigm, were examined at pre-and post-treatment in 49 individuals (74.5% female, 66.7% Caucasian, age M = 37.69, SD = 12.8 years) with chronic PTSD. Participants completed 10 weeks of either PE or sertraline. Results Individuals who made greater improvements with PE showed faster improvements in temporal inhibition on the critical inhibitory lag of AB than those who made greater improvements with sertraline (d = 0.94). These changes could not be accounted for by basic attention. Conclusions Greater improvement in fundamental attentional inhibitory processes with better treatment response to PE, compared to sertraline, suggests potential specificity in how PTSD treatments normalize inhibitory processes, such that exposure-based treatments like PE may target inhibitory processes and improve basic inhibitory functioning. Public Health Significance Statement Inhibitory processes, particularly related to temporal attention, may play a critical role in response to exposure therapy for PTSD. The main finding that individuals with PTSD who made more clinical improvement showed faster

  6. Changes in cannabis use among psychotic clients without specialised substance use treatment.

    PubMed

    Rebgetz, Shane; Kavanagh, David J; Hides, Leanne

    2016-08-01

    The need to address substance use among people with psychosis has been well established. However, treatment studies targeting substance use in this population have reported mixed results. Substance users with psychosis in no or minimal treatment control groups achieve similar reductions in substance use compared to those in more active substance use treatment, suggesting a role for natural recovery from substance use. This meta-analysis aims to quantify the amount of natural recovery from substance use within control groups of treatment studies containing samples of psychotic substance users, with a particular focus on changes in cannabis use. A systematic search was conducted to identify substance use treatment studies. Meta-analyses were performed to quantify reductions in the frequency of substance use in the past 30days. Significant but modest reductions (mean reduction of 0.3-0.4 SD across the time points) in the frequency of substance use were found at 6 to 24months follow up. The current study is the first to quantify changes in substance use in samples enrolled in no treatment or minimal treatment control conditions. These findings highlight the potential role of natural recovery from substance use among individuals with psychosis, although they do not rule out effects of regression to the mean. Additionally, the results provide a baseline from which to estimate likely changes or needed effects sizes in intervention studies. Future research is required to identify the processes underpinning these changes, in order to identify strategies that may better support self-management of substance use in people with psychosis. PMID:27068569

  7. The proper treatment of language acquisition and change in a population setting

    PubMed Central

    Niyogi, Partha; Berwick, Robert C.

    2009-01-01

    Language acquisition maps linguistic experience, primary linguistic data (PLD), onto linguistic knowledge, a grammar. Classically, computational models of language acquisition assume a single target grammar and one PLD source, the central question being whether the target grammar can be acquired from the PLD. However, real-world learners confront populations with variation, i.e., multiple target grammars and PLDs. Removing this idealization has inspired a new class of population-based language acquisition models. This paper contrasts 2 such models. In the first, iterated learning (IL), each learner receives PLD from one target grammar but different learners can have different targets. In the second, social learning (SL), each learner receives PLD from possibly multiple targets, e.g., from 2 parents. We demonstrate that these 2 models have radically different evolutionary consequences. The IL model is dynamically deficient in 2 key respects. First, the IL model admits only linear dynamics and so cannot describe phase transitions, attested rapid changes in languages over time. Second, the IL model cannot properly describe the stability of languages over time. In contrast, the SL model leads to nonlinear dynamics, bifurcations, and possibly multiple equilibria and so suffices to model both the case of stable language populations, mixtures of more than 1 language, as well as rapid language change. The 2 models also make distinct, empirically testable predictions about language change. Using historical data, we show that the SL model more faithfully replicates the dynamics of the evolution of Middle English. PMID:19497883

  8. Adapting water treatment design and operations to the impacts of global climate change

    NASA Astrophysics Data System (ADS)

    Clark, Robert M.; Li, Zhiwei; Buchberger, Steven G.

    2011-12-01

    It is anticipated that global climate change will adversely impact source water quality in many areas of the United States and will therefore, potentially, impact the design and operation of current and future water treatment systems. The USEPA has initiated an effort called the Water Resources Adaptation Program (WRAP) which is intended to develop tools and techniques that can assess the impact of global climate change on urban drinking water and wastewater infrastructure. A three step approach for assessing climate change impacts on water treatment operation and design is being persude in this effort. The first step is the stochastic characterization of source water quality, the second step is the application of the USEPA Water Treatment Plant model and the third step is the application of cost algorithms to provide a metric that can be used to assess the coat impact of climate change. A model has been validated using data collected from Cincinnati's Richard Miller Water Treatment Plant for the USEPA Information Collection Rule (ICR) database. An analysis of the water treatment processes in response to assumed perturbations in raw water quality identified TOC, pH, and bromide as the three most important parameters affecting performance of the Miller WTP. The Miller Plant was simulated using the EPA WTP model to examine the impact of these parameters on selected regulated water quality parameters. Uncertainty in influent water quality was analyzed to estimate the risk of violating drinking water maximum contaminant levels (MCLs).Water quality changes in the Ohio River were projected for 2050 using Monte Carlo simulation and the WTP model was used to evaluate the effects of water quality changes on design and operation. Results indicate that the existing Miller WTP might not meet Safe Drinking Water Act MCL requirements for certain extreme future conditions. However, it was found that the risk of MCL violations under future conditions could be controlled by

  9. Application of empirically supported treatments to clinical settings. In: Jelalian, E., Steele, R.G., editors. Handbook of Childhood and Adolescent Obesity

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This book chapter identifies treatments for pediatric obesity that have been shown to be effective in research settings and discusses how these treatments can be implemented in an applied clinical setting. Behavior-based treatments have demonstrated the best outcomes. Commonly used behavioral strate...

  10. Diminished Wastewater Treatment: Evaluation of Septic System Performance Under a Climate Change Scenario

    NASA Astrophysics Data System (ADS)

    Cooper, J.; Loomis, G.; Kalen, D.; Boving, T. B.; Morales, I.; Amador, J.

    2015-12-01

    The effects of climate change are expected to reduce the ability of soil-based onsite wastewater treatment systems (OWTS), to treat domestic wastewater. In the northeastern U.S., the projected increase in atmospheric temperature, elevation of water tables from rising sea levels, and heightened precipitation will reduce the volume of unsaturated soil and oxygen available for treatment. Incomplete removal of contaminants may lead to transport of pathogens, nutrients, and biochemical oxygen demand (BOD) to groundwater, increasing the risk to public health and likelihood of eutrophying aquatic ecosystems. Advanced OWTS, which include pre-treatment steps and provide unsaturated drainfields of greater volume relative to conventional OWTS, are expected to be more resilient to climate change. We used intact soil mesocosms to quantify water quality functions for two advanced shallow narrow drainfield types and a conventional drainfield under a current climate scenario and a moderate climate change scenario of 30 cm rise in water table and 5°C increase in soil temperature. While no fecal coliform bacteria (FCB) was released under the current climate scenario, up to 109 CFU FCB/mL (conventional) and up to 20 CFU FCB/mL (shallow narrow) were released under the climate change scenario. Total P removal rates dropped from 100% to 54% (conventional) and 71% (shallow narrow) under the climate change scenario. Total N removal averaged 17% under both climate scenarios in the conventional, but dropped from 5.4% to 0% in the shallow narrow under the climate change scenario, with additional leaching of N in excess of inputs indicating release of previously held N. No significant difference was observed between scenarios for BOD removal. The initial data indicate that while advanced OWTS retain more function under the climate change scenario, all three drainfield types experience some diminished treatment capacity.

  11. Geochemical and Geophysical Changes during Ammonia Gas Treatment of Vadose Zone Sediments for Uranium Remediation

    SciTech Connect

    Szecsody, James E.; Truex, Michael J.; Zhong, Lirong; Johnson, Timothy C.; Qafoku, Nikolla; Williams, Mark D.; Greenwood, William J.; Wallin, Erin L.; Bargar, John R.; Faurie, Danielle K.

    2012-10-30

    NH3 gas treatment of low water content sediments resulted in a significant decrease in aqueous and adsorbed uranium, which is attributed to incorporation into precipitates. Uranium associated with carbonates showed little change. Uranium associated with hydrous silicates such as Na-boltwoodite showed a significant decrease in mobility but no change in Na-boltwoodite concentration (by EXAFS/XANES), so is most likely caused by non-U precipitate coatings. Complex resistivity changes occurred in the sediment during NH3 and subsequent N2 gas injection, indicating ERT/IP could be used at field scale for injection monitoring.

  12. Therapeutic Communications and the Process of Change in a Psychoanalytic Treatment

    ERIC Educational Resources Information Center

    Vegas, Monica

    2013-01-01

    This study looked at the interplay of the analyst verbal speech acts and the process of change in a psychoanalytic treatment. Using a single case design on the session transcripts of the well studied case of Mrs. C., following Halfon and Weinstein's (2013) methodology the study tracked linguistic patterns as represented by the interaction of…

  13. Educating treatment professionals about addiction science research: demographics of knowledge and belief changes.

    PubMed

    Lawson, Kenneth A; Wilcox, Richard E; Littlefield, John H; Pituch, Keenan A; Erickson, Carlton K

    2004-06-01

    Communication of accurate, objective, and timely scientific information to treatment professionals is important--especially in the "drug abuse" and addiction field where misinformation and a lack of exposure to new information are common. The purpose of this study was to assess knowledge and belief changes that accompanied educational workshops (3 or 6 hr-long) on addiction science targeted to treatment professionals (N=1403) given in the United States and Puerto Rico between July 2000 and August 2001. Each workshop covered three main concepts: (1) terms and definitions; (2) basic neurochemistry of addiction; and (3) how new neurobiological knowledge will affect the treatment of addictions in the future. Analysis of variance was used to compare mean pretest to posttest change scores among levels of four independent variables: gender, age, occupation/position, and race/ethnicity. Workshop participants achieved a significant improvement in knowledge about addiction with younger groups achieving greater gains. Participants' beliefs shifted in the desired direction. Significant differences in belief shifts occurred among occupational and gender groups, but not among race/ethnicity or age groups. There was also a consistent change in the policy belief subscale that related to how strongly the audience members believed research on addiction was important. We conclude that addiction science education provided to treatment professionals can increase their knowledge and change their beliefs about the causes of addictions. In addition, the workshop participants form a base of constituents who are likely to support greater addiction research funding. PMID:15461020

  14. Mediation of Changes in Anxiety and Depression During Treatment of Social Phobia

    ERIC Educational Resources Information Center

    Moscovitch, David A.; Stefan G. Hofmann, Michael K.; Suvak, Michael K.; In-Albon, Tina

    2005-01-01

    To investigate the interactive process of changes in social anxiety and depression during treatment, the authors assessed weekly symptoms in 66 adult outpatients with social phobia (social anxiety disorder) who participated in cognitive- behavioral group therapy. Multilevel mediational analyses revealed that improvements in social anxiety mediated…

  15. Changes in Perception of Selected Concepts That Accompany Differing Leadership Treatments.

    ERIC Educational Resources Information Center

    Callan, Laurence Brian

    A study was made of effects of two different leadership treatments on perception of nonverbal stimuli relating to concepts of leaders, authority, and cohesion as measured by changes in the Semantic Differential Scale. Subjects (28 Yaqui Indian and Mexican-American members of the Neighborhood Youth Corps) were randomly assigned to an autocratic…

  16. NEW INSIGHTS INTO LEAD AND COPPER CORROSION CONTROL AND TREATMENT CHANGE IMPACTS

    EPA Science Inventory

    This presentation summarizes recent research into the chemistry of lead corrosion control, and focus on different areas that could impact the prediction of whether or not particular treatment changes are likely to either disturb existing lead corrosion scales, or to actually impr...

  17. Changes in Illness-Related Behavior and Dysphoria Accompanying Behavioral Treatment of Recurrent Headache.

    ERIC Educational Resources Information Center

    Rains, Jeanetta C.; Lohr, Jeffrey M.

    Psychophysiologic research indicates that muscle-contraction headache often is not characterized by excessive or unusual muscular activity, and muscular changes seldom accompany headache improvement resulting from treatment. Multidimensional models have been proposed, which emphasize the interdependence of physiological and psychological systems…

  18. Multi-dimensional self-esteem and magnitude of change in the treatment of anorexia nervosa.

    PubMed

    Collin, Paula; Karatzias, Thanos; Power, Kevin; Howard, Ruth; Grierson, David; Yellowlees, Alex

    2016-03-30

    Self-esteem improvement is one of the main targets of inpatient eating disorder programmes. The present study sought to examine multi-dimensional self-esteem and magnitude of change in eating psychopathology among adults participating in a specialist inpatient treatment programme for anorexia nervosa. A standardised assessment battery, including multi-dimensional measures of eating psychopathology and self-esteem, was completed pre- and post-treatment for 60 participants (all white Scottish female, mean age=25.63 years). Statistical analyses indicated that self-esteem improved with eating psychopathology and weight over the course of treatment, but that improvements were domain-specific and small in size. Global self-esteem was not predictive of treatment outcome. Dimensions of self-esteem at baseline (Lovability and Moral Self-approval), however, were predictive of magnitude of change in dimensions of eating psychopathology (Shape and Weight Concern). Magnitude of change in Self-Control and Lovability dimensions were predictive of magnitude of change in eating psychopathology (Global, Dietary Restraint, and Shape Concern). The results of this study demonstrate that the relationship between self-esteem and eating disorder is far from straightforward, and suggest that future research and interventions should focus less exclusively on self-esteem as a uni-dimensional psychological construct. PMID:26837476

  19. Change in Cognitive Functioning in Depressed Older Adults Following Treatment with Sertraline or Nortriptyline

    PubMed Central

    Culang-Reinlieb, Michelle E.; Sneed, Joel R.; Keilp, John G.; Roose, Steven P.

    2012-01-01

    Objective To compare the impact of nortriptyline to sertraline on change in cognitive functioning in depressed older adults. Methods We used pre-post neuropsychological data collected as part of a 12-week medication trial comparing sertraline to nortriptyline in the treatment of older adults with non-psychotic, unipolar major depression to examine change in cognitive functioning. Neuropsychological assessments included mental status (Mini-Mental Status Exam), psychomotor speed (Purdue Pegboard), attention (Continuous Performance Test; Trail Making Test A), executive functioning (Stroop Color/Word Test; Trail Making Test B), and memory (Buschke Selective Reminding Test). Results Within treatment groups, patients treated with sertraline improved only on verbal learning. This change did not depend on responder status. Between treatment groups, patients treated with sertraline improved more in verbal learning compared to patients treated with nortriptyline. Looking at change in cognition as a function of medication condition and responder status revealed that sertraline responders improved more in verbal learning compared to nortriptyline responders but not more than sertraline non-responders or nortriptyline non-responders. Nortriptyline responders were the only treatment by responder status group to show no improvement in verbal learning from baseline to endpoint. Conclusions Unexpectedly, nortriptyline responders showed no improvement in verbal learning as compared to patients treated with sertraline or nortriptyline non-responders. However, given the small sample sizes and number of statistical tests (potential for type 1 error), replication is warranted. PMID:21919060

  20. Therapeutic Responses of Psychopathic Sexual Offenders: Treatment Attrition, Therapeutic Change, and Long-Term Recidivism

    ERIC Educational Resources Information Center

    Olver, Mark E.; Wong, Stephen C. P.

    2009-01-01

    The authors examined the therapeutic responses of psychopathic sex offenders (greater than or equal to 25 Psychopathy Checklist-Revised; PCL-R) in terms of treatment dropout and therapeutic change, as well as sexual and violent recidivism over a 10-year follow-up among 156 federally incarcerated sex offenders treated in a high-intensity inpatient…

  1. Emotion Regulatory Brain Function and SSRI Treatment in PTSD: Neural Correlates and Predictors of Change.

    PubMed

    MacNamara, Annmarie; Rabinak, Christine A; Kennedy, Amy E; Fitzgerald, Daniel A; Liberzon, Israel; Stein, Murray B; Phan, K Luan

    2016-01-01

    Posttraumatic stress disorder (PTSD)-a chronic, debilitating condition, broadly characterized by emotion dysregulation-is prevalent among US military personnel who have returned from Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF). Selective serotonin reuptake inhibitors (SSRIs) are a first-line treatment for PTSD, but treatment mechanisms are unknown and patient response varies. SSRIs may exert their effects by remediating emotion regulatory brain activity and individual differences in patient response might be explained, in part, by pre-treatment differences in neural systems supporting the downregulation of negative affect. Thirty-four OEF/OIF veterans, 17 with PTSD and 17 without PTSD underwent 2 functional magnetic resonance imaging scans 12 weeks apart. At each scan, they performed an emotion regulation task; in the interim, veterans with PTSD were treated with the SSRI, paroxetine. SSRI treatment increased activation in both the left dorsolateral prefrontal cortex (PFC) and supplementary motor area (SMA) during emotion regulation, although only change in the SMA over time occurred in veterans with PTSD and not those without PTSD. Less activation of the right ventrolateral PFC/inferior frontal gyrus during pre-treatment emotion regulation was associated with greater reduction in PTSD symptoms with SSRI treatment, irrespective of pre-treatment severity. Patients with the least recruitment of prefrontal emotion regulatory brain regions may benefit most from treatment with SSRIs, which appear to augment activity in these regions. PMID:26111649

  2. Changes in social adjustment with cognitive processing therapy: effects of treatment and association with PTSD symptom change.

    PubMed

    Monson, Candice M; Macdonald, Alexandra; Vorstenbosch, Valerie; Shnaider, Philippe; Goldstein, Elizabeth S R; Ferrier-Auerbach, Amanda G; Mocciola, Katharine E

    2012-10-01

    The current study sought to determine if different spheres of social adjustment, social and leisure, family, and work and income improved immediately following a course of cognitive processing therapy (CPT) when compared with those on a waiting list in a sample of 46 U.S. veterans diagnosed with posttraumatic stress disorder (PTSD). We also sought to determine whether changes in different PTSD symptom clusters were associated with changes in these spheres of social adjustment. Overall social adjustment, extended family relationships, and housework completion significantly improved in the CPT versus waiting-list condition, η(2) = .08 to .11. Hierarchical multiple regression analyses revealed that improvements in total clinician-rated PTSD symptoms were associated with improvements in overall social and housework adjustment. When changes in reexperiencing, avoidance, emotional numbing, and hyperarousal were all in the model accounting for changes in total social adjustment, improvements in emotional numbing symptoms were associated with improvements in overall social, extended family, and housework adjustment (β = .38 to .55). In addition, improvements in avoidance symptoms were associated with improvements in housework adjustment (β = .30), but associated with declines in extended family adjustment (β = -.34). Results suggest that it is important to consider the extent to which PTSD treatments effectively reduce specific types of symptoms, particularly emotional numbing and avoidance, to generally improve social adjustment. PMID:23073971

  3. Automatic associations and panic disorder: Trajectories of change over the course of treatment

    PubMed Central

    Teachman, Bethany A.; Marker, Craig D.; Smith-Janik, Shannan B.

    2008-01-01

    Cognitive models of anxiety and panic suggest that symptom reduction during treatment should be preceded by changes in cognitive processing, including modifying the anxious schema. The current study tests these hypotheses by using a repeated measures design to evaluate whether the trajectory of change in automatic panic associations over the course of 12-week cognitive behavior therapy (CBT) is related to the trajectory of change in panic symptoms. Individuals with panic disorder (N=43) completed a measure of automatic panic associations (the Implicit Association Test, which reflects elements of the schema construct) every three weeks over the course of therapy, and measures of panic symptoms each week. Dynamic bivariate latent difference score modeling indicated that automatic panic associations not only changed over the course of CBT for panic disorder, but showed these changes were correlated with symptom reduction. Moreover, change in automatic panic associations was a significant predictor of change in panic symptom severity. These findings permit inferences about the temporality of change, suggesting that cognitive change does in fact precede and contribute to symptom change. PMID:19045967

  4. Mediators of Change in the Child/Adolescent Anxiety Multimodal Treatment Study

    PubMed Central

    Kendall, Philip C.; Cummings, Colleen M.; Villabø, Marianne A.; Narayanan, Martina K.; Treadwell, Kimberli; Birmaher, Boris; Compton, Scott; Piacentini, John; Sherrill, Joel; Walkup, John; Gosch, Elizabeth; Keeton, Courtney; Ginsburg, Golda; Suveg, Cindy; Albano, Anne Marie

    2015-01-01

    Objective Test changes in (a) coping efficacy and (b) anxious self-talk as potential mediators of treatment gains at 3-month follow-up in the Child/Adolescent Anxiety Multimodal Treatment Study (CAMS). Method Participants were 488 youth (ages 7-17; 50.4% male) randomized to cognitive-behavioral therapy (CBT; Coping cat program), pharmacotherapy (sertraline), their combination, or pill placebo. Participants met DSM-IV criteria for generalized anxiety disorder, social phobia, and/or separation anxiety disorder. Coping efficacy (reported ability to manage anxiety provoking situations) was measured by youth and parent reports on the Coping Questionnaire, and anxious self-talk was measured by youth report on the Negative Affectivity Self-Statement Questionnaire. Outcome was measured using the Pediatric Anxiety Rating Scale (completed by Independent Evaluators blind to condition). For temporal precedence, residualized treatment gains were assessed at 3-month follow-up. Results Residualized gains in coping efficacy mediated gains in the CBT, sertraline, and combination conditions. In the combination condition, some unique effect of treatment remained. Treatment assignment was not associated with a reduction in anxious self-talk, nor did anxious self-talk predict changes in anxiety symptoms. Conclusions The findings suggest that improvements in coping efficacy are a mediator of treatment gains. Anxious self-talk did not emerge as a mediator. PMID:26460572

  5. Mechanisms of Change in Written Exposure Treatment of Posttraumatic Stress Disorder

    PubMed Central

    Wisco, Blair E.; Baker, Aaron S.; Sloan, Denise M.

    2016-01-01

    Although the effectiveness of exposure therapy for PTSD is recognized, treatment mechanisms are not well understood. Emotional processing theory (EPT) posits that fear reduction within and between sessions creates new learning, but evidence is limited by self-report assessments and inclusion of treatment components other than exposure. We examined trajectories of physiological arousal and their relation to PTSD treatment outcome in a randomized controlled trial of written exposure treatment, a protocol focused on exposure to trauma memories. Hierarchical linear modeling was used to model reduction in Clinician Administered PTSD Scale score as a predictor of initial activation and within- and between-session change in physiological arousal. Treatment gains were significantly associated with initial physiological activation, but not with within- or between-session changes in physiological arousal. Treatment gains were associated with larger between-session reductions in self-reported arousal. These findings highlight the importance of multimethod arousal assessment and add to a growing literature suggesting refinements of EPT. PMID:26763498

  6. Quality of life and BMI changes in youth participating in an integrated pediatric obesity treatment program

    PubMed Central

    2013-01-01

    Background Changes in Quality of Life (QOL) measures over time with treatment of obesity have not previously been described for youth. We describe the changes from baseline through two follow up visits in youth QOL (assessed by the Pediatric Quality Life Inventory, PedsQL4.0), teen depression (assessed by the Patient Health Questionnaire, PHQ9A), Body Mass Index (BMI) and BMI z-score. We also report caregiver proxy ratings of youth QOL. Methods A sample of 267 pairs of youth and caregiver participants were recruited at their first visit to an outpatient weight-treatment clinic that provides care integrated between a physician, dietician, and mental health provider; of the 267, 113 attended a visit two (V2) follow-up appointment, and 48 attended visit three (V3). We investigated multiple factors longitudinally experienced by youth who are overweight and their caregivers across up to three different integrated care visits. We determined relationships at baseline in QOL, PHQ9A, and BMI z-score, as well as changes in variables over time using linear mixed models with time as a covariate. Results Overall across three visits the results indicate that youth had slight declines in relative BMI, significant increases in their QOL and improvements in depression. Conclusions We encourage clinicians and researchers to track youth longitudinally throughout treatment to investigate not only youth’s BMI changes, but also psychosocial changes including QOL. PMID:23837620

  7. Respiratory and Cognitive Mediators of Treatment Change in Panic Disorder: Evidence for Intervention Specificity

    PubMed Central

    Meuret, Alicia E.; Rosenfield, David; Seidel, Anke; Bhaskara, Lavanya; Hofmann, Stefan G.

    2012-01-01

    Objective There are numerous theories of panic disorder, each proposing a unique pathway of change leading to treatment success. However, little is known about whether improvements in proposed mediators are indeed associated with treatment outcomes and whether these mediators are specific to particular treatment modalities. Our purpose in this study was to analyze pathways of change in theoretically distinct interventions using longitudinal, moderated mediation analyses. Method Forty-one patients with panic disorder and agoraphobia were randomly assigned to receive 4 weeks of training aimed at altering either respiration (capnometry-assisted respiratory training) or panic-related cognitions (cognitive training). Changes in respiration (PCO2, respiration rate), symptom appraisal, and a modality-nonspecific mediator (perceived control) were considered as possible mediators. Results The reductions in panic symptom severity and panic-related cognitions and the improvements in perceived control were significant and comparable in both treatment groups. Capnometry-assisted respiratory training, but not cognitive training, led to corrections from initially hypocapnic to normocapnic levels. Moderated mediation and temporal analyses suggested that in capnometry-assisted respiratory training, PCO2 unidirectionally mediated and preceded changes in symptom appraisal and perceived control and was unidirectionally associated with changes in panic symptom severity. In cognitive training, reductions in symptom appraisal were bidirectionally associated with perceived control and panic symptom severity. In addition, perceived control was bidirectionally related to panic symptom severity in both treatment conditions. Conclusion The findings suggest that reductions in panic symptom severity can be achieved through different pathways, consistent with the underlying models. PMID:20873904

  8. Changes in renal function in cats following treatment of hyperthyroidism using 131I.

    PubMed

    Adams, W H; Daniel, G B; Legendre, A M; Gompf, R E; Grove, C A

    1997-01-01

    Changes in renal function of twenty-two cats treated for hyperthyroidism using radioiodine were evaluated. Serum thyroxine (T4), serum creatinine, blood urea nitrogen (BUN) and urine specific gravity were measured before treatment and 6 and 30 days after treatment. Twenty-two cats had pretreatment and 21 cats had 6 day posttreatment measurement of glomerular filtration rate (GFR) using nuclear medicine imaging techniques. There were significant declines in serum T4 at 6 days following treatment, but the changes in GFR, serum creatinine and BUN were not significant. At 30 days following treatment, there were significant increases in BUN and serum creatinine and further significant declines in serum T4. Nine cats were in renal failure prior to treatment and 13 cats were in renal failure 30 days following treatment. Renal failure was defined as BUN greater than 30 mg/dl and/or serum creatinine greater than 1.8 mg/dl with concurrent urine specific gravity less than 1.035. These 13 cats included eight of 9 cats in renal failure prior to treatment and 5 cats not previously in renal failure. Follow up information beyond 30 days following treatment on 9 of these 13 cats indicated that all remained in renal failure. Based on receiver operating curve analysis of pretreatment glomerular filtration rate (GFR) in predicting posttreatment renal failure, a value of 2.25 ml/kg/min as a point of maximum sensitivity (100%) and specificity (78%) was derived. Fifteen of 22 cats had pretreatment GFR measurements of less than 2.25 ml/kg/min. These 15 cats included all 9 cats in renal failure and 5 cats with normal renal clinicopathologic values prior to treatment. At 30 days following treatment, 13 of these 15 cats were in renal failure. The 2 cats not in renal failure had persistently increased serum T4 values. Seven of 22 cats had pretreatment GFR measurements greater than 2.25 ml/kg/min. None of these 7 cats was in renal failure at 30 days following treatment, all cats having normal

  9. Induction of Female-to-Male Sex Change in Adult Zebrafish by Aromatase Inhibitor Treatment

    NASA Astrophysics Data System (ADS)

    Takatsu, Kanae; Miyaoku, Kaori; Roy, Shimi Rani; Murono, Yuki; Sago, Tomohiro; Itagaki, Hideyuki; Nakamura, Masaru; Tokumoto, Toshinobu

    2013-12-01

    This study investigated whether undifferentiated germ and/or somatic stem cells remain in the differentiated ovary of a species that does not undergo sex changes under natural conditions and retain their sexual plasticity. The effect of aromatase inhibitor (AI)-treatment on sexually mature female zebrafish was examined. A 5-month AI treatment caused retraction of the ovaries after which testes-like organs appeared, and cyst structures filled with spermatozoa-like cells were observed in sections of these tissues. Electron microscopic observations revealed that these cells appeared as large sperm heads without tails. Sperm formation was re-examined after changing the diet to an AI-free food. A large number of normal sperm were obtained after eight weeks, and no formation of ovarian tissue was observed. Artificial fertilization using sperm from the sex-changed females was successful. These results demonstrated that sex plasticity remains in the mature ovaries of this species.

  10. Retrospective analysis of changing characteristics of treatment-seeking smokers: implications for further reducing smoking prevalence

    PubMed Central

    Leyro, Teresa M; Crew, Erin E; Bryson, Susan W; Lembke, Anna; Bailey, Steffani R; Prochaska, Judith J; Henriksen, Lisa; Fortmann, Stephen P; Killen, Joel D; Killen, Diana T; Hall, Sharon M; David, Sean P

    2016-01-01

    Objective The goal of the current study was to empirically compare successive cohorts of treatment-seeking smokers who enrolled in randomised clinical trials in a region of the USA characterised by strong tobacco control policies and low smoking prevalence, over the past three decades. Design Retrospective treatment cohort comparison. Setting Data were collected from 9 randomised clinical trials conducted at Stanford University and the University of California, San Francisco, between 1990 and 2013. Participants Data from a total of 2083 participants were included (Stanford, n=1356; University of California San Francisco, n=727). Primary and secondary outcomes One-way analysis of variance and covariance, χ2 and logistic regression analyses were used to examine relations between nicotine dependence, cigarettes per day, depressive symptoms and demographic characteristics among study cohorts. Results Similar trends were observed at both settings. When compared to earlier trials, participants in more recent trials smoked fewer cigarettes, were less nicotine-dependent, reported more depressive symptoms, were more likely to be male and more likely to be from a minority ethnic/racial group, than those enrolled in initial trials (all p's<0.05). Analysis of covariances revealed that cigarettes per day, nicotine dependence and current depressive symptom scores were each significantly related to trial (all p's<0.001). Conclusions Our findings suggest that more recent smoking cessation treatment-seeking cohorts in a low prevalence region were characterised by less smoking severity, more severe symptoms of depression and were more likely to be male and from a minority racial/ethnic group. PMID:27357195

  11. How weight change is modelled in population studies can affect research findings: empirical results from a large-scale cohort study

    PubMed Central

    Paige, E; Korda, R J; Banks, E; Rodgers, B

    2014-01-01

    Objectives To investigate how results of the association between education and weight change vary when weight change is defined and modelled in different ways. Design Longitudinal cohort study. Participants 60 404 men and women participating in the Social, Environmental and Economic Factors (SEEF) subcomponent of the 45 and Up Study—a population-based cohort study of people aged 45 years or older, residing in New South Wales, Australia. Outcome measures The main exposure was self-reported education, categorised into four groups. The outcome was annual weight change, based on change in self-reported weight between the 45 and Up Study baseline questionnaire and SEEF questionnaire (completed an average of 3.3 years later). Weight change was modelled in four different ways: absolute change (kg) modelled as (1) a continuous variable and (2) a categorical variable (loss, maintenance and gain), and relative (%) change modelled as (3) a continuous variable and (4) a categorical variable. Different cut-points for defining weight-change categories were also tested. Results When weight change was measured categorically, people with higher levels of education (compared with no school certificate) were less likely to lose or to gain weight. When weight change was measured as the average of a continuous measure, a null relationship between education and annual weight change was observed. No material differences in the education and weight-change relationship were found when comparing weight change defined as an absolute (kg) versus a relative (%) measure. Results of the logistic regression were sensitive to different cut-points for defining weight-change categories. Conclusions Using average weight change can obscure important directional relationship information and, where possible, categorical outcome measurements should be included in analyses. PMID:24907245

  12. Qualitative examination of cognitive change during PTSD treatment for active duty service members.

    PubMed

    Dondanville, Katherine A; Blankenship, Abby E; Molino, Alma; Resick, Patricia A; Wachen, Jennifer Schuster; Mintz, Jim; Yarvis, Jeffrey S; Litz, Brett T; Borah, Elisa V; Roache, John D; Young-McCaughan, Stacey; Hembree, Elizabeth A; Peterson, Alan L

    2016-04-01

    The current study investigated changes in service members' cognitions over the course of Cognitive Processing Therapy (CPT) for posttraumatic stress disorder (PTSD). Sixty-three active duty service members with PTSD were drawn from 2 randomized controlled trials of CPT-Cognitive Only (CPT-C). Participants wrote an impact statement about the meaning of their index trauma at the beginning and again at the end of therapy. Clauses from each impact statement were qualitatively coded into three categories for analysis: assimilation, accommodation, and overaccommodation. The PTSD Checklist, Posttraumatic Symptom Scale-Interview Version, and the Beck Depression Inventory-II were administered at baseline and posttreatment. Repeated measures analyses documented a significant decrease in the percentage of assimilated or overaccommodated statements and an increase in the percentage of accommodated statements from the beginning to the end of treatment. Changes in accommodated statements over the course of treatment were negatively associated with PTSD and depression symptom severity, while statements indicative of overaccommodation were positively associated with both PTSD and depression symptom severity. Treatment responders had fewer overaccommodated and more accommodated statements. Findings suggest that CPT-C changes cognitions over the course of treatment. Methodological limitations and the lack of association between assimilation and PTSD symptom severity are further discussed. PMID:26874683

  13. Postradiation imaging changes in the CNS: how can we differentiate between treatment effect and disease progression?

    PubMed Central

    Walker, Amanda J; Ruzevick, Jake; Malayeri, Ashkan A; Rigamonti, Daniele; Lim, Michael; Redmond, Kristin J; Kleinberg, Lawrence

    2015-01-01

    A familiar challenge for neuroradiologists and neuro-oncologists is differentiating between radiation treatment effect and disease progression in the CNS. Both entities are characterized by an increase in contrast enhancement on MRI and present with similar clinical signs and symptoms that may occur either in close temporal proximity to the treatment or later in the disease course. When radiation-related imaging changes or clinical deterioration are mistaken for disease progression, patients may be subject to unnecessary surgery and/or a change from otherwise effective therapy. Similarly, when disease progression is mistaken for treatment effect, a potentially ineffective therapy may be continued in the face of progressive disease. Here we describe the three types of radiation injury to the brain based on the time to development of signs and symptoms – acute, subacute and late – and then review specific imaging changes after intensity-modulated radiation therapy, stereotactic radiosurgery and brachytherapy. We provide an overview of these phenomena in the treatment of a wide range of malignant and benign CNS illnesses. Finally, we review the published data regarding imaging techniques under investigation to address this well-known problem. PMID:24947265

  14. Semi-arid aquifer responses to forest restoration treatments and climate change.

    PubMed

    Wyatt, Clinton J W; O'Donnell, Frances C; Springer, Abraham E

    2015-01-01

    The purpose of this study was to develop an interpretive groundwater-flow model to assess the impacts that planned forest restoration treatments and anticipated climate change will have on large regional, deep (>400 m), semi-arid aquifers. Simulations were conducted to examine how tree basal area reductions impact groundwater recharge from historic conditions to 2099. Novel spatial analyses were conducted to determine areas and rates of potential increases in groundwater recharge. Changes in recharge were applied to the model by identifying zones of basal area reduction from planned forest restoration treatments and applying recharge-change factors to these zones. Over a 10-year period of forest restoration treatment, a 2.8% increase in recharge to one adjacent groundwater basin (the Verde Valley sub-basin) was estimated, compared to conditions that existed from 2000 to 2005. However, this increase in recharge was assumed to quickly decline after treatment due to regrowth of vegetation and forest underbrush and their associated increased evapotranspiration. Furthermore, simulated increases in groundwater recharge were masked by decreases in water levels, stream baseflow, and groundwater storage resulting from surface water diversions and groundwater pumping. These results indicate that there is an imbalance between water supply and demand in this regional, semi-arid aquifer. Current water management practices may not be sustainable into the far future and comprehensive action should be taken to minimize this water budget imbalance. PMID:24665998

  15. Serum Inflammatory Mediators in Pregnancy: Changes Following Periodontal Treatment and Association with Pregnancy Outcomes

    PubMed Central

    Michalowicz, Bryan S.; Novak, M. John; Hodges, James S.; DiAngelis, Anthony; Buchanan, William; Papapanou, Panos N.; Mitchell, Dennis A.; Ferguson, James E.; Lupo, Virginia; Bofill, James; Matseoane, Stephen; Steffen, Michelle; Ebersole, Jeffrey L.

    2009-01-01

    Objective To determine: 1) if periodontal treatment in pregnant women before 21 weeks of gestation alters levels of inflammatory mediators in serum; and 2) if changes in these mediators are associated with birth outcomes. Methods 823 pregnant women with periodontitis were randomly assigned to receive scaling and root planing before 21 weeks of gestation or after delivery. Serum obtained between 13 weeks and 16 weeks 6 days (study baseline) and 29–32 weeks gestation was analyzed for C-reactive protein, prostaglandin E2, matrix metalloproteinase-9, fibrinogen, endotoxin, interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor-α. Cox regression, multiple linear regression, t-tests, chi-square and Fisher’s exact tests were used to examine associations between the biomarkers, periodontal treatment, and gestational age at delivery and birthweight. Results 796 women had baseline serum data; 620 had baseline and follow-up serum and birth data. Periodontal treatment did not significantly alter the level of any biomarker (P>0.05). Neither baseline levels nor change from baseline in any biomarker was significantly associated with preterm birth or infant birthweight (P>0.05). In treatment subjects, change in endotoxin was negatively associated with change in probing depth (P<0.05). Conclusions Non-surgical mechanical periodontal treatment in pregnant women delivered before 21 weeks of gestation did not reduce systemic (serum) markers of inflammation. In pregnant women with periodontitis, levels of these markers at 13–17 weeks and 29–32 weeks gestation were not associated with risk for preterm birth or with infant birthweight. PMID:19905943

  16. Group process as a mechanism of change in the group treatment of anger and aggression.

    PubMed

    Gerhart, James; Holman, Krista; Seymour, Bailey; Dinges, Brandy; Ronan, George F

    2015-04-01

    Angry reactions can present unique challenges to the process of conducting group therapy, especially when providing group treatment to participants who have histories of angry or aggressive behavior. This article briefly reviews relevant literature and describes a group-based violence reduction training program (VRTP). The VRTP conceptualizes anger and aggression from a frustration-aggression framework and employs treatment derived from research in the area of social problem-solving. An emphasis is placed on how fostering group experiences consistent with Irving Yalom's classic work on the theory and practice of group therapy can reinforce skill acquisition and general treatment responsiveness. Management of the group process is a plausible mechanism of change in group treatment of anger. We highlight the challenges and benefits of dealing with anger-infused communication while ensuring the integrity of the overall group process. Case examples are provided for illustration of VRTP. Future research can answer important questions about group process and mechanisms of change in group-based treatments for anger and aggression. PMID:25760784

  17. Cognitive Neuroscience Approaches to Understanding Behavior Change in Alcohol Use Disorder Treatments

    PubMed Central

    Naqvi, Nasir H.; Morgenstern, Jon

    2015-01-01

    Researchers have begun to apply cognitive neuroscience concepts and methods to study behavior change mechanisms in alcohol use disorder (AUD) treatments. This review begins with an examination of the current state of treatment mechanisms research using clinical and social psychological approaches. It then summarizes what is currently understood about the pathophysiology of addiction from a cognitive neuroscience perspective. Finally, it reviews recent efforts to use cognitive neuroscience approaches to understand the neural mechanisms of behavior change in AUD, including studies that use neural functioning to predict relapse and abstinence; studies examining neural mechanisms that operate in current evidence-based behavioral interventions for AUD; as well as research on novel behavioral interventions that are being derived from our emerging understanding of the neural and cognitive mechanisms of behavior change in AUD. The article highlights how the regulation of sub-cortical regions involved in alcohol incentive motivation by prefrontal cortical regions involved in cognitive control may be a core mechanism that plays a role in these varied forms of behavior change in AUD. We also lay out a multilevel framework for integrating cognitive neuroscience approaches with more traditional methods for examining AUD treatment mechanisms. PMID:26259087

  18. Cognitive Neuroscience Approaches to Understanding Behavior Change in Alcohol Use Disorder Treatments.

    PubMed

    Naqvi, Nasir H; Morgenstern, Jon

    2015-01-01

    Researchers have begun to apply cognitive neuroscience concepts and methods to study behavior change mechanisms in alcohol use disorder (AUD) treatments. This review begins with an examination of the current state of treatment mechanisms research using clinical and social psychological approaches. It then summarizes what is currently understood about the pathophysiology of addiction from a cognitive neuroscience perspective. Finally, it reviews recent efforts to use cognitive neuroscience approaches to understand the neural mechanisms of behavior change in AUD, including studies that use neural functioning to predict relapse and abstinence; studies examining neural mechanisms that operate in current evidence-based behavioral interventions for AUD; as well as research on novel behavioral interventions that are being derived from our emerging understanding of the neural and cognitive mechanisms of behavior change in AUD. The article highlights how the regulation of subcortical regions involved in alcohol incentive motivation by prefrontal cortical regions involved in cognitive control may be a core mechanism that plays a role in these varied forms of behavior change in AUD. We also lay out a multilevel framework for integrating cognitive neuroscience approaches with more traditional methods for examining AUD treatment mechanisms. PMID:26259087

  19. Empirical Comparison of Three Treatments for Adolescent Males with Physical and Sexual Aggression: Mode Deactivation Therapy, Cognitive Behavior Therapy and Social Skills Training

    ERIC Educational Resources Information Center

    Apsche, Jack A.; Bass, Christopher K.; Jennings, Jerry L.; Murphy, Christopher J.; Hunter, Linda A.; Siv, Alexander M.

    2005-01-01

    This research study compared the efficacy of three treatment methodologies for adolescent males in residential treatment with conduct disorders and/or personality dysfunctions and documented problems with physical and sexual aggression. The results showed that Mode Deactivation Therapy, an advanced form of cognitive behavioral therapy based on…

  20. Predictors of Change in the Provision of Services within Outpatient Substance Abuse Treatment Programs

    PubMed Central

    Knight, Danica Kalling; Edwards, Jennifer R.; Flynn, Patrick M.

    2010-01-01

    The current study examines patterns and predictors of change over a 2-year period in whether outpatient core and wraparound services are offered onsite or by referral. A sample of 69 outpatient non-methadone programs from four US regions provided organizational information across a 2-year period. Services provided within outpatient substance abuse programs were relatively stable over time, particularly with regard to core therapeutic services. The use of referral networks to provide a broader array of wraparound services increased, with programs adding services that reflect recent national initiatives toward program improvement, namely pharmacotherapy, medical diagnosis and treatment, and psychiatric services. Organizational factors such as parent affiliation, counselor caseload, staff size, budget change, and proportion of dually-diagnosed clients were related to change in core and wraparound services. Dynamic organizational factors, such as staff size and budgets can serve as barriers to and/or facilitate change in service provision over time and have managerial and policy implications. PMID:20885186

  1. Readiness to change as a moderator of outcome in transdiagnostic treatment

    PubMed Central

    BOSWELL, JAMES F.; SAUER, SHANNON E.; GALLAGHER, MATTHEW W.; DELGADO, NICOLE; BARLOW, DAVID H.

    2012-01-01

    Initial symptom severity is a client characteristic associated with psychotherapy outcome, although this relationship is not well-understood. Readiness to change is a factor that may influence this relationship. This study tested readiness as a moderator of the relationship between initial severity and symptom change. Data were derived from an RCT examining the efficacy of a transdiagnostic CBT treatment. Readiness was assessed with the URICA, and symptom and functioning outcomes were assessed. Multiple regression models indicated that severity was associated with less overall change, yet readiness moderated this relationship. At higher levels of readiness, the effect of initial severity on outcome was essentially reversed; for clients with higher initial readiness, higher levels of severity were associated with greater change. PMID:22607634

  2. Estimation of wildfire size and risk changes due to fuels treatments

    USGS Publications Warehouse

    Cochrane, M.A.; Moran, C.J.; Wimberly, M.C.; Baer, A.D.; Finney, M.A.; Beckendorf, K.L.; Eidenshink, J.; Zhu, Z.

    2012-01-01

    Human land use practices, altered climates, and shifting forest and fire management policies have increased the frequency of large wildfires several-fold. Mitigation of potential fire behaviour and fire severity have increasingly been attempted through pre-fire alteration of wildland fuels using mechanical treatments and prescribed fires. Despite annual treatment of more than a million hectares of land, quantitative assessments of the effectiveness of existing fuel treatments at reducing the size of actual wildfires or how they might alter the risk of burning across landscapes are currently lacking. Here, we present a method for estimating spatial probabilities of burning as a function of extant fuels treatments for any wildland fire-affected landscape. We examined the landscape effects of more than 72 000 ha of wildland fuel treatments involved in 14 large wildfires that burned 314 000 ha of forests in nine US states between 2002 and 2010. Fuels treatments altered the probability of fire occurrence both positively and negatively across landscapes, effectively redistributing fire risk by changing surface fire spread rates and reducing the likelihood of crowning behaviour. Trade offs are created between formation of large areas with low probabilities of increased burning and smaller, well-defined regions with reduced fire risk.

  3. Main occluding area in partially edentulous patients: changes before and after implant treatment.

    PubMed

    Goto, T; Nishinaka, H; Kashiwabara, T; Nagao, K; Ichikawa, T

    2012-09-01

    The 'main occluding area', the location where food crushing occurs during the first stroke of mastication, is reported to be an important concept; however, it is currently limited to findings in individuals with normal dentition. The purpose of this study was to assess the changes in the location, area and bite force of the main occluding area before and after implant treatments. We enrolled 50 partially edentulous and 22 normally dentate subjects. To identify the location of the main occluding area, each subject was instructed to freely bite once on a dental stopping using the partially edentulous side or the normally dentate area. The location, occluding contact area and bite force of the main occluding area before and after the implant treatments were analysed. The main occluding area was located at a reproducible location in the partially edentulous and normally dentate subjects. This location was principally the first molar region, and for the partially edentulous patients with missing teeth in the molar regions, it moved from the premolar region to the first molar region after treatment. The occluding contact area and bite force for the main occluding area increased (P < 0·05) after the implant treatment in the partially edentulous patients with missing teeth in the molar regions. These results suggest that the main occluding area can be restored to the first molar region after implant treatment and may be an important factor in the assessment of prosthodontic treatment. PMID:22672204

  4. Stories of change in drug treatment: a narrative analysis of 'whats' and 'hows' in institutional storytelling.

    PubMed

    Andersen, Ditte

    2015-06-01

    Addiction research has demonstrated how recovering individuals need narratives that make sense of past drug use and enable constructions of future, non-addict identities. However, there has not been much investigation into how these recovery narratives actually develop moment-to-moment in drug treatment. Building on the sociology of storytelling and ethnographic fieldwork conducted at two drug treatment institutions for young people in Denmark, this article argues that studying stories in the context of their telling brings forth novel insights. Through a narrative analysis of both 'the whats' (story content) and 'the hows' (storying process) the article presents four findings: (1) stories of change function locally as an institutional requirement; (2) professional drug treatment providers edit young people's storytelling through different techniques; (3) the narrative environment of the drug treatment institution shapes how particular stories make sense of the past, present and future; and (4) storytelling in drug treatment is an interactive achievement. A fine-grained analysis illuminates in particular how some stories on gender and drug use are silenced, while others are encouraged. The demonstration of how local narrative environments shape stories contributes to the general understanding of interactive storytelling in encounters between professionals and clients in treatment settings. PMID:25664499

  5. Distinguishing benign confounding treatment changes from residual prostate cancer on MRI following laser ablation

    NASA Astrophysics Data System (ADS)

    Litjens, G.; Huisman, H.; Elliott, R.; Shih, N.; Feldman, M.; Viswanath, S.; Fütterer, J.; Bomers, J.; Madabhushi, A.

    2014-03-01

    Laser interstitial thermotherapy (LITT) is a relatively new focal therapy technique for the ablation of localized prostate cancer. However, very little is known about the specific effects of LITT within the ablation zone and the surrounding normal tissue regions. For instance, it is important to be able to assess the extent of residual cancer within the prostate following LITT, which may be masked by thermally induced benign necrotic changes. Fortunately LITT is MRI compatible and hence this allows for quantitatively assessing LITT induced changes via multi-parametric MRI. Of course definite validation of any LITT induced changes on MRI requires confirmation via histopathology. The aim of this study was to quantitatively assess and distinguish the imaging characteristics of prostate cancer and benign confounding treatment changes following LITTon 3 Tesla multi-parametric MRI by carefully mapping the treatment related changes from the ex vivo surgically resected histopathologic specimens onto the pre-operative in vivo imaging. A better understanding of the imaging characteristics of residual disease and successfully ablated tissue might lead to improved treatment monitoring and as such patient prognosis. A unique clinical trial at the Radboud University Medical Center, in which 3 patients underwent a prostatectomy after LITT treatment, yielded ex-vivo histopathologic specimens along with pre- and post-LITT MRI. Using this data we (1) identified the computer extracted MRI signatures associated with treatment effects including benign necrotic changes and residual disease and (2) subsequently evaluated the computer extracted MRI features previously identified in distinguishing LITT induced changes in the ablated area relative to the residual disease. Towards this end first a pathologist annotated the ablated area and the residual disease on the ex-vivo histology and then we transferred the annotations to the post-LITT MRI using semi-automatic elastic registration. The

  6. Changes in acidity of Fe-pillared/delaminated smectites on heat treatment

    SciTech Connect

    Bandosz, T.J.; Cheng, K.

    1997-07-15

    Hydroxy-iron smectites were prepared using solutions with a OH/Fe content of about 1.2 and 2.5. To study thermal stability, the samples were heated in air at temperatures between 473 and 873 K. Changes in surface chemistry imposed by heat treatment were evaluated using potentiometric titration. The pK{sub a} distributions revealed peaks characteristic for iron complexes (Fe{sup III}) deposited on the surface of smectite. Heat treatment resulted in significant changes in the chemistry of the material and creation of new species; however, the sorbents textural properties did not alter significantly. Data obtained from X-ray diffraction and sorption of nitrogen demonstrate that iron species are adsorbed mainly on the external surface of smectite and that the properties of the final products depend upon the OH/Fe ratio of hydroxy-iron solutions used in their preparation.

  7. Life cycle cost analysis changes mixed waste treatment program at the Savannah River Site. Revision 1

    SciTech Connect

    Pickett, J.B.; England, J.L.; Martin, H.L.

    1992-12-31

    A direct result of the reduced need for weapons production has been a re-evaluation of the treatment projects for mixed (hazardous/radioactive) wastes generated from metal finishing and plating operations and from a mixed waste incinerator at the Savannah River Site (SRS). A Life Cycle Cost (LCC) analysis was conducted for two waste treatment projects to determine the most cost effective approach in response to SRS mission changes. A key parameter included in the LCC analysis was the cost of the disposal vaults required for the final stabilized wasteform(s) . The analysis indicated that volume reduction of the final stabilized wasteform(s) can provide significant cost savings. The LCC analysis demonstrated that one SRS project could be eliminated, and a second project could be totally ``rescoped and downsized.`` The changes resulted in an estimated Life Cycle Cost saving (over a 20 year period) of $270,000,000.

  8. Life cycle cost analysis changes mixed waste treatment program at the Savannah River Site

    SciTech Connect

    Pickett, J.B.; England, J.L.; Martin, H.L.

    1992-01-01

    A direct result of the reduced need for weapons production has been a re-evaluation of the treatment projects for mixed (hazardous/radioactive) wastes generated from metal finishing and plating operations and from a mixed waste incinerator at the Savannah River Site (SRS). A Life Cycle Cost (LCC) analysis was conducted for two waste treatment projects to determine the most cost effective approach in response to SRS mission changes. A key parameter included in the LCC analysis was the cost of the disposal vaults required for the final stabilized wasteform(s) . The analysis indicated that volume reduction of the final stabilized wasteform(s) can provide significant cost savings. The LCC analysis demonstrated that one SRS project could be eliminated, and a second project could be totally rescoped and downsized.'' The changes resulted in an estimated Life Cycle Cost saving (over a 20 year period) of $270,000,000.

  9. [Modern diagnosis-treatment approaches for inflammatory changes of mammary glands].

    PubMed

    Bilonenko, H A; Aks'onova, O H; Aks'onov, O A

    2013-11-01

    There were examined 567 women, in whom inflammatory changes of mammary glands (MG), not connected with a child borning, were revealed. There was established, that "nonlactational mastitis" of various structure: the cyst--in 36.5% of observations, periductal mastitis--in 32.1%, abscess--11.3%, purulent galactophoritis--12.9%, mastitis-like mammary gland cancer--7.2%. In the diagnosis of inflammatory changes of MG the ultrasonographic investigation is the main, which permit to determine the disease, to study the abscesses topography, to control miniinvasive diagnostic-treatment interventions, in cluding, for abscess and cyst. Purulent-inflammatory processes in MG while extralactational period demand individual differentiated treatment-diagnostic approach regarding khowledge of ultrasonographic (echographic) semiotics of pathological process. PMID:24501989

  10. Neuroimaging in aphasia treatment research: Issues of experimental design for relating cognitive to neural changes

    PubMed Central

    Rapp, Brenda; Caplan, David; Edwards, Susan; Visch-Brink, Evy; Thompson, Cynthia K.

    2012-01-01

    The design of functional neuroimaging studies investigating the neural changes that support treatment-based recovery of targeted language functions in acquired aphasia faces a number of challenges. In this paper, we discuss these challenges and focus on experimental tasks and experimental designs that can be used to address the challenges, facilitate the interpretation of results and promote integration of findings across studies. PMID:22974976

  11. Global Changes in the Rat Heart Proteome Induced by Prolonged Morphine Treatment and Withdrawal

    PubMed Central

    Drastichova, Zdenka; Skrabalova, Jitka; Jedelsky, Petr; Neckar, Jan; Kolar, Frantisek; Novotny, Jiri

    2012-01-01

    Morphine belongs among the most commonly used opioids in medical practice due to its strong analgesic effects. However, sustained administration of morphine leads to the development of tolerance and dependence and may cause long-lasting alterations in nervous tissue. Although proteomic approaches enabled to reveal changes in multiple gene expression in the brain as a consequence of morphine treatment, there is lack of information about the effect of this drug on heart tissue. Here we studied the effect of 10-day morphine exposure and subsequent drug withdrawal (3 or 6 days) on the rat heart proteome. Using the iTRAQ technique, we identified 541 proteins in the cytosol, 595 proteins in the plasma membrane-enriched fraction and 538 proteins in the mitochondria-enriched fraction derived from the left ventricles. Altogether, the expression levels of 237 proteins were altered by morphine treatment or withdrawal. The majority of changes (58 proteins) occurred in the cytosol after a 3-day abstinence period. Significant alterations were found in the expression of heat shock proteins (HSP27, α-B crystallin, HSP70, HSP10 and HSP60), whose levels were markedly up-regulated after morphine treatment or withdrawal. Besides that morphine exposure up-regulated MAPK p38 (isoform CRA_b) which is a well-known up-stream mediator of phosphorylation and activation of HSP27 and α-B crystallin. Whereas there were no alterations in the levels of proteins involved in oxidative stress, several changes were determined in the levels of pro- and anti-apoptotic proteins. These data provide a complex view on quantitative changes in the cardiac proteome induced by morphine treatment or withdrawal and demonstrate great sensitivity of this organ to morphine. PMID:23056601

  12. A Change of Traditional Method of Treatment of Partial Thickness Burn with Hydrofibre Dressings.

    PubMed

    Mitura, Kryspin; Osłowska, Jolanta; Mitura, Alicja

    2015-02-01

    Nearly 1% of population is affected with burn trauma annually. Among patients seeking advanced medical care almost 8% require hospital stay. Most burns are superficial and do not cause full thickness damage to the skin. Standard topical treatment of burn wounds with creams and ointments requires frequent dressings' changes. The healing process is long and expensive. The technological revolution, as occurred in the last decade in the field of dressing care allows us to introduce the use of advanced material solutions. Modern materials allow to shorten the treatment time, reduce the expenses and diminish the patient discomfort leading to good outcome. The study presented a case of four patients treated due to the partial thickness burn wound. Hydrofiber dressing with silver ions were introduced in the treatment. We observed good short and long term results. PMID:26146101

  13. The Key to Individualized Addiction Treatment is Comprehensive Assessment and Monitoring of Symptoms and Behavioral Change

    PubMed Central

    Hilton, Thomas F.; Pilkonis, Paul A.

    2015-01-01

    Modern health services now strive for individualized treatment. This approach has been enabled by the increase in knowledge derived from neuroscience and genomics. Substance use disorders are no exception to individualized treatment even though there are no gene-specific medications yet available. What is available is the ability to quickly and precisely assess and monitor biopsychosocial variables known to vary during addiction recovery and which place addicts at increased risk of relapse. Monitoring a broad spectrum of biopsychosocial health enables providers to address diverse genome-specific changes that might trigger withdrawal from treatment or recovery relapse in time to prevent that from occurring. This paper describes modern measurement tools contained in the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) and the NIH Toolbox and suggests how they might be applied to support recovery from alcohol and other substance use disorders in both pharmacological and abstinence-oriented modalities of care. PMID:26529025

  14. Trajectories of Change During a Randomized Controlled Trial of Internet-delivered Psychological Treatment for Adolescent Chronic Pain: How does Change in Pain and Function Relate?

    PubMed Central

    Palermo, Tonya M.; Law, Emily F.; Zhou, Chuan; Holley, Amy Lewandowski; Logan, Deirdre; Tai, Gabrielle

    2014-01-01

    Although pain and function improve at immediate post-treatment for youth receiving cognitive-behavioral therapy for chronic pain, limited data are available to understand changes that youth make during psychological treatment. We sought to characterize distinct trajectory patterns of change in pain and function in order to understand the temporal association of these changes during internet-delivered cognitive-behavioral treatment. Weekly repeated assessments of pain and function were conducted during eight weeks of treatment among 135 adolescents, ages 11 to 17 years, with chronic pain who were randomized to the cognitive-behavioral intervention (CBT) arm of an ongoing trial of internet-delivered CBT (Web-Based Management of Adolescent Pain; Web-MAP2). Using random effects growth mixture models we characterized pain and functional disability trajectories finding distinct trajectory groups indicating patterns of both linear as well as quadratic effects. Trajectories of change showed that some patients’ pain and functional disability was improving, others worsened, or changed minimally. Paired t-tests compared the within-subject relative change rate in pain and function demonstrating similar change range for pain and function during the treatment period. There was no support for improvements in either pain or function to precede changes in the other domain. Findings may be useful in informing future studies of psychosocial treatments for pediatric chronic pain to consider how to target treatment strategies to distinct patient response profiles. This may lead to the development of intervention strategies that can both more effectively target children’s pain and function during treatment, and lead to sustained changes following treatment. PMID:25775441

  15. Epidemiology and changed surgical treatment methods for fractures of the distal radius

    PubMed Central

    2013-01-01

    Background and purpose The incidence of fractures of the distal radius may have changed over the last decade, and operative treatment has been commoner during that time. We investigated the incidence of fractures of the distal radius and changing trends in surgical treatment during the period 2004–2010. Patients and methods Registry data on 42,583 patients with a fracture of the distal radius from 2004 to 2010 were evaluated regarding diagnosis, age, sex, and surgical treatment. Results The crude incidence rate was 31 per 104 person-years with a bimodal distribution. After the age of 45 years, the incidence rate in women increased rapidly and leveled off first at a very high age. The incidence rate in postmenopausal women was lower than previously reported. In men, the incidence was low and it increased slowly until the age of 80 years, when it amounted to 31 per 104 person-years. The number of surgical procedures increased by more than 40% despite the fact that there was reduced incidence during the study period. In patients ≥ 18 years of age, the proportion of fractures treated with plating increased from 16% to 70% while the use of external fixation decreased by about the same amount. Interpretation The incidence rate of distal radius fractures in postmenopausal women appears to have decreased over the last few decades. There has been a shift in surgical treatment from external fixation to open reduction and plating. PMID:23594225

  16. Changes of Corneal Wavefront Aberrations in Dry Eye Patients after Treatment with Artificial Lubricant Drops

    PubMed Central

    Lu, Ning; Lin, Fangyu; Huang, Zhu; He, Qin

    2016-01-01

    Purpose. To evaluate the corneal aberration changes in dry eye patients after treatment with artificial eye drops. Methods. Thirty mild to moderate dry eye patients treated with artificial eye drops and twenty comparable dry eye patients were recruited as controls. Anterior corneal aberrations over 3 mm and 5 mm analytical zones including total, 3rd to 5th high order aberrations (HOAs), spherical aberration (SA), and vertical (V-coma) and horizontal coma (H-coma) obtained from corneal topography data at baseline and 2 weeks after treatment were evaluated. Results. For 3 mm zone, trefoils, V-coma, H-coma terms, and 3rd and 5th HOAs were significantly decreased (p < 0.05) in the treatment group. For 5 mm zone, instillation of eye drops reduced H-coma, SA terms, 3rd to 5th orders, and total HOAs all showed a significant decrease (p < 0.05). The root mean square analysis of the Zernike terms also showed similar statistical results. For control group, all individual terms and total HOAs did not have significant changes over 3 mm and 5 mm zones (p > 0.05). Conclusions. Treatment with artificial eye drops can effectively improve the corneal optical quality of dry eye patients by ameliorating the HOAs of anterior corneal surface. PMID:27051526

  17. Changes in Protein Synthesis in Rapeseed (Brassica napus) Seedlings during a Low Temperature Treatment 1

    PubMed Central

    Meza-Basso, Luis; Alberdi, Miren; Raynal, Monique; Ferrero-Cadinanos, Maria-Luz; Delseny, Michel

    1986-01-01

    Changes induced by cold treatment in young rapeseed (Brassica napus) seedlings were investigated at the molecular level. Following germination at 18°C for 48 hours, one half of the seedlings was transferred to 0°C for another 48 hour period, the other half being kept at 18°C as a control. Newly synthesized proteins were labeled for the last 6 hours of incubation with [35S]methionine. The different polypeptides were separated by two-dimensional electrophoresis in polyacrylamide gels. Newly synthesized proteins were revealed by fluorography. Protein synthesis clearly continues at 0°C and some polypeptides preferentially accumulate at this temperature. On the other hand, synthesis of several others is repressed while many are insensitive to cold treatment. Similar changes are also observed when mRNA is prepared from cold treated seedlings, translated in vitro in a reticulocyte cell free system and compared with the products of mRNA extracted from control samples. Among the genes which are repressed we identified the small subunit of ribulose 1,6-bisphosphate carboxylase. These changes are also detectable after shorter treatments. Images Fig. 1 Fig. 2 Fig. 3 PMID:16665102

  18. Weight Gain and Metabolic Changes During Treatment with Antipsychotics and Antidepressants.

    PubMed

    Himmerich, Hubertus; Minkwitz, Juliane; Kirkby, Kenneth C

    2015-01-01

    Weight gain and metabolic disturbances are common side effects during psychopharmacological treatment with specific antipsychotics and antidepressants. The antipsychotics clozapine and olanzapine, and antidepressants tricyclics and mirtazapine have a high risk of inducing weight gain. Recently discovered pathophysiological mechanisms include antihistaminergic effects, activation of hypothalamic adenosine monophosphate-activated protein kinase (AMPK), modulation of hormonal signaling of ghrelin and leptin, changes in the production of cytokines such as tumor necrosis factor-alpha (TNF)-alpha and adipokines such as adiponektin, and the impact of genes, in particular the melanocortin 4 receptor (MC4R), serotonin 2C receptor (HTR2C), leptin, neuropeptide Y (NPY) and cannabinoid receptor 1 (CNR1) genes. Metabolic changes associated with weight gain include disturbances of glucose and lipid metabolism. Clozapine and olanzapine may, in addition to mechanisms resulting from weight gain, impair glucose metabolism by blockade of the muscarinic M3 receptor (M3R). Antidepressants associated with weight gain appear to have fewer unfavourable effects on glucose and lipid metabolism than the second-generation antipsychotics clozapine and olanzapine. To assess the risk of weight gain and its consequences for the patient's health, assessing body weight changes and metabolic monitoring in the first week of treatment as well as in long-term treatment is recommended. PMID:26100432

  19. Physiological Markers of Arousal Change with Psychological Treatment for Insomnia: A Preliminary Investigation

    PubMed Central

    Miller, Christopher B.; Kyle, Simon D.; Gordon, Christopher J.; Espie, Colin A.; Grunstein, Ronald R.; Mullins, Anna E.; Postnova, Svetlana; Bartlett, Delwyn J.

    2015-01-01

    Objectives The aim of this preliminary study was to evaluate if Sleep Restriction Therapy for insomnia is associated with modifications to physiological arousal, indexed through overnight measures of plasma cortisol concentrations and core body temperature. Methods In a pre-to-post open label study design, eleven patients with chronic and severe Psychophysiological Insomnia underwent 5 weeks of Sleep Restriction Therapy. Results Eight (73%) patients out of 11 consented completed therapy and showed a decrease in insomnia severity pre-to-post treatment (mean (SD): 18.1 (2.8) versus 8.4 (4.8); p = .001). Six patients were analyzed with pre-to-post overnight measures of temperature and cortisol. Contrary to our hypothesis, significantly higher levels of plasma cortisol concentrations were found during the early morning at post-treatment compared to baseline (p < .01), while no change was observed in the pre-sleep phase or early part of the night. Core body temperature during sleep was however reduced significantly (overall mean [95% CI]: 36.54 (°C) [36.3, 36.8] versus 36.45 [36.2, 36.7]; p < .05). Conclusions Sleep Restriction Therapy therefore was associated with increased early morning cortisol concentrations and decreased core body temperature, supporting the premise of physiological changes in functioning after effective therapy. Future work should evaluate change in physiological variables associated with clinical treatment response. Trial Registration Australian New Zealand Clinical Trials Registry ANZCTR 12612000049875 PMID:26683607

  20. Hemorheological changes in solid tumor patients after treatment with recombinant erythropoetin.

    PubMed

    Muravyov, A V; Cheporov, S V; Kislov, N V; Volkova, E L

    2009-01-01

    The subject of this study was the effect of erythropoetin (Epoetin) treatment of anemic patients (n=30) with solid tumors on parameters of hemorheological profile. Both prior to and following Epoetin treatment (10,000 units subcutaneously thrice weekly) for four weeks hemorheological measurements included plasma and red blood cell (RBC) suspension viscosity; high and low shear whole blood viscosity; hematocrit (Hct), hemoglobin, RBC aggregation (RBCA) and deformation. It was found that the patients had reduced Hb up to 92.96+/-2.99 g/l, and the Hct - 28.2%. These parameters were significant increased after four weeks of Epoetin treatment: Hb by 28% (p<0.01) and Hct by 31% (p<0.01). In macrorheological part of the profile, both the high shear blood viscosity, and the low one were increased by 23 and 27% (p<0.05), respectively. These changes were mainly associated with the Hct rise. As for microrheological part of profile after Epoetin treatment, RBCA was decreased by 25% (p<0.05). While the red cell rigidity index (Tk) was lowered only slightly (by 8%). RBC incubation with Epoetin (10.0 I.E./ml) was accompanied by 10% decrease of Tk. It is important to note that before Epoetin treatment incubation with it led to decrease of RBCA by 30% (p<0.05), whereas after four week of the treatment period a 27% (p<0.05) rise of aggregation was found in majority of patients. Thus these results suggest that Epoetin is an effective, safe and convenient therapy for the management of anaemia in patients with cancer. And this drug has a moderate positive hemorheological effect on RBC and on the microrheological properties in particular. These data suggested that Epoetin has an effect on the membrane properties regulating RBC aggregation and deformation and affects by the signal transduction system, including Ca2+-dependant signaling pathway and tyrosine kinase and phosphotase activity change. PMID:19136741

  1. Changes in patients’ symptoms and gastric emptying after Helicobacter pylori treatment

    PubMed Central

    Zhang, Chun-Ling; Geng, Chang-Hui; Yang, Zhi-Wei; Li, Yan-Lin; Tong, Li-Quan; Gao, Ping; Gao, Yue-Qiu

    2016-01-01

    AIM: To investigate the changes in clinical symptoms and gastric emptying and their association in functional dyspepsia (FD) patients. METHODS: Seventy FD patients were enrolled and divided into 2 groups Helicobacter pylori (H. pylori)-negative group (28 patients), and H. pylori-positive group (42 patients). Patients in the H. pylori-positive group were further randomly divided into groups: H. pylori-treatment group (21 patients) and conventional treatment group (21 patients). Seventy two healthy subjects were selected as the control group. The proximal and distal stomach area was measured by ultrasound immediately after patients took the test meal, and at 20, 40, 60 and 90 min; then, gastric half-emptying time was calculated. The incidence of symptoms and gastric half-emptying time between the FD and control groups were compared. The H. pylori-negative and conventional treatment groups were given conventional treatment: domperidone 0.6 mg/(kg/d) for 1 mo. The H. pylori-treatment group was given H. pylori eradication treatment + conventional treatment: lansoprazole 30 mg once daily, clarithromycin 0.5 g twice daily and amoxicillin 1.0 g twice daily for 1 wk, then domperidone 0.6 mg/(kg/d) for 1 mo. The incidence of symptoms and gastric emptying were compared between the FD and control groups. The relationship between dyspeptic symptoms and gastric half-emptying time in the FD and control groups were analyzed. Then total symptom scores before and after treatment and gastric half-emptying time were compared among the 3 groups. RESULTS: The incidence of abdominal pain, epigastric burning sensation, abdominal distension, nausea, belching, and early satiety symptoms in the FD group were significantly higher than in the control group (50.0% vs 20.8%; 37.1% vs 12.5%; 78.6% vs 44.4%; 45.7% vs 22.2%; 52.9% vs 15.3%; 57.1% vs 19.4%; all P < 0.05). The gastric half-emptying times of the proximal end, distal end, and the whole stomach in the FD group were slower than in the

  2. Proteome changes in banana fruit peel tissue in response to ethylene and high-temperature treatments

    PubMed Central

    Du, Lina; Song, Jun; Forney, Charles; Palmer, Leslie Campbell; Fillmore, Sherry; Zhang, ZhaoQi

    2016-01-01

    Banana (Musa AAA group) is one of the most consumed fruits in the world due to its flavor and nutritional value. As a typical climacteric fruit, banana responds to ethylene treatment, which induces rapid changes of color, flavor (aroma and taste), sweetness and nutritional composition. It has also been reported that ripening bananas at temperatures above 24 °C inhibits chlorophyll breakdown and color formation but increases the rate of senescence. To gain fundamental knowledge about the effects of high temperature and ethylene on banana ripening, a quantitative proteomic study employing multiplex peptide stable isotope dimethyl labeling was conducted. In this study, green (immature) untreated banana fruit were subjected to treatment with 10 μL L−1 of ethylene for 24 h. After ethylene treatment, treated and untreated fruit were stored at 20 or 30 °C for 24 h. Fruit peel tissues were then sampled after 0 and 1 day of storage, and peel color and chlorophyll fluorescence were evaluated. Quantitative proteomic analysis was conducted on the fruit peels after 1 day of storage. In total, 413 common proteins were identified and quantified from two biological replicates. Among these proteins, 91 changed significantly in response to ethylene and high-temperature treatments. Cluster analysis on these 91 proteins identified 7 groups of changed proteins. Ethylene treatment and storage at 20 °C induced 40 proteins that are correlated with pathogen resistance, cell wall metabolism, ethylene biosynthesis, allergens and ribosomal proteins, and it repressed 36 proteins that are associated with fatty acid and lipid metabolism, redox–oxidative responses, and protein biosynthesis and modification. Ethylene treatment and storage at 30 °C induced 32 proteins, which were mainly similar to those in group 1 but also included 8 proteins in group 3 (identified as chitinase, cinnamyl alcohol dehydrogenase 1, cysteine synthase, villin-2, leucine-transfer RNA ligase, CP47

  3. Proteome changes in banana fruit peel tissue in response to ethylene and high-temperature treatments.

    PubMed

    Du, Lina; Song, Jun; Forney, Charles; Palmer, Leslie Campbell; Fillmore, Sherry; Zhang, ZhaoQi

    2016-01-01

    Banana (Musa AAA group) is one of the most consumed fruits in the world due to its flavor and nutritional value. As a typical climacteric fruit, banana responds to ethylene treatment, which induces rapid changes of color, flavor (aroma and taste), sweetness and nutritional composition. It has also been reported that ripening bananas at temperatures above 24 °C inhibits chlorophyll breakdown and color formation but increases the rate of senescence. To gain fundamental knowledge about the effects of high temperature and ethylene on banana ripening, a quantitative proteomic study employing multiplex peptide stable isotope dimethyl labeling was conducted. In this study, green (immature) untreated banana fruit were subjected to treatment with 10 μL L(-1) of ethylene for 24 h. After ethylene treatment, treated and untreated fruit were stored at 20 or 30 °C for 24 h. Fruit peel tissues were then sampled after 0 and 1 day of storage, and peel color and chlorophyll fluorescence were evaluated. Quantitative proteomic analysis was conducted on the fruit peels after 1 day of storage. In total, 413 common proteins were identified and quantified from two biological replicates. Among these proteins, 91 changed significantly in response to ethylene and high-temperature treatments. Cluster analysis on these 91 proteins identified 7 groups of changed proteins. Ethylene treatment and storage at 20 °C induced 40 proteins that are correlated with pathogen resistance, cell wall metabolism, ethylene biosynthesis, allergens and ribosomal proteins, and it repressed 36 proteins that are associated with fatty acid and lipid metabolism, redox-oxidative responses, and protein biosynthesis and modification. Ethylene treatment and storage at 30 °C induced 32 proteins, which were mainly similar to those in group 1 but also included 8 proteins in group 3 (identified as chitinase, cinnamyl alcohol dehydrogenase 1, cysteine synthase, villin-2, leucine-transfer RNA ligase, CP47

  4. Changing Criminal Attitudes Among Incarcerated Offenders: Initial Examination of a Structured Treatment Program.

    PubMed

    Simourd, David J; Olver, Mark E; Brandenburg, Bryan

    2016-09-01

    The present study investigated the effect of a criminal attitude treatment program to changes on measured criminal attitudes and postprogram recidivism. The criminal attitude program (CAP) is a standardized therapeutic curriculum consisting of 15 modules offering 44 hr of therapeutic time. It was delivered by trained facilitators to a total of 113 male offenders incarcerated in one of five state correctional institutions. Pretreatment and posttreatment comparisons were made on standardized measures of criminal attitudes, response bias, and motivation for lifestyle changes. Results found statistically significant lower criminal attitudes at posttreatment that were unaffected by response bias. There were also increases in motivation for lifestyle changes, but these did not reach statistical significance. Fifty-seven participants were released into the community following the program and were eligible for recidivism analyses. Comparisons between participants who completed the CAP and those who did not complete the CAP revealed 7% lower rearrest among CAP completers. Although preliminary, these results indicate that the CAP had a positive effect on changes to criminal attitudes and recidivism. The findings are discussed in terms of conceptual and practical considerations in the assessment and treatment of criminal attitudes among offenders. PMID:25891270

  5. Changes in microbial diversity of brined green asparagus upon treatment with high hydrostatic pressure.

    PubMed

    Toledo Del Árbol, Julia; Pérez Pulido, Rubén; La Storia, Antonietta; Grande Burgos, Maria José; Lucas, Rosario; Ercolini, Danilo; Gálvez, Antonio

    2016-01-01

    The application of high hydrostatic pressure (HHP, 600MPa, 8 min) on brined green asparagus and the changes in bacterial diversity after treatments and during storage at 4 °C (30 days) or 22 °C (10 days) were studied. HHP treatments reduced viable cell counts by 3.6 log cycles. The residual surviving population did not increase during storage at 4 °C. However, bacterial counts significantly increased at 22 °C by day 3, leading to rapid spoilage. The microbiota of green asparagus was composed mainly by Proteobacteria (mainly Pantoea and Pseudomonas), followed by Firmicutes (mainly Lactococcus and Enterococcus) and to a less extent Bacteroidetes and Actinobacteria. During chill storage of untreated asparagus, the relative abundance of Proteobacteria as well as Enterococcus and Lactococcus decreased while Lactobacillus increased. During storage of untreated asparagus at 22 °C, the abundance of Bacteroidetes decreased while Proteobacteria increased during late storage. The HHP treatment determined a reduction of the Proteobacteria both early after treatment and during chill storage. In the HHP treated samples stored at 22 °C, the relative abundance of Pseudomonas rapidly decreased at day 1, with an increase of Bacteroidetes. This was followed by a marked increase in Enterobacteriaceae (Escherichia) simultaneously with increase in viable counts and spoilage. Results from the study indicate that the effect of HHP treatments on the viability ofmicrobial populations in foods also has an impact on the dynamics of microbial populations during the storage of the treated foods. PMID:26372734

  6. Modeling Manganese Silicate Inclusion Composition Changes during Ladle Treatment Using FactSage Macros

    NASA Astrophysics Data System (ADS)

    Piva, Stephano P. T.; Kumar, Deepoo; Pistorius, P. Chris

    2016-07-01

    This work investigated the use of FactSage macros to simulate steel-slag and steel-inclusion reaction kinetics in silicon-manganese killed steels, and predict oxide inclusion composition changes during ladle treatment. These changes were assessed experimentally using an induction furnace to simulate deoxidation and slag addition. The average steel mass transfer coefficient for the experimental setup was calculated from the analyzed aluminum pick-up by steel. Average oxide inclusion composition was measured using scanning electron microscopy and energy-dispersive X-ray spectroscopy. Confocal laser scanning microscopy was used to assess the physical state (solid or liquid) of oxide inclusions in selected samples. The changes in the chemical compositions of the oxide inclusions and the steel agreed with the FactSage macro simulations.

  7. Changes in repeating earthquake slip behavior following the 2004 Parkfield main shock from waveform empirical Green's functions finite-source inversion

    NASA Astrophysics Data System (ADS)

    Kim, Ahyi; Dreger, Douglas S.; Taira, Taka'aki; Nadeau, Robert M.

    2016-03-01

    Finite-source inversions are performed using small earthquake waveforms as empirical Green's functions (eGf) to investigate the rupture process of repeating earthquakes along the San Andreas Fault in Parkfield, California. The eGf waveform inversion method is applied to a repeating Mw 2.1 Parkfield earthquake sequence using three-component velocity waveforms recorded by an array of borehole seismometers. The obtained models show a circular slip distribution with a ~20 m radius, a 3.0-4.2 cm average slip of the main asperity, and peak displacement of 10.6-13.5 cm. The static stress drop distribution shows that the main asperity has a peak stress drop of 69.5-94.7 MPa. The inversion results support an earlier finding by Dreger et al. (2007) that high-strength asperities exist in the rupture areas of the Mw 2.1 events at Parkfield. In addition, notable temporal peak slip and stress drop reduction was observed after the 2004 Parkfield event while the average value remains constant (~12 MPa) over time. These events may represent mechanically strong sections of the fault, surrounded by regions that are undergoing continuous deformation (creep), Given repeated loading of the strong asperities, it would be expected that these similar repeating earthquakes should also have very similar slip distributions since surrounding regions are deforming aseismically. There are small differences in the waveforms of these repeating earthquakes, and this could be because of rupture nucleation points not being in exactly the same location within the region of the fault that is capable of stick-slip behavior. Our result indicates that waveform slip inversion is needed to reveal spatial and temporal variations of the stress drop within the rupture area to improve understanding of fault healing and rupture mechanics.

  8. Changes in water quality in the Owabi water treatment plant in Ghana

    NASA Astrophysics Data System (ADS)

    Akoto, Osei; Gyamfi, Opoku; Darko, Godfred; Barnes, Victor Rex

    2014-09-01

    The study was conducted on the status of the quality of water from the Owabi water treatment plant that supplies drinking water to Kumasi, a major city in Ghana, to ascertain the change in quality of water from source to point-of-use. Physico-chemical, bacteriological water quality parameters and trace metal concentration of water samples from five different treatment points from the Owabi water treatment plant were investigated. The raw water was moderately hard with high turbidity and colour that exceeds the WHO guideline limits. Nutrient concentrations were of the following order: NH3 < NO2 - < NO3 - < PO4 3- < SO4 2- and were all below WHO permissible level for drinking water in all the samples at different stages of treatment. Trace metal concentrations of the reservoir were all below WHO limit except chromium (0.06 mg/L) and copper (0.24 mg/L). The bacteriological study showed that the raw water had total coliform (1,766 cfu/100 mL) and faecal coliform (257 cfu/100 mL) that exceeded the WHO standard limits, rendering it unsafe for domestic purposes without treatment. Colour showed strong positive correlation with turbidity (r = 0.730), TSS (r ≥ 0.922) and alkalinity (0.564) significant at p < 0.01. The quality of the treated water indicates that colour, turbidity, Cr and Cu levels reduced and fall within the WHO permissible limit for drinking water. Treatment process at the water treatment plant is adjudged to be good.

  9. Changes in the Pelvic Anatomy After an IMRT Treatment Fraction of Prostate Cancer

    SciTech Connect

    Crevoisier, Renaud de; Melancon, Adam D.; Kuban, Deborah A.; Lee, Andrew K.; Cheung, Rex M.; Tucker, Susan L.; Kudchadker, Rajat J.; Newhauser, Wayne D.; Zhang Lifei; Mohan, Radhe; Dong Lei . E-mail: ldong@mdanderson.org

    2007-08-01

    Purpose: To quantify the three-dimensional variations of pelvic anatomy after a single treatment fraction. Methods and Materials: Forty-six prostate cancer patients underwent computed tomography (CT) scanning with an in-room CT-on-rail system, before and immediately after one intensity-modulated radiotherapy (IMRT) session. To study the soft-tissue anatomy changes, the pre- and post-treatment CT images were registered using the bony structure with an in-house image registration software system. The center of volume for both the prostate and seminal vesicles was used to assess the relative displacement of the same structure after the treatment fraction. Results: During one treatment fraction (21 {+-} 4 min), both the prostate and seminal vesicles showed statistically significant systematic trends in the superior and anterior directions of the patient's anatomy. The net increase in bladder volume was huge (127 {+-} 79 cm{sup 3}), yet this change did not translate into large target displacements. Although the population mean displacements in either direction were 1.3 {+-} 2.9 mm for the prostate and 1.2 {+-} 4.1 mm for the seminal vesicles in the anterior direction, a few patients had displacements as large as 8.4 mm and 15.6 mm, respectively. These large displacements correlated strongly (p < 0.001) with large rectal volume increases caused by gaseous build-up in the rectum. Conclusion: The observed intrafraction variations in anatomy during prostate IMRT sessions suggest that, for any given fraction, the organ motion and volume changes can potentially lead to compromised target coverage in about 15% of patients in whom the prostate position shifted >4 mm.

  10. Gender Differences in Substance Use, Consequences, Motivation to Change, and Treatment Seeking in People With Serious Mental Illness

    PubMed Central

    Drapalski, Amy; Bennett, Melanie; Bellack, Alan

    2013-01-01

    Gender differences in patterns and consequences of substance use, treatment-seeking, and motivation to change were examined in two samples of people with serious mental illness (SMI) and comorbid substance use disorders (SUDs): a community sample not currently seeking substance abuse treatment (N = 175) and a treatment-seeking sample (N = 137). In both groups, women and men demonstrated more similarities in the pattern and severity of their substance use than differences. However, treatment-seeking women showed greater readiness to change their substance use. Mental health problems and traumatic experiences may prompt people with SMI and SUD to enter substance abuse treatment, regardless of gender. PMID:21174496

  11. A Review and Empirical Comparison of Three Treatments for Adolescent Males with Conduct and Personality Disorder: Mode Deactivation Therapy, Cognitive Behavior Therapy and Social Skills Training

    ERIC Educational Resources Information Center

    Apsche, Jack A.; Bass, Christopher K.; Siv, Alexander M.

    2005-01-01

    This treatment research study extended the results of Apsche, Bass, Jennings, Murphy, Hunter, and Siv (2005), from behavioral data to standard measures of psychological distress. In Apsche, et. al. (2005) results suggest that Mode Deactivation Therapy (MDT) was more effective than Cognitive Behavior Therapy (CBT) and Social Skills Therapy (SST) in…

  12. Personality and symptom change in treatment-refractory inpatients: evaluation of the phase model of change using Rorschach,TAT, and DSM-IV Axis V.

    PubMed

    Fowler, J Christopher; Ackerman, Steven J; Speanburg, Stefanie; Bailey, Adrian; Blagys, Matthew; Conklin, Adam C

    2004-12-01

    In this study, we examined global treatment outcomes during 16 months of intensive, psychodynamic treatment for 77 inpatients suffering from treatment-refractory disorders. Hypotheses based on the phase model of treatment change (Howard, Lueger, Maling, & Martinovich, 1993; Howard, Moras, Brill, Martinovich, & Lutz, 1996) were supported in the study results. Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) Axis V scales assessing behavioral functioning demonstrated large and medium effect size change, whereas stable, enduring personality functioning assessed by psychoanalytic Rorschach scales and the Social Cognition and Object Relations Scale (Westen, 1995) for the Thematic Apperception Test (Murray, 1943) demonstrated small and medium effect size change. We also report assessment of reliable change index and clinical significance. The ecological validity of Rorschach measures is supported by significant validity coefficients (in the hypothesized directions) between implicit measures of personality functioning and behavioral ratings. PMID:15548467

  13. Superimpositional assessment of treatment-associated changes in the temporomandibular joint and the mandibular symphysis.

    PubMed

    Baumrind, S; Korn, E L; Isaacson, R J; West, E E; Molthen, R

    1983-12-01

    This article analyzes differences in the measured displacement of the condyle and of progonion when different vectors of force are delivered to the maxilla in the course of non-full-banded, Phase 1, mixed-dentition treatment for the correction of Class II malocclusion. The 238-case sample is identical to that for which changes in other parameters of facial form have been reported previously. Relative to superimposition on anterior cranial base and measured in a Frankfort-plane-determined coordinate system, we have attempted to identify and quantitate (1) the displacement of each structure which results from local remodeling and (2) the displacement of each structure which occurs as a secondary consequence of changes in other regions of the skull. We have also attempted to isolate treatment effects from those attributable to spontaneous growth and development. At the condyle, we note that in all three treatment groups and in the control group there is a small but real downward and backward displacement of the glenoid fossa. This change is not treatment induced but, rather, is associated with spontaneous growth and development. (See Fig. 5.) Some interesting differences in pattern of "growth at the condyle" were noted between samples. In the intraoral (modified activator) sample, there were small but statistically significant increases in growth rate as compared to the untreated group of Class II controls. To our surprise, similar statistically significant increases over the growth rate of the control group were noted in the cervical sample. (See Table III, variables 17 and 18.) Small but statistically significant differences between treatments were also noted in the patterns of change at pogonion. As compared to the untreated control group, the rate of total displacement in the modified activator group was significantly greater in the forward direction, while the rate of total displacement in the cervical group was significantly greater in the downward direction

  14. An evaluation of the treatment of risk and uncertainties in the IPCC reports on climate change.

    PubMed

    Aven, Terje; Renn, Ortwin

    2015-04-01

    Few global threats rival global climate change in scale and potential consequence. The principal international authority assessing climate risk is the Intergovernmental Panel on Climate Change (IPCC). Through repeated assessments the IPCC has devoted considerable effort and interdisciplinary competence to articulating a common characterization of climate risk and uncertainties. We have reviewed the assessment and its foundation for the Fifth Assessment Reports published in 2013 and 2014, in particular the guidance note for lead authors of the fifth IPCC assessment report on consistent treatment of uncertainties. Our analysis shows that the work carried out by the ICPP is short of providing a theoretically and conceptually convincing foundation on the treatment of risk and uncertainties. The main reasons for our assessment are: (i) the concept of risk is given a too narrow definition (a function of consequences and probability/likelihood); and (ii) the reports lack precision in delineating their concepts and methods. The goal of this article is to contribute to improving the handling of uncertainty and risk in future IPCC studies, thereby obtaining a more theoretically substantiated characterization as well as enhanced scientific quality for risk analysis in this area. Several suggestions for how to improve the risk and uncertainty treatment are provided. PMID:25443439

  15. The impact of syphilis mass treatment one year later: self-reported behaviour change among participants.

    PubMed

    Rekart, Michael L; Wong, Thomas; Wong, Elsie; Hutchinson, Kylie; Ogilvie, Gina

    2005-08-01

    In 2000, syphilis mass treatment using oral azithromycin was delivered to at-risk British Columbians during a sex trade-related outbreak. The initiative included education, counselling and referral. This cross-sectional, observational study examines knowledge, attitudes and self-reported behaviour after one year among mass treatment participants compared with eligible non-participants. Participants self-reported positive changes: reduction in sexual partners overall (P=0.001) and for sex workers (P<0.01), decrease in unprotected oral sex (P=0.03), knowledge of asymptomatic syphilis (P=0.02), positive attitudes to mass treatment (P=0.02) and to the street nurses (P=0.01). Increased awareness was associated with increased condom use for vaginal sex overall (P=0.02) and for sex workers (P=0.03) and increased condom use for oral sex (P=0.05). There was no difference in syphilis incidence. Syphilis outbreak interventions that include education, support and referral can result in long-term positive behaviour changes. PMID:16105193

  16. Determination of changes in wastewater quality through a treatment works using fluorescence spectroscopy.

    PubMed

    Bridgeman, John; Baker, Andy; Carliell-Marquet, Cynthia; Carstea, Elfrida

    2013-01-01

    Fluorescence spectroscopy was used to characterize municipal wastewater at various stages of treatment in order to understand how its fluorescence signature changes with treatment and how the signal relates to biochemical oxygen demand (BOD) and chemical oxygen demand (COD). The impact of size fractionation on the fluorescence signal was also investigated. Fluorescence measurements were taken for unfiltered and filtered (0.45 and 0.20 microm) samples of crude, settled and secondary treated wastewater (activated sludge and trickling filter), and final effluent. Good correlations were observed for unfiltered, diluted wastewater samples between BOD and fluorescence intensity at excitation 280 nm, emission 350 nm (Peak T1) (r = 0.92) and between COD and Peak T1 intensity (r = 0.85). The majority of the T1 and T2 signal was found to be derived from the <0.20 microm fraction. Initial results indicate that fluorescence spectroscopy, and changes in Peak T1 intensity in particular, could be used for continuous, real-time wastewater quality assessment and process control of wastewater treatment works. PMID:24617065

  17. Mandibular dental arch changes associated with treatment of crowding using self-ligating and conventional brackets.

    PubMed

    Pandis, Nicholas; Polychronopoulou, Argy; Makou, Margarita; Eliades, Theodore

    2010-06-01

    The purpose of this study was to investigate the effect of treatment of mandibular crowding with self-ligating and conventional brackets on dental arch variables. Fifty-six patients were selected from a pool of subjects satisfying the following inclusion criteria: non-extraction treatment in the mandibular or maxillary arches, eruption of all mandibular teeth, no spaces and an irregularity index greater than 2 mm in the mandibular arch, and no adjunct treatment such as etxra- or intraoral appliances. The patients were assigned to two groups: one group received treatment with the self-ligating bracket and the other with a conventional edgewise appliance, both with a 0.022 inch slot. Lateral cephalometric radiographs obtained at the beginning (T1) and end (T2) of treatment were used to assess the alteration in mandibular incisor inclination, and measurements of intercanine and intermolar widths were made on dental casts to investigate changes associated with the correction. The results were analysed with bivariate and multivariate linear regression analysis in order to examine the effect of the bracket systems on arch width or lower incisor inclination, adjusting for the confounding effect of demographic and clinical characteristics. An alignment-induced increase in the proclination of the mandibular incisors was observed for both groups; no difference was identified between self-ligating and conventional brackets with respect to this parameter. Likewise, an increase in intercanine and intermolar widths was noted for both bracket groups; the self-ligating group showed a higher intermolar width increase than the conventional group, whereas the amount of crowding and Angle classification were not significant predictors of post-treatment intermolar width. PMID:19959610

  18. RNA-SEQ Reveals Transcriptional Level Changes of Poplar Roots in Different Forms of Nitrogen Treatments

    PubMed Central

    Qu, Chun-Pu; Xu, Zhi-Ru; Hu, Yan-Bo; Lu, Yao; Yang, Cheng-Jun; Sun, Guang-Yu; Liu, Guan-Jun

    2016-01-01

    Poplar has emerged as a model plant for better understanding cellular and molecular changes accompanying tree growth, development, and response to environment. Long-term application of different forms of nitrogen (such as NO3--N and NH4+-N) may cause morphological changes of poplar roots; however, the molecular level changes are still not well-known. In this study, we analyzed the expression profiling of poplar roots treated by three forms of nitrogen: S1 (NH4+), S2 (NH4NO3), and S3 (NO3-) by using RNA-SEQ technique. We found 463 genes significantly differentially expressed in roots by different N treatments, of which a total of 112 genes were found to differentially express between S1 and S2, 171 genes between S2 and S3, and 319 genes between S1 and S3. A cluster analysis shows significant difference in many transcription factor families and functional genes family under different N forms. Through an analysis of Mapman metabolic pathway, we found that the significantly differentially expressed genes are associated with fermentation, glycolysis, and tricarboxylic acid cycle (TCA), secondary metabolism, hormone metabolism, and transport processing. Interestingly, we did not find significantly differentially expressed genes in N metabolism pathway, mitochondrial electron transport/ATP synthesis and mineral nutrition. We also found abundant candidate genes (20 transcription factors and 30 functional genes) regulating morphology changes of poplar roots under the three N forms. The results obtained are beneficial to a better understanding of the potential molecular and cellular mechanisms regulating root morphology changes under different N treatments. PMID:26870068

  19. Laryngeal Squamous Intraepithelial Lesions: An Updated Review on Etiology, Classification, Molecular Changes, and Treatment.

    PubMed

    Gale, Nina; Gnepp, Douglas R; Poljak, Mario; Strojan, Primož; Cardesa, Antonio; Helliwell, Tim; Šifrer, Robert; Volavšek, Metka; Sandison, Ann; Zidar, Nina

    2016-03-01

    Laryngeal carcinogenesis is a multistep process, characterized by an accumulation of genetic changes associated with architectural and cytologic alterations, ranging from squamous hyperplasia to carcinoma in situ and encompassed by the terminology of squamous intraepithelial lesions (SILs). The etiology, classification, genetic changes, and malignant progression of these lesions are reviewed. Tobacco remains the principal etiological factor with gastroesophageal reflux disease recently considered as a possible factor. In contrast, there is little evidence that microbiological agents, especially human papillomavirus infection, are frequently involved in laryngeal carcinogenesis and probably <10% of SILs are driven by biologically active human papillomavirus infection. Light microscopy, despite a degree of subjectivity, remains the mainstay of accurate diagnosis, prognosis, and guidance for a patient's treatment. The currently used classifications, the dysplasia system, squamous intraepithelial neoplasia, and the Ljubljana classification, reflect different standpoints on this important topic. The modified Ljubljana classification, with good interobserver agreement, could be considered as a proposal for a unified classification of laryngeal SILs. This review also briefly discusses recently discovered genetic changes, such as CDKN2A and CTNNB1 genes, and chromosome instability of chromosomes 1 and 7; however, none of these can at present improve histologic diagnosis. Malignant progression of precursor lesions varies from 2% to 74%, according to different studies. Cold-steel microinstruments, CO2 laser, and radiotherapy are used to treat the different grades of precursor lesions. There is as yet no worldwide agreement on the treatment of high-grade lesions and carcinoma in situ. PMID:26849814

  20. Empiric Antibiotic Treatment of Erythema Migrans-Like Skin Lesions As a Function of Geography: A Clinical and Cost Effectiveness Modeling Study

    PubMed Central

    Brinkerhoff, R. Jory; Wormser, Gary P.; Clemen, Robert

    2013-01-01

    Abstract The skin lesion of early Lyme disease, erythema migrans (EM), is so characteristic that routine practice is to treat all such patients with antibiotics. Because other skin lesions may resemble EM, it is not known whether presumptive treatment of EM is appropriate in regions where Lyme disease is rare. We constructed a decision model to compare the cost and clinical effectiveness of three strategies for the management of EM: Treat All, Observe, and Serology as a function of the probability that an EM-like lesion is Lyme disease. Treat All was found to be the preferred strategy in regions that are endemic for Lyme disease. Where Lyme disease is rare, Observe is the preferred strategy, as presumptive treatment would be expected to produce excessive harm and increased costs. Where Lyme disease is rare, clinicians and public health officials should consider observing patients with EM-like lesions who lack travel to Lyme disease-endemic areas. PMID:24107201

  1. Empiric antibiotic treatment of erythema migrans-like skin lesions as a function of geography: a clinical and cost effectiveness modeling study.

    PubMed

    Lantos, Paul M; Brinkerhoff, R Jory; Wormser, Gary P; Clemen, Robert

    2013-12-01

    The skin lesion of early Lyme disease, erythema migrans (EM), is so characteristic that routine practice is to treat all such patients with antibiotics. Because other skin lesions may resemble EM, it is not known whether presumptive treatment of EM is appropriate in regions where Lyme disease is rare. We constructed a decision model to compare the cost and clinical effectiveness of three strategies for the management of EM: Treat All, Observe, and Serology as a function of the probability that an EM-like lesion is Lyme disease. Treat All was found to be the preferred strategy in regions that are endemic for Lyme disease. Where Lyme disease is rare, Observe is the preferred strategy, as presumptive treatment would be expected to produce excessive harm and increased costs. Where Lyme disease is rare, clinicians and public health officials should consider observing patients with EM-like lesions who lack travel to Lyme disease-endemic areas. PMID:24107201

  2. Solubility and changes of mercury binding forms in contaminated soils after immobilization treatment

    SciTech Connect

    Biester, H.; Zimmer, H.

    1998-09-15

    Mobility at different pH and binding forms of mercury (Hg) have been investigated in three Hg-contaminated soils after immobilization treatment with alkali-polysulfide (APS) and trimercapto-s-triazine trisodium salt solution (TMT). Changes of solid-phase Hg binding forms after immobilization were determined by Hg pyrolysis. Hg concentrations in the water extracts of all samples increased after treatments due to the formation of soluble mercury sulfides (APS treatment), and the mobilization of humic acid bound Hg at the high pH of the reagents. In contrast, Hg concentrations decreased sharply at low pH due to decomposition of soluble mercury sulfides and precipitation of humic acid-bound Hg. Inorganic Hg compounds such as Hg{sup 0} or HgCl{sub 2} are effectively transformed to mercury sulfides by APS treatment, whereas TMT could transform HgCl{sub 2} but not Hg{sup 0}. Both reagents were found to affect humic acid bound Hg by way of increasing Hg desorption temperatures, although APS was found not to desorb Hg completely from humic acids and TMT-Hg complexes are actually incorporated into humic acids.

  3. Evolution of testosterone treatment over 25 years: symptom responses, endocrine profiles and cardiovascular changes

    PubMed Central

    Carruthers, Malcolm; Cathcart, Paul; Feneley, Mark R.

    2015-01-01

    Abstract Introduction: Testosterone treatment has evolved rapidly over the past 25 years as new, more effective and convenient methods have become available. This study reports experience with seven different methods, introduced on the market in the UK. Aim: To establish the symptom response when testosterone treatment was initiated on the basis of clinical features and symptoms of androgen deficiency, and the resulting endocrine, biochemical and physiological responses. Methods: Of 2693 patients attending the 3 Men’s Health Centers – The UK Androgen Study (UKAS), 2247 were treated. Treatments included pellet implants, oral testosterone undecanoate (Testocaps), mesterolone (Proviron), testosterone gel (Testogel), testosterone scrotal cream (Andromen) and scrotal gel (Tostran). Results: There was no correlation between initial testosterone level, initial symptom score or the success of treatment as defined by adequate resolution of symptoms. Despite the diverse endocrine patterns produced, the testosterone preparations appear equally safe over prolonged periods, with either no change or improvement of cardiovascular risk factors, especially in lowering cholesterol and diastolic blood pressure. Conclusions: It is suggested that because of excessive reliance on laboratory measures of androgens and undue safety concerns, many men who could benefit from symptom relief, improvement in related clinical conditions and given preventive medical benefits remain untreated. PMID:26218766

  4. Changes in acoustic emission peaks in precipitation strengthened alloys with heat treatment

    SciTech Connect

    Heiple, C.R.; Carpenter, S.H.

    1983-01-01

    Acoustic emission was measured during tensile deformation in a number of precipitation-strengthened alloys as a function of prior heat treatment. The alloys tested included 7075, 6061, and 2219 aluminum; a modified A-286 stainless steel (JBK-75) and an experimental beryllium-containing stainless steel; and Incoloy 903. A rms voltage peak was observed in all the alloys near the onset of plastic flow, and a second peak was usually observed in 7075, 2219, and Incoloy 903 at plastic strains greater than 1%. Some evidence of a second peak was also observed in 6061 aluminum. Changes with heat treatment in the stress and strain at which the second peak occurred were consistent with the peak arising from the fracture of inclusions. The shifts in the location of the peak were in a direction so as to make the stress on the inclusions at the second peak relatively insensitive to prior heat treatment. The amplitude distributions of acoustic emission signals were also consistent with this interpretation. The strain at which the first acoustic emission peak occurred also varied with heat treatment, but the dependence of peak location on prior aging was different for the various alloys.

  5. Aggregation and conformational change of mushroom (Agaricus bisporus) polyphenoloxidase subjected to thermal treatment.

    PubMed

    Zhou, Lei; Liu, Wei; Zou, Liqiang; Xiong, Zhiqiang; Hu, Xiuting; Chen, Jun

    2017-01-01

    This study investigated changes in the activity, conformation and microstructure of mushroom polyphenoloxidase (PPO) subjected to thermal treatment. The inactivation of PPO can be achieved by high temperature-short time or mild temperature-long time treatment. Circular dichroism and fluorescence spectra suggested that heating process induced the rearrangement of secondary structure and the disruption of tertiary structure. Red shifts of fluorescence spectra showed positive correlations with the inactivation rate of PPO. There were significant differences in the conformation and molecular microstructure among PPO samples with the same relative activity, which were obtained by treating PPO at 45, 55 and 65°C for different times. In summary, PPO molecules were deformed at mild temperature, while higher temperature induced the formation of large aggregates. PPO with the same relative activity might exist in different forms. PMID:27507494

  6. Investigation of rail wheel steel crystallographic texture changes due to modification and thermomechanical treatment

    NASA Astrophysics Data System (ADS)

    Lychagina, T.; Nikolayev, D.; Sanin, A.; Tatarko, J.; Ullemeyer, K.

    2015-04-01

    In this work crystallographic texture for a set of rail wheel steel samples with different regimes of thermo-mechanical treatment and with and without modification by system Al-Mg-Si- Fe-C-Ca-Ti-Ce was measured by neutron diffraction. The texture measurements were carried out by using time-of-flight technique at SKAT diffractometer situated at IBR-2 reactor (Dubna, JINR, Russia). The three complete pole figures (110), (200), (211) of α-Fe phase in 5°×5°grid were extracted from a set of 1368 spectra measured for each sample. The samples were cut from rail wheel rim and from transitional zone (between rail wheel hub and wheel disk). It was concluded that the steel modification and some changes in the heat treatment modes of the rail wheels from the experimental (modified) and the conventional (non-modified) steel lead to reorientation of texture component.

  7. Changes of HBV DNA After Chemoembolization for Hepatocellular Carcinoma and the Efficacy of Antiviral Treatment.

    PubMed

    Lin, Xiao-Jun; Lao, Xiang-Ming; Shi, Ming; Li, Sheng-Ping

    2016-09-01

    Unlike systemic chemotherapy for hematological malignancies with hepatitis B virus (HBV) infection, transarterial chemoembolization (TACE) for HBV-related hepatocellular carcinoma (HCC) has only recently been reported to cause HBV reactivation and subsequent hepatitis. Most patients with HBV-related HCC have an underlying disease with liver fibrosis or cirrhosis, and TACE may potentially induce HBV reactivation and liver decompensation. Currently, there are no clinical guidelines for managing TACE-caused HBV reactivation. In this review, we summarize the changes of HBV status and liver function after TACE and the effect of antiviral treatment before, during, or after TACE. PMID:27105647

  8. [The significance of cryotherapy for the treatment of benign and malignant mouth mucosal changes].

    PubMed

    Chilla, R; Opaitz, M

    1982-08-01

    Leukoplakia and haemangioma of the oral mucosa can be removed by cryosurgery with excellent success. Cryosurgical treatment of mucosal carcinoma should only be applied if the chances for an operation are restricted by certain factors, for instance poor general condition of the patient or haemorrhagic diathesis. The advantages of cryotherapy as applied to the oral mucosa rest in the bloodless application of this technique and in the possibility to heal, with tender scar formation, mucosal changes even of large dimensions, provided they grow superficially. PMID:7132505

  9. Motivation for Treatment and Motivation for Change in Substance-Dependent Patients with Co-Occurring Psychiatric Disorders.

    PubMed

    de Weert-van Oene, Gerdien H; Gongora, Vanesa; von Sternberg, Kirk; de Jong, Cor A J

    2015-01-01

    The aims of this study were to examine the relationship between motivation for treatment and for change, and to explore their role in the prediction of treatment completion. The sample was composed of 560 predominantly polydrug-using inpatients with co-occurring psychiatric disorders. Motivation for treatment was assessed with the Motivation for Treatment Scales, and motivation for change was measured with the Readiness to Change Questionnaire. Patients indicated strong motivation to change illegal drug and alcohol use. In initial factor analysis, motivation for treatment and for change did not load on the same factors, confirming that these are distinct domains. Four categories were discerned with respect to readiness for treatment and for change, with low agreement between the two. In performing survival analysis, we found that being in readiness category 4 (RT↑RC↑) was associated with a greater chance of remaining in treatment for a period of 105 days without premature attrition (Log Rank chi-sq=5.000; p=0.02). To a limited extent, intake measures of motivation can be used to predict attrition from treatment. Clinicians can use motivation assessment both for clinical purposes and in the prediction of those who need extra monitoring due to increased risk of premature attrition. PMID:26397714

  10. Hippocampal Neurophysiologic Changes after Mild Traumatic Brain Injury and Potential Neuromodulation Treatment Approaches

    PubMed Central

    Girgis, Fady; Pace, Jonathan; Sweet, Jennifer; Miller, Jonathan P.

    2016-01-01

    Traumatic brain injury (TBI) is the leading cause of death and disability in individuals below age 45, and five million Americans live with chronic disability as a result. Mild TBI (mTBI), defined as TBI in the absence of major imaging or histopathological defects, is responsible for a majority of cases. Despite the lack of overt morphological defects, victims of mTBI frequently suffer lasting cognitive deficits, memory difficulties, and behavioral disturbances. There is increasing evidence that cognitive and memory dysfunction is related to subtle physiological changes that occur in the hippocampus, and these impact both the phenotype of deficits observed and subsequent recovery. Therapeutic modulation of physiological activity by means of medications commonly used for other indications or brain stimulation may represent novel treatment approaches. This review summarizes the present body of knowledge regarding neurophysiologic changes that occur in the hippocampus after mTBI, as well as potential targets for therapeutic modulation of neurologic activity. PMID:26903824

  11. Chronic ethanol treatment changes the number of beta-receptors in rat brain microvessels

    SciTech Connect

    Lucchi, L.; Cazzaniga, A.; Picotti, G.B.; Covelli, V.; Magnoni, M.S.; Borriero, L.; Spano, P.F.; Trabucchi, M.

    1984-01-01

    The effect of chronic ethanol consumption on the binding (125I)-iodohydroxybenzylpindolol to beta-adrenergic receptors in rat brain microvessels has been studied. The results show that chronic ethanol treatment increases the number of beta-receptors present in brain microvessels without changing the binding affinity of the binding site for the beta-adrenoceptor ligand. This effect is apparently not associated with changes in peripheral adrenergic tone, since no differences in platelet epinephrine or norepinephrine concentrations were found between ethanol-treated and control animals. An increase in beta-receptor density in brain microvessels might contribute to the alterations of cerebral blood flow and oxygen consumption reported during chronic ethanol intoxication.

  12. Non-Empirical Confirmation

    NASA Astrophysics Data System (ADS)

    Dawid, Richard

    2016-06-01

    In fundamental physics today, some theories are taken to be probably viable despite a lack of strong (or any) empirical confirmation. This situation suggests, I argue, an extension of the concept of theory confirmation that allows for confirmation by observations that are not predicted by the theory in question. "Non-empirical confirmation", as I call the latter form of confirmation, plays a more conspicuous role today than in earlier periods of physics. It has always constituted a significant albeit implicit element of the assessment of physical theory, however, that has not been adequately accounted for in canonical reconstructions of the scientific method. The talk discusses the core argumentative structure of non-empirical confirmation, analyses the concept’s reliance on the empirical testability of the theories in question and addresses some worries that have been raised in its regard.

  13. Medium-long term soil resilience against different disturbances: wildfires, silvicultural treatments and climate change

    NASA Astrophysics Data System (ADS)

    Hedo de Santiago, Javier; Borja, Manuel Esteban Lucas; de las Heras, Jorge

    2016-04-01

    Soils of semiarid Mediterranean forest ecosystems are very fragile and sensitive to changes due to different anthropogenic and natural disturbances. The increasing vulnerability of semiarid lands within this world framework has generated growing awareness in the field of research, with highly intensified study into soils properties. One of the main problems of Mediterranean forests is wildfire disturbance. Fire should be considered more an ecological factor but, in contrast to the role of fire, it is now a closely related factor to human action. On the other hand, to improve the recovery of forest communities after fire, silvicultural treatments are needed and, for that matter, another disturbance is added to the ecosystem. By last, climate change is also affecting the fire regime increasing fire frequency and burned area, enhancing the destructiveness to Mediterranean ecosystems. After all of these three disturbances, changes in vegetation dynamics and soil properties are expected to occur due to the plant-soil feedback. Soil plays an essential role in the forest ecosystem's fertility and stability and specifically soil microorganisms, which accomplish reactions to release soil nutrients for vegetation development, for that is essential to enlarge knowledge about soil properties resilience in semiarid forest ecosystems. Physico-chemical and microbiological soil properties, and enzyme activities have been studied in two Aleppo pine forest stands that have suffered three disturbances: 1) a wildfire event, 2) silvicultural treatments (thinning) and 3) an artificial drought (simulating climate change) and results showed that soil recovered after 15 years. Final results showed that soils have been recovered from the three disturbances at the medium-long term.

  14. Optimized Protocol To Analyze Changes in the Lipidome of Xenografts after Treatment with 2-Hydroxyoleic Acid.

    PubMed

    Fernández, Roberto; Garate, Jone; Lage, Sergio; Terés, Silvia; Higuera, Mónica; Bestard-Escalas, Joan; Martin, M Laura; López, Daniel H; Guardiola-Serrano, Francisca; Escribá, Pablo V; Barceló-Coblijn, Gwendolyn; Fernández, José A

    2016-01-01

    Xenografts are a popular model for the study of the action of new antitumor drugs. However, xenografts are highly heterogeneous structures, and therefore it is sometimes difficult to evaluate the effects of the compounds on tumor metabolism. In this context, imaging mass spectrometry (IMS) may yield the required information, due to its inherent characteristics of sensitivity and spatial resolution. To the best of our knowledge, there is still no clear analysis protocol to properly evaluate the changes between samples due to the treatment. Here we present a protocol for the evaluation of the effect of 2-hydroxyoleic acid (2-OHOA), an antitumor compound, on xenografts lipidome based on IMS. Direct treated/control comparison did not show conclusive results. As we will demonstrate, a more sophisticated protocol was required to evaluate these changes including the following: (1) identification of different areas in the xenograft, (2) classification of these areas (necrotic/viable) to compare similar types of tissues, (3) suppression of the effect of the variation of adduct formation between samples, and (4) normalization of the variables using the standard deviation to eliminate the excessive impact of the stronger peaks in the statistical analysis. In this way, the 36 lipid species that experienced the largest changes between treated and control were identified. Furthermore, incorporation of 2-hydroxyoleic acid to a sphinganine base was also confirmed by MS/MS. Comparison of the changes observed here with previous results obtained with different techniques demonstrates the validity of the protocol. PMID:26607740

  15. Responses of ecosystem carbon cycling to climate change treatments along an elevation gradient

    USGS Publications Warehouse

    Wu, Zhuoting; Koch, George W.; Dijkstra, Paul; Bowker, Matthew A.; Hungate, Bruce A.

    2011-01-01

    Global temperature increases and precipitation changes are both expected to alter ecosystem carbon (C) cycling. We tested responses of ecosystem C cycling to simulated climate change using field manipulations of temperature and precipitation across a range of grass-dominated ecosystems along an elevation gradient in northern Arizona. In 2002, we transplanted intact plant–soil mesocosms to simulate warming and used passive interceptors and collectors to manipulate precipitation. We measured daytime ecosystem respiration (ER) and net ecosystem C exchange throughout the growing season in 2008 and 2009. Warming generally stimulated ER and photosynthesis, but had variable effects on daytime net C exchange. Increased precipitation stimulated ecosystem C cycling only in the driest ecosystem at the lowest elevation, whereas decreased precipitation showed no effects on ecosystem C cycling across all ecosystems. No significant interaction between temperature and precipitation treatments was observed. Structural equation modeling revealed that in the wetter-than-average year of 2008, changes in ecosystem C cycling were more strongly affected by warming-induced reduction in soil moisture than by altered precipitation. In contrast, during the drier year of 2009, warming induced increase in soil temperature rather than changes in soil moisture determined ecosystem C cycling. Our findings suggest that warming exerted the strongest influence on ecosystem C cycling in both years, by modulating soil moisture in the wet year and soil temperature in the dry year.

  16. Predictors of Staff Turnover and Turnover Intentions within Addiction Treatment Settings: Change Over Time Matters

    PubMed Central

    Garner, Bryan R; Hunter, Brooke D

    2014-01-01

    This study examined the extent to which changes over time in clinicians’ responses to measures of work attitude (eg, job satisfaction) and psychological climate (eg, supervisor support) could predict actual turnover and turnover intentions above and beyond absolute levels of these respective measures. Longitudinal data for this study were collected from a sample of clinicians (N = 96) being trained to implement an evidence-based treatment for adolescent substance use disorders. Supporting findings from a recent staff turnover study, we found job satisfaction change was able to predict actual turnover above and beyond average levels of job satisfaction. Representing new contributions to the staff turnover literature, we also found that change over time in several other key measures (eg, job satisfaction, role manageability, role clarity) explained a significant amount of variance in turnover intentions above and beyond the absolute level of each respective measure. A key implication of the current study is that organizations seeking to improve their ability to assess risk for staff turnover may want to consider assessing staff at multiple points in time in order to identify systematic changes in key employee attitudes like turnover intentions and job satisfaction. PMID:25336960

  17. Predictors of Staff Turnover and Turnover Intentions within Addiction Treatment Settings: Change Over Time Matters.

    PubMed

    Garner, Bryan R; Hunter, Brooke D

    2014-01-01

    This study examined the extent to which changes over time in clinicians' responses to measures of work attitude (eg, job satisfaction) and psychological climate (eg, supervisor support) could predict actual turnover and turnover intentions above and beyond absolute levels of these respective measures. Longitudinal data for this study were collected from a sample of clinicians (N = 96) being trained to implement an evidence-based treatment for adolescent substance use disorders. Supporting findings from a recent staff turnover study, we found job satisfaction change was able to predict actual turnover above and beyond average levels of job satisfaction. Representing new contributions to the staff turnover literature, we also found that change over time in several other key measures (eg, job satisfaction, role manageability, role clarity) explained a significant amount of variance in turnover intentions above and beyond the absolute level of each respective measure. A key implication of the current study is that organizations seeking to improve their ability to assess risk for staff turnover may want to consider assessing staff at multiple points in time in order to identify systematic changes in key employee attitudes like turnover intentions and job satisfaction. PMID:25336960

  18. An empirical study of the impact of human activity on long-term temperature change in China: A perspective from energy consumption

    NASA Astrophysics Data System (ADS)

    Li, Yan; Zhao, Xinyi

    2012-09-01

    Human activity is an important contributor to local temperature change, especially in urban areas. Energy consumption is treated here as an index of the intensity of human induced local thermal forcing. The relationship between energy consumption and temperature change is analyzed in China by Observation Minus Reanalysis (OMR) method. Temperature trends for observation, reanalysis and OMR are estimated from meteorological records and 2 m-temperature from NCEP/NCAR Reanalysis 1 for the period 1979-2007. A spatial mapping scheme based on the spatial and temporal relationship between energy consumption and Gross Domestic Production (GDP) is developed to derive the spatial distribution of energy consumption of China in 2003. A positive relationship between energy consumption and OMR trends is found in high and mid energy consumption region. OMR trends decline with the decreasing intensity of human activity from 0.20°C/decade in high energy consumption region to 0.13°C/decade in mid energy consumption region. Forty-four stations in high energy consumption region that are exposed to the largest human impact are selected to investigate the impact of energy consumption spatial pattern on temperature change. Results show human impact on temperature trends is highly dependent on spatial pattern of energy consumption. OMR trends decline from energy consumption center to surrounding areas (0.26 to 0.04°C/decade) and get strengthened as the spatial extent of high energy consumption area expands (0.14 to 0.25°C/decade).

  19. Age-Dependent Changes of the Temporal Order--Causes and Treatment.

    PubMed

    Gubin, Denis G; Weinert, Dietmar; Bolotnova, Tatyana V

    2016-01-01

    This review summarizes current knowledge on deteriorations in temporal order with advanced age. Changes of the overt rhythms will be described but also their putative causes and possible treatments of the disturbances. In aging animals and humans, all rhythm characteristics change. The most prominent changes are a decrease of circadian amplitude, leading to an extra-circadian dissemination (ECD), and a diminished ability to synchronize with the periodic environment. ECD is a shift from circadian to ultradian and infradian frequencies, accompanied by the loss of day-to-day phase stability. Responsiveness to photic and non-photic cues is decreased. As a consequence, both internal and external temporal order are disturbed not only under steady-state conditions but and even more markedly after changes in the periodic environment or following stressful events. Many of the changes seem to occur within the suprachiasmatic nucleus (SCN), the central circadian pacemaker, itself. The number of functioning neurons decreases with advancing age as does the coupling between them. Accordingly, the SCN generates a weaker and less stable circadian signal, insufficient to entrain peripheral oscillators properly or to regulate body functions rhythmically. However, age-dependent disturbances in peripheral organs must also be considered. These changes may occur at different ages, thus causing further internal desynchronization. Several possibilities exist with regard to treating circadian disruptions or at least minimizing their consequences for health and fitness and preventing sleep disturbances. Benefits of bright light, melatonin and other chronobiotics, physical activity, social contacts and regular feeding schedules in preserving the temporal order of aged organisms are discussed. PMID:26632427

  20. An empirical model of electronic portal imager response implemented within a commercial treatment planning system for verification of intensity-modulated radiation therapy fields.

    PubMed

    Khan, Rao F H; Ostapiak, Orest Z; Szabo, Joe J

    2008-01-01

    Quality assurance (QA) of an intensity-modulated radiation therapy (IMRT) plan is more complex than that of a conventional plan. To improve the efficiency of QA, electronic portal imaging devices (EPIDs) can be used. The major objective of the present work was to use a commercial treatment planning system to model EPID response for the purpose of pre-treatment IMRT dose verification. Images were acquired with an amorphous silicon flat panel portal imager (aS500: Varian Medical Systems, Palo Alto, CA) directly irradiated with a 6-MV photon beam from a Clinac 21EX linear accelerator (Varian Medical Systems). Portal images were acquired for a variety of rectangular fields, from which profiles and relative output factors were extracted. A dedicated machine model was created using the physics tools of the Pinnacle3 (Philips Medical Systems, Madison, WI) treatment planning system to model the data. Starting with the known photon spectrum and assuming an effective depth of 7 cm, machine model parameters were adjusted to best fit measured profile and output factors. The machine parameters of a second model, which assumed a 0.8 MeV monoenergetic photon spectrum and an effective depth in water of 3 cm, were also optimized. The second EPID machine model was used to calculate planar dose maps of simple geometric IMRT fields as well as a 9-field IMRT plan developed for clinical trials credentialing purposes. The choice of energy and depth for an EPID machine model influenced the best achievable fit of the optimized machine model to the measured data. When both energy and depth were reduced by a significant amount, a better overall fit was achieved. In either case, the secondary source size and strength could be adjusted to give reasonable agreement with measured data. The gamma evaluation method was used to compare planar dose maps calculated using the second EPID machine model with the EPID images of small IMRT fields. In each case, more than 95% of points fell within 3% of

  1. Economic analysis of empiric versus diagnostic-driven strategies for immunocompromised patients with suspected fungal infections in the People's Republic of China.

    PubMed

    Mao, Ningying; Lesher, Beth; Liu, Qifa; Qin, Lei; Chen, Yixi; Gao, Xin; Earnshaw, Stephanie R; McDade, Cheryl L; Charbonneau, Claudie

    2016-01-01

    Invasive fungal infections (IFIs) require rapid diagnosis and treatment. A decision-analytic model was used to estimate total costs and survival associated with a diagnostic-driven (DD) or an empiric treatment approach in neutropenic patients with hematological malignancies receiving chemotherapy or autologous/allogeneic stem cell transplants in Shanghai, Beijing, Chengdu, and Guangzhou, the People's Republic of China. Treatment initiation for the empiric approach occurred after clinical suspicion of an IFI; treatment initiation for the DD approach occurred after clinical suspicion and a positive IFI diagnostic test result. Model inputs were obtained from the literature; treatment patterns and resource use were based on clinical opinion. Total costs were lower for the DD versus the empiric approach in Shanghai (¥3,232 vs ¥4,331), Beijing (¥3,894 vs ¥4,864), Chengdu, (¥4,632 vs ¥5,795), and Guangzhou (¥8,489 vs ¥9,795). Antifungal administration was lower using the DD (5.7%) than empiric (9.8%) approach, with similar survival rates. Results from one-way and probabilistic sensitivity analyses were most sensitive to changes in diagnostic test sensitivity and IFI incidence; the DD approach dominated the empiric approach in 88% of scenarios. These results suggest that a DD compared to an empiric treatment approach in the People's Republic of China may be cost saving, with similar overall survival in immunocompromised patients with suspected IFIs. PMID:27366099

  2. Economic analysis of empiric versus diagnostic-driven strategies for immunocompromised patients with suspected fungal infections in the People’s Republic of China

    PubMed Central

    Mao, Ningying; Lesher, Beth; Liu, Qifa; Qin, Lei; Chen, Yixi; Gao, Xin; Earnshaw, Stephanie R; McDade, Cheryl L; Charbonneau, Claudie

    2016-01-01

    Invasive fungal infections (IFIs) require rapid diagnosis and treatment. A decision-analytic model was used to estimate total costs and survival associated with a diagnostic-driven (DD) or an empiric treatment approach in neutropenic patients with hematological malignancies receiving chemotherapy or autologous/allogeneic stem cell transplants in Shanghai, Beijing, Chengdu, and Guangzhou, the People’s Republic of China. Treatment initiation for the empiric approach occurred after clinical suspicion of an IFI; treatment initiation for the DD approach occurred after clinical suspicion and a positive IFI diagnostic test result. Model inputs were obtained from the literature; treatment patterns and resource use were based on clinical opinion. Total costs were lower for the DD versus the empiric approach in Shanghai (¥3,232 vs ¥4,331), Beijing (¥3,894 vs ¥4,864), Chengdu, (¥4,632 vs ¥5,795), and Guangzhou (¥8,489 vs ¥9,795). Antifungal administration was lower using the DD (5.7%) than empiric (9.8%) approach, with similar survival rates. Results from one-way and probabilistic sensitivity analyses were most sensitive to changes in diagnostic test sensitivity and IFI incidence; the DD approach dominated the empiric approach in 88% of scenarios. These results suggest that a DD compared to an empiric treatment approach in the People’s Republic of China may be cost saving, with similar overall survival in immunocompromised patients with suspected IFIs. PMID:27366099

  3. Changing Trends in Treatment of Acute Mania: Experience of a Tertiary Centre Over a Decade.

    PubMed

    Arıkan, Mehmet Kemal; Poyraz, Cana Aksoy; Baş, Alper; Sağlam, N Gamze Usta; Batun, Gizem Cetiner; Gültekin, Gözde; Poyraz, Burç Çağrı

    2016-06-01

    We investigated trends over a decade in the prescription of lithium, antiepileptics, and antipsychotic agents at discharge for patients hospitalised for acute mania. We conducted a retrospective review of medical records for 165 inpatients with acute mania who had been hospitalised in Cerrahpaşa Faculty of Medicine, Department of Psychiatry during 2001-2002 and 2011-2012. Among 165 patients, prescription of olanzapine at discharge increased from 3 to 46 % (p < 0.001), while prescription of haloperidol decreased from 55 to 21 % (p < 0.001). Use of other atypical antipsychotics did not change significantly (risperidone decreased from 14 to 11 %, p = 0.5; quetiapine increased from 10 to 16 %, p = 0.2). Use of valproate, carbamazepine, and lithium did not change significantly. Use of electroconvulsive therapy in acute mania decreased by half from 27 to 13 % (p = 0.02). Typical antipsychotics alone or in combination with antiepileptics were the most common treatment regimen at discharge at 2001-2002; while 10 years later, they had been largely replaced by lithium or antiepileptics combined with second generation antipsychotics. Antipsychotic agents remained to be an important component of acute treatment of mania in our practice. PMID:26220636

  4. Histone modifications change with age, dietary restriction and rapamycin treatment in mouse brain

    PubMed Central

    Gong, Huan; Qian, Hong; Ertl, Robin; Astle, Clinton M.; Wang, Gang G.; Harrison, David E.; Xu, Xiangru

    2015-01-01

    The risk of developing neurodegenerative disorders such as Alzheimer's disease (AD) increases dramatically with age. Understanding the underlying mechanisms of brain aging is crucial for developing preventative and/or therapeutic approaches for age-associated neurological diseases. Recently, it has been suggested that epigenetic factors, such as histone modifications, maybe be involved in brain aging and age-related neurodegenerations. In this study, we investigated 14 histone modifications in brains of a cohort of young (3 months), old (22 months), and old age-matched dietary restricted (DR) and rapamycin treated BALB/c mice. Results showed that 7 out of all measured histone markers were changed drastically with age. Intriguingly, histone methylations in brain tissues, including H3K27me3, H3R2me2, H3K79me3 and H4K20me2 tend to disappear with age but can be partially restored by both DR and rapamycin treatment. However, both DR and rapamycin treatment also have a significant impact on several other histone modifications such as H3K27ac, H4K16ac, H4R3me2, and H3K56ac, which do not change as animal ages. This study provides the first evidence that a broad spectrum of histone modifications may be involved in brain aging. Besides, this study suggests that both DR and rapamycin may slow aging process in mouse brain via these underlying epigenetic mechanisms. PMID:26021816

  5. Searching for the mechanisms of change: a protocol for a realist review of batterer treatment programmes

    PubMed Central

    Cheff, Rebecca; Finn, Debbie; Davloor, Whitney; O'Campo, Patricia

    2016-01-01

    Introduction Conflicting results reported by evaluations of typical batterer intervention programmes leave many judicial officials and policymakers uncertain about the best way to respond to domestic violence, and whether to recommend and fund these programmes. Traditional evaluations and systematic reviews tend to focus predominantly on whether the programmes ‘worked’ (eg, reduced recidivism) often at the exclusion of understanding for whom they may or may not have worked, under what circumstances, and why. Methods and analysis We are undertaking a realist review of the batterer treatment programme literature with the aim of addressing this gap. Keeping with the goals of realist review, our primary aims are to identify the theory that underlies these programmes, highlight the mechanisms that trigger changes in participant behaviour and finally explain why these programmes help some individuals reduce their use of violence and under what conditions they are effective or not effective. We begin by describing the process of perpetrator treatment, and by proposing an initial theoretical model of behaviour change that will be tested by our review. We then describe the criteria for inclusion of an evaluation into the review, the search strategy we will use to identify the studies, and the plan for data extraction and analysis. Ethics and dissemination The results of this review will be written up using the RAMESES Guidelines for Realist Synthesis, and disseminated through peer-reviewed publications aimed at the practitioner community as well as presented at community forums, and at violence against women conferences. Ethics approval was not needed. PMID:27053268

  6. Changes in Fluoroquinolone Use for Gonorrhea Following Publication of Revised Treatment Guidelines

    PubMed Central

    Dowell, Deborah; Tian, Lin H.; Stover, Jeffrey A.; Donnelly, Jennifer A.; Martins, Summer; Erbelding, Emily J.; Pino, Raul; Newman, Lori M.

    2012-01-01

    Objectives. We evaluated the impact of revised national treatment recommendations on fluoroquinolone use for gonorrhea in selected states. Methods. We evaluated gonorrhea cases reported through the Sexually Transmitted Disease Surveillance Network as treated between July 1, 2006 and May 31, 2008, using interrupted time series analysis. Outcomes were fluoroquinolone treatment overall, by area, and by practice setting. Results. Of 16 126 cases with treatment dates in this period, 15 669 noted the medication used. After revised recommendations were released, fluoroquinolone use decreased abruptly overall (21.5%; 95% confidence interval [CI] = 15.9%, 27.2%), in most geographic areas evaluated, and in sexually transmitted disease clinics (28.5%; 95% CI = 19.0%, 37.9%). More gradual decreases were seen in primary care (8.6%; 95% CI = 2.6%, 14.6%), and in emergency departments, urgent care, and hospitals (2.7%; 95% CI = 1.7%, 3.7%). Conclusions. Fluoroquinolone use decreased after the publication of revised national guidelines, particularly in sexually transmitted disease clinics. Additional mechanisms are needed to increase the speed and magnitude of changes in prescribing in primary care, emergency departments, urgent care, and hospitals. PMID:22095341

  7. Final Technical Report for Collaborative Research: Regional climate-change projections through next-generation empirical and dynamical models, DE-FG02-07ER64429

    SciTech Connect

    Smyth, Padhraic

    2013-07-22

    This is the final report for a DOE-funded research project describing the outcome of research on non-homogeneous hidden Markov models (NHMMs) and coupled ocean-atmosphere (O-A) intermediate-complexity models (ICMs) to identify the potentially predictable modes of climate variability, and to investigate their impacts on the regional-scale. The main results consist of extensive development of the hidden Markov models for rainfall simulation and downscaling specifically within the non-stationary climate change context together with the development of parallelized software; application of NHMMs to downscaling of rainfall projections over India; identification and analysis of decadal climate signals in data and models; and, studies of climate variability in terms of the dynamics of atmospheric flow regimes.

  8. Narrative Focus Predicts Symptom Change Trajectories in Group Treatment for Traumatized and Bereaved Adolescents.

    PubMed

    Grassetti, Stevie N; Herres, Joanna; Williamson, Ariel A; Yarger, Heather A; Layne, Christopher M; Kobak, Roger

    2015-01-01

    Growing evidence supports the effectiveness of Trauma and Grief Component Therapy for Adolescents (TGCT-A) in reducing posttraumatic stress disorder (PTSD) symptoms and maladaptive grief (MG) reactions. This pilot study explored whether the specific focus of students' narratives (i.e., focus on trauma vs. focus on loss) as shared by TGCT-A group members would predict initial pretreatment levels, as well as pre- to posttreatment change trajectories, of PTSD symptoms and MG reactions. Thirty-three adolescents from three middle schools completed a 17-week course of group-based TGCT-A. PTSD and MG symptoms were assessed at pretreatment, twice during treatment, and at posttreatment. The focus (trauma vs. loss) of each student's narrative was coded using transcripts of members' narratives as shared within the groups. The reliable change index showed that 61% of students reported reliable pre-post improvement in either PTSD symptoms or MG reactions. Students whose narratives focused on loss both reported higher starting levels and showed steeper rates of decline in MG reactions than students whose narratives focused on trauma. In contrast, students whose narratives focused on trauma reported higher starting levels of PTSD than students who narrated loss experiences. However, narrative focus was not significantly linked to the rate at which PTSD symptoms declined over the course of treatment. This study provides preliminary evidence that TGCT-A treatment components are associated with reduced PTSD symptoms and MG reactions. Loss-focused narratives, in particular, appear to be associated with greater decreases in MG reactions. PMID:24927497

  9. Autologous fat grafting in the treatment of fibrotic perioral changes in patients with systemic sclerosis.

    PubMed

    Del Papa, Nicoletta; Caviggioli, Fabio; Sambataro, Domenico; Zaccara, Eleonora; Vinci, Valeriano; Di Luca, Gabriele; Parafioriti, Antonina; Armiraglio, Elisabetta; Maglione, Wanda; Polosa, Riccardo; Klinger, Francesco; Klinger, Marco

    2015-01-01

    Autologous fat tissue grafting (AFTG) has been successfully used in the treatment of different sclerotic conditions, including localized scleroderma. Patients with advanced systemic sclerosis (SSc)-related perioral thickening and mouth opening limitation are candidates for this therapeutic approach. AFTG of the lips was performed to improve mouth opening in patients with SSc. We enrolled in the study 20 female patients with diffuse SSc (median age 35 ± 15 years and 11 ± 10 years of disease duration). Two-milliliter fractions of autologous fat drawn from trochanteric or periumbilical areas were injected in eight different sites around the mouth. Baseline and after-treatment mouth opening changes were assessed by measuring interincisal distance and oral perimeter, while skin hardness was tested by digital durometer. Pre- and posttreatment modifications of microvascular architecture were assessed by counting capillaries in the inferior lip videocapillaroscopy (VC) images and by scoring the microvascular density (MVD) in anti-CD34/CD31 immunohistochemical (IH) stained perioral skin biopsy sections. Similarly, histological sections were examined to evaluate dermoepidermic junction (DEJ) modifications. Three months after treatment, both the interincisal distance and oral perimeter significantly increased (p < 0.001). At the same time, a significant skin neovascularization became evident, both considering the VC images (p < 0.001) and MVD scores in IH sections (p < 0.0001). Finally, some skin histological aspects also improved, as shown by the significant changes in DEJ flattening scores (p < 0.0001). The present study suggests that, in patients with SSc, AFTG can improve mouth opening and function, induce a neovascularization, and partially restore the skin structure. PMID:25606975

  10. The empirical war on drugs.

    PubMed

    Vitellone, Nicole

    2013-05-01

    In a special issue of the journal Addictions (1995) academics, researchers and health care professionals debated the status of the empirical in socially orientated drugs research. A number of researchers noted that our knowledge and understanding of drugs and drug users has changed significantly since the 1990s. Post AIDS this shift is identified as a consequence of the development of qualitative research methods. The qualitative turn in drugs research has involved a shift away form traditional epidemiological approaches and the pursuit of more socially focused methods. Whilst qualitative research has yielded important empirical data on risk behavior the pursuit of these methods has not been without controversy. In addressing the debate on methods in the drugs field this article investigates the effects of social science methods for research on injecting drug use. In so doing I examine what counts and what gets left out of research on injecting beaviour. Drawing on Actor Network Theory (ANT) I suggest Bruno Latour's methodological approach offers critical insights for addressing the empirical objects of injecting drug use. PMID:23528994

  11. Raman spectroscopy detects biomolecular changes associated with nanoencapsulated hesperetin treatment in experimental oral carcinogenesis

    NASA Astrophysics Data System (ADS)

    Gurushankar, K.; Gohulkumar, M.; Kumar, Piyush; Krishna, C. Murali; Krishnakumar, N.

    2016-03-01

    Recently it has been shown that Raman spectroscopy possesses great potential in the investigation of biomolecular changes of tumor tissues with therapeutic drug response in a non-invasive and label-free manner. The present study is designed to investigate the antitumor effect of hespertin-loaded nanoparticles (HETNPs) relative to the efficacy of native hesperetin (HET) in modifying the biomolecular changes during 7,12-dimethyl benz(a)anthracene (DMBA)-induced oral carcinogenesis using a Raman spectroscopic technique. Significant differences in the intensity and shape of the Raman spectra between the control and the experimental tissues at 1800-500 cm-1 were observed. Tumor tissues are characterized by an increase in the relative amount of proteins, nucleic acids, tryptophan and phenylalanine and a decrease in the percentage of lipids when compared to the control tissues. Further, oral administration of HET and its nanoparticulates restored the status of the lipids and significantly decreased the levels of protein and nucleic acid content. Treatment with HETNPs showed a more potent antitumor effect than treatment with native HET, which resulted in an overall reduction in the intensity of several biochemical Raman bands in DMBA-induced oral carcinogenesis being observed. Principal component and linear discriminant analysis (PC-LDA), together with leave-one-out cross validation (LOOCV) on Raman spectra yielded diagnostic sensitivities of 100%, 80%, 91.6% and 65% and specificities of 100%, 65%, 60% and 55% for classification of control versus DMBA, DMBA versus DMBA  +  HET, DMBA versus DMBA  +  HETNPs and DMBA  +  HET versus DMBA  +  HETNPs treated tissue groups, respectively. These results further demonstrate that Raman spectroscopy associated with multivariate statistical algorithms could be a valuable tool for developing a comprehensive understanding of the process of biomolecular changes, and could reveal the signatures of the

  12. Detection of Treatment-Induced Changes in Signaling Pathways in Gastrointestinal Stromal Tumors using Transcriptomic Data

    PubMed Central

    Ochs, Michael F.; Rink, Lori; Tarn, Chi; Mburu, Sarah; Taguchi, Takahiro; Eisenberg, Burton; Godwin, Andrew K.

    2009-01-01

    Cell signaling plays a central role in the etiology of cancer. Numerous therapeutics in use or under development target signaling proteins, however off-target effects often limit assignment of positive clinical response to the intended target. As direct measurements of signaling protein activity are not generally feasible during treatment, there is a need for more powerful methods to determine if therapeutics inhibit their targets and when off-target effects occur. We have used the Bayesian Decomposition algorithm and data on transcriptional regulation to create a novel methodology, DESIDE (Differential Expression for SIgnaling DEtermination), for inferring signaling activity from microarray measurements. We applied DESIDE to deduce signaling activity in gastrointestinal stromal tumor cell lines treated with the targeted therapeutic imatinib mesylate (Gleevec). We detected the expected reduced activity in the KIT pathway, as well as unexpected changes in the P53 pathway. Pursuing these findings, we have determined that imatinib-induced DNA damage is responsible for the increased activity of P53, identifying a novel off-target activity for this drug. We then used DESIDE on data from resected, post-imatinib treatment tumor samples and identified a pattern in these tumors similar to that at late time points in the cell lines, and this pattern correlated with initial clinical response. The pattern showed increased activity of ELK1 and STAT3 transcription factors, which are associated with the growth of side population cells. DESIDE infers the global reprogramming of signaling networks during treatment, permitting treatment modification that leverages ongoing drug development efforts, which is crucial for personalized medicine. PMID:19903850

  13. 78 FR 6316 - Empire Pipeline, Inc. (Empire); Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-30

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Empire Pipeline, Inc. (Empire); Notice of Filing Take notice that on November 29, 2012 Empire Pipeline Company (Empire) submitted a request for a waiver of the...

  14. Changes in hypertension prevalence, awareness, treatment, and control rates in Turkey from 2003 to 2012

    PubMed Central

    Sengul, Sule; Akpolat, Tekin; Erdem, Yunus; Derici, Ulver; Arici, Mustafa; Sindel, Sukru; Karatan, Oktay; Turgan, Cetin; Hasanoglu, Enver; Caglar, Sali; Erturk, Sehsuvar

    2016-01-01

    Objectives: The study aimed to assess the current epidemiology of hypertension, including its prevalence, the awareness of the condition and its treatment and control, in Turkey to evaluate changes in these factors over the last 10 years by comparing the results with the prevalence, awareness, treatment, and control of hypertension in Turkey (PatenT) study data (2003), as well as to assess parameters affecting awareness and the control of hypertension. Methods: The PatenT 2 study was conducted on a representative sample of the Turkish adult population (n = 5437) in 2012. Specifically trained staff performed the data collection. Hypertension was defined as mean SBP or DBP at least 140/90 mmHg, previously diagnosed disease or the use of antihypertensive medication. Awareness and treatment were assessed by self-reporting, and control was defined as SBP/DBP less than 140/90 mmHg. Results: Although the prevalence of hypertension in the PatenT and PatenT 2 surveys was stable at approximately 30%, hypertension awareness, treatment, and control rates have improved in Turkey. Overall, 54.7% of hypertensive patients were aware of their diagnosis in 2012 compared with 40.7% in 2003. The hypertension treatment rate increased from 31.1% in 2003 to 47.4% in 2012, and the control rate in hypertensives increased from 8.1% in 2003 to 28.7% in 2012. The rate of hypertension control in treated patients improved between 2003 (20.7%) and 2012 (53.9%). Awareness of hypertension was positively associated with older age, being a woman, residing in an urban area, a history of parental hypertension, being a nonsmoker, admittance by a physician, presence of diabetes mellitus, and being obese or overweight; it was inversely associated with a higher amount of daily bread consumption. Factors associated with better control of hypertension were younger age, female sex, residing in an urban area, and higher education level in Turkey. Conclusion: Although some progress has been made in

  15. White matter changes in patients with Friedreich ataxia after treatment with erythropoietin

    PubMed Central

    Egger, Karl; Clemm von Hohenberg, Christian; Schocke, Michael F; Guttmann, Charles RG; Wassermann, Demian; Wigand, Marlene C; Nachbauer, Wolfgang; Kremser, Christian; Sturm, Brigitte; Scheiber-Mojdehkar, Barbara; Kubicki, Marek; Shenton, Martha E; Boesch, Sylvia

    2013-01-01

    Background and Purpose Erythropoietin (EPO) has received growing attention because of its neuro-regenerative properties. Preclinical and clinical evidence supports its therapeutic potential in brain conditions like stroke, multiple sclerosis and schizophrenia. Also in Friedreich ataxia, clinical improvement after EPO therapy was shown. The aim of the present study was to assess possible therapy-associated brain white-matter changes in these patients. Methods Nine patients with Friedreich ataxia underwent Diffusion Tensor Imaging (DTI) before and after EPO treatment. Tract-based spatial statistics (TBSS) was used for longitudinal comparison. Results We detected widespread longitudinal increase in fractional anisotropy (FA) and axial diffusivity (D||) in cerebral hemispheres bilaterally (p<0.05, corrected), while no changes were observed within the cerebellum, medulla oblongata and pons. Conclusions To the best of our knowledge, this is the first DTI study to investigate the effects of erythropoietin in a neurodegenerative disease. Anatomically, the diffusivity changes appear disease-unspecific, and their biological underpinnings deserve further study. PMID:24015771

  16. Structural Changes of Erythrocyte Surface Glycoconjugates after Treatment with Medicinal Mushrooms.

    PubMed

    Vitak, Taras Y; Wasser, Solomon P; Nevo, Eviatar; Sybirna, Nataliya O

    2015-01-01

    Under conditions of chronic hyperglycemia there is dysregulation of ion homeostasis, violation of redox metabolism and functioning of membrane enzymes, as well as changes in the structural and functional states of erythrocyte membranes. As a result, the aggregation ability of erythrocytes increased and their deformability decreased. These changes lead to complications to microcirculation blood flow and provoke the development of vascular complications caused by diabetes mellitus. This study investigated the effect of the medicinal mushrooms Agaricus brasiliensis and Ganoderma lucidum on the structure of carbohydrate determinants of surface membrane glycoconjugates of rat peripheral blood erythrocytes under both normal conditions and streptozotocin-induced diabetes mellitus. The research was carried out using Wistar outbred white rats. Diabetes was induced by streptozotocin intraperitoneally injected once at a dose of 50 mg/kg body weight. The mushroom preparations were orally administered at a dose of 1 g/kg for 14 days. The treatment of diabetic rats by submerged culture mycelium powder restored the physiological balance between sialylation and desialylation processes, renewed the membrane surface charge of red blood cells, normalized aggregation properties, and caused the structural recovery of oligosaccharide chains of erythrocyte membrane surface glycoconjugates. The discovered changes show an improvement in the erythrocyte functional state and rejuvenation of their population caused by biologically active compounds of the studied medicinal mushrooms. PMID:26756299

  17. Changes in body composition and energy expenditure after six weeks' growth hormone treatment.

    PubMed Central

    Gregory, J W; Greene, S A; Jung, R T; Scrimgeour, C M; Rennie, M J

    1991-01-01

    Changes in body composition and energy expenditure were assessed in 15 children after six weeks of human growth hormone (hGH) treatment. Body composition measurements were made by stable isotope labelled water (H2(18)O) dilution, bioelectrical impedance, and skinfold thickness techniques. Energy expenditure was assessed both by indirect ventilated hood calorimetry (resting energy expenditure) and the stable isotope doubly labelled water (2H2(18)O) technique (free living daily total energy expenditure). Mean increases in weight of 0.96 kg and fat free mass of 1.37 kg and a mean decrease in fat mass of 0.41 kg were observed. Significant increases both in resting energy expenditure and free living daily energy expenditure were detected. Absolute changes in fat mass and resting energy expenditure were correlated. The data suggest (i) that the increase in the fat free mass is the most significant early clinical measure of hGH response and (ii) that hGH increases the metabolic activity of the fat free mass. Monitoring such changes may be predictive of the efficacy of hGH in promoting growth. PMID:2039249

  18. Electroconvulsive therapy improves clinical manifestations of treatment-resistant depression without changing serum BDNF levels.

    PubMed

    Rapinesi, Chiara; Kotzalidis, Georgios D; Curto, Martina; Serata, Daniele; Ferri, Vittoria R; Scatena, Paola; Carbonetti, Paolo; Napoletano, Flavia; Miele, Jessica; Scaccianoce, Sergio; Del Casale, Antonio; Nicoletti, Ferdinando; Angeletti, Gloria; Girardi, Paolo

    2015-06-30

    Electroconvulsive therapy (ECT) is effective in treatment-resistant depression (TRD). It may act through intracellular process modulation, but its exact mechanism is still unknown. Animal research supports a neurotrophic effect for ECT. We aimed to investigate the association between changes in serum brain-derived neurotrophic factor (sBDNF) levels and clinical improvement following ECT in patients with TRD. Twenty-one patients with TRD (2 men, 19 women; mean age, 63.5 years; S.D., 11.9) were assessed through the Hamilton Depression Rating Scale (HDRS), the Brief Psychiatric Rating Scale (BPRS), and the Clinical Global Impressions scale, Severity (CGIs) before and after a complete ECT cycle. At the same time-points, patients underwent blood withdrawal for measuring sBDNF levels. ECT significantly reduced HDRS, BPRS, and CGIS scores, but not sBDNF levels. No significant correlation was found between sBDNF changes, and each of HDRS, BPRS, and CGIs score changes. sBDNF levels in TRD patients were low both at baseline and post-ECT. Our results do not support that improvements in TRD following ECT are mediated through increases in sBDNF levels. PMID:25910420

  19. Surface changes of biopolymers PHB and PLLA induced by Ar+ plasma treatment and wet etching

    NASA Astrophysics Data System (ADS)

    Slepičková Kasálková, N.; Slepička, P.; Sajdl, P.; Švorčík, V.

    2014-08-01

    Polymers, especially group of biopolymers find potential application in a wide range of disciplines due to their biodegradability. In biomedical applications these materials can be used as a scaffold or matrix. In this work, the influence of the Ar+ plasma treatment and subsequent wet etching (acetone/water) on the surface properties of polymers were studied. Two biopolymers - polyhydroxybutyrate with 8% polyhydroxyvalerate (PHB) and poly-L-lactic acid (PLLA) were used in these experiments. Modified surface layers were analyzed by different methods. Surface wettability was characterized by determination of water contact angle. Changes in elemental composition of modified surfaces were performed by X-ray Photoelectron Spectroscopy (XPS). Surface morphology and roughness was examined using Atomic Force Microscopy (AFM). Gravimetry method was used to study the mass loss. It was found that the modification from both with plasma and wet etching leads to dramatic changes of surface properties (surface chemistry, morphology and roughness). Rate of changes of these features strongly depends on the modification parameters.

  20. Changes in brain connectivity related to the treatment of depression measured through fMRI: a systematic review

    PubMed Central

    Gudayol-Ferré, Esteve; Peró-Cebollero, Maribel; González-Garrido, Andrés A.; Guàrdia-Olmos, Joan

    2015-01-01

    Depression is a mental illness that presents alterations in brain connectivity in the Default Mode Network (DMN), the Affective Network (AN) and other cortical-limbic networks, and the Cognitive Control Network (CCN), among others. In recent years the interest in the possible effect of the different antidepressant treatments on functional connectivity has increased substantially. The goal of this paper is to conduct a systematic review of the studies on the relationship between the treatment of depression and brain connectivity. Nineteen studies were found in a systematic review on this topic. In all of them, there was improvement of the clinical symptoms after antidepressant treatment. In 18 out of the 19 studies, clinical improvement was associated to changes in brain connectivity. It seems that both DMN and the connectivity between cortical and limbic structures consistently changes after antidepressant treatment. However, the current evidence does not allow us to assure that the treatment of depression leads to changes in the CCN. In this regard, some papers report a positive correlation between changes in brain connectivity and improvement of depressive symptomatology, particularly when they measure cortical-limbic connectivity, whereas the changes in DMN do not significantly correlate with clinical improvement. Finally, some papers suggest that changes in connectivity after antidepressant treatment might be partly related to the mechanisms of action of the treatment administered. This effect has been observed in two studies with stimulation treatment (one with rTMS and one with ECT), and in two papers that administered three different pharmacological treatments. Our review allows us to make a series of recommendations that might guide future researchers exploring the effect of anti-depression treatments on brain connectivity. PMID:26578927

  1. CBT for Childhood Anxiety Disorders: Differential Changes in Selective Attention between Treatment Responders and Non-Responders

    ERIC Educational Resources Information Center

    Legerstee, Jeroen S.; Tulen, Joke H. M.; Dierckx, Bram; Treffers, Philip D. A.; Verhulst, Frank C.; Utens, Elisabeth M. W. J.

    2010-01-01

    Background: This study examined whether treatment response to stepped-care cognitive-behavioural treatment (CBT) is associated with changes in threat-related selective attention and its specific components in a large clinical sample of anxiety-disordered children. Methods: Ninety-one children with an anxiety disorder were included in the present…

  2. Changes in the quality of life of Tanzanian school children after treatment interventions using the Child-OIDP.

    PubMed

    Mashoto, Kijakazi O; Astrøm, Anne N; Skeie, Marit S; Masalu, Joyce R

    2010-12-01

    This study aimed to examine the evaluative properties of the Child Oral Impacts on Daily Performances (Child-OIDP) inventory and to estimate treatment-associated changes in the OIDP and self-reported oral health following atraumatic restorative treatment (ART) and oral health education (OHE). A total of 1,306 school attendees in Kilwa, Tanzania, completed the Child-OIDP inventory before, and 6 months after, treatment. The post-treatment questionnaire assessed change in perceived oral health. Complete baseline and follow-up data were obtained for 104, 117, and 1,085 participants who received, respectively, ART fillings (Group A), ART fillings and tooth extraction (Group B), and OHE only (Group C). The longitudinal validity, responsiveness, and treatment-associated changes were calculated using anova, effect sizes, and repeated general linear models (GLM). The follow-up prevalence was 73.8%. The mean changes in the OIDP total- and subscale scores were negative within those who reported 'worsened' oral health, and positive in subjects reporting 'improved' oral health. Effect sizes for the total OIDP score ranged from -0.2 within the category 'worsened' to 0.4 within the category 'improved'. Changes following treatment were more extensive in Group B compared with Groups A and C, and in Group C compared with Group A. The Child-OIDP showed promising evaluative properties and responsiveness to change following ART fillings, ART fillings and tooth extraction, and OHE. PMID:21083625

  3. Proteomic analysis of human adipose tissue after rosiglitazone treatment shows coordinated changes to promote glucose uptake.

    PubMed

    Ahmed, Meftun; Neville, Matt J; Edelmann, Mariola J; Kessler, Benedikt M; Karpe, Fredrik

    2010-01-01

    The aim of this study was to identify potential protein targets for insulin sensitization in human adipose tissue using unbiased proteomic approaches. Ten moderately obese, but otherwise healthy, subjects were treated with rosiglitazone 4 mg b.i.d. for 14 days and global protein and gene expression changes were monitored. Proteomic analysis revealed distinct up- or downregulation (greater than twofold) in 187 protein spots on the two-dimensional (2-D) gel images between day 0 and day 1 adipose tissue samples. When comparing the protein spots on the gels from day 0 with that of 14-day-treated samples, 122 spots showed differential expression. There was a striking increase in the expression of proteins involved in glucose transporter-4 (GLUT4) granule transport and fusion (actin, myosin-9, tubulin, vimentin, annexins, moesin, LIM, and SH3 domain protein-1), signaling (calmodulin, guanine nucleotide-binding proteins), redox regulation (superoxide dismutase, catalase, ferritin, transferrin, heat shock proteins), and adipogenesis (collagens, galectin-1, nidogen-1, laminin, lamin A/C). However, there was an intriguing absence of correlated changes in mRNA expression, suggesting adaptation at a post-transcriptional level in response to rosiglitazone. Thus, the major changes observed were among proteins involved in cytoskeletal rearrangement, insulin and calcium signaling, and inflammatory and redox signals that decisively upregulate GLUT4 granule trafficking in human adipose tissue. Such orchestrated changes in expression of multiple proteins provide insights into the mechanism underlying the increased efficiency in glucose uptake and improvement of insulin sensitivity in response to rosiglitazone treatment. PMID:19556978

  4. Treatment-associated changes in body composition, health behaviors, and mood as predictors of change in body satisfaction in obese women: effects of age and race/ethnicity.

    PubMed

    Annesi, James J; Tennant, Gisèle A; Mareno, Nicole

    2014-12-01

    A lack of satisfaction with one's body is common among women with obesity, often prompting unhealthy "dieting." Beyond typically slow improvements in weight and body composition, behavioral factors might also affect change in body satisfaction. Age and race/ethnicity (African American vs. White) might moderate such change. Obese women (N = 246; M(age) = 43 years; M BMI = 39 kg/m(2)) initiating a 6-month cognitive-behaviorally based physical activity and nutrition treatment were assessed on possible predictors of body satisfaction change. At baseline, African American and younger women had significantly higher body satisfaction. The treatment was associated with significant within-group improvements in mood, health behaviors (physical activity and fruit/vegetable intake), and body composition (waist circumference). A multiple regression analysis indicated that mood, health behavior, and body composition changes explained a significant 27% of the variance in body satisfaction change. Of these predictors, changes in mood (β = -.36, p < .001) and health behaviors (β = .18, p = .01) made significant, unique contributions to the variance in change in body satisfaction that was accounted for, while only the measure of actual physiological change (body composition) did not. Neither age nor race/ethnicity was a significant moderator when each was entered separately into the multiple regression equation. Practical implications for leveraging manageable changes in behavioral factors for improving body satisfaction were discussed. PMID:24771083

  5. Surface profile changes of scuffed bearing surfaces. [before and after acid treatment

    NASA Technical Reports Server (NTRS)

    Lauer, J. L.; Fung, S. S.; Jones, W. R., Jr.

    1982-01-01

    A phase locked interference microscope capable of resolving depth differences to 30 A and planar displacements of 6000 A was constructed for the examination of the profiles of bearing surfaces without physical contact. This instrument was used to determine surface chemical reactivity by applying a drop of dilute alcoholic hydrochloric acid and measuring the profile of the solid surface before and after application of this probe. Scuffed bearing surfaces reacted much faster than unscuffed ones, but bearing surfaces which had been previously exposed to lubricants containing an organic chloride reacted much more slowly. In a separate series of experiments, a number of stainless steel plates were heated in a nitrogen atmosphere to different temperatures and their reactivity examined later at room temperature. The change of surface contour as a result of the probe reaction followed an Arrhenius type relation with respect to heat treatment temperature. This result could have implications on the scuffing mechanism.

  6. Changes in hypertension treatment and in congestive heart failure mortality in the United States.

    PubMed

    Yusuf, S; Thom, T; Abbott, R D

    1989-05-01

    The use of antihypertensive agents has increased in recent years and has been more marked among individuals in older age groups (65-74 years) than in middle-aged groups (45-54 years). Because hypertension is a strong risk factor for the development of congestive heart failure, more common use of antihypertensive agents would be expected to reduce the incidence of congestive heart failure. Examination of the national death statistics reveals decreases in congestive heart failure mortality at younger ages with mortality increases at older ages. The reasons for these divergent trends in congestive heart failure mortality in different ages and the apparent inconsistency with respect to the changes in the use of antihypertensive drugs are explored. We speculate that antihypertensive treatment does not completely prevent congestive heart failure but merely postpones its development by several decades. PMID:2490832

  7. The 2015 hospital treatment choice reform in Norway: Continuity or change?

    PubMed

    Ringard, Ånen; Saunes, Ingrid Sperre; Sagan, Anna

    2016-04-01

    In several European countries, including Norway, polices to increase patient choice of hospital provider have remained high on the political agenda. The main reason behind the interest in hospital choice reforms in Norway has been the belief that increasing choice can remedy the persistent problem of long waiting times for elective hospital care. Prior to the 2013 General Election, the Conservative Party campaigned in favour of a new choice reform: "the treatment choice reform". This article describes the background and process leading up to introduction of the reform in the autumn of 2015. It also provides a description of the content and discusses possible implications of the reform for patients, providers and government bodies. In sum, the reform contains elements of both continuity and change. The main novelty of the reform lies in the increased role of private for-profit healthcare providers. PMID:27005300

  8. Changes in Initial Treatment for Prostate Cancer Among Medicare Beneficiaries, 1999-2007

    SciTech Connect

    Dinan, Michaela A.; Robinson, Timothy J.; Zagar, Timothy M.; Scales, Charles D.; Curtis, Lesley H.; Reed, Shelby D.; Lee, W. Robert; Schulman, Kevin A.

    2012-04-01

    Purpose: In the absence of evidence from large clinical trials, optimal therapy for localized prostate cancer remains unclear; however, treatment patterns continue to change. We examined changes in the management of patients with prostate cancer in the Medicare population. Methods and Materials: We conducted a retrospective claims-based analysis of the use of radiation therapy, surgery, and androgen deprivation therapy in the 12 months after diagnosis of prostate cancer in a nationally representative 5% sample of Medicare claims. Patients were Medicare beneficiaries 67 years or older with incident prostate cancer diagnosed between 1999 and 2007. Results: There were 20,918 incident cases of prostate cancer between 1999 and 2007. The proportion of patients receiving androgen deprivation therapy decreased from 55% to 36%, and the proportion of patients receiving no active therapy increased from 16% to 23%. Intensity-modulated radiation therapy replaced three-dimensional conformal radiation therapy as the most common method of radiation therapy, accounting for 77% of external beam radiotherapy by 2007. Minimally invasive radical prostatectomy began to replace open surgical approaches, being used in 49% of radical prostatectomies by 2007. Conclusions: Between 2002 and 2007, the use of androgen deprivation therapy decreased, open surgical approaches were largely replaced by minimally invasive radical prostatectomy, and intensity-modulated radiation therapy replaced three-dimensional conformal radiation therapy as the predominant method of radiation therapy in the Medicare population. The aging of the population and the increasing use of newer, higher-cost technologies in the treatment of patients with prostate cancer may have important implications for nationwide health care costs.

  9. Effect of chelation treatment with dimercaptosuccinic acid (DMSA) on lead-related blood pressure changes

    SciTech Connect

    Khalil-Manesh, F.; Gonick, H.C.; Weiler, E.W.J. Univ. of California, Los Angeles ); Prins, B.; Purdy, R. ); Weber, M.A. Univ. of California, Irvine ); Ren, Qing )

    1994-04-01

    An elevation in mean blood pressure was found in rats treated with low lead (0.01%) for 6 months and then only water for an additional 6 months (discontinuous low lead). Not change in blood pressure was found in rats similarly treated with high lead (0.5%) (discontinuous high lead). Administration of DMSA (0.5% in drinking water), for 5 days every 2 months following cessation of lead administration, resulted in a significant lowering of blood pressure in both groups of animals. In the low-lead but not the high-lead group, this was associated with an increase in plasma cyclic GMP (acting as a second messenger for endothelium-derived relaxing factor, EDRF) and a decrease in the plasma concentration of 12-kDa hypertension-associated protein. Plasma endothelin-3 (ET-3) levels were decreased in discontinuous high-lead rats, increased in dicontinuous low-lead rats, but were unaltered by DMSA treatment. We infer that the elevated blood pressure in the discontinuous low-lead rats is related to an increase in the putative vasoconstrictors, ET-3 and the hypertension-associated protein, without a change in the vasodilator, EDRF. With DMSA treatment, plasma cyclic GMP in low-lead rats increased above normal, and the hypertension-associated protein decreased, resulting in lowered blood pressure. DMSA was shown to act as an antioxidant in vitro. Thus the DMSA effect on plasma cGMP (EDRF) may occur via a scavenging effect on EDRF-inactivating reactive oxygen species. 34 refs., 7 figs., 4 tabs.

  10. Changes in Initial Treatment for Prostate Cancer Among Medicare Beneficiaries, 1999-2007

    PubMed Central

    Dinan, Michaela A.; Robinson, Timothy J.; Zagar, Timothy M.; Scales, Charles D.; Curtis, Lesley H.; Reed, Shelby D.; Robert Lee, W.; Schulman, Kevin A.

    2012-01-01

    Purpose In the absence of evidence from large clinical trials, optimal therapy for localized prostate cancer remains unclear; however, treatment patterns continue to change. We examined changes in the management of patients with prostate cancer in the Medicare population. Methods and Materials We conducted a retrospective claims-based analysis of the use of radiation therapy, surgery, and androgen deprivation therapy in the 12 months after diagnosis of prostate cancer in a nationally representative 5% sample of Medicare claims. Patients were Medicare beneficiaries 67 years or older with incident prostate cancer diagnosed between 1999 and 2007. Results There were 20,918 incident cases of prostate cancer between 1999 and 2007. The proportion of patients receiving androgen deprivation therapy decreased from 55% to 36%, and the proportion of patients receiving no active therapy increased from 16% to 23%. Intensity-modulated radiation therapy replaced 3-dimensional conformal radiation therapy as the most common method of radiation therapy, accounting for 77% of external beam radiotherapy by 2007. Minimally invasive radical prostatectomy began to replace open surgical approaches, being used in 49% of radical prostatectomies by 2007. Conclusions Between 2002 and 2007, the use of androgen deprivation therapy decreased, open surgical approaches were largely replaced by minimally invasive radical prostatectomy, and intensity-modulated radiation therapy replaced 3-dimensional conformal radiation therapy as the predominant method of radiation therapy in the Medicare population. The aging of the population and the increasing use of newer, higher-cost technologies in the treatment of patients with prostate cancer may have important implications for nationwide health care costs. PMID:22331001

  11. Structural and biomechanical changes in the Achilles tendon after chronic treatment with statins.

    PubMed

    de Oliveira, L P; Vieira, C P; Guerra, F D; Almeida, M S; Pimentel, E R

    2015-03-01

    Cases of tendinopathy and tendon ruptures have been reported as side effects associated with statin therapy. This work assessed possible changes in the structural and biomechanical properties of the tendons after chronic treatment with statins. Wistar rats were divided into the following groups: treated with atorvastatin (A-20 and A-80), simvastatin (S-20 and S-80) and the group that received no treatment (C). The doses of statins were calculated using allometric scaling, based on the doses of 80 mg/day and 20 mg/day recommended for humans. The morphological aspect of the tendons in A-20, S-20 and S-80 presented signals consistent with degeneration. Both the groups A-80 and S-80 showed a less pronounced metachromasia in the compression region of the tendons. Measurements of birefringence showed that A-20, A-80 and S-80 groups had a lower degree of organization of the collagen fibers. In all of the groups treated with statins, the thickness of the epitenon was thinner when compared to the C group. In the biomechanical tests the tendons of the groups A-20, A-80 and S-20 were less resistant to rupture. Therefore, statins affected the organization of the collagen fibers and decreased the biomechanical strength of the tendons, making them more predisposed to ruptures. PMID:25544391

  12. Viability and morphological changes of Acanthamoeba spp. cysts after treatment with Effective microorganisms (EM).

    PubMed

    Sampaotong, Tanitta; Lek-Uthai, Usa; Roongruangchai, Jantima; Roongruangchai, Kosol

    2016-06-01

    Acanthamoeba is a free-living opportunistic protozoan parasite that is found in diverse environments. It can cause keratitis, mostly related to inappropriate use of contact lenses, as well as life threatening diseases including encephalitis, disseminated sinusitis, and skin ulcers. This study investigated morphological changes and fine structures of the cyst form of Acanthamoeba spp. after treatment with effective microorganisms (EM™) using light and scanning electron microscopies. Acanthamoeba cysts treated with 1:2, 1:4, 1:6, and undiluted EM™ showed higher percentages of non-viable cysts than those treated with 1:8, 1:10, 1:100, 1:200, and 1:400 EM™ and at 5 days post-treatment developed from cystic stage to trophozoite stage. Acanthamoeba cysts treated at concentrations of 1:2, 1:4, 1:6, and undiluted EM™ exhibited cytoplasmic clumping and shrinkage of amoeba cells away from cyst walls. The effective EM™ concentration lethal to Acanthamoeba spp. cyst could provide information to monitor the environmental control system. PMID:27413306

  13. Anthelmintic Treatment Does Not Change Foraging Strategies of Female Eastern Grey Kangaroos, Macropus giganteus

    PubMed Central

    Cripps, Jemma K.; Martin, Jennifer K.; Coulson, Graeme

    2016-01-01

    Large mammalian herbivores are commonly infected with gastrointestinal helminths. Heavily parasitised hosts are likely to have increased nutritional requirements and would be predicted to increase their food intake to compensate for costs of being parasitised, but experimental tests of the impacts of these parasites on the foraging efficiency of hosts are lacking, particularly in free-ranging wildlife. We conducted a field experiment on a population of free-ranging eastern grey kangaroos (Macropus giganteus) to test this prediction, removing nematodes from one group of adult females using an anthelmintic treatment. We then carried out observations before and following treatment to assess the influence of parasites on foraging behaviour. Contrary to our predictions, the manipulation of parasite burdens did not result in changes in any of the key foraging variables we measured. Our results suggest that despite carrying large burdens of gastrointestinal parasites, the foraging strategy of female kangaroos is likely be driven by factors unrelated to parasitism, and that kangaroos in high nutritional environments may be able acquire sufficient nutrients to offset the costs of parasitism. We conclude that the drivers of forage intake likely differ between domesticated and free-ranging herbivores, and that free-ranging hosts are likely more resilient to parasitism. PMID:26784582

  14. Testing a model of change in the experiential treatment of depression.

    PubMed

    Pos, Alberta E; Greenberg, Leslie S; Warwar, Serine H

    2009-12-01

    In this study, we measured emotional processing and the alliance across 3 phases of therapy (beginning, working, and termination) for 74 clients who each received brief experiential psychotherapy for depression. Using path analysis, we proposed and tested a model of relationships between these 2 processes across phases of therapy and how these processes relate to predict improvement in the domains of depressive and general symptoms, self-esteem, and interpersonal problems after experiential treatment. Both therapy processes significantly increased across phases of therapy. Controlling for both client processes at the beginning of therapy, working phase emotional processing was found to directly and best predict reductions in depressive and general symptoms, and it could directly predict gains in self-esteem. Within working and termination phases of therapy, the alliance significantly contributed to emotional processing and indirectly contributed to outcome. Surprisingly, beginning therapy alliance (measured after Session 1) also directly predicted all outcomes. Furthermore, only clients' beginning therapy process predicted reductions in interpersonal problems. Therefore, although the proposed theory of change was supported, clients' beginning therapy processes may constrain clients' success in experiential treatment and in particular their outcomes in some problem domains related to depression. PMID:19968382

  15. Treatment, failures and complications of ectopic pregnancy: changes over a 20 year period.

    PubMed

    Landström, G; Thorburn, J; Bryman, I

    1998-01-01

    Data from all 225 women operated on for ectopic pregnancy in 1992-1994 at Sahlgrenska University Hospital were collected and compared with three previous cross-sectional investigations from our hospital (1975-1979, 1981-1982 and 1986-1987) in order to evaluate the extent to which surgical treatment and post-operative complications have changed over a 20 year period. Laparoscopic surgery, which was not possible in the 1970s, was used in almost 85% of the ectopic pregnancies in 1992-1994. Conservative treatment was still the most frequently used technique. The complication rate was 1.2% in 1975-1979 when only laparotomies were carried out. After the introduction of laparoscopic surgery (1986-1987), the complication rate rose significantly (7.3%) and continued to increase even when this procedure was established as routine (14.2% in 1992-1994). Post-operative complications were most frequent after conservative laparoscopic surgery (24.4%) while there were no complications after laparotomies. In spite of increasing complication rates the frequency of patients in pre-shock, as well as the proportion of patients with heavy intra-abdominal bleeding and tubal rupture, decreased over time. PMID:9512258

  16. BnNHL18A shows a localization change by stress-inducing chemical treatments

    SciTech Connect

    Lee, Suk-Bae; Ham, Byung-Kook; Park, Jeong Mee; Kim, Young Jin; Paek, Kyung-Hee . E-mail: khpaek95@korea.ac.kr

    2006-01-06

    The two genes, named BnNHL18A and BnNHL18B, showing sequence homology with Arabidopsis NDR1/HIN1-like (NHL) genes, were isolated from cDNA library prepared with oilseed rape (Brassica napus) seedlings treated with NaCl. The transcript level of BnNHL18A was increased by sodium chloride, ethephon, hydrogen peroxide, methyl jasmonate, or salicylic acid treatment. The coding regions of BnNHL18A and BnNHL18B contain a sarcolipin (SLN)-like sequence. Analysis of the localization of smGFP fusion proteins showed that BnNHL18A is mainly localized to endoplasmic reticulum (ER). This result suggests that the SLN-like sequence plays a role in retaining proteins in ER membrane in plants. In response to NaCl, hydrogen peroxide, ethephon, and salicylic acid treatments, the protein localization of BnNHL18A was changed. Our findings suggest a common function of BnNHL18A in biotic and abiotic stresses, and demonstrate the presence of the shared mechanism of protein translocalization between the responses to plant pathogen and to osmotic stress.

  17. Anthelmintic Treatment Does Not Change Foraging Strategies of Female Eastern Grey Kangaroos, Macropus giganteus.

    PubMed

    Cripps, Jemma K; Martin, Jennifer K; Coulson, Graeme

    2016-01-01

    Large mammalian herbivores are commonly infected with gastrointestinal helminths. Heavily parasitised hosts are likely to have increased nutritional requirements and would be predicted to increase their food intake to compensate for costs of being parasitised, but experimental tests of the impacts of these parasites on the foraging efficiency of hosts are lacking, particularly in free-ranging wildlife. We conducted a field experiment on a population of free-ranging eastern grey kangaroos (Macropus giganteus) to test this prediction, removing nematodes from one group of adult females using an anthelmintic treatment. We then carried out observations before and following treatment to assess the influence of parasites on foraging behaviour. Contrary to our predictions, the manipulation of parasite burdens did not result in changes in any of the key foraging variables we measured. Our results suggest that despite carrying large burdens of gastrointestinal parasites, the foraging strategy of female kangaroos is likely be driven by factors unrelated to parasitism, and that kangaroos in high nutritional environments may be able acquire sufficient nutrients to offset the costs of parasitism. We conclude that the drivers of forage intake likely differ between domesticated and free-ranging herbivores, and that free-ranging hosts are likely more resilient to parasitism. PMID:26784582

  18. Statins induce biochemical changes in the Achilles tendon after chronic treatment.

    PubMed

    de Oliveira, Letícia Prado; Vieira, Cristiano Pedrozo; Da Ré Guerra, Flávia; de Almeida, Marcos dos Santos; Pimentel, Edson Rosa

    2013-09-15

    Statins have been widely prescribed as lipid-lowering drugs and are associated with tendon rupture. Therefore, this study aimed to evaluate the possible biochemical changes in the Achilles tendon of rats after chronic treatment with statins. Dosages of statins were calculated using allometric scaling with reference to the 80mg/day and 20mg/day, doses recommended for humans. The rats were divided into the following groups: treated with simvastatin (S-20 and S-80), treated with atorvastatin (A-20 and A-80), and the control group that received no treatment (C). Measurements of low-density lipoprotein (LDL) in the plasma were performed. The levels of non-collagenous proteins, glycosaminoglycans (GAGs) and hydroxyproline were quantified. Western blotting for collagen I was performed, and the presence of metalloproteinases (MMPs)-2 and -9 was investigated through zymography. The concentration of non-collagenous proteins in S-20 was less than the C group. There was a significant increase in pro-MMP-2 activity in A-80 group and in active MMP-2 in S-20 group compared to the C group. A significant increase in latent MMP-9 activity was observed in both the A-80 and S-20 groups when compared to C group. In the A-20 group, there was a lower amount of collagen I in relation to C group. In addition, a higher concentration of hydroxyproline was found in the S-20 group than the C group. The analysis of GAGs showed a significant increase in the A-20 group when compared to C group. The treatment induced remarkable alterations in the Achilles tendon and the response of the tissue seems to depend of the used statin dosage. The presence of MMP-2 and MMP-9 is evidence of the degradation and remodeling processes in the extracellular matrix of the tendons. Our results show that statins induce imbalance of extracellular matrix components and possibly induce microdamage in tendons. PMID:23831763

  19. Alliance-focused therapy for anorexia nervosa: integrative relational and behavioral change treatments in a single-case experimental design.

    PubMed

    Satir, Dana A; Goodman, David M; Shingleton, Rebecca M; Porcerelli, John H; Gorman, Bernard S; Pratt, Elizabeth M; Barlow, David H; Thompson-Brenner, Heather

    2011-12-01

    Evidence supporting outpatient treatments for anorexia nervosa (AN) is severely lacking, due to low retention and poor outcome. One explanation for drop-out is weak treatment alliances. A single-case experimental analysis accompanied by in-depth qualitative description is presented for Ms. O, who received a novel treatment for AN called Alliance Focused Treatment (AFT) that attends to ruptures in the alliance, interpersonal difficulties and emotional avoidance. At intake Ms. O met diagnostic criteria for AN, Major Depressive Disorder, and Social Phobia. She was characterized as having symptoms of Obsessive Compulsive, Avoidant, and Depressive personality disorders. Treatment began with a Baseline followed by the experimental (AFT) and comparison treatments (Behavioral Change Treatment [BCT]) using a replicated experimental single-case phase change design. Graphs of slopes of kilocalorie and alliance change facilitated observation of treatment effects. Ms. O participated in 16 sessions of AFT and 8 sessions of BCT with specific benefits. Ratings of the treatment alliance were consistently high and she evidenced significant changes in weight, quality of life, and personality pathology. Associations between rupture/repair episodes and kilocalorie increases were observed. The utility of the treatment relationship in facilitating emotional expression was evident. At posttreatment, Ms. O endorsed cognitive AN symptoms, although these were not explicitly treated. This study provides preliminary support for the feasibility and effect of AFT and BCT, and highlights the importance of the alliance in treating adults with AN. Further research on emotion regulation in AN and its effect on the treatment relationship are needed. PMID:22141420

  20. Empirically Based Myths: Astrology, Biorhythms, and ATIs.

    ERIC Educational Resources Information Center

    Ragsdale, Ronald G.

    1980-01-01

    A myth may have an empirical basis through chance occurrence; perhaps Aptitude Treatment Interactions (ATIs) are in this category. While ATIs have great utility in describing, planning, and implementing instruction, few disordinal interactions have been found. Article suggests narrowing of ATI research with replications and estimates of effect…

  1. Changes in bacterial community structure in a full-scale membrane bioreactor for municipal wastewater treatment.

    PubMed

    Hashimoto, Kurumi; Tsutsui, Hirofumi; Takada, Kazuki; Hamada, Hiroshi; Sakai, Kousuke; Inoue, Daisuke; Sei, Kazunari; Soda, Satoshi; Yamashita, Kyoko; Tsuji, Koji; Hashimoto, Toshikazu; Ike, Michihiko

    2016-07-01

    This study investigated changes in the structure and metabolic capabilities of the bacterial community in a full-scale membrane bioreactor (MBR) treating municipal wastewater. Microbial monitoring was also conducted for a parallel-running conventional activated sludge (CAS) process treating the same influent. The mixed-liquor suspended solid concentration in the MBR reached a steady-state on day 73 after the start-up. Then the MBR maintained higher rates of removal of organic compounds and nitrogen than the CAS process did. Terminal restriction fragment length polymorphism analysis revealed that the bacterial community structure in the MBR was similar to that in the CAS process at the start-up, but it became very different from that in the CAS process in the steady state. The bacterial community structure of the MBR continued to change dynamically even after 20 months of the steady-state operation, while that of the CAS process was maintained in a stable condition. By contrast, Biolog assay revealed that the carbon source utilization potential of the MBR resembled that of the CAS process as a whole, although it declined transiently. Overall, the results indicate that the bacterial community of the MBR has flexibility in terms of its phylogenetic structure and metabolic activity to maintain the high wastewater treatment capability. PMID:26811223

  2. Histological changes in connective tissue of rat tails after bipolar radiofrequency treatment.

    PubMed

    Beltrán-Frutos, E; Bernal-Mañas, C M; Navarro, S; Zuasti, A; Ferrer, C; Canteras, M; Seco-Rovira, V; García-Collado, A J; Pastor, L M

    2012-09-01

    Radiofrequency (RF) has been included in the techniques used in aesthetic surgery/medicine. To date, no studies have performed a histological assessment of changes in the tissue after application of bipolar radiofrequency (BRF) with low energy and frequency. The aim of this study was to examine changes that are produced in connective tissue, principally in the fibroblasts, following BRF treatment. Four groups of rats received a different number of RF sessions (1, 2, 3 and 5). The following parameters were determined: the number of fibroblasts/unit area (FA), the proliferation index (PI), the Heat shock Protein 47 index (HSPI) and the percentage of connective tissue (PC). For statistical analysis, two subgroups (A and B) were made for the variables FA, PI and PC, and another two subgroups (C and D) for the variable HSPI. Significant differences for FA, PI and PC were observed between subgroups A and B, FA and PI having higher values in A, while PC had higher values in B. The HSPI in subgroup C showed significantly higher values than in D. Low energy and frequency BRF led to an increase in the number, proliferation and biosynthetic activity of fibroblasts. The resulting stress suffered by fibroblasts as a result of heat may be associated with the phenomenon of hormesis. PMID:22806911

  3. Differential temporal changes of primary and secondary bacterial symbionts and whitefly host fitness following antibiotic treatments.

    PubMed

    Zhang, Chang-Rong; Shan, Hong-Wei; Xiao, Na; Zhang, Fan-Di; Wang, Xiao-Wei; Liu, Yin-Quan; Liu, Shu-Sheng

    2015-01-01

    Where multiple symbionts coexist in the same host, the selective elimination of a specific symbiont may enable the roles of a given symbiont to be investigated. We treated the Mediterranean species of the whitefly Bemisia tabaci complex by oral delivery of the antibiotic rifampicin, and then examined the temporal changes of its primary symbiont "Candidatus Portiera aleyrodidarum" and secondary symbiont "Ca. Hamiltonella defensa" as well as host fitness for three generations. In adults treated with rifampicin (F0), the secondary symbiont was rapidly reduced, approaching complete disappearance as adults aged. In contrast, the primary symbiont was little affected until later in the adult life. In the offspring of these adults (F1), both symbionts were significantly reduced and barely detectable when the hosts reached the adult stage. The F1 adults laid few eggs (F2), all of which failed to hatch. Mating experiments illustrated that the negative effects of rifampicin on host fitness were exerted via female hosts but not males. This study provides the first evidence of differential temporal reductions of primary and secondary symbionts in whiteflies following an antibiotic treatment. Studies that disrupt functions of bacterial symbionts must consider their temporal changes. PMID:26510682

  4. Differential temporal changes of primary and secondary bacterial symbionts and whitefly host fitness following antibiotic treatments

    PubMed Central

    Zhang, Chang-Rong; Shan, Hong-Wei; Xiao, Na; Zhang, Fan-Di; Wang, Xiao-Wei; Liu, Yin-Quan; Liu, Shu-Sheng

    2015-01-01

    Where multiple symbionts coexist in the same host, the selective elimination of a specific symbiont may enable the roles of a given symbiont to be investigated. We treated the Mediterranean species of the whitefly Bemisia tabaci complex by oral delivery of the antibiotic rifampicin, and then examined the temporal changes of its primary symbiont “Candidatus Portiera aleyrodidarum” and secondary symbiont “Ca. Hamiltonella defensa” as well as host fitness for three generations. In adults treated with rifampicin (F0), the secondary symbiont was rapidly reduced, approaching complete disappearance as adults aged. In contrast, the primary symbiont was little affected until later in the adult life. In the offspring of these adults (F1), both symbionts were significantly reduced and barely detectable when the hosts reached the adult stage. The F1 adults laid few eggs (F2), all of which failed to hatch. Mating experiments illustrated that the negative effects of rifampicin on host fitness were exerted via female hosts but not males. This study provides the first evidence of differential temporal reductions of primary and secondary symbionts in whiteflies following an antibiotic treatment. Studies that disrupt functions of bacterial symbionts must consider their temporal changes. PMID:26510682

  5. Reasons for changes in the value of unit pressure of compression products supporting external treatment

    NASA Astrophysics Data System (ADS)

    Kowalski, K.; Ilska, A.; Kłonowska, M.

    2016-07-01

    The paper presents the basics of modelling compression products with intended values of unit pressure for body circumferences with fixed and variable radius of curvature. The derived relationships referring to the dimensions of the fabric's circumferences in a relaxed state of the product were based on Laplace law, local values of the radius of curvature, and the characteristics of stretching and relaxing (deformation) of the knitted fabric, described by experimental relation for the stress and relaxation phase for the 6th hysteresis loop, taking into account confidence intervals. The article indicates the possibilities of using 3D scanning techniques of the human body to identify the radius of curvature of various circumference of the human silhouette, for which the intended value of the unit pressure is designed, and quantitative changes in the body deformation due to compression. Classic method of modelling and design of compression products, based on a cylindrical model of the human body does not provide in each case the intended value of unit pressure, according to specific normative requirements, because it neglects the effect of different values of the radius of curvature of the body circumference and the properties of the viscoelastic knitted fabrics. The model and experimental research allowed for a quantitative and qualitative assessment of the reasons for the changes in the value of unit pressure of compression products supporting the process of external treatment.

  6. Demonstrations to Support Change to the >260 ppm Mercury Treatment Regulations

    SciTech Connect

    Hulet, Gregory Albert; Maio, Vincent Carl; Morris, M. I.; Lewis, J.; Randall, P.; Rieser, L.

    2001-02-01

    The U.S. Department of Energy (DOE) and the U. S. Environmental Protection Agency (EPA) are working together to justify a change in the Land Disposal Restriction for High Mercury (>260 ppm mercury) waste. The present regulation that requires roasting or retorting is based on recovering and recycling the mercury in the waste. However, most of DOE’s High Mercury waste is radioactively contaminated, eliminating the possibility of its recycle. The radioactive mercury recovered must be amalgamated and disposed. In addition, concern over fugitive emissions from retorting and roasting operations has raised the question of whether such processing is environmentally sound. A change to the regulation to allow stabilization and disposal would reduce the overall environmental threat, if the stabilization process can reduce the leachability of the mercury to regulatory levels. Demonstrations are underway to gather data showing that the High Mercury waste can be safely stabilized. At the same time, comparison tests are being conducted using an improved form of the baseline retorting technology to better quantify the fugitive emission problem and determine the full capability of thermal desorption systems. A first round of demonstrations stabilizing mercury in soil from Brookhaven National Laboratory (BNL) has been completed. Four groups demonstrated their process on the waste: 1) BNL demonstrated its Sulfur Polymer Stabilization/Solidification process; 2) Nuclear Fuel Services used their DeHg (de-merk) process, 3) Allied Technology Group used chemical stabilization, and 4) Sepradyne demonstrated their vacuum thermal desorption system. All groups were successful in their tests, reaching regulatory levels for mercury leachability. Data for each group will be presented. DOE, EPA, and the University of Cincinnati are presently working on another series of tests involving treatment of surrogate sludge and soil by commercial vendors. Protocols that better determine the waste form

  7. Molecular and histological changes in cerebral cortex and lung tissues under the effect of tramadol treatment.

    PubMed

    Awadalla, Eatemad A; Salah-Eldin, Alaa-Eldin

    2016-08-01

    Tramadol abuse is one of the most frequent health problems in Egypt and worldwide. In most cases, tramadol abused by men face a problem with premature ejaculation. Tramadol like other opioids induces a decrease in plasma antioxidant levels, which may reflect a failure of the antioxidant defense mechanism against oxidative damage. The present work aimed to study the possible deleterious effects of oral administration of tramadol on brain and lung tissues in rats. Twenty adult male albino rats were divided into two groups; a control administered with normal saline and tramadol-treated (40mg/kg b.w.) group for 20 successive days. At the end of experimental period, blood was collected and specimens from brains and lungs were taken for histopathological and molecular studies. Malondialdehyde (MDA), reduced glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) activities were measured in serum of control and tramadol-treated groups. Brain and lung specimens were histopathological evaluated using light microscopy. The expression levels of apoptotic related genes; Bcl-2, Bax and Caspase-3 were study in brain and lung tissues using RT-PCR analysis. We recorded a significant increase MDA level, while antioxidant enzymes; GSH, SOD and CAT were significantly decreased after tramadol-treatment. The obtained results revealed that tramadol induced a remarkable histomorphological changes in rats' brains (cerebral cortex and hippocampus) and severe histopathological changes in rats' lung when compared to that of control. On molecular level, the expression of the pro-apoptotic Bax and Caspase-3 showed a significant increase whereas the anti-apoptotic Bcl-2 decreased markedly indicating that tramadol is harmful at cellular level and can induce apoptotic changes in brain tissues. Our data confirmed the risk of increased oxidative stress, neuronal and pulmonary damage due to tramadol abuse. Although tramadol is reported to be effective in pain management, its toxicity should

  8. Oestrus synchronization treatment induces histomorphological changes on the uterine tube epithelium of the gilt.

    PubMed

    Juárez-Mosqueda, M L; Anzaldúa Arce, S R; Palma Lara, I; García Dalmán, C; Cornejo Cortés, M A; Córdova Izquierdo, A; Villaseñor Gaona, H; Trujillo Ortega, M E

    2015-12-01

    The aim of this study was to determine the histomorphological changes that occurred in response to two treatments for oestrus synchronization in three different regions of the gilt's uterine tubes epithelium: the ampulla (AMP), ampulla-isthmic junction (AIJ) and isthmus (IST). Nine prepuberal gilts were divided into three groups (n = 3): (1) eCG 400 IU and hCG 200 IU (eCG/hCG), (2) progesterone agonist (P4) and (3) control group. The number of secretory cells (stained with periodic acid-Schiff reaction or PAS-positive cells) decreased in the AMP in the P4 treated group when compared to the control group, whereas, no difference was observed in the number of PAS-negative cells in the AMP of the three groups. A significant decrease in the number of PAS-positive cells was observed in the AIJ and IST of the P4 treated group when compared to the eCG/hCG and control groups. An increase in the number of PAS-negative cells was observed in the AIJ and IST in the P4 treated group. The epithelium height in the AMP and AIJ was increased in the eCG/hCG group when compared to the control and P4 groups. In this last group, we observed a reduced height compared with the other two groups for the AIJ. In the IST, there were no significant changes in the epithelium height of the control or the other two groups (eCG/hCG and P4). The epithelial cells of the P4 treated group had the least amount of cytoplasmic granules and the lowest intensity of PAS staining in the AMP, AIJ and IST. Animals treated with eCG/hCG showed an intermediate number of cytoplasmic granules and intensity in all regions evaluated. These data show that P4 treatment for synchronization induces a significant (P < 0.001) decrease of PAS-positive cells and staining intensity of cytoplasmic granules in the different regions studied and an increased number of PAS-negative cells in the AIJ and IST epithelium. Moreover, eCG/hCG treatment increased the height of the epithelium in the AMP and AIJ, while in this last

  9. Empires of the Mind

    ERIC Educational Resources Information Center

    Jackson, Shirley Ann

    2007-01-01

    In this article, the author discusses the challenge of educating students for service and leadership in this flat and integrated world, yet asymmetrical and unstable. She says that the future is now and educators have the opportunity and responsibility to create the environments that foster the empires of the mind, and to ensure that the future…

  10. Empirical Research without Certainty

    ERIC Educational Resources Information Center

    Floden, Robert E.

    2009-01-01

    In this essay, Robert Floden reviews three recent volumes in the Philosophy, Theory, and Educational Research series that address the philosophical implications of three "isms"-- postpositivism, pragmatism, and poststructuralism--for empirical educational research. These volumes, written by D.C. Phillips, Gert J.J. Biesta, and Michael A. Peters,…

  11. Empirical quantum mechanics

    NASA Astrophysics Data System (ADS)

    Nishimura, Hirokazu

    1996-06-01

    Machida and Namiki developed a many-Hilbert-spaces formalism for dealing with the interaction between a quantum object and a measuring apparatus. Their mathematically rugged formalism was polished first by Araki from an operator-algebraic standpoint and then by Ozawa for Boolean quantum mechanics, which approaches a quantum system with a compatible family of continuous superselection rules from a notable and perspicacious viewpoint. On the other hand, Foulis and Randall set up a formal theory for the empirical foundation of all sciences, at the hub of which lies the notion of a manual of operations. They deem an operation as the set of possible outcomes and put down a manual of operations at a family of partially overlapping operations. Their notion of a manual of operations was incorporated into a category-theoretic standpoint into that of a manual of Boolean locales by Nishimura, who looked upon an operation as the complete Boolean algebra of observable events. Considering a family of Hilbert spaces not over a single Boolean locale but over a manual of Boolean locales as a whole, Ozawa's Boolean quantum mechanics is elevated into empirical quantum mechanics, which is, roughly speaking, the study of quantum systems with incompatible families of continuous superselection rules. To this end, we are obliged to develop empirical Hilbert space theory. In particular, empirical versions of the square root lemma for bounded positive operators, the spectral theorem for (possibly unbounded) self-adjoint operators, and Stone's theorem for one-parameter unitary groups are established.

  12. Auditory Imagery: Empirical Findings

    ERIC Educational Resources Information Center

    Hubbard, Timothy L.

    2010-01-01

    The empirical literature on auditory imagery is reviewed. Data on (a) imagery for auditory features (pitch, timbre, loudness), (b) imagery for complex nonverbal auditory stimuli (musical contour, melody, harmony, tempo, notational audiation, environmental sounds), (c) imagery for verbal stimuli (speech, text, in dreams, interior monologue), (d)…

  13. Deterioration of Intellect among Children Surviving Leukemia: IQ Test Changes Modify Estimates of Treatment Toxicity.

    ERIC Educational Resources Information Center

    Mulhern, Raymond, K; And Others

    1992-01-01

    Assessed association of young age at treatment, cranial irradiation, and time since treatment with intellectual deterioration among 49 long-term survivors of childhood leukemia. Found no significant effects of treatment group (low-dose cranial irradiation versus high-dose chemotherapy) or age at treatment. Small but statistically significant…

  14. Changes in urinary excretion of water and sodium transporters during amiloride and bendroflumethiazide treatment

    PubMed Central

    Jensen, Janni M; Mose, Frank H; Kulik, Anna-Ewa O; Bech, Jesper N; Fenton, Robert A; Pedersen, Erling B

    2015-01-01

    AIM: To quantify changes in urinary excretion of aquaporin2 water channels (u-AQP2), the sodium-potassium-chloride co-transporter (u-NKCC2) and the epithelial sodium channels (u-ENaC) during treatment with bendroflumethiazide (BFTZ), amiloride and placebo. METHODS: In a randomized, double-blinded, placebo-controlled, 3-way crossover study we examined 23 healthy subjects on a standardized diet and fluid intake. The subjects were treated with amiloride 5 mg, BFTZ 1.25 mg or placebo twice a day for 4.5 d before each examination day. On the examination day, glomerular filtration rate was measured by the constant infusion clearance technique with 51Cr-EDTA as reference substance. To estimate the changes in water transport via AQP2 and sodium transport via NKCC2 and ENaC, u-NKCC2, the gamma fraction of ENaC (u-ENaCγ), and u-AQP2 were measured at baseline and after infusion with 3% hypertonic saline. U-NKCC2, u-ENaCγ, u-AQP2 and plasma concentrations of vasopressin (p-AVP), renin (PRC), angiotensin II (p-ANG II) and aldosterone (p-Aldo) were measured, by radioimmunoassay. Central blood pressure was estimated by applanation tonometry and body fluid volumes were estimated by bio-impedance spectroscopy. General linear model with repeated measures or related samples Friedman’s two-way analysis was used to compare differences. Post hoc Bonferroni correction was used for multiple comparisons of post infusion periods to baseline within each treatment group. RESULTS: At baseline there were no differences in u-NKCC2, u-ENaCγ and u-AQP2. PRC, p-Ang II and p-Aldo were increased during active treatments (P < 0.001). After hypertonic saline, u-NKCC2 increased during amiloride (6% ± 34%; P = 0.081) and increased significantly during placebo (17% ± 24%; P = 0.010). U-AQP2 increased significantly during amiloride (31% ± 22%; P < 0.001) and placebo (34% ± 27%; P < 0.001), while u-NKCC2 and u-AQP2 did not change significantly during BFTZ (-7% ± 28%; P = 0.257 and 5% ± 16%; P = 0

  15. A Review of Empirically Supported Marital Enrichment Programs

    ERIC Educational Resources Information Center

    Jakubowski, Scott F.; Milne, Eric P.; Brunner, Heidi; Miller, Richard B.

    2004-01-01

    Considering the popularity of marriage enrichment programs, it is important for clinicians and marriage educators to know which programs have received empirical support. Using criteria established for determining empirically supported treatments (ESTs), we provide a comprehensive review of the outcome research on 13 specific marital enrichment…

  16. Diel changes in water chemistry in an arsenic-rich stream and treatment-pond system

    USGS Publications Warehouse

    Gammons, C.H.; Grant, T.M.; Nimick, D.A.; Parker, S.R.; DeGrandpre, M.D.

    2007-01-01

    Arsenic concentrations are elevated in surface waters of the Warm Springs Ponds Operable Unit (WSPOU), located at the head of the upper Clark Fork River Superfund site, Montana, USA. Arsenic is derived from historical deposition of smelter emissions (Mill and Willow Creeks) and historical mining and milling wastes (Silver Bow Creek). Although long-term monitoring has characterized the general seasonal and flow-related trends in As concentrations in these streams and the pond system used to treat Silver Bow Creek water, little is known about solubility controls and sorption processes that influence diel cycles in As concentrations. Diel (24-h) sampling was conducted in July 2004 and August 2005 at the outlet of the treatment ponds, at two locations along a nearby reconstructed stream channel that diverts tributary water around the ponds, and at Silver Bow Creek 2??km below the ponds. Dissolved As concentration increased up to 51% during the day at most of the stream sites, whereas little or no diel change was displayed at the treatment-pond outlet. The strong cycle in streams is explained by pH- and temperature-dependent sorption of As onto hydrous metal oxides or biofilms on the streambed. Concentrations of dissolved Ca2+ and HCO3- at the stream sites showed a diel temporal pattern opposite to that of As, and geochemical modeling supports the hypothesis that the concentrations of Ca2+ and HCO3- were controlled by precipitation of calcite during the warm afternoon hours when pH rose above 9.0. Nightly increases in dissolved Mn and Fe(II) concentrations were out of phase with concentrations of other divalent cations and are more likely explained by redox phenomena. ?? 2007 Elsevier B.V. All rights reserved.

  17. Global changes in STAT target selection and transcription regulation upon interferon treatments

    PubMed Central

    Hartman, Stephen E.; Bertone, Paul; Nath, Anjali K.; Royce, Thomas E.; Gerstein, Mark; Weissman, Sherman; Snyder, Michael

    2005-01-01

    The STAT (signal transducer and activator of transcription) proteins play a crucial role in the regulation of gene expression, but their targets and the manner in which they select them remain largely unknown. Using chromatin immunoprecipitation and DNA microarray analysis (ChIP-chip), we have identified the regions of human chromosome 22 bound by STAT1 and STAT2 in interferon-treated cells. Analysis of the genomic loci proximal to these binding sites introduced new candidate STAT1 and STAT2 target genes, several of which are affiliated with proliferation and apoptosis. The genes on chromosome 22 that exhibited interferon-induced up- or down-regulated expression were determined and correlated with the STAT-binding site information, revealing the potential regulatory effects of STAT1 and STAT2 on their target genes. Importantly, the comparison of STAT1-binding sites upon interferon (IFN)-γ and IFN-α treatments revealed dramatic changes in binding locations between the two treatments. The IFN-α induction revealed nonconserved STAT1 occupancy at IFN-γ-induced sites, as well as novel sites of STAT1 binding not evident in IFN-γ-treated cells. Many of these correlated with binding by STAT2, but others were STAT2 independent, suggesting that multiple mechanisms direct STAT1 binding to its targets under different activation conditions. Overall, our results reveal a wealth of new information regarding IFN/STAT-binding targets and also fundamental insights into mechanisms of regulation of gene expression in different cell states. PMID:16319195

  18. Changes in B and T lymphocytes and chemokines with rituximab treatment in multiple sclerosis

    PubMed Central

    Piccio, Laura; Naismith, Robert T.; Trinkaus, Kathryn; Klein, Robyn S.; Parks, Becky J.; Lyons, Jeri A.; Cross, Anne H.

    2010-01-01

    Background B cells are implicated in the pathogenesis of multiple sclerosis (MS). A beneficial effect of B cell depletion using rituximab has been shown, but the complete mechanism of action for this drug is unclear. Objective To determine the relationship between T cells, B cells, and changes in CSF chemokines with rituximab, a monoclonal antibody that targets CD20. Design Phase II trial of rituximab as an add-on therapy. Setting The John L. Multiple Sclerosis Center, Washington University, St. Louis, Missouri. Patients Thirty relapsing-remitting MS subjects with clinical and MRI activity despite treatment with an immunomodulatory drug received four weekly doses of 375mg/m2 rituximab. Main Outcome Measures Lumbar puncture was performed before and after rituximab infusions in 26 subjects. CSF B and T lymphocytes were enumerated by flow cytometry, and chemoattractants were measured by ELISA. Results After rituximab administration, CSF B cells were decreased or undetectable in all subjects and CSF T cells were reduced in 81% of subjects. The mean reduction in CSF cellularity was 95% for B cells and 50% for T cells. After rituximab infusion, CSF CXCL13 and CCL19 decreased (P= 0.002, P=0.03, respectively). The proportional decline in CSF T cells correlated with the proportional decrease in CXCL13 (r=0.45;P=0.03), suggesting a possible relationship. CSF IgG index, IgG concentration, and oligoclonal band number were unchanged following treatment. Conclusions B cells are critical for T cell trafficking into the CNS in MS patients, and may alter T cell trafficking by influencing chemokine production within the CNS. PMID:20558389

  19. Evaluation of dental arch width and form changes after orthodontic treatment and retention with a new computerized method.

    PubMed

    Taner, Tülin Ugur; Ciger, Semra; El, Hakan; Germeç, Derya; Es, Alphan

    2004-10-01

    The purpose of this study was to evaluate longitudinal arch width and form changes and to define arch form types with a new computerized method. Maxillary and mandibular models of 21 Class II Division 1 patients were examined before treatment (T(0)), after treatment (T(1)), and an average of 3 years after retention (T(2)). Arch width measurements were made directly on scanned images of maxillary and mandibular models. Arch form changes at T(0)-T(1) and T(1)-T(2) were evaluated by superimposing the computer-generated Bezier arch curves with a computer program. Types of dental arch forms were defined by superimposing them with the pentamorphic arch system, which included 5 different types of arch forms: normal, ovoid, tapered, narrow ovoid, and narrow tapered. Maxillary arch widths were increased during orthodontic treatment. Mandibular posterior arch widths were also increased. The expansion of the mandibular arch forms was less than in the maxillary arch forms. Arch width changes were generally stable, except for reduction in maxillary and mandibular interlateral, inter-first premolar, and mandibular intercanine widths. Pretreatment maxillary arch forms were mostly tapered; mandibular arch forms were tapered and narrow tapered. In maxillary arch forms, 76% of the treatment changes were maintained. Mandibular arch form was maintained in 67% of the sample, both during treatment and after retention. In mandibular arches, 71% of orthodontically induced arch form changes were maintained. PMID:15470349

  20. Using Enhanced and Integrated Services to Improve Response to Standard Methadone Treatment: Changing the Clinical Infrastructure of Treatment Networks

    PubMed Central

    Neufeld, Karin; Kidorf, Michael; King, Van; Stoller, Ken; Clark, Michael; Peirce, Jessica; Brooner, Robert K.

    2009-01-01

    Outcomes are presented from opioid-dependent outpatients (N = 81) participating in a new community-based initiative designed to improve access to enhanced substance abuse and psychiatric services in the publicly-supported methadone maintenance treatment network in Baltimore, Maryland. The initiative, entitled Community Access to Specialized Treatment (CAST), is located at the Addiction Treatment Services (ATS), a program within this network. Network programs referred patients engaged in unremitting drug use and at risk for discharge to CAST, where they received methadone substitution, individual and group counseling within an adaptive platform, behavioral contingencies to reinforce adherence, and on-site psychiatric evaluation and care. Patients returned to their referring program after producing at least two consecutive weeks of drug-negative urine samples and full counseling adherence. CAST was well-utilized by the community. Patients had high rates of adherence to scheduled individual and group counseling services (93% and 73%, respectively); 43% of referrals successfully completed the program in an average of 101 days. This community-wide service delivery approach is a novel alternative to integrating intensive substance abuse and psychiatric care at each program within a treatment network. PMID:19717272

  1. Change of Mandibular Position during Two-Phase Orthodontic Treatment of Skeletal Class II in the Chinese Population

    PubMed Central

    Hägg, Urban; Wong, Ricky Wing Kit; Liao, Chongshan; Yang, Yanqi

    2015-01-01

    The aim of this study was to evaluate the change in mandibular position during a two-phase orthodontic treatment of skeletal Class II malocclusion. Thirty consecutively treated Chinese male adolescents who had undergone two-phase treatment with Herbst appliance and fixed appliance and fulfilled the specific selection criteria were sampled. Cephalograms taken at T0 (before treatment), T1 (at the end of functional appliance treatment), and T2 (at the end of fixed appliance treatment) were analyzed. The change in sagittal positioning of the mandible was 6.8±3.44 mm in phase I (T0-T1), 0.4±2.79 mm in phase II (T1-T2), and 7.2±4.61 mm in total. The mandible came forward in 100% of the patients at T1. In phase II, it came forward in one-third (positive group) remained unchanged in one-third (stable group) and went backward in one-third (negative group) of the patients. At T2, it came forward twice as much in the positive group compared to the negative group. Mandibular length was significantly increased in 100% of the patients in both phases. In conclusion, during the treatment with functional appliance, the mandibular prognathism increases in all patients, whereas during the treatment with fixed appliance there is no significant change in mandibular prognathism. PMID:25695103

  2. Changes in skin barrier during treatment with systemic alitretinoin: focus on skin susceptibility and stratum corneum ceramides.

    PubMed

    Jungersted, Jakob Mutanu; Høgh, Julie K; Hellgren, Lars I; Jemec, Gregor B E; Agner, Tove

    2010-11-01

    Alitretinoin is a new drug for systemic treatment of chronic hand eczema. Previous functional tests of skin topically treated with retinoids have indicated impaired skin barrier function, but no data are available on barrier parameters after systemic alitretinoin treatment. To investigate the effect of systemic alitretinoin on skin barrier function and response to irritants, a secondary objective was to determine if changes occur in the lipid profile of stratum corneum after treatment with systemic alitretinoin. We conducted an open clinical intervention study on eight people ascribed to systemic alitretinoin treatment. The criteria for being ascribed to alitretinoin were chronic hand eczema and insufficient therapeutic response to potent topical corticosteroids. Before initiation and after 2 months of systemic treatment with 30 mg alitretinoin, a challenge with sodium lauryl sulphate (SLS) was performed on the volar forearm and evaluated by trans-epidermal water loss (TEWL), erythema, and a cyanoacrylate skin sample was obtained for lipid analysis. We found no significant changes in response to SLS irritation as evaluated by TEWL and erythema, after treatment with alitretinoin for 2 months. No significant changes in stratum corneum lipids were found after 2 months of treatment. In conclusion, systemic alitretinoin does not influence skin susceptibility to irritants or the ceramide profile of stratum corneum. PMID:20535487

  3. Changes in perception of treatment efficacy are associated to the magnitude of the nocebo effect and to personality traits.

    PubMed

    Corsi, Nicole; Emadi Andani, Mehran; Tinazzi, Michele; Fiorio, Mirta

    2016-01-01

    The nocebo effect in motor performance consists in a reduction of force and increase of fatigue following the application of an inert treatment that the recipient believes to be effective. This effect is variable across individuals and it is usually stronger if conditioning -exposure to the active effect of the treatment- precedes a test session, in which the treatment is inert. In the current explorative study we used a conditioning procedure to investigate whether subjective perception of treatment effectiveness changes between the conditioning and the test session and whether this change is related to dispositional traits and to the nocebo-induced reduction of force. Results showed that 56.1% of participants perceived the treatment as more effective in the test than in the conditioning session, had a more pronounced reduction of force, felt more effort and sense of weakness and were characterized by lower levels of optimism and higher anxiety traits compared to the other 43.9% of participants, who conversely perceived the treatment as less effective in the test session than in the conditioning. These findings highlight for the first time a link between changes in perception of treatment effectiveness, personality traits and the magnitude of the nocebo response in motor performance. PMID:27470917

  4. Antiepileptic drug treatment in pregnancy: changes in drug disposition and their clinical implications.

    PubMed

    Tomson, Torbjörn; Landmark, Cecilie Johannessen; Battino, Dina

    2013-03-01

    Pregnancy is a state where pharmacokinetic changes are more pronounced and more rapid than during any other period of life. The consequences of such changes can be far reaching, not least in the management of epilepsy where the risks with uncontrolled seizures during pregnancy need to be balanced against potential teratogenic effects of antiepileptic drugs (AEDs). This article aims to review the literature on gestational effects on the pharmacokinetics of older and newer generation AEDs and discuss the implications for the treatment of epilepsy in women during pregnancy. Pregnancy can affect the pharmacokinetics of AEDs at any level from absorption, distribution, metabolism, to elimination. The effect varies depending on the type of AED. The most pronounced decline in serum concentrations is seen for AEDs that are eliminated by glucuronidation (UGT), in particular lamotrigine where the effect may be profound. Serum concentrations of AEDs that are cleared mainly through the kidneys, for example, levetiracetam, can also decline significantly. Some AEDs, such as carbamazepine seem to be affected only marginally by pregnancy. Data on pharmacokinetics during pregnancy are lacking completely for some of the newer generation AEDs: pregabalin, lacosamide, retigabine, and eslicarbazepine acetate. Where data are available, the effects of pregnancy on serum concentrations seem to vary considerably individually and are thus difficult to predict. Although large-scale systematic studies of the clinical relevance of the pharmacokinetic alterations are lacking, prospective and retrospective case series have reported an association between declining serum concentrations and deterioration in seizures control. The usefulness of routine monitoring of AED serum concentrations in pregnancy and of dose adjustments based on falling levels, are discussed in this review. We suggest that monitoring could be important, in particular when women have been titrated to the lowest effective AED

  5. Change in Brain Magnetic Resonance Spectroscopy after Treatment during Acute HIV Infection

    PubMed Central

    Sailasuta, Napapon; Ross, William; Ananworanich, Jintanat; Chalermchai, Thep; DeGruttola, Victor; Lerdlum, Sukalaya; Pothisri, Mantana; Busovaca, Edgar; Ratto-Kim, Silvia; Jagodzinski, Linda; Spudich, Serena; Michael, Nelson; Kim, Jerome H.; Valcour, Victor

    2012-01-01

    Objective Single voxel proton magnetic resonance spectroscopy (MRS) can be used to monitor changes in brain inflammation and neuronal integrity associated with HIV infection and its treatments. We used MRS to measure brain changes during the first weeks following HIV infection and in response to antiretroviral therapy (ART). Methods Brain metabolite levels of N-acetyl aspartate (NAA), choline (tCHO), creatine (CR), myoinositol (MI), and glutamate and glutamine (GLX) were measured in acute HIV subjects (n = 31) and compared to chronic HIV+individuals (n = 26) and HIV negative control subjects (n = 10) from Bangkok, Thailand. Metabolites were measured in frontal gray matter (FGM), frontal white matter (FWM), occipital gray matter (OGM), and basal ganglia (BG). Repeat measures were obtained in 17 acute subjects 1, 3 and 6 months following initiation of ART. Results After adjustment for age we identified elevated BG tCHO/CR in acute HIV cases at baseline (median 14 days after HIV infection) compared to control (p = 0.0014), as well as chronic subjects (p = 0.0023). A similar tCHO/CR elevation was noted in OGM; no other metabolite abnormalities were seen between acute and control subjects. Mixed longitudinal models revealed resolution of BG tCHO/CR elevation after ART (p = 0.022) with tCHO/CR similar to control subjects at 6 months. Interpretation We detected cellular inflammation in the absence of measurable neuronal injury within the first month of HIV infection, and normalization of this inflammation following acutely administered ART. Our findings suggest that early ART may be neuroprotective in HIV infection by mitigating processes leading to CNS injury. PMID:23229129

  6. Spontaneous Weight Change during Chronic Hepatitis C Treatment: Association with Virologic Response Rates

    PubMed Central

    Alwakeel, Hany R.; Zaghla, Hasan E.; Omar, Nabeel A.; Alashinnawy, Hasan A.; Rewisha, Eman A.; Matarese, Laura E.; Taha, Azza A.; Kandil, Hossam M.

    2013-01-01

    Objective: We examined weight changes during chronic hepatitis C (CHC) therapy and association with virologic response. Methods: Weight changes were compared between subjects achieving rapid, early, and sustained virologic response rates (RVR, EVR, and SVR). RVR, EVR and SVR were compared among patients with or without weight loss of ≥ 0.5 body mass index (BMI) units (kg/m2) at 4, 12, 48 weeks. Results: CHC therapy was initiated in 184 cases. Median pretreatment BMI was 27.7 (18.4-51.3) with 38% overweight and 31% obese (BMI ≥25 and ≥ 30, respectively). Among patients with liver biopsies (n = 90), steatosis was present in 31.6%; fibrosis grade of 1-2/6 in 46%, 3-4 in 37.3% and 5-6 in 14.7%. Mean weight loss at 4, 12, 24 and 48 weeks of therapy were 1.2, 2.6, 3.8 and 3.3 kg, respectively. After 4 and 12 weeks of treatment, 38% and 54.3% had a BMI decrement of ≥ 0.5 kg/m2. For genotype 1, weight loss at 4 weeks was associated with significantly higher EVR (90.0% vs. 70%, p = 0.01) and a tendency towards better RVR and SVR (42.9% vs. 26.0% and 55.2% vs. 34.8%, respectively, p = 0.08). In multivariate analysis, weight loss at 4 weeks was independently associated with EVR (OR 6.3, p = 0.02) but was not significantly associated with RVR or SVR Conclusions: Spontaneous weight loss at 4 and 12 weeks of CHC therapy was associated with improved EVR. Weight loss at 4 weeks was an independent predictor of EVR but not SVR. PMID:24324359

  7. Pulmonary Changes After Radiotherapy for Conservative Treatment of Breast Cancer: A Prospective Study

    SciTech Connect

    Krengli, Marco Sacco, Mariano; Loi, Gianfranco; Masini, Laura; Ferrante, Daniela; Gambaro, Giuseppina; Ronco, Marco; Magnani, Corrado; Carriero, Alessandro

    2008-04-01

    Purpose: Radiotherapy (RT) after conservative surgery for breast cancer involves part of the pulmonary parenchyma with a potential detrimental effect of reducing the normal functional reserve. Such an effect deserves to be studied in depth, considering the given long life expectancy of these women. We prospectively analyzed high-resolution computed tomography (HRCT) and pulmonary function tests (PFTs) with correlation with dosimetric data from RT. Methods and Materials: Lung HRCT and PFTs were performed in 41 women who had undergone conservative surgery for breast cancer before and 3 and 9 months after postoperative RT. The PFTs included forced vital capacity, forced expiratory volume in 1 s, total lung capacity, maximal expiratory flow at 50% and 25% of vital capacity, and the diffusion capacity of carbon monoxide. HRCT was matched with the RT treatment plan images to analyze the dosimetric correlation. Results: At 3 months after RT, the lung alterations were classified at HRCT as follows: 46.3% were Grade 1, 24.4% Grade 2, and 7.3% Grade 3, and at 9 months, 58.5% were Grade 1, 19.5% Grade 2, and 0% Grade 3. The PFTs showed a significant decrease at 3 months, with only partial recovery at 9 months. Chemotherapy, but not hormonal therapy, was associated with PFT changes. The grade of fibrosis increased with increasing lung volume treated to a dose {>=}25 Gy. Conclusion: Lung changes, mainly related to damage to the alveolar-capillary barrier and smallest airway ramifications, were observed at 3 months, with only partial recovery at 9 months after RT. Minimizing the lung volume receiving {>=}25 Gy could reduce pulmonary toxicity.

  8. Lifestyle changes as a treatment of gastroesophageal reflux disease: a survey of general practitioners in North Queensland, Australia

    PubMed Central

    Nowak, Madeleine; Büttner, Petra; Raasch, Beverly; Daniell, Kym; McCutchan, Cindy; Harrison, Simone

    2005-01-01

    Background Gastroesophageal reflux disease (GERD) is a common disorder in developed countries, with the usual treatment being medication. Previously, lifestyle modification was the only treatment for GERD; however, its effectiveness has not been assessed. Methods All practicing general practitioner (GP) members of two Divisions of General Practice (n = 193) in North Queensland, Australia, were surveyed in 2001 using a postal questionnaire to determine their views and practices relating to such treatment among adults with GERD. Results The response rate was 70.5%. Of those who responded, 17.6% recommended diet and postural advice as a first line of treatment, with postural advice (89.7%), avoid known precipitants (86.0%), reduce weight if overweight (79.4%), eat a low fat diet (45.6%), and stop smoking (17.6%) being the most common recommendations. Of the nine possible changes, the median number recommended was 3, interquartile range (IQR; 3, 4). Eighty-nine percent of GPs thought ≥ 10% of patients with GERD would benefit from lifestyle changes, but almost half thought ≤ 10% of patients would be prepared to change. Conclusion Most GPs thought lifestyle changes would be beneficial when treating GERD, but did not believe their patients would change. Most GPs recommended fewer than half the lifestyle changes their peers believed effective in treating GERD. PMID:18360562

  9. Changing Patterns of Primary Treatment in Korean Men with Prostate Cancer Over 10 Years: A Nationwide Population Based Study

    PubMed Central

    Park, Jinsung; Suh, Beomseok; Shin, Dong Wook; Hong, Jun Hyuk; Ahn, Hanjong

    2016-01-01

    Purpose We investigated changing patterns of primary treatment in Korean men with prostate cancer (PC) and impact of sociodemographic factors on treatment choice from a nationwide cohort over 10 years. Materials and Methods We conducted a cohort study of a 2% nationwide random sample of Korean National Health Insurance. A total of 1,382 patients who had undergone active treatments for newly diagnosed PC between 2003 and 2013 were included. Time trends in primary treatment of PC, including radical surgery, radiation therapy (RT), and androgen deprivation therapy (ADT) were analyzed. Results Total number of patients undergoing active treatments increased significantly (162%). Surgery cases showed the most significant increase, from 22.4% in 2003 to 45.4% in 2013, while the relative proportion of ADT showed a tendency to decrease from 60.3% in 2003 to 45.4% in 2013, and the relative proportion of RT was variable over 10 years (from 7.2% to 18.4%). While treatment patterns differed significantly according to age (p < 0.001) and income classes (p=0.014), there were differences in primary treatment according to residential area. In multinomial logistic regression analysis, older patients showed significant association with ADT or RT compared to surgery, while patients with higher income showed significant association with surgery. Conclusion Treatment pattern in Korean PC patients has changed remarkably over the last 10 years. Sociodemographic factors do affect the primary treatment choice. Our results will be valuable in overviewing changing patterns of primary treatment in Korean PC patients and planning future health policy for PC. PMID:26511804

  10. Psychological Mechanisms of Effective Cognitive–Behavioral Treatments for PTSD

    PubMed Central

    2015-01-01

    Several psychotherapies have been established as effective treatments for posttraumatic stress disorder (PTSD) including prolonged exposure, cognitive processing therapy, and cognitive therapy for PTSD. Understanding the key mechanisms of these treatments, i.e., how these treatments lead to therapeutic benefits, will enable us to maximize the efficacy, effectiveness, and efficiency of these therapies. This article provides an overview of the theorized mechanisms for each of these treatments, reviews the recent empirical evidence on psychological mechanisms of these treatments, discusses the ongoing debates in the field, and provides recommendations for future research. Few studies to date have examined whether changes in purported treatment mechanisms predict subsequent changes in treatment outcomes. Future clinical trials examining treatments for PTSD should use study designs that enable researchers to establish the temporal precedence of change in treatment mechanisms prior to symptom reduction. Moreover, further research is needed that explores the links between specific treatment components, underlying change mechanisms, and treatment outcomes. PMID:25749748

  11. Effect of pre-storage heat treatment on enzymological changes in peach.

    PubMed

    Bakshi, Parshant; Masoodi, F A

    2010-08-01

    Peach (Prunus persica (L.) Batsch) fruit was subjected to hot water and moist hot air treatment at varying temperatures. The activities of polyphenoloxidase (PPO) and polygalacturonase (PG) were monitored during storage for 0, 3 and 6 days. PPO activity decreased in all treatments during storage. This decrease was more in hot water treated fruits than in hot air. PPO activity decreased with the increase in treatment duration. However, the PG activity increased in heat treated fruits as well as control. This increase was more in mild heat treatments as compared to severe heat treatment. Both polyphenol and pectin contents decreased during storage in both heat treatments. PMID:23572672

  12. Proteome Changes in Maize Embryo (Zea mays L) Induced by Ion Beam Implantation Treatment

    NASA Astrophysics Data System (ADS)

    Li, Yongliang; Tang, Jihua; Qin, Guangyong; Huo, Yuping; Tian, Shuangqi

    2009-08-01

    Low energy ion beam implantation was applied to the maize (Zea mays L) embryo proteome using two-dimensional gel electrophoresis. Protein profile analysis detected more than 1100 protein spots, 72 of which were determined to be expressed differently in the treated and control (not exposed to ion beam implantation) embryos. Of the 72 protein spots, 53 were up-regulated in the control and 19 were more abundantly expressed in the ion beam-treated embryos. The spots of up- or down-regulated proteins were identified by matrix assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS). Among the identified proteins, 11 were up-regulated in the treated embryos. Four of these up-regulated proteins were antioxidant molecules, three were related to stress response, two to sugar metabolism and two were associated with heat shock response. Of the five proteins up-regulated in the control embryos, three were functionally related to carbohydrate metabolism; the functions of the remaining two proteins were unknown. The data collected during this study indicate that treatment of maize embryos with low energy ion beam implantation induces changes in stress tolerance enzymes/proteins, possibly as a result of alterations in metabolism.

  13. Sleep In Older Adults: Normative Changes, Sleep Disorders, and Treatment Options

    PubMed Central

    Gooneratne, Nalaka S.; Vitiello, Michael V.

    2014-01-01

    1 Synopsis Sleep disorders are common in older adults: Approximately 5% of older adults meet criteria for clinically significant insomnia disorders and 20% for sleep apnea syndromes. When considering insomnia symptoms, it is important to distinguish age-appropriate changes in sleep from clinically significant insomnia, with the latter distinguished by the presence of significant daytime symptoms such as fatigue. Evaluation with a sleep diary and screening for comorbid conditions, especially mood disorders, is essential. Non-pharmacologic therapies, such as cognitive-behavioral therapy for insomnia, can be highly effective and have sustained benefit. A broad range of pharmacologic therapies are also available but can have unwanted psychomotor effects. If left untreated, insomnia can be associated with increased risk of depression and significant impairments in quality of life. In regards to sleep apnea, a high index of suspicion is crucial for effective diagnosis because symptoms commonly noted in younger patients, such as obesity or loud snoring, may not be present in older patients. Diagnosis and management is fairly similar across age groups, except that a more nuanced approach to weight loss is warranted in older adults. The increasing use of home-based portable polysomnography and auto-titrating positive-airway pressure therapy can reduce barriers to treatment. PMID:25037297

  14. Changes in DNA methyltransferase induced by treatment with N-2-acetylaminofluorene.

    PubMed

    Bravo, L M; Salas, C E

    1989-11-01

    We have compared the levels of DNA methyltransferases from rat liver and spleen in both sexes following a single injection of N-2-acetylaminofluorene (AAF). Enzyme extracts from treated animals were obtained at different intervals (2-34 days) after treatment. The extracts were assayed in the presence of chicken erythrocyte DNA and S-adenosyl-L-[Me-3H]methionine. A 55% increase in male rat-liver methyltransferase activity measured by Me-3H incorporation into DNA occurred on day 14. By contrast, female methyltransferase after a similar period revealed a 33% decrease in activity. Between days 21 and 34, there is a progressive return to normal methyltransferase levels. Spleen-derived enzyme studied between days 7 and 14, showed a decrease in methylating activity in both sexes. After replacing corn seed oil by ethanol as the vehicle for AAF injection, we observed a change in liver methyltransferase 48 h after injection. Quantification of radioactive eluates in m5C fractions together with the increase in the integrated area identified as m5C in HPLC chromatograms allowed positive identification of methylated products. PMID:2811914

  15. Impact of changing pathogens and antimicrobial susceptibility patterns in the treatment of serious infections in hospitalized patients.

    PubMed

    Jones, R N

    1996-06-24

    The selection of drug-resistant pathogens in hospitalized patients with serious infections such as pneumonia, urinary tract infections (UTI), skin and skin-structure infections, and primary or secondary bacteremia has generally been ascribed to the widespread use of antimicrobial agents. Issues of concern regarding gram-negative bacilli include the expression of extended spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumonias and constitutive resistance in some Enterobacteriaceae caused by Bush group 1 beta-lactamases. Current concerns with gram-positive pathogens are increasing multidrug resistance in methicillin-resistant Staphylococcus aureus, enterococci, and coagulase-negative staphylococci, and increasing incidence of penicillin-resistant Streptococcus pneumoniae. Contemporary treatment strategies for pneumonia in hospitalized patients mandate early empiric therapy for the most likely gram-positive and gram-negative pathogens. Newer beta-lactams, such as fourth-generation cephalosporins, may be useful in the treatment of pneumonia, including those cases associated with bacteremia. Combination beta-lactam/beta-lactamase inhibitor drugs, an aminoglycoside co-drug, or a carbapenem may also be indicated. The initial treatment of UTI in the hospital setting also may be empirically treated with the newer cephalosporins, combination broad-spectrum penicillins plus an aminoglycoside, a quinolone, or a carbapenem. Current problems in treating UTI include the emergence of extended spectrum beta-lactamase-producing Escherichia coli, the tendency of fluoroquinolones both to select for resistant strains of major UTI pathogens and to induce cross-resistance among different drug classes, and beta-lactam and vancomycin resistance of enterococci and coagulase-negative staphylococci. Treatment of skin and skin-structure infections is complicated by the coexistence of gram-positive and gram-negative infections, which may be drug resistant. Both fourth

  16. Multidisciplinary Cancer Conferences for Gastrointestinal Malignancies Result in Measureable Treatment Changes: A Prospective Study of 149 Consecutive Patients

    PubMed Central

    Oxenberg, Jacqueline; Papenfuss, Wesley; Esemuede, Iyare; Attwood, Kristopher; Simunovic, Marko; Kuvshinoff, Boris; Francescutti, Valerie

    2016-01-01

    Background In most jurisdictions, a minority of patients are discussed at multidisciplinary cancer conference (MCC) despite recommendations for such reviews. We assessed the impact of MCC review of gastrointestinal (GI) cancers at a stand-alone cancer center. Methods Patient data were prospectively collected on consecutive cases presented at a GI MCC during a 6-month period. Original treatment plans were collected confidentially before presentation and compared to post-MCC treatment plans. We defined changes in management plans as major (change in treatment modality) or minor (testing prior to original plan). Results A total of 149 cases were evaluated: 115 upper GI (gastric/small bowel—10 %, liver—32 %, pancreaticobiliary— 36 %), and 34 lower GI (23 %). Reasons for presentation were: questions regarding progression/metastases (44 %), management (26 %), diagnosis (21 %), pathology (15 %), and resectability (7 %). Physicians were certain of their original plans being the final recommendations in 84 % (n = 125). Change in management was recommended in 36 %; 72 % were major and 28 % were minor. Patients underwent all recommended treatments at our institution in 77 % of cases, a portion in 5 %, and no recommended treatments in 18 %. On multivariate analysis, physician degree of certainty for original management plan was not predictive of a change in management plan (p = 0.61). Conclusions Although certainty of prediscussion treatment plan is high, changes in treatment recommendations occurred in more than one-third of patients after GI MCC. This prospective study demonstrates the value of MCC in GI cancer sites, even at a stand-alone cancer center. PMID:25323473

  17. Changes in the profiles of smokers seeking cessation treatment and in its effectiveness in Galicia (Spain) 2001–10

    PubMed Central

    2014-01-01

    Background In recent years, the prevalence of daily smokers has decreased in all developed countries due to a great variety of factors. Despite this decrease, the effectiveness of clinical treatments has decreased and several studies report a change in smokers’ characteristics. The purpose of the present study is to analyze the changes in the characteristics of Spanish smokers who seek smoking cessation treatment between 2001 and 2010 and the changes in the effectiveness of such treatment. Methods The sample was made up of 870 smokers who sought psychological treatment for giving up smoking at the Smoking Cessation Unit in the Faculty of Psychology of the University of Santiago de Compostela (Spain) during the period 2001 to 2010. Results Smokers in the 2006–2010 group, compared to those in the 2001–2005 group, were older, smoked fewer cigarettes per day and of a brand with fewer mg/nicotine, had been smoking longer, were less motivated to give up smoking, and had more antecedents of depression. Quit rates were validated by testing smokers' carbon monoxide (CO) levels. Percentages of abstinence were higher in the 2001–2005 group than in the 2006–2010 group (58.7% vs. 52.15 at the end of treatment, p = 0.05); 30.8% vs. 24.2% at 6 months follow-up, p = 0.031; 27.5% vs. 22% at 12 months follow-up, p = 0.059). Although abstinence decreased more than 5% in the 2006–2010 group there were no differences between the two groups in nicotine dependence. Those participants who did not assist to the follow-up were considered smokers at pretreatment level. Conclusions In Spain there has been a qualitative change in the profile of the smokers seeking smoking cessation treatment. Treatment effectiveness has decreased, and the variables predicting intervention outcome have changed. PMID:24938635

  18. Changes in metabolic profile, iron and ferritin levels during the treatment of metastatic renal cancer - A new potential biomarker?

    PubMed

    Golčić, Marin; Petković, Marija

    2016-09-01

    Metastatic renal cell carcinoma (mRCC) develops in approximately 33% of all renal cancer patients. First line treatment of mRCC includes drugs such as sunitinib, temsirolimus and pazopanib, with overall survival now reaching up to 43,6months in patients with favorable-risk metastatic disease. Several side-effects in mRCC treatment, such as hypothyroidism, can be used as positive prognostic factors and indicate good response to therapy. Hypercholesterolemia and hypertriglyceridemia independent of hypothyroidism are reported as side-effects in temsirolimus treatment and recently in sunitinib treatment, but the exact mechanism and significance of the changes remains elusive. Most likely, metabolic changes are caused by inhibition of mechanistic target of rapamycin (mTOR), a positive target of tumor growth suppression, but also a regulator of iron homeostasis. There are no clinical studies reporting changes in iron and ferritin levels during mRCC biotherapy, but we hypothesize that inhibition of mTOR will also affect iron and ferritin levels. If both lipid and iron changes correlate, there is a high possibility that both changes are primarily caused by mTOR inhibition and the level of change should correlate with the inhibition of mTOR pathway and hence the efficacy of targeted treatment. We lastly hypothesize that mRCC biotherapy causes hypercholesterolemia with a possibly improved cholesterol profile due to increase HDL/LDL ratio, so statins might not have a role as supplementary treatment, whereas a sharp rise in triglyceride levels seems to be the primary target for additional therapy. PMID:27515221

  19. Neural Rhythms of Change: Long-Term Improvement after Successful Treatment in Children with Disruptive Behavior Problems

    PubMed Central

    Woltering, Steven; Liao, Victoria; Liu, Zhong-Xu; Granic, Isabela

    2015-01-01

    Neural changes were investigated for children with disruptive behavior problems one year after a treatment program ended. Thirty-nine children and their parents visited the research lab before, after, and a year after treatment ended. During those lab visits, electroencephalography (EEG) was recorded during a challenging Go/No-go task. Treatment consisted of intensive 14-week combined cognitive behavioral therapy and parent management training sessions. For the analysis, participants were divided into long-term improvers (IMPs) and long-term nonimprovers (NIMPs) based on changes in their externalizing problem scores. The results showed early no-go theta power (4–8 Hz, 100–250 ms) decreased for long-term IMPs compared to NIMPs. When participants were divided based on changes in their comorbid internalizing symptoms, effects were stronger and reductions in theta power were found for early as well as later phases (250–650 ms). We provided preliminary evidence that theta power is a useful neural measure to trace behavioral change linked to improved self-regulation even up to a year after treatment ended. Results may have implications for the characterization of children with disruptive behavior problems and may lead to the development of novel markers of treatment success. PMID:26257962

  20. Changes in perception of treatment efficacy are associated to the magnitude of the nocebo effect and to personality traits

    PubMed Central

    Corsi, Nicole; Emadi Andani, Mehran; Tinazzi, Michele; Fiorio, Mirta

    2016-01-01

    The nocebo effect in motor performance consists in a reduction of force and increase of fatigue following the application of an inert treatment that the recipient believes to be effective. This effect is variable across individuals and it is usually stronger if conditioning –exposure to the active effect of the treatment– precedes a test session, in which the treatment is inert. In the current explorative study we used a conditioning procedure to investigate whether subjective perception of treatment effectiveness changes between the conditioning and the test session and whether this change is related to dispositional traits and to the nocebo-induced reduction of force. Results showed that 56.1% of participants perceived the treatment as more effective in the test than in the conditioning session, had a more pronounced reduction of force, felt more effort and sense of weakness and were characterized by lower levels of optimism and higher anxiety traits compared to the other 43.9% of participants, who conversely perceived the treatment as less effective in the test session than in the conditioning. These findings highlight for the first time a link between changes in perception of treatment effectiveness, personality traits and the magnitude of the nocebo response in motor performance. PMID:27470917

  1. Use of mental health telemetry to enhance identification and predictive value of early changes during augmentation treatment of major depression.

    PubMed

    Schaffer, Ayal; Kreindler, David; Reis, Catherine; Levitt, Anthony J

    2013-12-01

    Standard clinical trial methodology in depression does not allow for careful examination of early changes in symptom intensity. The purpose of this study was to use daily "Mental Health Telemetry" (MHT) to prospectively record change in depressive and anxiety symptoms for depressed patients receiving augmentation treatment, and determine the extent and predictive capacity of early changes. We report results of a 6-week, open-label study of the addition of quetiapine XR (range, 50-300 mg) for adult patients (n = 26) with major depressive disorder who were nonresponsive to antidepressant treatment. In addition to regular study visits, all participants completed daily, wirelessly transmitted self-report ratings of symptoms on a Smartphone. Daily and 3-day moving average mean scores were calculated, and associations between early symptom change and eventual response to treatment were determined. Improvement in depressive and anxiety symptoms was identified as early as day 1 of treatment. Of the total decline in depression severity over 6 weeks, 9% was present at day 1, 28% at day 2, 39% at days 3 and 4, 65% at day 7, and 80% at day 10. Self-report rating of early improvement (≥20%) in depressive symptoms at day 7 significantly predicted responder status at week 6 (P = 0.03). Clinician-rated depressive and anxiety symptoms only became significantly associated with responder status at day 14. In conclusion, very early changes in depressive symptoms were identified using MHT, early changes accounted for most of total change, and MHT-recorded improvement as early as day 7 significantly predicted response to treatment at study end point. PMID:24100787

  2. The curious conversion of Empire Blue Cross.

    PubMed

    Robinson, James C

    2003-01-01

    The for-profit conversion of Empire Blue Cross in New York challenges the case law and conventional policy wisdom that financial assets from formerly nonprofit organizations should be used to endow independent charitable foundations. The appropriation of Empire's assets by state government itself, and their subsequent deployment to subsidize health care institutions and repay political obligations, changes the conversion process from one that pits nonprofits against for-profits to one that pits private, nonprofit organizations against public-sector programs in the competition for new financial resources. PMID:12889758

  3. Treatment

    MedlinePlus

    ... Prevention Treatment 2003 U.S. Outbreak African Rodent Importation Ban For Clinicians Clinical Recognition Specimen Collection Treatment Smallpox ... Examining Animals with Suspected Monkeypox African Rodent Importation Ban Resources Related Links Poxvirus Molluscum Contagiosum Orf Virus ( ...

  4. Empirically Based Psychosocial Therapies for Schizophrenia: The Disconnection between Science and Practice

    PubMed Central

    Shean, Glenn D.

    2013-01-01

    Empirically validated psychosocial therapies for individuals diagnosed with schizophrenia were described in the report of the Schizophrenia Patient Outcomes Research Team (PORT, 2009). The PORT team identified eight psychosocial treatments: assertive community treatment, supported employment, cognitive behavioral therapy, family-based services, token economy, skills training, psychosocial interventions for alcohol and substance use disorders, and psychosocial interventions for weight management. PORT listings of empirically validated psychosocial therapies provide a useful template for the design of effective recovery-oriented mental health care systems. Unfortunately, surveys indicate that PORT listings have not been implemented in clinical settings. Obstacles to the implementation of PORT psychosocial therapy listings and suggestions for changes needed to foster implementation are discussed. Limitations of PORT therapy listings that are based on therapy outcome efficacy studies are discussed, and cross-cultural and course and outcome studies of correlates of recovery are summarized. PMID:23738068

  5. Empirically Based Psychosocial Therapies for Schizophrenia: The Disconnection between Science and Practice.

    PubMed

    Shean, Glenn D

    2013-01-01

    Empirically validated psychosocial therapies for individuals diagnosed with schizophrenia were described in the report of the Schizophrenia Patient Outcomes Research Team (PORT, 2009). The PORT team identified eight psychosocial treatments: assertive community treatment, supported employment, cognitive behavioral therapy, family-based services, token economy, skills training, psychosocial interventions for alcohol and substance use disorders, and psychosocial interventions for weight management. PORT listings of empirically validated psychosocial therapies provide a useful template for the design of effective recovery-oriented mental health care systems. Unfortunately, surveys indicate that PORT listings have not been implemented in clinical settings. Obstacles to the implementation of PORT psychosocial therapy listings and suggestions for changes needed to foster implementation are discussed. Limitations of PORT therapy listings that are based on therapy outcome efficacy studies are discussed, and cross-cultural and course and outcome studies of correlates of recovery are summarized. PMID:23738068

  6. Evaluating the dosimetric effect of treatment-induced changes in virally mediated head and neck cancer patients

    SciTech Connect

    Brown, Elizabeth; Owen, Rebecca; Mengersen, Kerrie; Harden, Fiona; Porceddu, Sandro

    2013-12-15

    Patients with virally mediated head and neck cancer (VMHNC) often present with advanced nodal disease that is highly radioresponsive as demonstrated by tumour and nodal regression during treatment. The resultant changes may impact on the planned dose distribution and so adversely affect the therapeutic ratio. The aim of this study was to evaluate the dosimetric effect of treatment-induced anatomical changes in VMHNC patients who had undergone a replan. Thirteen patients with virally mediated oropharyngeal or nasopharyngeal cancer who presented for definitive radiotherapy between 2005 and 2010 and who had a replan generated were investigated. The dosimetric effect of anatomical changes was quantified by comparing dose–volume histograms (DVH) of primary and nodal gross target volumes and organs at risk (OAR), including spinal cord and parotid glands, from the original plan and a comparison plan. Eleven three-dimensional conformal radiation therapy (3DCRT) and two intensity modulated radiation therapy (IMRT) plans were evaluated. Dose to the spinal cord and brainstem increased by 4.1% and 2.6%, respectively. Mean dose to the parotid glands also increased by 3.5%. In contrast, the dose received by 98% of the primary and nodal gross tumour volumes decreased by 0.15% and 0.3%, respectively, when comparing the initial treatment plan to the comparison plan. In this study, treatment-induced anatomical changes had the greatest impact on OAR dose with negligible effect on the dose to nodal gross tumour volumes. In the era of IMRT, accounting for treatment-induced anatomical changes is important as focus is placed on minimizing the acute and long-term side effects of treatment.

  7. Evaluating the dosimetric effect of treatment-induced changes in virally mediated head and neck cancer patients

    PubMed Central

    Brown, Elizabeth; Owen, Rebecca; Mengersen, Kerrie; Harden, Fiona; Porceddu, Sandro

    2013-01-01

    Introduction Patients with virally mediated head and neck cancer (VMHNC) often present with advanced nodal disease that is highly radioresponsive as demonstrated by tumour and nodal regression during treatment. The resultant changes may impact on the planned dose distribution and so adversely affect the therapeutic ratio. The aim of this study was to evaluate the dosimetric effect of treatment-induced anatomical changes in VMHNC patients who had undergone a replan. Methods Thirteen patients with virally mediated oropharyngeal or nasopharyngeal cancer who presented for definitive radiotherapy between 2005 and 2010 and who had a replan generated were investigated. The dosimetric effect of anatomical changes was quantified by comparing dose–volume histograms (DVH) of primary and nodal gross target volumes and organs at risk (OAR), including spinal cord and parotid glands, from the original plan and a comparison plan. Results Eleven three-dimensional conformal radiation therapy (3DCRT) and two intensity modulated radiation therapy (IMRT) plans were evaluated. Dose to the spinal cord and brainstem increased by 4.1% and 2.6%, respectively. Mean dose to the parotid glands also increased by 3.5%. In contrast, the dose received by 98% of the primary and nodal gross tumour volumes decreased by 0.15% and 0.3%, respectively, when comparing the initial treatment plan to the comparison plan. Conclusion In this study, treatment-induced anatomical changes had the greatest impact on OAR dose with negligible effect on the dose to nodal gross tumour volumes. In the era of IMRT, accounting for treatment-induced anatomical changes is important as focus is placed on minimizing the acute and long-term side effects of treatment. PMID:26229622

  8. Risk stratification based on change in plasma Epstein-Barr virus DNA load after treatment in nasopharyngeal carcinoma

    PubMed Central

    Mao, Yan-Ping; Guo, Rui; Tang, Ling-Long; Peng, Hao; Sun, Ying; Liu, Qing; Chen, Lei; Ma, Jun

    2016-01-01

    Background: Nasopharyngeal carcinoma is associated with Epstein-Barr virus (EBV). The current study investigated change in the plasma EBV DNA load in the first 3 months after treatment and its clinical significance in NPC. Methods: A total of 273 patients with non-metastatic, histologically-proven NPC treated with radiotherapy or chemoradiotherapy were retrospectively reviewed. Results: EBV DNA was detectable in 19/273 (7.0%) patients at the end of therapy (end-DNA). Three months later, 16/273 (5.9%) patients had detectable EBV DNA (3-month-DNA). To investigate risk stratified by the pattern of change in post-treatment EBV-DNA, we divided patients into four subgroups: Group 1, undetectable end-DNA and 3-month-DNA (n = 244); Group 2, detectable end-DNA and undetectable 3-month-DNA (n = 13); Group 3, undetectable end-DNA and detectable 3-month-DNA (n = 7); and Group 4, detectable end-DNA and 3-month-DNA (n = 2). Patients with delayed remission of EBV DNA after treatment (Group 2) had significantly poorer 3-year DFS (48.6% vs. 89.7%, P < 0.001), DMFS (48.6% vs. 94.6%, P < 0.001) and OS (91.7% vs. 97.5%, P < 0.001) than those with persistently undetectable EBV DNA post-treatment (Group 1). Five of the seven patients with re-emergent EBV DNA (Group 3) and both patients with persistent EBV DNA post-treatment (Group 4) developed disease failure. Conclusion: Plasma EBV DNA load continues to change during the first 3 months after treatment. The pattern of change in EBV DNA load post-treatment could help identify patients with different prognoses. PMID:26840023

  9. Changes in the mutagenic and estrogenic activities of bisphenol A upon treatment with nitrite.

    PubMed

    Masuda, Shuichi; Terashima, Yumeko; Sano, Ayako; Kuruto, Ryoko; Sugiyama, Yasumasa; Shimoi, Kayoko; Tanji, Kenichi; Yoshioka, Hisashi; Terao, Yoshiyasu; Kinae, Naohide

    2005-08-01

    Bisphenol A (4,4'isopropylidenediphenol: BPA), an endocrine-disrupting chemical, is contained in food-packaging and can-coating agents as well as in dental sealants. Nitrite is present in vegetables, fish and tap water as an ingredient or contaminant, and also in human saliva. Here, we explored the possible generation of genotoxicity from the reactions of BPA and nitrite under acidic conditions, a situation simulating the stomach. We determined the changes in the mutagenic and estrogenic activities of BPA before and after nitrite treatment. Untreated BPA did not exhibit any mutagenicity. However, the mixture of BPA and sodium nitrite after incubation at pH 3.0 showed strong mutagenic activity toward Salmonella typhimurium strains TA 100 and TA 98 either with or without a metabolic activation system (S9 mix). The clastogenic properties of nitrite-treated and untreated BPA were analyzed by a micronucleus test with male ICR mice. A single gastric intubation of nitrite-treated BPA induced a significantly higher frequency of micronucleated reticulocytes (MNRETs) in mice. The results of analysis of electron spin resonance (ESR) suggest that the expression of the mutagenic activity of nitrite-treated BPA is related to the generation of radicals in the reaction mixture. By applying 1H and 13C NMR, AB-MS and APCI/LC/MS, we identified two compounds 3-nitrobisphenol A and 3,3'-dinitro-bisphenol A. These compounds were synthesized by the reaction of BPA with nitric acid. 3,3'-Dinitro-bisphenol induced a significantly greater frequency of MNRETs in male ICR mice. By applying a green fluorescent protein (GFP)-reporter expression system and an estrogen R(alpha) competitor screening kit, we found that nitrite-treated BPA and 3,3'-dinitro-bisphenol A showed weak estrogenic activity compared to that of untreated BPA. PMID:15936980

  10. Changes in the blood-nerve barrier after sciatic nerve cold injury: indications supporting early treatment

    PubMed Central

    Li, Hao; Jia, Jian-ping; Xu, Min; Zhang, Lei

    2015-01-01

    Severe edema in the endoneurium can occur after non-freezing cold injury to the peripheral nerve, which suggests damage to the blood-nerve barrier. To determine the effects of cold injury on the blood-nerve barrier, the sciatic nerve on one side of Wistar rats was treated with low temperatures (3–5°C) for 2 hours. The contralateral sciatic nerve was used as a control. We assessed changes in the nerves using Evans blue as a fluid tracer and morphological methods. Excess fluid was found in the endoneurium 1 day after cold injury, though the tight junctions between cells remained closed. From 3 to 5 days after the cold injury, the fluid was still present, but the tight junctions were open. Less tracer leakage was found from 3 to 5 days after the cold injury compared with 1 day after injury. The cold injury resulted in a breakdown of the blood-nerve barrier function, which caused endoneurial edema. However, during the early period, the breakdown of the blood-nerve barrier did not include the opening of tight junctions, but was due to other factors. Excessive fluid volume produced a large increase in the endoneurial fluid pressure, prevented liquid penetration into the endoneurium from the microvasculature. These results suggest that drug treatment to patients with cold injuries should be administered during the early period after injury because it may be more difficult for the drug to reach the injury site through the microcirculation after the tissue fluid pressure becomes elevated. PMID:25878590

  11. Identifying MRI markers to evaluate early treatment-related changes post-laser ablation for cancer pain management

    NASA Astrophysics Data System (ADS)

    Tiwari, Pallavi; Danish, Shabbar; Madabhushi, Anant

    2014-03-01

    Laser interstitial thermal therapy (LITT) has recently emerged as a new treatment modality for cancer pain management that targets the cingulum (pain center in the brain), and has shown promise over radio-frequency (RF) based ablation which is reported to provide temporary relief. One of the major advantages enjoyed by LITT is its compatibility with magnetic resonance imaging (MRI), allowing for high resolution in vivo imaging to be used in LITT procedures. Since laser ablation for pain management is currently exploratory and is only performed at a few centers worldwide, its short-, and long-term effects on the cingulum are currently unknown. Traditionally treatment effects are evaluated by monitoring changes in volume of the ablation zone post-treatment. However, this is sub-optimal since it involves evaluating a single global parameter (volume) to detect changes pre-, and post-MRI. Additionally, the qualitative observations of LITT-related changes on multi-parametric MRI (MPMRI) do not specifically address differentiation between the appearance of treatment related changes (edema, necrosis) from recurrence of the disease (pain recurrence). In this work, we explore the utility of computer extracted texture descriptors on MP-MRI to capture early treatment related changes on a per-voxel basis by extracting quantitative relationships that may allow for an in-depth understanding of tissue response to LITT on MRI, subtle changes that may not be appreciable on original MR intensities. The second objective of this work is to investigate the efficacy of different MRI protocols in accurately capturing treatment related changes within and outside the ablation zone post-LITT. A retrospective cohort of studies comprising pre- and 24-hour post-LITT 3 Tesla T1-weighted (T1w), T2w, T2-GRE, and T2-FLAIR acquisitions was considered. Our scheme involved (1) inter-protocol as well as inter-acquisition affine registration of pre- and post-LITT MRI, (2) quantitation of MRI parameters

  12. Prostate cancer patients' quality of life assessments across the primary treatment trajectory: 'True' change or response shift?

    PubMed

    Gerlich, Christian; Schuler, Michael; Jelitte, Matthias; Neuderth, Silke; Flentje, Michael; Graefen, Markus; Krüger, Alexander; Mehnert, Anja; Faller, Hermann

    2016-07-01

    Background Self-report questionnaires are widely used to assess changes in quality of life (QoL) during the course of cancer treatment. However, comparing baseline scores to follow-up scores is only justified if patients' internal measurement standards have not changed over time, that is, no response shift occurred. We aimed to examine response shift in terms of reconceptualization, reprioritization and recalibration among prostate cancer patients. Material and methods We included 402 newly diagnosed patients (mean age 65 years) and assessed QoL at the beginning of cancer treatment and three months later. QoL was measured with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). We employed structural equation modeling testing measurement invariance between occasions to disentangle 'true' change and change in the measurement model (response shift). Results We found reprioritization effects for both the Physical Functioning and Role Functioning subscales of the EORTC QLQ-C30, indicating that both had gained importance for representing the latent construct of QoL at follow-up. These effects added to the worsening effect evident in the latent construct, thus rendering observed changes even more pronounced. In addition, we found recalibration effects for both the Emotional Functioning and Cognitive Functioning subscales indicating judgments becoming more lenient over time. These effects counteracted 'true' negative changes thus obscuring any substantial changes on the observed level. Conclusion Our results suggest that changes observed in some subscales of the EORTC QLQ-C30 should not be taken at face value as they may be affected by patients' changed measurement standards. PMID:26882096

  13. Incidence of Changes in Respiration-Induced Tumor Motion and Its Relationship With Respiratory Surrogates During Individual Treatment Fractions

    SciTech Connect

    Malinowski, Kathleen; McAvoy, Thomas J.; George, Rohini; Dietrich, Sonja; D'Souza, Warren D.

    2012-04-01

    Purpose: To determine how frequently (1) tumor motion and (2) the spatial relationship between tumor and respiratory surrogate markers change during a treatment fraction in lung and pancreas cancer patients. Methods and Materials: A Cyberknife Synchrony system radiographically localized the tumor and simultaneously tracked three respiratory surrogate markers fixed to a form-fitting vest. Data in 55 lung and 29 pancreas fractions were divided into successive 10-min blocks. Mean tumor positions and tumor position distributions were compared across 10-min blocks of data. Treatment margins were calculated from both 10 and 30 min of data. Partial least squares (PLS) regression models of tumor positions as a function of external surrogate marker positions were created from the first 10 min of data in each fraction; the incidence of significant PLS model degradation was used to assess changes in the spatial relationship between tumors and surrogate markers. Results: The absolute change in mean tumor position from first to third 10-min blocks was >5 mm in 13% and 7% of lung and pancreas cases, respectively. Superior-inferior and medial-lateral differences in mean tumor position were significantly associated with the lobe of lung. In 61% and 54% of lung and pancreas fractions, respectively, margins calculated from 30 min of data were larger than margins calculated from 10 min of data. The change in treatment margin magnitude for superior-inferior motion was >1 mm in 42% of lung and 45% of pancreas fractions. Significantly increasing tumor position prediction model error (mean {+-} standard deviation rates of change of 1.6 {+-} 2.5 mm per 10 min) over 30 min indicated tumor-surrogate relationship changes in 63% of fractions. Conclusions: Both tumor motion and the relationship between tumor and respiratory surrogate displacements change in most treatment fractions for patient in-room time of 30 min.

  14. Psychopathy, treatment change, and recidivism in high-risk, high-need sexual offenders.

    PubMed

    Looman, Jan; Abracen, Jeffrey; Serin, Ralph; Marquis, Peter

    2005-05-01

    The present study investigated 154 consecutive admissions to the Regional Treatment Center (Ontario) Sex Offender Treatment Program with reference to psychopathy and outcome. Ratings of treatment behavior, as well as clinical judgments as to whether risk was reduced, were coded based on treatment reports. With reference to Psychopathy Checklist-revised (PCL-R) scores, survival analyses indicated that high scorers recidivated at significantly higher rates than low scorers. However, offenders who received high PCL-R scores and lower scores on measures of treatment behavior recidivated at the same rate as low scorers on the PCL-R. Furthermore, among high PCL-R offenders, those rated as lower risk at post treatment in fact reoffended at a lower rate than those whose risk was rated as unchanged, although this difference failed to reach significance. Findings are discussed in light of the clinical and research literature. PMID:15788554

  15. Behavioral versus Cognitive Treatment of Obsessive-Compulsive Disorder: An Examination of Outcome and Mediators of Change

    ERIC Educational Resources Information Center

    Olatunji, Bunmi O.; Rosenfield, David; Tart, Candyce D.; Cottraux, Jean; Powers, Mark B.; Smits, Jasper A. J.

    2013-01-01

    Objective: To examine symptom change over time, the effect of attrition on treatment outcome, and the putative mediators of cognitive therapy (CT) versus behavior therapy (BT) for obsessive-compulsive disorder (OCD) using archival data. Method: Sixty-two adults with OCD were randomized to 20 sessions of CT (N = 30) or BT (N = 32) that consisted of…

  16. Assessing Client Progress Session by Session in the Treatment of Social Anxiety Disorder: The Social Anxiety Session Change Index

    ERIC Educational Resources Information Center

    Hayes, Sarah A.; Miller, Nathan A.; Hope, Debra A.; Heimberg, Richard G.; Juster, Harlan R.

    2008-01-01

    Frequent assessment during therapy can improve treatments and provide accountability. However, clinicians often do not monitor progress because of the time it takes to administer and score assessments. In response, the Social Anxiety Session Change Index (SASCI) was developed. The SASCI is a short, easily administered rating of subjective…

  17. Change Trajectories for the Youth Outcome Questionnaire Self-Report: Identifying Youth at Risk for Treatment Failure

    ERIC Educational Resources Information Center

    Cannon, Jennifer A. N.; Warren, Jared S.; Nelson, Philip L.; Burlingame, Gary M.

    2010-01-01

    This study used longitudinal youth outcome data in routine mental health services to test a system for identifying cases at risk for treatment failure. Participants were 2,715 youth (M age = 14) served in outpatient managed care and community mental health settings. Change trajectories were developed using multilevel modeling of archival data.…

  18. Alcohol expectancy changes over a 12-week cognitive-behavioral therapy program are predictive of treatment success.

    PubMed

    Young, Ross McD; Connor, Jason P; Feeney, Gerald F X

    2011-01-01

    This study examines if outcome expectancies (perceived consequences of engaging in certain behavior) and self-efficacy expectancies (confidence in personal capacity to regulate behavior) contribute to treatment outcome for alcohol dependence. Few clinical studies have examined these constructs. The Drinking Expectancy Profile (DEP), a psychometric measure of alcohol expectancy and drinking refusal self-efficacy, was administered to 298 alcohol-dependent patients (207 males) at assessment and on completion of a 12-week cognitive-behavioral therapy alcohol abstinence program. Baseline measures of expectancy and self-efficacy were not strong predictors of outcome. However, for the 164 patients who completed treatment, all alcohol expectancy and self-efficacy factors of the DEP showed change over time. The DEP scores approximated community norms at the end of treatment. Discriminant analysis indicated that change in social pressure drinking refusal self-efficacy, sexual enhancement expectancies, and assertion expectancies successfully discriminated those who successfully completed treatment from those who did not. Future research should examine the basis of expectancies related to social functioning as a possible mechanism of treatment response and a means to enhance treatment outcome. PMID:20864294

  19. Three-D imaging of dental alveolar bone change after fixed orthodontic treatment in patients with periodontitis

    PubMed Central

    Ma, Zhi-Gui; Yang, Chi; Fang, Bing; Xia, Yun-Hui; Mao, Li-Xia; Feng, Yi-Miao

    2015-01-01

    Objectives: The objective of this study was to radiographically quantify bone height and bone density in patients with periodontitis after fixed orthodontic treatment using cone beam computed tomography (CBCT). Materials and methods: A total of 81 patients including 40 patients with chronic periodontitis (group 1) and 41 patients with normal periodontal tissues (group 2) were selected. CBCT scanning for anterior teeth were taken before and after orthodontic treatment. Measurements of bone height and bone density were performed using CBCT software. Results: The group 1 presented a statistically lesser bone density and bone height when compared to group 2 before treatment. There was a significant loss of bone density for both groups after orthodontic treatment, but bone density loss was significantly greater in the group 1. There was no statistically significant bone height change in two groups after treatment. Conclusions: This study demonstrated that orthodontic treatment can preserve bone height but not capable of maintaining bone density, especially for patients with periodontitis. It is indicated that the change of bone density may be more susceptible than that of bone height when radiographically evaluating bone status under this combined periodontal and orthodontic therapy. PMID:25932177

  20. Changes in the Structure of the Microbial Community Associated with Nannochloropsis salina following Treatments with Antibiotics and Bioactive Compounds

    DOE PAGESBeta

    Geng, Haifeng; Tran-Gyamfi, Mary B.; Lane, Todd W.; Sale, Kenneth L.; Yu, Eizadora T.

    2016-07-26

    Open microalgae cultures host a myriad of bacteria, creating a complex system of interacting species that influence algal growth and health. Many algal microbiota studies have been conducted to determine the relative importance of bacterial taxa to algal culture health and physiological states, but these studies have not characterized the interspecies relationships in the microbial communities. Here we subjected Nanochroloropsis salina cultures to multiple chemical treatments (antibiotics and quorum sensing compounds) and obtained dense time-series data on changes to the microbial community using 16S gene amplicon metagenomic sequencing (21,029,577 reads for 23 samples) to measure microbial taxa-taxa abundance correlations. Short-termmore » treatment with antibiotics resulted in substantially larger shifts in the microbiota structure compared to changes observed following treatment with signaling compounds and glucose. We also calculated operational taxonomic unit (OTU) associations and generated OTU correlation networks to provide an overview of possible bacterial OTU interactions. This analysis identified five major cohesive modules of microbiota with similar co-abundance profiles across different chemical treatments. The Eigengenes of OTU modules were examined for correlation with different external treatment factors. This correlation-based analysis revealed that culture age (time) and treatment types have primary effects on forming network modules and shaping the community structure. Additional network analysis detected Alteromonadeles and Alphaproteobacteria as having the highest centrality, suggesting these species are “keystone” OTUs in the microbial community. Furthermore, we illustrated that the chemical tropodithietic acid, which is secreted by several species in the Alphaproteobacteria taxon, is able to drastically change the structure of the microbiota within 3 h. Lastly, taken together, these results provide valuable insights into the structure

  1. Changes in the Structure of the Microbial Community Associated with Nannochloropsis salina following Treatments with Antibiotics and Bioactive Compounds.

    PubMed

    Geng, Haifeng; Tran-Gyamfi, Mary B; Lane, Todd W; Sale, Kenneth L; Yu, Eizadora T

    2016-01-01

    Open microalgae cultures host a myriad of bacteria, creating a complex system of interacting species that influence algal growth and health. Many algal microbiota studies have been conducted to determine the relative importance of bacterial taxa to algal culture health and physiological states, but these studies have not characterized the interspecies relationships in the microbial communities. We subjected Nanochroloropsis salina cultures to multiple chemical treatments (antibiotics and quorum sensing compounds) and obtained dense time-series data on changes to the microbial community using 16S gene amplicon metagenomic sequencing (21,029,577 reads for 23 samples) to measure microbial taxa-taxa abundance correlations. Short-term treatment with antibiotics resulted in substantially larger shifts in the microbiota structure compared to changes observed following treatment with signaling compounds and glucose. We also calculated operational taxonomic unit (OTU) associations and generated OTU correlation networks to provide an overview of possible bacterial OTU interactions. This analysis identified five major cohesive modules of microbiota with similar co-abundance profiles across different chemical treatments. The Eigengenes of OTU modules were examined for correlation with different external treatment factors. This correlation-based analysis revealed that culture age (time) and treatment types have primary effects on forming network modules and shaping the community structure. Additional network analysis detected Alteromonadeles and Alphaproteobacteria as having the highest centrality, suggesting these species are "keystone" OTUs in the microbial community. Furthermore, we illustrated that the chemical tropodithietic acid, which is secreted by several species in the Alphaproteobacteria taxon, is able to drastically change the structure of the microbiota within 3 h. Taken together, these results provide valuable insights into the structure of the microbiota

  2. Changes in the Structure of the Microbial Community Associated with Nannochloropsis salina following Treatments with Antibiotics and Bioactive Compounds

    PubMed Central

    Geng, Haifeng; Tran-Gyamfi, Mary B.; Lane, Todd W.; Sale, Kenneth L.; Yu, Eizadora T.

    2016-01-01

    Open microalgae cultures host a myriad of bacteria, creating a complex system of interacting species that influence algal growth and health. Many algal microbiota studies have been conducted to determine the relative importance of bacterial taxa to algal culture health and physiological states, but these studies have not characterized the interspecies relationships in the microbial communities. We subjected Nanochroloropsis salina cultures to multiple chemical treatments (antibiotics and quorum sensing compounds) and obtained dense time-series data on changes to the microbial community using 16S gene amplicon metagenomic sequencing (21,029,577 reads for 23 samples) to measure microbial taxa-taxa abundance correlations. Short-term treatment with antibiotics resulted in substantially larger shifts in the microbiota structure compared to changes observed following treatment with signaling compounds and glucose. We also calculated operational taxonomic unit (OTU) associations and generated OTU correlation networks to provide an overview of possible bacterial OTU interactions. This analysis identified five major cohesive modules of microbiota with similar co-abundance profiles across different chemical treatments. The Eigengenes of OTU modules were examined for correlation with different external treatment factors. This correlation-based analysis revealed that culture age (time) and treatment types have primary effects on forming network modules and shaping the community structure. Additional network analysis detected Alteromonadeles and Alphaproteobacteria as having the highest centrality, suggesting these species are “keystone” OTUs in the microbial community. Furthermore, we illustrated that the chemical tropodithietic acid, which is secreted by several species in the Alphaproteobacteria taxon, is able to drastically change the structure of the microbiota within 3 h. Taken together, these results provide valuable insights into the structure of the microbiota

  3. Differential changes in functional disability and pain intensity over the course of psychological treatment for children with chronic pain

    PubMed Central

    Lynch-Jordan, Anne M.; Sil, Soumitri; Peugh, James; Cunningham, Natoshia; Kashikar-Zuck, Susmita; Goldschneider, Kenneth R.

    2015-01-01

    Patients presenting for treatment of chronic pain often believe that pain reduction must be achieved before returning to normal functioning. However, treatment programs for chronic pain typically take a rehabilitative approach, emphasizing decreasing pain-related disability first with the expectation that pain reduction will follow. This information is routinely provided to patients, yet no studies have systematically examined the actual trajectories of pain and disability in a clinical care setting. In this study of youth with chronic pain (N = 94, 8 to 18 years), it was hypothesized that 1) functional disability and pain would decrease over the course of psychological treatment for chronic pain and 2) functional disability would decrease more quickly than pain intensity. Participants received cognitive behavioral therapy (CBT) for pain management (M = 5.6 sessions) plus standard medical care. The Functional Disability Inventory and a Numeric Rating Scale of average pain intensity were completed by the child at every CBT session. Hierarchical linear modeling was conducted to examine the longitudinal trajectories of disability and pain. Standardized estimates of the slopes of change were obtained to test differences in rates of change between pain and disability. Results showed an overall significant decline in functional disability over time. Although pain scores reduced slightly from pretreatment to posttreatment, the longitudinal decline over treatment was not statistically significant. As expected, the rate of change of disability was significantly more rapid than pain. Evidence for variability in treatment response was noted, suggesting the need for additional research into individual trajectories of change in pediatric pain treatment. PMID:24954165

  4. Empirical microeconomics action functionals

    NASA Astrophysics Data System (ADS)

    Baaquie, Belal E.; Du, Xin; Tanputraman, Winson

    2015-06-01

    A statistical generalization of microeconomics has been made in Baaquie (2013), where the market price of every traded commodity, at each instant of time, is considered to be an independent random variable. The dynamics of commodity market prices is modeled by an action functional-and the focus of this paper is to empirically determine the action functionals for different commodities. The correlation functions of the model are defined using a Feynman path integral. The model is calibrated using the unequal time correlation of the market commodity prices as well as their cubic and quartic moments using a perturbation expansion. The consistency of the perturbation expansion is verified by a numerical evaluation of the path integral. Nine commodities drawn from the energy, metal and grain sectors are studied and their market behavior is described by the model to an accuracy of over 90% using only six parameters. The paper empirically establishes the existence of the action functional for commodity prices that was postulated to exist in Baaquie (2013).

  5. Catastrophic Misinterpretations as a Predictor of Symptom Change during Treatment for Panic Disorder

    ERIC Educational Resources Information Center

    Teachman, Bethany A.; Marker, Craig D.; Clerkin, Elise M.

    2010-01-01

    Objective: Cognitive models of panic disorder suggest that change in catastrophic misinterpretations of bodily sensations will predict symptom reduction. To examine change processes, we used a repeated measures design to evaluate whether the trajectory of change in misinterpretations over the course of 12-week cognitive behavior therapy is related…

  6. The Trajectory of Change for Children and Youth in Residential Treatment

    ERIC Educational Resources Information Center

    Noftle, J. W.; Cook, S.; Leschied, A.; St. Pierre, J.; Stewart, S. L.; Johnson, A. M.

    2011-01-01

    This study examined the symptom response trajectories for 225 children and youth throughout a period of residential treatment. With the 10-item "Conners' Global Index" ("CGI") as the primary outcome measure, assessments were completed on a bi-weekly basis during the average 4 month stay within the youth's residential treatment. Clients…

  7. Mexican "Curanderismo" as Ethnopsychotherapy: A Qualitative Study on Treatment Practices, Effectiveness, and Mechanisms of Change

    ERIC Educational Resources Information Center

    Zacharias, Steffi

    2006-01-01

    This article reports the results of a qualitative field study of the ethnotherapeutic treatment practices of "curanderos," the practitioners of traditional Mexican medicine, and their effectiveness in the treatment of mental illness. Three healers and their patients from the southwestern state of Oaxaca participated in the study. The patients had…

  8. Neural Changes after Phonological Treatment for Anomia: An fMRI Study

    ERIC Educational Resources Information Center

    Rochon, Elizabeth; Leonard, Carol; Burianova, Hana; Laird, Laura; Soros, Peter; Graham, Simon; Grady, Cheryl

    2010-01-01

    Functional magnetic resonance imaging (fMRI) was used to investigate the neural processing characteristics associated with word retrieval abilities after a phonologically-based treatment for anomia in two stroke patients with aphasia. Neural activity associated with a phonological and a semantic task was compared before and after treatment with…

  9. TREATMENT OF FEEDYARD DUST CONTAINING ENDOTOXIN AND ITS EFFECTS ON WEANING GOATS (TITLE CHANGE)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Thirty mixed-sex, weanling goats were randomly allotted to 4 treatment groups: principal autoclaved dust (n=6), control non-autoclaved dust (n=6), principal dry-heat dust (n=6), and control non-dry heat dust (n=6). Principals were treated with appropriate dust for one 4 hr treatment in a closed tent...

  10. Changes in Personality Disorder Traits Following 2 Years of Treatment in a Secure Therapeutic Community Milieu

    ERIC Educational Resources Information Center

    Morrissey, Catrin; Taylor, Jon

    2014-01-01

    Therapeutic community treatment models have not previously been applied to forensic patients with mild intellectual disabilities (IDs) with a comorbid diagnosis of personality disorder. Thirteen patients with mild IDs were allocated to a unit within a high secure psychiatric service operating a model of treatment based on the principles and…

  11. Addiction treatment outcomes, process and change: Texas Institute of Behavioral Research at Texas Christian University.

    PubMed

    Simpson, D Dwayne; Joe, George W; Dansereau, Donald F; Flynn, Patrick M

    2011-10-01

    For more than 40 years the Texas Institute of Behavioral Research (IBR) has given special attention to assessment and evaluation of drug user populations, addiction treatment services and various cognitive and behavioral interventions. Emphasis has been on studies in real-world settings and the use of multivariate methodologies to address evaluation issues within the context of longitudinal natural designs. Historically, its program of addiction treatment research may be divided into three sequential epochs-the first era dealt mainly with client assessment and its role in treatment outcome and evaluation (1969-89), the second focused upon modeling the treatment process and the importance of conceptual frameworks (1989-2009) in explaining the relationships among treatment environment, client attributes, treatment process and outcome, and the third (and current) era has expanded into studying tactical deployment of innovations and implementation. Recent projects focus upon adapting and implementing innovations for improving early engagement in adolescent residential treatment settings and drug-dependent criminal justice populations. Related issues include the spread of human immunodeficiency virus/acquired immune deficiency syndrome and other infectious diseases, organizational and systems functioning, treatment costs and process related to implementation of evidence-based practices. PMID:20840168

  12. Psychological Symptoms in Methadone Maintenance Patients: Prevalence and Change over Treatment.

    ERIC Educational Resources Information Center

    Corty, Eric; And Others

    1988-01-01

    Twice interviewed methadone maintenance patients in three cities using Addiction Severity Index. Of subjects followed, 35.4 percent reported having experienced recent psychological symptoms. Found no relation between length of time in treatment at first interview and psychiatric severity. Over one-year period, treatment that subjects received from…

  13. Series Length Used during Trend Analysis Affects Sensitivity to Changes in Progression Rate in the Ocular Hypertension Treatment Study

    PubMed Central

    Gardiner, Stuart K.; Demirel, Shaban; De Moraes, Carlos Gustavo; Liebmann, Jeffrey M.; Cioffi, George A.; Ritch, Robert; Gordon, Mae O.; Kass, Michael A.

    2013-01-01

    Purpose. Trend analysis techniques to detect glaucomatous progression typically assume a constant rate of change. This study uses data from the Ocular Hypertension Treatment Study to assess whether this assumption decreases sensitivity to changes in progression rate, by including earlier periods of stability. Methods. Series of visual fields (mean 24 per eye) completed at 6-month intervals from participants randomized initially to observation were split into subseries before and after the initiation of treatment (the “split-point”). The mean deviation rate of change (MDR) was derived using these entire subseries, and using only the window length (W) tests nearest the split-point, for different window lengths of W tests. A generalized estimating equation model was used to detect changes in MDR occurring at the split-point. Results. Using shortened subseries with W = 7 tests, the MDR slowed by 0.142 dB/y upon initiation of treatment (P < 0.001), and the proportion of eyes showing “rapid deterioration” (MDR <–0.5 dB/y with P < 5%) decreased from 11.8% to 6.5% (P < 0.001). Using the entire sequence, no significant change in MDR was detected (P = 0.796), and there was no change in the proportion of eyes progressing (P = 0.084). Window lengths 6 ≤ W ≤ 9 produced similar benefits. Conclusions. Event analysis revealed a beneficial treatment effect in this dataset. This effect was not detected by linear trend analysis applied to entire series, but was detected when using shorter subseries of length between six and nine fields. Using linear trend analysis on the entire field sequence may not be optimal for detecting and monitoring progression. Nonlinear analyses may be needed for long series of fields. (ClinicalTrials.gov number, NCT00000125.) PMID:23349433

  14. The ability of early changes in motivation to predict later antidepressant treatment response

    PubMed Central

    Gorwood, Philip; Vaiva, Guillaume; Corruble, Emmanuelle; Llorca, Pierre-Michel; Baylé, Franck J; Courtet, Philippe

    2015-01-01

    Introduction Baseline values and early changes of emotional reactivity, cognitive speed, psychomotor function, motivation, and sensory perception have not been studied to any extent in unipolar depression, although they could help to characterize different dimensions of illness that are harder to capture by clinicians, give new insights on how patients improve, and offer new early clinical markers for later treatment response. Methods About 1,565 adult outpatients with major depressive disorder receiving agomelatine completed the clinician-rated 16-item quick inventory of depressive symptoms, Clinical Global Impression, and Multidimensional Assessment of Thymic States (MAThyS) rating scales at inclusion, Week 2 and Week 6. The MAThyS includes a 20-item self-rated visual analog scale (from inhibition [0] to activation [10], with [5] representing the usual state) leading to five a priori dimensions (emotional reactivity, cognitive speed, psychomotor function, motivation, and sensory perception). Results All MAThyS dimension scores increased from inclusion to Week 2 and from inclusion to Week 6 (P<0.001). Improvement was around 2 points (out of 10) for motivation, 1.5 points for psychomotor function, and 0.5 points for other dimensions. Motivation showed a trend to being more severely impaired at inclusion in future nonresponders (t=1.25, df=1,563, P=0.10). Its improvement at Week 2 was the most discriminating MAThyS dimension between future responders and nonresponders, and represents the best predictor of future response, with the highest area under the receptor operating characteristic curve (area under curve =0.616, 95% confidence interval [0.588–0.643], P<0.001). Finally, improvements in motivation correlated the most strongly with clinician-rated 16-item quick inventory of depressive symptoms improvement (r=−0.491, df=1,563, P<0.001). Conclusion Motivation had the most capacity for early improvement, the best predictive value for response, and the largest

  15. Changes in benzodiazepine-GABA receptor coupling in an accumbens-habenula circuit after chronic diazepam treatment.

    PubMed Central

    Brett, R. R.; Pratt, J. A.

    1995-01-01

    1. The effects of subacute and of chronic diazepam treatment upon binding to the GABAA receptor have been examined by use of receptor autoradiography for determining flunitrazepam (FNZP) binding, GABA enhancement of FNZP binding. SR 95531 2-(3'-carboxy-2',propyl)-3-amino-6-p-methoxyphenylpyridazinium bromide) binding and GABA binding in parallel sections from rat brain. Prior to the autoradiographic procedures, a behavioural assessment of the rats was made in the elevated plus-maze test of anxiety. 2. Rats receiving diazepam either subacutely (3 days) or chronically (28 days) by both continuous release, from previously implanted subcutaneous silastic capsules, or by daily injection (5 mg kg-1) did not display changes in FNZP or GABA binding in any of the 47 brain structures analysed. Similarly, there were no significant effects of treatment upon mean total entries or on the open:total ratio for entries in the elevated plus-maze. 3. There were reductions in the GABA enhancement of FNZP binding in the nucleus accumbens and central grey after subacute diazepam treatment. This effect persisted in the nucleus accumbens after chronic treatment. Less marked effects occurred in the lateral habenula, dorsal raphe and substantia nigra pars compacta. In the dorsal tegmental nucleus, GABA enhancement of FNZP binding was enhanced after chronic treatment and this was accompanied by reductions in SR 95531 binding. Treatment did not otherwise affect SR 95531 binding, with the exception of the dorsal raphe where binding was decreased after subacute treatment. 4. In general, the patterns of binding produced by the two different treatment routes were very similar. However, SR 95531 binding was lower in certain hippocampal fields in the i.p. treated animals compared to the rats implanted with silastic capsules. 5. It is concluded that repeated administration of diazepam evokes changes in benzodiazepine and GABA receptor coupling, and to a lesser extent changes in low affinity GABA

  16. Prediction of DVH parameter changes due to setup errors for breast cancer treatment based on 2D portal dosimetry

    SciTech Connect

    Nijsten, S. M. J. J. G.; Elmpt, W. J. C. van; Mijnheer, B. J.; Minken, A. W. H.; Persoon, L. C. G. G.; Lambin, P.; Dekker, A. L. A. J.

    2009-01-15

    Electronic portal imaging devices (EPIDs) are increasingly used for portal dosimetry applications. In our department, EPIDs are clinically used for two-dimensional (2D) transit dosimetry. Predicted and measured portal dose images are compared to detect dose delivery errors caused for instance by setup errors or organ motion. The aim of this work is to develop a model to predict dose-volume histogram (DVH) changes due to setup errors during breast cancer treatment using 2D transit dosimetry. First, correlations between DVH parameter changes and 2D gamma parameters are investigated for different simulated setup errors, which are described by a binomial logistic regression model. The model calculates the probability that a DVH parameter changes more than a specific tolerance level and uses several gamma evaluation parameters for the planning target volume (PTV) projection in the EPID plane as input. Second, the predictive model is applied to clinically measured portal images. Predicted DVH parameter changes are compared to calculated DVH parameter changes using the measured setup error resulting from a dosimetric registration procedure. Statistical accuracy is investigated by using receiver operating characteristic (ROC) curves and values for the area under the curve (AUC), sensitivity, specificity, positive and negative predictive values. Changes in the mean PTV dose larger than 5%, and changes in V{sub 90} and V{sub 95} larger than 10% are accurately predicted based on a set of 2D gamma parameters. Most pronounced changes in the three DVH parameters are found for setup errors in the lateral-medial direction. AUC, sensitivity, specificity, and negative predictive values were between 85% and 100% while the positive predictive values were lower but still higher than 54%. Clinical predictive value is decreased due to the occurrence of patient rotations or breast deformations during treatment, but the overall reliability of the predictive model remains high. Based on our

  17. Changing Conceptual Change

    ERIC Educational Resources Information Center

    diSessa, Andrea A.

    2007-01-01

    This article reviews Giyoo Hatano's ground-breaking theoretical, empirical, and methodological contributions to conceptual change research. In particular, his discovery of "vitalism" as part of children's legitimate and distinctive biology at early ages stands as a landmark. In addition, his work reinterpreted childhood "personification," changing…

  18. Does physiologic response to loud tones change following cognitive-behavioral treatment for posttraumatic stress disorder?

    PubMed

    Griffin, Michael G; Resick, Patricia A; Galovski, Tara E

    2012-02-01

    This study examined responses to loud tones before and after cognitive-behavioral treatment for posttraumatic stress disorder (PTSD). Seventy-four women in a PTSD treatment outcome study for rape-related (n = 54) or physical assault-related PTSD (n = 20) were assessed in an auditory loud tone paradigm. Assessments were conducted before and after a 6-week period of cognitive-behavioral therapy. Physiologic responses to loud tones included heart rate (HR), skin conductance (SC), and eye-blink electromyogram (EMG). Groups were formed based upon treatment outcome and included a treatment responder group (no PTSD at posttreatment) and a nonresponder group (PTSD-positive at posttreatment). Treatment was successful for 53 of 74 women (72%) and unsuccessful for 21 women (28%). Responders and nonresponders were not significantly different from each other at pretreatment on the main outcome variables. Treatment responders showed a significant reduction in loud tone-related EMG, HR, and SC responses from pre- to posttreatment (partial η(2) = .24, .31, and .36, respectively; all p < .001) and the EMG and HR responses were significantly smaller than nonresponders at posttreatment (partial η(2) = .11, p = .004 and .19, p < .001, respectively). Successful cognitive-behavioral treatment of PTSD is associated with a quantifiable reduction in physiological responding to loud tones. PMID:22354505

  19. Does Physiologic Response to Loud Tones Change Following Cognitive–Behavioral Treatment for Posttraumatic Stress Disorder?

    PubMed Central

    Griffin, Michael G.; Resick, Patricia A.; Galovski, Tara E.

    2012-01-01

    This study examined responses to loud tones before and after cognitive–behavioral treatment for posttraumatic stress disorder (PTSD). Seventy-four women in a PTSD treatment outcome study for rape-related (n = 54) or physical assault-related PTSD (n = 20) were assessed in an auditory loud tone paradigm. Assessments were conducted before and after a 6-week period of cognitive–behavioral therapy. Physiologic responses to loud tones included heart rate (HR), skin conductance (SC), and eye-blink electromyogram (EMG). Groups were formed based upon treatment outcome and included a treatment responder group (no PTSD at posttreatment) and a nonresponder group (PTSD-positive at posttreatment). Treatment was successful for 53 of 74 women (72%) and unsuccessful for 21 women (28%). Responders and nonresponders were not significantly different from each other at pretreatment on the main outcome variables. Treatment responders showed a significant reduction in loud tone-related EMG, HR, and SC responses from pre- to posttreatment (partial η2 = .243, .308, and .365, respectively; all p < .001) and the EMG and HR responses were significantly smaller than nonresponders at posttreatment (partial η22 = .107, p = .004 and .193, p < .001, respectively). Successful cognitive–behavioral treatment of PTSD is associated with a quantifiable reduction in physiological responding to loud tones. PMID:22354505

  20. Improved Net Protein Balance, Lean Mass, and Gene Expression Changes With Oxandrolone Treatment in the Severely Burned

    PubMed Central

    Wolf, Steven E.; Thomas, Steven J.; Dasu, Mohan R.; Ferrando, Arny A.; Chinkes, David L.; Wolfe, Robert R.; Herndon, David N.

    2003-01-01

    Objective To determine the effects of the anabolic agent oxandrolone on muscle protein and gene expression in severely burned children. Summary Background Data The authors previously showed that oxandrolone increased net muscle protein synthesis in emaciated burned patients receiving delayed treatment for severe burns. They hypothesized that similar effects would be seen in those treated early after burn. Methods Thirty-two severely burned children were enrolled in a prospective randomized trial. Subjects underwent studies to assess leg protein net balance 5 days after the first excision and grafting procedure. Immediately after these studies, treatment with placebo (n = 18) or 0.1 mg/kg oxandrolone (n = 14) twice a day was started. One week after this, another net balance study was performed in each subject. Body weights and total body potassium counting were used to determine body compositional changes. Muscle biopsies were taken 1 week after treatment in oxandrolone subjects to examine gene expression changes with gene array (12,600 genes). Results Protein net balance did not change in the placebo group, while oxandrolone-treated subjects had a significant improvement. Body weights and fat free mass significantly decreased in the placebo group, while no changes were found in the oxandrolone-treated subjects. Expression changes were seen in 14 genes in the oxandrolone group compared to placebo. Some of these included myosin light chain (+2.7-fold change), tubulin (+2.3), calmodulin (−2.3), and protein phosphatase I inhibitor (−2.8). Conclusions Oxandrolone improves protein net balance and lean mass in the severely burned. These changes are associated with increased gene expression for functional muscle proteins. PMID:12796576

  1. Analysis of internal structure changes in black human hair keratin fibers resulting from bleaching treatments using Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Kuzuhara, Akio

    2013-09-01

    In order to investigate in detail the internal structure changes in virgin black human hair keratin fibers resulting from bleaching treatments, the structure of cross-sections at various depths of black human hair, which had been impossible due to high melanin grande content, was directly analyzed using Raman spectroscopy. The gauche-gauche-gauche (GGG) content of the sbnd SSsbnd groups existing from the cuticle region to the center of cortex region of the virgin black human hair remarkably decreased, while the gauche-gauche-trans and trans-gauche-trans contents were not changed by performing the excessive bleaching treatment. In particular, it was found that not only the β-sheet and/or random coil content, but also the α-helix content existing throughout the cortex region of virgin black human hair decreased. In addition, the transmission electron microscope observation shows that the proteins in the cell membrane complex, the cuticle and cortex of the virgin black human hair were remarkably eluted by performing the excessive bleaching treatment. From these experiments, the author concluded that the sbnd SSsbnd groups, which have a GGG conformation were decomposed and finally converted to cysteic acid, and the α-helix structure of some of the proteins existing in the keratin was changed to the random coil structure, or eluted from the cortex region, thereby leading to the reduction in the protein density of the virgin human hair after the excessive bleaching treatment.

  2. Motivation to change and treatment attendance as predictors of alcohol-use outcomes among project-based Housing First residents.

    PubMed

    Collins, Susan E; Malone, Daniel K; Larimer, Mary E

    2012-08-01

    Collins et al. (2012) indicated that time spent in a project-based Housing First (HF) intervention was associated with improved two-year alcohol-use trajectories among chronically homeless individuals with alcohol problems. To explore potential correlates of these findings, we tested the relative prediction of alcohol-use outcomes by motivation to change (MTC) and substance abuse treatment attendance. Participants (N=95) were chronically homeless individuals with alcohol problems receiving a project-based HF intervention in the context of a larger nonrandomized controlled trial (Larimer et al., 2009). Participants were interviewed regularly over the two-year follow-up. Treatment attendance and MTC were measured using items from the Addiction Severity Index and the SOCRATES, respectively. Alcohol-use outcomes included alcohol quantity, problems and dependence. Generalized estimating equation modeling indicated that MTC variables and not treatment attendance consistently predicted alcohol-use outcomes over the two-year follow-up. Findings suggest that the importance of motivation to change may outweigh treatment attendance in supporting alcohol behavior change in this population. PMID:22513197

  3. Cognitive processes as mediators of the relation between mindfulness and change in social anxiety symptoms following cognitive behavioral treatment

    PubMed Central

    Morgan, Jessica R.; Price, Matthew; Schmertz, Stefan K.; Johnson, Suzanne B.; Masuda, Akihiko; Calamaras, Martha; Anderson, Page L.

    2014-01-01

    The present study examined whether pretreatment mindfulness exerts an indirect effect on outcomes following cognitive-behavioral therapy (CBT). Cognitive processes of probability and cost bias (i.e., overestimations of the likelihood that negative social events will occur, and that these events will have negative consequences when they do occur) were explored as potential mediators of the relation between mindfulness and social anxiety symptom change. People with higher levels of mindfulness may be better able to benefit from treatments that reduce biases because mindfulness may aid in regulation of attention. Sixty-seven individuals with a primary diagnosis of social phobia identifying public speaking as their greatest fear received eight sessions of one of two types of exposure-based CBT delivered according to treatment manuals. Participants completed self-report measures of mindfulness, probability bias, cost bias, and social anxiety symptoms. Mediation hypotheses were assessed by a bootstrapped regression using treatment outcome data. Pretreatment mindfulness was not related to change in social anxiety symptoms from pre- to posttreatment. However, mindfulness had an indirect effect on treatment outcome via its association with probability bias, but not cost bias, at midtreatment. These findings were consistent across three metrics of social anxiety symptoms. Mindfulness may play a role in response to CBT among individuals with social phobia through its relation with probability bias – even when the treatment does not target mindfulness. PMID:24147809

  4. Cognitive processes as mediators of the relation between mindfulness and change in social anxiety symptoms following cognitive behavioral treatment.

    PubMed

    Morgan, Jessica R; Price, Matthew; Schmertz, Stefan K; Johnson, Suzanne B; Masuda, Akihiko; Calamaras, Martha; Anderson, Page L

    2014-05-01

    The present study examined whether pretreatment mindfulness exerts an indirect effect on outcomes following cognitive-behavioral therapy (CBT). Cognitive processes of probability and cost bias (i.e., overestimations of the likelihood that negative social events will occur, and that these events will have negative consequences when they do occur) were explored as potential mediators of the relation between mindfulness and social anxiety symptom change. People with higher levels of mindfulness may be better able to benefit from treatments that reduce biases because mindfulness may aid in regulation of attention. Sixty-seven individuals with a primary diagnosis of social phobia identifying public speaking as their greatest fear received eight sessions of one of two types of exposure-based CBT delivered according to treatment manuals. Participants completed self-report measures of mindfulness, probability bias, cost bias, and social anxiety symptoms. Mediation hypotheses were assessed by a bootstrapped regression using treatment outcome data. Pretreatment mindfulness was not related to change in social anxiety symptoms from pre- to posttreatment. However, mindfulness had an indirect effect on treatment outcome via its association with probability bias, but not cost bias, at midtreatment. These findings were consistent across three metrics of social anxiety symptoms. Mindfulness may play a role in response to CBT among individuals with social phobia through its relation with probability bias--even when the treatment does not target mindfulness. PMID:24147809

  5. Pattern of drug utilization for treatment of uncomplicated malaria in urban Ghana following national treatment policy change to artemisinin-combination therapy

    PubMed Central

    Dodoo, Alexander NO; Fogg, Carole; Asiimwe, Alex; Nartey, Edmund T; Kodua, Augustina; Tenkorang, Ofori; Ofori-Adjei, David

    2009-01-01

    Background Change of first-line treatment of uncomplicated malaria to artemisinin-combination therapy (ACT) is widespread in Africa. To expand knowledge of safety profiles of ACT, pharmacovigilance activities are included in the implementation process of therapy changes. Ghana implemented first-line therapy of artesunate-amodiaquine in 2005. Drug utilization data is an important component of determining drug safety, and this paper describes how anti-malarials were prescribed within a prospective pharmacovigilance study in Ghana following anti-malarial treatment policy change. Methods Patients with diagnosis of uncomplicated malaria were recruited from pharmacies of health facilities throughout Accra in a cohort-event monitoring study. The main drug utilization outcomes were the relation of patient age, gender, type of facility attended, mode of diagnosis and concomitant treatments to the anti-malarial regimen prescribed. Logistic regression was used to predict prescription of nationally recommended first-line therapy and concomitant prescription of antibiotics. Results The cohort comprised 2,831 patients. Curative regimens containing an artemisinin derivative were given to 90.8% (n = 2,574) of patients, although 33% (n = 936) of patients received an artemisinin-based monotherapy. Predictors of first-line therapy were laboratory-confirmed diagnosis, age >5 years, and attending a government facility. Analgesics and antibiotics were the most commonly prescribed concomitant medications, with a median of two co-prescriptions per patient (range 1–9). Patients above 12 years were significantly less likely to have antibiotics co-prescribed than patients under five years; those prescribed non-artemisinin monotherapies were more likely to receive antibiotics. A dihydroartemisinin-amodiaquine combination was the most used therapy for children under five years of age (29.0%, n = 177). Conclusion This study shows that though first-line therapy recommendations may change

  6. Ever-changing endoscopic treatment for early gastric cancer: Yesterday-today-tomorrow

    PubMed Central

    Kim, Mi-Young; Cho, Jun-Hyung; Cho, Joo Young

    2014-01-01

    Endoscopic resection has been an optimal treatment for selected patients with early gastric cancer (EGC) based on advances in endoscopic instruments and techniques. As endoscopic submucosal dissection (ESD) has been widely used for treatment of EGC along with expanding ESD indication, concerns have been asked to achieve curative resection for EGC while guaranteeing precise prediction of lymph node metastasis (LNM). Recently, new techniques including ESD or endoscopic full-thickness resection combined with sentinel node navigation enable minimal tumor resection and a laparoscopic lymphadenectomy in cases of EGC with high risk of LNM. This review covers the development and challenges of endoscopic treatment for EGC. Moreover, a new microscopic imaging and endoscopic techniques for precise endoscopic diagnosis and minimally invasive treatment of EGC are introduced. PMID:25309064

  7. 78 FR 69694 - Changing Regulatory and Reimbursement Paradigms for Medical Devices in the Treatment of Obesity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-20

    ... Devices in the Treatment of Obesity and Metabolic Diseases: How To Estimate and Reward True Patient... Metabolic Diseases: How to Estimate and Reward True Patient-Centric Value in Innovation.'' FDA...

  8. Rest versus exercise as treatment for patients with low back pain and Modic changes. a randomized controlled clinical trial

    PubMed Central

    2012-01-01

    Background Clinical experience suggests that many patients with Modic changes have relatively severe and persistent low back pain (LBP), which typically appears to be resistant to treatment. Exercise therapy is the recommended treatment for chronic LBP, however, due to their underlying pathology, Modic changes might be a diagnostic subgroup that does not benefit from exercise. The objective of this study was to compare the current state-of-the art treatment approach (exercise and staying active) with a new approach (load reduction and daily rest) for people with Modic changes using a randomized controlled trial design. Methods Participants were patients from an outpatient clinic with persistent LBP and Modic changes. They were allocated using minimization to either rest therapy for 10 weeks with a recommendation to rest for two hours daily and the option of using a flexible lumbar belt or exercise therapy once a week for 10 weeks. Follow-up was at 10 weeks after recruitment and 52 weeks after intervention and the clinical outcome measures were pain, disability, general health and global assessment, supplemented by weekly information on low back problems and sick leave measured by short text message (SMS) tracking. Results In total, 100 patients were included in the study. Data on 87 patients at 10 weeks and 96 patients at one-year follow-up were available and were used in the intention-to-treat analysis. No statistically significant differences were found between the two intervention groups on any outcome. Conclusions No differences were found between the two treatment approaches, 'rest and reduced load' and 'exercise and staying active', in patients with persistent LBP and Modic changes. Trial Registration ClinicalTrials.gov: NCT00454792 PMID:22376791

  9. Dietary Salt Intake Is a Determinant of Cardiac Changes After Treatment of Primary Aldosteronism: A Prospective Study.

    PubMed

    Catena, Cristiana; Colussi, GianLuca; Novello, Marileda; Verheyen, Nicolas D; Bertin, Nicole; Pilz, Stefan; Tomaschitz, Andreas; Sechi, Leonardo A

    2016-07-01

    Primary aldosteronism is associated with increased left ventricular (LV) mass independently of blood pressure. Previous studies suggest that elevated aldosterone causes cardiac damage only in the presence of an inappropriate salt status. We examined the relevance of dietary salt intake on cardiac changes in patients with primary aldosteronism before and after treatment. Sixty-five patients with tumoral or idiopathic primary aldosteronism were recruited at a University medical center and followed after either surgical (n=30) or medical (n=35) treatment. At baseline and 1 year after treatment, cardiac morphology and functional variables were measured by echocardiography together with duplicate 24-hour urinary sodium collections. At baseline, LV mass index was associated with urinary sodium excretion and plasma aldosterone levels. During follow-up, blood pressure (from 167/102-135/83 mm Hg; P<0.001) and LV mass index (from 50.5±13.0-44.4±8.9 g/m(2.7); P<0.001) decreased significantly with nonsignificant changes in LV geometry and functional properties. At the end of follow-up, percentage decrease in LV mass index was significantly greater in patients who had >10% reduction in urinary sodium excretion (15.0±12.5%) than in the remaining patients (5.5±9.3%; P<0.001). Changes in LV mass index induced by both surgical and medical treatment were directly and independently correlated with changes in blood pressure (β=0.419; P=0.009) and urinary sodium excretion (β=0.334; P=0.012) observed at follow-up. These findings strongly support the hypothesis that dietary salt intake has a crucial role in aldosterone-related LV changes and could contribute to cardiac damage in patients with primary aldosteronism. PMID:27245179

  10. Metabolic and Hormonal Changes of Severely Burned Children Receiving Long-Term Oxandrolone Treatment

    PubMed Central

    Przkora, Rene; Jeschke, Marc G.; Barrow, Robert E.; Suman, Oscar E.; Meyer, Walter J.; Finnerty, Celeste C.; Sanford, Arthur P.; Lee, Jong; Chinkes, David L.; Mlcak, Ronald P.; Herndon, David N.

    2005-01-01

    Objective: When given to children for 1 year after a severe burn, oxandrolone significantly improves lean body mass, bone mineral content, and muscle strength. The beneficial effects of oxandrolone on height and weight were observed 1 year after treatment was discontinued. To study the efficacy of oxandrolone in severely burned children for 12 months after burn and 12 months after the drug was discontinued. Summary Background Data: Oxandrolone attenuates body catabolism during the acute phase after burn. It is unclear whether oxandrolone would have any beneficial effects during long-term treatment or if there were any effects after the drug was stopped. Methods: Sixty-one children with 40% total body surface area burns were enrolled in this study. Patients were randomized into those to receive oxandrolone (n = 30) or placebo (n = 31) for the first 12 months. Treatment was discontinued after 12 months, and the patients were studied without the drug for the following 12 months. At discharge and 6, 12, 18, and 24 months after burn, height, weight, body composition, resting energy expenditure, muscle strength, and serum human growth hormone, insulin-like growth factor-I (IGF-1), IGF binding protein-3, insulin, cortisol, parathyroid hormone, tri-iodothyronine uptake (T3 uptake), and free thyroxine index (FTI) were measured. Statistical analysis used Tukey multiple comparison test. Significance was accepted at P < 0.05. Results: Oxandrolone improved lean body mass, bone mineral content and muscle strength compared with controls during treatment, P < 0.05. Serum IGF-1, T3 uptake, and FTI were significantly higher during drug treatment compared with controls, P < 0.05. Significant increases in height and weight with oxandrolone were observed after the end of treatment. Conclusions: Oxandrolone improved body composition and strength in severely burned children during the 12 months of treatment. Its effect on height and weight continued after treatment was discontinued. PMID

  11. Changes to antiretroviral drug regimens during integrated TB-HIV treatment: Results of the SAPiT trial

    PubMed Central

    Naidoo, Anushka; Naidoo, Kogieleum; Yende-Zuma, Nonhlanhla; Gengiah, Tanuja N; Padayatchi, Nesri; Gray, Andrew L.; Bamber, Sheila; Nair, Gonasagrie; Karim, Salim S Abdool

    2013-01-01

    Background Frequency of drug changes in combination antiretroviral therapy among patients starting both tuberculosis (TB) and human immunodeficiency virus (HIV) therapy, as a result of treatment-limiting toxicity or virological failure, is not well established. Methods Patients in the Starting Antiretroviral Therapy at Three Points in Tuberculosis (SAPiT) trial were randomized to initiate antiretroviral therapy either early or late during TB treatment or after completion of TB treatment. Drug changes due to toxicity (defined as due to grade 3 or 4 adverse events) or virological failure (defined as viral load > 1000 copies/ml on two occasions, taken at least 4 weeks apart) were assessed in these patients. Results A total of 501 TB-HIV co-infected patients were followed for a mean of 16.0 (95% confidence interval (CI): 15.5 to 16.6) months after antiretroviral therapy (ART) initiation. The standard first-line ARVs used, were efavirenz, lamivudine and didanosine. Individual drug switches for toxicity occurred in 14 patients (incidence rate: 2.1 per 100 person-years; 95% (CI): 1.1 to 3.5), and complete regimen changes due to virological failure in 25 patients (incidence rate: 3.7 per 100 person-years; CI: 2.4 to 5.5). The most common treatment limiting toxicities were neuropsychiatric effects (n=4; 0.8%), elevated transaminase levels and hyperlactatemia (n= 3; 0.6%), and peripheral neuropathy (n=2; 0.4%). Complete regimen change due to treatment failure was more common in patients with CD4+ cell count <50cells/mm3 (p<0.001) at ART initiation and body mass index greater than 25 kg/m2 (p=0.01) at entry into the study. Conclusion Both drug switches and complete regimen change were uncommon in patients co-treated for TB-HIV with the chosen regimen. Patients with severe immunosuppression need to be monitored carefully, as they were most at risk for treatment failure requiring regimen change. PMID:24176943

  12. Videotape assessment of changes in aberrant meal-time behaviors in anorexia nervosa after treatment.

    PubMed

    Tappe, K A; Gerberg, S E; Shide, D J; Andersen, A E; Rolls, B J

    1998-04-01

    This study compared meal-time behaviors in patients with anorexia nervosa to normal-weight controls and the effects of hospital treatment on these behaviors. Ten restricting-anorexics and six normal-weight controls were given a standard lunch and asked to eat the entire meal. Their behaviors were recorded via hidden camera. All participants were tested twice--anorexics before and after in-patient treatment, and controls at similar intervals. Videotapes of these sessions were analysed for occurrence and duration of eight categories of non-ingestive behaviors: food manipulation, food preparation, food moving, non-food manipulation, concealment, vigilance, passivity and physical activity. Food-ingestion patterns, including number of bites of food and switches between different kinds of food, were also recorded. Results indicated that anorexics spent significantly more time than controls in behaviors that were directly food-related, and exhibited more vigilance behavior. Pre-treatment anorexics spent significantly more time in these behaviors than did post-treatment anorexics. Few group differences or treatment effects were found in food-ingestion patterns, although there was an indication that both pre- and post-treatment anorexics avoided high-fat foods more than controls did. These results suggest that videotaping provides a useful technique for characterizing the behavior associated with eating disorders. Further studies should explore whether normalization of these behaviors is associated with a positive clinical outcome. PMID:9573451

  13. Nanophase Changes in Nickel Doped Titania Composites by Thermal Treatment and Photocatalytic Destruction of NO(x).

    PubMed

    Jeon, Ki-Yong; Kim, Wha-Jung; Lee, Chang-Joon; Gopalan, Anantha-Iyengar; Lee, Kwang-Pill

    2015-09-01

    This study investigated the influence of Ni doping and thermal treatment (600, 800 degrees and 1000 degrees C) on the physiochemical properties of a commercially available low cost KA100 TiO2. Ni containing KA100 samples were prepared with different loading of Ni (3%, 6% and 9% wt to KA100) and subjected to heat treatement at 600 degrees, 800 degrees and 1000 degrees C. The as-prepared samples were characterized by X-ray diffraction (XRD), Scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), Diffuse reflection UV-Visible spectroscopy and Raman spectroscopy and nitrogen-adsorption-desorption measurements to observe the nanophase changes in the particle characteristics following Ni modification and thermal treatment. The results show that the Ni atom entered the TiO2 lattice structure upon heat treatment at 800 degrees C and 1000 degrees C influencing the anatase-rutile phase transformation. The TiO2 powders after heat treatment had a bimodal pore-size distribution as the temperature of the heat treatment increased. In addition, the anatase crystallite size and average pore sizes increased. Photodegradation of NO(x) was investigated using the Ni doped KA100 as a photocatalyst. Modification of KA100 with nickel and heat treatment up to 1000 degrees C enhanced the photocatalysis for the degradation of NO(x). Typically, KA100 modified with 6% Ni and heat treated to 1000 degrees C exhibited excellent NO(x) removal activity. PMID:26716321

  14. What contributes to predicting change in the treatment of dissociation: initial levels of dissociation, PTSD, or overall distress?

    PubMed

    Brand, Bethany L; Stadnik, Ryan

    2013-01-01

    Individuals with dissociative disorders (DDs) suffer from high levels of dissociation as well as posttraumatic stress disorder (PTSD) and general distress. No research has investigated how changes in dissociation relate to changes in other symptoms over the course of treatment in patients with DD. Using a prospective, naturalistic design, we collected reports of symptoms from a sample of therapists and their patients diagnosed with dissociative identity disorder or dissociative disorder not otherwise specified who participated in the Treatment Outcome of Patients with Dissociative Disorders study. The patients completed surveys at intake (Time 1) into the study and at 30-month follow-up (Time 4). We found that dissociative symptoms, including amnesia, depersonalization/derealization, and absorption, at the initial assessment of the study ("initial") were related to initial levels of PTSD and general distress and that changes in dissociative symptoms were related to changes in PTSD and general distress. Initial dissociation was a significant predictor of change in dissociation at 30 months when we controlled for length of time for follow-up, length of time practicing therapy, and length of time treating dissociative patients. Our results suggest that a reduction in dissociative symptoms in DD patients is associated with reductions in the overall severity of dissociative, posttraumatic stress, and distress symptoms. PMID:23627481

  15. Implications of changes in the post-weld heat treatment requirements on properties of steels and welds for offshore structures

    SciTech Connect

    Pisarski, H.G.

    1996-12-01

    The reductions in the post-weld heat treatment temperatures and hold times proposed in revisions to pressure vessel (BS5500) and offshore steel (EN 10225) codes are considered in relation to their effects on resistance to fracture initiation. A review of the effects of the proposed changes on the mechanical properties and residual stresses in medium strength C-Mn steels and welds is described. It is concluded that the proposed reductions in temperature and hold time will, in general, minimize the changes in mechanical properties which would occur under current PWHT procedures. However, the levels of residual stresses will be significantly higher, and this will reduce the margin against fracture initiation.

  16. Multidimensional Family Therapy: Evidence Base for Transdiagnostic Treatment Outcomes, Change Mechanisms, and Implementation in Community Settings.

    PubMed

    Liddle, Howard A

    2016-09-01

    This article summarizes the 30+-year evidence base of Multidimensional Family Therapy (MDFT), a comprehensive treatment for youth substance abuse and antisocial behaviors. Findings from four types of MDFT studies are discussed: hybrid efficacy/effectiveness randomized controlled trials, therapy process studies, cost analyses, and implementation trials. This research has evaluated various versions of MDFT. These studies have systematically tested adaptations of MDFT for diverse treatment settings in different care sectors (mental health, substance abuse, juvenile justice, and child welfare), as well as adaptations according to treatment delivery features and client impairment level, including adolescents presenting with multiple psychiatric diagnoses. Many published scientific reviews, including meta-analyses, national and international government publications, and evidence-based treatment registries, offer consistent conclusions about the clinical effectiveness of MDFT compared with standard services as well as active treatments. The diverse and continuing MDFT research, the favorable, multi-source independent evaluations, combined with the documented receptivity of youth, parents, community-based clinicians and administrators, and national and international MDFT training programs (U.S.-based organization is MDFT International, www.mdft.org; and Europe-based organization is www.mdft.nl) all support the potential for continued transfer of MDFT to real-world clinical settings. PMID:27565445

  17. Techno-economical efficiency and productivity change of wastewater treatment plants: the role of internal and external factors.

    PubMed

    Hernández-Sancho, F; Molinos-Senante, M; Sala-Garrido, R

    2011-12-01

    Efficiency and productivity are important measures for identifying best practice in businesses and optimising resource-use. This study analyses how these two measures change across the period 2003-2008 for 196 wastewater treatment plants (WWTPs) in Spain, by using the benchmarking methods of Data Envelopment Analysis and the Malmquist Productivity Index. To identify which variables contribute to the sustainability of the WWTPs, differences in efficiency scores and productivity indices for external factors are also investigated. Our results indicate that both efficiency and productivity decreased over the five years. We verify that the productivity drop is primarily explained by technical change. Furthermore, certain external variables affected WWTP efficiency, including plant size, treatment technology and energy consumption. However, plants with low energy consumption are the only ones which improve their productivity. Finally, the benchmarking analyses proved to be useful as management tools in the wastewater sector, by providing vital information for improving the sustainability of plants. PMID:22037729

  18. Changes in functional connectivity related to direct training and generalization effects of a word finding treatment in chronic aphasia.

    PubMed

    Sandberg, Chaleece W; Bohland, Jason W; Kiran, Swathi

    2015-11-01

    The neural mechanisms that underlie generalization of treatment-induced improvements in word finding in persons with aphasia (PWA) are currently poorly understood. This study aimed to shed light on changes in functional network connectivity underlying generalization in aphasia. To this end, we used fMRI and graph theoretic analyses to examine changes in functional connectivity after a theoretically-based word-finding treatment in which abstract words were used as training items with the goal of promoting generalization to concrete words. Ten right-handed native English-speaking PWA (7 male, 3 female) ranging in age from 47 to 75 (mean=59) participated in this study. Direct training effects coincided with increased functional connectivity for regions involved in abstract word processing. Generalization effects coincided with increased functional connectivity for regions involved in concrete word processing. Importantly, similarities between training and generalization effects were noted as were differences between participants who generalized and those who did not. PMID:26398158

  19. Changes in sexual risk taking with antiretroviral treatment: influence of context and gender norms in Mombasa, Kenya.

    PubMed

    Sarna, Avina; Chersich, Matthew; Okal, Jerry; Luchters, Stanley M F; Mandaliya, Kishorchandra N; Rutenberg, Naomi; Temmerman, Marleen

    2009-11-01

    In-depth interviews were conducted with 23 sexually-active adults receiving antiretroviral treatment (ART) in Mombasa Kenya to understand changes in sexual behaviour after treatment initiation and factors influencing condom use. Advanced HIV disease had previously led to marked decreases in sexual desire and function. After HIV testing, numbers of partners reduced and monogamous relationships began to predominate. Receipt of ART strengthened these changes, while improving sexual health. However, concurrent sexual partnerships continue within polygamous marriage and unprotected sex occurs with regular partners, even those who are HIV-negative. Those who used condoms inconsistently prior to ART often remained inconsistent users thereafter. While disclosure of HIV status appeared to support condom use, this does not always predict protected sex. In addition to classic perceptions about condom's effect on intimacy and trust, traditional gender roles, misconceptions about potential harm from condoms and fertility desires hinder condom use. PMID:19557584

  20. Pluvials, Droughts, Energetics, and the Mongol Empire

    NASA Astrophysics Data System (ADS)

    Hessl, A. E.; Pederson, N.; Baatarbileg, N.

    2012-12-01

    consistent with a well-documented volcanic eruption that caused massive crop damage and famine throughout much of Europe. In Mongol history, this abrupt cooling also coincides with the move of the capital from Central Mongolia (Karakorum) to China (Beijing). In combination, the tree-ring records of water and temperature suggest that 1) the rise of the Mongol Empire occurred during an unusually consistent warm and wet climate and 2) the disintegration of the Empire occurred following a plunge into cold and dry conditions in Central Mongolia. These results represent the first step of a larger project integrating physical science and history to understand the role of energy in the evolution of the Mongol Empire. Using data from historic documents, ecological modeling, tree rings, and sediment cores, we will investigate whether the expansion and contraction of the empire was related to moisture and temperature availability and thus grassland productivity associated with climate change in the Orkhon Valley.