Science.gov

Sample records for adopted artemisinin-based combination

  1. Degradation of Artemisinin-Based Combination Therapies Under Tropical Conditions.

    PubMed

    Hall, Zoe; Allan, Elizabeth Louise; van Schalkwyk, Donelly Andrew; van Wyk, Albert; Kaur, Harparkash

    2016-05-01

    Poor quality antimalarials, including falsified, substandard, and degraded drugs, are a serious health concern in malaria-endemic countries. Guidelines are lacking on how to distinguish between substandard and degraded drugs. "Forced degradation" in an oven was carried out on three common artemisinin-based combination therapy (ACT) brands to detect products of degradation using liquid chromatography mass spectrometry and help facilitate classification of degraded drugs. "Natural aging" of 2,880 tablets each of ACTs artemether/lumefantrine and artesunate/amodiaquine was undertaken to evaluate their long-term stability in tropical climates. Samples were aged in the presence and absence of light on-site in Ghana and in a stability chamber (London), removed at regular intervals, and analyzed to determine loss of the active pharmaceutical ingredients (APIs) over time and detect products of degradation. Loss of APIs in naturally aged tablets (both in Ghana and the pharmaceutical stability chamber) was 0-7% over 3 years (∼12 months beyond expiry) with low levels of degradation products detected. Using this developed methodology, it was found that a quarter of ACTs purchased in Enugu, Nigeria (concurrent study), that would have been classified as substandard, were in fact degraded. Presence of degradation products together with evidence of insufficient APIs can be used to classify drugs as degraded.

  2. Degradation of Artemisinin-Based Combination Therapies under Tropical Conditions

    PubMed Central

    Hall, Zoe; Allan, Elizabeth Louise; van Schalkwyk, Donelly Andrew; van Wyk, Albert; Kaur, Harparkash

    2016-01-01

    Poor quality antimalarials, including falsified, substandard, and degraded drugs, are a serious health concern in malaria-endemic countries. Guidelines are lacking on how to distinguish between substandard and degraded drugs. “Forced degradation” in an oven was carried out on three common artemisinin-based combination therapy (ACT) brands to detect products of degradation using liquid chromatography mass spectrometry and help facilitate classification of degraded drugs. “Natural aging” of 2,880 tablets each of ACTs artemether/lumefantrine and artesunate/amodiaquine was undertaken to evaluate their long-term stability in tropical climates. Samples were aged in the presence and absence of light on-site in Ghana and in a stability chamber (London), removed at regular intervals, and analyzed to determine loss of the active pharmaceutical ingredients (APIs) over time and detect products of degradation. Loss of APIs in naturally aged tablets (both in Ghana and the pharmaceutical stability chamber) was 0–7% over 3 years (∼12 months beyond expiry) with low levels of degradation products detected. Using this developed methodology, it was found that a quarter of ACTs purchased in Enugu, Nigeria (concurrent study), that would have been classified as substandard, were in fact degraded. Presence of degradation products together with evidence of insufficient APIs can be used to classify drugs as degraded. PMID:26951346

  3. Declining Responsiveness of Plasmodium falciparum Infections to Artemisinin-Based Combination Treatments on the Kenyan Coast

    PubMed Central

    Borrmann, Steffen; Sasi, Philip; Mwai, Leah; Bashraheil, Mahfudh; Abdallah, Ahmed; Muriithi, Steven; Frühauf, Henrike; Schaub, Barbara; Pfeil, Johannes; Peshu, Judy; Hanpithakpong, Warunee; Rippert, Anja; Juma, Elizabeth; Tsofa, Benjamin; Mosobo, Moses; Lowe, Brett; Osier, Faith; Fegan, Greg; Lindegårdh, Niklas; Nzila, Alexis; Peshu, Norbert; Mackinnon, Margaret; Marsh, Kevin

    2011-01-01

    Background The emergence of artemisinin-resistant P. falciparum malaria in South-East Asia highlights the need for continued global surveillance of the efficacy of artemisinin-based combination therapies. Methods On the Kenyan coast we studied the treatment responses in 474 children 6–59 months old with uncomplicated P. falciparum malaria in a randomized controlled trial of dihydroartemisinin-piperaquine vs. artemether-lumefantrine from 2005 to 2008. (ISRCTN88705995) Results The proportion of patients with residual parasitemia on day 1 rose from 55% in 2005–2006 to 87% in 2007–2008 (odds ratio, 5.4, 95%CI, 2.7–11.1; P<0.001) and from 81% to 95% (OR, 4.1, 95%CI, 1.7–9.9; P = 0.002) in the DHA-PPQ and AM-LM groups, respectively. In parallel, Kaplan-Meier estimated risks of apparent recrudescent infection by day 84 increased from 7% to 14% (P = 0.1) and from 6% to 15% (P = 0.05) with DHA-PPQ and AM-LM, respectively. Coinciding with decreasing transmission in the study area, clinical tolerance to parasitemia (defined as absence of fever) declined between 2005–2006 and 2007–2008 (OR body temperature >37.5°C, 2.8, 1.9–4.1; P<0.001). Neither in vitro sensitivity of parasites to DHA nor levels of antibodies against parasite extract accounted for parasite clearance rates or changes thereof. Conclusions The significant, albeit small, decline through time of parasitological response rates to treatment with ACTs may be due to the emergence of parasites with reduced drug sensitivity, to the coincident reduction in population-level clinical immunity, or both. Maintaining the efficacy of artemisinin-based therapy in Africa would benefit from a better understanding of the mechanisms underlying reduced parasite clearance rates. Trial Registration Controlled-Trials.com ISRCTN88705995 PMID:22102856

  4. Access to artemisinin-based combination therapy (ACT) and quinine in malaria holoendemic regions of western Kenya

    PubMed Central

    2014-01-01

    Background Artemisinin-based combination therapy (ACT) has been adopted as the most effective treatment against malaria in many endemic countries like Kenya while quinine has remained the second line. The objective of the current study was to assess access to Kenya’s policy recommended anti-malarials, ACT and quinine in the public, private and not-for-profit drug outlets in western Kenya. Methods A cross-sectional survey using purposive sampling of 288 outlets (126 public, 96 private, 66 not-for-profit) was conducted in western Kenya in two regions with varying Plasmodium falciparum endemicities. Information on access (availability, price, affordability) on ACT and quinine was collected using the WHO and Healthcare Associated Infection (HAI) standardized methodologies for availability, prices and affordability of drugs. From a Ministry of Health database, the following were included in the analyses: one (1) main public hospital, followed by random selection of five hospitals under this main facility. Eight other public outlets under each of the hospitals were selected, to a total of 96. Matching number of private outlets (n = 96), all (66) not-for-profit outlets and additional 30 public health facilities were sampled to get the required sample size of 288. Results More public 111 (88.1%) and not-for-profit 27 (40.9%) outlets stocked subsidized ACT (artemether-lumefantrine, AL). Other artemisinin-based combinations were widely available for both children 93 (96.9%) and adults 82 (85.0%) in private outlets. Frequent stock-outs were in public in 106 (84%), reporting three times or more stock-outs in three months. Subsidized ACT (AL) was sold at median price of USD 0.94 and 0.75 in private and not-for-profit outlets respectively. The costs was higher than recommended price of USD 0.5 and requiring up to 0.20-0.25 days of disposable income for households in lowest economic status. Conclusion There is low availability of subsidized ACT (AL) and higher frequency of

  5. Simple Field Assays to Check Quality of Current Artemisinin-Based Antimalarial Combination Formulations

    PubMed Central

    Ioset, Jean-Robert; Kaur, Harparkash

    2009-01-01

    Introduction Malaria continues to be one of the major public health problems in Africa, Asia and Latin America. Artemisinin derivatives (ARTs; artesunate, artemether, and dihydroartemisinin) derived from the herb, Artemisia annua, are the most effective antimalarial drugs available providing rapid cures. The World Health Organisation (WHO) has recommended that all antimalarials must be combined with an artemisinin component (artemisinin-based combination therapy; ACT) for use as first line treatment against malaria. This class of drugs is now first-line policy in most malaria-endemic countries. Reports of ad hoc surveys from South East Asia show that up to 50% of the artesunate currently sold is counterfeit. Drug quality is rarely assessed in resource poor countries in part due to lack of dedicated laboratory facilities which are expensive to build, equip and maintain. With a view to address this unmet need we developed two novel colour reaction assays that can be used in the field to check the quality of ARTs. Methods and Findings Our assays utilise thin layer chromatography silica gel sheets and 2, 4 dinitrophenylhydrazine or 4-Benzoylamino-2, 5-dimethoxybenzenediazonium chloride hemi (zinc chloride) salt as the reagents showing a pink or blue product respectively only in the presence ARTs. We are able to detect as low as 10% of ARTs in ACTs (WINTHROP - artesunate/amodiaquine, Coartem®-artemether/lumefantrine and Duocortexcin - dihydroartemisinin/piperaquine). The assays have been validated extensively by testing eighty readily accessible and widely used drugs in malaria endemic countries. None of the other antimalarial drugs or a range of commonly used excipients, antiretroviral drugs or other frequently used drugs from the WHO essential drugs list such as analgesics or antibiotics are detected with our assays. Conclusions Our two independent assays requiring no specialist training are specific, simple to use, rapid, robust, reproducible, inexpensive and, have

  6. Increasing Access to Subsidized Artemisinin-based Combination Therapy through Accredited Drug Dispensing Outlets in Tanzania

    PubMed Central

    2011-01-01

    Background In Tanzania, many people seek malaria treatment from retail drug sellers. The National Malaria Control Program identified the accredited drug dispensing outlet (ADDO) program as a private sector mechanism to supplement the distribution of subsidized artemisinin-based combination therapies (ACTs) from public facilities and increase access to the first-line antimalarial in rural and underserved areas. The ADDO program strengthens private sector pharmaceutical services by improving regulatory and supervisory support, dispenser training, and record keeping practices. Methods The government's pilot program made subsidized ACTs available through ADDOs in 10 districts in the Morogoro and Ruvuma regions, covering about 2.9 million people. The program established a supply of subsidized ACTs, created a price system with a cost recovery plan, developed a plan to distribute the subsidized products to the ADDOs, trained dispensers, and strengthened the adverse drug reactions reporting system. As part of the evaluation, 448 ADDO dispensers brought their records to central locations for analysis, representing nearly 70% of ADDOs operating in the two regions. ADDO drug register data were available from July 2007-June 2008 for Morogoro and from July 2007-September 2008 for Ruvuma. This intervention was implemented from 2007-2008. Results During the pilot, over 300,000 people received treatment for malaria at the 448 ADDOs. The percentage of ADDOs that dispensed at least one course of ACT rose from 26.2% during July-September 2007 to 72.6% during April-June 2008. The number of malaria patients treated with ACTs gradually increased after the start of the pilot, while the use of non-ACT antimalarials declined; ACTs went from 3% of all antimalarials sold in July 2007 to 26% in June 2008. District-specific data showed substantial variation among the districts in ACT uptake through ADDOs, ranging from ACTs representing 10% of all antimalarial sales in Kilombero to 47% in

  7. Subsidising artemisinin-based combination therapy in the private retail sector

    PubMed Central

    Opiyo, Newton; Yamey, Gavin; Garner, Paul

    2016-01-01

    Background Malaria causes ill health and death in Africa. Treating illness promptly with artemisinin-based combination therapy (ACT) is likely to cure people and avoid the disease progressing to more severe forms and death. In many countries, ACT use remains low. Part of the problem is that most people seek treatment from the retail sector where ACTs are expensive; this expense is a barrier to their use. The Global Fund and other international organisations are subsidising the cost of ACTs for private retail providers to improve access to ACTs. The subsidy was initially organised through a stand-alone initiative, called the Affordable Medicines Facility-malaria (AMFm), but has since been integrated into the Global Fund core grant management and financial processes. Objectives To assess the effect of programmes that include ACT price subsidies for private retailers on ACT use, availability, price and market share. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 1, The Cochrane Library, including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register); MEDLINE (OvidSP), EMBASE (OvidSP), CINAHL (EbscoHost), EconLit (ProQuest), Global Health (OvidSP), Regional Indexes (Global Health Library, WHO), LILACS (Global Health Library, WHO), Science Citation Index and Social Sciences Citation Index (ISI Web of Science) and Health Management (ProQuest). All databases were searched February 2015, except for Health Management which was searched November 2013, without any date, language or publication status restrictions. We also searched the International Clinical Trials Registry Platform (ICTRP; WHO), ClinicalTrials.gov (NIH) and various grey literature sources. We also conducted a cited reference search for all included studies in ISI Web of Knowledge, checked references of identified articles and contacted authors to identify additional studies. Selection criteria Randomised trials, non

  8. Subsidising artemisinin-based combination therapy in the private retail sector

    PubMed Central

    Opiyo, Newton; Yamey, Gavin; Garner, Paul

    2016-01-01

    Background Malaria causes ill health and death in Africa. Treating illness promptly with artemisinin-based combination therapy (ACT) is likely to cure people and avoid the disease progressing to more severe forms and death. In many countries, ACT use remains low. Part of the problem is that most people seek treatment from the retail sector where ACTs are expensive; this expense is a barrier to their use. The Global Fund and other international organisations are subsidising the cost of ACTs for private retail providers to improve access to ACTs. The subsidy was initially organised through a stand-alone initiative, called the Affordable Medicines Facility-malaria (AMFm), but has since been integrated into the Global Fund core grant management and financial processes. Objectives To assess the effect of programmes that include ACT price subsidies for private retailers on ACT use, availability, price and market share. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 1, The Cochrane Library, including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register); MEDLINE (OvidSP), EMBASE (OvidSP), CINAHL (EbscoHost), EconLit (ProQuest), Global Health (OvidSP), Regional Indexes (Global Health Library, WHO), LILACS (Global Health Library, WHO), Science Citation Index and Social Sciences Citation Index (ISI Web of Science) and Health Management (ProQuest). All databases were searched February 2015, except for Health Management which was searched November 2013, without any date, language or publication status restrictions. We also searched the International Clinical Trials Registry Platform (ICTRP; WHO), ClinicalTrials.gov (NIH) and various grey literature sources. We also conducted a cited reference search for all included studies in ISI Web of Knowledge, checked references of identified articles and contacted authors to identify additional studies. Selection criteria Randomised trials, non

  9. Should countries implementing an artemisinin-based combination malaria treatment policy also introduce rapid diagnostic tests?

    PubMed Central

    Zikusooka, Charlotte M; McIntyre, Diane; Barnes, Karen I

    2008-01-01

    Background Within the context of increasing antimalarial costs and or decreasing malaria transmission, the importance of limiting antimalarial treatment to only those confirmed as having malaria parasites becomes paramount. This motivates for this assessment of the cost-effectiveness of routine use of rapid diagnostic tests (RDTs) as an integral part of deploying artemisinin-based combination therapies (ACTs). Methods The costs and cost-effectiveness of using RDTs to limit the use of ACTs to those who actually have Plasmodium falciparum parasitaemia in two districts in southern Mozambique were assessed. To evaluate the potential impact of introducing definitive diagnosis using RDTs (costing $0.95), five scenarios were considered, assuming that the use of definitive diagnosis would find that between 25% and 75% of the clinically diagnosed malaria patients are confirmed to be parasitaemic. The base analysis compared two ACTs, artesunate plus sulfadoxine/pyrimethamine (AS+SP) costing $1.77 per adult treatment and artemether-lumefantrine (AL) costing $2.40 per adult treatment, as well as the option of restricting RDT use to only those older than six years. Sensitivity analyses considered lower cost ACTs and RDTs and different population age distributions. Results Compared to treating patients on the basis of clinical diagnosis, the use of RDTs in all clinically diagnosed malaria cases results in cost savings only when 29% and 52% or less of all suspected malaria cases test positive for malaria and are treated with AS+SP and AL, respectively. These cut-off points increase to 41.5% (for AS+SP) and to 74% (for AL) when the use of RDTs is restricted to only those older than six years of age. When 25% of clinically diagnosed patients are RDT positive and treated using AL, there are cost savings per malaria positive patient treated of up to $2.12. When more than 29% of clinically diagnosed cases are malaria test positive, the incremental cost per malaria positive patient

  10. Impact of retreatment with an artemisinin-based combination on malaria incidence and its potential selection of resistant strains: study protocol for a randomized controlled clinical trial

    PubMed Central

    2013-01-01

    Background Artemisinin-based combination therapy is currently recommended by the World Health Organization as first-line treatment of uncomplicated malaria. Recommendations were adapted in 2010 regarding rescue treatment in case of treatment failure. Instead of quinine monotherapy, it should be combined with an antibiotic with antimalarial properties; alternatively, another artemisinin-based combination therapy may be used. However, for informing these policy changes, no clear evidence is yet available. The need to provide the policy makers with hard data on the appropriate rescue therapy is obvious. We hypothesize that the efficacy of the same artemisinin-based combination therapy used as rescue treatment is as efficacious as quinine + clindamycin or an alternative artemisinin-based combination therapy, without the risk of selecting drug resistant strains. Design We embed a randomized, open label, three-arm clinical trial in a longitudinal cohort design following up children with uncomplicated malaria until they are malaria parasite free for 4 weeks. The study is conducted in both the Democratic Republic of Congo and Uganda and performed in three steps. In the first step, the pre-randomized controlled trial (RCT) phase, children aged 12 to 59 months with uncomplicated malaria are treated with the recommended first-line drug and constitute a cohort that is passively followed up for 42 days. If the patients experience an uncomplicated malaria episode between days 14 and 42 of follow-up, they are randomized either to quinine + clindamycin, or an alternative artemisinin-based combination therapy, or the same first-line artemisinin-based combination therapy to be followed up for 28 additional days. If between days 14 and 28 the patients experience a recurrent parasitemia, they are retreated with the recommended first-line regimen and actively followed up for another 28 additional days (step three; post-RCT phase). The same methodology is followed for each subsequent

  11. Stabilizing supply of artemisinin and artemisinin-based combination therapy in an era of wide-spread scale-up.

    PubMed

    Shretta, Rima; Yadav, Prashant

    2012-01-01

    The global demand for artemisinin-based combination therapy (ACT) has grown sharply since its recommendation by the World Health Organization in 2002. However, a combination of financing and programmatic uncertainties, limited suppliers of finished products, information opacity across the different tiers in the supply chain, and widespread fluctuations in raw material prices have together contributed to a market fraught with demand and supply uncertainties and price volatility. Various short-term solutions have been deployed to alleviate supply shortages caused by these challenges; however, new mechanisms are required to build resilience into the supply chain. This review concludes that a mix of strategies is required to stabilize the artemisinin and ACT market. First, better and more effective pooling of demand and supply risks and better contracting to allow risk sharing among the stakeholders are needed. Physical and financial buffer stocks will enable better matching of demand and supply in the short and medium term. Secondly, physical buffers will allow stable supplies when there are procurement and supply management challenges while financial buffer funds will address issues around funding disruptions. Finally, in the medium to long term, significant investments in country level system strengthening will be required to minimize national level demand uncertainties. In addition a voluntary standard for extractors to ensure appropriate purchasing and sales practices as well as minimum quality and ethical standards could help stabilize the artemisinin market in the long term. PMID:23198961

  12. Stabilizing supply of artemisinin and artemisinin-based combination therapy in an era of wide-spread scale-up.

    PubMed

    Shretta, Rima; Yadav, Prashant

    2012-12-02

    The global demand for artemisinin-based combination therapy (ACT) has grown sharply since its recommendation by the World Health Organization in 2002. However, a combination of financing and programmatic uncertainties, limited suppliers of finished products, information opacity across the different tiers in the supply chain, and widespread fluctuations in raw material prices have together contributed to a market fraught with demand and supply uncertainties and price volatility. Various short-term solutions have been deployed to alleviate supply shortages caused by these challenges; however, new mechanisms are required to build resilience into the supply chain. This review concludes that a mix of strategies is required to stabilize the artemisinin and ACT market. First, better and more effective pooling of demand and supply risks and better contracting to allow risk sharing among the stakeholders are needed. Physical and financial buffer stocks will enable better matching of demand and supply in the short and medium term. Secondly, physical buffers will allow stable supplies when there are procurement and supply management challenges while financial buffer funds will address issues around funding disruptions. Finally, in the medium to long term, significant investments in country level system strengthening will be required to minimize national level demand uncertainties. In addition a voluntary standard for extractors to ensure appropriate purchasing and sales practices as well as minimum quality and ethical standards could help stabilize the artemisinin market in the long term.

  13. Globally prevalent PfMDR1 mutations modulate Plasmodium falciparum susceptibility to artemisinin-based combination therapies.

    PubMed

    Veiga, M Isabel; Dhingra, Satish K; Henrich, Philipp P; Straimer, Judith; Gnädig, Nina; Uhlemann, Anne-Catrin; Martin, Rowena E; Lehane, Adele M; Fidock, David A

    2016-01-01

    Antimalarial chemotherapy, globally reliant on artemisinin-based combination therapies (ACTs), is threatened by the spread of drug resistance in Plasmodium falciparum parasites. Here we use zinc-finger nucleases to genetically modify the multidrug resistance-1 transporter PfMDR1 at amino acids 86 and 184, and demonstrate that the widely prevalent N86Y mutation augments resistance to the ACT partner drug amodiaquine and the former first-line agent chloroquine. In contrast, N86Y increases parasite susceptibility to the partner drugs lumefantrine and mefloquine, and the active artemisinin metabolite dihydroartemisinin. The PfMDR1 N86 plus Y184F isoform moderately reduces piperaquine potency in strains expressing an Asian/African variant of the chloroquine resistance transporter PfCRT. Mutations in both digestive vacuole-resident transporters are thought to differentially regulate ACT drug interactions with host haem, a product of parasite-mediated haemoglobin degradation. Global mapping of these mutations illustrates where the different ACTs could be selectively deployed to optimize treatment based on regional differences in PfMDR1 haplotypes. PMID:27189525

  14. Globally prevalent PfMDR1 mutations modulate Plasmodium falciparum susceptibility to artemisinin-based combination therapies

    PubMed Central

    Veiga, M. Isabel; Dhingra, Satish K.; Henrich, Philipp P.; Straimer, Judith; Gnädig, Nina; Uhlemann, Anne-Catrin; Martin, Rowena E.; Lehane, Adele M.; Fidock, David A.

    2016-01-01

    Antimalarial chemotherapy, globally reliant on artemisinin-based combination therapies (ACTs), is threatened by the spread of drug resistance in Plasmodium falciparum parasites. Here we use zinc-finger nucleases to genetically modify the multidrug resistance-1 transporter PfMDR1 at amino acids 86 and 184, and demonstrate that the widely prevalent N86Y mutation augments resistance to the ACT partner drug amodiaquine and the former first-line agent chloroquine. In contrast, N86Y increases parasite susceptibility to the partner drugs lumefantrine and mefloquine, and the active artemisinin metabolite dihydroartemisinin. The PfMDR1 N86 plus Y184F isoform moderately reduces piperaquine potency in strains expressing an Asian/African variant of the chloroquine resistance transporter PfCRT. Mutations in both digestive vacuole-resident transporters are thought to differentially regulate ACT drug interactions with host haem, a product of parasite-mediated haemoglobin degradation. Global mapping of these mutations illustrates where the different ACTs could be selectively deployed to optimize treatment based on regional differences in PfMDR1 haplotypes. PMID:27189525

  15. Effect of Nutritional Status on Response to Treatment with Artemisinin-Based Combination Therapy in Young Ugandan Children with Malaria▿

    PubMed Central

    Verret, Wendy J.; Arinaitwe, Emmanuel; Wanzira, Humphrey; Bigira, Victor; Kakuru, Abel; Kamya, Moses; Tappero, Jordan W.; Sandison, Taylor; Dorsey, Grant

    2011-01-01

    The relationship between malnutrition and malaria in young children is under debate, and no studies evaluating the association between malnutrition and response to artemisinin-based combination therapies (ACTs) have been published. We evaluated the association between malnutrition and response to antimalarial therapy in Ugandan children treated with ACTs for repeated episodes of malaria. Children aged 4 to 12 months diagnosed with uncomplicated malaria were randomized to dihydroartemisinin-piperaquine (DP) or artemether-lumefantrine (AL) and followed for up to 2 years. All HIV-exposed and HIV-infected children received trimethoprim-sulfamethoxazole prophylaxis (TS). The primary exposure variables included height-for-age and weight-for-age z scores. Outcomes included parasite clearance at days 2 and 3 and risk of recurrent parasitemia after 42 days of follow-up. Two hundred ninety-two children were randomized to DP or AL, resulting in 2,013 malaria treatments. Fewer than 1% of patients had a positive blood smear by day 3 (DP, 0.2%; AL, 0.6% [P = 0.18]). There was no significant association between height-for-age or weight-for-age z scores and a positive blood smear 2 days following treatment. For children treated with DP but not on TS, decreasing height-for-age z scores of <−1 were associated with a higher risk of recurrent parasitemia than a height-for-age z score of >0 (hazard ratio [HR] for height-for-age z score of <−1 and ≥−2 = 2.89 [P = 0.039]; HR for height-for-age z score of <−2 = 3.18 [P = 0.022]). DP and AL are effective antimalarial therapies in chronically malnourished children in a high-transmission setting. However, children with mild to moderate chronic malnutrition not taking TS are at higher risk for recurrent parasitemia and may be considered a target for chemoprevention. PMID:21383095

  16. Plasmodium falciparum Polymorphisms associated with ex vivo drug susceptibility and clinical effectiveness of artemisinin-based combination therapies in Benin.

    PubMed

    Dahlström, Sabina; Aubouy, Agnès; Maïga-Ascofaré, Oumou; Faucher, Jean-François; Wakpo, Abel; Ezinmègnon, Sèm; Massougbodji, Achille; Houzé, Pascal; Kendjo, Eric; Deloron, Philippe; Le Bras, Jacques; Houzé, Sandrine

    2014-01-01

    Artemisinin-based combination therapies (ACTs) are the main option to treat malaria, and their efficacy and susceptibility must be closely monitored to avoid resistance. We assessed the association of Plasmodium falciparum polymorphisms and ex vivo drug susceptibility with clinical effectiveness. Patients enrolled in an effectiveness trial comparing artemether-lumefantrine (n = 96), fixed-dose artesunate-amodiaquine (n = 96), and sulfadoxine-pyrimethamine (n = 48) for the treatment of uncomplicated malaria 2007 in Benin were assessed. pfcrt, pfmdr1, pfmrp1, pfdhfr, and pfdhps polymorphisms were analyzed pretreatment and in recurrent infections. Drug susceptibility was determined in fresh baseline isolates by Plasmodium lactate dehydrogenase enzyme-linked immunosorbent assay (ELISA). A majority had 50% inhibitory concentration (IC50) estimates (the concentration required for 50% growth inhibition) lower than those of the 3D7 reference clone for desethylamodiaquine, lumefantrine, mefloquine, and quinine and was considered to be susceptible, while dihydroartemisinin and pyrimethamine IC50s were higher. No association was found between susceptibility to the ACT compounds and treatment outcome. Selection was observed for the pfmdr1 N86 allele in artemether-lumefantrine recrudescences (recurring infections) (4/7 [57.1%] versus 36/195 [18.5%]), and of the opposite allele, 86Y, in artesunate-amodiaquine reinfections (new infections) (20/22 [90.9%] versus 137/195 [70.3%]) compared to baseline infections. The importance of pfmdr1 N86 in lumefantrine tolerance was emphasized by its association with elevated lumefantrine IC50s. Genetic linkage between N86 and Y184 was observed, which together with the low frequency of 1246Y may explain regional differences in selection of pfmdr1 loci. Selection of opposite alleles in artemether-lumefantrine and artesunate-amodiaquine recurrent infections supports the strategy of multiple first-line treatment. Surveillance based on clinical, ex

  17. Artemisinin-based combination therapy in the treatment of uncomplicated malaria: review of recent regulatory experience at the European Medicines Agency

    PubMed Central

    Pelfrene, Eric; Pinheiro, Marie-Hélène; Cavaleri, Marco

    2015-01-01

    Malaria remains a major public health challenge with almost half of the world's population exposed to the risk of contracting the illness. Prompt, effective and well tolerated treatment remains one of the cornerstones in the disease management, with artemisinin-based combination therapy the recommended option for non-severe malaria in endemic areas with predominant Plasmodium falciparum infections. Recent experience has been obtained at the European Medicines Agency with regulatory approval of two such antimalarial fixed combination products. For these cases, two different regulatory pathways were applied. As such, the present contribution describes this experience, emphasising main differences and applicability offered by these regulatory choices. PMID:25855638

  18. Monitoring the efficacy and safety of three artemisinin based-combinations therapies in Senegal: results from two years surveillance

    PubMed Central

    2013-01-01

    Background Malaria remains a major public health problem in developing countries. Then in these countries prompt access to effective antimalarial treatment such as Artemisinin based-Combination Therapies (ACT) proves to be an essential tool for controlling the disease. In Senegal, since 2006 a nationwide scaling up program of ACT is being implemented. In this context it has become relevant to monitor ACT efficacy and provide recommendations for the Senegalese national malaria control program. Methods An open randomized trial was conducted during two malaria transmission seasons (2011 and 2012) to assess the efficacy and safety of three combinations: dihydro-artemisinin-piperaquine (DHAPQ), artemether-lumefantrine (AL) and artesunate-amodiaquine (ASAQ). The primary end point of the study was represented by a PCR adjusted adequate clinical and parasitological response (ACPR) at day 28. Secondary end points included: (i) a ACPR at days 35 and 42, (ii) a parasite and fever clearance time, (iii) ACTs safety and tolerability. The 2003 WHO’s protocol for antimalarial drug evaluation was used to assess each outcome. Results Overall, 534 patients were randomized selected to receive, either ASAQ (n = 180), AL (n = 178) or DHAPQ (n = 176). The PCR adjusted ACPR at day 28 was 99.41% for the group ASAQ, while that was 100% in the AL and DHAPQ groups (p = 0.37). The therapeutic efficacy was evaluated at 99.37% in the ASAQ arm versus 100% in AL and DHAPQ arm at day 35 (p = 0.37). At day 42, the ACPR was 99.27% in the ASAQ group versus 100% for both AL and DHAPQ groups, (p = 0.36). No serious adverse event was noted during the study period. Also a similar safety profile was noted in the 3 study groups. Conclusion In the context of scaling up of ACTs in Senegal, ASAQ, AL and DHAPQ are highly effective and safe antimalarial drugs. However, it’s remains important to continue to monitor their efficacy. Trial registration PACTR 201305000552290. PMID:24354627

  19. Artemisinin-Based Combination Therapy Versus Quinine or Other Combinations for Treatment of Uncomplicated Plasmodium falciparum Malaria in the Second and Third Trimester of Pregnancy: A Systematic Review and Meta-Analysis.

    PubMed

    Burger, Renée J; van Eijk, Anna M; Bussink, Milena; Hill, Jenny; Ter Kuile, Feiko O

    2016-01-01

    The World Health Organization recommends artemisinin-based combination therapies (ACTs) for the treatment of uncomplicated falciparum malaria in the second and third trimesters of pregnancy. We conducted a meta-analysis to compare efficacy, safety and tolerability of ACTs versus quinine and other non-ACT antimalarials. The median PCR-adjusted failure rate by days 28 to 63 in the non-ACT group was 6 (range 0-37) per 100 women, lower in the ACT group overall (pooled risk ratio [PRR] random effects, 0.41; 95% confidence interval [CI], 0.16-1.05; 6 trials), and significantly lower compared with oral quinine (PRR, 0.20; 95% CI, 0.08-0.49; 4 trials). There were no differences in fetal deaths and congenital abnormalities. Compared with quinine, artemisinin-based combinations therapies were associated with less tinnitus (PRR, 0.19; 95% CI, 0.03-1.11; 4 studies), dizziness (PRR, 0.64; 95% CI, 0.44-0.93; 3 trials), and vomiting (PRR, 0.33; 95% CI, 0.15-0.73; 3 trials). Artemisinin-based combination therapies are better than quinine in the second and third trimesters; their use should be encouraged among health workers. PMID:26788543

  20. Towards subsidized malaria rapid diagnostic tests. Lessons learned from programmes to subsidise artemisinin-based combination therapies in the private sector: a review

    PubMed Central

    Lussiana, Cristina

    2016-01-01

    The idea of a private sector subsidy programme of artemisinin-based combination therapies (ACTs) was first proposed in 2004. Since then, several countries around the world have hosted pilot projects or programmes on subsidized ACTs and/or the Affordable Medicines Facility-malaria programme (AMFm). Overall the private sector subsidy programmes of ACTs have been effective in increasing availability of ACTs in the private sector and driving down average prices but struggled to crowd out antimalarial monotherapies. The results obtained from this ambitious strategy should inform policy makers in the designing of future interventions aimed to control malaria morbidity and mortality. Among the interventions recently proposed, a subsidy of rapid diagnostic tests (RDTs) in the private sector has been recommended by governments and international donors to cope with over-treatment with ACTs and to delay the emergence of resistance to artemisinin. In order to improve the cost-effectiveness of co-paid RDTs, we should build on the lessons we learned from almost 10 years of private sector subsidy programmes of ACTs in malaria-endemic countries. PMID:25862732

  1. Awareness of antimalarial policy and use of artemisinin-based combination therapy for malaria treatment in communities of two selected local government areas of Ogun State, Nigeria.

    PubMed

    Adeneye, Adeniyi K; Jegede, Ayodele S; Mafe, Margaret A; Nwokocha, Ezebunwa E

    2014-01-01

    With limited data on the awareness of changes in the use of antimalaria drugs and availability and use of artemisinin-based combination therapy (ACT) in the context of the Roll Back Malaria (RBM) program, we conducted this descriptive cross-sectional study of 262 registered women attending antenatal clinics and 233 mothers of under-five children. We used a questionnaire to assess the awareness, availability and use of ACT in Ijebu North and Yewa North Local Government Areas (LGAs) of Ogun State. Malaria is holo-endemic in these areas, and the RBM program has been implemented for years prior to the 2010 RBM deadline. Data were also collected through focus group discussions, along with secondary data from hospital records. Hospital stock records showed inadequate and inconsistent supplies of ACT drugs in hospitals surveyed. Only 23.0% of respondents knew about ACT drugs. About 48% preferred analgesics over ACT drugs (0.6%) for malaria treatment. Lack of awareness was the major reason for non-use of ACT drugs (86.1%). Communities in Yewa North had more supplies of ACT drugs and knew more about ACT than those in Ijebu North. Adequate information on ACT needs to be made available and accessible under a public-private partnership if 2010 RBM targets (now past) and the 2015 Millennium Development Goal (ongoing) for malaria are to be realized in the study communities and Ogun State in general.

  2. Lack of artemisinin resistance in Plasmodium falciparum in northwest Benin after 10 years of use of artemisinin-based combination therapy

    PubMed Central

    Ogouyèmi-Hounto, Aurore; Damien, Georgia; Deme, Awa Bineta; Ndam, Nicaise T.; Assohou, Constance; Tchonlin, Didier; Mama, Atika; Hounkpe, Virgile Olivier; Moutouama, Jules Doumitou; Remoué, Franck; Ndiaye, Daouda; Gazard, Dorothée Kinde

    2016-01-01

    Aim: In Benin, artemisinin-based combination therapy (ACT) has been recommended as the first-line treatment for uncomplicated Plasmodium falciparum malaria since 2004. The emergence in Southeast Asia of parasites that are resistant to artemisinins poses a serious threat to global control of this disease. The presence of artemisinin resistance genotypes in parasite populations in Benin is currently unknown. The present study investigated the prevalence of relevant K13-propeller gene polymorphisms in parasite isolates from the north-western region of Benin. Method: Plasmodium falciparum isolates were collected from children with a confirmed diagnosis of malaria aged 6 months to 5 years in two towns, Cobly and Djougou, in the north-western part of Benin. The study was conducted during the rainy season from July to November 2014 in local health facilities. The K13-propeller gene was amplified in parasite isolates using nested PCR and subsequently sequenced. Results: A total of 108 children were recruited into the study. The efficiency of amplification reactions was 72% (78/108). The propeller domain of the K13 gene was successfully sequenced in 78 P. falciparum isolates; all of them were wild type with no polymorphisms detectable. Conclusion: The absence of mutations in the K13 gene indicates that P. falciparum parasite populations in the study area are still fully susceptible to artemisinins. PMID:27443837

  3. Willingness-to-pay for a rapid malaria diagnostic test and artemisinin-based combination therapy from private drug shops in Mukono district, Uganda

    PubMed Central

    Hansen, Kristian Schultz; Pedrazzoli, Debora; Mbonye, Anthony; Clarke, Sian; Cundill, Bonnie; Magnussen, Pascal; Yeung, Shunmay

    2013-01-01

    In Uganda, as in many parts of Africa, the majority of the population seek treatment for malaria in drug shops as their first point of care; however, parasitological diagnosis is not usually offered in these outlets. Rapid diagnostic tests (RDTs) for malaria have attracted interest in recent years as a tool to improve malaria diagnosis, since they have proved accurate and easy to perform with minimal training. Although RDTs could feasibly be performed by drug shop vendors, it is not known how much customers would be willing to pay for an RDT if offered in these settings. We conducted a contingent valuation survey among drug shop customers in Mukono District, Uganda. Exit interviews were undertaken with customers aged 15 years and above after leaving a drug shop having purchased an antimalarial and/or paracetamol. The bidding game technique was used to elicit the willingness-to-pay (WTP) for an RDT and a course of artemisinin-based combination therapy (ACT) with and without RDT confirmation. Factors associated with WTP were investigated using linear regression. The geometric mean WTP for an RDT was US$0.53, US$1.82 for a course of ACT and US$2.05 for a course of ACT after a positive RDT. Factors strongly associated with a higher WTP for these commodities included having a higher socio-economic status, no fever/malaria in the household in the past 2 weeks and if a malaria diagnosis had been obtained from a qualified health worker prior to visiting the drug shop. The findings further suggest that the WTP for an RDT and a course of ACT among drug shop customers is considerably lower than prevailing and estimated end-user prices for these commodities. Increasing the uptake of ACTs in drug shops and restricting the sale of ACTs to parasitologically confirmed malaria will therefore require additional measures. PMID:22589226

  4. Randomized comparison of the efficacies and tolerabilities of three artemisinin-based combination treatments for children with acute Plasmodium falciparum malaria in the Democratic Republic of the Congo.

    PubMed

    Onyamboko, M A; Fanello, C I; Wongsaen, K; Tarning, J; Cheah, P Y; Tshefu, K A; Dondorp, A M; Nosten, F; White, N J; Day, N P J

    2014-09-01

    An open-label, randomized controlled trial was carried out in 2011-2012 in the Democratic Republic of the Congo to test the efficacy, safety, and tolerability of the artemisinin-based combination treatments dihydroartemisinin-piperaquine, amodiaquine-artesunate, and artemether-lumefantrine. Six hundred eighty-four children aged 3 to 59 months with uncomplicated Plasmodium falciparum malaria were randomly allocated to each study arm. Children were hospitalized for 3 days, given supervised treatment, and followed up weekly for 42 days. All regimens were well tolerated and rapidly effective. The median parasitemia clearance half-life was 2.2 h, and half-lives were similar between arms (P=0.19). The PCR-uncorrected cure rates by day 42 were 73.0% for amodiaquine-artesunate, 70.2% for artemether-lumefantrine, and 86.3% for dihydroartemisinin-piperaquine (P=0.001). Early treatment failure occurred in three patients (0.5%), one in each arm. The PCR-corrected cure rates were 93.4% for amodiaquine-artesunate, 92.7% for artemether-lumefantrine, and 94.3% for dihydroartemisinin-piperaquine (P=0.78). The last provided a longer posttreatment prophylactic effect than did the other two treatments. The day 7 plasma concentration of piperaquine was below 30 ng/ml in 47% of the children treated with dihydroartemisinin-piperaquine, and the day 7 lumefantrine concentration was below 280 ng/ml in 37.0% of children who received artemether-lumefantrine. Thus, although cure rates were all satisfactory, they could be improved by increasing the dose. (This study has been registered with the International Standard Randomized Controlled Trial Number Register [www.isrctn.org] under registration no. ISRCTN20984426.).

  5. [Evaluation of the quality of prescription and dispensing of artemisinin-based therapeutic combinations in the Bamako District, Mali].

    PubMed

    Eve, Sangaré; Samba, Diop; Benoît, Dembélé; Diawara, Sory I; Seidina, Diakité; Saibou, Doumbia; Karim, Traore; Drissa, Konaté; Seydou, Doumbia; Fanta Mady, Traore Sékou; Mahamadou, Diakité

    2010-01-01

    The increasingly increasing resistance of the parasites of malaria to chloroquine pushed all the African countries almost to adopt the ACTs like treatment of first intention of uncomplicated malaria. However, correct use of the ACTs proves to be imperative to guarantee their effectiveness and to even delay the spread resistant parasites to these molecules. Thus, we have conducted this study in order to assess the quality of the prescription and the dispensation of ACTs in randomly selected health centers across Bamako. Our study was a cross-sectional study conducted between April and July 2008 with interview of patients received in clinic for malaria, a questionnaire was administered to physicians and other health workers who give prescription of antimalarials, and pharmacists and other people working in pharmacy or drugs deposit. In total, 52 prescribers, 72 dispensers and 92 patients were included. Our study has shown that the ACT constituted the treatment of first choice of malaria within prescribers (75%) and dispensers (78.8%). However, 57.61% of the prescriptions against malaria did not contain any ACTs. The ACTs recommended by the National Malaria Program (NMCP) were known by 59.7% of dispensers and 73.1% of prescribers. The majority of the prescribers (71.15%) and of the dispensers (84.72%) were favorable to the NMCP's recommendations. Many patients (41.30%) did not understand at all the dose of the prescribed ACTs. Almost all of the prescription containing ACT was a generic drug prescribed (97.72%; n = 44). The prices of the ACTs varied between 140 and 3,380 FCFA with an average of 750 FCFA. According to prescribers and dispensers, the ACT constitutes their first choice (75% of prescribers and 78.8% of the dispensers). However, 57.61% of the prescriptions against malaria did not contain any ACTs. The majority of prescribers (71.15%) and dispensers (84.72%) were favorable to the NMCP's recommendations of malaria treatment in Mali. The average cost of

  6. Artemisinin-based combination therapy availability and use in the private sector of five AMFm phase 1 countries

    PubMed Central

    2013-01-01

    Background In 2009, the Global Fund to Fight AIDS, Tuberculosis and Malaria established the Affordable Medicines Facility-malaria (AMFm) in order to increase access to quality-assured artemisinin combination therapy (QAACT). AMFm Phase 1, which includes nine pilot programmes in eight countries, was launched in 2009. The objective of this study was to assess anti-malarial stock and purchase patterns at private outlets in five AMFm Phase 1 countries in regard to three of the core AMFm goals: increase the affordability of QAACT, increase the availability of QAACT, and crowd out artemisinin monotherapies and other substandard therapies. Methods The study was conducted between April and May 2012 and included interviews with personnel in 598 private pharmaceutical outlets in Ghana, Kenya, Nigeria, Tanzania, and Uganda. Questionnaires were administered at private retail outlets and the data were analyzed to assess within- and between-country differences in QAACT price, availability, and popularity. Results AMFm medications were less expensive than their non-AMFm counterparts, yet prices for both types were above country-specific suggested retail prices. Market penetration of AMFm QAACT in both urban and rural areas was high, although stock-outs of both AMFm and non-AMFm products were more common in rural compared with urban outlets in Ghana and Kenya (p = 0.0013). Government recommendation was the most significant factor influencing anti-malarial stock choices in urban (41.5%) and rural (31.9%) outlets. The three top-selling anti-malarials reported for both urban and rural areas in each country were, with the exception of rural Uganda and urban Nigeria, combination therapies. Conclusions Results from this study indicate that the AMFm has not fully achieved its affordability and crowd-out objectives. Still, the final purchase price of AMFm QAACT was substantially lower than non-AMFm equivalents. Moreover, for both urban and rural areas, AMFm QAACT availability was

  7. A pharmacy too far? Equity and spatial distribution of outcomes in the delivery of subsidized artemisinin-based combination therapies through private drug shops

    PubMed Central

    2010-01-01

    Background Millions of individuals with malaria-like fevers purchase drugs from private retailers, but artemisinin-based combination therapies (ACTs), the only effective treatment in regions with high levels of resistance to older drugs, are rarely obtained through these outlets due to their relatively high cost. To encourage scale up of ACTs, the Affordable Medicines Facility – malaria is being launched to subsidize their price. The Government of Tanzania and the Clinton Foundation piloted this subsidized distribution model in two Tanzanian districts to examine concerns about whether the intervention will successfully reach poor, rural communities. Methods Stocking of ACTs and other antimalarial drugs in all retail shops was observed at baseline and in four subsequent surveys over 15 months. Exit interviews were conducted with antimalarial drug customers during each survey period. All shops and facilities were georeferenced, and variables related to population density and proximity to distribution hubs, roads, and other facilities were calculated. To understand the equity of impact, shops stocking ACTs and consumers buying them were compared to those that did not, according to geographic and socioeconomic variables. Patterning in ACT stocking and sales was evaluated against that of other common antimalarials to identify factors that may have impacted access. Qualitative data were used to assess motivations underlying stocking, distribution, and buying disparities. Results Results indicated that although total ACT purchases rose from negligible levels to nearly half of total antimalarial sales over the course of the pilot, considerable geographic variation in stocking and sales persisted and was related to a variety of socio-spatial factors; ACTs were stocked more often in shops located closer to district towns (p<0.01) and major roads (p<0.01) and frequented by individuals of higher socioeconomic status (p<0.01). However, other antimalarial drugs displayed

  8. Effect of Single Nucleotide Polymorphisms in Cytochrome P450 Isoenzyme and N-Acetyltransferase 2 Genes on the Metabolism of Artemisinin-Based Combination Therapies in Malaria Patients from Cambodia and Tanzania

    PubMed Central

    Staehli Hodel, Eva Maria; Csajka, Chantal; Ariey, Frédéric; Guidi, Monia; Kabanywanyi, Abdunoor Mulokozi; Duong, Socheat; Decosterd, Laurent Arthur; Olliaro, Piero; Genton, Blaise

    2013-01-01

    The pharmacogenetics of antimalarial agents are poorly known, although the application of pharmacogenetics might be critical in optimizing treatment. This population pharmacokinetic-pharmacogenetic study aimed at assessing the effects of single nucleotide polymorphisms (SNPs) in cytochrome P450 isoenzyme genes (CYP, namely, CYP2A6, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP3A4, and CYP3A5) and the N-acetyltransferase 2 gene (NAT2) on the pharmacokinetics of artemisinin-based combination therapies in 150 Tanzanian patients treated with artemether-lumefantrine, 64 Cambodian patients treated with artesunate-mefloquine, and 61 Cambodian patients treated with dihydroartemisinin-piperaquine. The frequency of SNPs varied with the enzyme and the population. Higher frequencies of mutant alleles were found in Cambodians than Tanzanians for CYP2C9*3, CYP2D6*10 (100C→T), CYP3A5*3, NAT2*6, and NAT2*7. In contrast, higher frequencies of mutant alleles were found in Tanzanians for CYP2D6*17 (1023C→T and 2850C→T), CYP3A4*1B, NAT2*5, and NAT2*14. For 8 SNPs, no significant differences in frequencies were observed. In the genetic-based population pharmacokinetic analyses, none of the SNPs improved model fit. This suggests that pharmacogenetic data need not be included in appropriate first-line treatments with the current artemisinin derivatives and quinolines for uncomplicated malaria in specific populations. However, it cannot be ruled out that our results represent isolated findings, and therefore more studies in different populations, ideally with the same artemisinin-based combination therapies, are needed to evaluate the influence of pharmacogenetic factors on the clearance of antimalarials. PMID:23229480

  9. Quality of Artemisinin-Based Combination Formulations for Malaria Treatment: Prevalence and Risk Factors for Poor Quality Medicines in Public Facilities and Private Sector Drug Outlets in Enugu, Nigeria

    PubMed Central

    Kaur, Harparkash; Allan, Elizabeth Louise; Mamadu, Ibrahim; Hall, Zoe; Ibe, Ogochukwu; El Sherbiny, Mohamed; van Wyk, Albert; Yeung, Shunmay; Swamidoss, Isabel; Green, Michael D.; Dwivedi, Prabha; Culzoni, Maria Julia; Clarke, Siân; Schellenberg, David; Fernández, Facundo M.; Onwujekwe, Obinna

    2015-01-01

    Background Artemisinin-based combination therapies are recommended by the World Health Organisation (WHO) as first-line treatment for Plasmodium falciparum malaria, yet medication must be of good quality for efficacious treatment. A recent meta-analysis reported 35% (796/2,296) of antimalarial drug samples from 21 Sub-Saharan African countries, purchased from outlets predominantly using convenience sampling, failed chemical content analysis. We used three sampling strategies to purchase artemisinin-containing antimalarials (ACAs) in Enugu metropolis, Nigeria, and compared the resulting quality estimates. Methods ACAs were purchased using three sampling approaches - convenience, mystery clients and overt, within a defined area and sampling frame in Enugu metropolis. The active pharmaceutical ingredients were assessed using high-performance liquid chromatography and confirmed by mass spectrometry at three independent laboratories. Results were expressed as percentage of APIs stated on the packaging and used to categorise each sample as acceptable quality, substandard, degraded, or falsified. Results Content analysis of 3024 samples purchased from 421 outlets using convenience (n=200), mystery (n=1,919) and overt (n=905) approaches, showed overall 90.8% ACAs to be of acceptable quality, 6.8% substandard, 1.3% degraded and 1.2% falsified. Convenience sampling yielded a significantly higher prevalence of poor quality ACAs, but was not evident by the mystery and overt sampling strategies both of which yielded results that were comparable between each other. Artesunate (n=135; 4 falsified) and dihydroartemisinin (n=14) monotherapy tablets, not recommended by WHO, were also identified. Conclusion Randomised sampling identified fewer falsified ACAs than previously reported by convenience approaches. Our findings emphasise the need for specific consideration to be given to sampling frame and sampling approach if representative information on drug quality is to be obtained

  10. Status of allele frequency and diversity of Plasmodium falciparum msp1, msp2 and glurp before implementation of an artemisinin-based combined therapy in Northwestern Colombia.

    PubMed Central

    Arango, Eliana; Carmona-Fonseca, Jaime

    2013-01-01

    Introduction: The status of msp1, msp2 and glurp allele frequency and the diversity of Plasmodium falciparum in Northwestern Colombia before the implementation of an artemisinin-combined therapy have been explored only by a few authors and in a relatively small number of samples from this highly endemic region. Objective: To evaluate the frequency of msp1, msp2, and glurp alleles and the diversity of P. falciparum in two Colombian regions before the use of an artemisinin-combined therapy. Methods: This study was part of a major anti-malarial efficacy trial designed as a random, clinically-controlled study for which 224 subjects were recruited. Region 2 of msp1 and msp2 (central region) were amplified by a nested PCR; glurp (region R2) was amplified by a semi-nested PCR. Results: For msp1, five genotypes were observed, representing the K1, MAD20, and RO33 allelic families. All samples corresponded to a MAD20 150 bp allele. For msp2 (IC family), two alleles were detected and for glurp, eight were observed. A total 33 haplotypes were detected. Conclusions: Analysis of glurpcan be used to successfully genotype parasite populations in the new studies in Colombia aimed at exploring Plasmodium spp population dynamics. In addition, analysis of msp1 and msp2 can also be of value for comparisons with past studies, but not when the objective is to study parasites obtained from the same patient in a reduced period of time; for instance, during treatment efficacy studies. PMID:24892236

  11. Who Gets Prompt Access to Artemisinin-Based Combination Therapy? A Prospective Community-Based Study in Children from Rural Kilosa, Tanzania

    PubMed Central

    Simba, Daudi O.; Warsame, Marian; Kakoko, Deodatus; Mrango, Zakayo; Tomson, Goran; Premji, Zul; Petzold, Max

    2010-01-01

    Background Effective and timely case management remains one of the fundamental pillars for control of malaria. Tanzania introduced artemisinin-combination therapy [ACT] for uncomplicated malaria; however, the policy change is challenged by limited availability of ACTs due to high cost. This study aimed to determine factors influencing prompt access to ACTs among febrile children in rural Kilosa, Tanzania. Methods and Findings In a community-based study, 1,235 randomly selected children under five were followed up weekly for six months, in 2008. Using a structured questionnaire, children's caretakers were asked about the child's febrile history in the last seven days, and treatment actions including timing, medicines used and source of care. Caretakers' knowledge about malaria and socioeconomic and demographic data were also obtained. About half of followed-up children had at least one episode of fever. Less than half (44.8%) of febrile children were taken to government facilities. Almost one-third (37.6%; 95% CI 33.1–42.1) of febrile children had prompt access to ACT. Care-seeking from a government facility was the overriding factor, increasing the likelihood of prompt access to an ACT 18 times (OR 17.7; 95% CI 10.55–29.54; adjusted OR 16.9; 95% CI 10.06–28.28). Caretakers from the better-off household (3rd–5th quintiles) were more likely to seek care from government facilities (OR 3.66; 95% CI 2.56–5.24; adjusted OR 1.80; 95% CI 1.18–2.76). The majority of antimalarials accessed by the poor were ineffective [86.0%; 295/343], however, they paid more for them (median Tsh 500) compared to the better-offs (median Tsh 0). Conclusions Prompt access to ACT among febrile children was unacceptably low, due mainly to limited availability of subsidised ACT at the location where most caretakers sought care. There is urgent need to accelerate implementation of strategies that will ensure availability of ACT at an affordable price in remote rural areas, where the

  12. Access to artemisinin-based anti-malarial treatment and its related factors in rural Tanzania

    PubMed Central

    2013-01-01

    Background Artemisinin-based combination treatment (ACT) has been widely adopted as one of the main malaria control strategies. However, its promise to save thousands of lives in sub-Saharan Africa depends on how effective the use of ACT is within the routine health system. The INESS platform evaluated effective coverage of ACT in several African countries. Timely access within 24 hours to an authorized ACT outlet is one of the determinants of effective coverage and was assessed for artemether-lumefantrine (Alu), in two district health systems in rural Tanzania. Methods From October 2009 to June 2011we conducted continuous rolling household surveys in the Kilombero-Ulanga and the Rufiji Health and Demographic Surveillance Sites (HDSS). Surveys were linked to the routine HDSS update rounds. Members of randomly pre-selected households that had experienced a fever episode in the previous two weeks were eligible for a structured interview. Data on individual treatment seeking, access to treatment, timing, source of treatment and household costs per episode were collected. Data are presented on timely access from a total of 2,112 interviews in relation to demographics, seasonality, and socio economic status. Results In Kilombero-Ulanga, 41.8% (CI: 36.6–45.1) and in Rufiji 36.8% (33.7–40.1) of fever cases had access to an authorized ACT provider within 24 hours of fever onset. In neither of the HDSS site was age, sex, socio-economic status or seasonality of malaria found to be significantly correlated with timely access. Conclusion Timely access to authorized ACT providers is below 50% despite interventions intended to improve access such as social marketing and accreditation of private dispensing outlets. To improve prompt diagnosis and treatment, access remains a major bottle neck and new more innovative interventions are needed to raise effective coverage of malaria treatment in Tanzania. PMID:23651521

  13. CRISPR-Cas9-modified pfmdr1 protects Plasmodium falciparum asexual blood stages and gametocytes against a class of piperazine-containing compounds but potentiates artemisinin-based combination therapy partner drugs.

    PubMed

    Ng, Caroline L; Siciliano, Giulia; Lee, Marcus C S; de Almeida, Mariana J; Corey, Victoria C; Bopp, Selina E; Bertuccini, Lucia; Wittlin, Sergio; Kasdin, Rachel G; Le Bihan, Amélie; Clozel, Martine; Winzeler, Elizabeth A; Alano, Pietro; Fidock, David A

    2016-08-01

    Emerging resistance to first-line antimalarial combination therapies threatens malaria treatment and the global elimination campaign. Improved therapeutic strategies are required to protect existing drugs and enhance treatment efficacy. We report that the piperazine-containing compound ACT-451840 exhibits single-digit nanomolar inhibition of the Plasmodium falciparum asexual blood stages and transmissible gametocyte forms. Genome sequence analyses of in vitro-derived ACT-451840-resistant parasites revealed single nucleotide polymorphisms in pfmdr1, which encodes a digestive vacuole membrane-bound ATP-binding cassette transporter known to alter P. falciparum susceptibility to multiple first-line antimalarials. CRISPR-Cas9 based gene editing confirmed that PfMDR1 point mutations mediated ACT-451840 resistance. Resistant parasites demonstrated increased susceptibility to the clinical drugs lumefantrine, mefloquine, quinine and amodiaquine. Stage V gametocytes harboring Cas9-introduced pfmdr1 mutations also acquired ACT-451840 resistance. These findings reveal that PfMDR1 mutations can impart resistance to compounds active against asexual blood stages and mature gametocytes. Exploiting PfMDR1 resistance mechanisms provides new opportunities for developing disease-relieving and transmission-blocking antimalarials.

  14. Adoption

    MedlinePlus

    ... the birth nor adoptive parents know the others' identities. Other adoptions are handled more openly. Open adoptions, ... desire to seek out more information about the identity of the birth family. Most of us (whether ...

  15. Measuring the Association between Artemisinin-Based Case Management and Malaria Incidence in Southern Vietnam, 1991–2010

    PubMed Central

    Peak, Corey M.; Thuan, Phung Duc; Britton, Amadea; Nguyen, Tran Dang; Wolbers, Marcel; Thanh, Ngo Viet; Buckee, Caroline O.; Boni, Maciej F.

    2015-01-01

    In addition to being effective, fast-acting, and well tolerated, artemisinin-based combination therapies (ACTs) are able to kill certain transmission stages of the malaria parasite. However, the population-level impacts of ACTs on reducing malaria transmission have been difficult to assess. In this study on the history of malaria control in Vietnam, we assemble annual reporting on malaria case counts, coverage with insecticide-treated nets (ITN) and indoor residual spraying (IRS), and drug purchases by provincial malaria control programs from 1991 to 2010 in Vietnam's 20 southern provinces. We observe a significant negative association between artemisinin use and malaria incidence, with a 10% absolute increase in the purchase proportion of artemisinin-containing regimens being associated with a 29.1% (95% confidence interval: 14.8–41.0%) reduction in slide-confirmed malaria incidence, after accounting for changes in urbanization, ITN/IRS coverage, and two indicators of health system capacity. One budget-related indicator of health system capacity was found to have a smaller association with malaria incidence, and no other significant factors were found. Our findings suggest that including an artemisinin component in malaria drug regimens was strongly associated with reduced malaria incidence in southern Vietnam, whereas changes in urbanization and coverage with ITN or IRS were not. PMID:25667053

  16. Evaluation of the Quality of Artemisinin-Based Antimalarial Medicines Distributed in Ghana and Togo

    PubMed Central

    Agbonon, Amegnona; Konadu, Daniel Yeboah; Edoh, Mamadou; Gordon, Andrew; Gbeassor, Messanvi; Addae-Mensah, Ivan

    2014-01-01

    This study, conducted as part of our overall goal of regular pharmacovigilance of antimalarial medicines, reports on the quality of 132 artemisinin-based antimalarial medicines distributed in Ghana and Togo. Three methods were employed in the quality evaluation—basic (colorimetric) tests for establishing the identity of the requisite active pharmaceutical ingredients (APIs), semi-quantitative TLC assay for the identification and estimation of API content, and HPLC assay for a more accurate quantification of API content. From the basic tests, only one sample totally lacked API. The HPLC assay, however, showed that 83.7% of the ACTs and 57.9% of the artemisinin-based monotherapies failed to comply with international pharmacopoeia requirements due to insufficient API content. In most of the ACTs, the artemisinin component was usually the insufficient API. Generally, there was a good correlation between the HPLC and SQ-TLC assays. The overall failure rates for both locally manufactured (77.3%) and imported medicines (77.5%) were comparable. Similarly the unregistered medicines recorded a slightly higher overall failure rate (84.7%) than registered medicines (70.8%). Only two instances of possible cross-border exchange of medicines were observed and there was little difference between the medicine quality of collections from border towns and those from inland parts of both countries. PMID:25400975

  17. Systematic Review and Meta-Analysis of Artemisinin Based Therapies for the Treatment and Prevention of Schistosomiasis

    PubMed Central

    Pérez del Villar, Luis; Burguillo, Francisco J.; López-Abán, Julio; Muro, Antonio

    2012-01-01

    Background Chemotherapy based on repeated doses of praziquantel is still the most effective control strategy against Schistosomiasis, however artemisinin derivatives emerged as a family of compounds with schistomicide activity. The aim of the present work is to compare the efficacy of artemisinin-based therapies in the treatment and prophylaxis of human schistosomiasis. The design of this work involved a quantitative systematic review and meta-analysis. Methodology/Principal Findings Retrieval of published studies was carried out through an electronic search of the PubMed (MEDLINE), EMBASE, Cochrane Library and CINAHL databases. This included reports comparing the therapeutic efficacy of artesunate alone, artesunate plus sulfadoxine-pyrimethamine and a combination of artemisinin derivatives plus praziquantel against praziquantel alone on different types of schistosomiasis. Moreover, studies on artesunate and artemether used as preventive drugs were also analyzed against placebo. The primary outcome measure for schistosomiasis treatment was “parasitological cure”, whereas for the prophylaxis the outcome evaluated was “infection rate”. Our results show that patients treated with artesunate alone have significantly lower cure rates than those treated with praziquantel (OR = 0.27 (95% C.I. 0.13–0.53; p<0.001)) and that the combined therapy of artesunate plus sulfadoxine-pyrimethamine is also significantly less effective than praziquantel treatment (OR = 0.14 (95% C.I. 0.02–0.92; p = 0.04)). However, the combination of an artemisinin derivatives plus praziquantel showed a higher cure rate than praziquantel monotherapy with OR = 2.07 (95% C.I. 1.27–3.36; p = 0.003). Finally, chemoprophylaxis with either artesunate (RR = 0.11 (95% C.I. 0.06–0.22; p<0.001)) or artemether (RR = 0.25 (95% C.I. 0.16–0.40; p<0.001)) was significantly better than a placebo in both cases. Conclusions/Significance This meta-analysis confirms that

  18. Adoptive immunotherapy combined chemoradiotherapy for non-small-cell lung cancer: a meta-analysis.

    PubMed

    Qian, Haili; Wang, Haijuan; Guan, Xiuwen; Yi, Zongbi; Ma, Fei

    2016-06-01

    The aim of this study was to compare the efficacies between adoptive immunotherapy combined chemoradiotherapy and chemoradiotherapy alone in patients with non-small-cell lung cancer (NSCLC). The databases PubMed, EMBASE, and Cochrane database were searched to identify eligible clinical trials. Data analyses were carried out using a comprehensive meta-analysis program, version 2 software. A total of seven articles were finally included in the analysis. Meta-analyses showed that compared with chemoradiotherapy alone, adoptive immunotherapy combined with chemoradiotherapy could improve the 2-year overall survival [odds ratio (OR)=2.45, 95% confidence interval (CI): 1.60-3.75, P<0.001], but not 2-year progression-free survival (OR=1.81, 95% CI: 0.61-5.36, P=0.284). Specifically, early (OR=3.32, 95% CI: 1.38-7.95, P<0.01) but not advanced (OR=3.75, 95% CI: 0.96-14.68, P=0.057) NSCLC patients were likely to gain a large benefit from the adoptive immunotherapy. Most of the adoptive immunotherapy-induced adverse effects were self-limited, mainly including fever, shiver, nausea, fatigue, etc. and severe toxicities were not observed. Adoptive immunotherapy combined with chemoradiotherapy can delay the recurrence of NSCLC and improve survival in patients, where the benefits are even more significant in patients with early-stage NSCLC. PMID:26872311

  19. Adoptive immunotherapy combined with intratumoral TLR agonist delivery eradicates established melanoma in mice

    PubMed Central

    Amos, Sally M.; Pegram, Hollie J.; Westwood, Jennifer A.; John, Liza B.; Devaud, Christel; Clarke, Chris J.; Restifo, Nicholas P.; Smyth, Mark J.; Darcy, Phillip K.; Kershaw, Michael H.

    2012-01-01

    Toll-like receptor (TLR) agonists can trigger broad inflammatory responses that elicit rapid innate immunity and promote the activities of lymphocytes, which can potentially enhance adoptive immunotherapy in the tumor-bearing setting. In the present study, we found that Polyinosinic:Polycytidylic Acid [Poly(I:C)] and CpG oligodeoxynucleotide 1826 [CpG], agonists for TLR 3 and 9, respectively, potently activated adoptively transferred T cells against a murine model of established melanoma. Intratumoral injection of Poly(I:C) and CpG, combined with systemic transfer of activated pmel-1 T cells, specific for gp10025–33, led to enhanced survival and eradication of 9-day established subcutaneous B16F10 melanomas in a proportion of mice. A series of survival studies in knockout mice supported a key mechanistic pathway, whereby TLR agonists acted via host cells to enhance IFN-γ production by adoptively transferred T cells. IFN-γ, in turn, enhanced the immunogenicity of the B16F10 melanoma line, leading to increased killing by adoptively transferred T cells. Thus, this combination approach counteracted tumor escape from immunotherapy via downregulation of immunogenicity. In conclusion, TLR agonists may represent advanced adjuvants within the setting of adoptive T-cell immunotherapy of cancer and hold promise as a safe means of enhancing this approach within the clinic. PMID:21327636

  20. Combining α-Radioimmunotherapy and Adoptive T Cell Therapy to Potentiate Tumor Destruction

    PubMed Central

    Ménager, Jérémie; Gorin, Jean-Baptiste; Maurel, Catherine; Drujont, Lucile; Gouard, Sébastien; Louvet, Cédric; Chérel, Michel; Faivre-Chauvet, Alain; Morgenstern, Alfred; Bruchertseifer, Frank; Davodeau, François

    2015-01-01

    Ionizing radiation induces direct and indirect killing of cancer cells and for long has been considered as immunosuppressive. However, this concept has evolved over the past few years with the demonstration that irradiation can increase tumor immunogenicity and can actually favor the implementation of an immune response against tumor cells. Adoptive T-cell transfer (ACT) is also used to treat cancer and several studies have shown that the efficacy of this immunotherapy was enhanced when combined with radiation therapy. α-Radioimmunotherapy (α-RIT) is a type of internal radiotherapy which is currently under development to treat disseminated tumors. α-particles are indeed highly efficient to destroy small cluster of cancer cells with minimal impact on surrounding healthy tissues. We thus hypothesized that, in the setting of α-RIT, an immunotherapy like ACT, could benefit from the immune context induced by irradiation. Hence, we decided to further investigate the possibilities to promote an efficient and long-lasting anti-tumor response by combining α-RIT and ACT. To perform such study we set up a multiple myeloma murine model which express the tumor antigen CD138 and ovalbumine (OVA). Then we evaluated the therapeutic efficacy in the mice treated with α-RIT, using an anti-CD138 antibody coupled to bismuth-213, followed by an adoptive transfer of OVA-specific CD8+ T cells (OT-I CD8+ T cells). We observed a significant tumor growth control and an improved survival in the animals treated with the combined treatment. These results demonstrate the efficacy of combining α-RIT and ACT in the MM model we established. PMID:26098691

  1. Effects of a carbon tax on microgrid combined heat and power adoption

    SciTech Connect

    Siddiqui, Afzal S.; Marnay, Chris; Edwards, Jennifer L.; Firestone, Ryan M.; Ghosh, Srijay; Stadler, Michael

    2004-11-01

    This paper describes the economically optimal adoption and operation of distributed energy resources (DER) by a hypothetical California microgrid consisting of a group of commercial buildings over an historic test year, 1999. The optimization is conducted using a customer adoption model (DER-CAM) developed at Berkeley Lab and implemented in the General Algebraic Modeling System (GAMS). A microgrid is a semiautonomous grouping of electricity and heat loads interconnected to the existing utility grid (macrogrid) but able to island from it. The microgrid minimizes the cost of meeting its energy requirements (consisting of both electricity and heat loads) by optimizing the installation and operation of DER technologies while purchasing residual energy from the local combined natural gas and electricity utility. The available DER technologies are small-scale generators (< 500 kW), such as reciprocating engines, microturbines, and fuel cells, with or without combined heat and power (CHP) equipment, such as water and space heating and/or absorption cooling. By introducing a tax on carbon emissions, it is shown that if the microgrid is allowed to install CHP-enabled DER technologies, its carbon emissions are mitigated more than without CHP, demonstrating the potential benefits of small-scale CHP technology for climate change mitigation. Reciprocating engines with heat recovery and/or absorption cooling tend to be attractive technologies for the mild southern California climate, but the carbon mitigation tends to be modest compared to purchasing utility electricity because of the predominance of relatively clean central station generation in California.

  2. Cancer treatment by photodynamic therapy combined with NK-cell-line-based adoptive immunotherapy

    NASA Astrophysics Data System (ADS)

    Korbelik, Mladen; Sun, Jinghai

    1998-05-01

    Treatment of solid cancers by photodynamic therapy (PDT) triggers a strong acute inflammatory reaction localized to the illuminated malignant tissue. This event is regulated by a massive release of various potent mediators which have a profound effect not only on local host cell populations, but also attract different types of immune cells to the treated tumor. Phagocytosis of PDT-damaged cancerous cells by antigen presenting cells, such as activated tumor associated macrophages, enables the recognition of even poorly immunogenic tumors by specific immune effector cells and the generation of immune memory populations. Because of its inflammatory/immune character, PDT is exceptionally responsive to adjuvant treatments with various types of immunotherapy. Combining PDT with immuneactivators, such as cytokines or other specific or non-specific immune agents, rendered marked improvements in tumor cures with various cancer models. Another clinically attractive strategy is adoptive immunotherapy, and the prospects of its use in conjunction with PDT are outlined.

  3. Effects of a carbon tax on combined heat and power adoption by a microgrid

    SciTech Connect

    Marnay, Chris; Edwards, Jennifer L.; Firestone, Ryan M.; Ghosh, Srijay; Siddidqui, Afzal S.; Stadler, Michael

    2002-10-01

    This paper describes the economically optimal adoption and operation of distributed energy resources (DER) by a hypothetical California microgrid ((mu)Grid) consisting of a group of commercial buildings over an historic test year, 1999. The optimization is conducted using a customer adoption model (DER-CAM) developed at Berkeley Lab and implemented in the General Algebraic Modeling System (GAMS). A (mu)Grid is a semiautonomous grouping of electricity and heat loads interconnected to the existing utility grid (macrogrid) but able to island from it. The (mu)Grid minimizes the cost of meeting its energy requirements (consisting of both electricity and heat loads) by optimizing the installation and operation of DER technologies while purchasing residual energy from the local combined natural gas and electricity utility. The available DER technologies are small-scale generators (< 500 kW), such as reciprocating engines, microturbines, and fuel cells, with or without CHP equipment, such as water- and space-heating and/or absorption cooling. By introducing a tax on carbon emissions, it is shown that if the (mu)Grid is allowed to install CHP-enabled DER technologies, its carbon emissions are mitigated more than without CHP, demonstrating the potential benefits of small-scale CHP technology for climate change mitigation. Reciprocating engines with heat recovery and/or absorption cooling tend to be attractive technologies for the mild southern California climate, but the carbon mitigation tends to be modest compared to purchasing utility electricity because of the predominance of relatively clean generation in California.

  4. Community response to artemisinin-based combination therapy for childhood malaria: a case study from Dar es Salaam, Tanzania

    PubMed Central

    2010-01-01

    Background New malaria treatment guidelines in Tanzania have led to the large-scale deployment of artemether-lumefantrine (Coartem®), popularly known as ALu or dawa mseto. Very little is known about how people in malaria endemic areas interpret policy makers' decision to replace existing anti-malarials, such as sulphadoxine-pyrimethamine (SP) with "new" treatment regimens, such as ALu or other formulations of ACT. This study was conducted to examine community level understandings and interpretations of ALu's efficacy and side-effects. The paper specifically examines the perceived efficacy of ALu as articulated by the mothers of young children diagnosed with malaria and prescribed ALu. Methods Participant observation, six focus group discussions in two large villages, followed by interviews with a random sample of 110 mothers of children less than five years of age, who were diagnosed with malaria and prescribed ALu. Additionally, observations were conducted in two village dispensaries involving interactions between mothers/caretakers and health care providers. Results While more than two-thirds of the mothers had an overall negative disposition toward SP, 97.5% of them spoke favourably about ALu, emphasizing it's ability to help their children to rapidly recover from malaria, without undesirable side-effects. 62.5% of the mothers reported that they were spending less money dealing with malaria than previously when their child was treated with SP. 88% of the mothers had waited for 48 hours or more after the onset of fever before taking their child to the dispensary. Mothers' knowledge and reporting of ALu's dosage was, in many cases, inconsistent with the recommended dosage schedule for children. Conclusion Deployment of ALu has significantly changed community level perceptions of anti-malarial treatment. However, mothers continue to delay seeking care before accessing ALu, limiting the impact of highly subsidized rollout of the drug. Implementation of ACT-based treatment guidelines must be complemented with educational campaigns to insure that mothers seek prompt help for their children within 24 hours of the onset of fever. Improved communication between health care providers and mothers of sick children can facilitate better adherence to ALu's recommended dosage. Community level interpretations of anti-malarials are multifaceted; integrating knowledge of local beliefs and practices surrounding consumption of anti-malarials into programmatic goals can help to significantly improve malaria control interventions. PMID:20187949

  5. Efficacy of Artemisinin-Based Combination Treatments of Uncomplicated Falciparum Malaria in Under-Five-Year-Old Nigerian Children

    PubMed Central

    Oguche, Stephen; Okafor, Henrietta U.; Watila, Ismaila; Meremikwu, Martin; Agomo, Philip; Ogala, William; Agomo, Chimere; Ntadom, Godwin; Banjo, Olajide; Okuboyejo, Titilope; Ogunrinde, Gboye; Odey, Friday; Aina, Olugbemiga; Sofola, Tolulope; Sowunmi, Akintunde

    2014-01-01

    The efficacy of 3-day regimens of artemether-lumefantrine and artesunate-amodiaquine were evaluated in 747 children < 5 years of age with uncomplicated malaria from six geographical areas of Nigeria. Fever clearance was significantly faster (P = 0.006) and the proportion of children with parasitemia 1 day after treatment began was significantly lower (P = 0.016) in artesunate-amodiaquine—compared with artemether-lumefantrine-treated children. Parasite clearance times were similar with both treatments. Overall efficacy was 96.3% (95% confidence interval [CI] 94.5–97.6%), and was similar for both regimens. Polymerase chain reaction-corrected parasitologic cure rates on Day 28 were 96.9% (95% CI 93.9–98.2%) and 98.3% (95% CI 96.1–99.3%) for artemether-lumefantrine and artesunate-amodiaquine, respectively. Gametocyte carriage post treatment was significantly lower than pretreatment (P < 0.0001). In anemic children, mean time to recovery from anemia was 10 days (95% CI 9.04–10.9) and was similar for both regimens. Both treatments were well tolerated and are safe and efficacious treatments of uncomplicated falciparum malaria in young Nigerian children. PMID:25246693

  6. Efficacy of artemisinin-based combination treatments of uncomplicated falciparum malaria in under-five-year-old Nigerian children.

    PubMed

    Oguche, Stephen; Okafor, Henrietta U; Watila, Ismaila; Meremikwu, Martin; Agomo, Philip; Ogala, William; Agomo, Chimere; Ntadom, Godwin; Banjo, Olajide; Okuboyejo, Titilope; Ogunrinde, Gboye; Odey, Friday; Aina, Olugbemiga; Sofola, Tolulope; Sowunmi, Akintunde

    2014-11-01

    The efficacy of 3-day regimens of artemether-lumefantrine and artesunate-amodiaquine were evaluated in 747 children < 5 years of age with uncomplicated malaria from six geographical areas of Nigeria. Fever clearance was significantly faster (P = 0.006) and the proportion of children with parasitemia 1 day after treatment began was significantly lower (P = 0.016) in artesunate-amodiaquine-compared with artemether-lumefantrine-treated children. Parasite clearance times were similar with both treatments. Overall efficacy was 96.3% (95% confidence interval [CI] 94.5-97.6%), and was similar for both regimens. Polymerase chain reaction-corrected parasitologic cure rates on Day 28 were 96.9% (95% CI 93.9-98.2%) and 98.3% (95% CI 96.1-99.3%) for artemether-lumefantrine and artesunate-amodiaquine, respectively. Gametocyte carriage post treatment was significantly lower than pretreatment (P < 0.0001). In anemic children, mean time to recovery from anemia was 10 days (95% CI 9.04-10.9) and was similar for both regimens. Both treatments were well tolerated and are safe and efficacious treatments of uncomplicated falciparum malaria in young Nigerian children.

  7. A pharmacokinetic approach to assess artemisinin-naphthoquine combination therapy for uncomplicated pediatric malaria.

    PubMed

    Liu, Rong; Dong, Hui-Fen; Jiang, Ming-Sen

    2012-09-01

    Artemisinin-based combination therapies (ACTs) have been adopted as the first line of treatment against malaria in nearly all malaria-endemic countries, mainly as a result of Plasmodium falciparum infection, as this species of malaria parasite has developed resistance to most of the available non-artemisinin antimalarial drugs. Artemisinin-naphthoquine (ART-NQ, also named as ARCO™; Kunming Pharmaceuticals, Kunming, China) is one of the several currently available ACTs that show a promising approach to dealing with drug-resistant malaria rather than monotherapies. Unlike other ACTs, ART-NQ requires either a single-dose treatment or a two-dose treatment within 24 h against uncomplicated P. falciparum malaria; however, this was mainly validated in adults rather than children. Batty et al. performed the first pharmacokinetic study of ART-NQ combination therapy for uncomplicated pediatric malaria, and the authors' results are described and discussed below.

  8. Distributed energy resources customer adoption modeling with combined heat and power applications

    SciTech Connect

    Siddiqui, Afzal S.; Firestone, Ryan M.; Ghosh, Srijay; Stadler, Michael; Edwards, Jennifer L.; Marnay, Chris

    2003-07-01

    In this report, an economic model of customer adoption of distributed energy resources (DER) is developed. It covers progress on the DER project for the California Energy Commission (CEC) at Berkeley Lab during the period July 2001 through Dec 2002 in the Consortium for Electric Reliability Technology Solutions (CERTS) Distributed Energy Resources Integration (DERI) project. CERTS has developed a specific paradigm of distributed energy deployment, the CERTS Microgrid (as described in Lasseter et al. 2002). The primary goal of CERTS distributed generation research is to solve the technical problems required to make the CERTS Microgrid a viable technology, and Berkeley Lab's contribution is to direct the technical research proceeding at CERTS partner sites towards the most productive engineering problems. The work reported herein is somewhat more widely applicable, so it will be described within the context of a generic microgrid (mGrid). Current work focuses on the implementation of combined heat and power (CHP) capability. A mGrid as generically defined for this work is a semiautonomous grouping of generating sources and end-use electrical loads and heat sinks that share heat and power. Equipment is clustered and operated for the benefit of its owners. Although it can function independently of the traditional power system, or macrogrid, the mGrid is usually interconnected and exchanges energy and possibly ancillary services with the macrogrid. In contrast to the traditional centralized paradigm, the design, implementation, operation, and expansion of the mGrid is meant to optimize the overall energy system requirements of participating customers rather than the objectives and requirements of the macrogrid.

  9. Systemic chemotherapy combined with local adoptive immunotherapy cures rats bearing 9L gliosarcoma.

    PubMed

    Kruse, C A; Mitchell, D H; Kleinschmidt-DeMasters, B K; Bellgrau, D; Eule, J M; Parra, J R; Kong, Q; Lillehei, K O

    1993-02-01

    Survival of Fischer rats bearing 9L gliosarcoma in the brain was measured to determine the efficacy of 1) systemically administered chemotherapy with local adoptive immunotherapy (chemo-adoptive immunotherapy) or 2) systemically administered chemo-immunotherapy. Winn assays, where tumor instillation coincided with the start of treatment, and one-week established tumor assays were conducted. Survival of chemo-adoptive immunotherapy treated groups given intraperitoneal cyclophosphamide and intracranial lymphokine activated killer cells and recombinant Interleukin-2 was significantly extended when compared to sham treated control groups, to groups given chemotherapy with intraperitoneal cyclophosphamide, and to groups treated by local adoptive immunotherapy with intracranial lymphokine activated killer cells and Interleukin-2. The killer cells were generated from spleens of donor rats that either had or had not been given cyclophosphamide 24 h earlier. Long-term survivors (9/39), sacrificed at day 70, were obtained only in the chemo-adoptive immunotherapy treated groups; 7/39 had no histologic evidence of tumor and had focal sterile abscesses at the site of killer cell instillation. Average group weight plotted over time showed that there was acceptable toxicity with chemo-adoptive immunotherapy; the toxicity was identical to that obtained with systemic cyclophosphamide treatment. In contrast, survival of chemo-immunotherapy treated groups given systemic cyclophosphamide and Interleukin-2 was not significantly extended from groups which were sham treated or treated only with systemic Interleukin-2. Rapid decline of average group weight plotted over time and early deaths following chemo-immunotherapy treatment indicated that the regimen was toxic. The effect of cyclophosphamide administration on the splenocytes of donor rats and the LAK cells generated from them was determined by in vitro studies analyzing cell number, viability, phenotypic expression and cytotoxicity

  10. Shared environmental influences on personality: A combined twin and adoption approach

    PubMed Central

    Matteson, Lindsay K.; McGue, Matt; Iacono, William G.

    2013-01-01

    In the past, shared environmental influences on personality traits have been found to be negligible in behavior genetic studies (e.g., Bouchard & McGue, 2003). However, most studies have been based on biometrical modeling of twins only. Failure to meet key assumptions of the classical twin design could lead to biased estimates of shared environmental effects. Alternative approaches to the etiology of personality are needed. In the current study we estimated the impact of shared environmental factors on adolescent personality by simultaneously modeling both twin and adoption data. We found evidence for significant shared environmental influences on Multidimensional Personality Questionnaire (MPQ) Absorption (15% variance explained), Alienation (10%), Harm Avoidance (14%), and Traditionalism (26%) scales. Additionally, we found that in most cases biometrical models constraining parameter estimates to be equal across study type (twins versus adoptees) fit no worse than models allowing these parameters to vary; this suggests that results converge across study design despite the potential (sometimes opposite) biases of twin and adoption studies. Thus, we can be more confident that our findings represent the true contribution of shared environmental variance to personality development. PMID:24065564

  11. Shared environmental influences on personality: a combined twin and adoption approach.

    PubMed

    Matteson, Lindsay K; McGue, Matt; Iacono, William G

    2013-11-01

    In the past, shared environmental influences on personality traits have been found to be negligible in behavior genetic studies (e.g., Bouchard and McGue, J Neurobiol 54:4-45, 2003). However, most studies have been based on biometrical modeling of twins only. Failure to meet key assumptions of the classical twin design could lead to biased estimates of shared environmental effects. Alternative approaches to the etiology of personality are needed. In the current study we estimated the impact of shared environmental factors on adolescent personality by simultaneously modeling both twin and adoption data. We found evidence for significant shared environmental influences on Multidimensional Personality Questionnaire Absorption (15% variance explained), Alienation (10%), Harm Avoidance (14%), and Traditionalism (26%) scales. Additionally, we found that in most cases biometrical models constraining parameter estimates to be equal across study type (twins vs. adoptees) fit no worse than models allowing these parameters to vary; this suggests that results converge across study design despite the potential (sometimes opposite) biases of twin and adoption studies. Thus, we can be more confident that our findings represent the true contribution of shared environmental variance to personality development.

  12. [Experimental and clinical study of adoptive immunotherapy combined with preadministration of OK-432: a method to augment the therapeutic effect].

    PubMed

    Kan, N; Okino, T; Nakanishi, M; Sato, K; Mise, K; Teramura, Y; Yamasaki, S; Hori, T; Ohgaki, K; Tobe, T

    1989-04-01

    Our previous method of adoptive immunotherapy using IL2-cultured autologous lymphocytes consists of (1) in vitro sensitization by sonicated autologous tumor extract, (2) the induction and proliferation of active CTL by crude IL2, and (3) the preadministration of OK-432 for the augmentation of the therapeutic effect. Here we describe a new method to augment the therapeutic effect of OK432-combined AIT. In BALB/c mice with advanced malignant ascites (MOPC 104E), serial therapy with OK-432, cyclophosphamide and AIT significantly prolonged the survival compared with other therapeutic schedules through synergism between host's effector cells induced by immuno-chemotherapy and transferred killer cells. Many patients with advanced malignancies, for example, unresectable gastrointestinal cancer, locally advanced breast cancer or lung metastases of breast cancer, respond to such immuno-chemo-lymphocytotherapy, while previous OK432-combined AIT was effective only in malignant pleural effusion or metastatic liver tumor from breast cancer or peritoneal dissemination of gastric cancer.

  13. Combinational targeting offsets antigen escape and enhances effector functions of adoptively transferred T cells in glioblastoma.

    PubMed

    Hegde, Meenakshi; Corder, Amanda; Chow, Kevin K H; Mukherjee, Malini; Ashoori, Aidin; Kew, Yvonne; Zhang, Yi Jonathan; Baskin, David S; Merchant, Fatima A; Brawley, Vita S; Byrd, Tiara T; Krebs, Simone; Wu, Meng Fen; Liu, Hao; Heslop, Helen E; Gottschalk, Stephen; Gottachalk, Stephen; Yvon, Eric; Ahmed, Nabil

    2013-11-01

    Preclinical and early clinical studies have demonstrated that chimeric antigen receptor (CAR)-redirected T cells are highly promising in cancer therapy. We observed that targeting HER2 in a glioblastoma (GBM) cell line results in the emergence of HER2-null tumor cells that maintain the expression of nontargeted tumor-associated antigens. Combinational targeting of these tumor-associated antigens could therefore offset this escape mechanism. We studied the single-cell coexpression patterns of HER2, IL-13Rα2, and EphA2 in primary GBM samples using multicolor flow cytometry and immunofluorescence, and applied a binomial routine to the permutations of antigen expression and the related odds of complete tumor elimination. This mathematical model demonstrated that cotargeting HER2 and IL-13Rα2 could maximally expand the therapeutic reach of the T cell product in all primary tumors studied. Targeting a third antigen did not predict an added advantage in the tumor cohort studied. We therefore generated bispecific T cell products from healthy donors and from GBM patients by pooling T cells individually expressing HER2 and IL-13Rα2-specific CARs and by making individual T cells to coexpress both molecules. Both HER2/IL-13Rα2-bispecific T cell products offset antigen escape, producing enhanced effector activity in vitro immunoassays (against autologous glioma cells in the case of GBM patient products) and in an orthotopic xenogeneic murine model. Further, T cells coexpressing HER2 and IL-13Rα2-CARs exhibited accentuated yet antigen-dependent downstream signaling and a particularly enhanced antitumor activity.

  14. Artemisinin-based antimalarial research: application of biotechnology to the production of artemisinin, its mode of action, and the mechanism of resistance of Plasmodium parasites.

    PubMed

    Muangphrom, Paskorn; Seki, Hikaru; Fukushima, Ery Odette; Muranaka, Toshiya

    2016-07-01

    Malaria is a worldwide disease caused by Plasmodium parasites. A sesquiterpene endoperoxide artemisinin isolated from Artemisia annua was discovered and has been accepted for its use in artemisinin-based combinatorial therapies, as the most effective current antimalarial treatment. However, the quantity of this compound produced from the A. annua plant is very low, and the availability of artemisinin is insufficient to treat all infected patients. In addition, the emergence of artemisinin-resistant Plasmodium has been reported recently. Several techniques have been applied to enhance artemisinin availability, and studies related to its mode of action and the mechanism of resistance of malaria-causing parasites are ongoing. In this review, we summarize the application of modern technologies to improve the production of artemisinin, including our ongoing research on artemisinin biosynthetic genes in other Artemisia species. The current understanding of the mode of action of artemisinin as well as the mechanism of resistance against this compound in Plasmodium parasites is also presented. Finally, the current situation of malaria infection and the future direction of antimalarial drug development are discussed. PMID:27250562

  15. Combining the Power of Statistical Analyses and Community Interviews to Identify Adoption Barriers for Stormwater Best-Management Practices

    NASA Astrophysics Data System (ADS)

    Hoover, F. A.; Bowling, L. C.; Prokopy, L. S.

    2015-12-01

    Urban stormwater is an on-going management concern in municipalities of all sizes. In both combined or separated sewer systems, pollutants from stormwater runoff enter the natural waterway system during heavy rain events. Urban flooding during frequent and more intense storms are also a growing concern. Therefore, stormwater best-management practices (BMPs) are being implemented in efforts to reduce and manage stormwater pollution and overflow. The majority of BMP water quality studies focus on the small-scale, individual effects of the BMP, and the change in water quality directly from the runoff of these infrastructures. At the watershed scale, it is difficult to establish statistically whether or not these BMPs are making a difference in water quality, given that watershed scale monitoring is often costly and time consuming, relying on significant sources of funds, which a city may not have. Hence, there is a need to quantify the level of sampling needed to detect the water quality impact of BMPs at the watershed scale. In this study, a power analysis was performed on data from an urban watershed in Lafayette, Indiana, to determine the frequency of sampling required to detect a significant change in water quality measurements. Using the R platform, results indicate that detecting a significant change in watershed level water quality would require hundreds of weekly measurements, even when improvement is present. The second part of this study investigates whether the difficulty in demonstrating water quality change represents a barrier to adoption of stormwater BMPs. Semi-structured interviews of community residents and organizations in Chicago, IL are being used to investigate residents understanding of water quality and best management practices and identify their attitudes and perceptions towards stormwater BMPs. Second round interviews will examine how information on uncertainty in water quality improvements influences their BMP attitudes and perceptions.

  16. Adoptive transfer of Mammaglobin-A epitope specific CD8 T cells combined with a single low dose of total body irradiation eradicates breast tumors.

    PubMed

    Lerret, Nadine M; Rogozinska, Magdalena; Jaramillo, Andrés; Marzo, Amanda L

    2012-01-01

    Adoptive T cell therapy has proven to be beneficial in a number of tumor systems by targeting the relevant tumor antigen. The tumor antigen targeted in our model is Mammaglobin-A, expressed by approximately 80% of human breast tumors. Here we evaluated the use of adoptively transferred Mammaglobin-A specific CD8 T cells in combination with low dose irradiation to induce breast tumor rejection and prevent relapse. We show Mammaglobin-A specific CD8 T cells generated by DNA vaccination with all epitopes (Mammaglobin-A2.1, A2.2, A2.4 and A2.6) and full-length DNA in vivo resulted in heterogeneous T cell populations consisting of both effector and central memory CD8 T cell subsets. Adoptive transfer of spleen cells from all Mammaglobin-A2 immunized mice into tumor-bearing SCID/beige mice induced tumor regression but this anti-tumor response was not sustained long-term. Additionally, we demonstrate that only the adoptive transfer of Mammaglobin-A2 specific CD8 T cells in combination with a single low dose of irradiation prevents tumors from recurring. More importantly we show that this single dose of irradiation results in the down regulation of the macrophage scavenger receptor 1 on dendritic cells within the tumor and reduces lipid uptake by tumor resident dendritic cells potentially enabling the dendritic cells to present tumor antigen more efficiently and aid in tumor clearance. These data reveal the potential for adoptive transfer combined with a single low dose of total body irradiation as a suitable therapy for the treatment of established breast tumors and the prevention of tumor recurrence.

  17. Dynamics of Plasmodium falciparum Parasitemia Regarding Combined Treatment Regimens for Acute Uncomplicated Malaria, Antioquia, Colombia

    PubMed Central

    Álvarez, Gonzalo; Tobón, Alberto; Piñeros, Juan-Gabriel; Ríos, Alexandra; Blair, Silvia

    2010-01-01

    Selecting suitable anti-malarial treatment represents one of the best tools for reducing morbidity and mortality caused by this disease. Sexual and asexual parasite dynamics were thus evaluated in patients involved in antimalarial drug efficacy studies by using combined treatment with and without artemisinin derivatives for treating uncomplicated acute Plasmodium falciparum malaria in Antioquia, Colombia. All treatment doses were supervised and administered according to patients' weight; sexual and asexual parasitemia were evaluated during 28- or 42-days follow-up in 468 patients. Artemisinin-based combination therapy showed greater parasiticidal ability, showing a mean asexual parasitemia survival rate of one day and mean gametocyte survival rate of 1–2 days. Sexual and asexual parasitemias were eliminated more quickly and effectively in the group receiving artemisinin-based combination therapy. Adding 45 mg of primaquine to treatment with artesunate and mefloquine reduced gametocyte and asexual parasite survival by one day. PMID:20595483

  18. Modulation of tumor response to photodynamic therapy in severe combined immunodeficient (SCID) mice by adoptively transferred lymphoid cells

    NASA Astrophysics Data System (ADS)

    Korbelik, Mladen; Krosl, Gorazd; Krosl, Jana; Dougherty, Graeme J.

    1996-04-01

    Photodynamic treatment, consisting of intravenous injection of PhotofrinR (10 mg/kg) followed by exposure to 110 J/cm2 of 630 plus or minus 10 nm light 24 hours later, cured 100% of EMT6 tumors (murine mammary sarcoma) growing in syngeneic immunocompetent BALB/C mice. In contrast, the same treatment produced no cures of EMT6 tumors growing in either nude or SCID mice (immunodeficient strains). EMT6 tumors growing in BALB/C and SCID mice showed no difference in either the level of PhotofrinR accumulated per gram of tumor tissue, or the extent of tumor cell killing during the first 24 hours post photodynamic therapy (PDT). In an attempt to improve the sensitivity to PDT of EMT6 tumors growing in SCID mice, these hosts were given either splenic T lymphocytes or whole bone marrow from BALB/C mice. The adoptive transfer of lymphocytes 9 days before PDT was successful in delaying tumor recurrence but produced no cures. A better improvement in PDT response was obtained with tumors growing in SCID mice reconstituted with BALB/C bone marrow (tumor cure rate of 63%). The results of this study demonstrate that, at least with the EMT6 tumor model, antitumor immune activity mediated by lymphoid cell populations makes an important contribution to the curative effect of PDT.

  19. Pilot Cluster Randomized Controlled Trials to Evaluate Adoption of Water, Sanitation, and Hygiene Interventions and Their Combination in Rural Western Kenya

    PubMed Central

    Christensen, Garret; Dentz, Holly N.; Pickering, Amy J.; Bourdier, Tomoé; Arnold, Benjamin F.; Colford, John M.; Null, Clair

    2015-01-01

    In preparation for a larger trial, the Water, Sanitation, and Hygiene (WASH) Benefits pilot study enrolled 72 villages and 499 subjects in two closely related randomized trials of WASH interventions in rural western Kenya. Intervention households received hardware and promotion for one of the following: water treatment, sanitation and latrine improvements, handwashing with soap, or the combination of all three. Interventions were clustered by village. A follow-up survey was conducted 4 months after intervention delivery to assess uptake. Intervention households were significantly more likely than controls to have chlorinated stored water (36–60 percentage point increases), covers over latrine drop holes (55–75 percentage point increases), less stool visible on latrine floors (16–47 percentage point reductions), and a place for handwashing (71–85 percentage point increases) with soap available (49–66 percentage point increases). The high uptake in all arms shows that combined interventions can achieve high short-term adoption rates if well-designed. PMID:25422394

  20. Aerosol Delivery of Interleukin-2 in Combination with Adoptive Transfer of Natural Killer Cells for the Treatment of Lung Metastasis: Methodology and Effect.

    PubMed

    Kiany, Simin; Gordon, Nancy

    2016-01-01

    Natural killer (NK) cells are a subtype of lymphocytes with a major role as a host defense mechanism against tumor cells. Allogeneic NK cell therapy is being used as an alternative promising therapy for many different cancers. Interleukin-2 (IL-2) is a critical cytokine for NK cell proliferation, survival, and effector functions. Cytokine support is essential to activate, expand, and increase the life span of NK cells. Aerosol delivery of IL-2 in combination with adoptive transfer of NK cells offers a reasonable approach for the treatment of lung metastases as it avoids the deleterious side effects of systemic IL-2. Using a human OS mouse model, we demonstrated the efficacy of this approach. Combination therapy of aerosol IL-2 with NK cells resulted in a better therapeutic effect against OS lung metastases as compared with each therapy alone. Aerosol IL-2 selectively increased infiltration, retention, and proliferation of infused NK cells in the lung, and there was no local inflammation or toxicity in the lungs or any other organ. Our results demonstrate that delivery of IL-2 via the aerosol route offers a feasible and innovative approach to enhance the immunotherapeutic effect of NK cells against pulmonary metastases. In the following chapter, we describe the methodology and effect of this innovative therapeutic approach. PMID:27177675

  1. Optimized human CYP4B1 in combination with the alkylator prodrug 4-ipomeanol serves as a novel suicide gene system for adoptive T-cell therapies.

    PubMed

    Roellecke, K; Virts, E L; Einholz, R; Edson, K Z; Altvater, B; Rossig, C; von Laer, D; Scheckenbach, K; Wagenmann, M; Reinhardt, D; Kramm, C M; Rettie, A E; Wiek, C; Hanenberg, H

    2016-07-01

    Engineering autologous or allogeneic T cells to express a suicide gene can control potential toxicity in adoptive T-cell therapies. We recently reported the development of a novel human suicide gene system that is based on an orphan human cytochrome P450 enzyme, CYP4B1, and the naturally occurring alkylator prodrug 4-ipomeanol. The goal of this study was to systematically develop a clinically applicable self-inactivating lentiviral vector for efficient co-expression of CYP4B1 as an ER-located protein with two distinct types of cell surface proteins, either MACS selection genes for donor lymphocyte infusions after allogeneic stem cell transplantation or chimeric antigen receptors for retargeting primary T cells. The U3 region of the myeloproliferative sarcoma virus in combination with the T2A site was found to drive high-level expression of our CYP4B1 mutant with truncated CD34 or CD271 as MACS suitable selection markers. This lentiviral vector backbone was also well suited for co-expression of CYP4B1 with a codon-optimized CD19 chimeric antigen receptor (CAR) construct. Finally, 4-ipomeanol efficiently induced apoptosis in primary T cells that co-express mutant CYP4B1 and the divergently located MACS selection and CAR genes. In conclusion, we here developed a clinically suited lentiviral vector that supports high-level co-expression of cell surface proteins with a potent novel human suicide gene. PMID:27092941

  2. Effect of artemether administered alone or in combination with praziquantel to mice infected with Plasmodium berghei or Schistosoma mansoni or both.

    PubMed

    Shu-Hua, Xiao; Utzinger, Jürg; Chollet, Jacques; Tanner, Marcel

    2006-07-01

    The artemisinins have become key drugs for the treatment and control of malaria, particularly within artemisinin-based combination therapies. Since the artemisinins also exhibit antischistosomal properties, their use in areas where malaria and schistosomiasis are co-endemic may have an effect on both diseases and co-infection might alter drug efficacy. We assessed the antimalarial and antischistosomal efficacies of artemether in mice infected with Plasmodium berghei or Schistosoma mansoni or both parasites concurrently. Three oral doses of 400 mg/kg artemether at 14-day intervals reduced total and female S. mansoni worm burdens by 98.7-100%, regardless of a concurrent P. berghei infection. When four daily doses of 55 mg/kg artemether were administered, which is a standard treatment schedule to cure P. berghei-infected mice, significantly lower total and female S. mansoni worm burden reductions were observed (73.1-89.2%). Artemether, administered at both of the above-mentioned treatment schemes, showed excellent antimalarial efficacy with no indications of delayed clearance of P. berghei or recrudescence, also in mice co-infected with S. mansoni. Co-infection with P. berghei had no effect on S. mansoni worm burden reductions following artemether-praziquantel combinations. Our findings point to the need for epidemiological studies in areas where malaria and schistosomiasis co-exist and where artemisinin-based combination therapies are introduced, since artemisinin-based combination therapies as part of a malaria control package may have ancillary benefits against schistosomiasis. PMID:16750833

  3. Combination therapy--a way to forestall artemisinin resistance and optimize uncomplicated malaria treatment.

    PubMed

    Ștefan, I

    2015-01-01

    Artemisinin resistance represents a global concern, which requires a concerted and coordinated effort at a global level. Lessons learned from the experience of drug combination therapies in HIV, TB, and HCV infections showed that combination therapies reduce the risk of drug resistance development. In order to maximize the effectiveness of artemisinin and its derivates and to protect it from the development of resistance, WHO recommended that they should be combined with other drugs that have different mechanisms of action and longer half-lives. Until the attainment of new pharmaceuticals, artemisinin-based combination therapy (ACT) is the way to forestall artemisinin resistance and optimize uncomplicated malaria treatment. PMID:26351534

  4. Strengthening Adoption Practice, Listening to Adoptive Families

    ERIC Educational Resources Information Center

    Atkinson, Anne; Gonet, Patricia

    2007-01-01

    In-depth interviews with 500 adoptive families who received postadoption services through Virginia's Adoptive Family Preservation (AFP) program paint a richly detailed picture of the challenges adoptive families face and what they need to sustain adoption for many years after finalization. Findings document the need for support in a variety of…

  5. Medical Issues in Adoption

    MedlinePlus

    ... to Know About Zika & Pregnancy Medical Issues in Adoption KidsHealth > For Parents > Medical Issues in Adoption Print ... or emotional abuse of the child continue Agency Adoptions If you adopt through an agency, you might ...

  6. The Place of Genetic Counselling in Adoption.

    ERIC Educational Resources Information Center

    Hockey, Athel; Bain, Jill

    1982-01-01

    An approach combining social worker and geneticist expertise in adoption is outlined in the study involving 180 families. Genetic counseling has shown to be an essential safeguard to the preservation of the adoptive family unit. (Author/SW)

  7. The effect of an anti-malarial subsidy programme on the quality of service provision of artemisinin-based combination therapy in Kenya: a cluster-randomized, controlled trial

    PubMed Central

    2013-01-01

    Background Many patients with suspected malaria in sub-Saharan Africa seek treatment from private providers, but this sector suffers from sub-standard medicine dispensing practices. To improve the quality of care received for presumptive malaria from the highly accessed private retail sector in western Kenya, subsidized pre-packaged artemether-lumefantrine (AL) was provided to private retailers, together with a one day training for retail staff on malaria diagnosis and treatment, job aids and community engagement activities. Methods The intervention was assessed using a cluster-randomized, controlled design. Provider and mystery-shopper cross-sectional surveys were conducted at baseline and eight months post-intervention to assess provider practices. Data were analysed based on cluster-level summaries, comparing control and intervention arms. Results On average, 564 retail outlets were interviewed per year. At follow-up, 43% of respondents reported that at least one staff member had attended the training in the intervention arm. The intervention significantly increased the percentage of providers knowing the first line treatment for uncomplicated malaria by 24.2% points (confidence interval (CI): 14.8%, 33.6%; adjusted p=0.0001); the percentage of outlets stocking AL by 31.7% points (CI: 22.0%, 41.3%; adjusted p=0.0001); and the percentage of providers prescribing AL for presumptive malaria by 23.6% points (CI: 18.7%, 28.6%; adjusted p=0.0001). Generally outlets that received training and job aids performed better than those receiving one or none of these intervention components. Conclusion Overall, subsidizing ACT and retailer training can significantly increase the percentage of outlets stocking and selling AL for the presumptive treatment of malaria, but further research is needed on strategies to improve the provision of counselling advice to retail customers. PMID:23452547

  8. Adopted Children and Discipline

    MedlinePlus

    ... a Pediatrician Family Life Medical Home Family Dynamics Adoption & Foster Care Communication & Discipline Types of Families Media ... Your Community Healthy Children > Family Life > Family Dynamics > Adoption & Foster Care > Adopted Children & Discipline Family Life Listen ...

  9. Adoption & Foster Care

    MedlinePlus

    ... Children > Family Life > Family Dynamics > Adoption & Foster Care Adoption & Foster Care Article Body ​Each year, many children join families through adoption and foster care. These families may face unique ...

  10. The Family of Adoption.

    ERIC Educational Resources Information Center

    Pavao, Joyce Maguire

    This book aims to provide a broad framework within which to think about adoption as a whole system, so that everyone involved will learn to feel some empathy for the other members of the adoption process. The book, written by a family and adoption therapist who was adopted as an infant, describes predictable developmental stages and challenges for…

  11. Taking Adoption Seriously.

    ERIC Educational Resources Information Center

    Pierce, William

    1990-01-01

    Argues that adoption should be included in strategies to help children, teen parents, and other women with difficult pregnancies because adolescents are not equipped to raise children. Discusses the need for longitudinal research on adoption, adoption education in secondary schools, and studying mass media impact on adoption. (FMW)

  12. Efficacy of monotherapies and artesunate-based combination therapies in children with uncomplicated malaria in Somalia.

    PubMed

    Warsame, Marian; Atta, Hoda; Klena, John D; Waqar, Butt Ahmed; Elmi, Hussein Haji; Jibril, Ali Mohamed; Hassan, Hassan Mohamed; Hassan, Abdullahi Mohamed

    2009-02-01

    In order to guide the antimalarial treatment policy of Somalia, we conducted therapeutic efficacy studies of routinely used antimalarial monotherapies as well as artemisinin-based combination therapies (ACTs) for uncomplicated malaria in three sentinel sites during 2003-2006. Therapeutic efficacy of chloroquine (CQ), amodiaquine (AQ) and sulfadoxine/pyrimetahmine (SP) monotherapies, and artesunate plus SP (AS+SP) or AQ (AS+AQ) were evaluated in children 6 months to 10 years old with uncomplicated malaria. For the assessment of the monotherapies, 2003 WHO protocol with 14-day follow-up was used while the 2005 WHO protocol with 28-day follow-up was used for testing the ACTs. Of the monotherapies, CQ performed very poorly with treatment failures varying from 76.5% to 88% between the sites. AQ treatment failure was low except for Janale site with treatment failure of 23.4% compared to 2.8% and 8% in Jamame and Jowhar, respectively. For SP, treatment failures from 7.8% to 12.2% were observed. A 28-day test of artemisinin-based combinations, AS+SP and AS+AQ, proved to be highly efficacious with cure rates of 98-100% supporting the choice of AS+SP combination as first line treatment for uncomplicated malaria for Somalia.

  13. Combined effects of solvation and aggregation propensity on the final supramolecular structures adopted by hydrophobic, glycine-rich, elastin-like polypeptides.

    PubMed

    Salvi, Anna M; Moscarelli, Pasquale; Bochicchio, Brigida; Lanza, Giuseppe; Castle, James E

    2013-05-01

    Previous work on elastin-like polypeptides (ELPs) made of hydrophobic amino acids of the type XxxGlyGlyZzzGly (Xxx, Zzz = Val, Leu) has consistently shown that differing dominant supramolecular structures were formed when the suspending media were varied: helical, amyloid-like fibers when suspended in water and globules evolving into "string of bead" structures, poly(ValGlyGlyValGly), or cigar-like bundles, poly(ValGlyGlyLeuGly), when suspended in methyl alcohol. Comparative experiments with poly(LeuGlyGlyValGly) have further indicated that the interface energy plays a significant role and that solvation effects act in concomitance with the intrinsic aggregation propensity of the repeat sequence. Continuing our investigation on ELPs using surface (X-ray photoelectron spectroscopy, atomic force microscopy) and bulk (circular dichroism, Fourier transform infrared spectroscopy) techniques for their characterization, here we have compared the effect of suspending solvents (H(2)O, dimethylsulfoxide, ethylene glycol, and MeOH) on poly(ValGlyGlyValGly), the polypeptide most inclined to form long and well-refined helical fibers in water, searching for the signature of intermolecular interactions occurring between the polypeptide chains in the given suspension. The influence of sequence specificities has been studied by comparing poly(ValGlyGlyValGly) and poly(LeuGlyGlyValGly) with a similar degree of polymerization. Deposits on substrates of the polypeptides were characterized taking into account the differing evaporation rate of solvents, and tests on their stability in ultra high vacuum were performed. Finally, combining experimental and computational studies, we have revaluated the three-dimensional modeling previously proposed for the supramolecular assembly in water of poly(ValGlyGlyValGly). The results were discussed and rationalized also in the light of published data. PMID:23426573

  14. Hemolysis after Oral Artemisinin Combination Therapy for Uncomplicated Plasmodium falciparum Malaria

    PubMed Central

    Lingscheid, Tilman; Steiner, Florian; Stegemann, Miriam S.; Bélard, Sabine; Menner, Nikolai; Pongratz, Peter; Kim, Johanna; von Bernuth, Horst; Mayer, Beate; Damm, Georg; Seehofer, Daniel; Salama, Abdulgabar; Suttorp, Norbert; Zoller, Thomas

    2016-01-01

    Episodes of delayed hemolysis 2–6 weeks after treatment of severe malaria with intravenous artesunate have been described. We performed a prospective observational study of patients with uncomplicated malaria to investigate whether posttreatment hemolysis also occurs after oral artemisinin-based combination therapy. Eight of 20 patients with uncomplicated malaria who were given oral artemisinin-based combination therapy met the definition of posttreatment hemolysis (low haptoglobin level and increased lactate dehydrogenase level on day 14). Five patients had hemolysis persisting for 1 month. Patients with posttreatment hemolysis had a median decrease in hemoglobin level of 1.3 g/dL (interquartile range 0.3–2.0 g/dL) in the posttreatment period, and patients without posttreatment hemolysis had a median increase of 0.3 g/dL (IQR −0.1 to 0.7 g/dL; p = 0.002). These findings indicate a need for increased vigilance for hemolytic events in malaria patients, particularly those with predisposing factors for anemia. PMID:27434054

  15. Questions about Adoption

    MedlinePlus

    ... Español Text Size Email Print Share Questions About Adoption Page Content Article Body What's the best way to handle my child's questions about her adoption? Many parents want to know when is the ...

  16. What's Happening in Adoption?

    ERIC Educational Resources Information Center

    Gallagher, Ursula M.

    1975-01-01

    Reviews current issues in adoption: termination of parental rights, rights of unwed fathers, subsidized adoption, the recent influx of Vietnamese children, black market babies, agency accountability in placing children, the right of the adoptee to know his biological parents. (ED)

  17. Adoption: The Bigger Boxes.

    ERIC Educational Resources Information Center

    Smyer, Michael A.

    1999-01-01

    Identifies two theoretical frameworks for adoption research: stress and coping literature and life-span developmental psychology. Recognizes that placing adoption within these larger study areas encourages differentiated, conditional questions such as when does adoption have which types of impacts for which types of individuals. (DLH)

  18. The Transracial Adoption Paradox

    PubMed Central

    Lee, Richard M.

    2008-01-01

    The number of transracial adoptions in the United States, particularly international adoptions, is increasing annually. Counseling psychology as a profession, however, is a relatively silent voice in the research on and practice of transracial adoption. This article presents an overview of the history and research on transracial adoption to inform counseling psychologists of the set of racial and ethnic challenges and opportunities that transracial adoptive families face in everyday living. Particular attention is given to emergent theory and research on the cultural socialization process within these families. PMID:18458794

  19. The claim from adoption.

    PubMed

    Petersen, Thomas Sobirk

    2002-08-01

    In this article several justifications of what I call 'the claim from adoption' are examined. The claim from adoption is that, instead of expending resources on bringing new children into the world using reproductive technology and then caring for these children, we ought to devote these resources to the adoption and care of existing destitute children. Arguments trading on the idea that resources should be directed to adoption instead of assisted reproduction because already existing people can benefit from such a use of resources whereas we cannot benefit individuals by bringing them into existence are rejected. It is then argued that a utilitarian argument proposed by Christian Munthe that supports the claim from adoption in some situations should be rejected because the support it offers does not extend to certain situations in which it seems morally obvious that resources should be expended on adoption rather than assisted reproduction. A version of the Priority View improves upon Munthe's utilitarianism by supporting the claim from adoption in the cases in which Munthe's argument failed. Some allegedly counterintuitive implications of the Priority View are then discussed, and it is concluded that the Priority View is more plausible than utilitarianism. In a concluding section on policy issues it is argued that, even though the claim from adoption can be justified in a variety of situations, it does not follow that, in these situations, governments should direct resources away from assisted reproduction and towards adoption.

  20. Single Parent Adoption.

    ERIC Educational Resources Information Center

    Administration for Children, Youth, and Families (DHHS), Washington, DC.

    Presenting two views of the single-parent family, this pamphlet includes an article by two researchers (William Feigelman and Arnold R. Silverman) and a short statement by a single adoptive parent (Amanda Richards). The first paper summarizes earlier research on single-parent adoptions and discusses the results of a nationwide survey of 713…

  1. The Colorado Adoption Project.

    PubMed

    Plomin, R; DeFries, J C

    1983-04-01

    This report provides an overview of the Colorado Adoption Project (CAP), a longitudinal, prospective, multivariate adoption study of behavioral development. Examples of the types of analyses that can be conducted using this design are presented. The examples are based on general cognitive-ability data for adoptive, biological, and control parents; assessments of their home environment; and Bayley Mental Development Index scores for 152 adopted children and 120 matched control children tested at both 1 and 2 years of age. The illustrative analyses include matched control children tested at both 1 and 2 years of age. The illustrative analyses include examination of genetic and environmental sources of variance, identification of environmental influence devoid of genetic bias, assessment of genotype-environment interaction and correlation, and analyses of the etiology of change and continuity in development.

  2. Adoption and Sibling Rivalry

    MedlinePlus

    ... child in your family should understand her own origins, and those of her brothers and sisters. But ... children can seem exaggerated because of their different origins. For instance, i f your adoptive child does ...

  3. Parenting Your Adopted Teenager

    MedlinePlus

    ... https: / / www. childwelfare. gov/ pubs/ f- openadopt/ .) The Internet and the explosion of social media sites (e. ... 4 Howard, J. (2012). Untangling the web: The Internet’s transformative impact on adoption . New York, NY: Evan ...

  4. Travelers' Health: International Adoption

    MedlinePlus

    ... preadoption living standards, varying disease epidemiology in the countries of origin, the presence of previously unidentified medical problems, and ... know the disease risks in the adopted child’s country of origin and the medical and social histories of the ...

  5. Adolescents' Feelings about Openness in Adoption: Implications for Adoption Agencies

    ERIC Educational Resources Information Center

    Berge, Jerica M.; Mendenhall, Tai J.; Wrobel, Gretchen M.; Grotevant, Harold D.; McRoy, Ruth G.

    2006-01-01

    Adoption research commonly uses parents' reports of satisfaction when examining openness in adoption arrangements. This qualitative study aimed to fill a gap in the adoption research by using adolescents' voices to gain a better understanding of their adoption experiences. Adopted adolescents (n = 152) were interviewed concerning their…

  6. The Colorado Adoption Project.

    PubMed

    Rhea, Sally-Ann; Bricker, Josh B; Wadsworth, Sally J; Corley, Robin P

    2013-02-01

    This paper describes the Colorado Adoption Project (CAP), an ongoing genetically informative longitudinal study of behavioral development. We describe the features of the adoption design used in CAP, and discuss how this type of design uses data from both parent-offspring and related- versus unrelated-sibling comparisons to estimate the importance of genetic and shared environmental influences for resemblance among family members. The paper provides an overview of CAP's history, how subjects were ascertained, recruited, and retained, and the domains of assessment that have been explored since the CAP's initiation in 1975. Findings from some representative papers that make use of data from CAP participants illustrate the study's multifaceted nature as a parent-offspring and sibling behavioral genetic study, a study that parallels a complimentary twin study, a longitudinal study of development, a source of subjects for molecular genetic investigation, and a study of the outcomes of the adoption process itself. As subjects assessed first at age 1 approach age 40, we hope the CAP will establish itself as the first prospective adoption study of lifespan development.

  7. The Colorado Adoption Project

    PubMed Central

    Rhea, Sally-Ann; Bricker, Josh B.; Wadsworth, Sally J.; Corley, Robin P.

    2013-01-01

    This paper describes the Colorado Adoption Project (CAP), an ongoing genetically-informative longitudinal study of behavioral development. We describe the features of the adoption design used in CAP, and discuss how this type of design uses data from both parent-offspring and related- versus unrelated- sibling comparisons to estimate the importance of genetic and shared environmental influences for resemblance among family members. The paper provides an overview of CAP’s history, how subjects were ascertained, recruited, and retained, and the domains of assessment that have been explored since the CAP’s initiation in 1975. Findings from some representative papers that make use of data from CAP participants illustrate the study’s multifaceted nature as a parent-offspring and sibling behavioral genetic study, a study that parallels a complimentary twin study, a longitudinal study of development, a source of subjects for molecular genetic investigation, and a study of the outcomes of the adoption process itself. As subjects assessed first at age 1 approach age 40, we hope the CAP will establish itself as the first prospective adoption study of lifespan development. PMID:23158098

  8. CERTS customer adoption model

    SciTech Connect

    Rubio, F. Javier; Siddiqui, Afzal S.; Marnay, Chris; Hamachi,Kristina S.

    2000-03-01

    This effort represents a contribution to the wider distributed energy resources (DER) research of the Consortium for Electric Reliability Technology Solutions (CERTS, http://certs.lbl.gov) that is intended to attack and, hopefully, resolve the technical barriers to DER adoption, particularly those that are unlikely to be of high priority to individual equipment vendors. The longer term goal of the Berkeley Lab effort is to guide the wider technical research towards the key technical problems by forecasting some likely patterns of DER adoption. In sharp contrast to traditional electricity utility planning, this work takes a customer-centric approach and focuses on DER adoption decision making at, what we currently think of as, the customer level. This study reports on Berkeley Lab's second year effort (completed in Federal fiscal year 2000, FY00) of a project aimed to anticipate patterns of customer adoption of distributed energy resources (DER). Marnay, et al., 2000 describes the earlier FY99 Berkeley Lab work. The results presented herein are not intended to represent definitive economic analyses of possible DER projects by any means. The paucity of data available and the importance of excluded factors, such as environmental implications, are simply too important to make such an analysis possible at this time. Rather, the work presented represents a demonstration of the current model and an indicator of the potential to conduct more relevant studies in the future.

  9. Toddler Adoption: The Weaver's Craft.

    ERIC Educational Resources Information Center

    Hopkins-Best, Mary

    Based on concern about the lack of information on adopting toddlers, this book examines the special needs of adopted toddlers and their adoptive parents. Chapter 1, "Why Write a Book on Toddler Adoption?" details the lack of information on the difficulties of adopted toddlers in forming attachments and parents' child rearing difficulties. Chapter…

  10. Open Adoption: Adoptive Parents' Reactions Two Decades Later

    ERIC Educational Resources Information Center

    Siegel, Deborah H.

    2013-01-01

    Unlike in the past, most adoption agencies today offer birth parents and adoptive parents the opportunity to share identifying information and have contact with each other. To understand the impacts of different open adoption arrangements, a qualitative descriptive study using a snowball sample of 44 adoptive parents throughout New England began…

  11. Hospitious Adoption: How Hospitality Empowers Children and Transforms Adoption

    ERIC Educational Resources Information Center

    Gritter, James L.

    2009-01-01

    Building on previous books by the author, "Hospitious Adoption: How Hospitality Empowers Children and Transforms Adoption" examines the next step after open adoption. Gritter takes the approach that practicing goodwill, respect, and courage within the realm of adoption makes the process move smoother and enriches children's lives. Following a…

  12. Adoption Research: Trends, Topics, Outcomes

    ERIC Educational Resources Information Center

    Palacios, Jesus; Brodzinsky, David

    2010-01-01

    The current article provides a review of adoption research since its inception as a field of study. Three historical trends in adoption research are identified: the first focusing on risk in adoption and identifying adoptee-nonadoptee differences in adjustment; the second examining the capacity of adopted children to recover from early adversity;…

  13. Becoming Lesbian Adoptive Parents: An Exploratory Study of Lesbian Adoptive, Lesbian Birth, and Heterosexual Adoptive Parents.

    ERIC Educational Resources Information Center

    Shelley-Sireci, Lynn M.; Ciano-Boyce, Claudia

    2002-01-01

    Surveyed lesbian adoptive parents, heterosexual adoptive parents, and lesbian parents who had used assisted fertilization, regarding the adoption process. Found that the process was similar for both heterosexual and lesbian parents, but lesbian adoptive parents perceived more discrimination and were more inclined to omit information during the…

  14. Special topics in international adoption.

    PubMed

    Jenista, Jerri Ann

    2005-10-01

    As international adoption has become more "mainstream," the issues recently addressed in domestic adoption have become more important in adoptions involving children originating in other countries. Certain groups of prospective adoptive parents, such as gay or lesbian couples, single parents, and parents with disabilities, have begun to apply to adopt in ever increasing numbers. Children who may have been considered unadoptable in the past are now routinely being offered to prospective adoptive parents. The numbers and ages of the children placed and the spacing between adoptions have come under scrutiny. The rates of adoption dissolutions and disruptions are being examined carefully by the receiving and sending countries. There is a pressing need for research into numerous social aspects of adoption.

  15. Parents' Feelings towards Their Adoptive and Non-Adoptive Children

    ERIC Educational Resources Information Center

    Glover, Marshaun B.; Mullineaux, Paula Y.; Deater-Deckard, Kirby; Petrill, Stephen A.

    2010-01-01

    In the current study, we examined parent gender differences in feelings (negativity and positivity) and perceptions of child behavioural and emotional problems in adoptive and biological parent-child dyads. In a sample of 85 families, we used a novel within-family adoption design in which one child was adopted and one child was a biological child…

  16. Open adoption: adoptive parents' reactions two decades later.

    PubMed

    Siegel, Deborah H

    2013-01-01

    Unlike in the past, most adoption agencies today offer birth parents and adoptive parents the opportunity to share identifying information and have contact with each other. To understand the impacts of different open adoption arrangements, a qualitative descriptive study using a snowball sample of 44 adoptive parents throughout New England began in 1988. Every seven years these parents who adopted infants in open adoptions have participated in tape-recorded interviews to explore their evolving reactions to their open adoption experiences. This article reports the results of in-depth interviews with these parents now that their children have reached young adulthood. This longitudinal research illuminates how open adoptions change over the course of childhood and adolescence, parents' feelings about open adoption, challenges that emerge in their relationships with their children's birth families, how those challenges are managed and viewed, and parents' advice for others living with open adoption and for clinical social work practice and policy. Findings reveal that regardless of the type of openness, these adoptive parents generally feel positive about knowing the birth parents and having contact with them, are comfortable with open adoption, and see it serving the child's best interests.

  17. Who Is Adopted? Measuring Adoption Status Using National Survey Data.

    ERIC Educational Resources Information Center

    Miller, Brent C.; Bayley, Bruce K.; Christensen, Mathew; Fan, Xitao; Coyl, Diana; Grotevant, Harold D.; van Dulmen, Manfred; Dunbar, Nora

    2001-01-01

    Draws on data from the National Longitudinal Survey of Adolescent Health to illustrate the complexities of using large-scale surveys to measure adoption status. Discusses conceptual and methodological issues in measuring adoption status. Presents decision rules for determining adoption status across three sources of data: school self-administered…

  18. The Texas Adoption Project: adopted children and their intellectual resemblance to biological and adoptive parents.

    PubMed

    Horn, J M

    1983-04-01

    Intelligence test scores were obtained from parents and children in 300 adoptive families and compared with similar measures available for the biological mothers of the same adopted children. Results supported the hypothesis that genetic variability is an important influence in the development of individual differences for intelligence. The most salient finding was that adopted children resemble their biological mothers more than they resemble the adoptive parents who reared them from birth. A small subset of the oldest adopted children did not resemble their biological mothers. The suggestion that the influence of genes declines with age is treated with caution since other adoption studies report a trend in the opposite direction.

  19. Adoptive cellular therapy.

    PubMed

    Grupp, Stephan A; June, Carl H

    2011-01-01

    Cell-based therapies with various lymphocytes and antigen-presenting cells are promising approaches for cancer immunotherapy. The transfusion of T lymphocytes, also called adoptive cell therapy (ACT), is an effective treatment for viral infections, has induced regression of cancer in early stage clinical trials, and may be a particularly important and efficacious modality in the period following hematopoietic stem cell transplantation (HSCT). Immune reconstitution post-SCT is often slow and incomplete, which in turn leads to an increased risk of infection and may impact relapse risk in patients with malignant disease. Immunization post-HSCT is frequently unsuccessful, due to the prolonged lymphopenia, especially of CD4 T cells, seen following transplant. ACT has the potential to enhance antitumor and overall immunity, and augment vaccine efficacy in the post-transplant setting. The ability to genetically engineer lymphocyte subsets has the further potential to improve the natural immune response, correct impaired immunity, and redirect T cells to an antitumor effector response. This chapter focuses on various applications of ACT for cancer immunotherapy, and we discuss some of the latest progress and hurdles in translating these technologies to the clinic.

  20. Adoption Resource Directory: Region X.

    ERIC Educational Resources Information Center

    1983

    State, regional, and national adoption resources are described in this directory for residents of Region X states (Alaska, Idaho, Oregon, and Washington). Emphasizing the adoption of children with special needs, the directory gives organizational contacts for parents in various stages of the adoption process and mentions resources for social…

  1. Recruiting Mexican American Adoptive Parents.

    ERIC Educational Resources Information Center

    Bausch, Robert S.; Serpe, Richard T.

    1999-01-01

    Interviews were conducted with 591 Mexican Americans to determine adoption interest and create recruiting practices for prospective parents. Approximately one-third of sample reported an interest in adoption, but many perceived both structural and cultural obstacles to adoption. Based on findings, recommendations for increasing recruitment of…

  2. Intellectual resemblance among adoptive adoptive and biological relatives: the Texas adoption project.

    PubMed

    Horn, J M; Loehlin, J C; Willerman, L

    1979-05-01

    Intellectual and personality measures were available from unwed mothers who gave their children up for adoption at birth. The same or similar measures have been obtained from 300 sets of adoptive parents and all of their adopted and natural children in the Texas Adoption Project. The sample characteristics are discussed in detail, and the basic findings for IQ are presented. Initial analyses of the data on IQ suggest moderate heritabilities. Emphasis is placed on the preliminary nature of these findings.

  3. Technology Adoption: an Interaction Perspective

    NASA Astrophysics Data System (ADS)

    Sitorus, Hotna M.; Govindaraju, Rajesri; Wiratmadja, I. I.; Sudirman, Iman

    2016-02-01

    The success of a new technology depends on how well it is accepted by its intended users. Many technologies face the problem of low adoption rate, despite the benefits. An understanding of what makes people accept or reject a new technology can help speed up the adoption rate. This paper presents a framework for technology adoption based on an interactive perspective, resulting from a literature study on technology adoption. In studying technology adoption, it is necessary to consider the interactions among elements involved in the system, for these interactions may generate new characteristics or new relationships. The interactions among elements in a system adoption have not received sufficient consideration in previous studies of technology adoption. Based on the proposed interaction perspective, technology adoption is elaborated by examining interactions among the individual (i.e. the user or prospective user), the technology, the task and the environment. The framework is formulated by adopting several theories, including Perceived Characteristics of Innovating, Diffusion of Innovation Theory, Technology Acceptance Model, Task-Technology Fit and usability theory. The proposed framework is illustrated in the context of mobile banking adoption. It is aimed to offer a better understanding of determinants of technology adoption in various contexts, including technology in manufacturing systems.

  4. Adoption: medical and legal aspects.

    PubMed

    Bhalla, C K

    1978-06-01

    The problem of abandoned children is of great magnitude in India. Placement of these children in a family environment is essential for their physical, mental, and emotional development. Adoption must be approached from the child welfare perspective. The pediatrician can play an important role in the adoption process. The pediatrician should perform a thorough medical examination of infants to be adopted, both to ensure the child's welfare and to give adoptive parents an assessment of the child's health. Information should be collected on the medical history of the child's biologic parents to aid in the evaluation process. Adoptive parents should also undergo medical and pyschological examinations. Pediatricians can additionally work with social welfare departments in establishing criteria for matching children with adoptive parents. Adoptions in India are currently governed by provisions or the 1956 Hindu Adoptions and Maintenance Act. Since this legislation excludes groups such as Muslims, Christians, and Parsis from its purview, there has been a demand for national legislation providing a uniform adoption law for all the communities in India. The Union Government introduced such a comprehensive bill in 1972, the Adoption of Children Bill; however, no action was ever taken. It is urged that this legislation be reactivated, and that the restriction on the removal of children for adoption outside India be lifted. PMID:721273

  5. Intercountry versus Transracial Adoption: Analysis of Adoptive Parents' Motivations and Preferences in Adoption

    ERIC Educational Resources Information Center

    Zhang, Yuanting; Lee, Gary R.

    2011-01-01

    The United States is one of the major baby-receiving countries in the world. Relatively little research has focused on why there is such a high demand for intercountry adoption. Using in-depth qualitative interviews with adoptive parents, the authors explored the reasons why Americans prefer to adopt foreign-born children instead of adopting…

  6. Validation and pharmacokinetic application of a high-performance liquid chromatographic technique for determining the concentrations of amodiaquine and its metabolite in plasma of patients treated with oral fixed-dose amodiaquine-artesunate combination in areas of malaria endemicity.

    PubMed

    Adedeji, Olumuyiwa N; Bolaji, Oluseye O; Falade, Catherine O; Osonuga, Odusoga A; Ademowo, Olusegun G

    2015-09-01

    Artemisinin-based combination therapies (ACTs) have been adopted by most African countries, including Nigeria, as first-line treatments for uncomplicated falciparum malaria. Fixed-dose combinations of these ACTs, amodiaquine-artesunate (FDC AQAS) and artemether-lumefantrine (AL), were introduced in Nigeria to improve compliance and achieve positive outcomes of malaria treatment. In order to achieve clinical success with AQAS, we developed and validated a simple and sensitive high-performance liquid chromatography (HPLC) method with UV detection for determination of amodiaquine (AQ) and desethylamodiaquine (DAQ) in plasma using liquid-liquid extraction of the drugs with diethyl ether following protein precipitation with acetonitrile. Chromatographic separation was achieved using an Agilent Zorbax C18 column and a mobile phase consisting of distilled water-methanol (80:20 [vol/vol]) with 2% (vol/vol) triethylamine, pH 2.2, at a flow rate of 1 ml/min. Calibration curves in spiked plasma were linear from 100 to 1,000 ng/ml (r > 0.99) for both AQ and DAQ. The limit of detection was 1 ng (sample size, 20 μl). The intra- and interday coefficients of variation at 150, 300, and 900 ng/ml ranged from 1.3 to 4.8%, and the biases were between 6.4 and 9.5%. The mean extraction recoveries of AQ and DAQ were 80.0% and 68.9%, respectively. The results for the pharmacokinetic parameters of DAQ following oral administration of FDC AQAS (612/200 mg) for 3 days in female and male patients with uncomplicated falciparum malaria showed that the maximum plasma concentrations (C max) (740 ± 197 versus 767 ± 185 ng/ml), areas under the plasma concentration-time curve (AUC) (185,080 ± 20,813 versus 184,940 ± 16,370 h · ng/ml), and elimination half-life values (T 1/2) (212 ± 1.14 versus 214 ± 0.84 h) were similar (P > 0.05).

  7. Adoption and Assisted Reproduction. Adoption and Ethics, Volume 4.

    ERIC Educational Resources Information Center

    Freundlich, Madelyn

    The controversies in adoption have extended across a spectrum of policy and practice issues, and although the issues have become clear, resolution has not been achieved nor has consensus developed regarding a framework on which to improve the quality of adoption policy and practice. This book is the fourth in a series to use an ethics-based…

  8. The Market Forces in Adoption. Adoption and Ethics, Volume 2.

    ERIC Educational Resources Information Center

    Freundlich, Madelyn

    The controversies in adoption have extended across a spectrum of policy and practice issues, and although the issues have become clear, resolution has not been achieved nor has consensus developed regarding a framework on which to improve the quality of adoption policy and practice. This book is the second in a series to use an ethics-based…

  9. Homosexuality and adoption in Brazil.

    PubMed

    Uziel, A P

    2001-11-01

    Western societies are undergoing legal and policy changes in relation to laws governing the family, marital status, sexual orientation and the welfare of children, including in Brazil where, in the 1990s, the rights of homosexuals were incorporated into ongoing debates about what constitutes a family. This paper discusses the issue of adoption of children by homosexual men in Brazil, using information from court records from 1995-2000 in Rio de Janeiro, and from interviews with two judges, five psychologists and four social workers who evaluate those wishing to adopt. It uses the case records of one man's application to adopt, in which homosexuality became a central issue. Both the construction of masculinity in relation to parenting and concepts of the family were the parameters upon which the decision to allow him to adopt or not depended. Because the legislation does not specify what the sexual orientation of would-be adoptive parents should be, it is possible for single persons to adopt if they show they can be good parents. As more single people, alone or in couples, seek to adopt, it is important to clarify the criteria for judicial decisions on adoption applications. A dialogue is therefore needed on the meaning of family and whether and how it relates to sexual orientation. It is only on this basis that the courts can take a clear decision as to whether being homosexual is a relevant issue in regard to applications to adopt or not.

  10. High prevalence of pfdhfr-pfdhps triple mutations associated with anti-malarial drugs resistance in Plasmodium falciparum isolates seven years after the adoption of sulfadoxine-pyrimethamine in combination with artesunate as first-line treatment in Iran.

    PubMed

    Rouhani, Maryam; Zakeri, Sedigheh; Pirahmadi, Sakineh; Raeisi, Ahmad; Djadid, Navid Dinparast

    2015-04-01

    The spread of anti-malarial drug resistance will challenge any malaria control and elimination strategies, and routine monitoring of resistance-associated molecular markers of commonly used anti-malarial drugs is very important. Therefore, in the present investigation, the extent of mutations/haplotypes in dhfr and dhps genes of Plasmodium falciparum isolates (n=72) was analyzed seven years after the introduction of sulfadoxine-pyrimethamine (SP) plus artesunate (AS) as first-line anti-malarial treatment in Iran using PCR-RFLP methods. The results showed that the majority of the patients (97.2%) carried both 59R and 108N mutations in pure form with wild-type genotype at positions N51 and I164. Additionally, a significant increase (P<0.05) was observed in the frequency of R59N108/G437 haplotype (79.2%) during 2012-2014. This raise was because of the significant increase (P<0.05) in the frequency of 437G mutation (81.9%), which more likely was due to more availability of SP as anti-malarial drug for treatment of falciparum patients in these malaria-endemic areas of Iran. However, no quintuple mutations associated with treatment failure were detected. In conclusion, the present results along with in vivo assays suggest that seven years after the adoption of SP-AS as the first-line treatment in Iran, this drug remains efficacious for treatment of uncomplicated falciparum malaria, as a partner drug with AS in these malaria-endemic areas.

  11. Stories of Aboriginal Transracial Adoption

    ERIC Educational Resources Information Center

    Nuttgens, Simon

    2013-01-01

    Despite the significant number of transracial Aboriginal adoptions that have taken place in Canada, little research is available that addresses the psychological and psychosocial ramifications for the children involved. The scant literature that does exist raises concerns about the psychological impact of this type of adoption. The present…

  12. The Temporal Context of Adoption.

    ERIC Educational Resources Information Center

    Pontius, Steven K.

    This paper analyzes the amount of time required by farmers in four villages on the western edge of the central plain of Thailand to adopt four agricultural innovations--fertilizer, herbicide, insecticide, and fungicide. The general objective is to help researchers interested in the relationship of the adoption of new ideas to economic development…

  13. Adopting Children with Attachment Problems.

    ERIC Educational Resources Information Center

    Hughes, Daniel A.

    1999-01-01

    Notes that attachment behavior in infants is a facet of normal child development, and that children with attachment problems require special attention during and after the adoption process. Presents actions needed to increase the probability that such children can be successfully adopted, detailed attachment patterns, and parenting strategies and…

  14. Faculty Adoption of Educational Technology

    ERIC Educational Resources Information Center

    Moser, Franziska Zellweger

    2007-01-01

    Although faculty support has been identified as a critical factor in the success of educational-technology programs, many people involved in such efforts underestimate the complexities of integrating technology into teaching. In this article, the author proposes an adoption cycle to help tackle the complex issue of technology adoption for…

  15. Adoption of Practices Following an Adult Education Program in Nutrition.

    ERIC Educational Resources Information Center

    Dickson, Anita

    This study investigated the adoption and use of practices in preparation and use of vegetables following adult classes in nutrition. Data were obtained on 63 Brazilian women through interviews, diet intake records, a pretest in nutrition, and a food belief inventory, and practices were compared on prior use, adoption, combined use, rejection, and…

  16. Characteristics of adopted juvenile delinquents.

    PubMed

    Kim, W J; Zrull, J P; Davenport, C W; Weaver, M

    1992-05-01

    There have been many reports describing the uniqueness of adopted children and adolescents' delinquent behaviors in terms of both their delinquent characteristics and courts' treatment of them. A total of 43 adopted juveniles, 32 extrafamilial (1.0%) and 11 intrafamilial (0.3%) adoptions were initially identified out of 3,280 juvenile delinquents. The adopted subjects were then compared with the demographically matched and offense matched nonadopted subjects. The family variables, such as marital and employment status of parents, were significantly different. However, there were only a few discernible trends, and in general there were no significant differences between the adopted and nonadopted juveniles in terms of their offense characteristics and dispositions. PMID:1592787

  17. Quantifying the pharmacology of antimalarial drug combination therapy

    NASA Astrophysics Data System (ADS)

    Hastings, Ian M.; Hodel, Eva Maria; Kay, Katherine

    2016-09-01

    Most current antimalarial drugs are combinations of an artemisinin plus a ‘partner’ drug from another class, and are known as artemisinin-based combination therapies (ACTs). They are the frontline drugs in treating human malaria infections. They also have a public-health role as an essential component of recent, comprehensive scale-ups of malaria interventions and containment efforts conceived as part of longer term malaria elimination efforts. Recent reports that resistance has arisen to artemisinins has caused considerable concern. We investigate the likely impact of artemisinin resistance by quantifying the contribution artemisinins make to the overall therapeutic capacity of ACTs. We achieve this using a simple, easily understood, algebraic approach and by more sophisticated pharmacokinetic/pharmacodynamic analyses of drug action; the two approaches gave consistent results. Surprisingly, the artemisinin component typically makes a negligible contribution (≪0.0001%) to the therapeutic capacity of the most widely used ACTs and only starts to make a significant contribution to therapeutic outcome once resistance has started to evolve to the partner drugs. The main threat to antimalarial drug effectiveness and control comes from resistance evolving to the partner drugs. We therefore argue that public health policies be re-focussed to maximise the likely long-term effectiveness of the partner drugs.

  18. Quantifying the pharmacology of antimalarial drug combination therapy.

    PubMed

    Hastings, Ian M; Hodel, Eva Maria; Kay, Katherine

    2016-01-01

    Most current antimalarial drugs are combinations of an artemisinin plus a 'partner' drug from another class, and are known as artemisinin-based combination therapies (ACTs). They are the frontline drugs in treating human malaria infections. They also have a public-health role as an essential component of recent, comprehensive scale-ups of malaria interventions and containment efforts conceived as part of longer term malaria elimination efforts. Recent reports that resistance has arisen to artemisinins has caused considerable concern. We investigate the likely impact of artemisinin resistance by quantifying the contribution artemisinins make to the overall therapeutic capacity of ACTs. We achieve this using a simple, easily understood, algebraic approach and by more sophisticated pharmacokinetic/pharmacodynamic analyses of drug action; the two approaches gave consistent results. Surprisingly, the artemisinin component typically makes a negligible contribution (≪0.0001%) to the therapeutic capacity of the most widely used ACTs and only starts to make a significant contribution to therapeutic outcome once resistance has started to evolve to the partner drugs. The main threat to antimalarial drug effectiveness and control comes from resistance evolving to the partner drugs. We therefore argue that public health policies be re-focussed to maximise the likely long-term effectiveness of the partner drugs. PMID:27604175

  19. Quantifying the pharmacology of antimalarial drug combination therapy

    PubMed Central

    Hastings, Ian M.; Hodel, Eva Maria; Kay, Katherine

    2016-01-01

    Most current antimalarial drugs are combinations of an artemisinin plus a ‘partner’ drug from another class, and are known as artemisinin-based combination therapies (ACTs). They are the frontline drugs in treating human malaria infections. They also have a public-health role as an essential component of recent, comprehensive scale-ups of malaria interventions and containment efforts conceived as part of longer term malaria elimination efforts. Recent reports that resistance has arisen to artemisinins has caused considerable concern. We investigate the likely impact of artemisinin resistance by quantifying the contribution artemisinins make to the overall therapeutic capacity of ACTs. We achieve this using a simple, easily understood, algebraic approach and by more sophisticated pharmacokinetic/pharmacodynamic analyses of drug action; the two approaches gave consistent results. Surprisingly, the artemisinin component typically makes a negligible contribution (≪0.0001%) to the therapeutic capacity of the most widely used ACTs and only starts to make a significant contribution to therapeutic outcome once resistance has started to evolve to the partner drugs. The main threat to antimalarial drug effectiveness and control comes from resistance evolving to the partner drugs. We therefore argue that public health policies be re-focussed to maximise the likely long-term effectiveness of the partner drugs. PMID:27604175

  20. Counseling Issues in Adoptions by Stepparents.

    ERIC Educational Resources Information Center

    Wolf, Patricia A.; Mast, Emily

    1987-01-01

    Although the number of nonrelative adoptions is decreasing, stepparent adoptions are not. These adoptions are viewed as nonproblematic family business separate from the general adoption picture. This article examines demographic data in Lancaster County, Pennsylvania, from 55 stepparent adoptions concerning stepparent adopters, birth parents, and…

  1. Technological advances in adoptive immunotherapy.

    PubMed

    Oelke, Mathias; Krueger, Christine; Schneck, Jonathan P

    2005-01-01

    Adoptive immunotherapy is an attractive and elegant strategy for treating a variety of life-threatening diseases. Several approaches have been developed to generate antigen-specific CD4+ and CD8+ T cells for adoptive T-cell therapy in cancer and infectious diseases. Currently, many approaches are based on either the use of autologous peptide pulsed dendritic cells as antigen-presenting cells or nonspecific expansion of T cells. Unfortunately, current approaches lack the ability to serve as reproducible and economically viable methods. Several groups are developing new artificial approaches to overcome problems associated with dendritic cells and the nonspecific expansion of T-cell clones in order to make adoptive immunotherapy more feasible and effective. Thus, by increasing the availability of adoptive immunotherapy, we will be able to better determine the efficacy of the approaches in the treatment of a variety of diseases. In this review, we focus on technological advances that will facilitate adoptive immunotherapy. Specifically, we summarize current strategies which are either based on artificial antigen-presenting cells or on T-cell receptor gene transfer. PMID:15753966

  2. Personality disorders in adopted versus non-adopted adults.

    PubMed

    Westermeyer, Joseph; Yoon, Gihyun; Amundson, Carla; Warwick, Marion; Kuskowski, Michael A

    2015-04-30

    The goal of this epidemiological study was to investigate lifetime history and odds ratios of personality disorders in adopted and non-adopted adults using a nationally representative sample. Data, drawn from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), were compared in adopted (n=378) versus non-adopted (n=42,503) adults to estimate the odds of seven personality disorders using logistic regression analyses. The seven personality disorders were histrionic, antisocial, avoidant, paranoid, schizoid, obsessive-compulsive, and dependent personality disorder. Adoptees had a 1.81-fold increase in the odds of any personality disorder compared with non-adoptees. Adoptees had increased odds of histrionic, antisocial, avoidant, paranoid, schizoid, and obsessive-compulsive personality disorder compared with non-adoptees. Two risk factors associated with lifetime history of a personality disorder in adoptees compared to non-adoptees were (1) being in the age cohort 18-29 years (but no difference in the age 30-44 cohort), using the age 45 or older cohort as the reference and (2) having 12 years of education (but no difference in higher education groups), using the 0-11 years of education as the reference. These findings support the higher rates of personality disorders among adoptees compared to non-adoptees.

  3. Re an Adoption Application (Surrogacy)

    PubMed

    1987-03-01

    In England, it is illegal under the Adoption Act 1958 to pay or reward anyone in an effort to adopt a child. A family court was asked in this case whether a surrogacy arrangement involving the payment of 5,000 pounds violated the Act. The applicants, a husband and wife, were unable to have children and had entered into an informal arrangement with a woman who agreed to engage in sexual intercourse with the husband and bear a child for the couple in exchange for 10,000 pounds. Because the surrogate wrote a book about her experience from which she made money, and sincerely wanted to help out the childless couple, she accepted only half of her fee. Convinced that the surrogate arrangement was not commercial in nature, the court found no violation of English law, authorized the payment to the mother, and authorized adoption of the child by the father and his wife.

  4. Why Adoption of Standards Matters

    ERIC Educational Resources Information Center

    Journal of Staff Development, 2016

    2016-01-01

    A total of 39 states have adopted, adapted, or endorsed the Standards for Professional Learning, including the standards issued in 2011 (labeled in red) and those published earlier (labeled in blue). Making a commitment to the standards is a commitment to continuous learning for all educators in a school.

  5. Internet Adoption: An Empirical Investigation

    ERIC Educational Resources Information Center

    Ma, Junzhao

    2011-01-01

    The Internet has brought significant changes to the retail industry because it revolutionizes how information is transmitted and accessed. The main objective of this research is to enhance our understanding of people's adoption of the Internet and its implications for retail competition. This dissertation consists of two essays. The first essay…

  6. Has the Academy Adopted TQM?

    ERIC Educational Resources Information Center

    Birnbaum, Robert; Deshotels, Judy

    1999-01-01

    A survey of 469 colleges and universities assessed the degree to which colleges and universities have adopted total quality management (TQM) or continuous quality improvement (CQI) techniques. Results suggest use of TQM/CQI is lower than predicted, at about 13% of institutions. Variations in extent of use of the approach are discussed. (MSE)

  7. Adoption and Children with Learning and Behavior Problems

    PubMed Central

    Taichert, Louise C.; Harvin, Donya D.

    1975-01-01

    One representative case study is used to illustrate the complex interaction of factors that can lead to tragic family dysfunction when an adopted child has learning and behavior problems. The presence of neurodevelopmental problems in an adopted child, special adoption issues and interparental and intraparental conflicts combine to place the child and his family at high risk. The child's neurodevelopmental difficulties are expressed primarily as subtle learning and behavior problems which make him a focus for parental conflict. In addition, the adoption issues of difference, impermanence, feelings of mutual obligation and fear of abandonment are generally poorly understood and form the basis for the development of unique interactional patterns of communication. Finally, in the families studied, it was often found that the adopting parents had serious personal and/or marital difficulties. PMID:49131

  8. Embryo adoption: Some further considerations.

    PubMed

    Patterson, Colin

    2015-02-01

    Recent discussions of embryo adoption have sought to make sense of the teaching of the Congregation for the Doctrine of the Faith (CDF) document Dignitas personae which appeared to provide a negative judgment on such a practice. This article aims to provide a personalist account of the process of fertilization and implantation that might serve as the basis for the negative judgment of the CDF document. In doing so, it relies upon the idea that a person, including an embryo, is not to be considered in isolation, but always in relation to God and to others. This approach extends the substantialist conceptualizations commonly employed in discussions of this issue. More generally, the article seeks to highlight the value of a personalist re-framing for an understanding of the moral questions surrounding the beginning of life. Lay summary: This article seeks to make sense of what appears to be a clear-cut rejection, set out in the Congregation for the Doctrine of the Faith (CDF) document Dignitas personae, of the proposal for women to "adopt" surplus frozen embryos. It draws upon more recently developed modes of philosophical/theological reasoning to argue that, in human procreation, both fertilization and implantation represent constitutive dimensions of divine creative activity and so must be protected from manipulative technological intervention. Since embryo adoption requires this kind of technology, it makes sense for the Church document not to approve it. PMID:25698841

  9. Policy Issues in Gay and Lesbian Adoption.

    ERIC Educational Resources Information Center

    Sullivan, Ann

    1995-01-01

    Notes that adoption agencies have developed few specific policies on the issue of lesbian and gay adoption. Provides an overview of key considerations about homosexual adopters, including beliefs and values of agency professionals, the legal and social ramifications of adoption into a relationship not based on marriage, and possible consequences…

  10. 18 CFR 341.6 - Adoption rule.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Adoption rule. 341.6... SUBJECT TO SECTION 6 OF THE INTERSTATE COMMERCE ACT § 341.6 Adoption rule. (a) Change in name of carrier... such occurrence. The filing of adoption notices and adoption supplements requires no notice period....

  11. 18 CFR 341.6 - Adoption rule.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Adoption rule. 341.6... SUBJECT TO SECTION 6 OF THE INTERSTATE COMMERCE ACT § 341.6 Adoption rule. (a) Change in name of carrier... such occurrence. The filing of adoption notices and adoption supplements requires no notice period....

  12. 18 CFR 341.6 - Adoption rule.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Adoption rule. 341.6... SUBJECT TO SECTION 6 OF THE INTERSTATE COMMERCE ACT § 341.6 Adoption rule. (a) Change in name of carrier... such occurrence. The filing of adoption notices and adoption supplements requires no notice period....

  13. 18 CFR 341.6 - Adoption rule.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Adoption rule. 341.6... SUBJECT TO SECTION 6 OF THE INTERSTATE COMMERCE ACT § 341.6 Adoption rule. (a) Change in name of carrier... such occurrence. The filing of adoption notices and adoption supplements requires no notice period....

  14. 33 CFR 230.21 - Adoption.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... FOR IMPLEMENTING NEPA § 230.21 Adoption. See 40 CFR 1506.3. A district commander will normally adopt... recirculated as provided in 40 CFR 1506.3 (b) or (c), the adopted EIS with the supplement, if any, will be processed in accordance with this regulation. A district commander may also adopt another agency's EA/FONSI....

  15. 33 CFR 230.21 - Adoption.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... FOR IMPLEMENTING NEPA § 230.21 Adoption. See 40 CFR 1506.3. A district commander will normally adopt... recirculated as provided in 40 CFR 1506.3 (b) or (c), the adopted EIS with the supplement, if any, will be processed in accordance with this regulation. A district commander may also adopt another agency's EA/FONSI....

  16. 33 CFR 230.21 - Adoption.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... FOR IMPLEMENTING NEPA § 230.21 Adoption. See 40 CFR 1506.3. A district commander will normally adopt... recirculated as provided in 40 CFR 1506.3 (b) or (c), the adopted EIS with the supplement, if any, will be processed in accordance with this regulation. A district commander may also adopt another agency's EA/FONSI....

  17. 33 CFR 230.21 - Adoption.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... FOR IMPLEMENTING NEPA § 230.21 Adoption. See 40 CFR 1506.3. A district commander will normally adopt... recirculated as provided in 40 CFR 1506.3 (b) or (c), the adopted EIS with the supplement, if any, will be processed in accordance with this regulation. A district commander may also adopt another agency's EA/FONSI....

  18. 33 CFR 230.21 - Adoption.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... FOR IMPLEMENTING NEPA § 230.21 Adoption. See 40 CFR 1506.3. A district commander will normally adopt... recirculated as provided in 40 CFR 1506.3 (b) or (c), the adopted EIS with the supplement, if any, will be processed in accordance with this regulation. A district commander may also adopt another agency's EA/FONSI....

  19. Adoption and Single Parents: A Review.

    ERIC Educational Resources Information Center

    Groze, Vic

    1991-01-01

    Examines the literature about people who choose to become single adoptive parents. Reviews the demographic and personal characteristics of single parents who adopt, and summarizes the experiences of single parents with the children they adopt. Calls for further research on single parents who adopt special needs children. (GH)

  20. Adopted: A practical salinity scale

    NASA Astrophysics Data System (ADS)

    The Unesco/ICES/SCOR/IAPSO Joint Panel on Oceanographic Tables and Standards has recommended the adoption of a Practical Salinity Scale, 1978, and a corresponding new International Equation of State of Seawater, 1980. A full account of the research leading to their recommendation is available in the series Unesco Technical Papers in Marine Science.The parent organizations have accepted the panel's recommendations and have set January 1, 1982, as the date when the new procedures, formulae, and tables should replace those now in use.

  1. Adoptive cell therapy for sarcoma

    PubMed Central

    Mata, Melinda; Gottschalk, Stephen

    2015-01-01

    Current therapy for sarcomas, though effective in treating local disease, is often ineffective for patients with recurrent or metastatic disease. To improve outcomes, novel approaches are needed and cell therapy has the potential to meet this need since it does not rely on the cytotoxic mechanisms of conventional therapies. The recent successes of T-cell therapies for hematological malignancies have led to renewed interest in exploring cell therapies for solid tumors such as sarcomas. In this review, we will discuss current cell therapies for sarcoma with special emphasis on genetic approaches to improve the effector function of adoptively transferred cells. PMID:25572477

  2. UN adopts Law of Sea

    NASA Astrophysics Data System (ADS)

    Richman, Barbara T.

    After more than 8 years of diplomatic wrangling, the United Nations Convention on the Law of the Sea was adopted on April 30 by a vote of 130 to 4. The United States, Israel, Turkey, and Venezuela voted against the treaty; 17 nations—including the Soviet Union, West Germany, and Britain—abstained.The treaty, which would give nations the exclusive rights to natural resources in the continental shelf up to approximately 650 km offshore, will be signed in December. The treaty becomes effective 1 year after at least 60 nations ratify it.

  3. [Adoptive parents' satisfaction with the adoption experience and with its impact on family life].

    PubMed

    Sánchez-Sandoval, Yolanda

    2011-11-01

    In this study, we discuss the relevance of adoptive families' satisfaction in the assessment of adoption processes. The effects of adoption on a sample group of 272 adoptive families are analyzed. Most families show high levels of satisfaction as to: their decision to adopt, the features of their adopted children and how adoption has affected them as individuals and as a family. Statistical analyses show that these families can have different satisfaction levels depending on certain features of the adoptees, of the adoptive families or of their educational style. Life satisfaction of the adoptees is also related to how their adoptive parents evaluate the adoption.

  4. [Adoptive parents' satisfaction with the adoption experience and with its impact on family life].

    PubMed

    Sánchez-Sandoval, Yolanda

    2011-11-01

    In this study, we discuss the relevance of adoptive families' satisfaction in the assessment of adoption processes. The effects of adoption on a sample group of 272 adoptive families are analyzed. Most families show high levels of satisfaction as to: their decision to adopt, the features of their adopted children and how adoption has affected them as individuals and as a family. Statistical analyses show that these families can have different satisfaction levels depending on certain features of the adoptees, of the adoptive families or of their educational style. Life satisfaction of the adoptees is also related to how their adoptive parents evaluate the adoption. PMID:22047850

  5. Embryo adoption: Some further considerations

    PubMed Central

    Patterson, Colin

    2015-01-01

    Recent discussions of embryo adoption have sought to make sense of the teaching of the Congregation for the Doctrine of the Faith (CDF) document Dignitas personae which appeared to provide a negative judgment on such a practice. This article aims to provide a personalist account of the process of fertilization and implantation that might serve as the basis for the negative judgment of the CDF document. In doing so, it relies upon the idea that a person, including an embryo, is not to be considered in isolation, but always in relation to God and to others. This approach extends the substantialist conceptualizations commonly employed in discussions of this issue. More generally, the article seeks to highlight the value of a personalist re-framing for an understanding of the moral questions surrounding the beginning of life. Lay summary: This article seeks to make sense of what appears to be a clear-cut rejection, set out in the Congregation for the Doctrine of the Faith (CDF) document Dignitas personae, of the proposal for women to “adopt” surplus frozen embryos. It draws upon more recently developed modes of philosophical/theological reasoning to argue that, in human procreation, both fertilization and implantation represent constitutive dimensions of divine creative activity and so must be protected from manipulative technological intervention. Since embryo adoption requires this kind of technology, it makes sense for the Church document not to approve it. PMID:25698841

  6. [Adoption: an alternative to assisted reproductive techniques?].

    PubMed

    Blanchy, S

    2011-09-01

    Information on adoption must be given to couples who seek treatment for medically-assisted procreation. But is adoption a real alternative? What are the chances for a couple who consults to see its desire for adoption be achieved according to its own situation, the characteristics of the child he wants, and the general situation of adoption? Can adoption, just like assisted procreation, often described by the couples as a "obstacle course", go parallel? Or should one try adoption once assisted reproduction failed? Is the couple willing to suffer the social and legal control of adoption after having supported the medical control of the ART? In all cases, the reality is that two out of three couples engaged in assisted reproduction will have a child whereas scarcely more than one candidate to adoption will be offered to adopt a child after three or four-years procedure.

  7. Electronic Dental Records System Adoption.

    PubMed

    Abramovicz-Finkelsztain, Renata; Barsottini, Claudia G N; Marin, Heimar Fatima

    2015-01-01

    The use of Electronic Dental Records (EDRs) and management software has become more frequent, following the increase in prevelance of new technologies and computers in dental offices. The purpose of this study is to identify and evaluate the use of EDRs by the dental community in the São Paulo city area. A quantitative case study was performed using a survey on the phone. A total of 54 offices were contacted and only one declinedparticipation in this study. Only one office did not have a computer. EDRs were used in 28 offices and only four were paperless. The lack of studies in this area suggests the need for more usability and implementation studies on EDRs so that we can improve EDR adoption by the dental community.

  8. Adoption of Children with Disabilities: An Exploration of the Issues for Adoptive Families

    ERIC Educational Resources Information Center

    Good, Gretchen A.

    2016-01-01

    This systematic literature review is an exploration of issues for adoptive families throughout the adoption process and into the various phases of the life of the adoptive family. Although there has been much recent research related to adoption, in general, very little adoption literature addresses the often unspoken needs of families who want to…

  9. In Their Own Words: Adopted Persons' Experiences of Adoption Disclosure and Discussion in Their Families

    ERIC Educational Resources Information Center

    Wydra, Maria; O'Brien, Karen M.; Merson, Erica S.

    2012-01-01

    This study explored adoption disclosure in a sample of 18 adult adoptees who were adopted as infants. A qualitative analysis of semistructured interviews with adoptees was used to learn about participants' experiences of adoption disclosure. The majority always knew they were adopted, were able to talk openly with parents about adoption, and had…

  10. Impact of Adoption on Birth Parents

    MedlinePlus

    ... This relationship, as well as the birth parent’s perception of his or her identity, may change over ... McRoy, R. G., & Grotevant, H. D. (2000). Birthmother perceptions of the psychologically present adopted child: Adoption openness ...

  11. When to Tell Your Child About Adoption

    MedlinePlus

    ... adopted youngsters need to be told about their origins, ideally even before middle childhood. Introducing the Information ... needs to have an honest understanding of his origin. Adopted children who have not been told seem ...

  12. National Foster Care and Adoption Directory Search

    MedlinePlus

    ... on the Placement of Children (ICPC) Administrator - Provides legal and fiscal oversight for ICPC, which regulates the interstate movement of children in foster care, adoption, residential treatment, or juvenile justice programs. This person should be contacted by adoption ...

  13. Macro influencers of electronic health records adoption.

    PubMed

    Raghavan, Vijay V; Chinta, Ravi; Zhirkin, Nikita

    2015-01-01

    While adoption rates for electronic health records (EHRs) have improved, the reasons for significant geographical differences in EHR adoption within the USA have remained unclear. To understand the reasons for these variations across states, we have compiled from secondary sources a profile of different states within the USA, based on macroeconomic and macro health-environment factors. Regression analyses were performed using these indicator factors on EHR adoption. The results showed that internet usage and literacy are significantly associated with certain measures of EHR adoption. Income level was not significantly associated with EHR adoption. Per capita patient days (a proxy for healthcare need intensity within a state) is negatively correlated with EHR adoption rate. Health insurance coverage is positively correlated with EHR adoption rate. Older physicians (>60 years) tend to adopt EHR systems less than their younger counterparts. These findings have policy implications on formulating regionally focused incentive programs.

  14. A Narrative Inquiry of International Adoption Stories

    ERIC Educational Resources Information Center

    Pryor, Christin; Pettinelli, J. Douglas

    2011-01-01

    The international adoption entrance story is an unexplored topic in the adoption literature. The stories that families tell of beginning life with their new children has important implications for the development of an autobiographical narrative of an adopted child. A coherent autobiographical narrative is vital for healthy childhood development.…

  15. 32 CFR 584.4 - Adoption proceedings.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 3 2012-07-01 2009-07-01 true Adoption proceedings. 584.4 Section 584.4... CUSTODY, AND PATERNITY § 584.4 Adoption proceedings. (a) General. This chapter does not apply to those... normally may not be put up for adoption without the consent of the parents. Therefore, communications...

  16. 14 CFR 221.160 - Adoption notice.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Adoption notice. 221.160 Section 221.160... REGULATIONS TARIFFS Adoption Publications Required To Show Change in Carrier's Name or Transfer of Operating Control § 221.160 Adoption notice. (a) When the name of a carrier is changed or when its operating...

  17. 25 CFR 75.18 - Adoption.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Adoption. 75.18 Section 75.18 Indians BUREAU OF INDIAN... OF CHEROKEE INDIANS, NORTH CAROLINA § 75.18 Adoption. The Tribal Council of the Eastern Band of Cherokee Indians shall be empowered to enact ordinances governing the adoption of new members....

  18. 40 CFR 1506.3 - Adoption.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Adoption. 1506.3 Section 1506.3 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY OTHER REQUIREMENTS OF NEPA § 1506.3 Adoption. (a) An agency may adopt a Federal draft or final environmental impact statement or portion...

  19. 40 CFR 1506.3 - Adoption.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Adoption. 1506.3 Section 1506.3 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY OTHER REQUIREMENTS OF NEPA § 1506.3 Adoption. (a) An agency may adopt a Federal draft or final environmental impact statement or portion...

  20. 32 CFR 584.4 - Adoption proceedings.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 3 2013-07-01 2013-07-01 false Adoption proceedings. 584.4 Section 584.4... CUSTODY, AND PATERNITY § 584.4 Adoption proceedings. (a) General. This chapter does not apply to those... normally may not be put up for adoption without the consent of the parents. Therefore, communications...

  1. 47 CFR 61.171 - Adoption notice.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 3 2013-10-01 2013-10-01 false Adoption notice. 61.171 Section 61.171 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) TARIFFS Adoption of Tariffs and Other Documents of Predecessor Carriers § 61.171 Adoption notice. When a...

  2. 14 CFR 221.160 - Adoption notice.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Adoption notice. 221.160 Section 221.160... REGULATIONS TARIFFS Adoption Publications Required To Show Change in Carrier's Name or Transfer of Operating Control § 221.160 Adoption notice. (a) When the name of a carrier is changed or when its operating...

  3. 25 CFR 75.18 - Adoption.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Adoption. 75.18 Section 75.18 Indians BUREAU OF INDIAN... OF CHEROKEE INDIANS, NORTH CAROLINA § 75.18 Adoption. The Tribal Council of the Eastern Band of Cherokee Indians shall be empowered to enact ordinances governing the adoption of new members....

  4. 14 CFR 221.160 - Adoption notice.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Adoption notice. 221.160 Section 221.160... REGULATIONS TARIFFS Adoption Publications Required To Show Change in Carrier's Name or Transfer of Operating Control § 221.160 Adoption notice. (a) When the name of a carrier is changed or when its operating...

  5. 47 CFR 61.171 - Adoption notice.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Adoption notice. 61.171 Section 61.171 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) TARIFFS Adoption of Tariffs and Other Documents of Predecessor Carriers § 61.171 Adoption notice. When a...

  6. 40 CFR 1506.3 - Adoption.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 34 2012-07-01 2012-07-01 false Adoption. 1506.3 Section 1506.3 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY OTHER REQUIREMENTS OF NEPA § 1506.3 Adoption. (a) An agency may adopt a Federal draft or final environmental impact statement or portion...

  7. 40 CFR 1506.3 - Adoption.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 34 2013-07-01 2013-07-01 false Adoption. 1506.3 Section 1506.3 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY OTHER REQUIREMENTS OF NEPA § 1506.3 Adoption. (a) An agency may adopt a Federal draft or final environmental impact statement or portion...

  8. 14 CFR 221.160 - Adoption notice.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Adoption notice. 221.160 Section 221.160... REGULATIONS TARIFFS Adoption Publications Required To Show Change in Carrier's Name or Transfer of Operating Control § 221.160 Adoption notice. (a) When the name of a carrier is changed or when its operating...

  9. 32 CFR 584.4 - Adoption proceedings.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 3 2014-07-01 2014-07-01 false Adoption proceedings. 584.4 Section 584.4... CUSTODY, AND PATERNITY § 584.4 Adoption proceedings. (a) General. This chapter does not apply to those... normally may not be put up for adoption without the consent of the parents. Therefore, communications...

  10. 14 CFR 221.160 - Adoption notice.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Adoption notice. 221.160 Section 221.160... REGULATIONS TARIFFS Adoption Publications Required To Show Change in Carrier's Name or Transfer of Operating Control § 221.160 Adoption notice. (a) When the name of a carrier is changed or when its operating...

  11. 47 CFR 61.171 - Adoption notice.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 3 2012-10-01 2012-10-01 false Adoption notice. 61.171 Section 61.171 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) TARIFFS Adoption of Tariffs and Other Documents of Predecessor Carriers § 61.171 Adoption notice. When a...

  12. 40 CFR 1506.3 - Adoption.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 33 2014-07-01 2014-07-01 false Adoption. 1506.3 Section 1506.3 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY OTHER REQUIREMENTS OF NEPA § 1506.3 Adoption. (a) An agency may adopt a Federal draft or final environmental impact statement or portion...

  13. 32 CFR 584.4 - Adoption proceedings.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 3 2011-07-01 2009-07-01 true Adoption proceedings. 584.4 Section 584.4... CUSTODY, AND PATERNITY § 584.4 Adoption proceedings. (a) General. This chapter does not apply to those... normally may not be put up for adoption without the consent of the parents. Therefore, communications...

  14. 47 CFR 61.171 - Adoption notice.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 3 2011-10-01 2011-10-01 false Adoption notice. 61.171 Section 61.171 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) TARIFFS Adoption of Tariffs and Other Documents of Predecessor Carriers § 61.171 Adoption notice. When a...

  15. 25 CFR 75.18 - Adoption.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false Adoption. 75.18 Section 75.18 Indians BUREAU OF INDIAN... OF CHEROKEE INDIANS, NORTH CAROLINA § 75.18 Adoption. The Tribal Council of the Eastern Band of Cherokee Indians shall be empowered to enact ordinances governing the adoption of new members....

  16. 47 CFR 61.171 - Adoption notice.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 3 2014-10-01 2014-10-01 false Adoption notice. 61.171 Section 61.171 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) TARIFFS Adoption of Tariffs and Other Documents of Predecessor Carriers § 61.171 Adoption notice. When a...

  17. 25 CFR 75.18 - Adoption.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Adoption. 75.18 Section 75.18 Indians BUREAU OF INDIAN... OF CHEROKEE INDIANS, NORTH CAROLINA § 75.18 Adoption. The Tribal Council of the Eastern Band of Cherokee Indians shall be empowered to enact ordinances governing the adoption of new members....

  18. 25 CFR 75.18 - Adoption.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true Adoption. 75.18 Section 75.18 Indians BUREAU OF INDIAN... OF CHEROKEE INDIANS, NORTH CAROLINA § 75.18 Adoption. The Tribal Council of the Eastern Band of Cherokee Indians shall be empowered to enact ordinances governing the adoption of new members....

  19. International Adoption: Current Status and Future Prospects.

    ERIC Educational Resources Information Center

    Bartholet, Elizabeth

    1993-01-01

    Laws regulating adoption are varied and complex in countries that offer children for international adoption (IA), while United States Immigration laws pose additional obstacles to Americans wishing to adopt foreign-born children. Declarations by the United Nations and the development of a convention on IA by the Hague Conference offer some hope…

  20. The Adopted Adolescent. Selected Papers Number 55.

    ERIC Educational Resources Information Center

    Banning, Anne

    This review of studies on clinical and nonclinical populations explores outcomes of adoption and developmental issues for adolescents, and in particular, developmental problems for adopted adolescents. Studies on nonclinical populations demonstrate that adoption is a highly successful form of substitute care. Prospective longitudinal studies show…

  1. Adoption Bibliography and Multi-Ethnic Sourcebook.

    ERIC Educational Resources Information Center

    Van Why, Elizabeth Wharton, Comp.

    Designed for parents who have adopted or who contemplate adoption, and for educational, legal, medical, social, and theological professionals, this bibliography and source book contains over 1250 citations relating to adoption. The book is divided into two parts. The first section is a bibliography of articles, personal narratives, dissertations,…

  2. Update on international adoption: focus on Russia.

    PubMed

    McGuinness, Teena M; Robinson, Cheryl Broadus

    2011-06-01

    American families will continue to adopt children from foreign countries; the desire to have a child transcends national boundaries. Sadly, not all adoptions have happy outcomes. A recent and well-reported incident involved an American mother, who, exasperated with her adopted son's severe behavioral problems, returned him to Russia, alone, on an aircraft. Other tragic reports involve internationally adopted children who have died at the hands of their American parents. This article provides an overview of the consequences of institutionalization as a risk factor for behavioral health of children; implications for nursing care of adoptive families follow. PMID:21598869

  3. Adoptive immunotherapy of advanced melanoma.

    PubMed

    Shapira-Frommer, Ronnie; Schachter, Jacob

    2012-09-01

    Adoptive cell therapy (ACT) has emerged as an effective therapy for patients with metastatic melanoma. Since the first introduction of the protocol in 1988 [1], major improvements have been achieved with response rates of 40%-72% among patients who were resistant to previous treatment lines. Both cell product and conditioning regimen are major determinants of treatment efficacy; therefore, developing ACT protocols explore diverse ways to establish autologous intra-tumoral lymphocyte cultures or peripheral effector cells as well as different lymphodepleting regimens. While a proof of feasibility and a proof of concept had been established with previous published results, ACT will need to move beyond single-center experiences, to confirmatory, multi-center studies. If ACT is to move into widespread practice, it will be necessary to develop reproducible high quality cell production methods and accepted lymphodepleting regimen. Two new drugs, ipilimumab (Yervoy, Bristol-Myers Squibb) and vemurafenib (Zelboraf, Roche), were approved in 2011 for the treatment of metastatic melanoma based on positive phase III trials. Both drugs show a clear overall survival benefit, so the timing of when to use ACT will need to be carefully thought out. In contrast to these 2 new, commercially available outpatient treatments, ACT is a personally-specified product and labor-intensive therapy that demands both acquisition of high standard laboratory procedures and close clinical inpatient monitoring during treatment. It is unique among other anti-melanoma treatments, providing the potential for a durable response following a single, self-limited treatment. This perspective drives the efforts to make this protocol accessible for more patients and to explore modifications that may optimize treatment results.

  4. [Attachment and Adoption: Diagnostics, Psychopathology, and Therapy].

    PubMed

    Brisch, Karl-Heinz

    2015-01-01

    This presentation describes the development of attachment between adopted children and their adoptive parents with a focus on the particular issues seen in international adoptions. The questions of settling in, trauma in the country of origin, and the motivations of the adoptive parents will be discussed. Diagnosis and various psychopathological manifestations will be examined, as will outpatient and inpatient modes of therapy. The treatment of children of various ages will be covered along with the necessity for intensive counseling and psychotherapy for the adoptive parents. This will enable the parents to work through early trauma, which will give them and their adopted child the basis for developing healthy attachment patterns. This in turn will enable the child to mature and integrate into society. Possibilities of prevention are discussed. Many of the approaches discussed here regarding attachment and adoption may be applied to foster children and their foster parents. PMID:26645775

  5. [Attachment and Adoption: Diagnostics, Psychopathology, and Therapy].

    PubMed

    Brisch, Karl-Heinz

    2015-01-01

    This presentation describes the development of attachment between adopted children and their adoptive parents with a focus on the particular issues seen in international adoptions. The questions of settling in, trauma in the country of origin, and the motivations of the adoptive parents will be discussed. Diagnosis and various psychopathological manifestations will be examined, as will outpatient and inpatient modes of therapy. The treatment of children of various ages will be covered along with the necessity for intensive counseling and psychotherapy for the adoptive parents. This will enable the parents to work through early trauma, which will give them and their adopted child the basis for developing healthy attachment patterns. This in turn will enable the child to mature and integrate into society. Possibilities of prevention are discussed. Many of the approaches discussed here regarding attachment and adoption may be applied to foster children and their foster parents.

  6. 43 CFR 4750.4-2 - Adoption fee.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... wild horses and burros? You must pay an adoption fee for each wild horse or burro you adopt. Usually... adoption events for wild horses or burros. At competitive adoptions, qualified adopters set adoption fees... Director may reduce or waive the fee when wild horses or burros are un-adoptable at the base adoption...

  7. 43 CFR 4750.4-2 - Adoption fee.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... wild horses and burros? You must pay an adoption fee for each wild horse or burro you adopt. Usually... adoption events for wild horses or burros. At competitive adoptions, qualified adopters set adoption fees... Director may reduce or waive the fee when wild horses or burros are un-adoptable at the base adoption...

  8. 43 CFR 4750.4-2 - Adoption fee.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... wild horses and burros? You must pay an adoption fee for each wild horse or burro you adopt. Usually... adoption events for wild horses or burros. At competitive adoptions, qualified adopters set adoption fees... Director may reduce or waive the fee when wild horses or burros are un-adoptable at the base adoption...

  9. 43 CFR 4750.4-2 - Adoption fee.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... wild horses and burros? You must pay an adoption fee for each wild horse or burro you adopt. Usually... adoption events for wild horses or burros. At competitive adoptions, qualified adopters set adoption fees... Director may reduce or waive the fee when wild horses or burros are un-adoptable at the base adoption...

  10. Economic incentives and foster child adoption.

    PubMed

    Argys, Laura; Duncan, Brian

    2013-06-01

    Every year, a large number of children in the United States enter the foster care system. Many of them are eventually reunited with their biological parents or quickly adopted. A significant number, however, face long-term foster care, and some of these children are eventually adopted by their foster parents. The decision by foster parents to adopt their foster child carries significant economic consequences, including for feiting foster care payments while also assuming responsibility for medical, legal, and educational expenses, to name a few. Since 1980, U.S. states have begun to offer adoption subsidies to offset some of these expenses, significantly lowering the cost of adopting a child who is in the foster care system. This article presents empirical evidence of the role that these economic incentives play in foster parents' decision of when, or if, to adopt their foster child. We find that adoption subsidies increase adoptions through two distinct price mechanisms: by lowering the absolute cost of adoption, and by lowering the relative cost of adoption versus long-term foster care.

  11. Changes in Motivation for Adoption, Value Orientations and Behavior in Three Generations of Adoptive Parents.

    ERIC Educational Resources Information Center

    Hoksbergen, Rene A. C.

    1998-01-01

    Hypothesizes that in this century a pattern of three generations of adoptive parents has developed, differing in motives and attitudes toward adoption: traditional-closed, open-idealistic, and materialistic-realistic. Maintains that adoption has lost its taboo character, domestic adoption is decreasing or has almost vanished (Scandinavia,…

  12. Building Adoption of Visual Analytics Software

    SciTech Connect

    Chinchor, Nancy; Cook, Kristin A.; Scholtz, Jean

    2012-01-05

    Adoption of technology is always difficult. Issues such as having the infrastructure necessary to support the technology, training for users, integrating the technology into current processes and tools, and having the time, managerial support, and necessary funds need to be addressed. In addition to these issues, the adoption of visual analytics tools presents specific challenges that need to be addressed. This paper discusses technology adoption challenges and approaches for visual analytics technologies.

  13. Measures for Predictors of Innovation Adoption

    PubMed Central

    Chor, Ka Ho Brian; Wisdom, Jennifer P.; Olin, Su-Chin Serene; Hoagwood, Kimberly E.; Horwitz, Sarah M.

    2014-01-01

    Building on a narrative synthesis of adoption theories by Wisdom et al. (2013), this review identifies 118 measures associated with the 27 adoption predictors in the synthesis. The distribution of measures is uneven across the predictors and predictors vary in modifiability. Multiple dimensions and definitions of predictors further complicate measurement efforts. For state policymakers and researchers, more effective and integrated measurement can advance the adoption of complex innovations such as evidence-based practices. PMID:24740175

  14. [Choosing the name in international adoption].

    PubMed

    van Effenterre, Aude; Harf, Aurélie; Skandrani, Sandra; Taïeb, Olivier; Moro, Marie Rose

    2014-01-01

    In the context of international adoption, the question is raised of the links which the adoptive parents may or may not maintain with the culture of the child's birth country. The name which the adoptive parents choose reflects this questioning. A study was carried out into this subject with parents and children in order to gain a better understanding of the feelings of belonging, filiation and affiliation in these situations.

  15. Induction of maternal behavior in non-parturient adoptive mares.

    PubMed

    Porter, R H; Duchamp, G; Nowak, R; Daels, P F

    2002-09-01

    An attempt was made to elicit maternal behavior in non-parturient Welsh pony mares through a combination of hormonal treatment and vaginal-cervical stimulation (VCS). Lactation was induced in 16 nonpregnant, non-parturient mares via a combination of estradiol, progesterone and a dopamine antagonist (sulpiride). During the adoption trials, each lactating mare was confined behind a padded bar and a newborn foal was held near her head. Eight of the mares received two 3-min periods of VCS when the foster foal was introduced. Following VCS, the foal was released and its interactions with the adoptive mare observed until the acceptance criterion was met (i.e. the mare accepted the foal at the udder with no signs of aggression). The remaining eight adoptive mares were treated in the same manner but did not receive VCS. All 16 non-parturient mares eventually accepted and nursed their adopted foal. However, acceptance latencies were significantly shorter for mares in the VCS condition than for those without VCS, and did not differ between the VCS condition and a group of control mares with their biological offspring. In subsequent choice tests, both groups of foster mares (with/without VCS), like the control mares, displayed a preference for their 'own' foal. Once the non-parturient mares accepted their foster foal, their maternal behavior resembled that of control mothers. The positive effect of VCS on maternal acceptance may reflect a release of oxytocin triggered by this treatment. PMID:12213513

  16. Adoptive T-cell Immunotherapy

    PubMed Central

    Gottschalk, Stephen; Rooney, Cliona

    2015-01-01

    Epstein-Barr virus (EBV) is associated with a range of malignancies involving B-cells, T-cells, natural killer (NK)-cells, epithelial cells and smooth muscle. All of these are associated with the latent life cycles of EBV, but the pattern of latency-associated viral antigens expressed in tumor cells depends on the type of tumor. EBV-specific T cells (EBVSTs) have been explored as prophylaxis and therapy for EBV-associated malignancies for more than two decades. EBVSTs have been most successful as prophylaxis and therapy for post-transplant lymphoproliferative disease (PTLD), which expresses the full array of latent EBV antigens (type 3 latency), in hematopoietic stem cell transplant recipients. While less effective, clinical studies have also demonstrated their therapeutic potential for PTLD post solid organ transplant, and for EBV-associated malignancies such as Hodgkin’s Lymphoma, Non-Hodgkin’s Lymphoma, and nasopharyngeal carcinoma that express a limited array of latent EBV antigens (type 2 latency),. Several approaches are actively being pursued to improve the antitumor activity of EBVSTs including activation and expansion of T cells specific for the EBV antigens expressed in type 2 latency, genetic approaches to render EBVSTs resistant to the immunosuppressive tumor environment and combination approaches with other immune-modulating modalities. Given the recent advances and renewed interest in cell therapy, we hope that EBVSTs will become an integral part of our treatment armamentarium against EBV-positive malignancies in the near future. PMID:26428384

  17. Envisaging the adoption process to strengthen gay- and lesbian-headed families: recommendations for adoption professionals.

    PubMed

    Matthews, John D; Cramer, Elizabeth P

    2006-01-01

    Although a growing number of child placement agencies are serving lesbians and gay men, a dearth of literature exists for adoption agency policies and practices related to working with this population. This article explores the unique characteristics and strengths of prospective gay and lesbian adoptive parents throughout each of the three phases of the adoption process-preplacement, placement, and postplacement-as well as provides suggestions for adoption professionals working with gays and lesbians. Data from a recent qualitative study of single, gay adoptive fathers are used to illustrate examples and expose areas of potential strengths of adoptive parents not generally explored in the preplacement or preparatory stage. Special attention also is given to the continuing needs of adoptive families headed by gays and lesbians after adoptive placement. Specifically explored are the needs for developing linkages with similar families, as well as providing resources designed to promote successful outcomes of adopted children raised by gays and lesbians.

  18. Predictors of race, adoption, and sexual orientation related socialization of adoptive parents of young children.

    PubMed

    Goldberg, Abbie E; Smith, JuliAnna Z

    2016-04-01

    Using a sample of 125 lesbian, gay, and heterosexual adoptive parent couples with young children (M = 6.32 years), this study examined predictors of direct socialization (preparation for adoptism, racism, and heterosexism) and indirect socialization (modeling interactions by responding to outsiders' inquiries about their child's adoptive status, racial background, or family structure). In terms of direct socialization, parents of older children tended to engage in more socialization around adoptism and heterosexism, and parents of daughters tended to engage in more socialization around racism and heterosexism. Greater perceived child interest in adoption was related to more direct socialization around adoptism. Parents of color reported more direct socialization around racism. Having a child of color was related to more direct socialization around heterosexism. Regarding indirect socialization, sexual minority parents reported more socialization around adoption and race. Greater perceived child interest in adoption was related to more indirect adoption socialization. Being more "out" was related to more indirect socialization around parent sexual orientation.

  19. Healthy depictions? Depicting adoption and adoption news events on broadcast news.

    PubMed

    Kline, Susan L; Chatterjee, Karishma; Karel, Amanda I

    2009-01-01

    Given that the public uses the media to learn about adoption as a family form, this study analyzes U.S. television news coverage of adoption between 2001 and 2005 (N = 309 stories), to identify the types of news events covered about adoption. A majority of news stories covered fraud, crime, legal disputes, and negative international adoption cases. Adoptees as defective or unhealthy were depicted more in negative news event stories, birth parents appeared less overall, and adoptive parents were most likely to have healthy depictions in positively oriented adoption experience, big family, and reunion stories. Although three quarters of the stories used primary adoption participants as news sources, one-third of the negative event stories did not contain healthy depictions of adoption participants. The authors discuss ways journalists and researchers might improve adoption news coverage.

  20. 75 FR 68166 - National Adoption Month, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-04

    ... From the Federal Register Online via the Government Publishing Office TD04NO10.016 [FR Doc. 2010... the United States of America the two hundred and thirty-fifth. (Presidential Sig.) [FR Doc. 2010-28117... small. National Adoption Day is a day of hope and happiness when courthouses finalize the adoptions...

  1. Predicting Language Outcomes for Internationally Adopted Children

    ERIC Educational Resources Information Center

    Glennen, Sharon L.

    2007-01-01

    Purpose: Language and speech are difficult to assess in newly arrived internationally adopted children. The purpose of this study was to determine if assessments completed when toddlers were first adopted could predict language outcomes at age 2. Local norms were used to develop early intervention guidelines that were evaluated against age 2…

  2. Covering Adoption: General Depictions in Broadcast News

    ERIC Educational Resources Information Center

    Kline, Susan L.; Karel, Amanda I.; Chatterjee, Karishma

    2006-01-01

    Using theories of stigma (Goffman, 1963) and media frames (Iyengar, 1991), 292 news stories pertaining to adoption that appeared on major broadcast networks between 2001 and 2004 were analyzed. Media coverage of adoptees contained more problematic than positive depictions. Although birth parents were not always depicted, adoptive parent and…

  3. Issues in Adoption and Foster Care.

    ERIC Educational Resources Information Center

    Hepworth, H. Philip

    This speech presents an overview of issues and trends in the provision of foster care and adoption services in Canada. The number of children "in care" in Canada (in foster homes, institutions, or adoptive homes) appears to have peaked around 1969 and declined thereafter. Information on contraceptives and the availaibility of abortions are seen as…

  4. Why Wasn't This Child Adopted?

    ERIC Educational Resources Information Center

    Raspberry, William

    1982-01-01

    Critizes the public child care policy with regard to adoption services through the story of "Joey", a black child in his teens. Shortly after his birth, Joey was sent by his teenage mother to a city agency for adoption and until now no real effort has been made to place him in a permanent home. (Author/MP)

  5. 43 CFR 10010.20 - Adoption.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Adoption. 10010.20 Section 10010.20 Public Lands: Interior Regulations Relating to Public Lands (Continued) UTAH RECLAMATION MITIGATION AND... Environmental Assessments § 10010.20 Adoption. (a) An EA prepared for a proposal before the Commission...

  6. 43 CFR 10010.20 - Adoption.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Adoption. 10010.20 Section 10010.20 Public Lands: Interior Regulations Relating to Public Lands (Continued) UTAH RECLAMATION MITIGATION AND... Environmental Assessments § 10010.20 Adoption. (a) An EA prepared for a proposal before the Commission...

  7. 43 CFR 10010.20 - Adoption.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Adoption. 10010.20 Section 10010.20 Public Lands: Interior Regulations Relating to Public Lands (Continued) UTAH RECLAMATION MITIGATION AND... Environmental Assessments § 10010.20 Adoption. (a) An EA prepared for a proposal before the Commission...

  8. A Research and Development Adoption Model

    ERIC Educational Resources Information Center

    Hull, Ronald E.

    1974-01-01

    An elaboration of the adoption phase of the Clark and Guba R and D model. A brief discussion of the normative structures of the organizations and organizational boundary permeability provides the rationale for a set of suggested procedures for adoption of innovations at the school building level. (Author)

  9. Fuzzy Cognitive Map Modelling Educational Software Adoption

    ERIC Educational Resources Information Center

    Hossain, Sarmin; Brooks, Laurence

    2008-01-01

    Educational software adoption across UK secondary schools is seen as unsatisfactory. Based on stakeholders' perceptions, this paper uses fuzzy cognitive maps (FCMs) to model this adoption context. It discusses the development of the FCM model, using a mixed-methods approach and drawing on participants from three UK secondary schools. The study…

  10. Adoption of Improved Agricultural Practices in Uruguay.

    ERIC Educational Resources Information Center

    Rucks, Carlos Alberto

    Conducted in Uruguay during 1965-68, this study compared adoption rates for selected agricultural practices between one area which received an extension program and one which did not; and sought relationships between selected characteristics of individual farmers and the adoption of new practices. Data came from interviews with 69 experimental and…

  11. 32 CFR 584.4 - Adoption proceedings.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... situations were a soldier is trying to adopt a child. It applies to those situations where another person is trying to adopt a legitimate or illegitimate child of a soldier. A child born in or out of wedlock... has stated that he or she is not the natural parent of the child. (v) Since the soldier is not...

  12. Adopting the Caregiver Role: A Family Legacy.

    ERIC Educational Resources Information Center

    Piercy, Kathleen W.; Chapman, Jeffery G.

    2001-01-01

    A qualitative study was done to investigate how adult children become caregivers to older parents with functional impairments and what roles their own children adopt in their family's care arrangement. Interviews revealed five influences on children and grandchildren's adoption of caregiver roles: expectations; family rules; religious training;…

  13. Conservation Tillage: Monitoring Adoption with Satellite Imagery

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Conservation tillage is a commonly adopted best management practice for improving soil quality and reducing erosion. However, there are currently no methods in place to monitor conservation tillage adoption at the watershed scale. The primary objective of this study was to evaluate the utility of ...

  14. 76 FR 68613 - National Adoption Month, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-04

    ... Sig.) [FR Doc. 2011-28839 Filed 11-3-11; 11:15 am] Billing code 3295-F2-P ... Documents#0;#0; ] Proclamation 8744 of November 1, 2011 National Adoption Month, 2011 By the President of... basic support, and still more children abroad live without families. During National Adoption Month,...

  15. 78 FR 66609 - National Adoption Month, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-05

    .... (Presidential Sig.) [FR Doc. 2013-26669 Filed 11-4-13; 11:15 am] Billing code 3295-F4 ... Documents#0;#0; ] Proclamation 9049 of October 31, 2013 National Adoption Month, 2013 By the President of... million children and teenagers. During National Adoption Month, we celebrate these families and...

  16. 77 FR 66517 - National Adoption Month, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-06

    ... Sig.) [FR Doc. 2012-27190 Filed 11-5-12; 8:45 am] Billing code 3295-F3 ... Documents#0;#0; ] Proclamation 8896 of November 1, 2012 National Adoption Month, 2012 By the President of... knowing the love and protection of a permanent family. During National Adoption Month, we give voice...

  17. Nurturing Development of Foster and Adopted Children

    ERIC Educational Resources Information Center

    Nowak-Fabrykowski, Krystyna Teresa

    2015-01-01

    The goal of this study is to investigate early childhood teachers' perspective of teaching foster and adopted children. The main purpose is to seek suggestions how teachers can nurture the development of foster and adopted children. A 6 question survey was sent to 44 teachers pursuing graduate studies in early childhood education. Of this 50%…

  18. States Adopt Standards at Fast Clip

    ERIC Educational Resources Information Center

    Gewertz, Catherine

    2010-01-01

    Nearly half the states have adopted a new set of common academic standards, barely a month after their final release and, in most cases, with little opposition. As of July 9, 23 states had decided to replace their mathematics and English/language arts standards with the common set. Another flurry of adoptions is expected by Aug. 2, since the $4…

  19. Wrongful Adoption: Law, Policy and Practice.

    ERIC Educational Resources Information Center

    Freundlich, Madelyn; Peterson, Lisa

    The past decade has seen an increase in cases where adoptive parents fail to receive accurate or complete information about a child's physical, emotional, or developmental problems or about the child's birth family and history. In these cases adoptive parents are confronted with extremely expensive medical care or mental health care. This…

  20. Faculty Adoption of Active Learning Classrooms

    ERIC Educational Resources Information Center

    Van Horne, Sam; Murniati, Cecilia Titiek

    2016-01-01

    Although post-secondary educational institutions are incorporating more active learning classrooms (ALCs) that support collaborative learning, researchers have less often examined the cultural obstacles to adoption of those environments. In this qualitative research study, we adopted the conceptual framework of activity theory to examine the…

  1. A Model of U.S. Commercial Distributed Generation Adoption

    SciTech Connect

    LaCommare, Kristina Hamachi; Ryan Firestone; Zhou, Nan; Maribu,Karl; Marnay, Chris

    2006-01-10

    Small-scale (100 kW-5 MW) on-site distributed generation (DG) economically driven by combined heat and power (CHP) applications and, in some cases, reliability concerns will likely emerge as a common feature of commercial building energy systems over the next two decades. Forecasts of DG adoption published by the Energy Information Administration (EIA) in the Annual Energy Outlook (AEO) are made using the National Energy Modeling System (NEMS), which has a forecasting module that predicts the penetration of several possible commercial building DG technologies over the period 2005-2025. NEMS is also used for estimating the future benefits of Department of Energy research and development used in support of budget requests and management decisionmaking. The NEMS approach to modeling DG has some limitations, including constraints on the amount of DG allowed for retrofits to existing buildings and a small number of possible sizes for each DG technology. An alternative approach called Commercial Sector Model (ComSeM) is developed to improve the way in which DG adoption is modeled. The approach incorporates load shapes for specific end uses in specific building types in specific regions, e.g., cooling in hospitals in Atlanta or space heating in Chicago offices. The Distributed Energy Resources Customer Adoption Model (DER-CAM) uses these load profiles together with input cost and performance DG technology assumptions to model the potential DG adoption for four selected cities and two sizes of five building types in selected forecast years to 2022. The Distributed Energy Resources Market Diffusion Model (DER-MaDiM) is then used to then tailor the DER-CAM results to adoption projections for the entire U.S. commercial sector for all forecast years from 2007-2025. This process is conducted such that the structure of results are consistent with the structure of NEMS, and can be re-injected into NEMS that can then be used to integrate adoption results into a full forecast.

  2. [International adoption: children's health risk evolution].

    PubMed

    Dartiguenave, C

    2012-05-01

    The socioeconomic and sanitary conditions in many countries make it necessary to weigh as precisely as possible the uncertainties which might affect the health of internationally adopted children, which is one of the key drivers to adoption decision. Indeed, health troubles are more and more frequent among children proposed by countries, at a time when there are fewer children to be adopted. Hence the institutions and the actors in the field of international adoption are compelled to frequently update their professional practices, so as to cope both with the declining offer for adoptable children and with the increasing pressure from the birth countries of children to make host countries adopt children with high age or with special needs. It also requires from the administrations the will to provide better initial information and to implement the demand for an agreement. Meanwhile, in spite of those growing constraints, adopting families have been more and more risk adverse during the latest decades, this being a common trend in our developed countries.

  3. Parallel Process Issues for Lesbian and Gay Adoptive Parents and Their Adopted Children

    ERIC Educational Resources Information Center

    Matthews, John D.; Cramer, Elizabeth P.

    2005-01-01

    Gays and lesbians, both single and coupled, are increasingly turning to adoption to create or expand their families. This manuscript specifically addresses the continuing needs of adoptees and adoptive parents by exploring key issues in the life course of gays and lesbians and their adopted children, and identifying potential parallel development…

  4. 20 CFR 404.733 - Evidence you are the legally adopting parent or legally adopted child.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... or legally adopted child. 404.733 Section 404.733 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Evidence Evidence for Child's and Parent's Benefits § 404.733 Evidence you are the legally adopting parent or legally adopted child. If you are...

  5. Factors Influencing the Adoption Decision: An Analysis of Adopters and Nonadopters.

    ERIC Educational Resources Information Center

    King, Robert N.; Rollins, Timothy

    1995-01-01

    An agricultural innovation (nitrogen testing) had been used by 127 of a sample of 220 farmers. Adoption of the technique was influenced by information and change agents' attitudes. Adopters were also motivated by cost savings. Both adopters and nonadopters either did not have or use soil sampling skills needed to perform the test correctly.…

  6. Open Adoption of Infants: Adoptive Parents' Perceptions of Advantages and Disadvantages.

    ERIC Educational Resources Information Center

    Siegel, Deborah H.

    1993-01-01

    Conducted qualitative study of adoptive parents' (n=21 couples) reactions to recent open adoptions of their infants. Findings indicated overwhelmingly positive feelings about open adoption. Respondents often noted that issue of openness was eclipsed by other concerns: coping with infertility, finding a baby, dealing with personnel, and dealing…

  7. 20 CFR 404.733 - Evidence you are the legally adopting parent or legally adopted child.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... or legally adopted child. 404.733 Section 404.733 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Evidence Evidence for Child's and Parent's Benefits § 404.733 Evidence you are the legally adopting parent or legally adopted child. If you are...

  8. Cultural Tourism in Transnational Adoption: "Staged Authenticity" and Its Implications for Adopted Children

    ERIC Educational Resources Information Center

    Quiroz, Pamela Anne

    2012-01-01

    The discursive practices of adoptive parents in two online transnational adoption forums (2006-2008) and observations of five international adoption workshops suggest that what Heather Jacobson described as "culture keeping", the cultural socialization of children that retains a sense of native group identity, is more aptly characterized as…

  9. Korean Adoptee Identity: Adoptive and Ethnic Identity Profiles of Adopted Korean Americans

    ERIC Educational Resources Information Center

    Beaupre, Adam J.; Reichwald, Reed; Zhou, Xiang; Raleigh, Elizabeth; Lee, Richard M.

    2015-01-01

    Adopted Korean adolescents face the task of grappling with their identity as Koreans and coming to terms with their adoptive status. In order to explore these dual identities, the authors conducted a person-centered study of the identity profiles of 189 adopted Korean American adolescents. Using cluster analytic procedures, the study examined…

  10. A Study of Self-Esteem in Adopted Non-adopted Adolescents.

    ERIC Educational Resources Information Center

    Steward, Robbie J.; Lynn, Betty Jane

    This study tested the hypothesis that adopted adolescents have lower self-esteem than do non-adopted adolescents. Male and female students (N=159) between the ages of 18 and 22 were conveniently sampled from college undergraduate populations. Forty-four of the participants reported adoptive status. Each participant completed the Coopersmith…

  11. Pricing Health Behavior Interventions to Promote Adoption

    PubMed Central

    Ribisl, Kurt M.; Leeman, Jennifer; Glasser, Allison M.

    2015-01-01

    The relatively high cost of delivering many public health interventions limits their potential for broad public impact by reducing their likelihood of adoption and maintenance over time. Practitioners identify cost as the primary factor for which interventions they select to implement, but researchers rarely disseminate cost information or consider its importance when developing new interventions. A new approach is proposed, whereby intervention developers assess what individuals and agencies adopting their interventions are willing to pay and then design interventions that are responsive to this price range. The ultimate goal is to develop effective and affordable interventions, called lean interventions, which are widely adopted and have greater public health impact. PMID:24842743

  12. Intercountry adoption: a review of the evidence.

    PubMed

    Tizard, B

    1991-07-01

    Studies of the outcome of intercountry adoption are reviewed in the context of its history and politics. Intercountry adoption is a post-World War II phenomenon, and has become largely a service for childless couples in the West. Many Third World countries, and some Western social workers, are bitterly opposed to the practice, on both political and psychological grounds. Outcome studies have produced results similar to those found in studies of incountry adoption, although, to date, insufficient attention has been paid to issues of identity and racism. The policy implications of these studies will depend on political considerations, as well as the research evidence.

  13. Phonological skills of children adopted from China: implications for assessment.

    PubMed

    Pollock, Karen E; Price, Johanna R

    2005-02-01

    Little is known about the acquisition of English phonology by children adopted from China. Data are summarized from three recent studies with a focus on the phonological skills of children adopted from China as infants or toddlers. Two longitudinal studies (combined n = 8) described early phonological behaviors (e.g., babbling, phonetic inventories), and found substantial individual variation. In spite of this variation by 3 years of age, nearly all of the children were performing at a level comparable to nonadopted monolingual English-speaking peers. No clear relationship between the early behaviors and outcome at age 3 was found. The third study provided descriptions of the phonological skills of preschoolers ( n = 25) who had been adopted 2 or more years earlier, and found that only a few had persistent phonological delays. Errors were predominantly common developmental errors frequently observed in nonadopted monolingual English-speaking children. These findings suggest that tests and measures developed for monolingual English-speaking children may be used cautiously with children adopted as infants or toddlers who have been in their permanent homes for 2 or more years. Prior to that time, assessment should focus on independent analyses of phonological behaviors with consideration of the child's chronological age, length of exposure to English, and development in other language domains.

  14. Barriers for Adopting Electronic Health Records (EHRs) by Physicians

    PubMed Central

    Ajami, Sima

    2013-01-01

    CONFLICT OF INTEREST: NONE DECLARED Introduction Electronic Medical Records (EMRs) are computerized medical information systems that collect, store and display patient information. They are means to create legible and organized recordings and to access clinical information about individual patients. Despite of the positive effects of the EMRs usage in medical practices, the adoption rate of such systems is still low and meets resistance from physicians. The EHRs represent an essential tool for improving both in the safety and quality of health care, though physicians must actively use these systems to accrue the benefits. This study was unsystematic-review. Aim The aim of this study was to express barriers perceived y physicians to the adoption of the EHRs. Method of the study This study was non-systematic reviewed which the literature was searched on barriers perceived by physicians to the adoption of Electronic Health Records (EHRs) with the help of library, books, conference proceedings, data bank, and also searches engines available at Google, Google scholar. Discussion For our searches, we employed the following keywords and their combinations: physicians, electronic medical record, electronic health record, barrier, and adoption in the searching areas of title, keywords, abstract, and full text. In this study, more than 100 articles and reports were collected and 27 of them were selected based on their relevancy. Electronic health record use requires the presence of certain user and system attributes, support from others, and numerous organizational and environment facilitators. PMID:24058254

  15. Internationally Adopted Children: Important Information for Parents

    MedlinePlus

    ... iodine). Newborn metabolic screen up to 2 years. Infectious Diseases PPD or currently recommended testing for tuberculosis exposure ( ... Pediatrics. Medical Evaluation of Internationally Adopted Children for Infectious Diseases. In: Pickering LK, Baker CJ, Kimberlin DW, Long SS, ...

  16. Parental Bonding in Older-Child Adoptions.

    ERIC Educational Resources Information Center

    Ward, Margaret

    1981-01-01

    Examines various factors (such as periods of high emotion, ritual and claiming behaviors and positive interaction) in the attachment process between adoptive parents and older children. Shows that most components parallel those of bonding in biological parents. (Author/RH)

  17. 43 CFR 10010.20 - Adoption.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... augment such an EA when it is essentially, but not entirely, in compliance in order to make it so. (c) If an EA or augmented EA is adopted, the responsible Commission official must prepare his/her own NOI...

  18. Are You Pregnant and Thinking about Adoption?

    MedlinePlus

    ... stories . O.J. Howard Publishing. Siegel, D.H., & Smith, S.L. (2012). Openness in adoption: From secrecy and ... from- secrecy- and- stigma- to- knowledge- and- connections/ Smith, S. (2007). Safeguarding the rights and well-being of ...

  19. Drivers and Barriers in Health IT Adoption

    PubMed Central

    Avgar, A.C.; Litwin, A.S.; Pronovost, P.J.

    2012-01-01

    Despite near (and rare) consensus that the adoption and diffusion of health information technology (health IT) will bolster outcomes for organizations, individuals, and the healthcare system as a whole, there has been surprisingly little consideration of the structures and processes within organizations that might drive the adoption and effective use of the technology. Management research provides a useful lens through which to analyze both the determinants of investment and the benefits that can ultimately be derived from these investments. This paper provides a conceptual framework for understanding health IT adoption. In doing so, this paper highlights specific organizational barriers or enablers at different stages of the adoption process – investment, implementation, and use – and at different levels of organizational decision-making – strategic, operational, and frontline. This framework will aid both policymakers and organizational actors as they make sense of the transition from paper-based to electronic systems. PMID:23646093

  20. The African orphan crisis and international adoption.

    PubMed

    Roby, Jini L; Shaw, Stacey A

    2006-07-01

    The plight of Africa's AIDS orphans has reached crisis proportions, and the international community is beginning to mobilize at the family, community, national, and international levels. Despite these encouraging efforts, the response is inadequate, and increased attention and action are needed. The authors suggest that international adoption, although a small and temporary solution, may fit within the framework being used as a global working model. Issues surrounding adoption, such as racism, racial and cultural identity development, waiting children in the U.S. public child welfare system, and the potential legal risks, are delineated. The African perspective toward adoption is presented, although the response varies and is not collectively defined. The authors conclude that although international adoptions should be used as a last-resort solution, and with tight regulations, the potential benefits to some children merit the opening of a dialogue on the topic.

  1. Distributed PV Adoption in Maine Through 2021

    SciTech Connect

    Gagnon, Pieter; Sigrin, Ben

    2015-11-06

    NREL has used its dSolar (distributed solar) model to generate low-medium-high estimates of distributed PV adoption in Maine through 2021. This presentation gives a high-level overview of the model and modeling results.

  2. Disparities in Primary Care EHR Adoption Rates

    PubMed Central

    Mack, Dominic; Zhang, Shun; Douglas, Megan; Sow, Charles; Strothers, Harry; Rust, George

    2016-01-01

    This study evaluates electronic health record (EHR) adoption by primary care providers in Georgia to assess adoption disparities according to practice size and type, payer mix, and community characteristics. Frequency variances of EHR “Go Live” status were estimated. Odds ratios were calculated by univariate and multivariate logistic regression models. Large practices and community health centers (CHCs) were more likely to Go Live (>80% EHR adoption) than rural health clinics and other underserved settings (53%). A significantly lower proportion (68.9%) of Medicaid predominant providers had achieved Go Live status and had a 47% higher risk of not achieving Go Live status than private insurance predominant practices. Disparities in EHR adoption rates may exacerbate existing disparities in health outcomes of patients served by these practices. Targeted support such as that provided to CHCs would level the playing field for practices now at a disadvantage. PMID:27587942

  3. COMBINES AND COMBINING.

    ERIC Educational Resources Information Center

    RIDENOUR, HARLAN E.

    THROUGH THE USE OF THIS MANUAL, VOCATIONAL AGRICULTURE STUDENTS WITH OCCUPATIONAL INTEREST IN GRAIN FARMING AND CUSTOM COMBINE OPERATION MAY GAIN KNOWLEDGE ABOUT THE BASIC DESIGN AND OPERATION OF COMBINES. DEVELOPMENT BY A STATE CURRICULUM MATERIALS DIRECTOR INCLUDED CONSULTATION WITH ENGINEERS, TRIAL, AND REVISION. OBJECTIVES ARE STATED IN TERMS…

  4. The family romance fantasies of adopted children.

    PubMed

    Wieder, H

    1977-01-01

    Despite the absence of psychoanalytic studies to support the position, family romance fantasies have been assumed to be similar in form and function in both the adopted child and the blood kin child. My studies, documented herein from the analyses of three adoptees, reveal that knowing one is adopted results in modifications of the fantasy and that certain types of adoptees seem incapable of effectively creating the paradigmatic family romance fantasy.

  5. [The outcomes of Adoption in the Case of the "British Chinese Adoption Study"].

    PubMed

    Rushton, Alan

    2015-01-01

    Practitioners can over-estimate the incidence of problems in adopted children and adults because they do not see those who make good psychological and social adjustments. Research into adoption outcomes can be hard to interpret without information about differing pre-adoption histories. Examples are given of research into three types of adoption: domestic infant adoption, adoptions from public care of maltreated children and international adoption of ex-orphanage children. Although negative outcomes are indisputably evident for some, recovery from adversity is more common than many would predict. It is important to recognize that subsequent nurturing in consistent and stimulating environments can build a platform for effective adaptations to challenges in the future. However, a proper understanding of the consequences of adoption has been limited by the fact that follow-up studies have rarely extended beyond adolescence and early adulthood. The British Chinese Adoption Study is a 50 year follow-up of orphanage girls internationally adopted into the United Kingdom, and is given as an example of good outcomes despite early years of adversity. Scores on mental health assessments were equivalent to the non-adopted, age-matched comparison group of UK women. Most of the women were rated as "good functioning" and educational achievements were many times higher than the comparison women. Life-long adverse effects are not inevitable following early adversity. Improved circumstances can promote recovery and good adult adjustment. Practice and research implications are discussed.

  6. [The outcomes of Adoption in the Case of the "British Chinese Adoption Study"].

    PubMed

    Rushton, Alan

    2015-01-01

    Practitioners can over-estimate the incidence of problems in adopted children and adults because they do not see those who make good psychological and social adjustments. Research into adoption outcomes can be hard to interpret without information about differing pre-adoption histories. Examples are given of research into three types of adoption: domestic infant adoption, adoptions from public care of maltreated children and international adoption of ex-orphanage children. Although negative outcomes are indisputably evident for some, recovery from adversity is more common than many would predict. It is important to recognize that subsequent nurturing in consistent and stimulating environments can build a platform for effective adaptations to challenges in the future. However, a proper understanding of the consequences of adoption has been limited by the fact that follow-up studies have rarely extended beyond adolescence and early adulthood. The British Chinese Adoption Study is a 50 year follow-up of orphanage girls internationally adopted into the United Kingdom, and is given as an example of good outcomes despite early years of adversity. Scores on mental health assessments were equivalent to the non-adopted, age-matched comparison group of UK women. Most of the women were rated as "good functioning" and educational achievements were many times higher than the comparison women. Life-long adverse effects are not inevitable following early adversity. Improved circumstances can promote recovery and good adult adjustment. Practice and research implications are discussed. PMID:26645770

  7. Beyond preadoptive risk: The impact of adoptive family environment on adopted youth's psychosocial adjustment.

    PubMed

    Ji, Juye; Brooks, Devon; Barth, Richard P; Kim, Hansung

    2010-07-01

    Adopted children often are exposed to preadoptive stressors--such as prenatal substance exposure, child maltreatment, and out-of-home placements--that increase their risks for psychosocial maladjustment. Psychosocial adjustment of adopted children emerges as the product of pre- and postadoptive factors. This study builds on previous research, which fails to simultaneously assess the influences of pre- and postadoptive factors, by examining the impact of adoptive family sense of coherence on adoptee's psychosocial adjustment beyond the effects of preadoptive risks. Using a sample of adoptive families (n = 385) taking part in the California Long Range Adoption Study, structural equation modeling analyses were performed. Results indicate a significant impact of family sense of coherence on adoptees' psychosocial adjustment and a considerably less significant role of preadoptive risks. The findings suggest the importance of assessing adoptive family's ability to respond to stress and of helping families to build and maintain their capacity to cope with stress despite the sometimes fractious pressures of adoption.

  8. Adoption first? The disposition of human embryos.

    PubMed

    Murphy, Timothy F

    2014-06-01

    Anja Karnein has suggested that because of the importance of respect for persons, law and policy should require some human embryos created in vitro to be available for adoption for a period of time. If no one comes forward to adopt the embryos during that time, they may be destroyed (in the case of embryos left over from fertility medicine) or used in research (in the case of embryos created for that purpose or left over from fertility medicine). This adoption option would increase the number of embryos available for couples looking for help in having children, but that effect is less important--Karnein argues--than the observance of respect for human persons. As possible persons, she holds that embryos ought to be treated, as if they will become children, if only for a while. If enacted as a matter of law and policy, an 'adoption option' would wrongly interfere with the dispositional rights women and men ought to have over embryos they create in the course of trying to have children. Karnein's proposal would also deprive researchers of certainty that the embryos they create for research would actually be available that way, leading to increased burdens of time and money and maybe even to more embryos than would otherwise be produced. Karnein's analysis does not show, moreover, that any duty of rescue applies to embryos. No woman is required to adopt any embryo, which significantly undercuts the justification for an obligatory adoption period.

  9. Adoption in the age of reproductive technology.

    PubMed

    van den Akker, O B A

    2001-05-01

    The choice of adoption over genetic parenthood was investigated in 105 women retrospectively by questionnaire. Participants were divided into four groups: female/male subfertility; female subfertility; male subfertility; and female/male fertility. Half the sample (59/105) answered the question about the importance of a genetic link. Women who failed to adopt thought a genetic link was important, as did those who were less likely to disclose alternative reproductive conceptions to their child. First thoughts following diagnosis were more focused and actions more centered on adoption in the female/male subfertile group compared to the other groups. Communication of the child's origins was least prevalent in the female/male subfertile group, followed by the male subfertile group, although all groups would disclose adoption. The choice of adoption was determined by a number of factors, not all associated with infertility resolution. Although it is unlikely that resolution to infertility can be achieved in any population attempting to overcome infertility, the cognitive dissonance identified in this population is likely to be generalizable to those choosing other options to overcome infertility. Cultural and counselling acknowledgement of postmodern family theory principles is likely to ease cognitive consistency regarding the status of adoptive familyhood, and dispel the importance of reproductive options emphasizing a genetic link. PMID:12449936

  10. Social Context and Hearing Aid Adoption

    PubMed Central

    Launer, Stefan

    2016-01-01

    Hearing rehabilitation tends to focus on the influence of intraindividual factors and concepts such as readiness for change and health beliefs. In contrast, less is known about the role of social context and the potential role of significant others on hearing aid adoption. This explorative retrospective study investigated whether hearing aid adoption is associated with significant other attendance at audiology appointments. The study sample consisted of 33,933 and 27,031 individuals who attended appointments either alone or with a significant other, respectively (n = 60,964). It was found that hearing aid adoption was significantly greater when patients attended audiology appointments with a significant other (63.8%) than when attending appointments alone (50.6%). The association between hearing aid adoption and attendance by a significant other was hearing dependent, with 96% higher hearing aid adoption for patients with mild hearing losses when patients attended appointments with a significant other than when attending appointments alone. Hearing aid return rates were comparable when patients attended appointments alone (27%) or with a significant other (24%). Several potential explanations for the observed association are discussed. The pattern of results is consistent with the view that greater adherence is observed when audiologic care is provided from a patient-centered care perspective. Future research should establish whether there is a causal relationship between attendance at appointments by significant others and hearing aid adoption and should attempt to better understand the mechanisms underpinning the relationship between these variables. PMID:27733672

  11. Moses and Superman Come Home: Counseling Adoptees and Adoptive Families.

    ERIC Educational Resources Information Center

    Saiz, Stephen G.

    This paper looks at three parties impacted by adoption: the adoptive parents, the adopted child, and the adoptive family. When working with adoptive parents, counselors should respect the strength of the couple, their commitment to parenthood, and the closeness that may develop from weathering the issue of childlessness. Adoptive parents are…

  12. Adoption Activities on the Internet: A Call for Regulation

    ERIC Educational Resources Information Center

    Roby, Jini L.; White, Holly

    2010-01-01

    There is a growing practice of adoption services on the Internet with varying degrees of regulation, depending on whether it is domestic infant adoption, public foster care adoption, or international adoption. Regulation is particularly lacking in domestic infant adoptions, with Web sites connecting prospective birth and adoptive parents,…

  13. 5 CFR 843.404 - Proof of adoption.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Proof of adoption. 843.404 Section 843... Proof of adoption. (a) An adopted child is— (1) A child adopted by the employee or retiree before the... petition for adoption was filed by the employee or retiree and who is adopted by the current spouse of...

  14. 5 CFR 843.404 - Proof of adoption.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Proof of adoption. 843.404 Section 843... Proof of adoption. (a) An adopted child is— (1) A child adopted by the employee or retiree before the... petition for adoption was filed by the employee or retiree and who is adopted by the current spouse of...

  15. 5 CFR 843.404 - Proof of adoption.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Proof of adoption. 843.404 Section 843... Proof of adoption. (a) An adopted child is— (1) A child adopted by the employee or retiree before the... petition for adoption was filed by the employee or retiree and who is adopted by the current spouse of...

  16. 5 CFR 843.404 - Proof of adoption.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Proof of adoption. 843.404 Section 843... Proof of adoption. (a) An adopted child is— (1) A child adopted by the employee or retiree before the... petition for adoption was filed by the employee or retiree and who is adopted by the current spouse of...

  17. 5 CFR 843.404 - Proof of adoption.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Proof of adoption. 843.404 Section 843... Proof of adoption. (a) An adopted child is— (1) A child adopted by the employee or retiree before the... petition for adoption was filed by the employee or retiree and who is adopted by the current spouse of...

  18. The Practice of Adoption: History, Trends, and Social Context

    ERIC Educational Resources Information Center

    Zamostny, Kathy P.; O'Brien, Karen M.; Baden, Amanda L.; Wiley, Mary O'Leary

    2003-01-01

    This article presents an overview of the practice of adoption to counseling psychologists to promote clinical understanding of the adoption experience and to stimulate research on adoption. The article includes definitions of adoption terminology, important historical and legal developments for adoption, a summary of adoption statistics,…

  19. Psychological Ramifications of Adoption and Implications for Counseling.

    ERIC Educational Resources Information Center

    Helwig, Andrew A.; Ruthven, Dorothy H.

    1990-01-01

    Examines adoption issues including family member loss, infertility, transracial adoptions, special-needs adoptions, older child adoption, inherited traits, adoptive family, biological parents, and open adoption. Suggests specific therapeutic interventions including redefinition, use of paradox, family therapy approaches, group therapy, and…

  20. Assessing access for prospective adoptive parents living with HIV: an environmental scan of Ontario's adoption agencies.

    PubMed

    Underhill, Angela A; Kennedy, V Logan; Lewis, Johanna; Ross, Lori E; Loutfy, Mona

    2016-10-01

    Work has been underway to increase the availability of parenting options for people living with and affected by HIV. One option, adoption, has not yet been explored in the literature. The study aimed to gain a better understanding of the potential of adoption for individuals/couples living with HIV in Ontario, and to assess potential structural barriers or facilitators that may impact their experience navigating the adoption system by conducting an environmental scan of adoption service providers in Ontario. A list of adoption service providers was compiled using the Ontario government's website. Information relevant to the study's measures was collected using service providers' websites. Service providers without websites, or with websites that did not address all of the research measures, were contacted via telephone to complete a structured interview. Online data extraction was possible for 2 and telephone surveys were completed with 75 adoption service providers (total n = 77). Most service providers reported that HIV status is not an exclusion criterion for prospective parents (64%). However, more than one-fifth of the participants acknowledged they were not sure if people with HIV were eligible to adopt. Domestic service providers were the only providers who did not report knowledge of restrictions due to HIV status. Private domestic adoption presented social barriers as birth parent(s) of a child can access health records of a prospective parent and base their selection of an adoptive parent based on health status. Adoption practitioners and licensees involved in international adoptions reported the most structural barriers for prospective parent(s) living with HIV, attributed to the regulations established by the host country of the child(ren) eligible for adoption. Although international adoptions may present insurmountable barriers for individuals living with HIV, public and private domestic adoption appears to be a viable option.

  1. Metabolite identification of the antimalarial piperaquine in vivo using liquid chromatography-high-resolution mass spectrometry in combination with multiple data-mining tools in tandem.

    PubMed

    Yang, Aijuan; Zang, Meitong; Liu, Huixiang; Fan, Peihong; Xing, Jie

    2016-08-01

    Artemisinin-based combination therapy is widely used for the treatment of uncomplicated Plasmodium falciparum malaria, and piperaquine (PQ) is one of important partner drugs. The pharmacokinetics of PQ is characterized by a low clearance and a large volume of distribution; however, metabolism of PQ has not been thoroughly investigated. In this work, the metabolite profiling of PQ in human and rat was studied using liquid chromatography tandem high-resolution LTQ-Orbitrap mass spectrometry (HRMS). The biological samples were pretreated by solid-phase extraction. Data processes were carried out using multiple data-mining techniques in tandem, i.e., isotope pattern filter followed by mass defect filter. A total of six metabolites (M1-M6) were identified for PQ in human (plasma and urine) and rat (plasma, urine and bile). Three reported metabolites were also found in this study, which included N-oxidation (M1, M2) and carboxylic products (M3). The subsequent N-oxidation of M3 resulted in a new metabolite M4 detected in urine and bile samples. A new metabolic pathway N-dealkylation was found for PQ in human and rat, leading to two new metabolites (M5 and M6). This study demonstrated that LC-HRMS(n) in combination with multiple data-mining techniques in tandem can be a valuable analytical strategy for rapid metabolite profiling of drugs. Copyright © 2016 John Wiley & Sons, Ltd. PMID:26821381

  2. Principles of adoptive T cell cancer therapy

    PubMed Central

    June, Carl H.

    2007-01-01

    The transfusion of T cells, also called adoptive T cell therapy, is an effective treatment for viral infections and has induced regression of cancer in early-stage clinical trials. However, recent advances in cellular immunology and tumor biology are guiding new approaches to adoptive T cell therapy. For example, use of engineered T cells is being tested as a strategy to improve the functions of effector and memory T cells, and manipulation of the host to overcome immunotoxic effects in the tumor microenvironment has led to promising results in early-stage clinical trials. Challenges that face the field and must be addressed before adoptive T cell therapy can be translated into routine clinical practice are discussed. PMID:17476350

  3. Breaking the addiction to technology adoption.

    PubMed

    Bryan, Stirling; Mitton, Craig; Donaldson, Cam

    2014-04-01

    A major driver of cost growth in health care is the rapid increase in the utilisation of existing technology and not simply the adoption of new technology. Health economists and their health technology assessment colleagues have become obsessed by technology adoption questions and have largely ignored 'technology management' questions. Technology management would include the life-cycle assessment of technologies in use, to assess their real-world performance; and monitoring of technology indication creep. A rebalancing of focus might serve to encourage a more self-critical and learning culture amongst those involved in technology evaluation analysis. Further, health economists and health technology assessment analysts could make a more significant contribution to system efficiency through rebalancing their efforts away from technology adoption questions towards technology management issues.

  4. Accepting adoption's uncertainty: the limited ethics of pre-adoption genetic testing.

    PubMed

    Leighton, Kimberly J

    2014-06-01

    An increasing number of children are adopted in the United States from countries where both medical care and environmental conditions are extremely poor. In response to worries about the accuracy of medical histories, prospective adoptive parents increasingly request genetic testing of children prior to adoption. Though a general consensus on the ethics of pre-adoption genetic testing (PAGT) argues against permitting genetic testing on children available for adoption that is not also permitted for children in general, a view gaining traction argues for expanding the tests permitted. The reasoning behind this view is that the State has a duty to provide a child with parents who are the best "match," and thus all information that advances this end should be obtained. While the matching argument aims to promote the best interests of children, I show how it rests on the claim that what is in the best interests of children available for adoption is for prospective adoptive parents to have their genetic preferences satisfied such that the "genetics" of the children they end up adopting accurately reflects those preferences. Instead of protecting a vulnerable population, I conclude, PAGT contributes to the risks of harm such children face as it encourages people with strong genetic preferences to adopt children whose genetic backgrounds will always be uncertain.

  5. Who adopts? Characteristics of women and men who have adopted children.

    PubMed

    Jones, Jo

    2009-01-01

    In 2002, 2 percent of adults aged 18-44 years had adopted children, approximately 2 million people. Significantly more adopters are men, over age 30, are ever married, have biological children, and have ever used infertility services. Women who have adopted are older than women who have given birth to a child. Significantly more ever-married men have adopted children compared with never-married men or women in either marital status. Women who have ever used infertility services are more likely to have adopted compared with women who have not used these services. Men who have adopted are more likely than men who have not adopted to have also fathered a child. Hispanic women are significantly less likely than non-Hispanic women or men of any race or ethnicity to have adopted children. Women with incomes below 150% of the poverty level are significantly less likely than women with higher incomes or men, irrespective of poverty status, to have adopted children. The percentage of infants relinquished by never-married mothers has declined to 1.0%, or fewer than 7,000 infants annually.

  6. Hurdling barriers through market uncertainty: Case studies ininnovative technology adoption

    SciTech Connect

    Payne, Christopher T.; Radspieler Jr., Anthony; Payne, Jack

    2002-08-18

    The crisis atmosphere surrounding electricity availability in California during the summer of 2001 produced two distinct phenomena in commercial energy consumption decision-making: desires to guarantee energy availability while blackouts were still widely anticipated, and desires to avoid or mitigate significant price increases when higher commercial electricity tariffs took effect. The climate of increased consideration of these factors seems to have led, in some cases, to greater willingness on the part of business decision-makers to consider highly innovative technologies. This paper examines three case studies of innovative technology adoption: retrofit of time-and-temperature signs on an office building; installation of fuel cells to supply power, heating, and cooling to the same building; and installation of a gas-fired heat pump at a microbrewery. We examine the decision process that led to adoption of these technologies. In each case, specific constraints had made more conventional energy-efficient technologies inapplicable. We examine how these barriers to technology adoption developed over time, how the California energy decision-making climate combined with the characteristics of these innovative technologies to overcome the barriers, and what the implications of hurdling these barriers are for future energy decisions within the firms.

  7. Environmental Justice and Green-Technology Adoption

    ERIC Educational Resources Information Center

    Ong, Paul

    2012-01-01

    This paper presents an analysis of an environmental justice (EJ) program adopted by the South Coast Air Quality Management District (SCAQMD) as a part of its regulation to phase out a toxic chemical used by dry cleaners. SCAQMD provided financial incentives to switch early and gave establishments in EJ neighborhoods priority in applying for…

  8. 50 CFR 38.7 - Adopted offenses.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... NATIONAL WILDLIFE REFUGE SYSTEM MIDWAY ATOLL NATIONAL WILDLIFE REFUGE Prohibitions § 38.7 Adopted offenses. Any person who commits any act or omission on Midway Atoll National Wildlife Refuge which, although... commits any act or omission on Midway Atoll National Wildlife Refuge which, although not made...

  9. 50 CFR 38.7 - Adopted offenses.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... NATIONAL WILDLIFE REFUGE SYSTEM MIDWAY ATOLL NATIONAL WILDLIFE REFUGE Prohibitions § 38.7 Adopted offenses. Any person who commits any act or omission on Midway Atoll National Wildlife Refuge which, although... commits any act or omission on Midway Atoll National Wildlife Refuge which, although not made...

  10. 50 CFR 38.7 - Adopted offenses.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... NATIONAL WILDLIFE REFUGE SYSTEM MIDWAY ATOLL NATIONAL WILDLIFE REFUGE Prohibitions § 38.7 Adopted offenses. Any person who commits any act or omission on Midway Atoll National Wildlife Refuge which, although... commits any act or omission on Midway Atoll National Wildlife Refuge which, although not made...

  11. 50 CFR 38.7 - Adopted offenses.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... NATIONAL WILDLIFE REFUGE SYSTEM MIDWAY ATOLL NATIONAL WILDLIFE REFUGE Prohibitions § 38.7 Adopted offenses. Any person who commits any act or omission on Midway Atoll National Wildlife Refuge which, although... commits any act or omission on Midway Atoll National Wildlife Refuge which, although not made...

  12. 50 CFR 38.7 - Adopted offenses.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... NATIONAL WILDLIFE REFUGE SYSTEM MIDWAY ATOLL NATIONAL WILDLIFE REFUGE Prohibitions § 38.7 Adopted offenses. Any person who commits any act or omission on Midway Atoll National Wildlife Refuge which, although... commits any act or omission on Midway Atoll National Wildlife Refuge which, although not made...

  13. International Adoption: Benefits, Risks, and Vulnerabilities

    ERIC Educational Resources Information Center

    Rochat, Tamsen; Richter, Linda

    2007-01-01

    International adoption is on the rise in the United States and is not without controversy. Reasons for the increase include higher rates of infertility in couples who have delayed parenthood; increased numbers of children who are relinquished, abandoned, or orphaned around the world; and the influence of third party agencies. Internationally…

  14. Indian Foster and Adoptive Care Manual.

    ERIC Educational Resources Information Center

    National Indian Child Abuse and Neglect Resource Center, Tulsa, OK.

    Designed to assist Indian tribes and oganizations in the recruitment, training, licensing, and evaluation of Indian foster and adoptive homes, the manual is presented in six sections. The introduction provides a definition for foster care and foster children, along with excerpts from the Bill of Rights for Foster Children. Section I discusses the…

  15. Cultural Competence for Transracial Adoptive Parents.

    ERIC Educational Resources Information Center

    Vonk, M. Elizabeth

    2001-01-01

    Provides a clear conceptual definition of cultural competence for transracial-cultural adoptive (TRA) parents based on an extensive review of the literature and feedback from experts and parents. A three part definition of cultural competence for TRA parents includes: racial awareness, multicultural planning, and survival skills. Implications for…

  16. Examining Teachers' Decisions to Adopt New Technology

    ERIC Educational Resources Information Center

    Sugar, William; Crawley, Frank; Fine, Bethann

    2004-01-01

    This study examined teachers' beliefs about technology adoption as a reasoned, deliberate, intentional decision-making process, as reflected in Ajzen's (1985) Theory of Planned Behavior. Qualitative and quantitative data were collected from teachers in four schools located in the southeastern region of the United States. Overall results indicated…

  17. Comment on the Minnesota Transracial Adoption Study.

    ERIC Educational Resources Information Center

    Levin, Michael; And Others

    1994-01-01

    Michael Levin argues that data from the study are consistent with a black/white IQ difference that is significantly genetic. Richard Lynn maintains that adoption by middle-class, white families has no effect on intelligence. Waldman, Weinberg, and Scarr respond to these criticisms and support the original conclusions. (SLD)

  18. Outcomes of Children Adopted from Eastern Europe

    ERIC Educational Resources Information Center

    Miller, Laurie; Chan, Wilma; Tirella, Linda; Perrin, Ellen

    2009-01-01

    Behavioral problems are frequent among post-institutionalized Eastern European adoptees. However, risk factors related to outcomes have not been fully delineated. We evaluated 50 Eastern European adoptees, age 8-10 years, with their adoptive families for more than five years. Cognitive and behavioral outcomes and parenting stress were evaluated in…

  19. TILE at Iowa: Adoption and Adaptation

    ERIC Educational Resources Information Center

    Florman, Jean C.

    2014-01-01

    This chapter introduces a University of Iowa effort to enhance and support active learning pedagogies in technology-enhanced (TILE) classrooms and three elements that proved essential to the campus-wide adoption of those pedagogies. It then describes the impact of those professional development efforts on the curricula and cultures of three…

  20. Adoption of Energy Conservation among California Homeowners.

    ERIC Educational Resources Information Center

    Leonard-Barton, Dorothy; Rogers, Everett M.

    In spring 1977, just as California was emerging from one of the worst droughts in its history, 215 Palo Alto homeowners were interviewed about their views on energy and water conservation, and about the extent to which they had adopted 11 energy-conserving practices (ECP) in the home. The objective was to discover variables both important to…

  1. The African Orphan Crisis and International Adoption

    ERIC Educational Resources Information Center

    Roby, Jini L.; Shaw, Stacey A.

    2006-01-01

    The plight of Africa's AIDS orphans has reached crisis proportions, and the international community is beginning to mobilize at the family, community, national, and international levels. Despite these encouraging efforts, the response is inadequate, and increased attention and action are needed. The authors suggest that international adoption,…

  2. Adopting Learning Technologies: From Belief to Practice

    ERIC Educational Resources Information Center

    Bothma, Cornelius H.; Cant, Michael C.

    2011-01-01

    A challenge faced by most heads of academic departments around the world is to manage the adoption and use of appropriate learning technologies in order to support the department's learning offerings to students. Earlier research undertaken by the authors revealed that lecturers within the Department of Marketing and Retail Management at the…

  3. Adopt-A-Stream Teacher's Handbook.

    ERIC Educational Resources Information Center

    Delta Labs, Inc., Rochester, NY.

    Water pollution is not a recently discovered problem. Humankind's ability to generate pollutants continues to exceed its ability to control them. The Adopt-A-Stream program invites people who care for waterways to take an active role in assuring their well-being. High school groups supported by local co-sponsors agree to evaluate their adopted…

  4. The Symbolic Crises of Adoption: Popular Media's Agenda Setting.

    ERIC Educational Resources Information Center

    Waggenspack, Beth M.

    1998-01-01

    Uses a symbolic interaction approach to examine the dimensions of symbolic crises faced by adoptive families and adoption advocates resulting from changing adoption patterns and motives, language transformations that create tensions, and media misrepresentations of adoption. Explores common myths about adoption spread by popular news and…

  5. Books on Adoption for Young Children: Looking at Language.

    ERIC Educational Resources Information Center

    Schimmel, Nancy; Love, Susan

    1997-01-01

    Books can inform, reassure, and give young children the vocabulary to talk about adoption. This article presents and examines the language used to talk about adoption in eleven current children's books. Discusses surrogacy, adoption, "natural" parents, grief, "chosen-baby" stories, age at adoption, international adoption, foster children, and open…

  6. Effects of the history of adoption in the emotional adjustment of adopted adolescents.

    PubMed

    Reppold, Caroline Tozzi; Hutz, Claudio Simon

    2009-11-01

    Since the decade of 1980, the model of stress and coping proposed for the assessment of vulnerability of adoptive families emphasizes that the emotional adjustment of those adopted is moderated by variables such as institutionalization, the manner and age at which the adoption was revealed, the change of first name, and the contact with the biological family. The objective of this study was to investigate the relationship of these variables to the perceived parenting style, mood, and self-esteem of the adopted adolescents. Participants in the study were 68 adolescents, between the ages of 14 and 15, adopted during infancy through judicial channels. The adolescents responded to a questionnaire about the history of adoption and to scales of Parenting Styles, Depression and Self-esteem. The main results indicated that the late revelation of adoption and the change of the first name are connected to higher levels of depression and low self-esteem and to more frequent perceptions of negligent or authoritarian parenting style. The contact with the biological family was frequently mentioned among those who perceived their parents as authoritative and presented the best indicator of mood and self-esteem. These findings were discussed in light of the necessity for multidisciplinary actions which can improve the psychological adaptation of the adopting families. PMID:19899647

  7. Envisaging the Adoption Process to Strengthen Gay- and Lesbian-Headed Families: Recommendations for Adoption Professionals

    ERIC Educational Resources Information Center

    Matthews, John D.; Cramer, Elizabeth P.

    2006-01-01

    Although a growing number of child placement agencies are serving lesbians and gay men, a dearth of literature exists for adoption agency policies and practices related to working with this population. This article explores the unique characteristics and strengths of prospective gay and lesbian adoptive parents throughout each of the three phases…

  8. Effects of the history of adoption in the emotional adjustment of adopted adolescents.

    PubMed

    Reppold, Caroline Tozzi; Hutz, Claudio Simon

    2009-11-01

    Since the decade of 1980, the model of stress and coping proposed for the assessment of vulnerability of adoptive families emphasizes that the emotional adjustment of those adopted is moderated by variables such as institutionalization, the manner and age at which the adoption was revealed, the change of first name, and the contact with the biological family. The objective of this study was to investigate the relationship of these variables to the perceived parenting style, mood, and self-esteem of the adopted adolescents. Participants in the study were 68 adolescents, between the ages of 14 and 15, adopted during infancy through judicial channels. The adolescents responded to a questionnaire about the history of adoption and to scales of Parenting Styles, Depression and Self-esteem. The main results indicated that the late revelation of adoption and the change of the first name are connected to higher levels of depression and low self-esteem and to more frequent perceptions of negligent or authoritarian parenting style. The contact with the biological family was frequently mentioned among those who perceived their parents as authoritative and presented the best indicator of mood and self-esteem. These findings were discussed in light of the necessity for multidisciplinary actions which can improve the psychological adaptation of the adopting families.

  9. Kids Speak Out on Adoption: A Multiage Bookwriting Group for Adopted Children with Special Needs.

    ERIC Educational Resources Information Center

    Moroz, Kathleen Jennings

    1996-01-01

    Describes the conceptualization and development of a multiage bookwriting group entitled the Saturday Club for Adopted Kids. Describes the benefits of offering this project-oriented group in which adoptees can tell their stories and share their experiences in an environment that supports their recovery from early trauma. Notes adoptive parents'…

  10. A comparison of adoptive parents' perceptions of their child's behavior among Indian children adopted to Norway, the United States, and within country: implications for adoption policy.

    PubMed

    Brown, Suzanne; Groza, Victor

    2013-01-01

    The Hague Convention on the Protection of Children suggests that intercountry adoption be considered as a permanent care option only after other solutions within the child's country of origin have been exhausted. Data from the Child Behavior Checklist (CBCL) were examined for 478 Indian children ages 4-18 adopted domestically, adopted to Norway, and adopted to the United States. The CBCL has a reported reliability of .9 (Achenbach, 1991; Achenbach & Edelbrock, 1983) and contains five subscales assessing internalizing problems plus a summative Internalizing Scale, and three subscales assessing externalizing problems plus a summative Externalizing Scale. Perceptions of Norwegian, American, and Indian adoptive parents regarding their child's functioning were compared. Children adopted to Norway and the United States were perceived by their parents to be functioning significantly better behaviorally than children adopted within country, while controlling for age of child and gender of adoptive parent completing the CBCL. Policymakers should examine the evidence prioritizing within country adoption over intercountry adoption.

  11. A Swedish national adoption study of criminality

    PubMed Central

    Kendler, K. S.; Lönn, S. Larsson; Morris, N. A.; Sundquist, J.; Långström, N.; Sundquist, K.

    2014-01-01

    Background To clarify the role of genetic and environmental factors in criminal behavior (CB), we examined all CB and violent and non-violent subtypes (VCB and NVCB, respectively) in a Swedish national sample of adoptees and their relatives. Method CB was defined by a conviction in the Swedish Crime Register with standard definitions for VCB and NVCB subtypes. We examined adoptees born 1950–1991 (n=18070) and their biological (n=79206) and adoptive (n=47311) relatives. Results The risk for all CB was significantly elevated in the adopted-away offspring of biological parents of which at least one had CB [odds ratio (OR) 1.5, 95% confidence interval (CI) 1.4–1.6] and in the biological full and half-siblings of CB adoptees (OR 1.4, 95% CI 1.2–1.6 and OR 1.3, 95% CI 1.2–1.3, respectively). A genetic risk index (including biological parental/sibling history of CB and alcohol abuse) and an environmental risk index (including adoptive parental and sibling CB and a history of adoptive parental divorce, death, and medical illness) both strongly predicted probability of CB. These genetic and environmental risk indices acted additively on adoptee risk for CB. Moderate specificity was seen in the transmission of genetic risk for VCB and NVCB between biological parents and siblings and adoptees. Conclusions CB is etiologically complex and influenced by a range of genetic risk factors including a specific liability to CB and a vulnerability to broader externalizing behaviors, and by features of the adoptive environment including parental CB, divorce and death. Genetic risk factors for VCB and NVCB may be at least partially distinct. PMID:24180693

  12. A signalling theory of excessive technological adoption.

    PubMed

    Barros, P P; Pinto, C G; Machado, A

    1999-05-01

    Technology adoption has been identified as one of the main elements behind the growth of health care expenditures. It has been argued that the health insurance arrangements in the US justify, to a certain extent, the technology-driven rise in costs. Moreover, it eases the adoption of less cost-effective procedures and devices. This paper presents an additional argument by which excessive technology investments may occur: providers of care invest in technology as a way to "signal" their intrinsic (and unobservable) quality. Providers face the option of adopting a new technology. The decision of adoption in itself may convey information about his/her quality: for example, patients conjecture that providers who display newer technology are of higher quality. Providers, being aware of this, may invest in technology to reveal themselves as high quality. Thus, technology adoption could result only from the desire to attract patients. The investment is self-defeating in the sense that if all providers invest, no information about quality is transmitted to patients. We evaluate the argument in a context of demand for health care services where patients have initially no information about the quality of different providers. We show that an incentive to invest as a way to signal quality may or may not lead to overinvestment. It is also possible that only some providers invest. They reveal themselves as high quality providers. The analysis suggests that the argument is more important for some services than for others. Overall, an additional argument for overinvestment in technology in some circumstances is provided.

  13. Review: Adoption, fostering, and the needs of looked-after and adopted children

    PubMed Central

    Fisher, Philip A.

    2014-01-01

    Background This review of the literature examines adoption, fostering, and the needs of looked-after and adopted children. Three domains of research about looked-after children are examined. Findings There is extensive evidence that early adverse experiences affect psychological and neurobiological development in looked-after and adopted children. There is also evidence that some looked-after and adopted children show remarkable resilience in the face of adversity; intervention research provides evidence of the ability to reduce risks and promote positive outcomes in this population. The intervention studies have revealed not only the potential for improved behavioral trajectories, but also the plasticity of neurobiological systems affected by early stress. Conclusion Foster and adopted children face many challenges, but scientific knowledge also provides reason for hope and information about how to maximize positive outcomes. PMID:25678858

  14. Subacute therapeutic dosing of artemether-lumefantrine and artesunate-amodiaquine combination preserves plasma cholesterol, renal antioxidant status, and organ weights in rats.

    PubMed

    Otuechere, Chiagoziem A; Edewor, Gloria; Kale, Oluwafemi Ezekiel; Ekor, Martins

    2012-01-01

    Recent instances of breakdowns of malaria control programs and the constant emergence of drug-resistant parasites to monotherapies have shored up the use of artemisinin-based combination therapy (ACT) as the malaria therapy of choice. We evaluated a subacute therapeutic dosing of artemether-lumefantrine and artesunate-amodiaquine on plasma cholesterol, renal antioxidants, and organ weights in rats. Sixteen albino rats were grouped into three. Group A (n = 5) served as the control. Groups B (n = 6) and C (n = 5) were administered, twice daily, oral therapeutic doses of artemether-lumefantrine (1.14/6.86 mg/kg/d) and artesunate-amodiaquine (2.86/8.58 mg/kg/d), respectively, for seven days. From our results, ACTs did not significantly (P > 0.05) alter catalase, superoxide dismutase, glutathione S-transferase, myeloperoxidase, and total glutathione levels when compared with the control. Plasma total cholesterol levels also decreased insignificantly (P > 0.05). Organ-system weights were not significantly (P > 0.05) different from control rats. Artesunate-amodiaquine, but not artemether-lumefantrine, significantly increased (P < 0.05) lactate dehydrogenase activity and also afforded a 27.2% decrease in heart weight when compared with control. Also, both ACTs increased (P < 0.05) lipid peroxidation. Overall, artesunate-amodiaquine and artemether-lumefantrine may preserve renal antioxidants and organ weights in vivo. However, caution is required above therapeutic indications or in chronic doses as this may predispose to renal oxidative stress.

  15. Nursing students' perceptions of adoption: educational preparation needed.

    PubMed

    Foli, Karen J; Forster, Anna; Lim, Eunjung

    2014-01-01

    Adoption is a worldwide practice; most know someone who has been adopted, has adopted a child, or has relinquished a child for adoption. Healthcare professionals will have contact with patients who have a connection to adoption. This study examined the overall perceptions, current knowledge, and gaps in a nursing curriculum as reported by undergraduate nursing students and offers insight into caring for those impacted by adoption.

  16. 45 CFR 1356.41 - Nonrecurring expenses of adoption.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) There must be no income eligibility requirement (means test) for adopting parents in determining whether... psychological examination, supervision of the placement prior to adoption, transportation and the...

  17. 45 CFR 1356.41 - Nonrecurring expenses of adoption.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) There must be no income eligibility requirement (means test) for adopting parents in determining whether... psychological examination, supervision of the placement prior to adoption, transportation and the...

  18. Evaluating IPv6 Adoption in the Internet

    NASA Astrophysics Data System (ADS)

    Colitti, Lorenzo; Gunderson, Steinar H.; Kline, Erik; Refice, Tiziana

    As IPv4 address space approaches exhaustion, large networks are deploying IPv6 or preparing for deployment. However, there is little data available about the quantity and quality of IPv6 connectivity. We describe a methodology to measure IPv6 adoption from the perspective of a Web site operator and to evaluate the impact that adding IPv6 to a Web site will have on its users. We apply our methodology to the Google Web site and present results collected over the last year. Our data show that IPv6 adoption, while growing significantly, is still low, varies considerably by country, and is heavily influenced by a small number of large deployments. We find that native IPv6 latency is comparable to IPv4 and provide statistics on IPv6 transition mechanisms used.

  19. Adopting a direction. Forum of Parliamentarians.

    PubMed

    Sakurai, S

    1999-01-01

    National security, poverty alleviation, and refugees are global issues which all urgently need to be addressed. However, no major issue will be resolved until the population problem is solved. Humankind needs to find a way to live in harmony with the earth and its natural environment. The 1994 International Conference on Population and Development (ICPD) adopted a program of action outlining practical measures to be taken with regard to population and development. The concepts of reproductive health and women's empowerment were also adopted. The ICPD was in many ways an historic conference which set the future direction for the issues of population and development. The conference program of action must be fully implemented to ensure a healthy future for humankind and the earth. Elected officials must do their best to ensure that the ICPD program of action is successfully implemented.

  20. Validation of ELISA for Quantitation of Artemisinin-Based Antimalarial Drugs

    PubMed Central

    Wang, Min; Cui, Yongliang; Zhou, Guofa; Yan, Guiyun; Cui, Liwang; Wang, Baomin

    2013-01-01

    The circulation of counterfeit or substandard artemisinins (ARTs) in malaria-endemic areas poses a serious threat to the long-term use of these drugs. Here, we validated an indirect competitive enzyme-linked immunosorbent assay (icELISA) for quantification of ARTs and found that 50% of inhibitory concentrations of dihydroartemisinin, artemether, and artesunate were 8.1, 207.0, and 4.7 ng/mL, respectively. We compared the icELISA with high-performance liquid chromatography (HPLC) for quantifying ART and its derivatives in 22 convenience samples of commercial antimalarial drugs. Paired t tests showed a borderline significant difference between the two methods (mean = 0.03, 95% confidence interval [CI] 0.00–0.07, P = 0.074) and the icELISA results were more variable than those of the HPLC analysis (P < 0.001), suggesting that further improvement is needed to enhance the performance of the icELISA. Our results showed that the icELISA has the potential to be improved for quality assurance of ARTs at the point of care in endemic settings. PMID:24080636

  1. Sensitive and selective electrochemical detection of artemisinin based on its reaction with p-aminophenylboronic acid.

    PubMed

    Wang, Chao; Zholudov, Yuriy T; Nsabimana, Anaclet; Xu, Guobao; Li, Jianping

    2016-09-21

    The electrochemical detection of artemisinin generally requires high oxidation potential or the use of complex electrode modification. We find that artemisinin can react with p-aminophenylboronic acid to produce easily electrochemically detectable aminophenol for the first time. By making use of the new reaction, we report an alternative method to detect artemisinin through the determination of p-aminophenol. The calibration curve for the determination of artemisinin is linear in the range of 2 μmol L(-1) to 200 μmol L(-1) with the detection limit of 0.8 μmol L(-1), which is more sensitive than other reported electrochemical methods. The relative standard deviation is 4.83% for the determination of 10 μM artemisinin. Because the oxidation potential of p-aminophenol is around 0 V, the present method is high selective. When 40 μM, 90 μM and 140 μM of artemisinin were spiked to compound naphthoquine phosphate tablet samples, the recoveries are 107.6%, 105.4% and 101.7%, respectively. This detection strategy is attractive for the detection of artemisinin and its derivatives. The finding that artemisinin can react with aromatic boronic acid has the potential to be exploited for the development of other sensors, such as fluorescence artemisinin sensors. PMID:27590543

  2. Three Major banks adopt carbon principles

    SciTech Connect

    2008-04-15

    People in the electric power sector stopped and took notice in early February when three major Wall Street banks announced that they were adopting new carbon principles in considering investment loans for power plants because of pending federal CO2 regulation 'could make such investments more risky'. The principles, meant to become industry-wide practice, could slow investment in coal plants and other major emitters, as banks require power companies to offer plans to deal with greenhouse gas emissions.

  3. Treaty to Curb Mercury Pollution Adopted

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    2013-10-01

    The international Minamata Convention on Mercury to protect human health and the environment from anthropogenic emissions and releases of mercury and mercury compounds was formally adopted at a 10 October meeting in Minamata, Japan. The legally binding treaty, currently signed by 92 countries, comes 57 years after the government of Japan officially acknowledged, in 1956, the existence of Minamata disease, which was caused by eating seafood contaminated with methylmercury compounds discharged into Minamata Bay in southern Japan.

  4. Safety monitoring of artemisinin combination therapy through a national pharmacovigilance system in an endemic malaria setting

    PubMed Central

    2013-01-01

    Background The National Malaria Control Programme in Senegal, introduced since 2006, artemisinin-based combination therapy (ACT administration) for the treatment of uncomplicated malaria cases. In this framework, an anti-malarial pharmacovigilance plan was developed and implemented in all public health services. This study investigated the occurrence of Adverse Drug Events (ADEs) after ACT. Methods The study was conducted between January 2007 and December 2009. It was based on spontaneous reports of ADEs in public health facilities. Data on patient demographic characteristics, dispensing facility, adverse signs and symptoms and causality were collected from a total of 123 patients. Results The age range of these patients was six months to 93 years with a mean of 25.9 years. Of the reported symptoms, 46.7% were related to the abdomen and the digestive system. Symptoms related to the nervous system, skin and subcutaneous tissue, circulatory and respiratory systems and general symptoms and signs were 7%, 9.7%, 3.5% and 31.3%, respectively. Causality results linked 14.3% of symptoms to Falcimon® (Artesunate-Amodiaquine) with certainty. Effects were classified as mild and severe in 69.1% and 7.3% of cases respectively while 23.6% were serious. All patients with serious ADEs were hospitalized. One death was reported in a patient who had taken 24 pills at once. Conclusion These results confirm the need to develop and implement pharmacovigilance systems in malaria endemic countries in order to monitor the safety of anti-malarial treatments. PMID:23384036

  5. In Vivo and In Vitro Antimalarial Properties of Azithromycin-Chloroquine Combinations That Include the Resistance Reversal Agent Amlodipine ▿ †

    PubMed Central

    Pereira, Marcus R.; Henrich, Philipp P.; Sidhu, Amar bir Singh; Johnson, David; Hardink, Joel; Van Deusen, Jeffrey; Lin, Jian; Gore, Katrina; O'Brien, Connor; Wele, Mamadou; Djimde, Abdoulaye; Chandra, Richa; Fidock, David A.

    2011-01-01

    Evidence of emerging Plasmodium falciparum resistance to artemisinin-based combination therapies, documented in western Cambodia, underscores the continuing need to identify new antimalarial combinations. Given recent reports of the resurgence of chloroquine-sensitive P. falciparum parasites in Malawi, after the enforced and prolonged withdrawal of this drug, and indications of a possible synergistic interaction with the macrolide azithromycin, we sought to further characterize chloroquine-azithromycin combinations for their in vitro and in vivo antimalarial properties. In vitro 96-h susceptibility testing of chloroquine-azithromycin combinations showed mostly additive interactions against freshly cultured P. falciparum field isolates obtained from Mali. Some evidence of synergy, however, was apparent at the fractional 90% inhibitory concentration level. Additional in vitro testing highlighted the resistance reversal properties of amlodipine for both chloroquine and quinine. In vivo experiments, using the Peters 4-day suppressive test in a P. yoelii mouse model, revealed up to 99.9% suppression of parasitemia following treatment with chloroquine-azithromycin plus the R enantiomer of amlodipine. This enantiomer was chosen because it does not manifest the cardiac toxicities observed with the racemic mixture. Pharmacokinetic/pharmacodynamic analyses in this rodent model and subsequent extrapolation to a 65-kg adult led to the estimation that 1.8 g daily of R-amlodipine would be required to achieve similar efficacy in humans, for whom this is likely an unsafe dose. While these data discount amlodipine as an additional partner for chloroquine-based combination therapy, our studies continue to support azithromycin as a safe and effective addition to antimalarial combination therapies. PMID:21464242

  6. An Analysis of the External Environmental and Internal Organizational Factors Associated with Adoption of the Electronic Health Record

    ERIC Educational Resources Information Center

    Kruse, Clemens Scott

    2013-01-01

    Despite a Presidential Order in 2004 that launched national incentives for the use of health information technology, specifically the Electronic Health Record (EHR), adoption of the EHR has been slow. This study attempts to quantify factors associated with adoption of the EHR and Computerized Provider Order Entry (CPOE) by combining multiple…

  7. The Adoption Experience: Families Who Give Children a Second Chance.

    ERIC Educational Resources Information Center

    Morris, Ann

    This book examines the adoption process in Great Britain, recounting first-hand experiences to take the reader through each stage of the process from the adopter's point of view. The book also examines the success and failure of several types of adoption. The chapters are: (1) "You Want to Adopt"; (2) "First Meetings, First Months, Falling in…

  8. Responding to the Needs of the Adopted Child

    ERIC Educational Resources Information Center

    Gajda, Rebecca

    2004-01-01

    In today's societal landscape, "adoption," the legal process by which a child becomes a full and permanent member of a new family, is becoming commonplace. Even though most people have had a personal experience with adoption in some capacity, those most closely associated with adoption (birth parents, adoptees, and adoptive parents) continue to be…

  9. Launching a Baby's Adoption: Practical Strategies for Parents and Professionals.

    ERIC Educational Resources Information Center

    Johnston, Patricia Irwin

    Intended for adoptive parents and adoption practitioners and intermediaries, this book uses the metaphor of space exploration to provide practical strategies for meeting the adopted infant's needs and smoothing the transition. Chapter 1, "Mission: To Explore New Worlds," discusses adoptive and birth parent preparation, loss issues, and society's…

  10. 27 CFR 24.127 - Adoption of formulas.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Adoption of formulas. 24... Establishment § 24.127 Adoption of formulas. The adoption of approved formulas by a successor proprietor will be... formulas for adoption by formula number, name of product, and date of approval. The application...

  11. 22 CFR 96.12 - Authorized adoption service providers.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Authorized adoption service providers. 96.12... AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA) Accreditation and Approval Requirements for the Provision of Adoption Services § 96.12 Authorized adoption service providers. (a) Once...

  12. 20 CFR 222.33 - Relationship resulting from legal adoption.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Relationship resulting from legal adoption... RETIREMENT ACT FAMILY RELATIONSHIPS Relationship as Child § 222.33 Relationship resulting from legal adoption... applicable State law. Legal adoption differs from equitable adoption in that in the case of legal...

  13. Connecting the Dots: Exploring Themes in Adoption Picturebooks

    ERIC Educational Resources Information Center

    Mattix, April A.; Crawford, Patricia A.

    2011-01-01

    Approximately 1.4 million school-aged children entered their families through adoption. As such, adoption represents a real and complex social issue with which young children--adopted or not--can grapple. Adoption picturebooks provide a medium by which children can explore this complicated concept. This manuscript analyzes a standard library…

  14. 7 CFR 1794.71 - Adoption of an EA.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 12 2013-01-01 2013-01-01 false Adoption of an EA. 1794.71 Section 1794.71... AGRICULTURE (CONTINUED) ENVIRONMENTAL POLICIES AND PROCEDURES Adoption of Environmental Documents § 1794.71 Adoption of an EA. RUS may adopt a Federal EA or EIS or a portion thereof as its EA. RUS shall make the...

  15. 27 CFR 19.187 - Adoption of formulas.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Adoption of formulas. 19... After Original Qualification § 19.187 Adoption of formulas. (a) Forms 5110.38. The adoption by a... the appropriate TTB officer. The application shall list the formulas for adoption by (1)...

  16. 22 CFR 96.12 - Authorized adoption service providers.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Authorized adoption service providers. 96.12... AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA) Accreditation and Approval Requirements for the Provision of Adoption Services § 96.12 Authorized adoption service providers. (a) Once...

  17. Implications of Transnational Adoption Status for Adult Korean Adoptees

    ERIC Educational Resources Information Center

    Langrehr, Kimberly J.; Yoon, Eunju; Hacker, Jason; Caudill, Kathy

    2015-01-01

    This study used a consensual qualitative research method to explore the implications of transnational adoption in the lives of 12 adult Korean adoptees. From the analysis, 6 domains emerged: (a) adoption history and preadoptive memories, (b) meaning of adoption, (c) adoptive family dynamics, (d) racism, (e) identity formation, and (f) counseling…

  18. 20 CFR 222.33 - Relationship resulting from legal adoption.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Relationship resulting from legal adoption... RETIREMENT ACT FAMILY RELATIONSHIPS Relationship as Child § 222.33 Relationship resulting from legal adoption... applicable State law. Legal adoption differs from equitable adoption in that in the case of legal...

  19. 7 CFR 1794.71 - Adoption of an EA.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false Adoption of an EA. 1794.71 Section 1794.71... AGRICULTURE (CONTINUED) ENVIRONMENTAL POLICIES AND PROCEDURES Adoption of Environmental Documents § 1794.71 Adoption of an EA. RUS may adopt a Federal EA or EIS or a portion thereof as its EA. RUS shall make the...

  20. 22 CFR 96.12 - Authorized adoption service providers.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Authorized adoption service providers. 96.12... AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA) Accreditation and Approval Requirements for the Provision of Adoption Services § 96.12 Authorized adoption service providers. (a) Once...

  1. 27 CFR 17.125 - Adoption of formulas and processes.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Adoption of formulas and... NONBEVERAGE PRODUCTS Formulas and Samples § 17.125 Adoption of formulas and processes. (a) Adoption of... of adoption with the appropriate TTB officer. The notice shall be filed with the first claim...

  2. 22 CFR 96.12 - Authorized adoption service providers.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Authorized adoption service providers. 96.12... AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA) Accreditation and Approval Requirements for the Provision of Adoption Services § 96.12 Authorized adoption service providers. (a) Once...

  3. 27 CFR 17.125 - Adoption of formulas and processes.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Adoption of formulas and... NONBEVERAGE PRODUCTS Formulas and Samples § 17.125 Adoption of formulas and processes. (a) Adoption of... of adoption with the appropriate TTB officer. The notice shall be filed with the first claim...

  4. 20 CFR 222.33 - Relationship resulting from legal adoption.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Relationship resulting from legal adoption... RETIREMENT ACT FAMILY RELATIONSHIPS Relationship as Child § 222.33 Relationship resulting from legal adoption... applicable State law. Legal adoption differs from equitable adoption in that in the case of legal...

  5. 22 CFR 96.12 - Authorized adoption service providers.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Authorized adoption service providers. 96.12... AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA) Accreditation and Approval Requirements for the Provision of Adoption Services § 96.12 Authorized adoption service providers. (a) Once...

  6. 27 CFR 24.127 - Adoption of formulas.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Adoption of formulas. 24... Establishment § 24.127 Adoption of formulas. The adoption of approved formulas by a successor proprietor will be... formulas for adoption by formula number, name of product, and date of approval. The application...

  7. 7 CFR 1794.71 - Adoption of an EA.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 12 2012-01-01 2012-01-01 false Adoption of an EA. 1794.71 Section 1794.71... AGRICULTURE (CONTINUED) ENVIRONMENTAL POLICIES AND PROCEDURES Adoption of Environmental Documents § 1794.71 Adoption of an EA. RUS may adopt a Federal EA or EIS or a portion thereof as its EA. RUS shall make the...

  8. 27 CFR 17.125 - Adoption of formulas and processes.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Adoption of formulas and... NONBEVERAGE PRODUCTS Formulas and Samples § 17.125 Adoption of formulas and processes. (a) Adoption of... of adoption with the appropriate TTB officer. The notice shall be filed with the first claim...

  9. 27 CFR 24.127 - Adoption of formulas.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Adoption of formulas. 24... Establishment § 24.127 Adoption of formulas. The adoption of approved formulas by a successor proprietor will be... formulas for adoption by formula number, name of product, and date of approval. The application...

  10. 27 CFR 17.125 - Adoption of formulas and processes.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Adoption of formulas and... NONBEVERAGE PRODUCTS Formulas and Samples § 17.125 Adoption of formulas and processes. (a) Adoption of... of adoption with the appropriate TTB officer. The notice shall be filed with the first claim...

  11. 27 CFR 24.127 - Adoption of formulas.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Adoption of formulas. 24... Establishment § 24.127 Adoption of formulas. The adoption of approved formulas by a successor proprietor will be... formulas for adoption by formula number, name of product, and date of approval. The application...

  12. 20 CFR 222.33 - Relationship resulting from legal adoption.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Relationship resulting from legal adoption... RETIREMENT ACT FAMILY RELATIONSHIPS Relationship as Child § 222.33 Relationship resulting from legal adoption... applicable State law. Legal adoption differs from equitable adoption in that in the case of legal...

  13. 27 CFR 24.127 - Adoption of formulas.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Adoption of formulas. 24... Establishment § 24.127 Adoption of formulas. The adoption of approved formulas by a successor proprietor will be... formulas for adoption by formula number, name of product, and date of approval. The application...

  14. 27 CFR 17.125 - Adoption of formulas and processes.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Adoption of formulas and... NONBEVERAGE PRODUCTS Formulas and Samples § 17.125 Adoption of formulas and processes. (a) Adoption of... of adoption with the appropriate TTB officer. The notice shall be filed with the first claim...

  15. 7 CFR 1794.71 - Adoption of an EA.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 12 2011-01-01 2011-01-01 false Adoption of an EA. 1794.71 Section 1794.71... AGRICULTURE (CONTINUED) ENVIRONMENTAL POLICIES AND PROCEDURES Adoption of Environmental Documents § 1794.71 Adoption of an EA. RUS may adopt a Federal EA or EIS or a portion thereof as its EA. RUS shall make the...

  16. 20 CFR 222.33 - Relationship resulting from legal adoption.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Relationship resulting from legal adoption... RETIREMENT ACT FAMILY RELATIONSHIPS Relationship as Child § 222.33 Relationship resulting from legal adoption... applicable State law. Legal adoption differs from equitable adoption in that in the case of legal...

  17. Adoption and the Guatemalan Journey to American Parenthood

    ERIC Educational Resources Information Center

    Noonan, Emily J.

    2007-01-01

    Examining the adoption of Guatemalan children by US citizens, this article argues that adoptive parents make meanings and form identities through their participation in the adoption process and in their production of both Internet-based and spoken narratives about adoption. Using theories of globalization and narrative theory, the article…

  18. Sensory Processing in Internationally Adopted, Post-Institutionalized Children

    ERIC Educational Resources Information Center

    Wilbarger, Julia; Gunnar, Megan; Schneider, Mary; Pollak, Seth

    2010-01-01

    Background/Methods: Sensory processing capacities of 8-12-year-old internationally adopted (IA) children who experienced prolonged institutional care (greater than 12 months with 75% of pre-adoption lives in institutional care) prior to adoption into family environments (PI) were compared to a group of IA children who were adopted early (less than…

  19. Communication Development in Infants and Toddlers Adopted from Abroad

    ERIC Educational Resources Information Center

    Hwa-Froelich, Deborah A.

    2009-01-01

    Approximately 20,000 children are adopted from foreign countries each year. Of these children, approximately 46% are adopted before they are 12 months old and 43% are adopted between 1 and 4 years of age. The development of children adopted from abroad before or by 2 years of age is the focus of this article. Given the impoverished language input…

  20. Understanding Technology Adoption: Theory and Future Directions for Informal Learning

    ERIC Educational Resources Information Center

    Straub, Evan T.

    2009-01-01

    How and why individuals adopt innovations has motivated a great deal of research. This article examines individuals' computing adoption processes through the lenses of three adoption theories: Rogers's innovation diffusion theory, the Concerns-Based Adoption Model, the Technology Acceptance Model, and the United Theory of Acceptance and Use of…

  1. Partitioning the Adoption Process to Better Predict Permanency

    ERIC Educational Resources Information Center

    McDonald, Tom; Press, Alan; Billings, Peggy; Moore, Terry

    2007-01-01

    Under federal outcome standards established by the Adoption and Safe Families Act of 1997, discharges to adoption are expected to occur within 24 months of the most recent removal from home for at least 32% of cases. In the research recounted here, adoption is treated as a process composed of two discrete steps: adoptive placement, and adoption…

  2. The Economics of Adoption of Children from Foster Care

    ERIC Educational Resources Information Center

    Hansen, Mary Eschelbach; Hansen, Bradley A.

    2006-01-01

    Federal initiatives since 1996 have intensified the efforts of states to achieve adoption for children in foster care. For many waiting children, the path to adoption is long. The authors offer an economic analysis of adoption from foster care, with an emphasis on the reasons why achieving the goal of adoption for all waiting children may be so…

  3. Domestic Transracial Adoption: In the Words of African American Adoptees

    ERIC Educational Resources Information Center

    Smith, Ellen M.

    2013-01-01

    Domestic transracial adoption has sparked more controversy than any other type of adoption. For the purposes of this study domestic transracial adoption is defined as European American parents adopting African American children. Many of the studies completed are contradictory and fail to control for variables that affect the outcome such as age of…

  4. Enabling international adoption of LOINC through translation

    PubMed Central

    Vreeman, Daniel J.; Chiaravalloti, Maria Teresa; Hook, John; McDonald, Clement J.

    2012-01-01

    Interoperable health information exchange depends on adoption of terminology standards, but international use of such standards can be challenging because of language differences between local concept names and the standard terminology. To address this important barrier, we describe the evolution of an efficient process for constructing translations of LOINC terms names, the foreign language functions in RELMA, and the current state of translations in LOINC. We also present the development of the Italian translation to illustrate how translation is enabling adoption in international contexts. We built a tool that finds the unique list of LOINC Parts that make up a given set of LOINC terms. This list enables translation of smaller pieces like the core component “hepatitis c virus” separately from all the suffixes that could appear with it, such “Ab.IgG”, “DNA”, and “RNA”. We built another tool that generates a translation of a full LOINC name from all of these atomic pieces. As of version 2.36 (June 2011), LOINC terms have been translated into 9 languages from 15 linguistic variants other than its native English. The five largest linguistic variants have all used the Part-based translation mechanism. However, even with efficient tools and processes, translation of standard terminology is a complex undertaking. Two of the prominent linguistic challenges that translators have faced include: the approach to handling acronyms and abbreviations, and the differences in linguistic syntax (e.g. word order) between languages. LOINC’s open and customizable approach has enabled many different groups to create translations that met their needs and matched their resources. Distributing the standard and its many language translations at no cost worldwide accelerates LOINC adoption globally, and is an important enabler of interoperable health information exchange PMID:22285984

  5. Adoptive Cellular Therapy (ACT) for Cancer Treatment.

    PubMed

    Yang, Fan; Jin, Hao; Wang, Jian; Sun, Qian; Yan, Cihui; Wei, Feng; Ren, Xiubao

    2016-01-01

    Adoptive cellular therapy (ACT) with various lymphocytes or antigen-presenting cells is one stone in the pillar of cancer immunotherapy, which relies on the tumor-specific T cell. The transfusion of bulk T-cell population into patients is an effective treatment for regression of cancer. In this chapter, we summarize the development of various strategies in ACT for cancer immunotherapy and discuss some of the latest progress and obstacles in technical, safety, and even regulatory aspects to translate these technologies to the clinic. ACT is becoming a potentially powerful approach to cancer treatment. Further experiments and clinical trials are needed to optimize this strategy.

  6. Adopting a Family-Oriented Approach

    PubMed Central

    Becker, Lorne A.

    1991-01-01

    Although many family physicians believe that a family-oriented approach to patient care leads to better outcomes, and in spite of a growing body of literature on the principles and theory of working with families in primary care, most physicians have been very slow to move from an individual approach to a family approach with their patients. This paper will examine some of the issues involved in the adoption of innovations by practitioners and explore their implications for the increased inclusion of the family in medical practice. PMID:21229054

  7. Modeling of customer adoption of distributed energy resources

    SciTech Connect

    Marnay, Chris; Chard, Joseph S.; Hamachi, Kristina S.; Lipman, Timothy; Moezzi, Mithra M.; Ouaglal, Boubekeur; Siddiqui, Afzal S.

    2001-08-01

    This report describes work completed for the California Energy Commission (CEC) on the continued development and application of the Distributed Energy Resources Customer Adoption Model (DER-CAM). This work was performed at Ernest Orlando Lawrence Berkeley National Laboratory (Berkeley Lab) between July 2000 and June 2001 under the Consortium for Electric Reliability Technology Solutions (CERTS) Distributed Energy Resources Integration (DERI) project. Our research on distributed energy resources (DER) builds on the concept of the microgrid ({mu}Grid), a semiautonomous grouping of electricity-generating sources and end-use sinks that are placed and operated for the benefit of its members. Although a {mu}Grid can operate independent of the macrogrid (the utility power network), the {mu}Grid is usually interconnected, purchasing energy and ancillary services from the macrogrid. Groups of customers can be aggregated into {mu}Grids by pooling their electrical and other loads, and the most cost-effective combination of generation resources for a particular {mu}Grid can be found. In this study, DER-CAM, an economic model of customer DER adoption implemented in the General Algebraic Modeling System (GAMS) optimization software is used, to find the cost-minimizing combination of on-site generation customers (individual businesses and a {mu}Grid) in a specified test year. DER-CAM's objective is to minimize the cost of supplying electricity to a specific customer by optimizing the installation of distributed generation and the self-generation of part or all of its electricity. Currently, the model only considers electrical loads, but combined heat and power (CHP) analysis capability is being developed under the second year of CEC funding. The key accomplishments of this year's work were the acquisition of increasingly accurate data on DER technologies, including the development of methods for forecasting cost reductions for these technologies, and the creation of a credible

  8. Adoption: biological and social processes linked to adaptation.

    PubMed

    Grotevant, Harold D; McDermott, Jennifer M

    2014-01-01

    Children join adoptive families through domestic adoption from the public child welfare system, infant adoption through private agencies, and international adoption. Each pathway presents distinctive developmental opportunities and challenges. Adopted children are at higher risk than the general population for problems with adaptation, especially externalizing, internalizing, and attention problems. This review moves beyond the field's emphasis on adoptee-nonadoptee differences to highlight biological and social processes that affect adaptation of adoptees across time. The experience of stress, whether prenatal, postnatal/preadoption, or during the adoption transition, can have significant impacts on the developing neuroendocrine system. These effects can contribute to problems with physical growth, brain development, and sleep, activating cascading effects on social, emotional, and cognitive development. Family processes involving contact between adoptive and birth family members, co-parenting in gay and lesbian adoptive families, and racial socialization in transracially adoptive families affect social development of adopted children into adulthood.

  9. Adoption activities on the Internet: a call for regulation.

    PubMed

    Roby, Jini L; White, Holly

    2010-07-01

    There is a growing practice of adoption services on the Internet with varying degrees of regulation, depending on whether it is domestic infant adoption, public foster care adoption, or international adoption. Regulation is particularly lacking in domestic infant adoptions, with Web sites connecting prospective birth and adoptive parents, sometimes through an adoption brokerage service. International adoptions can also be plagued by unethical practices as the Internet has become available in both developed and developing countries. These activities, although offering the benefits of privacy and convenience, also pose serious problems of potential fraud, exploitation, and, most important, lack of professional consideration of the child's best interest. In this article, the authors review the landscape of current Internet-based adoption activities, examine the benefits and risks of Internet-based adoption activities, and call for social work self-regulation and leadership. PMID:20632655

  10. Adoption activities on the Internet: a call for regulation.

    PubMed

    Roby, Jini L; White, Holly

    2010-07-01

    There is a growing practice of adoption services on the Internet with varying degrees of regulation, depending on whether it is domestic infant adoption, public foster care adoption, or international adoption. Regulation is particularly lacking in domestic infant adoptions, with Web sites connecting prospective birth and adoptive parents, sometimes through an adoption brokerage service. International adoptions can also be plagued by unethical practices as the Internet has become available in both developed and developing countries. These activities, although offering the benefits of privacy and convenience, also pose serious problems of potential fraud, exploitation, and, most important, lack of professional consideration of the child's best interest. In this article, the authors review the landscape of current Internet-based adoption activities, examine the benefits and risks of Internet-based adoption activities, and call for social work self-regulation and leadership.

  11. Information architecture: Profile of adopted standards

    SciTech Connect

    1997-09-01

    The Department of Energy (DOE), like other Federal agencies, is under increasing pressure to use information technology to improve efficiency in mission accomplishment as well as delivery of services to the public. Because users and systems have become interdependent, DOE has enterprise wide needs for common application architectures, communication networks, databases, security, and management capabilities. Users need open systems that provide interoperability of products and portability of people, data, and applications that are distributed throughout heterogeneous computing environments. The level of interoperability necessary requires the adoption of DOE wide standards, protocols, and best practices. The Department has developed an information architecture and a related standards adoption and retirement process to assist users in developing strategies and plans for acquiring information technology products and services based upon open systems standards that support application software interoperability, portability, and scalability. This set of Departmental Information Architecture standards represents guidance for achieving higher degrees of interoperability within the greater DOE community, business partners, and stakeholders. While these standards are not mandatory, particular and due consideration of their applications in contractual matters and use in technology implementations Department wide are goals of the Chief Information Officer.

  12. Determinants of HMO Formulary Adoption Decisions

    PubMed Central

    Dranove, David; Hughes, Edward FX; Shanley, Mark

    2003-01-01

    Objective To identify economic and organizational characteristics that affect the likelihood that health maintenance organizations (HMOs) include new drugs on their formularies. Data Sources We administered an original survey to directors of pharmacy at 75 HMOs, of which 41 returned usable responses. We obtained drug-specific data from an industry trade journal. Study Design We performed multivariate logistic regression analysis, adjusting for fixed-drug effects and random-HMO effects. We used factor analysis to limit the number of predictors. Data Collection Methods We held initial focus groups to help with survey design. We administered the survey in two waves. We asked respondents to report on seven popular new drugs, and to describe a variety of HMO organizational characteristics. Principal Findings Several HMO organizational characteristics, including nonprofit status, the incentives facing the director of the pharmacy, size and make-up of the pharmacy and therapeutics committee, and relationships with drugs makers, all affect formulary adoption. Conclusions There are many organizational factors that may cause HMOs to make different formulary adoption decisions for certain prescription drugs. PMID:12650387

  13. Endogenous Technology Adoption and Medical Costs.

    PubMed

    Lamiraud, Karine; Lhuillery, Stephane

    2016-09-01

    Despite the claim that technology has been one of the most important drivers of healthcare spending growth over the past decades, technology variables are rarely introduced explicitly in cost equations. Furthermore, technology is often considered exogenous. Using 1996-2007 panel data on Swiss geographical areas, we assessed the impact of technology availability on per capita healthcare spending covered by basic health insurance whilst controlling for the endogeneity of health technology availability variables. Our results suggest that medical research, patent intensity and the density of employees working in the medical device industry are influential factors for the adoption of technology and can be used as instruments for technology availability variables in the cost equation. These results are similar to previous findings: CT and PET scanner adoption is associated with increased healthcare spending, whilst increased availability of percutaneous transluminal coronary angioplasty facilities is associated with reductions in per capita spending. However, our results suggest that the magnitude of these relationships is much greater in absolute value than that suggested by previous studies that did not control for the possible endogeneity of the availability of technologies. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27492052

  14. Skin diseases in internationally adopted children.

    PubMed

    Rigal, Émilie; Nourrisson, Céline; Sciauvaud, Julie; Pascal, Julie; Texier, Charlotte; Corbin, Violaine; Poirier, Véronique; Beytout, Jean; Labbe, André; Lesens, Olivier

    2016-08-01

    Internationally adopted children often present diseases contracted in the country of origin. Skin diseases are common in new arrivals, and diagnosis may prove challenging for GPs or even dermatologists if they are inexperienced in the extensive geographic and ethnic diversity of international adoptees. To analyse the frequency and characteristics of skin diseases in international adoptees. In total, 142 adoptees were evaluated for a cross-sectional cohort study. The most frequent diseases observed at arrival were dermatological conditions. Of the adoptees, 70% presented at least one skin disease, of which 57.5% were infectious; Tinea capitis being the most frequent (n = 42). The recovery rate of Tinea capitis was 89% (n = 32/36). Ten cases of scabies were diagnosed. Other diseases included viral skin infection (n = 22), with 16 cases of Molluscum contagiosum and bacterial infection. Skin diseases are very common in internationally adopted children. There is a need for close collaboration between dermatologists and paediatricians to diagnose such infections, as well as clear guidelines to treat them. PMID:27436771

  15. Endogenous Technology Adoption and Medical Costs.

    PubMed

    Lamiraud, Karine; Lhuillery, Stephane

    2016-09-01

    Despite the claim that technology has been one of the most important drivers of healthcare spending growth over the past decades, technology variables are rarely introduced explicitly in cost equations. Furthermore, technology is often considered exogenous. Using 1996-2007 panel data on Swiss geographical areas, we assessed the impact of technology availability on per capita healthcare spending covered by basic health insurance whilst controlling for the endogeneity of health technology availability variables. Our results suggest that medical research, patent intensity and the density of employees working in the medical device industry are influential factors for the adoption of technology and can be used as instruments for technology availability variables in the cost equation. These results are similar to previous findings: CT and PET scanner adoption is associated with increased healthcare spending, whilst increased availability of percutaneous transluminal coronary angioplasty facilities is associated with reductions in per capita spending. However, our results suggest that the magnitude of these relationships is much greater in absolute value than that suggested by previous studies that did not control for the possible endogeneity of the availability of technologies. Copyright © 2016 John Wiley & Sons, Ltd.

  16. Overcoming the Adoption Barrier to Electric Flight

    NASA Technical Reports Server (NTRS)

    Borer, Nicholas K.; Nickol, Craig L.; Jones, Frank P.; Yasky, Richard J.; Woodham, Kurt; Fell, Jared S.; Litherland, Brandon L.; Loyselle, Patricia L.; Provenza, Andrew J.; Kohlman, Lee W.; Samuel, Aamod G.

    2016-01-01

    Electrically-powered aircraft can enable dramatic increases in efficiency and reliability, reduced emissions, and reduced noise as compared to today's combustion-powered aircraft. This paper describes a novel flight demonstration concept that will enable the benefits of electric propulsion, while keeping the extraordinary convenience and utility of common fuels available at today's airports. A critical gap in airborne electric propulsion research is addressed by accommodating adoption at the integrated aircraft-airport systems level, using a confluence of innovative but proven concepts and technologies in power generation and electricity storage that need to reside only on the airframe. Technical discriminators of this demonstrator concept include (1) a novel, high-efficiency power system that utilizes advanced solid oxide fuel cells originally developed for ultra-long-endurance aircraft, coupled with (2) a high-efficiency, high-power electric propulsion system selected from mature products to reduce technical risk, assembled into (3) a modern, high-performance demonstration platform to provide useful and compelling data, both for the targeted early adopters and the eventual commercial market.

  17. Accelerating Industrial Adoption of Metal Additive Manufacturing Technology

    NASA Astrophysics Data System (ADS)

    Vartanian, Kenneth; McDonald, Tom

    2016-03-01

    While metal additive manufacturing (AM) technology has clear benefits, there are still factors preventing its adoption by industry. These factors include the high cost of metal AM systems, the difficulty for machinists to learn and operate metal AM machines, the long approval process for part qualification/certification, and the need for better process controls; however, the high AM system cost is the main barrier deterring adoption. In this paper, we will discuss an America Makes-funded program to reduce AM system cost by combining metal AM technology with conventional computerized numerical controlled (CNC) machine tools. Information will be provided on how an Optomec-led team retrofitted a legacy CNC vertical mill with laser engineered net shaping (LENS®—LENS is a registered trademark of Sandia National Labs) AM technology, dramatically lowering deployment cost. The upgraded system, dubbed LENS Hybrid Vertical Mill, enables metal additive and subtractive operations to be performed on the same machine tool and even on the same part. Information on the LENS Hybrid system architecture, learnings from initial system deployment and continuing development work will also be provided to help guide further development activities within the materials community.

  18. Engineering antitumor immunity by T-cell adoptive immunotherapy.

    PubMed

    Riddell, Stanley R

    2007-01-01

    The adoptive transfer of antigen-specific T cells has been used successfully to treat experimental tumors in animal models and viral infections in humans, but harnessing the exquisite specificity and potency of T cells to treat human malignancy has proven challenging. The efforts to use T cells to treat patients with cancer have often been informative in identifying limitations that must be overcome to improve therapeutic efficacy, and a clearer picture of the requirements for successful adoptive T-cell transfer is gradually emerging. Indolent and a subset of aggressive B-cell lymphomas in humans have been shown to be susceptible to eradication by T cells in clinical settings where highly immunogenic minor histocompatibility or viral antigens are presented by tumor cells. In this article, we will review how recent advances in our understanding of the properties of antigen-specific T cells that facilitate their long-term persistence in vivo and reversion to the memory pool after in vitro culture, combined with approaches to molecularly engineer T cells with receptors that target molecules expressed by B-cell lymphoma, are providing opportunities to broaden the application of T-cell therapy and improve its efficacy for this disease.

  19. Development and Validation of the "Attitudes toward Adoption Scale" and the "Gay and Lesbian Parents' Adoption Scale."

    ERIC Educational Resources Information Center

    Shelley-Sireci, Lynn M.; Ciano-Boyce, Claudia

    Two studies were conducted to evaluate newly developed measures of attitudes about adoption. The Attitudes toward Adoption Scale was developed, based on research literature, to investigate the attitudes of people with and without experience with adoption toward adoption. Eighty-six college students completed this scale and made open-ended comments…

  20. Mitigating Effects of the Adoptive Caregiving Environment on Inattention/Overactivity in Children Adopted from Romanian Orphanages

    ERIC Educational Resources Information Center

    Audet, Karyn; Le Mare, Lucy

    2011-01-01

    We examined inattention/overactivity (I/O) over time and in relation to caregiving in three matched groups: (1) Romanian Orphans (RO) with a minimum of eight months' deprivation prior to adoption, (2) Early Adopted (EA) children adopted from Romania prior to age four months, and (3) Canadian Born (CB) non-adopted children. Comparisons among groups…

  1. The intricacies of induced lactation for same-sex mothers of an adopted child.

    PubMed

    Wilson, Erica; Perrin, Maryanne Tigchelaar; Fogleman, April; Chetwynd, Ellen

    2015-02-01

    The definition of a modern family is changing. In this case study, we describe the breastfeeding experience of a child receiving human milk from all 3 of his mothers: his 2 adoptive mothers, who induced lactation to nurse him, and his birth mother, who shared in his early feeding during the open adoption process and continued to pump and send milk to him for several months. We review the lactation protocol used by his adoptive mothers and the unique difficulties inherent in this multi-mother family dynamic. Both adoptive mothers successfully induced moderate milk production using a combination of hormonal birth control, domperidone, herbal supplements, and a schedule of breast pumping. However, because of the increased complexity of the immediate postpartum period and concerns with defining parental roles in a same-sex marriage, maintenance of milk production was difficult. PMID:25311827

  2. Adoption of safety eyewear among citrus harvesters in rural Florida.

    PubMed

    Monaghan, Paul F; Bryant, Carol A; McDermott, Robert J; Forst, Linda S; Luque, John S; Contreras, Ricardo B

    2012-06-01

    The community-based prevention marketing program planning framework was used to adapt an evidence-based intervention to address eye injuries among Florida's migrant citrus harvesters. Participant-observer techniques, other direct observations, and individual and focus group interviews provided data that guided refinement of a safety eyewear intervention. Workers were attracted to the eyewear's ability to minimize irritation, offer protection from trauma, and enable work without declines in productivity or comfort. Access to safety glasses equipped with worker-designed features reduced the perceived barriers of using them; deployment of trained peer-leaders helped promote adoption. Workers' use of safety glasses increased from less than 2% to between 28% and 37% in less than two full harvesting seasons. The combination of formative research and program implementation data provided insights for tailoring an existing evidence-based program for this occupational community and increase potential for future dissemination and worker protection.

  3. Adoption of safety eyewear among citrus harvesters in rural Florida.

    PubMed

    Monaghan, Paul F; Bryant, Carol A; McDermott, Robert J; Forst, Linda S; Luque, John S; Contreras, Ricardo B

    2012-06-01

    The community-based prevention marketing program planning framework was used to adapt an evidence-based intervention to address eye injuries among Florida's migrant citrus harvesters. Participant-observer techniques, other direct observations, and individual and focus group interviews provided data that guided refinement of a safety eyewear intervention. Workers were attracted to the eyewear's ability to minimize irritation, offer protection from trauma, and enable work without declines in productivity or comfort. Access to safety glasses equipped with worker-designed features reduced the perceived barriers of using them; deployment of trained peer-leaders helped promote adoption. Workers' use of safety glasses increased from less than 2% to between 28% and 37% in less than two full harvesting seasons. The combination of formative research and program implementation data provided insights for tailoring an existing evidence-based program for this occupational community and increase potential for future dissemination and worker protection. PMID:21643727

  4. MSU Adopts Business-Engineering Program

    ERIC Educational Resources Information Center

    Chemical and Engineering News, 1973

    1973-01-01

    A program leading to a bachelor of science degree is discussed which combines a required core of engineering studies with application studies in one of four fields: industrial design, business, communication, or social sciences. (DF)

  5. Ethnic and adoption attitudes among Guatemalan University students.

    PubMed

    Gibbons, Judith L; González-Oliva, Ana Gabriela; Mylonas, Kostas

    2015-01-01

    Intercountry adoptions from Guatemala were highly controversial, because of the large numbers of children being adopted to the USA, along with evidence of corruption and child theft. Since the implementation of the Hague Convention on Intercountry Adoption in 2008, Guatemala's central authority for adoption has prioritized domestic placements for children over intercountry adoption. A possible attitudinal barrier to domestic adoption in Guatemala-negative attitudes and prejudice against Indigenous people-was investigated through questionnaires measuring attitudes toward adoption and attitudes toward and social distance from the two major ethnic groups (Ladino and Indigenous). Guatemalan university students (N = 177, 61 % men) were recruited from basic required courses at a private university. Results showed that attitudes toward adoption in general were more favorable than toward interethnic adoption, with the most negative attitudes toward adoption of Ladino children by Indigenous parents. Multiple regression and analysis of covariance models revealed that female gender, experience with adoption and more positive attitudes about Indigenous persons were associated with more positive attitudes toward adoption. The findings imply that negative attitudes toward Indigenous persons are associated with negative attitudes toward adoption, and serve as barriers to promoting domestic adoption in Guatemala. PMID:26702374

  6. Ethnic and adoption attitudes among Guatemalan University students.

    PubMed

    Gibbons, Judith L; González-Oliva, Ana Gabriela; Mylonas, Kostas

    2015-01-01

    Intercountry adoptions from Guatemala were highly controversial, because of the large numbers of children being adopted to the USA, along with evidence of corruption and child theft. Since the implementation of the Hague Convention on Intercountry Adoption in 2008, Guatemala's central authority for adoption has prioritized domestic placements for children over intercountry adoption. A possible attitudinal barrier to domestic adoption in Guatemala-negative attitudes and prejudice against Indigenous people-was investigated through questionnaires measuring attitudes toward adoption and attitudes toward and social distance from the two major ethnic groups (Ladino and Indigenous). Guatemalan university students (N = 177, 61 % men) were recruited from basic required courses at a private university. Results showed that attitudes toward adoption in general were more favorable than toward interethnic adoption, with the most negative attitudes toward adoption of Ladino children by Indigenous parents. Multiple regression and analysis of covariance models revealed that female gender, experience with adoption and more positive attitudes about Indigenous persons were associated with more positive attitudes toward adoption. The findings imply that negative attitudes toward Indigenous persons are associated with negative attitudes toward adoption, and serve as barriers to promoting domestic adoption in Guatemala.

  7. Adopting software quality measures for healthcare processes.

    PubMed

    Yildiz, Ozkan; Demirörs, Onur

    2009-01-01

    In this study, we investigated the adoptability of software quality measures for healthcare process measurement. Quality measures of ISO/IEC 9126 are redefined from a process perspective to build a generic healthcare process quality measurement model. Case study research method is used, and the model is applied to a public hospital's Entry to Care process. After the application, weak and strong aspects of the process can be easily observed. Access audibility, fault removal, completeness of documentation, and machine utilization are weak aspects and these aspects are the candidates for process improvement. On the other hand, functional completeness, fault ratio, input validity checking, response time, and throughput time are the strong aspects of the process.

  8. Adopting Internet Standards for Orbital Use

    NASA Technical Reports Server (NTRS)

    Wood, Lloyd; Ivancic, William; da Silva Curiel, Alex; Jackson, Chris; Stewart, Dave; Shell, Dave; Hodgson, Dave

    2005-01-01

    After a year of testing and demonstrating a Cisco mobile access router intended for terrestrial use onboard the low-Earth-orbiting UK-DMC satellite as part of a larger merged ground/space IP-based internetwork, we reflect on and discuss the benefits and drawbacks of integration and standards reuse for small satellite missions. Benefits include ease of operation and the ability to leverage existing systems and infrastructure designed for general use, as well as reuse of existing, known, and well-understood security and operational models. Drawbacks include cases where integration work was needed to bridge the gaps in assumptions between different systems, and where performance considerations outweighed the benefits of reuse of pre-existing file transfer protocols. We find similarities with the terrestrial IP networks whose technologies we have adopted and also some significant differences in operational models and assumptions that must be considered.

  9. Home Energy Displays. Consumer Adoption and Response

    SciTech Connect

    LaMarche, Janelle; Cheney, K.; Akers, C.; Roth, K.; Sachs, O.

    2012-12-01

    The focus of this project was to investigate the factors influencing consumer adoption of Home Energy Displays (HEDs) and to evaluate electricity consumption in households with basic HEDs versus enhanced feedback methods - web portals or alerts. The team hypothesized that providing flexible and relatable information to users, in addition to a basic HED, would make feedback more effective and achieve persistent energy savings. In Phase I, Fraunhofer conducted three user research studies and found preferences for aesthetically pleasing, easy to understand feedback that is accessible through multiple media and offered free of charge. The deployment of HEDs in 150 households planned for Phase II encountered major recruitment and HED field deployment problems. In light of these challenges, the team is pursuing a modified study investigating the energy savings of a web portal versus alert-based energy feedback instead of a physical HED.

  10. Adoption of information technology by resident physicians.

    PubMed

    Parekh, Selene G; Nazarian, David G; Lim, Charles K

    2004-04-01

    The Internet represents a technological revolution that is transforming our society. In the healthcare industry, physicians have been typified as slow adopters of information technology. However, young physicians, having been raised in a computer-prevalent society, may be more likely to embrace technology. We attempt to characterize the use and acceptance of the Internet and information technology among resident physicians in a large academic medical center and to assess concerns regarding privacy, security, and credibility of information on the Internet. A 41-question survey was distributed to 150 pediatric, medical, and surgical residents at an urban, academic medical center. One hundred thirty-five residents completed the survey (response rate of 90%). Responses were evaluated and statistical analysis was done. The majority of resident physicians in our survey have adopted the tools of information technology. Ninety-eight percent used the Internet and 96% use e-mail. Two-thirds of the respondents used the Internet for healthcare-related purposes and a similar percentage thought that the Internet has affected their practice of medicine positively. The majority of residents thought that Internet healthcare services such as electronic medical records, peer-support websites, and remote patient monitoring would be beneficial for the healthcare industry. However, they are concerned about the credibility, privacy, and security of health and medical information online. The majority of resident physicians in our institution use Internet and information technology in their practice of medicine. Most think that the Internet will continue to have a beneficial role in the healthcare industry.

  11. Adoptive parenting and attachment: association of the internal working models between adoptive mothers and their late-adopted children during adolescence

    PubMed Central

    Pace, Cecilia S.; Di Folco, Simona; Guerriero, Viviana; Santona, Alessandra; Terrone, Grazia

    2015-01-01

    Introduction: Recent literature has shown that the good outcome of adoption would mostly depend on the quality of adoptive parenting, which is strongly associated with the security of parental internal working models (IWMs) of attachment. Specifically, attachment states-of-mind of adoptive mothers classified as free and autonomous and without lack of resolution of loss or trauma could represent a good protective factor for adopted children, previously maltreated and neglected. While most research on adoptive families focused on pre-school and school-aged children, the aim of this study was to assess the concordance of IWMs of attachment in adoptive dyads during adolescence. Method: Our pilot-study involved 76 participants: 30 adoptive mothers (mean age = 51.5 ± 4.3), and their 46 late-adopted adolescents (mean age = 13.9 ± 1.6), who were all aged 4–9 years old at time of adoption (mean age = 6.3 ± 1.5). Attachment representations of adopted adolescents were assessed by the Friend and Family Interview (FFI), while adoptive mothers’ state-of-mind with respect to attachment was classified by the Adult Attachment Interview (AAI). Adolescents’ verbal intelligence was controlled for. Results: Late-adopted adolescents were classified as follows: 67% secure, 26% dismissing, and 7% preoccupied in the FFI, while their adoptive mothers’ AAI classifications were 70% free-autonomous, 7% dismissing, and 23% unresolved. We found a significant concordance of 70% (32 dyads) between the secure–insecure FFI and AAI classifications. Specifically adoptive mothers with high coherence of transcript and low unresolved loss tend to have late-adopted children with high secure attachment, even if the adolescents’ verbal intelligence made a significant contribution to this prediction. Discussion: Our results provides an empirical contribution to the literature concerning the concordance of attachment in adoptive dyads, highlighting the beneficial impact of highly coherent

  12. City Governments and Aging in Place: Community Design, Transportation and Housing Innovation Adoption

    ERIC Educational Resources Information Center

    Lehning, Amanda J.

    2012-01-01

    Purpose of the study: To examine the characteristics associated with city government adoption of community design, housing, and transportation innovations that could benefit older adults. Design and methods: A mixed-methods study with quantitative data collected via online surveys from 62 city planners combined with qualitative data collected via…

  13. Improving the outcome of adoptive cell transfer by targeting tumor escape.

    PubMed

    Kaluza, Karen M; Vile, Richard

    2013-01-01

    Adoptive T-cell transfer is among the most promising immunotherapies against cancer. To continue increasing the potential of this therapy, our studies focus on the inhibition of tumor recurrence. Recently, we have demonstrated several ways in which combination therapies involving multiple T-cell populations and immunostimulatory chemotherapy can enhance long-term survival.

  14. Post-Adoption Face-to-Face Contact with Birth Parents: Prospective Adopters' Views

    ERIC Educational Resources Information Center

    Turkington, Selina; Taylor, Brian J.

    2009-01-01

    The trend in adoption since the 1960s has been away from secrecy and towards greater openness; contact through an intermediary, and direct contact by letter, is now widely accepted. More controversial is the challenge of face-to-face contact with birth parents, and social workers involved in the decision-making process find themselves having to…

  15. The British Chinese Adoption Study: Orphanage Care, Adoption and Mid-Life Outcomes

    ERIC Educational Resources Information Center

    Rushton, Alan; Grant, Margaret; Feast, Julia; Simmonds, John

    2013-01-01

    Background: While studies of ex-orphanage care show adverse effects on development, the longer-term impact on mid-life psychosocial functioning and physical health has not been established. Methods: Orphanage records provided baseline data on a sample of 100 Hong Kong Chinese girls who were subsequently adopted into the UK. A mid-life follow-up…

  16. Adoption of a Non-Lecture Pedagogy in Chemical Engineering: Insights Gained from Observing an Adopter

    ERIC Educational Resources Information Center

    Golter, P. B.; Thiessen, D. B.; Van Wie, B. J.; Brown, G. R.

    2012-01-01

    Promoting the adoption of an alternative pedagogy can be a difficult process. Many professors are not interested in significantly modifying how they teach their course. Those that are interested in pedagogical reform still have concerns that must be addressed before or during an implementation. This paper presents a case study following the…

  17. Experiences of School Bullying among Internationally Adopted Children: Results from the Finnish Adoption (FINANDO) Study

    ERIC Educational Resources Information Center

    Raaska, Hanna; Lapinleimu, Helena; Sinkkonen, Jari; Salmivalli, Christina; Matomaki, Jaakko; Makipaa, Sanna; Elovainio, Marko

    2012-01-01

    This study investigated the prevalence of and factors associated with school bullying and victimization among Finnish international adoptees. The Olweus bully/victim questionnaire was sent to all 9-15-year-old children adopted in Finland between 1985 and 2007 through the mediating organizations officially approved by the Ministry of Social Affairs…

  18. Technology Adoption of Medical Faculty in Teaching: Differentiating Factors in Adopter Categories

    ERIC Educational Resources Information Center

    Zayim, Nese; Yildirim, Soner; Saka, Osman

    2006-01-01

    Despite large investments by higher education institutions in technology for faculty and student use, instructional technology is not being integrated into instruction in higher education institutions including medical education institutions. While the diffusion of instructional technologies has reached a saturation point among early adopters of…

  19. An open randomized controlled trial to compare the efficacy of two fixed dose combinations of artemesinin based combinations for uncomplicated falciparum malaria in Bangladesh.

    PubMed

    Samad, R; Rahman, M R; Yunus, E B; Hussain, M A; Arif, S M; Islam, M N; Hafiz, S A M M A; Hossain, M M; Faiz, M A

    2013-12-01

    National Malaria Control Program (NMCP) of Bangladesh has introduced Artemisinin Based Combination (ACT), Coartem(R) (Artemether-Lumefantrine (AL), fixed dose combination, in the confirmed cases of uncomplicated P. falciparum malaria since 2004. Despite the reduction of mortality due to malaria, the development and spread of anti-malarial drug resistance wordwide posing a threat to the health services and will make it difficult to control malaria in Bangladesh in future. We need to have an alternative to Coartem which could be Artesunate-amodiaquine (AA) in a fixed dose combination (FDC), a cheaper altenative not yet evidenced to be effective and safe to our population. In this study we compared the efficacy and safety of Artemether + Lumefantrene (FDC, Coartem) with Artesunate +Amodiaquine tablets (100/270 mg FDC) for the treatment of uncomplicated P. falciparum malaria in three high risk multi-drug resistant malaria prevalent areas of Bangladesh. It was an open label randomized controlled trial conducted between December 2008 and November 2009 in 4 upazillas in patients over the age 12 to 60 years diagnosed as a case of uncomplicated P. falciparum malaria. The outcome of the cases were measured as clinical response, parasitological response, defervescence time and parasite clearance time. Drug safety was assessed by comparing the adverse events. A total of 252 cases were randomized to receive Artesunate + Amodiaquine (AA group, 147 cases) and Artemether + Lumefantrene (AL group, 106 cases), one lost to follow up at day 28 in AA group. The distribution of the cases was comparable by age, sex and study sites. Treatment success' response was observed 100% in the AL group and AA group had 99%, two failures with AA were late treatment failures and the difference was not statistically significant (p > .1). The parasitological sensitive (S) response was observed in 97% of cases in AL group and 95% in the AA group, and was not a statistically significant difference

  20. PET imaging of adoptive progenitor cell therapies.

    SciTech Connect

    Gelovani, Juri G.

    2008-05-13

    Objectives. The overall objective of this application is to develop novel technologies for non-invasive imaging of adoptive stem cell-based therapies with positron emission tomography (PET) that would be applicable to human patients. To achieve this objective, stem cells will be genetically labeled with a PET-reporter gene and repetitively imaged to assess their distribution, migration, differentiation, and persistence using a radiolabeled reporter probe. This new imaging technology will be tested in adoptive progenitor cell-based therapy models in animals, including: delivery pro-apoptotic genes to tumors, and T-cell reconstitution for immunostimulatory therapy during allogeneic bone marrow progenitor cell transplantation. Technical and Scientific Merits. Non-invasive whole body imaging would significantly aid in the development and clinical implementation of various adoptive progenitor cell-based therapies by providing the means for non-invasive monitoring of the fate of injected progenitor cells over a long period of observation. The proposed imaging approaches could help to address several questions related to stem cell migration and homing, their long-term viability, and their subsequent differentiation. The ability to image these processes non-invasively in 3D and repetitively over a long period of time is very important and will help the development and clinical application of various strategies to control and direct stem cell migration and differentiation. Approach to accomplish the work. Stem cells will be genetically with a reporter gene which will allow for repetitive non-invasive “tracking” of the migration and localization of genetically labeled stem cells and their progeny. This is a radically new approach that is being developed for future human applications and should allow for a long term (many years) repetitive imaging of the fate of tissues that develop from the transplanted stem cells. Why the approach is appropriate. The novel approach to

  1. Adoption research: building blocks for the next decade.

    PubMed

    Barth, R P

    1994-01-01

    Basic national and state adoption indicators are now unavailable and must await future data collection efforts. The focus of future efforts on the adoption of children in foster care is appropriate. Case-level adoption data with unique child indicators must be developed to advance the field and further clarify the odds of adoption and disruption. Available psychosocial research clearly indicates that adoption generally results in successful outcomes. Yet, more comparative research on differences between long-term outcomes for children who are adopted and those remaining in foster care would better estimate the value of adoption to children and the public. Rigorous research on strategies to successfully place children for adoption is essential. PMID:7924567

  2. 75 FR 71069 - Adopted Adjustments to Alternative Site Framework

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-22

    ... adjustments stem from a staff proposal published in August 2010 (75 FR 46916, 8/4/2010). The adopted... framework (ASF) originally adopted by the Board in December 2008 (74 FR 1170, 01/12/09; correction 74...

  3. The Role of Social Networks in Early Adoption of Mobile Devices

    NASA Astrophysics Data System (ADS)

    Tscherning, Heidi; Mathiassen, Lars

    As mobile devices have become the personal information-processing interface of choice, many individuals seem to swiftly follow fashion. Yet, the literature is silent on how early adopters of mobile devices overcome uncertainties related to shifts in technology. Based on purposive sampling, this paper presents detailed insights into why and how five closely related individuals made the decision to adopt the iPhone before it was available through traditional supply chains. Focusing on the role played by social networks, we analyze how adoption threshold, opinion leaders, social contagion, and social learning shaped adoption behaviors and outcomes. The analyses confirm that network structures impact the early decision to accept the iPhone; they show that when facing uncertainty, adoption decisions emerged as a combined result of individual adoption reflections and major influences from the social network as well as behaviors observed within the network, and, they reveal interesting behaviors that differed from expectations. In conclusion, we discuss implications for both theory and practice.

  4. Home Energy Displays: Consumer Adoption and Response

    SciTech Connect

    LaMarche, J.; Cheney, K.; Akers, C.; Roth, K.; Sachs, O.

    2012-12-01

    The focus of this project was to investigate the factors influencing consumer adoption of Home Energy Displays (HEDs) and to evaluate electricity consumption in households with basic HEDs versus enhanced feedback methods - web portals or alerts. We hypothesized that providing flexible and relatable information to users, in addition to a basic HED, would make feedback more effective and achieve persistent energy savings. In Phase I, we conducted three user research studies and found preferences for aesthetically pleasing, easy to understand feedback that is accessible through multiple media and offered free of charge. The deployment of HEDs in 150 households planned for Phase II encountered major recruitment and HED field deployment problems. First, after extensive outreach campaigns to apartment complexes with 760 units, only 8% of building's tenants elected to receive a free HED in their homes as part of the field study. Second, the HED used, a leading market model, had a spectrum of problems, including gateway miscommunications, failure to post to a data-hosting third party, and display malfunctions. In light of these challenges, we are pursuing a modified study investigating the energy savings of a web portal versus alert-based energy feedback instead of a physical HED.

  5. Should health care managers adopt Theory Z?

    PubMed

    Safranski, S R; Kwon, I W; Walker, W R; Unger, M

    1986-04-01

    Health care administrators should carefully consider the situations in which they apply management methods used in industry, since such methods may not be effective in motivating certain groups of hospital employees. Physicians, for example, may display little loyalty to the health care organization, even though as a group they exert significant influence on policies, standards, and administration. As a result, management styles such as Theory Z that focus on holistic concern, individual decision-making responsibility, and long-term employment guarantees may fail to interest them. Nurses also may be reluctant to commit themselves to an organization because of the high rate of turnover in their profession in recent years. Support staff, however, probably would be receptive to management techniques that offer security through long-term employment guarantees. Other factors necessary for the effective use of Theory Z industrial management techniques are a clear hierarchy with well-defined reporting relationships, moderately specialized career paths, and trust among employees that the organization's concern for their welfare is genuine. The key consideration, however, in applying any theory is that only those aspects which best serve the organization's needs should be adopted.

  6. Abortion, Adoption, and Marriage: Alternative Resolutions of an Unwanted Pregnancy.

    ERIC Educational Resources Information Center

    Nock, Steven L.

    1994-01-01

    Responds to previous article by Stolley and Hall (this issue) on presentation of adoption and abortion in undergraduate marriage and family textbooks. Contends that Stolley and Hall have constructed the issue as involving but two options (abortion and adoption). Asserts that abortion and adoption are but two of several related topics. Considers…

  7. Post-Adoption Depression: Clinical Windows on an Emerging Concept

    ERIC Educational Resources Information Center

    Speilman, Eda

    2011-01-01

    In recent years, the concept of post-adoption depression--with both parallels and differences from postpartum depression--has emerged as a salient descriptor of the experience of a significant minority of newly adoptive parents. This article offers a clinical perspective on post-adoption depression through the stories of several families seen in…

  8. A School District's Adoption of an Elementary Science Curriculum

    ERIC Educational Resources Information Center

    Lorsbach, Anthony W.

    2008-01-01

    The author describes how case study methods were used to understand the intricacies of curriculum adoption in one school district and the context in which an adoption decision was made. As data collection and interpretation commenced, understanding of the perceptions of the district stakeholders of their process of curriculum adoption became an…

  9. Understanding the Adoption of TELEs--The Importance of Management

    ERIC Educational Resources Information Center

    Christiansen, Ellen; Nyvang, Tom

    2006-01-01

    For a TELE to become adopted by the vast majority of individual learners as a tool for learning, adoption at the institutional level must be considered, because the vast majority of a population of technology users depends on external stimuli to adopt the technology. This article analyses a case where a social simulation game, a prize-winning…

  10. 49 CFR 237.31 - Adoption of bridge management programs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Adoption of bridge management programs. 237.31... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION BRIDGE SAFETY STANDARDS Railroad Bridge Safety Assurance § 237.31 Adoption of bridge management programs. Each track owner shall adopt a bridge safety management program...

  11. 49 CFR 237.31 - Adoption of bridge management programs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Adoption of bridge management programs. 237.31... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION BRIDGE SAFETY STANDARDS Railroad Bridge Safety Assurance § 237.31 Adoption of bridge management programs. Each track owner shall adopt a bridge safety management program...

  12. 49 CFR 237.31 - Adoption of bridge management programs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Adoption of bridge management programs. 237.31... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION BRIDGE SAFETY STANDARDS Railroad Bridge Safety Assurance § 237.31 Adoption of bridge management programs. Each track owner shall adopt a bridge safety management program...

  13. 49 CFR 237.31 - Adoption of bridge management programs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Adoption of bridge management programs. 237.31... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION BRIDGE SAFETY STANDARDS Railroad Bridge Safety Assurance § 237.31 Adoption of bridge management programs. Each track owner shall adopt a bridge safety management program...

  14. 49 CFR 237.31 - Adoption of bridge management programs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Adoption of bridge management programs. 237.31... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION BRIDGE SAFETY STANDARDS Railroad Bridge Safety Assurance § 237.31 Adoption of bridge management programs. Each track owner shall adopt a bridge safety management program...

  15. 49 CFR 190.329 - Adoption of final rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Adoption of final rules. 190.329 Section 190.329 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PROCEDURES Procedures for Adoption of Rules § 190.329 Adoption of final rules. Final rules are prepared...

  16. 14 CFR 221.162 - Receiver shall file adoption notices.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Receiver shall file adoption notices. 221... (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS TARIFFS Adoption Publications Required To Show Change in Carrier's Name or Transfer of Operating Control § 221.162 Receiver shall file adoption notices. A...

  17. 49 CFR 1110.8 - Adoption of final rules.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 8 2013-10-01 2013-10-01 false Adoption of final rules. 1110.8 Section 1110.8 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT... Adoption of final rules. If, after consideration of all comments received, final rules are adopted,...

  18. 45 CFR 1151.43 - Adoption of grievance procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Adoption of grievance procedures. 1151.43 Section 1151.43 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE... Enforcement § 1151.43 Adoption of grievance procedures. A recipient may adopt an internal grievance...

  19. 49 CFR 553.29 - Adoption of final rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 6 2010-10-01 2010-10-01 false Adoption of final rules. 553.29 Section 553.29... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RULEMAKING PROCEDURES Procedures for Adoption of Rules § 553.29 Adoption of final rules. Final rules are prepared by representatives of the office concerned and the...

  20. 49 CFR 1110.8 - Adoption of final rules.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 8 2014-10-01 2014-10-01 false Adoption of final rules. 1110.8 Section 1110.8 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT... Adoption of final rules. If, after consideration of all comments received, final rules are adopted,...

  1. 49 CFR 389.29 - Adoption of final rules.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 5 2013-10-01 2013-10-01 false Adoption of final rules. 389.29 Section 389.29 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER SAFETY...-FEDERAL MOTOR CARRIER SAFETY REGULATIONS Procedures for Adoption of Rules § 389.29 Adoption of final...

  2. 7 CFR 1794.71 - Adoption of an EA.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 12 2014-01-01 2013-01-01 true Adoption of an EA. 1794.71 Section 1794.71 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) ENVIRONMENTAL POLICIES AND PROCEDURES Adoption of Environmental Documents § 1794.71 Adoption...

  3. 10 CFR 1021.103 - Adoption of CEQ NEPA regulations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... PROCEDURES General § 1021.103 Adoption of CEQ NEPA regulations. DOE adopts the regulations for implementing NEPA published by CEQ at 40 CFR parts 1500 through 1508. ... 10 Energy 4 2011-01-01 2011-01-01 false Adoption of CEQ NEPA regulations. 1021.103 Section...

  4. 45 CFR 1151.43 - Adoption of grievance procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 3 2014-10-01 2014-10-01 false Adoption of grievance procedures. 1151.43 Section 1151.43 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE... Enforcement § 1151.43 Adoption of grievance procedures. A recipient may adopt an internal grievance...

  5. 45 CFR 1356.41 - Nonrecurring expenses of adoption.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 4 2012-10-01 2012-10-01 false Nonrecurring expenses of adoption. 1356.41 Section..., FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES REQUIREMENTS APPLICABLE TO TITLE IV-E § 1356.41 Nonrecurring expenses of adoption. (a) The amount of the payment made...

  6. 49 CFR 553.29 - Adoption of final rules.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 6 2011-10-01 2011-10-01 false Adoption of final rules. 553.29 Section 553.29... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RULEMAKING PROCEDURES Procedures for Adoption of Rules § 553.29 Adoption of final rules. Final rules are prepared by representatives of the office concerned and the...

  7. 45 CFR 1151.43 - Adoption of grievance procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 3 2012-10-01 2012-10-01 false Adoption of grievance procedures. 1151.43 Section 1151.43 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE... Enforcement § 1151.43 Adoption of grievance procedures. A recipient may adopt an internal grievance...

  8. 27 CFR 5.28 - Adoption of predecessor's formulas.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Adoption of predecessor's..., DEPARTMENT OF THE TREASURY LIQUORS LABELING AND ADVERTISING OF DISTILLED SPIRITS Formulas § 5.28 Adoption of predecessor's formulas. The adoption by a successor of approved Forms 5110.38 (27-B Supplemental) shall be...

  9. 36 CFR 905.735-102 - Adoption of regulations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... CORPORATION STANDARDS OF CONDUCT General Provisions § 905.735-102 Adoption of regulations. Under the authority of 5 CFR 735.104(f), the Corporation adopts the following sections of the Civil Service Commission... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Adoption of regulations....

  10. 49 CFR 553.29 - Adoption of final rules.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 6 2012-10-01 2012-10-01 false Adoption of final rules. 553.29 Section 553.29... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RULEMAKING PROCEDURES Procedures for Adoption of Rules § 553.29 Adoption of final rules. Final rules are prepared by representatives of the office concerned and the...

  11. 49 CFR 190.329 - Adoption of final rules.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Adoption of final rules. 190.329 Section 190.329 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... REGULATORY PROCEDURES Procedures for Adoption of Rules § 190.329 Adoption of final rules. Final rules...

  12. 49 CFR 1110.8 - Adoption of final rules.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 8 2012-10-01 2012-10-01 false Adoption of final rules. 1110.8 Section 1110.8 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT... Adoption of final rules. If, after consideration of all comments received, final rules are adopted,...

  13. 36 CFR 905.735-102 - Adoption of regulations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... CORPORATION STANDARDS OF CONDUCT General Provisions § 905.735-102 Adoption of regulations. Under the authority of 5 CFR 735.104(f), the Corporation adopts the following sections of the Civil Service Commission... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Adoption of regulations....

  14. 49 CFR 1110.8 - Adoption of final rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Adoption of final rules. 1110.8 Section 1110.8 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT... Adoption of final rules. If, after consideration of all comments received, final rules are adopted,...

  15. 49 CFR 553.29 - Adoption of final rules.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 6 2013-10-01 2013-10-01 false Adoption of final rules. 553.29 Section 553.29... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RULEMAKING PROCEDURES Procedures for Adoption of Rules § 553.29 Adoption of final rules. Final rules are prepared by representatives of the office concerned and the...

  16. 49 CFR 389.29 - Adoption of final rules.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 5 2011-10-01 2011-10-01 false Adoption of final rules. 389.29 Section 389.29 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER SAFETY...-FEDERAL MOTOR CARRIER SAFETY REGULATIONS Procedures for Adoption of Rules § 389.29 Adoption of final...

  17. 36 CFR 905.735-102 - Adoption of regulations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... CORPORATION STANDARDS OF CONDUCT General Provisions § 905.735-102 Adoption of regulations. Under the authority of 5 CFR 735.104(f), the Corporation adopts the following sections of the Civil Service Commission... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Adoption of regulations....

  18. 27 CFR 5.28 - Adoption of predecessor's formulas.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Adoption of predecessor's..., DEPARTMENT OF THE TREASURY ALCOHOL LABELING AND ADVERTISING OF DISTILLED SPIRITS Formulas § 5.28 Adoption of predecessor's formulas. The adoption by a successor of approved Forms 5110.38 (27-B Supplemental) shall be...

  19. 49 CFR 389.29 - Adoption of final rules.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 5 2012-10-01 2012-10-01 false Adoption of final rules. 389.29 Section 389.29 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER SAFETY...-FEDERAL MOTOR CARRIER SAFETY REGULATIONS Procedures for Adoption of Rules § 389.29 Adoption of final...

  20. 45 CFR 1151.43 - Adoption of grievance procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 3 2011-10-01 2011-10-01 false Adoption of grievance procedures. 1151.43 Section 1151.43 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE... Enforcement § 1151.43 Adoption of grievance procedures. A recipient may adopt an internal grievance...

  1. 49 CFR 190.329 - Adoption of final rules.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Adoption of final rules. 190.329 Section 190.329 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PROCEDURES Procedures for Adoption of Rules § 190.329 Adoption of final rules. Final rules are prepared...

  2. 49 CFR 389.29 - Adoption of final rules.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 5 2014-10-01 2014-10-01 false Adoption of final rules. 389.29 Section 389.29 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER SAFETY...-FEDERAL MOTOR CARRIER SAFETY REGULATIONS Procedures for Adoption of Rules § 389.29 Adoption of final...

  3. 27 CFR 5.28 - Adoption of predecessor's formulas.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Adoption of predecessor's..., DEPARTMENT OF THE TREASURY ALCOHOL LABELING AND ADVERTISING OF DISTILLED SPIRITS Formulas § 5.28 Adoption of predecessor's formulas. The adoption by a successor of approved Forms 5110.38 (27-B Supplemental) shall be...

  4. 14 CFR 221.162 - Receiver shall file adoption notices.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Receiver shall file adoption notices. 221... (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS TARIFFS Adoption Publications Required To Show Change in Carrier's Name or Transfer of Operating Control § 221.162 Receiver shall file adoption notices. A...

  5. 49 CFR 1110.8 - Adoption of final rules.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 8 2011-10-01 2011-10-01 false Adoption of final rules. 1110.8 Section 1110.8 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT... Adoption of final rules. If, after consideration of all comments received, final rules are adopted,...

  6. 10 CFR 1021.103 - Adoption of CEQ NEPA regulations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... PROCEDURES General § 1021.103 Adoption of CEQ NEPA regulations. DOE adopts the regulations for implementing NEPA published by CEQ at 40 CFR parts 1500 through 1508. ... 10 Energy 4 2013-01-01 2013-01-01 false Adoption of CEQ NEPA regulations. 1021.103 Section...

  7. 10 CFR 1021.103 - Adoption of CEQ NEPA regulations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... PROCEDURES General § 1021.103 Adoption of CEQ NEPA regulations. DOE adopts the regulations for implementing NEPA published by CEQ at 40 CFR parts 1500 through 1508. ... 10 Energy 4 2012-01-01 2012-01-01 false Adoption of CEQ NEPA regulations. 1021.103 Section...

  8. 49 CFR 553.29 - Adoption of final rules.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 6 2014-10-01 2014-10-01 false Adoption of final rules. 553.29 Section 553.29... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RULEMAKING PROCEDURES Procedures for Adoption of Rules § 553.29 Adoption of final rules. Final rules are prepared by representatives of the office concerned and the...

  9. 18 CFR 401.24 - Preparation and adoption.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... adoption. 401.24 Section 401.24 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL RULES OF PRACTICE AND PROCEDURE Water Resources Program § 401.24 Preparation and adoption. The Water Resources Program will be prepared and considered by the Commission for adoption...

  10. 10 CFR 1021.103 - Adoption of CEQ NEPA regulations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... PROCEDURES General § 1021.103 Adoption of CEQ NEPA regulations. DOE adopts the regulations for implementing NEPA published by CEQ at 40 CFR parts 1500 through 1508. ... 10 Energy 4 2010-01-01 2010-01-01 false Adoption of CEQ NEPA regulations. 1021.103 Section...

  11. 45 CFR 1151.43 - Adoption of grievance procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 3 2013-10-01 2013-10-01 false Adoption of grievance procedures. 1151.43 Section 1151.43 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE... Enforcement § 1151.43 Adoption of grievance procedures. A recipient may adopt an internal grievance...

  12. 49 CFR 389.29 - Adoption of final rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 5 2010-10-01 2010-10-01 false Adoption of final rules. 389.29 Section 389.29 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER SAFETY...-FEDERAL MOTOR CARRIER SAFETY REGULATIONS Procedures for Adoption of Rules § 389.29 Adoption of final...

  13. 49 CFR 190.329 - Adoption of final rules.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Adoption of final rules. 190.329 Section 190.329 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PROCEDURES Procedures for Adoption of Rules § 190.329 Adoption of final rules. Final rules are prepared...

  14. 18 CFR 401.24 - Preparation and adoption.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... adoption. 401.24 Section 401.24 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL RULES OF PRACTICE AND PROCEDURE Water Resources Program § 401.24 Preparation and adoption. The Water Resources Program will be prepared and considered by the Commission for adoption...

  15. 18 CFR 401.24 - Preparation and adoption.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Preparation and adoption... ADMINISTRATIVE MANUAL RULES OF PRACTICE AND PROCEDURE Water Resources Program § 401.24 Preparation and adoption. The Water Resources Program will be prepared and considered by the Commission for adoption...

  16. 27 CFR 5.28 - Adoption of predecessor's formulas.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Adoption of predecessor's..., DEPARTMENT OF THE TREASURY LIQUORS LABELING AND ADVERTISING OF DISTILLED SPIRITS Formulas § 5.28 Adoption of predecessor's formulas. The adoption by a successor of approved Forms 5110.38 (27-B Supplemental) shall be...

  17. 10 CFR 1021.103 - Adoption of CEQ NEPA regulations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... PROCEDURES General § 1021.103 Adoption of CEQ NEPA regulations. DOE adopts the regulations for implementing NEPA published by CEQ at 40 CFR parts 1500 through 1508. ... 10 Energy 4 2014-01-01 2014-01-01 false Adoption of CEQ NEPA regulations. 1021.103 Section...

  18. 18 CFR 401.24 - Preparation and adoption.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... adoption. 401.24 Section 401.24 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL RULES OF PRACTICE AND PROCEDURE Water Resources Program § 401.24 Preparation and adoption. The Water Resources Program will be prepared and considered by the Commission for adoption...

  19. 14 CFR 221.162 - Receiver shall file adoption notices.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Receiver shall file adoption notices. 221... (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS TARIFFS Adoption Publications Required To Show Change in Carrier's Name or Transfer of Operating Control § 221.162 Receiver shall file adoption notices. A...

  20. 14 CFR 221.162 - Receiver shall file adoption notices.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Receiver shall file adoption notices. 221... (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS TARIFFS Adoption Publications Required To Show Change in Carrier's Name or Transfer of Operating Control § 221.162 Receiver shall file adoption notices. A...

  1. 14 CFR 221.162 - Receiver shall file adoption notices.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Receiver shall file adoption notices. 221... (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS TARIFFS Adoption Publications Required To Show Change in Carrier's Name or Transfer of Operating Control § 221.162 Receiver shall file adoption notices. A...

  2. 36 CFR 905.735-102 - Adoption of regulations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... CORPORATION STANDARDS OF CONDUCT General Provisions § 905.735-102 Adoption of regulations. Under the authority of 5 CFR 735.104(f), the Corporation adopts the following sections of the Civil Service Commission... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true Adoption of regulations....

  3. 27 CFR 5.28 - Adoption of predecessor's formulas.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Adoption of predecessor's..., DEPARTMENT OF THE TREASURY LIQUORS LABELING AND ADVERTISING OF DISTILLED SPIRITS Formulas § 5.28 Adoption of predecessor's formulas. The adoption by a successor of approved Forms 5110.38 (27-B Supplemental) shall be...

  4. 36 CFR 905.735-102 - Adoption of regulations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... CORPORATION STANDARDS OF CONDUCT General Provisions § 905.735-102 Adoption of regulations. Under the authority of 5 CFR 735.104(f), the Corporation adopts the following sections of the Civil Service Commission... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Adoption of regulations....

  5. Our Own: Adopting and Parenting the Older Child.

    ERIC Educational Resources Information Center

    Maskew, Trish

    Children adopted when they are older come with histories, fully formed personalities, and intense anger over what they have lost. Drawing on stories of families who have adopted older children, as well as research, interviews with professionals, and opinions of adults who were adopted as children, this book explores the joys and challenges of…

  6. 38 CFR 3.58 - Child adopted out of family.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Child adopted out of... ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Relationship § 3.58 Child adopted out of family. A child of a veteran adopted out of the family of the veteran either prior...

  7. 38 CFR 3.58 - Child adopted out of family.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Child adopted out of... ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Relationship § 3.58 Child adopted out of family. A child of a veteran adopted out of the family of the veteran either prior...

  8. 38 CFR 3.58 - Child adopted out of family.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Child adopted out of... ADJUDICATION Pension, Compensation, and Dependency and Indemnity Compensation Relationship § 3.58 Child adopted out of family. A child of a veteran adopted out of the family of the veteran either prior...

  9. Real Parents, Real Children: Parenting the Adopted Child.

    ERIC Educational Resources Information Center

    van Gulden, Holly; Bartels-Rabb, Lisa M.

    Parenting an adopted child is, for the most part, the same as parenting any other child, but is different in some unique and critical ways related to the child's separation from birth parents and genetic roots. Understanding how a child interprets, understands, and feels about adoption, and why, can help the parent guide the adopted child…

  10. 20 CFR 222.34 - Relationship resulting from equitable adoption.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... RAILROAD RETIREMENT ACT FAMILY RELATIONSHIPS Relationship as Child § 222.34 Relationship resulting from... adopted child. A claimant will have the relationship of an equitably adopted child for annuity and lump... as parent and child; and (d) The agreement to adopt is recognized under applicable State law...

  11. 20 CFR 222.34 - Relationship resulting from equitable adoption.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... RAILROAD RETIREMENT ACT FAMILY RELATIONSHIPS Relationship as Child § 222.34 Relationship resulting from... adopted child. A claimant will have the relationship of an equitably adopted child for annuity and lump... as parent and child; and (d) The agreement to adopt is recognized under applicable State law...

  12. 20 CFR 222.34 - Relationship resulting from equitable adoption.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... RAILROAD RETIREMENT ACT FAMILY RELATIONSHIPS Relationship as Child § 222.34 Relationship resulting from... adopted child. A claimant will have the relationship of an equitably adopted child for annuity and lump... as parent and child; and (d) The agreement to adopt is recognized under applicable State law...

  13. Autism Spectrum Disorder in Children Adopted after Early Care Breakdown

    ERIC Educational Resources Information Center

    Green, Jonathan; Leadbitter, Kathy; Kay, Catherine; Sharma, Kishan

    2016-01-01

    Syndromic autism has been described in children adopted after orphanage rearing. We investigated whether the same existed in children adopted after family breakdown. Families of 54/60 adopted children aged 6-11 years (mean 102 months; SD 20; 45% male) returned screening questionnaires for autism spectrum disorder (ASD); 21/54 (39%) screened…

  14. Reliability and Validity of the Transracial Adoption Parenting Scale

    ERIC Educational Resources Information Center

    Massatti, Richard R.; Vonk, M. Elizabeth; Gregoire, Thomas K.

    2004-01-01

    The present study provides information on the reliability and validity of the Transracial Adoption Parenting Scale (TAPS), a multidimensional 36-item Likert-type scale that measures cultural competence among transracial adoptive (TRA) parents. The TAPS was theoretically developed and refined through feedback from experts in TRA adoption. A…

  15. Transracial Adoption: Families Identify Issues and Needed Support Services.

    ERIC Educational Resources Information Center

    Vidal de Haymes, Maria; Simon, Shirley

    2003-01-01

    The gap between the number of children of color in care and the recruitment of minority foster and adoptive homes has triggered growing support for transracial adoption. This study explored a number of transracial placements and adoptions, with the goal of identifying, from the perspective of the families interviewed, potential services that would…

  16. Pre-adoptive Factors Predicting Lesbian, Gay, and Heterosexual Couples’ Relationship Quality Across the Transition to Adoptive Parenthood

    PubMed Central

    Goldberg, Abbie E.; Smith, JuliAnna Z.; Kashy, Deborah A.

    2010-01-01

    The current study examined pre-adoptive factors as predictors of relationship quality (love, ambivalence, and conflict) among 125 couples (44 lesbian couples, 30 gay couples, and 51 heterosexual couples) across the first year of adoptive parenthood. On average, all new parents experienced declines in their relationship quality across the first year of parenthood, regardless of sexual orientation, with women experiencing steeper declines in love. Parents who, pre-adoption, reported higher levels of depression, greater use of avoidant coping, lower levels of relationship maintenance behaviors, and less satisfaction with their adoption agencies reported lower relationship quality at the time of the adoption. The effect of avoidant coping on relationship quality varied by gender. Parents who, pre-adoption, reported higher levels of depression, greater use of confrontative coping, and higher levels of relationship maintenance behaviors reported greater declines in relationship quality. These findings have implications for professionals who work with adoptive parents both pre- and post-adoption. PMID:20545395

  17. Adoption of Clinical Decision Support in Multimorbidity: A Systematic Review

    PubMed Central

    Arguello Casteleiro, Mercedes; Ainsworth, John; Buchan, Iain

    2015-01-01

    Background Patients with multiple conditions have complex needs and are increasing in number as populations age. This multimorbidity is one of the greatest challenges facing health care. Having more than 1 condition generates (1) interactions between pathologies, (2) duplication of tests, (3) difficulties in adhering to often conflicting clinical practice guidelines, (4) obstacles in the continuity of care, (5) confusing self-management information, and (6) medication errors. In this context, clinical decision support (CDS) systems need to be able to handle realistic complexity and minimize iatrogenic risks. Objective The aim of this review was to identify to what extent CDS is adopted in multimorbidity. Methods This review followed PRISMA guidance and adopted a multidisciplinary approach. Scopus and PubMed searches were performed by combining terms from 3 different thesauri containing synonyms for (1) multimorbidity and comorbidity, (2) polypharmacy, and (3) CDS. The relevant articles were identified by examining the titles and abstracts. The full text of selected/relevant articles was analyzed in-depth. For articles appropriate for this review, data were collected on clinical tasks, diseases, decision maker, methods, data input context, user interface considerations, and evaluation of effectiveness. Results A total of 50 articles were selected for the full in-depth analysis and 20 studies were included in the final review. Medication (n=10) and clinical guidance (n=8) were the predominant clinical tasks. Four studies focused on merging concurrent clinical practice guidelines. A total of 17 articles reported their CDS systems were knowledge-based. Most articles reviewed considered patients’ clinical records (n=19), clinical practice guidelines (n=12), and clinicians’ knowledge (n=10) as contextual input data. The most frequent diseases mentioned were cardiovascular (n=9) and diabetes mellitus (n=5). In all, 12 articles mentioned generalist doctor(s) as the

  18. Experiences of school bullying among internationally adopted children: results from the Finnish Adoption (FINADO) Study.

    PubMed

    Raaska, Hanna; Lapinleimu, Helena; Sinkkonen, Jari; Salmivalli, Christina; Matomäki, Jaakko; Mäkipää, Sanna; Elovainio, Marko

    2012-08-01

    This study investigated the prevalence of and factors associated with school bullying and victimization among Finnish international adoptees. The Olweus bully/victim questionnaire was sent to all 9-15-year-old children adopted in Finland between 1985 and 2007 through the mediating organizations officially approved by the Ministry of Social Affairs and Health. The children were identified through official adoption organizations. The response rate in the target sample was 49.4%: the study sample consisted of 364 children (190 girls, 52.2%). The children's background factors and symptoms of reactive attachment disorder (RAD) were evaluated using a FINADO questionnaire. Their learning difficulties and social and language skills were assessed using a standardized parental questionnaire (Five to Fifteen). Of the participants, 19.8% reported victimization by peers while 8% had bullied others. Both victimization and bullying were associated with severe symptoms of RAD at the time of adoption (RR 2.68, 95%CI 1.50-4.77 and RR 2.08, 95%CI 1.17-3.69 for victimization and bullying, respectively). Lack of social skills was associated with victimization (RR 1.74, 95%CI 1.06-2.85) but not independently with being a bully (RR 1.50, 95%CI 0.91-2.45). In a multivariate analysis the child's learning difficulties and language difficulties were not associated with either bullying others or victimization.

  19. Adoption in rock and white-tailed ptarmigan

    USGS Publications Warehouse

    Wong, M.M.L.; Fedy, B.C.; Wilson, S.; Martin, K.M.

    2009-01-01

    Reports of adoption in birds are widespread, but few studies report rates of adoption or possible mechanisms for this phenomenon, particularly in the Order Galliformes. We report incidents of adoption in Rock Ptarmigan (Lagopus muta) and White-tailed Ptarmigan (L. leucura) from two sites in western Canada. Adoption rates for White-tailed Ptarmigan on Vancouver Island, British Columbia, and the Ruby Ranges, Yukon Territory were 13% (n = 16 broods) and 4% (n = 27), respectively, while rates for Rock Ptarmigan were 14% (n = 29) in the Ruby Ranges. Low brood densities may result in lower rates of adoption for ptarmigan. ?? 2009 The Wilson Ornithological Society.

  20. Awareness, persuasion, and adoption: Enriching the Bass model

    NASA Astrophysics Data System (ADS)

    Colapinto, Cinzia; Sartori, Elena; Tolotti, Marco

    2014-02-01

    In the context of diffusion of innovations, we propose a probabilistic model based on interacting populations connected through new communication channels. The potential adopters are heterogeneous in the connectivity levels and in their taste for innovation. The proposed framework can model the different stages of the adoption dynamics. In particular, the adoption curve is the result of a micro-founded decision process following the awareness phase. Eventually, we recover stylized facts pointed out by the extant literature in the field, such as delayed adoptions and non-monotonic adoption curves.

  1. Remote sensing to monitor cover crop adoption in southeastern Pennsylvania

    USGS Publications Warehouse

    Hively, Wells; Sjoerd Duiker,; Greg McCarty,; Prabhakara, Kusuma

    2015-01-01

    In the Chesapeake Bay Watershed, winter cereal cover crops are often planted in rotation with summer crops to reduce the loss of nutrients and sediment from agricultural systems. Cover crops can also improve soil health, control weeds and pests, supplement forage needs, and support resilient cropping systems. In southeastern Pennsylvania, cover crops can be successfully established following corn (Zea mays L.) silage harvest and are strongly promoted for use in this niche. They are also planted following corn grain, soybean (Glycine max L.), and vegetable harvest. In Pennsylvania, the use of winter cover crops for agricultural conservation has been supported through a combination of outreach, regulation, and incentives. On-farm implementation is thought to be increasing, but the actual extent of cover crops is not well quantified. Satellite imagery can be used to map green winter cover crop vegetation on agricultural fields and, when integrated with additional remote sensing data products, can be used to evaluate wintertime vegetative groundcover following specific summer crops. This study used Landsat and SPOT (System Probatoire d’ Observation de la Terre) satellite imagery, in combination with the USDA National Agricultural Statistics Service Cropland Data Layer, to evaluate the extent and amount of green wintertime vegetation on agricultural fields in four Pennsylvania counties (Berks, Lebanon, Lancaster, and York) from 2010 to 2013. In December of 2010, a windshield survey was conducted to collect baseline data on winter cover crop implementation, with particular focus on identifying corn harvested for silage (expected earlier harvest date and lower levels of crop residue), versus for grain (expected later harvest date and higher levels of crop residue). Satellite spectral indices were successfully used to detect both the amount of green vegetative groundcover and the amount of crop residue on the surveyed fields. Analysis of wintertime satellite imagery

  2. Combination Vaccines

    PubMed Central

    Skibinski, David AG; Baudner, Barbara C; Singh, Manmohan; O’Hagan, Derek T

    2011-01-01

    The combination of diphtheria, tetanus, and pertussis vaccines into a single product has been central to the protection of the pediatric population over the past 50 years. The addition of inactivated polio, Haemophilus influenzae, and hepatitis B vaccines into the combination has facilitated the introduction of these vaccines into recommended immunization schedules by reducing the number of injections required and has therefore increased immunization compliance. However, the development of these combinations encountered numerous challenges, including the reduced response to Haemophilus influenzae vaccine when given in combination; the need to consolidate the differences in the immunization schedule (hepatitis B); and the need to improve the safety profile of the diphtheria, tetanus, and pertussis combination. Here, we review these challenges and also discuss future prospects for combination vaccines. PMID:21572611

  3. Power combiner

    SciTech Connect

    Arnold, Mobius; Ives, Robert Lawrence

    2006-09-05

    A power combiner for the combining of symmetric and asymmetric traveling wave energy comprises a feed waveguide having an input port and a launching port, a reflector for reflecting launched wave energy, and a final waveguide for the collection and transport of launched wave energy. The power combiner has a launching port for symmetrical waves which comprises a cylindrical section coaxial to the feed waveguide, and a launching port for asymmetric waves which comprises a sawtooth rotated about a central axis.

  4. [Adoptive immunotherapy with interleukin 2 in oncology].

    PubMed

    Favrot, M; Bouffet, E; Négrier, S; Combaret, V; Philip, I; Philip, T

    1990-01-01

    Forty-seven patients with renal carcinoma were included in first line or rescue protocols of immunotherapy including IL2 alone or in association with LAK cells, INF alpha or TNF. The toxicity was mild and the mortality was 2% (1 patient). The response rate was 26%. Nineteen children with neuroblastoma received IL2 either alone or in combination with LAK cells. The morbidity and mortality were higher in patients with end stage disease who had previously received high dose and prolonged chemotherapy. In contrast, the toxicity was mild and transient in patients treated in the months following autologous bone marrow transplantation. The only complete response observed was in 1 child treated with IL2, 4 months after high dose chemotherapy and ABMT. Immunological analysis showed that the immunomodulatory effect of IL2 is very different depending on whether IL2 is used alone or in combination with other cytokines; moreover, the biological effect of IL2 is dependent on the immunological status of the patients prior to IL2 therapy.

  5. Declining Efficacy of Artemisinin Combination Therapy Against P. Falciparum Malaria on the Thai–Myanmar Border (2003–2013): The Role of Parasite Genetic Factors

    PubMed Central

    Phyo, Aung Pyae; Ashley, Elizabeth A.; Anderson, Tim J. C.; Bozdech, Zbynek; Carrara, Verena I.; Sriprawat, Kanlaya; Nair, Shalini; White, Marina McDew; Dziekan, Jerzy; Ling, Clare; Proux, Stephane; Konghahong, Kamonchanok; Jeeyapant, Atthanee; Woodrow, Charles J.; Imwong, Mallika; McGready, Rose; Lwin, Khin Maung; Day, Nicholas P. J.; White, Nicholas J.; Nosten, Francois

    2016-01-01

    Background. Deployment of mefloquine–artesunate (MAS3) on the Thailand–Myanmar border has led to a sustained reduction in falciparum malaria, although antimalarial efficacy has declined substantially in recent years. The role of Plasmodium falciparum K13 mutations (a marker of artemisinin resistance) in reducing treatment efficacy remains controversial. Methods. Between 2003 and 2013, we studied the efficacy of MAS3 in 1005 patients with uncomplicated P. falciparum malaria in relation to molecular markers of resistance. Results. Polymerase chain reaction (PCR)–adjusted cure rates declined from 100% in 2003 to 81.1% in 2013 as the proportions of isolates with multiple Pfmdr1 copies doubled from 32.4% to 64.7% and those with K13 mutations increased from 6.7% to 83.4%. K13 mutations conferring moderate artemisinin resistance (notably E252Q) predominated initially but were later overtaken by propeller mutations associated with slower parasite clearance (notably C580Y). Those infected with both multiple Pfmdr1 copy number and a K13 propeller mutation were 14 times more likely to fail treatment. The PCR-adjusted cure rate was 57.8% (95% confidence interval [CI], 45.4, 68.3) compared with 97.8% (95% CI, 93.3, 99.3) in patients with K13 wild type and Pfmdr1 single copy. K13 propeller mutation alone was a strong risk factor for recrudescence (P = .009). The combined population attributable fraction of recrudescence associated with K13 mutation and Pfmdr1 amplification was 82%. Conclusions. The increasing prevalence of K13 mutations was the decisive factor for the recent and rapid decline in efficacy of artemisinin-based combination (MAS3) on the Thailand–Myanmar border. PMID:27313266

  6. Adoption in Eastern Grey Kangaroos: A Consequence of Misdirected Care?

    PubMed Central

    King, Wendy J.; Forsyth, David M.; Coulson, Graeme; Festa-Bianchet, Marco

    2015-01-01

    Adoption is rare in animals and is usually attributed to kin selection. In a 6-year study of eastern grey kangaroos (Macropus giganteus), 11 of 326 juveniles were adopted. We detected eight adoptions by observing behavioural associations and nursing between marked mothers and young and three more by analysing the relatedness of mothers and young using microsatellite DNA. Four adoptions involved reciprocal switches and three were by mothers whose own pouch young were known to subsequently disappear. Adoptive mothers were not closely related to each other or to adoptees but adoptive mothers and young associated as closely as did biological pairs, as measured by half-weight indices. Switch mothers did not associate closely. Maternal age and body condition did not influence the likelihood of adoption but females were more likely to adopt in years with high densities of females with large pouch young. Adoption did not improve juvenile survival. We conclude that adoptions in this wild population were potentially costly and likely caused by misdirected care, suggesting that eastern grey kangaroos may have poorly developed mother-offspring recognition mechanisms. PMID:25970624

  7. Adoption in eastern grey kangaroos: a consequence of misdirected care?

    PubMed

    King, Wendy J; Forsyth, David M; Coulson, Graeme; Festa-Bianchet, Marco

    2015-01-01

    Adoption is rare in animals and is usually attributed to kin selection. In a 6-year study of eastern grey kangaroos (Macropus giganteus), 11 of 326 juveniles were adopted. We detected eight adoptions by observing behavioural associations and nursing between marked mothers and young and three more by analysing the relatedness of mothers and young using microsatellite DNA. Four adoptions involved reciprocal switches and three were by mothers whose own pouch young were known to subsequently disappear. Adoptive mothers were not closely related to each other or to adoptees but adoptive mothers and young associated as closely as did biological pairs, as measured by half-weight indices. Switch mothers did not associate closely. Maternal age and body condition did not influence the likelihood of adoption but females were more likely to adopt in years with high densities of females with large pouch young. Adoption did not improve juvenile survival. We conclude that adoptions in this wild population were potentially costly and likely caused by misdirected care, suggesting that eastern grey kangaroos may have poorly developed mother-offspring recognition mechanisms.

  8. Assessing access for prospective adoptive parents living with HIV: an environmental scan of Ontario’s adoption agencies

    PubMed Central

    Underhill, Angela A.; Kennedy, V. Logan; Lewis, Johanna; Ross, Lori E.; Loutfy, Mona

    2016-01-01

    ABSTRACT Work has been underway to increase the availability of parenting options for people living with and affected by HIV. One option, adoption, has not yet been explored in the literature. The study aimed to gain a better understanding of the potential of adoption for individuals/couples living with HIV in Ontario, and to assess potential structural barriers or facilitators that may impact their experience navigating the adoption system by conducting an environmental scan of adoption service providers in Ontario. A list of adoption service providers was compiled using the Ontario government’s website. Information relevant to the study’s measures was collected using service providers’ websites. Service providers without websites, or with websites that did not address all of the research measures, were contacted via telephone to complete a structured interview. Online data extraction was possible for 2 and telephone surveys were completed with 75 adoption service providers (total n = 77). Most service providers reported that HIV status is not an exclusion criterion for prospective parents (64%). However, more than one-fifth of the participants acknowledged they were not sure if people with HIV were eligible to adopt. Domestic service providers were the only providers who did not report knowledge of restrictions due to HIV status. Private domestic adoption presented social barriers as birth parent(s) of a child can access health records of a prospective parent and base their selection of an adoptive parent based on health status. Adoption practitioners and licensees involved in international adoptions reported the most structural barriers for prospective parent(s) living with HIV, attributed to the regulations established by the host country of the child(ren) eligible for adoption. Although international adoptions may present insurmountable barriers for individuals living with HIV, public and private domestic adoption appears to be a viable option. PMID

  9. Attitude, interest, and motivation for adoption and foster care.

    PubMed

    Tyebjee, Tyzoon

    2003-01-01

    This survey compares prospective foster and adoptive parents' attitudes, willingness, and motivations, and discusses implications for media campaigns. The results show that demographic profiles of targets for adoption and foster placements are the same, an opportunity exists to shape positive attitudes toward foster care in immigrant populations, the most compelling way to attract parents is to focus on the child in need, and testimonials of personal experiences of foster and adoptive parents should address perceived barriers to adopting or fostering. Political, religious, and environmental ideology were unrelated to attitudes or willingness to adopt or foster. Respondents with strong identifications with gay or lesbian lifestyles exhibited a higher than average willingness to adopt or foster.

  10. Attitudes of European farmers towards GM crop adoption.

    PubMed

    Areal, Francisco J; Riesgo, Laura; Rodríguez-Cerezo, Emilio

    2011-12-01

    This article analyses European Union (EU) farmers' attitudes towards adoption of genetically modified crops by identifying and classifying groups of farmers. Cluster analysis provided two groups of farmers allowing us to classify farmers into potential adopters or rejecters of genetically modified herbicide-tolerant (GMHT) crops. Results showed that economic issues such as the guarantee of a higher income and the reduction of weed control costs are the most encouraging reasons for potential adopters and rejecters of GMHT crops. This article also examines how putting in place measures to ensure coexistence between GM and non-GM crops may influence farmers' attitudes towards GMHT crop adoption. Results show that the implementation of a coexistence policy would have a negative impact on farmers' attitudes on adoption and consequently may hamper GMHT adoption in the EU. PMID:21923717

  11. The Effect of Family Communication Patterns on Adopted Adolescent Adjustment

    PubMed Central

    Rueter, Martha A.

    2008-01-01

    Adoption and family communication both affect adolescent adjustment. We proposed that adoption status and family communication interact such that adopted adolescents in families with certain communication patterns are at greater risk for adjustment problems. We tested this hypothesis using a community-based sample of 384 adoptive and 208 nonadoptive families. Adolescents in these families were, on average, 16 years of age. The results supported our hypothesis. Adopted adolescents were at significantly greater risk for adjustment problems compared to nonadopted adolescents in families that emphasized conformity orientation without conversation orientation and in families that emphasized neither conformity nor conversation orientation. Adolescents in families emphasizing conversation orientation were at lower risk for adjustment problems, regardless of adoption status. PMID:19649145

  12. Bacterial flagellar capping proteins adopt diverse oligomeric states

    PubMed Central

    Postel, Sandra; Deredge, Daniel; Bonsor, Daniel A; Yu, Xiong; Diederichs, Kay; Helmsing, Saskia; Vromen, Aviv; Friedler, Assaf; Hust, Michael; Egelman, Edward H; Beckett, Dorothy; Wintrode, Patrick L; Sundberg, Eric J

    2016-01-01

    Flagella are crucial for bacterial motility and pathogenesis. The flagellar capping protein (FliD) regulates filament assembly by chaperoning and sorting flagellin (FliC) proteins after they traverse the hollow filament and exit the growing flagellum tip. In the absence of FliD, flagella are not formed, resulting in impaired motility and infectivity. Here, we report the 2.2 Å resolution X-ray crystal structure of FliD from Pseudomonas aeruginosa, the first high-resolution structure of any FliD protein from any bacterium. Using this evidence in combination with a multitude of biophysical and functional analyses, we find that Pseudomonas FliD exhibits unexpected structural similarity to other flagellar proteins at the domain level, adopts a unique hexameric oligomeric state, and depends on flexible determinants for oligomerization. Considering that the flagellin filaments on which FliD oligomers are affixed vary in protofilament number between bacteria, our results suggest that FliD oligomer stoichiometries vary across bacteria to complement their filament assemblies. DOI: http://dx.doi.org/10.7554/eLife.18857.001 PMID:27664419

  13. Evaluating local policy adoption campaigns in California: Tobacco Retail License (TRL) adoption.

    PubMed

    Satterlund, Travis D; Treiber, Jeanette; Haun, Sue; Cassady, Diana

    2014-06-01

    As part of its state-wide "denormalization" campaign, the California Tobacco Control Program has funded local tobacco control projects to secure tobacco retail licenses (TRLs) in their communities. TRL policies generate funding by requiring tobacco retailers within a jurisdiction to obtain a license, which is in addition to the state license that tobacco retailers are legally required to purchase to sell tobacco products. The funding provided by TRLs enables local law enforcement to carry out inspection and enforcement operations. This paper examines the unique processes by which local project campaigns attempt to get TRL policies adopted in communities across the State of California. Twenty-two local projects submitted final evaluation reports pertaining to the adoption of TRLs, and the reports from these projects form the basis of the analysis. Successful campaigns tended to include the following strategies: (1) determining policy readiness; (2) gathering local data; (3) identifying and working with a "champion"; (4) building relationships with local law enforcement agencies and decision makers; and (5) educating community and decision makers. The major challenges faced by local projects included budget cuts and staffing issues, concern about creating an unfavorable environment for business by imposing more regulations and fees, and complaints about using law enforcement resources for tobacco control in light of more "pressing" public safety issues. These challenges proved difficult for local projects to overcome, and also highlight the need for projects to create and carry out strong but flexible tactical plans that incorporate the aforementioned strategies.

  14. Associations between Discussions of Racial and Ethnic Differences in Internationally Adoptive Families and Delinquent Behavior among Korean Adopted Adolescents

    PubMed Central

    Anderson, Kayla N.; Lee, Richard M.; Rueter, Martha A.; Kim, Oh Myo

    2015-01-01

    Internationally adopted adolescents may have more delinquent behavior than non-adopted adolescents. One explanation is these adolescents experience discrimination and loss of culture, and adoptive parents are not adequately addressing these experiences. However, studies have not examined the effects of family discussions of racial and ethnic differences within adoptive families on adopted adolescents’ delinquent behavior. To test this relationship, this study utilized data from 111 U.S. internationally adoptive families with 185 South Korean adopted adolescents (55% female, M age = 17.75). During an observational assessment, families discussed the importance of their racial and ethnic differences, and adolescents completed a delinquent behavior questionnaire. Analysis of covariance showed differences in adolescent delinquent behavior across three ways adoptive families discussed racial and ethnic differences; adolescents whose families acknowledged differences had the fewest mean delinquent behaviors. There were no significant differences in delinquent behavior between adolescents whose families acknowledged or rejected the importance of racial and ethnic differences. However, adopted adolescents whose families held discrepant views of differences had significantly more problem behavior than adolescents whose families either acknowledged or rejected the importance of racial and ethnic differences. Clinicians, adoption professionals, and other parenting specialists should focus on building cohesive family identities about racial and ethnic differences, as discrepant views of differences are associated with the most adoptee delinquent behavior. PMID:25729119

  15. Assortative mating by unwed biological parents of adopted children.

    PubMed

    Plomin, R; DeFries, J C; Roberts, M K

    1977-04-22

    Analyses of data obtained from 662 unwed couples whose children were relinquished for adoption reveal that biological parents of adopted children mate assortatively. For physical characters, assortative mating of unwed parents was similar to that of wed parents; for behavior characters, however, there was less assortative mating by the unwed parents. Because assortative mating inflates estimates of genetic parameters in adoption studies, future studies should collect information on both biological parents.

  16. Adoption of new drugs by physicians: a survival analysis

    PubMed Central

    2012-01-01

    Background New drugs often substitute others cheaper and with a risk-benefit balance better established. Our aim was to analyse the diffusion of new drugs during the first months of use, examining the differences between family physicians and specialists. Methods Prescription data were obtained of cefditoren, duloxetine, etoricoxib, ezetimibe, levocetirizine, olmesartan, pregabalin and tiotropium 36 months after their launching. We obtained the monthly number of prescriptions per doctor and the number prescribers of each drug by specialty. After discarding those with less than 10 prescriptions during this period, physicians were defined as adopters if the number of prescriptions was over the 25th percentile for each drug and level (primary or secondary care). The diffusion of each drug was studied by determining the number of adopter family physicians throughout the study period. Among the group of adopters, we compared the month of the first prescription by family physicians to that of other specialists using the Kaplan-Meier method. Results The adoption of the drugs in primary care follows an exponential diffusion curve that reaches a plateau at month 6 to 23. Tiotropium was the most rapidly and widely adopted drug. Cefditoren spread at a slower rate and was the least adopted. The diffusion of etoricoxib was initially slowed down due to administrative requirements for its prescription. The median time of adoption in the case of family physicians was 4-6 months. For each of the drugs, physicians of a specialty other than family physicians adopted it first. Conclusions The number of adopters of a new drug increases quickly in the first months and reaches a plateau. The number of adopter family physicians varies considerably for different drugs. The adoption of new drugs is faster in specialists. The time of adoption should be considered to promote rational prescribing by providing timely information about new drugs and independent medical education. PMID:22401169

  17. Lesbian and heterosexual preadoptive couples' openness to transracial adoption.

    PubMed

    Goldberg, Abbie E

    2009-01-01

    This study uses data from 147 White preadoptive couples (54 lesbian, 93 heterosexual) to examine adopters' subjective explanations for why they are open or not open to adopting transracially. Participant perceptions of racial-ethnic diversity in their communities and families, perceptions of family support or nonsupport, and attitudes about race were among the factors they cited as influencing their openness. These findings hold important implications for training and service delivery in transracial adoption.

  18. OPIMIZATION OF COMBINED SEWER OVERFLOW CONTROL SYSTEMS

    EPA Science Inventory

    The highly variable and intermittent pollutant concentrations and flowrates associated with wet-weather events in combined sewersheds necessitates the use of storage-treatment systems to control pollution. A strategy should be adopted to develop an optimized combined sewer overfl...

  19. Surrogacy, Compensation, and Legal Parentage: Against the Adoption Model.

    PubMed

    van Zyl, Liezl; Walker, Ruth

    2015-09-01

    Surrogate motherhood is treated as a form of adoption in many countries: the birth mother and her partner are presumed to be the parents of the child, while the intended parents have to adopt the baby once it is born. Other than compensation for expenses related to the pregnancy, payment to surrogates is not permitted. We believe that the failure to compensate surrogate mothers for their labour as well as the significant risks they undertake is both unfair and exploitative. We accept that introducing payment for surrogates would create a significant tension in the adoption model. However, we recommend rejecting the adoption model altogether rather than continuing to prohibit compensation to surrogates.

  20. Innovation Adoption: A Review of Theories and Constructs

    PubMed Central

    Chor, Ka Ho Brian; Hoagwood, Kimberly E.; Horwitz, Sarah M.

    2013-01-01

    Many theoretical frameworks seek to describe the dynamic process of the implementation of innovations. Little is known, however, about factors related to decisions to adopt innovations and how the likelihood of adoption of innovations can be increased. Using a narrative synthesis approach, this paper compared constructs theorized to be related to adoption of innovations proposed in existing theoretical frameworks in order to identify characteristics likely to increase adoption of innovations. The overall goal was to identify elements across adoption frameworks that are potentially modifiable and, thus, might be employed to improve the adoption of evidence-based practices. The review identified 20 theoretical frameworks that could be grouped into two broad categories: theories that mainly address the adoption process (N = 10) and theories that address adoption within the context of implementation, diffusion, dissemination, and/or sustainability (N = 10). Constructs of leadership, operational size and structure, innovation fit with norms and values, and attitudes/motivation toward innovations each are mentioned in at least half of the theories, though there were no consistent definitions of measures for these constructs. A lack of precise definitions and measurement of constructs suggests further work is needed to increase our understanding of adoption of innovations. PMID:23549911

  1. 45 CFR 1356.41 - Nonrecurring expenses of adoption.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) There must be no income eligibility requirement (means test) for adopting parents in determining whether... study, including health and psychological examination, supervision of the placement prior to...

  2. 45 CFR 1356.41 - Nonrecurring expenses of adoption.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) There must be no income eligibility requirement (means test) for adopting parents in determining whether... study, including health and psychological examination, supervision of the placement prior to...

  3. Interorganizational Systems Adoption: A Socio-Technical Perspective

    NASA Astrophysics Data System (ADS)

    Bunker, Deborah; Kautz, Karlheinz; Pyne, Clayton

    This paper discusses a case study of an electronic data interchange (EDI) interorganizational system (IOS) adoption project between two organizations (ProvideCo and BuildCo) highlighting that IOS adoption is not only technological in nature and orientation but that organizational factors also play their part. As a result of the case analysis and key findings, an interorganizational collaboration model (Barratt 2004) is amended to explain and highlight the effect of organizational factors on IOS adoption. The amended model includes the relationship of technology (IOS) adoption to cross-functional collaborative activities and risk, power, opportunism, and trust.

  4. Innovation adoption: a review of theories and constructs.

    PubMed

    Wisdom, Jennifer P; Chor, Ka Ho Brian; Hoagwood, Kimberly E; Horwitz, Sarah M

    2014-07-01

    Many theoretical frameworks seek to describe the dynamic process of the implementation of innovations. Little is known, however, about factors related to decisions to adopt innovations and how the likelihood of adoption of innovations can be increased. Using a narrative synthesis approach, this paper compared constructs theorized to be related to adoption of innovations proposed in existing theoretical frameworks in order to identify characteristics likely to increase adoption of innovations. The overall goal was to identify elements across adoption frameworks that are potentially modifiable and, thus, might be employed to improve the adoption of evidence-based practices. The review identified 20 theoretical frameworks that could be grouped into two broad categories: theories that mainly address the adoption process (N = 10) and theories that address adoption within the context of implementation, diffusion, dissemination, and/or sustainability (N = 10). Constructs of leadership, operational size and structure, innovation fit with norms and values, and attitudes/motivation toward innovations each are mentioned in at least half of the theories, though there were no consistent definitions of measures for these constructs. A lack of precise definitions and measurement of constructs suggests further work is needed to increase our understanding of adoption of innovations.

  5. Adopting kin enhances inclusive fitness in asocial red squirrels.

    PubMed

    Gorrell, Jamieson C; McAdam, Andrew G; Coltman, David W; Humphries, Murray M; Boutin, Stan

    2010-01-01

    Orphaned animals benefit from being adopted, but it is unclear why an adopting parent should incur the costs of rearing extra young. Such altruistic parental behaviour could be favoured if it is directed towards kin and the inclusive benefits of adoption exceed the costs. Here, we report the occurrence of adoption (five occurrences among 2,230 litters over 19 years) in asocial red squirrels (Tamiasciurus hudsonicus). Adoptions were always between kin, while orphans without nearby kin were never adopted. Adoptions were confined exclusively to circumstances in which the benefits to the adopted juvenile (b), discounted by the degree of relatedness between the surrogate and the orphan (r), exceeded the fitness costs of adding an extra juvenile to her litter (c), as predicted by Hamilton's rule (rb>c) for the evolution of altruism. By focusing on adoption in an asocial species, our study provides a clear test of Hamilton's rule that explains the persistence of occasional altruism in a natural mammal population. PMID:20975694

  6. Adoption policy and evidence-based domestic adoption practice: a comparison of Romania, Ukraine, India, Guatemala, and Ethiopia.

    PubMed

    Groza, Victor; Bunkers, Kelley M

    2014-01-01

    The United Nations Convention on the Rights of the Child (1989), The Hague Convention on the Protection of Children and Co-operation in Respect of Intercountry Adoption (The Hague Permanent Bureau, 1993), and the Guidelines for the Alternative Care of Children (2009) have provided a comprehensive, rights-based framework and guidance for developing domestic adoption and alternative, family based care programs. Domestic adoption is a critical component of any child-protection system and a core part of the range of alternative care options that the United Nations and other international organizations recommend be developed, resourced, and made accessible to children without parental care. This article uses data collected from adoptive parents' postadoption and governmental data in Romania, Ukraine, India, Guatemala, and Ethiopia to focus on domestic adoption in each of these countries. The article highlights both promising practices in domestic adoption as well as policies and practices that require additional research.

  7. Why farmers adopt best management practice in the United States: A meta-analysis of the adoption literature

    USGS Publications Warehouse

    Baumgart-Getz, Adam; Stalker Prokopy, Linda; Floress, Kristin

    2012-01-01

    This meta-analysis of both published and unpublished studies assesses factors believed to influence adoption of agricultural Best Management Practices in the United States. Using an established statistical technique to summarize the adoption literature in the United States, we identified the following variables as having the largest impact on adoption: access to and quality of information, financial capacity, and being connected to agency or local networks of farmers or watershed groups. This study shows that various approaches to data collection affect the results and comparability of adoption studies. In particular, environmental awareness and farmer attitudes have been inconsistently used and measured across the literature. This meta-analysis concludes with suggestions regarding the future direction of adoption studies, along with guidelines for how data should be presented to enhance the adoption of conservation practices and guide research.

  8. The clinical adoption meta-model: a temporal meta-model describing the clinical adoption of health information systems.

    PubMed

    Price, Morgan; Lau, Francis

    2014-01-01

    Health information systems (HISs) hold the promise to transform health care; however, their adoption is challenged. We have developed the Clinical Adoption Meta-Model (CAMM) to help describe processes and possible challenges with clinical adoption. The CAMM, developed through an action research study to evaluate a provincial HIS, is a temporal model with four dimensions: availability, use, behaviour changes, and outcome changes. Seven CAMM archetypes are described, illustrating classic trajectories of adoption of HISs over time. Each archetype includes an example from the literature. The CAMM and its archetypes can support HIS implementers, evaluators, learners, and researchers. PMID:24884588

  9. Speed of Dog Adoption: Impact of Online Photo Traits.

    PubMed

    Lampe, Rachel; Witte, Thomas H

    2015-01-01

    The Internet has radically changed how dogs are advertised for adoption in the United States. This study was used to investigate how different characteristics in dogs' photos presented online affected the speed of their adoptions, as a proof of concept to encourage more research in this field. The study analyzed the 1st images of 468 adopted young and adult black dogs identified as Labrador Retriever mixed breeds across the United States. A subjective global measure of photo quality had the largest impact on time to adoption. Other photo traits that positively impacted adoption speed included direct canine eye contact with the camera, the dog standing up, the photo being appropriately sized, an outdoor photo location, and a nonblurry image. Photos taken in a cage, dogs wearing a bandana, dogs having a visible tongue, and some other traits had no effect on how fast the dogs were adopted. Improving the quality of online photos of dogs presented for adoption may speed up and possibly increase the number of adoptions, thereby providing a cheap and easy way to help fight the homeless companion animal population problem. PMID:25495493

  10. The Role of Perceptions in Instructional Development and Adoption.

    ERIC Educational Resources Information Center

    Surry, Daniel W.; Gustafson, Kent L.

    The roles of perceptions in instructional development and adoption processes were studied with regard to the attributes of three computer-based learning modules designed for use in weather-forecasting agencies as on-site training for forecasters. Twenty-nine forecasters were the potential adoption group studied as intended end-users. Seven…

  11. "School Adopts an Experiment": The Magnetic Levitation of Superconductors

    ERIC Educational Resources Information Center

    Gallitto, Aurelio Agliolo

    2010-01-01

    The event "School adopts an experiment" is an event targeted at high schools and secondary schools. It is based on a tight and direct collaboration between researchers and school students and teachers. Several schools were involved in the event by "adopting" an experiment in physics research laboratories. Groups of selected students were first…

  12. Speed of Dog Adoption: Impact of Online Photo Traits.

    PubMed

    Lampe, Rachel; Witte, Thomas H

    2015-01-01

    The Internet has radically changed how dogs are advertised for adoption in the United States. This study was used to investigate how different characteristics in dogs' photos presented online affected the speed of their adoptions, as a proof of concept to encourage more research in this field. The study analyzed the 1st images of 468 adopted young and adult black dogs identified as Labrador Retriever mixed breeds across the United States. A subjective global measure of photo quality had the largest impact on time to adoption. Other photo traits that positively impacted adoption speed included direct canine eye contact with the camera, the dog standing up, the photo being appropriately sized, an outdoor photo location, and a nonblurry image. Photos taken in a cage, dogs wearing a bandana, dogs having a visible tongue, and some other traits had no effect on how fast the dogs were adopted. Improving the quality of online photos of dogs presented for adoption may speed up and possibly increase the number of adoptions, thereby providing a cheap and easy way to help fight the homeless companion animal population problem.

  13. Children's Recovery after Early Adversity: Lessons from Intercountry Adoption

    ERIC Educational Resources Information Center

    Greene, Sheila; Kelly, Ruth; Nixon, Elizabeth; Kelly, Greg; Borska, Zofia; Murphy, Sile; Daly, Aoife

    2008-01-01

    Research on children who have been internationally adopted provides many strong examples of resilience. This paper discusses what counts as resilience in intercountry adoption and includes new data from the first study in this area conducted in Ireland. As with studies conducted in other jurisdictions, the Irish data indicate a remarkable capacity…

  14. Developing a Broadband Adoption Model in the UK Context

    NASA Astrophysics Data System (ADS)

    Dwivedi, Yogesh K.; Mustafee, Navonil; Williams, Michael D.; Lal, Banita

    This research examines the factors affecting the consumer adoption of broadband in the United Kingdom. A conceptual model of broadband adoption was developed by selecting and justifying a number of relevant constructs from the technology adoption literature. The model was then empirically tested by employing survey data that was randomly collected from 358 UK broadband consumers. The findings suggest that, with the exception of one construct that was included in the conceptual model (namely, knowledge), all of the con structs significantly influence consumers when adopting broadband in a UK household. The significant constructs include relative advantage, utilitarian outcomes, hedonic outcomes, primary influence, facilitating conditions resources, and self-efficacy. Furthermore, when considering the behavioral intention and facilitating conditions resources constructs together, they significantly explain UK broad band adoption behavior. The theoretical contri bution of this research is that it determines and integrates the appropriate constructs from the technology adoption literature in order to enhance the knowledge of technology adoption from the consumer's perspective. This research has implications for policy makers and broadband providers since the results of this study can be exploited by the aforementioned stakeholders in order to encourage and promote the adoption and usage of broadband among the general population.

  15. 23 CFR 1210.4 - Adoption of zero tolerance law.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 23 Highways 1 2012-04-01 2012-04-01 false Adoption of zero tolerance law. 1210.4 Section 1210.4 Highways NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION AND FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION GUIDELINES OPERATION OF MOTOR VEHICLES BY INTOXICATED MINORS § 1210.4 Adoption of zero...

  16. 50 CFR 100.18 - Regulation adoption process.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... accepted by the Secretary of the Interior in accordance with 43 CFR part 14. ... 50 Wildlife and Fisheries 9 2014-10-01 2014-10-01 false Regulation adoption process. 100.18... Structure § 100.18 Regulation adoption process. (a) The Board will accept proposals for changes to...

  17. 34 CFR 300.151 - Adoption of State complaint procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Adoption of State complaint procedures. 300.151 Section 300.151 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF... EDUCATION OF CHILDREN WITH DISABILITIES State Eligibility State Complaint Procedures § 300.151 Adoption...

  18. 23 CFR 1210.4 - Adoption of zero tolerance law.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Adoption of zero tolerance law. 1210.4 Section 1210.4 Highways NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION AND FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION GUIDELINES OPERATION OF MOTOR VEHICLES BY INTOXICATED MINORS § 1210.4 Adoption of zero...

  19. 45 CFR 605.0 - Adoption of HHS regulations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Provisions § 605.0 Adoption of HHS regulations. The regulations of the Department of Health and Human Services on Nondiscrimination on the Basis of Handicap, 45 CFR part 84, including any amendments thereto... 45 Public Welfare 3 2013-10-01 2013-10-01 false Adoption of HHS regulations. 605.0 Section...

  20. 50 CFR 100.18 - Regulation adoption process.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... accepted by the Secretary of the Interior in accordance with 43 CFR part 14. ... 50 Wildlife and Fisheries 8 2011-10-01 2011-10-01 false Regulation adoption process. 100.18... Structure § 100.18 Regulation adoption process. (a) The Board will accept proposals for changes to...