Ifosfamide: chemotherapy with new promise and new problems for the urologist.

PubMed

Watson, R A

1984-11-01

Ifosfamide, a chemotherapeutic agent, offers new hope as well as new problems for the uro-oncologist. The "good news" is that this drug is achieving marked benefits in treating resistant testis tumors and may even hold hope for patients with renal cell carcinoma. The "bad news" is that a price must be paid in toxicity--predominantly a severe and restrictive hemorrhagic cystitis. A breakthrough is the finding that oral administration of acetylcysteine (Mucomyst) may, to a large extent, prevent this untoward side effect.

Long term unemployment, income, poverty, and social public expenditure, and their relationship with self-perceived health in Spain (2007-2011).

PubMed

López Del Amo González, M Puerto; Benítez, Vivian; Martín-Martín, José J

2018-01-15

There is scant research that simultaneously analyzes the joint effects of long-term unemployment, poverty and public expenditure policies on poorer self-perceived health during the financial crisis. The aim of the study is to analyze the joint relationship between long-term unemployment, social deprivation, and regional social public expenditure on one side, and self-perceived health in Spain (2007-2011) on the other. Longitudinal data were extracted from the Survey on Living Conditions, 2007-2010 and 2008-2011 (9105 individuals and 36,420 observations), which were then used to estimate several random group effects in the constant multilevel logistic longitudinal models (level 1: year; level 2: individual; level 3: region). The dependent variable was self-perceived health. Individual independent interest variables were long and very long term unemployment, available income, severe material deprivation and regional variables were per capita expenditure on essential public services and per capita health care expenditure. All of the estimated models show a robust association between bad perceived health and the variables of interest. When compared to employed individuals, long term unemployment increases the odds of reporting bad health by 22% to 67%; very long-term unemployment (24 to 48 months) increases the odds by 54% to 132%. Family income reduces the odds of reporting bad health by 16% to 28% for each additional percentage point in income. Being a member of a household with severe material deprivation increases the odds of perceiving one's health as bad by between 70% and 140%. Regionally, per capita expenditure on essential public services increases the odds of reporting good health, although the effect of this association was limited. Long and very long term unemployment, available income and poverty were associated to self-perceived bad health in Spain during the financial crisis. Regional expenditure on fundamental public services is also associated to poor self-perceived health, although in a more limited fashion. Results suggest the positive role in health of active employment and redistributing income policies.

Intravenous flurbiprofen axetil can increase analgesic effect in refractory cancer pain

PubMed Central

Wu, Hongyang; Chen, Zhendong; Sun, Guoping; Gu, Kangsheng; Pan, Yueyin; Hao, Jiqing; Du, Yingying; Ning, Jie

2009-01-01

Background The aim of this study was to investigate the analgesic effects of intravenous flurbiprofen axetil for the refractory pain in cancer patients. Methods 2109 patients were screened from the department of medical oncology, the first affiliated hospital of Anhui medical university in China between October of 2007 and October of 2008. Thirty-seven cases of cancer patients who had bad effect from anaesthetic drugs were received administration of intravenous flurbiprofen axetil with dose of 50 mg/5 ml/day. The pain score was evaluated for pre- and post- treatment by Pain Faces Scale criteria, and the side effects were also observed. Results Intravenous flurbiprofen axetil increased the analgesic effects. The total effective rate was 92%. The side effects, such as abdominal pain, alimentary tract bleeding which were found in using NSAIDs or constipation, nausea, vomit, sleepiness which were found in using opioid drugs did not be found. Conclusion Intravenous flurbiprofen axetil could provide better analgesia effects and few side effects to patients with refractory cancer pain. It could also increase analgesia effects when combining with anesthetic drugs in treatment of moderate or severe pain, especially breakthrough pain, and suit to patients who can not take oral drugs for the reason of constipation and psychosomatic symptoms. PMID:19267934

Planar triode pulser socket

DOEpatents

Booth, Rex

1994-01-01

A planar triode is mounted in a PC board orifice by means of a U-shaped capacitor housing and anode contact yoke removably attached to cathode leg extensions passing through and soldered to the cathode side of the PC board by means of a PC cathode pad. A pliant/flexible contact attached to the orifice make triode grid contact with a grid pad on the grid side of the PC board, permitting quick and easy replacement of bad triodes.

Antipsychotics and physical attractiveness.

PubMed

Seeman, Mary V

2011-10-01

Antipsychotics are effective in treating the symptoms of schizophrenia, but they may induce adverse effects, some of which-those that impact negatively on physical appearance-have not been sufficiently discussed in the psychiatric literature. Through a narrative review, to catalog antipsychotic side effects that interfere with physical attractiveness and to suggest ways of addressing them. PubMed databases were searched for information on the association between "antipsychotic side effects" and "attractiveness" using those two search phrases plus the following terms: "weight," "teeth," "skin," "hair," "eyes," "gait," "voice," "odor." Data from relevant qualitative and quantitative articles were considered, contextualized, and summarized. Antipsychotics, as a group, increase weight and may lead to dry mouth and bad breath, cataracts, hirsutism, acne, and voice changes; they may disturb symmetry of gait and heighten the risk for tics and spasms and incontinence, potentially undermining a person's attractiveness. Clinicians need to be aware of the impact of therapeutic drugs on appearance and how important this issue is to patients. Early in treatment, they need to plan preventive and therapeutic strategies.

Planar triode pulser socket

DOEpatents

Booth, R.

1994-10-25

A planar triode is mounted in a PC board orifice by means of a U-shaped capacitor housing and anode contact yoke removably attached to cathode leg extensions passing through and soldered to the cathode side of the PC board by means of a PC cathode pad. A pliant/flexible contact attached to the orifice make triode grid contact with a grid pad on the grid side of the PC board, permitting quick and easy replacement of bad triodes. 14 figs.

[Construction of BAD Lentivirus Vector and Its Effect on Proliferation in A549 Cell Lines].

PubMed

Huang, Na; He, Yan-qi; Zhu, Jing; Li, Wei-min

2015-05-01

To construct the recombinant lentivirus expressing vector BAD (Bcl-2-associated death protein) gene and to study its effect on A549 cell proliferation. The BAD gene was amplified from plasmid pAV-MCMV-BAD-GFP by PCR. The purified BAD gene fragment was inserted into a lentivirus vector (pLVX-IRES-ZsGreen 1), and the insertion was identified by PCR, restriction endonuclease analysis and DNA sequencing. A549 cells were then transfected with the packaged recombinant lentivirus, and resistant cell clones were selected with flow cytometry. The expression of BAD in A549 cell lines stably transduction with a lentivirus was examined using Western blot. The effect of BAD overexpression on proliferation of A549 cells was evaluated by using CCK-8 kit. Restriction enzyme digestion and DNA sequencing showed that the full-length BAD gene (507 bp) had been successfully subcloned into the lentiviral vector to result in the recombinant vector pLVX-IRES-ZsGreen 1. Monoclonal cell lines BAD-A549 was produced after transfection with the recombinant lentivirus and selected with flow cytometry. Stable expression of BAD protein was verified by Western blot. In vitro, the OD value in BAD group was significantly lower than that of control groups from 120-144 h (P<0. 05). A549 cell lines stably transduced with a lentivirus expressing the BAD gene had been successfully generated. In vitro, BAD overexpression significantly inhibited A549 cells proliferation.

Effects of "Good News" and "Bad News" on Newscast Image and Community Image.

ERIC Educational Resources Information Center

Galician, Mary-Lou; Vestre, Norris D.

1987-01-01

Investigates whether the relative amount of bad, neutral, and good news on television has corresponding effects on viewers' image of the community depicted and of the carrying newscast. Concludes that bad news creates a bad image for the community but that good news does not produce a more favorable image than neutral news. (MM)

The Effects of Bad News and Good News on a Newspaper's Image.

ERIC Educational Resources Information Center

Haskins, Jack B.; Miller, M. Mark

1984-01-01

Concludes that whether a newspaper carries mostly good news or mostly bad news affects the image of the paper, with bad news having negative effects and good news having positive effects on readers' perceptions of the newspaper. (FL)

BCL-2 family protein, BAD is down-regulated in breast cancer and inhibits cell invasion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cekanova, Maria, E-mail: mcekanov@utk.edu; Fernando, Romaine I.; Siriwardhana, Nalin

We have previously demonstrated that the anti-apoptotic protein BAD is expressed in normal human breast tissue and shown that BAD inhibits expression of cyclin D1 to delay cell-cycle progression in breast cancer cells. Herein, expression of proteins in breast tissues was studied by immunohistochemistry and results were analyzed statistically to obtain semi-quantitative data. Biochemical and functional changes in BAD-overexpressing MCF7 breast cancer cells were evaluated using PCR, reporter assays, western blotting, ELISA and extracellular matrix invasion assays. Compared to normal tissues, Grade II breast cancers expressed low total/phosphorylated forms of BAD in both cytoplasmic and nuclear compartments. BAD overexpression decreasedmore » the expression of β-catenin, Sp1, and phosphorylation of STATs. BAD inhibited Ras/MEK/ERK and JNK signaling pathways, without affecting the p38 signaling pathway. Expression of the metastasis-related proteins, MMP10, VEGF, SNAIL, CXCR4, E-cadherin and TlMP2 was regulated by BAD with concomitant inhibition of extracellular matrix invasion. Inhibition of BAD by siRNA increased invasion and Akt/p-Akt levels. Clinical data and the results herein suggest that in addition to the effect on apoptosis, BAD conveys anti-metastatic effects and is a valuable prognostic marker in breast cancer. - Highlights: • BAD and p-BAD expressions are decreased in breast cancer compared with normal breast tissue. • BAD impedes breast cancer invasion and migration. • BAD inhibits the EMT and transcription factors that promote cancer cell migration. • Invasion and migration functions of BAD are distinct from the BAD's role in apoptosis.« less

[The lived experience of the women with schizophrenia taking antipsychotic medication].

PubMed

Song, Eun-Ju

2011-06-01

This study was done to identify some natural meaning through the dosage experience of psychoactive drugs in women patients with schizophrenia. The Hermeneutic phenomenology written by van Manen was used. The period for data collection was from November 2009 to January 2010. This study took place in mental health hospitals and mental health centers in two cities in North Jeolla Province. Nine patients with schizophrenia participated. Data collection was done through individual in-depth interview. The seven natural subjects demonstrated by participants from this study were 'Pills forcibly taken like veiled threats', 'A terrible side effect, a side effect rooted slowly', 'Shame which cannot be hidden as a woman', 'A bad medicine took away from motherhood', 'The fate of a wife who can't be equal', 'A struggle for the complete recovery without promise', and 'Participants want the future without medicine'. The results of this study indicate that the urgent need to develop a safe and believable psychoactive drug for woman patients considering the time of menstruation, pregnancy, childbirth, and child raising.

Randomized Controlled Feasibility Trial of Intranasal Ketamine Compared to Intranasal Fentanyl for Analgesia in Children with Suspected Extremity Fractures.

PubMed

Reynolds, Stacy L; Bryant, Kathleen K; Studnek, Jonathan R; Hogg, Melanie; Dunn, Connell; Templin, Megan A; Moore, Charity G; Young, James R; Walker, Katherine Rivera; Runyon, Michael S

2017-12-01

We compared the tolerability and efficacy of intranasal subdissociative ketamine to intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger noninferiority trial that could investigate the potential opioid-sparing effects of intranasal ketamine. This randomized controlled trial compared 1 mg/kg intranasal ketamine to 1.5 μg/kg intranasal fentanyl in children 4 to 17 years old with acute pain from suspected isolated extremity fractures presenting to an urban Level II pediatric trauma center from December 2015 to November 2016. Patients, parents, treating physicians, and outcome assessors were blinded to group allocation. The primary outcome, a tolerability measure, was the frequency of cumulative side effects and adverse events within 60 minutes of drug administration. The secondary outcomes included the difference in mean pain score reduction at 20 minutes, the proportion of patients achieving a clinically significant reduction in pain in 20 minutes, total dose of opioid pain medication in morphine equivalents/kg/hour (excluding study drug) required during the emergency department (ED) stay, and the feasibility of enrolling children presenting to the ED in acute pain into a randomized trial conducted under U.S. regulations. All patients were monitored until 6 hours after their last dose of study drug or until admission to the hospital ward or operating room. Of 629 patients screened, 87 received the study drug and 82 had complete data for the primary outcome (41 patients in each group). The median (interquartile range) age was 8 (6-11) years and 62% were male. Baseline pain scores were similar among patients randomized to receive ketamine (73 ± 26) and fentanyl (69 ± 26; mean difference [95% CI] = 4 [-7 to 15]). The cumulative number of side effects was 2.2 times higher in the ketamine group, but there were no serious adverse events and no patients in either group required intervention. The most common side effects of ketamine were bad taste in the mouth (37; 90.2%), dizziness (30; 73.2%), and sleepiness (19; 46.3%). The most common side effects of fentanyl were sleepiness (15; 36.6%), bad taste in the mouth (9; 22%), and itchy nose (9; 22%). No patients experienced respiratory side effects. At 20 minutes, the mean pain scale score reduction was 44 ± 36 for ketamine and 35 ± 29 for fentanyl (mean difference = 9 [95% CI = -4 to 23]). Procedural sedation with ketamine occurred in 28 ketamine patients (65%) and 25 fentanyl patients (57%) prior to completing the study. Intranasal ketamine was associated with more minor side effects than intranasal fentanyl. Pain relief at 20 minutes was similar between groups. Our data support the feasibility of a larger, noninferiority trial to more rigorously evaluate the safety, efficacy, and potential opioid-sparing benefits of intranasal ketamine analgesia for children with acute pain. © 2017 by the Society for Academic Emergency Medicine.

Plotting Inequalities, Building Resistance

ERIC Educational Resources Information Center

Renner, Adam; Brew, Bridget; Proctor, Crystal

2012-01-01

Media depictions of San Francisco show idyllic images of fog pouring under the Golden Gate Bridge or happy tourists riding cable cars, but rarely the mostly nonwhite neighborhoods of the east side. San Francisco public schools have a bad track record of mimicking this masquerade, with very low numbers of African American and Latina/o students…

BAD and KATP channels regulate neuron excitability and epileptiform activity.

PubMed

Martínez-François, Juan Ramón; Fernández-Agüera, María Carmen; Nathwani, Nidhi; Lahmann, Carolina; Burnham, Veronica L; Danial, Nika N; Yellen, Gary

2018-01-25

Brain metabolism can profoundly influence neuronal excitability. Mice with genetic deletion or alteration of Bad ( B CL-2 a gonist of cell d eath) exhibit altered brain-cell fuel metabolism, accompanied by resistance to acutely induced epileptic seizures; this seizure protection is mediated by ATP-sensitive potassium (K ATP ) channels. Here we investigated the effect of BAD manipulation on K ATP channel activity and excitability in acute brain slices. We found that BAD's influence on neuronal K ATP channels was cell-autonomous and directly affected dentate granule neuron (DGN) excitability. To investigate the role of neuronal K ATP channels in the anticonvulsant effects of BAD, we imaged calcium during picrotoxin-induced epileptiform activity in entorhinal-hippocampal slices. BAD knockout reduced epileptiform activity, and this effect was lost upon knockout or pharmacological inhibition of K ATP channels. Targeted BAD knockout in DGNs alone was sufficient for the antiseizure effect in slices, consistent with a 'dentate gate' function that is reinforced by increased K ATP channel activity. © 2018, Martínez-François et al.

Can culture influence body-specific associations between space and valence?

PubMed

de la Fuente, Juanma; Casasanto, Daniel; Román, Antonio; Santiago, Julio

2015-05-01

People implicitly associate positive ideas with their dominant side of space and negative ideas with their non-dominant side. Right-handers tend to associate "good" with "right" and "bad" with "left," but left-handers associate "bad" with "right" and "good" with "left." Whereas right-handers' implicit associations align with idioms in language and culture that link "good" with "right," left-handers' implicit associations go against them. Can cultural conventions modulate the body-specific association between valence and left-right space? Here, we compared people from Spanish and Moroccan cultures, which differ in the strength of taboos against the use of the left hand, and therefore in their preference for the right. Results showed stronger explicit associations between space and valence in Moroccan participants than in Spaniards, but they did not show any increased tendency for right-handed Moroccans to associate "good" with "right" implicitly. Despite differences in cultural conventions between Spaniards and Moroccans, we find no evidence for a cross-cultural difference in the implicit association between space and valence, which appears to depend on patterns of bodily experience. © 2014 Cognitive Science Society, Inc.

Effect of the environmental pollutant bisphenol A dimethacylate (BAD) on Ca2+ movement and viability in OC2 human oral cancer cells.

PubMed

Chien, Jau-Min; Chou, Chiang-Ting; Lu, Yi-Chau; Lu, Ti; Chi, Chao-Chuan; Tseng, Li-Ling; Liu, Shiuh-Inn; Cheng, Jin-Shiung; Kuo, Chun-Chi; Liang, Wei-Zhe; Jan, Chung-Ren

2013-03-01

The environmental pollutant bisphenol A dimethacylate (BAD) has been used as a dental composite. The effect of BAD on cytosolic Ca(2+) concentrations ([Ca(2+)]i) and viability in OC2 human oral cancer cells was explored. The Ca(2+)-sensitive fluorescent dye fura-2 was applied to measure [Ca(2+)]i. BAD induced [Ca(2+)]i rises in a concentration-dependent manner. The response was reduced by removing extracellular Ca(2+). BAD-evoked Ca(2+) entry was suppressed by nifedipine, econazole, and SK&F96365. In Ca(2+)-free medium, incubation with the endoplasmic reticulum Ca(2+) pump inhibitor thapsigargin abolished BAD-induced [Ca(2+)]i rise. Inhibition of phospholipase C with U73122 did not alter BAD-induced [Ca(2+)]i rise. At 10-30μM, BAD inhibited cell viability, which was not reversed by chelating cytosolic Ca(2+). BAD (20-30μM) also induced apoptosis. Collectively, in OC2 cells, BAD induced a [Ca(2+)]i rise by evoking phospholipase C-independent Ca(2+) release from the endoplasmic reticulum and Ca(2+) entry via store-operated Ca(2+) channels. BAD also caused apoptosis. Copyright © 2012 Elsevier B.V. All rights reserved.

The means/side-effect distinction in moral cognition: A meta-analysis.

PubMed

Feltz, Adam; May, Joshua

2017-09-01

Experimental research suggests that people draw a moral distinction between bad outcomes brought about as a means versus a side effect (or byproduct). Such findings have informed multiple psychological and philosophical debates about moral cognition, including its computational structure, its sensitivity to the famous Doctrine of Double Effect, its reliability, and its status as a universal and innate mental module akin to universal grammar. But some studies have failed to replicate the means/byproduct effect especially in the absence of other factors, such as personal contact. So we aimed to determine how robust the means/byproduct effect is by conducting a meta-analysis of both published and unpublished studies (k=101; 24,058 participants). We found that while there is an overall small difference between moral judgments of means and byproducts (standardized mean difference=0.87, 95% CI 0.67-1.06; standardized mean change=0.57, 95% CI 0.44-0.69; log odds ratio=1.59, 95% CI 1.15-2.02), the mean effect size is primarily moderated by whether the outcome is brought about by personal contact, which typically involves the use of personal force. Copyright © 2017 Elsevier B.V. All rights reserved.

Biochemical and biophysical investigations of the interaction between human glucokinase and pro-apoptotic BAD.

PubMed

Rexford, Alix; Zorio, Diego A R; Miller, Brian G

2017-01-01

The glycolytic enzyme glucokinase (GCK) and the pro-apoptotic protein BAD reportedly reside within a five-membered complex that localizes to the mitochondria of mammalian hepatocytes and pancreatic β-cells. Photochemical crosslinking studies using a synthetic analog of BAD's BH3 domain and in vitro transcription/translation experiments support a direct interaction between BAD and GCK. To investigate the biochemical and biophysical consequences of the BAD:GCK interaction, we developed a method for the production of recombinant human BAD. Consistent with published reports, recombinant BAD displays high affinity for Bcl-xL (KD = 7 nM), and phosphorylation of BAD at S118, within the BH3 domain, abolishes this interaction. Unexpectedly, we do not detect association of recombinant, full-length BAD with recombinant human pancreatic GCK over a range of protein concentrations using various biochemical methods including size-exclusion chromatography, chemical cross-linking, analytical ultracentrifugation, and isothermal titration calorimetry. Furthermore, fluorescence polarization assays and isothermal titration calorimetry detect no direct interaction between GCK and BAD BH3 peptides. Kinetic characterization of GCK in the presence of high concentrations of recombinant BAD show modest (<15%) increases in GCK activity, observable only at glucose concentrations well below the K0.5 value. GCK activity is unaffected by BAD BH3 peptides. These results raise questions as to the mechanism of action of stapled peptide analogs modeled after the BAD BH3 domain, which reportedly enhance the Vmax value of GCK and stimulate insulin release in BAD-deficient islets. Based on our results, we postulate that the BAD:GCK interaction, and any resultant regulatory effect(s) upon GCK activity, requires the participation of additional members of the mitochondrial complex.

The tools of PDT: light sources and devices. Can they help in getting better therapeutic results?

NASA Astrophysics Data System (ADS)

Boucher, Didier

2011-08-01

PDT is a drug and device therapy using photosensitizing drugs activated by laser light, for tissue ablation. PDT light sources must deliver wavelengths matching the absorption of photosensitizers' compound without any side thermal effect. According to applications, these sources need to be: - pled to relatively small optical fibres so as to bring the light energy, of specific wavelength, inside of the body (gastroenterology, head & neck, urology, pneumology), - coupled to a slit lamp adapter to transmit the light to the eye (AMD) - or allow a direct illumination of tissues when large areas must be treated (dermatology). But they also need to be user-friendly with limited investment and installation costs. So as to achieve the required effects, several light sources are available and will be used but practical and economical reasons have limited the number and types of these sources. For PDT oncology applications, besides dermatology, it has also been necessary to develop specific light delivery systems based on optical fibres. These devices allow the treatment: - of circular lumens such as oesophagus, bile ducts, lungs - of solid volumes such as prostate, pancreas - of surfaces such as in head and neck - of empty volumes such as bladder, uterus, cervix. Due to the variety of these treatments, a full family of sources has been developed from original sophisticated costly lasers to more recent easy-to-use diode laser systems. The aim of this presentation is to present the actual state of the art of actual available PDT tools, analyze their qualities and weaknesses, analyze the consequences of a good and/or bad choice or good and/or bad utilization on the quality of the therapeutic results and resulting side effects. It will also evaluate the short and medium term developments of new tools and their effect on the development of the therapy including economical aspects.

BAD and KATP channels regulate neuron excitability and epileptiform activity

PubMed Central

Fernández-Agüera, María Carmen; Nathwani, Nidhi; Lahmann, Carolina; Burnham, Veronica L

2018-01-01

Brain metabolism can profoundly influence neuronal excitability. Mice with genetic deletion or alteration of Bad (BCL-2 agonist of cell death) exhibit altered brain-cell fuel metabolism, accompanied by resistance to acutely induced epileptic seizures; this seizure protection is mediated by ATP-sensitive potassium (KATP) channels. Here we investigated the effect of BAD manipulation on KATP channel activity and excitability in acute brain slices. We found that BAD’s influence on neuronal KATP channels was cell-autonomous and directly affected dentate granule neuron (DGN) excitability. To investigate the role of neuronal KATP channels in the anticonvulsant effects of BAD, we imaged calcium during picrotoxin-induced epileptiform activity in entorhinal-hippocampal slices. BAD knockout reduced epileptiform activity, and this effect was lost upon knockout or pharmacological inhibition of KATP channels. Targeted BAD knockout in DGNs alone was sufficient for the antiseizure effect in slices, consistent with a ‘dentate gate’ function that is reinforced by increased KATP channel activity. PMID:29368690

Displaying fairness while delivering bad news: Testing the effectiveness of organizational bad news training in the layoff context.

PubMed

Richter, Manuela; König, Cornelius J; Koppermann, Christopher; Schilling, Michael

2016-06-01

Although giving bad news at work is a stressful experience, managers are often underprepared for this challenging task. As a solution, we introduce organizational bad news training that integrates (a) principles of delivering bad news from the context of health care (i.e., bad news delivery component), and (b) principles of organizational justice theory (i.e., fairness component). We argue that both the formal and fair delivery of bad news at work can be enhanced with the help of training to mitigate distress both for the messenger and the recipient. We tested the effectiveness of training for the delivery of a layoff as a typical bad news event at work. In 2 studies, we compared the performance of a training group (receiving both components of training) with that of a control group (Study 1, Study 2) and a basics group (receiving the bad news delivery component only; Study 2) during a simulated dismissal notification meeting. In general, the results supported our hypotheses: Training improved the formal delivery of bad news and predicted indicators of procedural fairness during the conversation in both studies. In Study 2, we also considered layoff victims' negativity after the layoff and found that training significantly reduced negative responses. This relationship was fully mediated by layoff victims' fairness perceptions. Despite preparation, however, giving bad news remained a challenging task in both studies. In summary, we recommend that organizations provide managers with organizational bad news training in order to promote professional and fair bad news conversations at work. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Physical Development: Indoor Motor Activities

ERIC Educational Resources Information Center

Strickland, Eric

2005-01-01

In this article, the author features creative ways to fit a lot of movement and fun inside the classroom when there is bad weather. He suggests that, to be creative in the classroom, one can create crawling tunnels for children by moving chairs away from tables and draping sheets or towels over their tops and sides. Or one can weave an obstacle…

BCL-2 family protein, BAD is down-regulated in breast cancer and inhibits cell invasion.

PubMed

Cekanova, Maria; Fernando, Romaine I; Siriwardhana, Nalin; Sukhthankar, Mugdha; De la Parra, Columba; Woraratphoka, Jirayus; Malone, Christine; Ström, Anders; Baek, Seung J; Wade, Paul A; Saxton, Arnold M; Donnell, Robert M; Pestell, Richard G; Dharmawardhane, Suranganie; Wimalasena, Jay

2015-02-01

We have previously demonstrated that the anti-apoptotic protein BAD is expressed in normal human breast tissue and shown that BAD inhibits expression of cyclin D1 to delay cell-cycle progression in breast cancer cells. Herein, expression of proteins in breast tissues was studied by immunohistochemistry and results were analyzed statistically to obtain semi-quantitative data. Biochemical and functional changes in BAD-overexpressing MCF7 breast cancer cells were evaluated using PCR, reporter assays, western blotting, ELISA and extracellular matrix invasion assays. Compared to normal tissues, Grade II breast cancers expressed low total/phosphorylated forms of BAD in both cytoplasmic and nuclear compartments. BAD overexpression decreased the expression of β-catenin, Sp1, and phosphorylation of STATs. BAD inhibited Ras/MEK/ERK and JNK signaling pathways, without affecting the p38 signaling pathway. Expression of the metastasis-related proteins, MMP10, VEGF, SNAIL, CXCR4, E-cadherin and TlMP2 was regulated by BAD with concomitant inhibition of extracellular matrix invasion. Inhibition of BAD by siRNA increased invasion and Akt/p-Akt levels. Clinical data and the results herein suggest that in addition to the effect on apoptosis, BAD conveys anti-metastatic effects and is a valuable prognostic marker in breast cancer. Copyright © 2014 Elsevier Inc. All rights reserved.

BCL-2 family protein, BAD is down-regulated in breast cancer and inhibits cancer cell invasion

PubMed Central

Cekanova, Maria; Fernando, Romaine I.; Siriwardhana, Nalin; Sukhthankar, Mugdha; de la Parra, Columba; Woraratphoka, Jirayus; Malone, Christine; Ström, Anders; Baek, Seung J.; Wade, Paul A.; Saxton, Arnold M.; Donnell, Robert M.; Pestell, Richard G.; Dharmawardhane, Suranganie; Wimalasena, Jay

2015-01-01

We have previously demonstrated that the anti-apoptotic protein BAD is expressed in normal human breast tissue and shown that BAD inhibits expression of cyclin D1 to delay cell-cycle progression in breast cancer cells. Herein, expression of proteins in breast tissues was studied by immunohistochemistry and results were analyzed statistically to obtain semi-quantitative data. Biochemical and functional changes in BAD-overexpressing MCF7 breast cancer cells were evaluated using PCR, reporter assays, western blotting, ELISA and extracellular matrix invasion assays. Compared to normal tissues, Grade II breast cancers expressed low total/phosphorylated forms of BAD in both cytoplasmic and nuclear compartments. BAD overexpression decreased the expression of β-catenin, Sp1, and phosphorylation of STATs. BAD inhibited Ras/MEK/ERK and JNK signaling pathways, without affecting the p38 signaling pathway. Expression of the metastasis-related proteins, MMP10, VEGF, SNAIL, CXCR4, E-cadherin and TlMP2 were regulated by BAD with concomitant inhibition of extracellular matrix invasion. siRNA knockdown of BAD increased invasion and Akt/p-Akt levels. Clinical data and the results herein suggest that in addition to the effect on apoptosis, BAD conveys anti-metastatic effects and is a valuable prognostic marker in breast cancer. PMID:25499972

Nurses' perspectives on breaking bad news to patients and their families: a qualitative content analysis.

PubMed

Abbaszadeh, Abbas; Ehsani, Seyyedeh Roghayeh; Begjani, Jamal; Kaji, Mohammad Akbari; Dopolani, Fatemeh Nemati; Nejati, Amir; Mohammadnejad, Esmaeil

2014-01-01

Breaking bad news is quite often not done in an effective manner in clinical settings due to the medical staff lacking the skills necessary for speaking to patients and their families. Bad news is faced with similar reactions on the part of the news receiver in all cultures and nations. The purpose of this study was to explore the perspectives of Iranian nurses on breaking bad news to patients and their families. In this research, a qualitative approach was adopted. In-depth and semi-structured interviews were conducted with 19 nurses who had at least one year work experience in the ward, and content analysis was performed to analyze the data. Five major categories emerged from data analysis, including effective communication with patients and their families, preparing the ground for delivering bad news, minimizing the negativity associated with the disease, passing the duty to physicians, and helping patients and their families make logical treatment decisions. The results of this study show that according to the participants, it is the physicians' duty to give bad news, but nurses play an important role in delivering bad news to patients and their companions and should therefore be trained in clinical and communicative skills to be able to give bad news in an appropriate and effective manner.

Breaking Bad News: An Evidence-Based Review of Communication Models for Oncology Nurses.

PubMed

Bumb, Meridith; Keefe, Joanna; Miller, Lindsay; Overcash, Janine

2017-10-01

A diagnosis of cancer is a stressful, difficult, and life-altering event. Breaking bad news is distressing to patients and families and is often uncomfortable for the nurse delivering it. Evidence-based communication models have been developed and adapted for use in clinical practice to assist nurses with breaking bad news.

. The purpose of this article is to provide an overview on breaking bad news and to review the utility of the SPIKES and PEWTER evidence-based communication models for oncology nurses.
. Perceptions of breaking bad news from the nurse and patient perspectives, as well as barriers and consequences to effective communication, will be presented. Clinical examples of possible situations of breaking bad news will demonstrate how to use the SPIKES and PEWTER models of communication when disclosing bad news to patients and their families.
. By using the evidence-based communication strategies depicted in this article, oncology nurses can support the delivery of bad news and maintain communication with their patients and their patients' families in an effective and productive manner.

BAD overexpression inhibits cell growth and induces apoptosis via mitochondrial-dependent pathway in non-small cell lung cancer.

PubMed

Jiang, Li; Luo, Man; Liu, Dan; Chen, Bojiang; Zhang, Wen; Mai, Lin; Zeng, Jing; Huang, Na; Huang, Yi; Mo, Xianming; Li, Weimin

2013-06-01

The pro-apoptotic Bcl-2 protein BAD initiated apoptosis in human cells and has been identified as a prognostic marker in non-small cell lung cancer (NSCLC). In this study, we aimed to explore the functions of BAD in NSCLC. Overexpression of BAD was performed by transfecting different NSCLC cell lines with wild-type BAD. Cell proliferation, cell cycle, apoptosis, and invasion were characterized in vitro. Tumorigenicity was analyzed in vivo. Western blot was performed to determine the effects of BAD overexpression on the Bcl-2 family proteins and apoptosis-related proteins. Overexpression of BAD significantly inhibited cell proliferation in H1299, H292, and SPC-A1 but not in SK-MES-1 and H460 cell lines in vitro. BAD overexpression also reduced the tumorigenicity of H1299/SPC-A1 cell in vivo. However, no appreciable effects on cell cycle distribution and invasion were observed in all these cell lines. BAD overexpression also induced apoptosis in all cell types, in which process expression of mitochondrial cytochrom c (cyto-c) and caspase 3 were increased, whereas Bcl-xl, Bcl-2, Bax and caspase 8 expressions did not changed. These findings indicated that a mitochondrial pathway, in which process cyto-c was released from mitochondrial to activate caspase 3, was involved in BAD overexpression-mediated apoptosis. Our data suggested that increased expression of BAD enhance apoptosis and has negative influence on cell proliferation and tumor growth in NSCLC. Bad is a new potential target for tumor interventions.

[Effect of ginsenoside Rg3 on Pim-3 and Bad proteins in human pancreatic cancer cell line PANC-1].

PubMed

Jian, Jie; Hu, Zhi-Fang; Huang, Yuan

2009-05-01

Ginsenoside Rg3 is a traditional Chinese medicine monomer which possesses anticancer effects. This study was to investigate the effects of ginsenoside Rg3 on Pim-3 and phosphorylated Bad (pBad) proteins, pBad (Ser112) and pBad (Ser136) in human pancreatic cancer cell line PANC-1. PANC-1 cells were exposed to 10, 20, 40 and 80 micromol/L ginsenoside Rg3 for 24 h. A short hairpin RNA (shRNA) of Pim-3 was cloned and inserted into a eukaryotic expression vector pSilencer 3.1-H1 Neo to construct pSilencer 3.1-H1 Neo-Pim-3. pSilencer 3.1-H1 Neo-Pim-3 was then transfected into PANC-1 cells. Cell proliferation was measured by MTT assay; cell apoptosis was observed under an invert microscope and measured by flow cytometry with Annexin V/PI staining; protein expressions of Pim-3, Bad, pBad (Ser112) and pBad (Ser136) were measured by Western blot. The inhibitory rates of 10, 20, 40 and 80 micromol/L ginsenoside Rg3 on PANC-1 cells were 20.2%, 33.4%, 52.8% and 65.3%, respectively. Typical morphological changes in apoptosis were induced by ginsenoside Rg3. The apoptotic rate of PANC-1 cells was significantly higher in the ginsenoside Rg3 treatment group (80 micromol/L) than in the control group (12.2% vs. 3.3%, P<0.05). Ginsenoside Rg3 had no influence on the total Bad protein expression, but decreased both Pim-3 and pBad (Ser112) expressions in a dose-dependent manner. pBad (Ser136) was not expressed in PANC-1 cells. Compared with the control group, the percentages of early and total apoptotic cells were significantly increased in PANC-1 cells transfected with pim-3-shRNA [(11.5+/-3.7)% vs. (5.8+/-2.2)%,P<0.01;(20.8+/-2.6)% vs.(13.0+/-4.1)%,P<0.05], while the expressions of pim-3 and pBad (Ser112) were both decreased. The anti-tumor effect of ginsenoside Rg3 may be associated with the decrease of Pim-3 and pBad (Ser112).

Looking on the Bright Side: Children's Knowledge about the Benefits of Positive versus Negative Thinking

ERIC Educational Resources Information Center

Bamford, Christi; Lagattuta, Kristin Hansen

2012-01-01

Five- to 10-year-olds (N = 90) listened to 6 illustrated scenarios featuring 2 characters that jointly experience the same positive event (and feel good), negative event (and feel bad), or ambiguous event (and feel okay). Afterward, one character thinks a positive thought and the other thinks a negative thought. Children predicted and explained…

High-Quality Professional Development for Teachers: Supporting Teacher Training to Improve Student Learning

ERIC Educational Resources Information Center

DeMonte, Jenny

2013-01-01

Professional development in education has gotten a bad reputation, and for good reason. Everyone on all sides of the education reform and improvement debate agrees that what most teachers receive as professional opportunities to learn are thin, sporadic, and of little use when it comes to improving teaching. This paper is the first of a periodic…

Laughter and MIRTH (Methodical Investigation of Risibility, Therapeutic and Harmful): narrative synthesis.

PubMed

Ferner, R E; Aronson, J K

2013-12-12

To review the beneficial and harmful effects of laughter. Narrative synthesis. We searched Medline (1946 to June 2013) and Embase (1974 to June 2013) for reports of benefits or harms from laughter in humans, and counted the number of papers in each category. Benefits of laughter include reduced anger, anxiety, depression, and stress; reduced tension (psychological and cardiovascular); increased pain threshold; reduced risk of myocardial infarction (presumably requiring hearty laughter); improved lung function; increased energy expenditure; and reduced blood glucose concentration. However, laughter is no joke-dangers include syncope, cardiac and oesophageal rupture, and protrusion of abdominal hernias (from side splitting laughter or laughing fit to burst), asthma attacks, interlobular emphysema, cataplexy, headaches, jaw dislocation, and stress incontinence (from laughing like a drain). Infectious laughter can disseminate real infection, which is potentially preventable by laughing up your sleeve. As a side effect of our search for side effects, we also list pathological causes of laughter, among them epilepsy (gelastic seizures), cerebral tumours, Angelman's syndrome, strokes, multiple sclerosis, and amyotrophic lateral sclerosis or motor neuron disease. Laughter is not purely beneficial. The harms it can cause are immediate and dose related, the risks being highest for Homeric (uncontrollable) laughter. The benefit-harm balance is probably favourable. It remains to be seen whether sick jokes make you ill or jokes in bad taste cause dysgeusia, and whether our views on comedians stand up to further scrutiny.

Students’ Perceptions of Contraceptives in University of Ghana

PubMed Central

Kayi, Esinam Afi

2013-01-01

Objective This study sought to explore University of Ghana Business School diploma student's knowledge of contraceptives, types of contraceptives, attitudes towards contraceptive users, preference for contraceptives, benefits, and side-effects of contraceptives. Materials and methods Data was conducted with three sets of focus group discussions. Participants were systematically sampled from accounting and public administration departments. Results Findings showed that students had little knowledge of contraceptives. The male and female condoms were the main contraceptive types reported out of the many modern and traditional methods of contraceptives. The main benefits of contraceptives were; ability to protect against STIs, abortions, unwanted pregnancy and psychological trauma. Whilst most respondents preferred future use of pills, side-effects of contraceptives were mostly reported for condoms than other contraceptive methods. Results showed that participants had bad attitudes towards unmarried contraceptive users. Conclusion Generally, our findings show that detailed knowledge about contraceptives is low. There is a little gap of information on contraception knowledge, timing, and contraceptive types among university diploma students. Reproductive and maternal services should be available and accessible for tertiary students. PMID:24971101

BAD-Dependent Regulation of Fuel Metabolism and KATP Channel Activity Confers Resistance to Epileptic Seizures

PubMed Central

Giménez-Cassina, Alfredo; Martínez-François, Juan Ramón; Fisher, Jill K.; Szlyk, Benjamin; Polak, Klaudia; Wiwczar, Jessica; Tanner, Geoffrey R.; Lutas, Andrew; Yellen, Gary; Danial, Nika N.

2012-01-01

Summary Neuronal excitation can be substantially modulated by alterations in metabolism, as evident from the anticonvulsant effect of diets that reduce glucose utilization and promote ketone body metabolism. We provide genetic evidence that BAD, a protein with dual functions in apoptosis and glucose metabolism, imparts reciprocal effects on metabolism of glucose and ketone bodies in brain cells. These effects involve phospho-regulation of BAD and are independent of its apoptotic function. BAD modifications that reduce glucose metabolism produce a marked increase in the activity of metabolically sensitive KATP channels in neurons, as well as resistance to behavioral and electrographic seizures in vivo. Seizure resistance is reversed by genetic ablation of the KATP channel, implicating the BAD-KATP axis in metabolic control of neuronal excitation and seizure responses. PMID:22632729

The medicalization of love.

PubMed

Earp, Brian D; Sandberg, Anders; Savulescu, Julian

2015-07-01

Pharmaceuticals or other emerging technologies could be used to enhance (or diminish) feelings of lust, attraction, and attachment in adult romantic partnerships. Although such interventions could conceivably be used to promote individual (and couple) well-being, their widespread development and/or adoption might lead to the 'medicalization' of human love and heartache--for some, a source of a serious concern. In this essay, we argue that the medicalization of love need not necessarily be problematic, on balance, but could plausibly be expected to have either good or bad consequences depending upon how it unfolds. By anticipating some of the specific ways in which these technologies could yield unwanted outcomes, bioethicists and others can help to direct the course of love's medicalization--should it happen to occur--more toward the 'good' side than the 'bad.'

[Breaking bad news in oncology: the Belgian experience].

PubMed

Delevallez, F; Lienard, A; Gibon, A-S; Razavi, D

2014-10-01

Breaking bad news is a complex and frequent clinical task for physicians working in oncology. It can have a negative impact on patients and their relatives who are often present during breaking bad news consultations. Many factors influence how the delivery of bad news will be experienced especially the communication skills used by physicians. A three-phase process (post-delivery phase, delivery phase, pre-delivery phase) has been developed to help physician to handle this task more effectively. Communication skills and specific breaking bad news training programs are both necessary and effective. A recent study conducted in Belgium has shown their impact on the time allocated to each of the three phases of this process, on the communication skills used, on the inclusion of the relative in the consultation and on physicians' physiological arousal. These results underscore the importance of promoting intensive communication skills and breaking bad news training programs for health care professionals.

Breaking Bad Habits: Teaching Effective PowerPoint Use to Working Graduate Students

ERIC Educational Resources Information Center

Vik, Gretchen N.

2004-01-01

One interesting aspect of teaching students to use PowerPoint and similar graphics packages effectively is that graduate students who are already in the workforce often have bad presentation habits that they need to break. In this article, the author discusses ways of breaking these bad habits. Using storyboards is one way to keep students from…

"Feeling Bad" or "Being Bad?" The Trapping Effect of Effort in Academic Failure in a Confucian Cultural Context

ERIC Educational Resources Information Center

Fwu, Bih-Jen; Wang, Hsiou-Huai; Chen, Shun-Wen; Wei, Chih-Fen

2017-01-01

A predicament faced by students who fail academically in East Asian Confucian societies, such as Taiwan, is being obscured by students' outstanding performances in international academic assessments. This article proposes that there is a trapping effect of effort for these students. They are trapped in a dilemma between "feeling bad"…

BAD-dependent regulation of fuel metabolism and K(ATP) channel activity confers resistance to epileptic seizures.

PubMed

Giménez-Cassina, Alfredo; Martínez-François, Juan Ramón; Fisher, Jill K; Szlyk, Benjamin; Polak, Klaudia; Wiwczar, Jessica; Tanner, Geoffrey R; Lutas, Andrew; Yellen, Gary; Danial, Nika N

2012-05-24

Neuronal excitation can be substantially modulated by alterations in metabolism, as evident from the anticonvulsant effect of diets that reduce glucose utilization and promote ketone body metabolism. We provide genetic evidence that BAD, a protein with dual functions in apoptosis and glucose metabolism, imparts reciprocal effects on metabolism of glucose and ketone bodies in brain cells. These effects involve phosphoregulation of BAD and are independent of its apoptotic function. BAD modifications that reduce glucose metabolism produce a marked increase in the activity of metabolically sensitive K(ATP) channels in neurons, as well as resistance to behavioral and electrographic seizures in vivo. Seizure resistance is reversed by genetic ablation of the K(ATP) channel, implicating the BAD-K(ATP) axis in metabolic control of neuronal excitation and seizure responses. Copyright © 2012 Elsevier Inc. All rights reserved.

A scoping research literature review to assess the state of existing evidence on the "bad" death.

PubMed

Wilson, Donna M; Hewitt, Jessica A

2018-02-01

A scoping research literature review on "bad death" was undertaken to assess the overall state of the science on this topic and to determine what evidence exists on how often bad deaths occur, what contributes to or causes a bad death, and what the outcomes and consequences of bad deaths are. A search for English-language research articles was conducted in late 2016, with 25 articles identified and all retained for examination, as is expected with scoping reviews. Only 3 of the 25 articles provided incidence information, specifying that 7.8 to 23% of deaths were bad and that bad deaths were more likely to occur in hospitals than in community-care settings. Many different factors were associated with bad deaths, with unrelieved pain being the most commonly identified. Half of the studies provided information on the possible consequences or outcomes of bad deaths, such as palliative care not being initiated, interpersonal and team conflict, and long-lasting negative community effects. This review identified a relatively small number of research articles that focused in whole or in part on bad deaths. Although the reasons why people consider a death to be bad may be highly individualized and yet also socioculturally based, unrelieved pain is a commonly held reason for bad deaths. Although bad and good deaths may have some opposing causative factors, this literature review revealed some salient bad death attributes, ones that could be avoided to prevent bad deaths from occurring. A routine assessment to allow planning so as to avoid bad deaths and enhance the probability of good deaths is suggested.

The News Delivery Sequence: Bad News and Good News in Conversational Interaction.

ERIC Educational Resources Information Center

Maynard, Douglas W.

1997-01-01

Explores the conditional nature of good and bad news while focusing on three topics: (1) the status of information as news according the participants in a conversation; (2) the valence of this information with regard to its perception as good or bad; and (3) the effect of news on individuals. Notes that good news is privileged over bad news in…

Metabolic syndrome and atypical antipsychotics: Possibility of prediction and control.

PubMed

Franch Pato, Clara M; Molina Rodríguez, Vicente; Franch Valverde, Juan I

Schizophrenia and other psychotic disorders are associated with high morbidity and mortality, due to inherent health factors, genetic factors, and factors related to psychopharmacological treatment. Antipsychotics, like other drugs, have side-effects that can substantially affect the physical health of patients, with substantive differences in the side-effect profile and in the patients in which these side-effects occur. To understand and identify these risk groups could help to prevent the occurrence of the undesired effects. A prospective study, with 24 months follow-up, was conducted in order to analyse the physical health of severe mental patients under maintenance treatment with atypical antipsychotics, as well as to determine any predictive parameters at anthropometric and/or analytical level for good/bad outcome of metabolic syndrome in these patients. There were no significant changes in the physical and biochemical parameters individually analysed throughout the different visits. The baseline abdominal circumference (lambda Wilks P=.013) and baseline HDL-cholesterol levels (lambda Wilks P=.000) were the parameters that seem to be more relevant above the rest of the metabolic syndrome constituents diagnosis criteria as predictors in the long-term. In the search for predictive factors of metabolic syndrome, HDL-cholesterol and abdominal circumference at the time of inclusion were selected, as such that the worst the baseline results were, the higher probability of long-term improvement. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

A survey of awareness related to the use of antibiotics for dental issues among non-medical female university students in Riyadh, Saudi Arabia.

PubMed

Abu-Mostafa, Nedal A; Al-Mejlad, Najmah J; Al-Yami, Amal S; Al-Sakhin, Fatimah Z; Al-Mudhi, Shahad A

Inappropriate use of antibiotics may lead to adverse side effects. This cross-sectional survey aimed to investigate the knowledge and attitude of female non-medical students regarding the medical and dental use of antibiotics. Four hundred validated self-administered questionnaires were distributed in Princess Norah Bint-Abdurrahman University, Riyadh, Saudi Arabia. The questionnaire included questions about accessibility, attitude toward usage, efficacy, side effects, resistance, and usage for dental issues. Knowledge was estimated for every respondent by counting the correct answers, which were considered as points. The scores were categorized as poor, moderate, and high. Of the respondents, 77.8% answered they get antibiotics according to a doctor's prescription; however, 31% stops taking antibiotics when they feel well. Only 38.8% of respondents knew that antibiotics may cause allergic reactions while 59.8% believed the human body can be resistant to antibiotics. The percentages of answers related to dental issues were: antibiotics relieve dental pain (68.8%), antibiotics can be harmful for children's teeth (27.3%), antibiotics are best avoided in pregnancy (56.7%) and no need for antibiotics after scaling (33.8%), root canal treatment (16%), or simple extraction (40.3%). Of respondents, 68% had poor scores about antibiotics efficacy, side effects, and resistance while 86.8% had poor scores related to dental problems. This study noticed a bad attitude related to antibiotics usage, with many misconceptions and poor knowledge. Moreover, the necessity of antibiotics for treatment of dental disease or after dental procedures was totally unclear for the respondents. Community campaigns are recommended every university semester to educate students about the indications, efficacy, and side effects of antibiotics. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

The outweigh of toxicity versus risk of recurrence for adjuvant interferon therapy: a survey in German melanoma patients and their treating physicians.

PubMed

Kähler, Katharina C; Blome, Christine; Forschner, Andrea; Gutzmer, Ralf; Hauschild, Axel; Heinzerling, Lucie; Livingstone, Elisabeth; Loquai, Carmen; Müller-Brenne, Tina; Schadendorf, Dirk; Utikal, Jochen; Wagner, Tobias; Augustin, Matthias

2018-05-25

After more than two decades with interferon alfa-2a and 2b (IFN) as the only approved drugs in the adjuvant setting for melanoma, new treatment approaches like immune checkpoint inhibitors and BRAF-MEK inhibitors improve the progression free survival (PFS) and also the overall survival (OS). We compared physicians' preferences ("utilities") for health states associated with IFN therapy to their patients' preferences. Utilities describe a preference for a specific health state on a scale of 0 (as bad as death) to 1.0 (perfect health). We assessed utilities for health states associated with adjuvant IFN using the standard gamble technique in 108 physicians and 130 melanoma patients. Four IFN toxicity scenarios and three outcome scenarios were given to the participants. Both groups were asked for the 5-year disease free survival (DFS) they would need to accept the described IFN-related side effects. In both groups, utilities for melanoma relapse were significantly lower than for IFN side effects, showing that toxicity was more acceptable than relapse. Physicians indicated higher utilities for each scenario and needed lower 5-year DFS both in case of mild-to-moderate and severe side effects. Patients were willing to tolerate mild-to-moderate and severe toxicity for a 50% and 75% chance of 5-year DFS, while physicians only required a chance of 40% and 50%, respectively. Both physicians and patients rated melanoma recurrence much lower than even severe IFN side effects. In direct comparison, physicians rated cancer-related scenarios more positively and accepted IFN toxicity for an even lower treatment benefit.

Planning actions in robot automated operations

NASA Technical Reports Server (NTRS)

Das, A.

1988-01-01

Action planning in robot automated operations requires intelligent task level programming. Invoking intelligence necessiates a typical blackboard based architecture, where, a plan is a vector between the start frame and the goal frame. This vector is composed of partially ordered bases. A partial ordering of bases presents good and bad sides in action planning. Partial ordering demands the use of a temporal data base management system.

The Relationship between Preschool Teachers' Professional Ethical Behavior Perceptions, Moral Judgment Levels and Attitudes to Teaching

ERIC Educational Resources Information Center

Oktay, Ayla; Ramazan, Oya; Sakin, Ahmet

2010-01-01

Morality is the stance and attitude that makes a social human being; the display of behaviors such as praise, criticism, tolerance and intolerance, confirmation and rejection; the taking of sides by stating what one finds good or bad, right or wrong, instead of staying indifferent to what other people say and do (Pieper, 1999). Moral development…

Targeting proapoptotic protein BAD inhibits survival and self-renewal of cancer stem cells.

PubMed

Sastry, K S R; Al-Muftah, M A; Li, Pu; Al-Kowari, M K; Wang, E; Ismail Chouchane, A; Kizhakayil, D; Kulik, G; Marincola, F M; Haoudi, A; Chouchane, L

2014-12-01

Emerging evidence suggests that the resistance of cancer stem cells (CSC) to many conventional therapies is one of the major limiting factors of cancer therapy efficacy. Identification of mechanisms responsible for survival and self-renewal of CSC will help design new therapeutic strategies that target and eliminate both differentiated cancer cells and CSC. Here we demonstrated the potential role of proapoptotic protein BAD in the biology of CSC in melanoma, prostate and breast cancers. We enriched CD44(+)/CD24(-) cells (CSC) by tumorosphere formation and purified this population by FACS. Both spheres and CSC exhibited increased potential for proliferation, migration, invasion, sphere formation, anchorage-independent growth, as well as upregulation of several stem cell-associated markers. We showed that the phosphorylation of BAD is essential for the survival of CSC. Conversely, ectopic expression of a phosphorylation-deficient mutant BAD induced apoptosis in CSC. This effect was enhanced by treatment with a BH3-mimetic, ABT-737. Both pharmacological agents that inhibit survival kinases and growth factors that are involved in drug resistance delivered their respective cytotoxic and protective effects by modulating the BAD phosphorylation in CSC. Furthermore, the frequency and self-renewal capacity of CSC was significantly reduced by knocking down the BAD expression. Consistent with our in vitro results, significant phosphorylation of BAD was found in CD44(+) CSC of 83% breast tumor specimens. In addition, we also identified a positive correlation between BAD expression and disease stage in prostate cancer, suggesting a role of BAD in tumor advancement. Our studies unveil the role of BAD in the survival and self-renewal of CSC and propose BAD not only as an attractive target for cancer therapy but also as a marker of tumor progression.

Positive Organizational Behavior: A Buffer for Bad News

ERIC Educational Resources Information Center

French, Sandra L.; Holden, Tracey Quigley

2012-01-01

Most communication research on bad news messages focuses on crisis communication, where attention is often limited to image repair strategies. The authors argue that a key indicator of an organization's effectiveness in communicating "bad news" messages is its organizational culture. Developing an organizational culture that values positive…

WE-AB-207A-02: John’s Equation Based Consistency Condition and Incomplete Projection Restoration Upon Circular Orbit CBCT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ma, J; Qi, H; Wu, S

Purpose: In transmitted X-ray tomography imaging, projections are sometimes incomplete due to a variety of reasons, such as geometry inaccuracy, defective detector cells, etc. To address this issue, we have derived a direct consistency condition based on John’s Equation, and proposed a method to effectively restore incomplete projections based on this consistency condition. Methods: Through parameter substitutions, we have derived a direct consistency condition equation from John’s equation, in which the left side is only projection derivative of view and the right side is projection derivative of other geometrical parameters. Based on this consistency condition, a projection restoration method ismore » proposed, which includes five steps: 1) Forward projecting reconstructed image and using linear interpolation to estimate the incomplete projections as the initial result; 2) Performing Fourier transform on the projections; 3) Restoring the incomplete frequency data using the consistency condition equation; 4) Performing inverse Fourier transform; 5) Repeat step 2)∼4) until our criteria is met to terminate the iteration. Results: A beam-blocking-based scatter correction case and a bad-pixel correction case were used to demonstrate the efficacy and robustness of our restoration method. The mean absolute error (MAE), signal noise ratio (SNR) and mean square error (MSE) were employed as our evaluation metrics of the reconstructed images. For the scatter correction case, the MAE is reduced from 63.3% to 71.7% with 4 iterations. Compared with the existing Patch’s method, the MAE of our method is further reduced by 8.72%. For the bad-pixel case, the SNR of the reconstructed image by our method is increased from 13.49% to 21.48%, with the MSE being decreased by 45.95%, compared with linear interpolation method. Conclusion: Our studies have demonstrated that our restoration method based on the new consistency condition could effectively restore the incomplete projections, especially for their high frequency component.« less

Evidence of nonuniform phase-diffusion in a bad-cavity laser

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kuppens, S.J.M.; Exter, M.P. van; Duin, M. van

1995-07-01

The quantum-limited linewidth of a short HeNe 3.39-{micro}m laser was measured and seen to increase with increasing nonuniformity of the intracavity intensity distribution. Experiments were done inside as well as outside the bad-cavity regime; in this regime the polarization of the gain medium can not be adiabatically eliminated but acts as a memory. Good quantitative agreement with theory is obtained inside as well as outside the bad-cavity regime. The effect of nonuniformity is well described by the longitudinal Petermann K-factor. The bad-cavity and nonuniformity effects can be separated from each other as predicted by theory.

When It Is Bad to Be Too Good.

ERIC Educational Resources Information Center

Cappon, Daniel

1980-01-01

Excessive "too-goodness" in a child can lead to obsessive neuroses which result in compulsions or ruminations. The only effective treatment is early prevention, culturally, socially, and behaviorally. Children must understand that all excesses are bad. Being bad is sometimes good. Being too good can be unhealthy. (Author/BEF)

75 FR 74008 - Jake's Fireworks, Inc., Far East Imports, Inc., Wholesale Fireworks Enterprises LLC, Pacific...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-30

...-810-4104 The Big Dog. 07-810-4106 One Bad Mother 16 Shot. 07-810-4111 Time Is On My Side. 07-810-4118... shall pay a civil penalty of one hundred thousand dollars ($100,000.00), for which all Respondents are... fifty thousand dollars ($750,000.00) in any one calendar year. The remedy in this paragraph shall be in...

Laughter and MIRTH (Methodical Investigation of Risibility, Therapeutic and Harmful): narrative synthesis

PubMed Central

Aronson, J K

2013-01-01

Objective To review the beneficial and harmful effects of laughter. Design Narrative synthesis. Data sources and review methods We searched Medline (1946 to June 2013) and Embase (1974 to June 2013) for reports of benefits or harms from laughter in humans, and counted the number of papers in each category. Results Benefits of laughter include reduced anger, anxiety, depression, and stress; reduced tension (psychological and cardiovascular); increased pain threshold; reduced risk of myocardial infarction (presumably requiring hearty laughter); improved lung function; increased energy expenditure; and reduced blood glucose concentration. However, laughter is no joke—dangers include syncope, cardiac and oesophageal rupture, and protrusion of abdominal hernias (from side splitting laughter or laughing fit to burst), asthma attacks, interlobular emphysema, cataplexy, headaches, jaw dislocation, and stress incontinence (from laughing like a drain). Infectious laughter can disseminate real infection, which is potentially preventable by laughing up your sleeve. As a side effect of our search for side effects, we also list pathological causes of laughter, among them epilepsy (gelastic seizures), cerebral tumours, Angelman’s syndrome, strokes, multiple sclerosis, and amyotrophic lateral sclerosis or motor neuron disease. Conclusions Laughter is not purely beneficial. The harms it can cause are immediate and dose related, the risks being highest for Homeric (uncontrollable) laughter. The benefit-harm balance is probably favourable. It remains to be seen whether sick jokes make you ill or jokes in bad taste cause dysgeusia, and whether our views on comedians stand up to further scrutiny. PMID:24336308

Giving bad news: a qualitative research exploration.

PubMed

Aein, Fereshteh; Delaram, Masoumeh

2014-06-01

The manner in which healthcare professionals deliver bad news affects the way it is received, interpreted, understood, and dealt with. Despite the fact that clinicians are responsible for breaking bad news, it has been shown that they lack skills necessary to perform this task. The purpose of this study was to explore Iranian mothers' experiences to receive bad news about their children cancer and to summarize suggestions for improving delivering bad news by healthcare providers. A qualitative approach using content analysis was adopted. Semi-structured interviews were conducted with 14 mothers from two pediatric hospitals in Iran. Five major categories emerged from the data analysis, including dumping information, shock and upset, emotional work, burden of delivering bad news to the family members, and a room for multidisciplinary approach. Effective communication of healthcare team with mothers is required during breaking bad news. Using multidisciplinary approaches to prevent harmful reactions and providing appropriate support are recommended.

Dialect Interference in Lexical Processing: Effects of Familiarity and Social Stereotypes.

PubMed

Clopper, Cynthia

2017-01-01

The current study explored the roles of dialect familiarityand social stereotypes in dialect interference effects in a speeded lexical classification task. Listeners classified the words bad and bed or had and head produced by local Midland and non-local Northern talkers and the words sod and side or rod and ride produced by non-local, non-stereotyped Northern and nonlocal, stereotyped Southern talkers in single- and mixed-talker blocks. Lexical classification was better for the local dialect than for the non-local dialects, and for the stereotyped non-local dialect than for the non-stereotyped non-local dialect. Dialect interference effects were observed for all three dialects, although the patterns of interference differed. For the local dialect, dialect interference was observed for response times, whereas for the non-local dialects, dialect interference was observed primarily for accuracy. These findings reveal complex interactions between indexical and lexical information in speech processing. © 2016 S. Karger AG, Basel.

Inhibitory efficacy of the quantified prunellae spica extract on H22 tumor bearing mice

NASA Astrophysics Data System (ADS)

Wang, Zhi-ping; Chen, Tong-sheng

2013-02-01

Hepatocarcinoma, a malignant cancer, threaten human life badly. It is a current issue to seek the effective natural remedy from plant to treat cancer due to the resistence of the advanced hepatocarcinoma to chemotherapy. In this report, we assessed the antitumor activity of a prunellae spica aqueous extract (PSE) in vitro and in vivo. PSE was quantified by HPLC and UV. MTT assay showed that PSE did not effectively inhibit the growth of H22 cells. The in vivo anti-tumor activity was assessed by using the mice bearing H22 tumor. In vivo studies showed the higher antitumor efficacy of PSE without significant side effect assessed by the reduced tumor weight, and the extended survival time of the mice bearing H22 solid and ascites tumor. Collectively, PSE is a promising Chinese medicinal herb for treating hepatocarcinoma.

Six habits of merely effective negotiators.

PubMed

Sebenius, J K

2001-04-01

Most executives know the basics of negotiation; some are spectacularly adept. Yet even experienced negotiators routinely leave money on the table, end up in deadlock, damage relationships, or allow conflicts to spiral. They fall prey to common mistakes that keep them from solving the right negotiation problem. In any negotiation, each side ultimately chooses between two options: accepting a deal or taking its best no-deal option--that is, the course of action if a deal were not possible. As a negotiator, you seek to advance your interests by persuading the other side to say yes to a proposal that meets your interests better than your best no-deal option. Because the other side will say yes only to a proposal that meets its own interests better than its best no-deal option, you must understand and shape your counterpart's decision so that it chooses in its own interest what you want. Far from being exercises in manipulation, understanding your counterpart's interests and shaping the decision so that the other side agrees to a proposal for its own reasons are the keys to jointly creating and claiming sustainable value from a negotiation. In this article, James Sebenius compares good negotiating practice with bad, providing examples from the business world and insights from 50 years of research and analysis on negotiation. The author describes six common mistakes that result in merely effective negotiation: neglecting your counterpart's problem, letting price bulldoze other interests, letting positions drive out interests, searching too hard for common ground, neglecting no-deal alternatives, and failing to correct for skewed vision.

Delivering and Receiving Bad News: What School Psychologists Need to Know

ERIC Educational Resources Information Center

Frost, Megan; Rogers, Margaret R.; O'Bryon, Elisabeth C.; Perry, Kimberly Hill

2010-01-01

Delivering bad news to students, teachers, and parents is not an uncommon occurrence for school psychologists. Skillfully communicating bad news requires sensitivity, thoughtful wording, and an awareness of the potential effect on the recipients. Despite the importance of this skill, school psychology has devoted little attention to what is…

Use of traditional plants in management of halitosis in a Moroccan population

PubMed Central

Akkaoui, Sanae; Ennibi, Oum keltoum

2017-01-01

Introduction: The use of medicinal plants was a very spread therapeutic way. At present, several studies are moving toward this ancestral option, seen the emergence of several bacterial resistance and for the large number of side effects of some synthetic drugs. Objective: The objective of this study was to collect and evaluate information on medicinal plants commonly used in five Moroccan cities: Rabat, Salé, Témara, Khémisset, and Tiflet for the management of halitosis. Methods: This is a cross-sectional survey; conducted among 171 herbalists. The tool of the study was a questionnaire filled by herbalists. SPSS in its version 13 was used for statistical calculations. Quantitative variables were expressed as a mean and standard deviation. Categorical variables were expressed as numbers and percentage. Results: Analysis of the results of this study identified 23 plants that are used the most. The herbal knowledge herbalists prescribed on the toxicity of plants and their side effects were appreciated. Conclusions: Preliminary results presented in this work allow knowing the plants used by this population. This data could be the basis for experimental and clinical studies to promote the use of natural agents in the treatment of bad breath. PMID:28894624

Variants in KCNJ11 and BAD do not predict response to ketogenic dietary therapies for epilepsy.

PubMed

Schoeler, Natasha E; Leu, Costin; White, Jon; Plagnol, Vincent; Ellard, Sian; Matarin, Mar; Yellen, Gary; Thiele, Elizabeth A; Mackay, Mark; McMahon, Jacinta M; Scheffer, Ingrid E; Sander, Josemir W; Cross, J Helen; Sisodiya, Sanjay M

2015-12-01

In the absence of specific metabolic disorders, predictors of response to ketogenic dietary therapies (KDT) are unknown. We aimed to determine whether variants in established candidate genes KCNJ11 and BAD influence response to KDT. We sequenced KCNJ11 and BAD in individuals without previously-known glucose transporter type 1 deficiency syndrome or other metabolic disorders, who received KDT for epilepsy. Hospital records were used to obtain demographic and clinical data. Two response phenotypes were used: ≥ 50% seizure reduction and seizure-freedom at 3-month follow-up. Case/control association tests were conducted with KCNJ11 and BAD variants with minor allele frequency (MAF)>0.01, using PLINK. Response to KDT in individuals with variants with MAF<0.01 was evaluated. 303 Individuals had KCNJ11 and 246 individuals had BAD sequencing data and diet response data. Six SNPs in KCNJ11 and two in BAD had MAF>0.01. Eight variants in KCNJ11 and seven in BAD (of which three were previously-unreported) had MAF<0.01. No significant results were obtained from association analyses, with either KDT response phenotype. P-values were similar when accounting for ethnicity using a stratified Cochran-Mantel-Haenszel test. There did not seem to be a consistent effect of rare variants on response to KDT, although the cohort size was too small to assess significance. Common variants in KCNJ11 and BAD do not predict response to KDT for epilepsy. We can exclude, with 80% power, association from variants with a MAF of >0.05 and effect size >3. A larger sample size is needed to detect associations from rare variants or those with smaller effect sizes. Copyright © 2015 Elsevier B.V. All rights reserved.

Breaking bad medical news in a dental care setting.

PubMed

Güneri, Pelin; Epstein, Joel; Botto, Ronald W

2013-04-01

Dental care providers may diagnose diseases and conditions that affect a patient's general health. The authors reviewed issues related to breaking bad medical news to dental practice patients and provide guidance to clinicians about how to do so. To help reduce the potentially negative effects associated with emotionally laden communication with patients about serious health care findings, the authors present suggestions for appropriately and sensitively delivering bad medical news to both patients and their families in a supportive fashion. Preparing to deliver bad news by means of education and practice is recommended to help prevent or reduce psychological distress. One form of communication guidance is the ABCDE model, which involves Advance preparation, Building a therapeutic relationship or environment, Communicating well, Dealing with patient and family reactions, and Encouraging and validating emotions. An alternative model is the six-step SPIKES sequence-Setting, Perception, Invitation or Information, Knowledge, Empathy, and Strategize and Summarize. Using either model can assist in sensitive and empathetic communication. For both practitioners' and patients' well-being, empathetic and effective delivery of bad medical news should be included in dental school curricula and continuing education courses. Dental care providers should be familiar with the oral manifestations of diseases and the care needed before the patient undergoes medical treatment and use effective communication necessary to share bad news with patients.

Bad Dream Frequency in Older Adults with Generalized Anxiety Disorder: Prevalence, Correlates, and Effect of Cognitive Behavioral Treatment for Anxiety

PubMed Central

Nadorff, Michael R.; Porter, Ben; Rhoades, Howard M.; Greisinger, Anthony J.; Kunik, Mark E.; Stanley, Melinda A.

2012-01-01

This study investigated the relation between generalized anxiety disorder (GAD) and frequency of bad dreams in older adults. A secondary analysis from a randomized clinical trial comparing cognitive behavioral therapy for anxiety (CBT) to enhanced usual care (EUC), it assessed bad dream frequency at baseline, post-treatment (3 months), and 6, 9, 12 and 15 months. Of 227 participants (mean age = 67.4), 134 met GAD diagnostic criteria (CBT = 70, EUC = 64), with the remaining 93 serving as a comparison group. Patients with GAD had significantly more bad dreams than those without, and bad dream frequency was significantly associated with depression, anxiety, worry, and poor quality of life. CBT for anxiety significantly reduced bad dream frequency at post-treatment and throughout follow-up compared to EUC. PMID:23470116

Eye movements to audiovisual scenes reveal expectations of a just world.

PubMed

Callan, Mitchell J; Ferguson, Heather J; Bindemann, Markus

2013-02-01

When confronted with bad things happening to good people, observers often engage reactive strategies, such as victim derogation, to maintain a belief in a just world. Although such reasoning is usually made retrospectively, we investigated the extent to which knowledge of another person's good or bad behavior can also bias people's online expectations for subsequent good or bad outcomes. Using a fully crossed design, participants listened to auditory scenarios that varied in terms of whether the characters engaged in morally good or bad behavior while their eye movements were tracked around concurrent visual scenes depicting good and bad outcomes. We found that the good (bad) behavior of the characters influenced gaze preferences for good (bad) outcomes just prior to the actual outcomes being revealed. These findings suggest that beliefs about a person's moral worth encourage observers to foresee a preferred deserved outcome as the event unfolds. We include evidence to show that this effect cannot be explained in terms of affective priming or matching strategies. 2013 APA, all rights reserved

Giving Bad News: A Qualitative Research Exploration

PubMed Central

Aein, Fereshteh; Delaram, Masoumeh

2014-01-01

Background: The manner in which healthcare professionals deliver bad news affects the way it is received, interpreted, understood, and dealt with. Despite the fact that clinicians are responsible for breaking bad news, it has been shown that they lack skills necessary to perform this task. Objectives: The purpose of this study was to explore Iranian mothers’ experiences to receive bad news about their children cancer and to summarize suggestions for improving delivering bad news by healthcare providers. Materials and Methods: A qualitative approach using content analysis was adopted. Semi-structured interviews were conducted with 14 mothers from two pediatric hospitals in Iran. Results: Five major categories emerged from the data analysis, including dumping information, shock and upset, emotional work, burden of delivering bad news to the family members, and a room for multidisciplinary approach. Conclusions: Effective communication of healthcare team with mothers is required during breaking bad news. Using multidisciplinary approaches to prevent harmful reactions and providing appropriate support are recommended. PMID:25068066

Handling of buses on slippery roads during the influence of side wind--a study of the effects of different tyres.

PubMed

Hjort, Mattias; Jansson, Jonas

2010-05-01

Accident statistics assembled by the Swedish National Road and Transport Research Institute (VTI) have shown that buses are overrepresented when it comes to accidents on icy and snowy roads. For a better understanding of the problem, the performance of modern summer and winter tyres on winter road conditions had to be assessed. The objective of this work has been to go beyond standard road grip studies, and instead investigate how the driver's possibility to deal with one challenging situation depends on the tyres and tyre configuration. This paper describes a novel methodology where measurements with different tyres on ice in VTI's tyre test facility, enabled a simulator study for evaluating the impact of different tyre characteristics when driving in conditions with strong side wind on a slippery road. The main results of the study are: to deal with strong side wind, good front wheel grip is most important, and while non-studded winter tyres provided little or no improvement over summer tyres, studded winter tyres significantly reduced the risk to run off the road. Furthermore, it is very difficult for the drivers to judge, beforehand, whether a vehicle with a particular tyre configuration will perform good or bad. Copyright (c) 2009 Elsevier Ltd. All rights reserved.

Effect of cAMP signaling on expression of glucocorticoid receptor, Bim and Bad in glucocorticoid-sensitive and resistant leukemic and multiple myeloma cells.

PubMed

Dong, Hongli; Carlton, Michael E; Lerner, Adam; Epstein, Paul M

2015-01-01

Stimulation of cAMP signaling induces apoptosis in glucocorticoid-sensitive and resistant CEM leukemic and MM.1 multiple myeloma cell lines, and this effect is enhanced by dexamethasone in both glucocorticoid-sensitive cell types and in glucocorticoid-resistant CEM cells. Expression of the mRNA for the glucocorticoid receptor alpha (GR) promoters 1A3, 1B and 1C, expression of mRNA and protein for GR, and the BH3-only proapoptotic proteins, Bim and Bad, and the phosphorylation state of Bad were examined following stimulation of the cAMP and glucocorticoid signaling pathways. Expression levels of GR promoters were increased by cAMP and glucocorticoid signaling, but GR protein expression was little changed in CEM and decreased in MM.1 cells. Stimulation of these two signaling pathways induced Bim in CEM cells, induced Bad in MM.1 cells, and activated Bad, as indicated by its dephosphorylation on ser112, in both cell types. This study shows that leukemic and multiple myeloma cells, including those resistant to glucocorticoids, can be induced to undergo apoptosis by stimulating the cAMP signaling pathway, with enhancement by glucocorticoids, and the mechanism by which this occurs may be related to changes in Bim and Bad expression, and in all cases, to activation of Bad.

Bad news transmission as a function of the definitiveness of consequences and the relationship between communicator and recipient.

PubMed

Weenig, M W; Groenenboom, A C; Wilke, H A

2001-03-01

There is ample evidence suggesting (e.g., A. Tesser & S. Rosen, 1975) that people are reluctant to transmit bad news. Research on rumors, on the other hand, suggests that people sometimes are less reluctant to transmit bad news. It is argued that differences between the 2 lines of research include the definitiveness of the consequences of the news and the relationship between communicator and recipient. The influence of these 2 factors on news transmission was investigated in 3 experiments. Results showed that bad news with indefinite consequences was transmitted more often than bad news with definite consequences and that both kinds of bad news were transmitted more often if the recipient was a friend rather than a stranger. Differences in feelings of moral responsibility to transmit the news largely accounted for both effects. The 2 factors did not affect the likelihood of good news transmission.

Convenience, the bane of our existence, and other barriers to donating.

PubMed

Schreiber, George B; Schlumpf, Karen S; Glynn, Simone A; Wright, David J; Tu, Yongling; King, Melissa R; Higgins, Martha J; Kessler, Debra; Gilcher, Ronald; Nass, Catharie C; Guiltinan, Anne M

2006-04-01

To prevent donor loss and improve retention, it is important to understand the major deterrents to blood donation and to identify factors that can be effectively addressed by blood centers. A 30-item self-administered questionnaire was completed in 2003 by 1705 first-time and 2437 repeat US donors who had not donated in 2 to 3 years. Asian, Hispanic, black, and white first-time and repeat donors rated the importance of deterrents to donation in their decision to not return with a 1 to 5 scale. Categorical analysis of variance methods were used to compare the importance of deterrents between first-time and repeat donors of different race or ethnicity. Not having a convenient place to donate was most commonly cited as an important or very important reason for not returning by 32 to 42 percent of first-time and 26 to 43 percent of repeat respondents. Although bad treatment and poor staff skills were less of a barrier than convenience, they were more important for minority donors. Other factors such as physical side effects, foreign travel, or length of the process appeared less important. Inconvenience is a major barrier to donating, suggesting that mobile collections and increased hours of operation might help recapture lapsed donors. The finding that lapsed minority donors were more likely to give bad treatment and poor staff skills as important reasons to not donate is disconcerting in light of the changing donor demographics and increased efforts to recruit these donors.

Learn good from bad: Effects of good and bad neighbors in spatial prisoners' dilemma games

NASA Astrophysics Data System (ADS)

Lu, Peng

2015-10-01

Cooperation is vital for the human society and this study focuses on how to promote cooperation. In our stratification model, there exist three classes: two minorities are elites who are prone to cooperate and scoundrels who are born to defect; one majority is the class of common people. Agents of these three classes interact with each other on a square lattice. Commons' cooperation and its factors are investigated. Contradicting our common sense, it indicates that elites play a negative role while scoundrels play a positive one in promoting commons' cooperation. Besides, effects of good and bad neighbors vary with temptation. When the temptation is smaller the positive effect is able to overcome the negative effect, but the later prevails when the temptation is larger. It concludes that common people are more prone to cooperate in harsh environment with bad neighbors, and a better environment with good neighbors merely leads to laziness and free riding of commons.

Postmarketing surveillance: perspectives of a journal editor.

PubMed

Gelenberg, A J

1993-01-01

In the absence of a systematic monitoring program for drugs newly approved by the Food and Drug Administration (FDA), reports in clinical journals provide a legitimate forum for disseminating information about unexpected pharmacologic events. A journal editor bears the responsibility for publishing educated clinical observations that meet standards of scientific rigor while not giving premature credibility to chance and dubious reports of side effects of new drugs. Often this responsibility involves overcoming the fear of bad publicity and withstanding pressures from pharmaceutical companies to print only positive information about new products. Published preliminary observations may contribute to the problem of product liability, but they also generate testable hypotheses and healthy debate. If hypotheses later prove to be incorrect, they can be refuted by systematic studies and clarified in reviews and editorials. Our goal of effective education will be reached not by self-censorship but by scientific openness.

[A PhD completed. Prevention and treatment of periodontal diseases and bad breath].

PubMed

van der Sluijs, E; Slot, D E; van der Weijden, G A

2018-01-01

Rinsing the mouth with water, or brushing with a dry toothbrush, does not contribute to an improvement in plaque removal during toothbrushing, nor does brushing according to a specific brushing regimen. Rinsing with water or drinking water has an immediate effect on bad morning breath. The combination of toothbrushing, tongue cleaning and a mouthwash has an effect on bad morning breath after 24 hours, in contrast with brushing with toothpaste only. The use of mouthwash with the specific ingredients chlorhexidine and essential oils has a positive effect on the reduction of gingivitis. The use of similar mouthwashes as a cooling solution in an ultrasonic device has no added effect on treatment results among periodontal patients. Water is an effective cooling solution.

Understanding drug targets: no such thing as bad news.

PubMed

Roberts, Ruth A

2018-05-24

How can small-to-medium pharma and biotech companies enhance the chances of running a successful drug project and maximise the return on a limited number of assets? Having a full appreciation of the safety risks associated with proposed drug targets is a crucial element in understanding the unwanted side-effects that might stop a project in its tracks. Having this information is necessary to complement knowledge about the probable efficacy of a future drug. However, the lack of data-rich insight into drug-target safety is one of the major causes of drug-project failure today. Conducting comprehensive target-safety reviews early in the drug discovery process enables project teams to make the right decisions about which drug targets to take forward. Copyright © 2018 Elsevier Ltd. All rights reserved.

Educating the delivery of bad news in medicine: Preceptorship versus simulation

PubMed Central

Jacques, Andrew P; Adkins, Eric J; Knepel, Sheri; Boulger, Creagh; Miller, Jessica; Bahner, David P

2011-01-01

Simulation experiences have begun to replace traditional education models of teaching the skill of bad news delivery in medical education. The tiered apprenticeship model of medical education emphasizes experiential learning. Studies have described a lack of support in bad news delivery and inadequacy of training in this important clinical skill as well as poor familial comprehension and dissatisfaction on the part of physicians in training regarding the resident delivery of bad news. Many residency training programs lacked a formalized training curriculum in the delivery of bad news. Simulation teaching experiences may address these noted clinical deficits in the delivery of bad news to patients and their families. Unique experiences can be role-played with this educational technique to simulate perceived learner deficits. A variety of scenarios can be constructed within the framework of the simulation training method to address specific cultural and religious responses to bad news in the medical setting. Even potentially explosive and violent scenarios can be role-played in order to prepare physicians for these rare and difficult situations. While simulation experiences cannot supplant the model of positive, real-life clinical teaching in the delivery of bad news, simulation of clinical scenarios with scripting, self-reflection, and peer-to-peer feedback can be powerful educational tools. Simulation training can help to develop the skills needed to effectively and empathetically deliver bad news to patients and families in medical practice. PMID:22229135

Educating the delivery of bad news in medicine: Preceptorship versus simulation.

PubMed

Jacques, Andrew P; Adkins, Eric J; Knepel, Sheri; Boulger, Creagh; Miller, Jessica; Bahner, David P

2011-07-01

Simulation experiences have begun to replace traditional education models of teaching the skill of bad news delivery in medical education. The tiered apprenticeship model of medical education emphasizes experiential learning. Studies have described a lack of support in bad news delivery and inadequacy of training in this important clinical skill as well as poor familial comprehension and dissatisfaction on the part of physicians in training regarding the resident delivery of bad news. Many residency training programs lacked a formalized training curriculum in the delivery of bad news. Simulation teaching experiences may address these noted clinical deficits in the delivery of bad news to patients and their families. Unique experiences can be role-played with this educational technique to simulate perceived learner deficits. A variety of scenarios can be constructed within the framework of the simulation training method to address specific cultural and religious responses to bad news in the medical setting. Even potentially explosive and violent scenarios can be role-played in order to prepare physicians for these rare and difficult situations. While simulation experiences cannot supplant the model of positive, real-life clinical teaching in the delivery of bad news, simulation of clinical scenarios with scripting, self-reflection, and peer-to-peer feedback can be powerful educational tools. Simulation training can help to develop the skills needed to effectively and empathetically deliver bad news to patients and families in medical practice.

Comparison of the analgesic effect of intravenous acetaminophen with that of flurbiprofen axetil on post-breast surgery pain: a randomized controlled trial.

PubMed

Nonaka, Takahiro; Hara, Marie; Miyamoto, Chisato; Sugita, Michiko; Yamamoto, Tatsuo

2016-06-01

Acetaminophen is known to be a relatively weak analgesic with fewer side effects than nonsteroidal anti-inflammatory drugs (NSAIDs). This study aimed to determine whether intravenous (iv) acetaminophen produces comparable analgesic effects to those of flurbiprofen (positive control drug), an intravenously injectable NSAID, after partial mastectomies. The primary outcome assessed was pain intensity during the first 24 h after the operation, and the secondary outcome was the satisfaction rating at discharge. After obtaining Institutional Ethics Committee approval, a series of 40 consecutive female patients who were scheduled for partial mastectomies were enrolled. Participants were randomly divided into two groups: an acetaminophen (1000 mg × 3) group (group A) and a flurbiprofen (50 mg × 3) group (group F). Each drug was administered 15 min before the end of surgery, and at 6 and 12 h after the operation. Postoperative pain was evaluated using a 100-mm visual analog scale (VAS) at 3, 6, and 24 h postoperatively. Satisfaction rating was evaluated on a 5-point scale (very good, good, well, bad, and very bad). VAS scores (mm) with movement in groups A and F at 3, 6, and 24 h after the surgery were 22 vs. 28, 14 vs. 24, and 12 vs. 20.5 (median), respectively, with no significant differences between the two groups. Eighteen of 20 patients in group A and 20 of 20 patients in group F expressed a satisfaction rating of greater than good. Acetaminophen produces an equivalent analgesic effect to flurbiprofen in post-partial mastectomy patients.

Does emotional intelligence predict breaking bad news skills in pediatric interns? A pilot study

PubMed Central

Reed, Suzanne; Kassis, Karyn; Nagel, Rollin; Verbeck, Nicole; Mahan, John D.; Shell, Richard

2015-01-01

Background While both patients and physicians identify communication of bad news as an area of great challenge, the factors underlying this often complex task remain largely unknown. Emotional intelligence (EI) has been positively correlated with good general communication skills and successful leadership, but there is no literature relating EI to the delivery of bad news. Purpose Our objectives were to determine: 1) performance of first-year pediatric residents in the delivery of bad news in a standardized patient (SP) setting; and 2) the role of EI in these assessments. Our hypothesis was that pediatric trainees with higher EI would demonstrate more advanced skills in this communication task. Methods Forty first- year residents participated. Skill in bad news delivery was assessed via SP encounters using a previously published assessment tool (GRIEV_ING Death Notification Protocol). Residents completed the Emotional and Social Competency Inventory (ESCI) as a measure of EI. Results Residents scored poorly on bad news delivery skills but scored well on EI. Intraclass correlation coefficients indicated moderate to substantial inter-rater reliability among raters using the delivering bad news assessment tool. However, no correlation was found between bad news delivery performance and EI. Conclusions We concluded that first-year pediatric residents have inadequate skills in the delivery of bad news. In addition, our data suggest that higher EI alone is not sufficient to effectively deliver death news and more robust skill training is necessary for residents to gain competence and acquire mastery in this important communication domain. PMID:26286897

Does emotional intelligence predict breaking bad news skills in pediatric interns? A pilot study.

PubMed

Reed, Suzanne; Kassis, Karyn; Nagel, Rollin; Verbeck, Nicole; Mahan, John D; Shell, Richard

2015-01-01

While both patients and physicians identify communication of bad news as an area of great challenge, the factors underlying this often complex task remain largely unknown. Emotional intelligence (EI) has been positively correlated with good general communication skills and successful leadership, but there is no literature relating EI to the delivery of bad news. Our objectives were to determine: 1) performance of first-year pediatric residents in the delivery of bad news in a standardized patient (SP) setting; and 2) the role of EI in these assessments. Our hypothesis was that pediatric trainees with higher EI would demonstrate more advanced skills in this communication task. Forty first-year residents participated. Skill in bad news delivery was assessed via SP encounters using a previously published assessment tool (GRIEV_ING Death Notification Protocol). Residents completed the Emotional and Social Competency Inventory (ESCI) as a measure of EI. Residents scored poorly on bad news delivery skills but scored well on EI. Intraclass correlation coefficients indicated moderate to substantial inter-rater reliability among raters using the delivering bad news assessment tool. However, no correlation was found between bad news delivery performance and EI. We concluded that first-year pediatric residents have inadequate skills in the delivery of bad news. In addition, our data suggest that higher EI alone is not sufficient to effectively deliver death news and more robust skill training is necessary for residents to gain competence and acquire mastery in this important communication domain.

Does emotional intelligence predict breaking bad news skills in pediatric interns? A pilot study.

PubMed

Reed, Suzanne; Kassis, Karyn; Nagel, Rollin; Verbeck, Nicole; Mahan, John D; Shell, Richard

2015-01-01

Background While both patients and physicians identify communication of bad news as an area of great challenge, the factors underlying this often complex task remain largely unknown. Emotional intelligence (EI) has been positively correlated with good general communication skills and successful leadership, but there is no literature relating EI to the delivery of bad news. Purpose Our objectives were to determine: 1) performance of first-year pediatric residents in the delivery of bad news in a standardized patient (SP) setting; and 2) the role of EI in these assessments. Our hypothesis was that pediatric trainees with higher EI would demonstrate more advanced skills in this communication task. Methods Forty first- year residents participated. Skill in bad news delivery was assessed via SP encounters using a previously published assessment tool (GRIEV_ING Death Notification Protocol). Residents completed the Emotional and Social Competency Inventory (ESCI) as a measure of EI. Results Residents scored poorly on bad news delivery skills but scored well on EI. Intraclass correlation coefficients indicated moderate to substantial inter-rater reliability among raters using the delivering bad news assessment tool. However, no correlation was found between bad news delivery performance and EI. Conclusions We concluded that first-year pediatric residents have inadequate skills in the delivery of bad news. In addition, our data suggest that higher EI alone is not sufficient to effectively deliver death news and more robust skill training is necessary for residents to gain competence and acquire mastery in this important communication domain.

Bile acid disease: the emerging epidemic.

PubMed

Oduyebo, Ibironke; Camilleri, Michael

2017-05-01

Our objective was to review advances in bile acids in health and disease published in the last 2 years. Bile acid diarrhea (BAD) is recognized as a common cause of chronic diarrhea, and its recognition has been facilitated by development of new screening tests. Primary BAD can account for 30% of cases of chronic diarrhea. The mechanisms leading to BAD include inadequate feedback regulation by fibroblast growth factor 19 (FGF-19) from ileal enterocytes, abnormalities in synthesis or degradation of proteins involved in FGF-19 regulation in hepatocytes and variations as a function of the bile acid receptor, TGR5 (GPBAR1). SeHCAT is the most widely used test for diagnosis of BAD. There has been significant validation of fasting serum FGF-19 and 7 α-hydroxy-cholesten-3-one (C4), a surrogate measure of bile acid synthesis. Bile acid sequestrants are the primary treatments for BAD; the farnesoid X-receptor-FGF-19 pathway provides alternative therapeutic targets for BAD. Bile acid-stimulated intestinal mechanisms contribute to the beneficial effects of bariatric surgery on obesity, glycemic control and the treatment of recurrent Clostridium difficile infection. Renewed interest in the role of bile acids is leading to novel management of diverse diseases besides BAD.

Smokeless tobacco cessation: report of a preliminary trial using nicotine chewing gum.

PubMed

Sinusas, K; Coroso, J G

1993-09-01

Smokeless tobacco use is a major public health hazard whose incidence is increasing, particularly among male adolescents. Little research has been done on cessation programs designed to assist smokeless tobacco users in ending their habit. There have been no studies on the use of nicotine polacrilex chewing gum as an adjunct to cessation. Fourteen of 88 male smokeless tobacco users in a professional baseball organization enrolled in a cessation program and were followed for up to 12 months. The program consisted of two support group sessions at the spring training camp followed by adjunctive use of nicotine polacrilex chewing gum during the baseball season as monitored by the athletic trainers. At 2 to 4 months, only 3 of 14 participants were completely abstinent from smokeless tobacco. Follow-up data at 6 to 12 months revealed that only one participant was abstinent. The 14 ballplayers experienced various side effects of nicotine chewing gum: bad taste (6), nausea (4), headache (4), jaw discomfort (3), and dizziness (1). Despite these side effects, 11 of the 14 participants replied that they would recommend the gum to others trying to quit. Most participants (10) felt that quitting the smokeless tobacco habit was "very difficult." We conclude that nicotine chewing gum as an adjunct to smokeless tobacco cessation had limited effectiveness. Further study on smokeless tobacco cessation methods is needed.

Risk management in dermatology: an analysis of data available from several British-based reporting systems.

PubMed

Gawkrodger, D J

2011-03-01

The elimination or reduction of risk is a prime requirement of all healthcare workers. The matter has come to the fore in dermatological practice recently with the widespread use of effective drugs that have significant side-effects (e.g. retinoids, cytotoxic drugs, biologics), the increase in skin surgery, especially for skin cancer, and the extensive use of phototherapies. To examine the available database from different agencies to which adverse events may be reported over at least a 5-year time frame, categorize the risks, look forward to where as yet unidentified risks might exist, and draw conclusions to improve the safety of dermatological practice. This work came about through a request from the National Patient Safety Agency [to the Joint Specialty Committee of the British Association of Dermatologists (BAD) and Royal College of Physicians] for information on risks to patients receiving treatment or investigation for skin disease. Organizations in the U.K. that receive information about adverse events, whether caused by drugs or procedures in dermatological treatments, were approached for information about reported events over a 5-year (or, in one case, 10-year) time frame up to 2009. Data were received from the National Patient Safety Agency, the Medicines and Healthcare Products Regulatory Agency, the National Health Service Litigation Authority, the Medical Protection Society and the Medical Defence Union. In addition, the results of a survey conducted in 2010 by the BAD of its members concerning potential critical incident reporting were included. The received information was analysed according to category of event and conclusions drawn about how best to manage the risks that were identified. Adverse events were divided into the following categories, listed in order of the number of reports received: drug side-effects (biologics and retinoids), phototherapy dosage, drug monitoring (including initial screening), pregnancy prevention programmes, skin cancer follow-up (including acting on reports), dermatopathological reporting and conduct of dermatological surgery (including management of complications, equipment problems, use of lasers, cosmetic procedures and cryotherapy). Critical incidents reported by BAD members often concerned follow-up failures, e.g. of patients receiving systemic drugs or of those with skin cancer. Several of the reported adverse events concern systemic failures. Recommendations for risk reduction include the following points: better systems for drug monitoring (including regularity of attendance, provision of sufficient follow-up appointments, acting on results and adequacy of pregnancy prevention programmes); staff training and record keeping for phototherapy; acting on skin cancer multidisciplinary team meeting outcomes (including provision of sufficient follow-up appointments); and adequate training of staff in dermatological surgery including cryotherapy. Regular monitoring of the occurrence of such reports is needed to ensure safe practice and to identify early areas of new risk. © 2011 The Author. BJD © 2011 British Association of Dermatologists.

Comparative analysis of general characteristics of ischemic stroke of BAD and non-BAD CISS subtypes.

PubMed

Mei, Bin; Liu, Guang-zhi; Yang, Yang; Liu, Yu-min; Cao, Jiang-hui; Zhang, Jun-jian

2015-12-01

Based on the recently proposed Chinese ischemic stroke subclassification (CISS) system, intracranial branch atheromatous disease (BAD) is divided into large artery atherosclerosis (LAA) and penetrating artery disease (PAD). In the current retrospective analysis, we compared the general characteristics of BAD-LAA with BAD-PAD, BAD-LAA with non-BAD-LAA and BAD-PAD with non-BAD-PAD. The study included a total of 80 cases, including 45 cases of BAD and 35 cases of non-BAD. Subjects were classified using CISS system: BAD-LAA, BAD-PAD, non-BAD-LAA and non-BAD-PAD. In addition to analysis of general characteristics, the correlation between the factors and the two subtypes of BAD was evaluated. The number of cases included in the analysis was: 32 cases of BAD-LAA, 13 cases of BAD-PAD, 21 cases of non-BAD-LAA, and 14 cases of non-BAD-PAD. Diabetes mellitus affected more non-BAD-LAA patients than BAD-LAA patients (P=0.035). In comparison with non-BAD-PAD, patients with BAD-PAD were younger (P=0.040), had higher initial NIHSS score (P<0.001) and morbidity of ischemic heart disease (P=0.033). Within patients with BAD, the PAD subtype was associated with smoking (OR=0.043; P=0.011), higher low-density lipoprotein (OR=5.339; P=0.029), ischemic heart disease (OR=9.383; P=0.047) and diabetes mellitus (OR=12.59; P=0.020). It was concluded that large artery atherosclerosis was the primary mechanism of BAD. The general characteristics showed no significant differences between the CISS subtypes of LAA and PAD within BAD, as well as between the BAD and non-BAD within LAA subtype. Several differences between PAD subtypes of BAD and non-BAD were revealed.

BAD-mediated apoptotic pathway is associated with human cancer development.

PubMed

Stickles, Xiaomang B; Marchion, Douglas C; Bicaku, Elona; Al Sawah, Entidhar; Abbasi, Forough; Xiong, Yin; Bou Zgheib, Nadim; Boac, Bernadette M; Orr, Brian C; Judson, Patricia L; Berry, Amy; Hakam, Ardeshir; Wenham, Robert M; Apte, Sachin M; Berglund, Anders E; Lancaster, Johnathan M

2015-04-01

The malignant transformation of normal cells is caused in part by aberrant gene expression disrupting the regulation of cell proliferation, apoptosis, senescence and DNA repair. Evidence suggests that the Bcl-2 antagonist of cell death (BAD)-mediated apoptotic pathway influences cancer chemoresistance. In the present study, we explored the role of the BAD-mediated apoptotic pathway in the development and progression of cancer. Using principal component analysis to derive a numeric score representing pathway expression, we evaluated clinico-genomic datasets (n=427) from corresponding normal, pre-invasive and invasive cancers of different types, such as ovarian, endometrial, breast and colon cancers in order to determine the associations between the BAD-mediated apoptotic pathway and cancer development. Immunofluorescence was used to compare the expression levels of phosphorylated BAD [pBAD (serine-112, -136 and -155)] in immortalized normal and invasive ovarian, colon and breast cancer cells. The expression of the BAD-mediated apoptotic pathway phosphatase, PP2C, was evaluated by RT-qPCR in the normal and ovarian cancer tissue samples. The growth-promoting effects of pBAD protein levels in the immortalized normal and cancer cells were assessed using siRNA depletion experiments with MTS assays. The expression of the BAD-mediated apoptotic pathway was associated with the development and/or progression of ovarian (n=106, p<0.001), breast (n=185, p<0.0008; n=61, p=0.04), colon (n=22, p<0.001) and endometrial (n=33, p<0.001) cancers, as well as with ovarian endometriosis (n=20, p<0.001). Higher pBAD protein levels were observed in the cancer cells compared to the immortalized normal cells, whereas PP2C gene expression was lower in the cancer compared to the ovarian tumor tissue samples (n=76, p<0.001). The increased pBAD protein levels after the depletion of PP2C conferred a growth advantage to the immortalized normal and cancer cells. The BAD-mediated apoptotic pathway is thus associated with the development of human cancers likely influenced by the protein levels of pBAD.

Reducing patients' anxiety and uncertainty, and improving recall in bad news consultations.

PubMed

van Osch, Mara; Sep, Milou; van Vliet, Liesbeth M; van Dulmen, Sandra; Bensing, Jozien M

2014-11-01

Patients' recall of provided information during bad news consultations is poor. According to the attentional narrowing hypothesis, the emotional arousal caused by the bad news might be responsible for this hampered information processing. Because affective communication has proven to be effective in tempering patients' emotional reactions, the current study used an experimental design to explore whether physician's affective communication in bad news consultations decreases patients' anxiety and uncertainty and improves information recall. Two scripted video-vignettes of a bad news consultation were used in which the physician's verbal communication was manipulated (standard vs. affective condition). Fifty healthy women (i.e., analogue patients) randomly watched 1 of the 2 videos. The effect of communication on participants' anxiety, uncertainty, and recall was assessed by self-report questionnaires. Additionally, a moderator analysis was performed. Affective communication reduced anxiety (p = .01) and uncertainty (p = .04), and improved recall (p = .05), especially for information about prognosis (p = .04) and, to some extent, for treatment options (p = .07). The moderating effect of (reduced) anxiety and uncertainty on recall could not be confirmed and showed a trend for uncertainty. Physicians' affective communication can temper patients' anxiety and uncertainty during bad news consultations, and enhance their ability to recall medical information. The reduction of anxiety and uncertainty could not explain patients' enhanced recall, which leaves the underlying mechanism unspecified. Our findings underline the importance of addressing patients' emotions and provide empirical support to incorporate this in clinical guidelines and recommendations. PsycINFO Database Record (c) 2014 APA, all rights reserved.

PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial.

PubMed

Voskuijl, W; de Lorijn, F; Verwijs, W; Hogeman, P; Heijmans, J; Mäkel, W; Taminiau, J; Benninga, M

2004-11-01

Recently, polyethylene glycol (PEG 3350) has been suggested as a good alternative laxative to lactulose as a treatment option in paediatric constipation. However, no large randomised controlled trials exist evaluating the efficacy of either laxative. To compare PEG 3350 (Transipeg: polyethylene glycol with electrolytes) with lactulose in paediatric constipation and evaluate clinical efficacy/side effects. One hundred patients (aged 6 months-15 years) with paediatric constipation were included in an eight week double blinded, randomised, controlled trial. After faecal disimpaction, patients <6 years of age received PEG 3350 (2.95 g/sachet) or lactulose (6 g/sachet) while children > or =6 years started with 2 sachets/day. Primary outcome measures were: defecation and encopresis frequency/week and successful treatment after eight weeks. Success was defined as a defecation frequency > or =3/week and encopresis < or =1 every two weeks. Secondary outcome measures were side effects after eight weeks of treatment. A total of 91 patients (49 male) completed the study. A significant increase in defecation frequency (PEG 3350: 3 pre v 7 post treatment/week; lactulose: 3 pre v 6 post/week) and a significant decrease in encopresis frequency (PEG 3350: 10 pre v 3 post/week; lactulose: 8 pre v 3 post/week) was found in both groups (NS). However, success was significantly higher in the PEG group (56%) compared with the lactulose group (29%). PEG 3350 patients reported less abdominal pain, straining, and pain at defecation than children using lactulose. However, bad taste was reported significantly more often in the PEG group. PEG 3350 (0.26 (0.11) g/kg), compared with lactulose (0.66 (0.32) g/kg), provided a higher success rate with fewer side effects. PEG 3350 should be the laxative of first choice in childhood constipation.

Good IR duals of bad quiver theories

NASA Astrophysics Data System (ADS)

Dey, Anindya; Koroteev, Peter

2018-05-01

The infrared dynamics of generic 3d N = 4 bad theories (as per the good-bad-ugly classification of Gaiotto and Witten) are poorly understood. Examples of such theories with a single unitary gauge group and fundamental flavors have been studied recently, and the low energy effective theory around some special point in the Coulomb branch was shown to have a description in terms of a good theory and a certain number of free hypermultiplets. A classification of possible infrared fixed points for bad theories by Bashkirov, based on unitarity constraints and superconformal symmetry, suggest a much richer set of possibilities for the IR behavior, although explicit examples were not known. In this note, we present a specific example of a bad quiver gauge theory which admits a good IR description on a sublocus of its Coulomb branch. The good description, in question, consists of two decoupled quiver gauge theories with no free hypermultiplets.

New drugs in treatment of asthma.

PubMed

Weisberg, S C; Kaiser, H B

1976-09-01

Therapy for bronchial asthma should be preventive when possible. Around-the-clock treatment with theophylline is a new way of using an old drug. Beta2-adrenergic receptor stimulators, cromolyn sodium, and steroids in aerosol form are new drugs that are useful in treatment of asthma. The good news with respect to drug treatment of asthma is that in addition to the old reliable medications which have provided good relief-including epinephrine, ephedrine, isoproterenol, aminophylline, and steroids given orally and parenterally-new drugs are available which have been extremely helpful in controlling symptoms in many patients. The bad news is that none of the new agents is a panacea and that many of them have significant undesirable side effects. It is the physician's responsibility to be wary of the new drugs for asthma and to use them appropriately.

Recovering of images degraded by atmosphere

NASA Astrophysics Data System (ADS)

Lin, Guang; Feng, Huajun; Xu, Zhihai; Li, Qi; Chen, Yueting

2017-08-01

Remote sensing images are seriously degraded by multiple scattering and bad weather. Through the analysis of the radiative transfer procedure in atmosphere, an image atmospheric degradation model considering the influence of atmospheric absorption multiple scattering and non-uniform distribution is proposed in this paper. Based on the proposed model, a novel recovering method is presented to eliminate atmospheric degradation. Mean-shift image segmentation and block-wise deconvolution are used to reduce time cost, retaining a good result. The recovering results indicate that the proposed method can significantly remove atmospheric degradation and effectively improve contrast compared with other removal methods. The results also illustrate that our method is suitable for various degraded remote sensing, including images with large field of view (FOV), images taken in side-glance situations, image degraded by atmospheric non-uniform distribution and images with various forms of clouds.

[Levonorgestrel contraceptive implants. Facts and controversies of a current contraceptive method].

PubMed

Vasconcelos-Allende, M; Unda-Ugalde, J M

1996-11-01

Research in the world of birth control technology advance daily. In México we now count with one of the best and most advanced contraceptive methods levonorgestrel implants. Even though it is far from being the ideal anticonceptive. It is in advantage over those known today in this country, because it does not content estrogens, it lasts up to 5 years, its reversible and it can be easily installed in a doctor's office. Some mexican doctors do not recognize yet this product or have been the victims of bad taste advertising. Learning about the method, its indications, contraindications, side effects, correct application and removal technics you can easily end the wrong ideas of it as a problematic device. The objective of the present work is to inform to the medical field of an excellent birth control alternative.

Preferences and attitudes of the Saudi population toward receiving medical bad news: A primary study from Riyadh city.

PubMed

Alrukban, Mohammed O; Albadr, Badr O; Almansour, Mohammed; Sami, Waqas; Alshuil, Mussab; Aldebaib, Abulrahman; Algannam, Tamim; Alhafaf, Faisal; Almohanna, Abdulaziz; Alfifi, Tariq; Alshehri, Abdullah; Alshahrani, Muhannad

2014-05-01

Breaking bad news is one of the most stressful and difficult things a physician has to do. Good communication skills are required in order to ensure that bad news is delivered in a humane but effective way. This study was designed to explore the preferences and attitude of the Saudi population toward receiving bad news. Second, it was to identify the associations between preferences, attitudes, and sociodemographic characteristics. This was a cross-sectional study conducted during the month of April 2009 in Riyadh. Data were collected from 1013 adult Saudis. Stratified random sampling technique was used through a self-administered questionnaire. In this study, 474 (46.8%) were males and 539 (53.2%) were females. Almost two-third of the participants preferred to be the first to receive the bad news. A majority of the participants 695 (68.6%) preferred to be told the bad news at a private place, whereas, 441 (43.5%) preferred to be told by the head of the medical team. Moreover, almost half of the participants would like the one who breaks the bad news to remain with them to give them some more information about the disease. Significant associations were observed between participants' perception and attitude with age, marital status, gender, and education (P < 0.001), respectively. Factors such as marital status, age, and gender, and education play significant roles in how bad news is received. Understanding what is important in the process of breaking bad news may help in determining how best to perform this challenging task.

Breaking bad news and personality assessment.

PubMed

Rudnick, A; Ezra, Y; Melamed, E

2000-09-01

Breaking bad news to seriously ill patients is an especially difficult and important part of patient education and counseling. Guidelines for breaking bad news have been previously presented, but this is the first report to address the personality of the patient in deciding how to break had news. A case study of a patient diagnosed with amyotrophic lateral sclerosis is presented. A psychiatric consultation assisted in assessing the patient's personality and thus preparing the medical staff for breaking the bad news to him. The patient was assessed as having an obsessive-compulsive personality, and consequently the staff was instructed to concentrate on facts and not on feelings when breaking the bad news to him. The patient coped adaptively with this procedure, as did the staff. This case report illustrates that personality assessment may be of benefit in breaking bad news to seriously ill patients. It remains to be seen whether this procedure can be successfully generalized to other patients and settings as well as to other domains of patient education and counseling, and if so--whether this will also prove to be cost-effective.

HK2 Recruitment to Phospho-BAD Prevents Its Degradation, Promoting Warburg Glycolysis by Theileria-Transformed Leukocytes.

PubMed

Haidar, Malak; Lombès, Anne; Bouillaud, Frédéric; Kennedy, Eileen J; Langsley, Gordon

2017-03-10

Theileria annulata infects bovine leukocytes, transforming them into invasive, cancer-like cells that cause the widespread disease called tropical theileriosis. We report that in Theileria-transformed leukocytes hexokinase-2 (HK2) binds to B cell lymphoma-2-associated death promoter (BAD) only when serine (S) 155 in BAD is phosphorylated. We show that HK2 recruitment to BAD is abolished by a cell-penetrating peptide that acts as a nonphosphorylatable BAD substrate that inhibits endogenous S155 phosphorylation, leading to complex dissociation and ubiquitination and degradation of HK2 by the proteasome. As HK2 is a critical enzyme involved in Warburg glycolysis, its loss forces Theileria-transformed macrophages to switch back to HK1-dependent oxidative glycolysis that down-regulates macrophage proliferation only when they are growing on glucose. When growing on galactose, degradation of HK2 has no effect on Theileria-infected leukocyte proliferation, because metabolism of this sugar is independent of hexokinases. Thus, targeted disruption of the phosphorylation-dependent HK2/BAD complex may represent a novel approach to control Theileria-transformed leukocyte proliferation.

Breaking bad news: Effects of forecasting diagnosis and framing prognosis.

PubMed

Porensky, Emily K; Carpenter, Brian D

2016-01-01

Research to support guidelines for breaking bad news is lacking. This study used an experimental paradigm to test two communication strategies, forecasting bad news and framing prognosis, in the context of cancer. In a 2×2 design, 128 participants received bad news in a hypothetical consultation. A videotaped physician presented diagnostic and prognostic information, varying warning (warning shot vs. no warning), and framing (positive vs. negative). Effects on psychological distress, recall accuracy, and subjective interpretations of the news were assessed. Warning was not associated with lower psychological distress or improved recall. Individuals who heard a positively-framed prognosis had significantly less psychological distress, rated their prognosis better, and were more hopeful than those who heard a negatively-framed prognosis. However, they also showed a trend toward reduced accuracy in recalling prognostic statistics. Results contribute to a growing body of literature exploring optimal approaches for communicating bad news in health care. Although research in clinical settings is needed to bolster results, findings suggest that when providers use positive framing to reduce distress about prognosis, they should also consider ways to overcome potential reductions in recall accuracy, such as repeating statistical information or supplementing with written information. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

High resolution magnetic resonance imaging in pathogenesis diagnosis of single lenticulostriate infarction with nonstenotic middle cerebral artery, a retrospective study.

PubMed

Sun, Li-Li; Li, Zhong-Hao; Tang, Wen-Xiong; Liu, Lei; Chang, Fei-Yan; Zhang, Xue-Bin; Ye, Wei-Jie; Lu, Shuo; Liu, Zun-Jing; Zhu, Xian-Jin

2018-04-25

It is usually difficult to identify stroke pathogenesis for single lenticulostriate infarction with nonstenotic middle cerebral artery (MCA). Our aim is to differentiate the two pathogeneses, non-branch atheromatous small vessel disease and branch atheromatous disease (BAD) by high-resolution magnetic resonance imaging (HR-MRI). Thirty-two single lenticulostriate infarction patients with nonstenotic MCA admitted to the China-Japan Friendship Hospital from December 2014 to August 2017 were enrolled for retrospective analysis. National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), atherosclerotic risk factors, imaging features, and the characteristic of MCA vessel wall in HR-MRI were evaluated. MCA plaques were detected in 15(46.9%) patients which implied BAD and 8 of 15 (53.3%) patients had plaques location in upper dorsal side of the vessel wall. Patients with HR-MRI identified plaques had a significantly larger infarction lesion length (1.95 ± 0.86 cm versus 1.38 ± 0.55 cm; P = 0.031) and larger lesion volume (2.95 ± 3.94 cm 3 versus 0.90 ± 0.94 cm 3 ; P = 0.027) than patients without plaques. Patients with HR-MRI identified plaques had a significant higher percentage of proximal lesions than patients without plaques (P = 0.055). However, according to the location of MCA plaques, there were no significant differences in terms of imaging features, NIHSS and mRS. We demonstrated high frequency of MCA atheromatous plaques visualized in single lenticulostriate infarction patients with nonstenotic MCA by using HR-MRI. Patients with HR-MRI identified plaque presented larger infarction lesions and more proximal lesions than patients without plaque, which were consistent with imaging features of BAD. HR-MRI is an important and effective tool for identifying stroke etiology in patients with nonstenotic MCA.

Physician as partner or salesman? Shared decision-making in real-time encounters.

PubMed

Karnieli-Miller, Orit; Eisikovits, Zvi

2009-07-01

The results of recent research have led to the increased advocacy of shared decision-making regarding medical treatment. Nonetheless, only a limited number of studies have focused on the process of decision-making in real-time encounters. The present paper aims to document and analyze this process. Specifically, we assess whether these decisions are the result of partnership or of persuasive tactics based on power and hierarchical relationships. We will describe and analyze different strategies used by pediatric gastroenterologists in breaking bad news encounters, as well as their consequences. The analysis is based on a multi-method, multi-participant phenomenological study on breaking bad news to adolescents and their families regarding a chronic illness. It included 17 units of analysis (actual encounters and 52 interviews with physicians, parents and adolescents). Data were collected from three hospitals in Northern Israel using observations and audiotapes of diagnosis disclosure encounters and audio-taped interviews with all participants. The analysis identified eight different presentation tactics used in actual encounters during which physicians made various use of language, syntax and different sources of power to persuade patients to agree with their preferred treatment choice. The tactics included various ways of presenting the illness, treatment and side effects; providing examples from other success or failure stories; sharing the decision only concerning technicalities; and using plurals and authority. The findings suggest that shared decision-making may be advocated as a philosophical tenet or a value, but it is not necessarily implemented in actual communication with patients. Rather, treatment decisions tend to be unilaterally made, and a variety of persuasive approaches are used to ensure agreement with the physician's recommendation. The discussion is focused on the complexity of sharing a decision, especially in the initial bad news encounter; and the potentially harmful implications on building a trusting relationship between the physician and the family when a decision is not shared.

Clinical experience of CGC tablet (Cysteine, vitamin C) in the patients treated with radiation. I (in Japanese)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kinoshita, F.; Maekawa, Z.

1973-03-01

Three tablets of CGC, which is a mixture of cysteine and vitamin C, were given orally three times a day to the patients with malignant neoplasms immediately before irradiation. Reduction of side effects is discussed. As side effects, subjective symptoms, blood findings, liver function test, and effects on therapeutic response were observed. Diseases of the patients (a total of 27 cases) were as follows: eight cases of breast cancer, seven of cervical uterus cancer, three of eosophagus cancer, two of myoma uteri, and each one case of lung cancer, penis cancer, brain neoplasms, duodenum cancer, rectal cancer, osteosarcoma of themore » pelvis, and orchis cancer. The mean leukocyte count dropped from 5500 before irradiation to 4600 after irradiation. There were two cases of which leukocyte count was less than 3000, but its count recovered more than 4000 in ten days after termination of irradiation. The mean red blood cell count increased from 3,440,000 before irradiation to 3,480,000 after irradiation. The mean amount of hemoglobin increased from 75% before irradiation to 76% after irradiation. There was no case in which examination results of liver function test before irradiation took a bad turn after irradiation. All 27 cases were given prearranged dose within a fixed period, and expected effects of radiotherapy were obtained. Furthermore, symptoms and treatment progress of each case administered with CGC were explained. (JA)« less

Bartonella henselae trimeric autotransporter adhesin BadA expression interferes with effector translocation by the VirB/D4 type IV secretion system.

PubMed

Lu, Yun-Yueh; Franz, Bettina; Truttmann, Matthias C; Riess, Tanja; Gay-Fraret, Jérémie; Faustmann, Marco; Kempf, Volkhard A J; Dehio, Christoph

2013-05-01

The Gram-negative, zoonotic pathogen Bartonella henselae is the aetiological agent of cat scratch disease, bacillary angiomatosis and peliosis hepatis in humans. Two pathogenicity factors of B. henselae - each displaying multiple functions in host cell interaction - have been characterized in greater detail: the trimeric autotransporter Bartonella adhesin A (BadA) and the type IV secretion system VirB/D4 (VirB/D4 T4SS). BadA mediates, e.g. binding to fibronectin (Fn), adherence to endothelial cells (ECs) and secretion of vascular endothelial growth factor (VEGF). VirB/D4 translocates several Bartonella effector proteins (Beps) into the cytoplasm of infected ECs, resulting, e.g. in uptake of bacterial aggregates via the invasome structure, inhibition of apoptosis and activation of a proangiogenic phenotype. Despite this knowledge of the individual activities of BadA or VirB/D4 it is unknown whether these major virulence factors affect each other in their specific activities. In this study, expression and function of BadA and VirB/D4 were analysed in a variety of clinical B. henselae isolates. Data revealed that most isolates have lost expression of either BadA or VirB/D4 during in vitro passages. However, the phenotypic effects of coexpression of both virulence factors was studied in one clinical isolate that was found to stably coexpress BadA and VirB/D4, as well as by ectopic expression of BadA in a strain expressing VirB/D4 but not BadA. BadA, which forms a dense layer on the bacterial surface, negatively affected VirB/D4-dependent Bep translocation and invasome formation by likely preventing close contact between the bacterial cell envelope and the host cell membrane. In contrast, BadA-dependent Fn binding, adhesion to ECs and VEGF secretion were not affected by a functional VirB/D4 T4SS. The obtained data imply that the essential virulence factors BadA and VirB/D4 are likely differentially expressed during different stages of the infection cycle of Bartonella. © 2012 Blackwell Publishing Ltd.

Effect of breaking bad news on patients' perceptions of doctors

PubMed Central

Barnett, Mandy M

2002-01-01

The breaking of bad news is a routine but difficult task for many health professionals. There are numerous anecdotes of insensitive practice but the subject has attracted little systematic research. We therefore interviewed 106 patients with advanced cancer (from an original sample of 195) to assess their perceptions of the doctors involved in their care. Aspects of the ‘breaking bad news’ event were recorded during discussion of the illness history and were subsequently rated. Participants were also asked to nominate doctors under the headings ‘most helpful’ and ‘less helpful’, and completed standardized psychological screening questionnaires. In 94 of the 106 cases the bad news had been given by a doctor, usually a surgeon. Of the 13 doctors categorized as ‘most helpful’ when breaking bad news, 8 were general practitioners; of the 7 categorized as ‘less helpful’ all were surgeons. 69% of patients were neutral or positive about the bad-news consultation, but 20% were negative and 6% very negative. Doctors in surgical specialties were significantly more likely to be rated poorly than non-surgical specialists or general practitioners. Surgeons were the group of doctors most likely to break bad news, but non-surgical doctors were rated more positively in performance of the task. This finding has implications for training. PMID:12091508

Delivering bad news in emergency care medicine.

PubMed

Maynard, Douglas W

2017-01-01

Forecasting is a strategy for delivering bad news and is compared to two other strategies, stalling and being blunt. Forecasting provides some warning that bad news is forthcoming without keeping the recipient in a state of indefinite suspense (stalling) or conveying the news abruptly (being blunt). Forecasting appears to be more effective than stalling or being blunt in helping a recipient to "realize" the bad news because it involves the deliverer and recipient in a particular social relation. The deliverer of bad news initiates the telling by giving an advance indication of the bad news to come; this allows the recipient to calculate the news in advance of its final presentation, when the deliverer confirms what the recipient has been led to anticipate. Thus, realization of bad news emerges from intimate collaboration, whereas stalling and being blunt require recipients to apprehend the news in a social vacuum. Exacerbating disruption to recipients' everyday world, stalling and being blunt increase the probability of misapprehension (denying, blaming, taking the situation as a joke, etc.) and thereby inhibit rather than facilitate realization. Particular attention is paid to the "perspective display sequence", a particular forecasting strategy that enables both confirming the recipient's perspective and using that perspective to affirm the clinical news. An example from acute or emergency medicine is examined at the close of the paper.

Effect of berberine on cell cycle arrest and cell survival during cerebral ischemia and reperfusion and correlations with p53/cyclin D1 and PI3K/Akt.

PubMed

Chai, Yu-Shuang; Hu, Jun; Lei, Fan; Wang, Yu-Gang; Yuan, Zhi-Yi; Lu, Xi; Wang, Xin-Pei; Du, Feng; Zhang, Dong; Xing, Dong-Ming; Du, Li-Jun

2013-05-15

Berberine acted as a natural medicine with multiple pharmacological activities. In the present study, we examined the effect of berberine against cerebral ischemia damage from cell cycle arrest and cell survival. Oxygen-glucose deprivation of PC12 cells and primary neurons, and carotid artery ligation in mice were used as in vitro and in vivo cerebral ischemia models. We found that the effect of berberine on cell cycle arrest during ischemia was mediated by decreased p53 and cyclin D1, increased phosphorylation of Bad (higher expression of p-Bad and higher ratio of p-Bad to Bad) and decreased cleavage of caspase 3. Meanwhile, berberine activated the PI3K/Akt pathway during the reperfusion, especially the phosphor-activation of Akt, to promote the cell survival. The neural protective effect of berberine was remained in the presence of inhibitor of mitogen-activated protein/extracellular signal-regulated kinase (MEK), but was suppressed by the inhibitors of PI3K and Akt. We demonstrated that berberine induced cell cycle arrest and cell survival to resist cerebral ischemia injury. Copyright © 2013 Elsevier B.V. All rights reserved.

48 CFR 2131.205-3 - Bad debts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 2131.205-3 Federal Acquisition Regulations System OFFICE OF PERSONNEL MANAGEMENT, FEDERAL... PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 2131.205-3 Bad debts. Erroneous benefit... the erroneous overpayment or it would not be cost effective to recover the erroneous overpayment. The...

Bad splits in bilateral sagittal split osteotomy: systematic review and meta-analysis of reported risk factors.

PubMed

Steenen, S A; van Wijk, A J; Becking, A G

2016-08-01

An unfavourable and unanticipated pattern of the bilateral sagittal split osteotomy (BSSO) is generally referred to as a 'bad split'. Patient factors predictive of a bad split reported in the literature are controversial. Suggested risk factors are reviewed in this article. A systematic review was undertaken, yielding a total of 30 studies published between 1971 and 2015 reporting the incidence of bad split and patient age, and/or surgical technique employed, and/or the presence of third molars. These included 22 retrospective cohort studies, six prospective cohort studies, one matched-pair analysis, and one case series. Spearman's rank correlation showed a statistically significant but weak correlation between increasing average age and increasing occurrence of bad splits in 18 studies (ρ=0.229; P<0.01). No comparative studies were found that assessed the incidence of bad split among the different splitting techniques. A meta-analysis pooling the effect sizes of seven cohort studies showed no significant difference in the incidence of bad split between cohorts of patients with third molars present and concomitantly removed during surgery, and patients in whom third molars were removed at least 6 months preoperatively (odds ratio 1.16, 95% confidence interval 0.73-1.85, Z=0.64, P=0.52). In summary, there is no robust evidence to date to show that any risk factor influences the incidence of bad split. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

[Structuralistic and meta-psychological approaches to ambivalence in schizophrenia].

PubMed

Sumida, Kyoko; Tsuda, Hitoshi

2003-01-01

The word "ambivalence" generally signifies a psychic state in which a subject holds a contradictory or conflicted attitude towards an object. The literal meaning of the word is that two valences occur simultaneously, and this connotes the epistemological and ethical problem of where and how the valences arise. The concept of ambivalence implies that the relationship between the subject and the world is ambivalent, that the subject has free will in the alternative evaluation, and that the meanings of the two valences derive from the meta-level outside the world. These reflections lead us to the supposition that ambivalence is closely associated with the function of language. The ambivalent attitude of the subject divides the significance of the object; the appearance of the given ambivalent meanings is the moment of the subject's choice. This phenomenon of division, choice, and given meanings is more than analogous to F. de Saussure's conception of language in terms of sign, différenciation, and l'arbitraire de langue. A view of ambivalence as a fundamental phenomenon concerning subject, world, and language affords insight specifically into ambivalence in schizophrenia. For people with schizophrenia, ambivalent conflict often takes the form of a dichotomy between "good and bad". The more severe the ambivalent symptom, the more similar it seems to a philosophical question about the nature of existence in the world. When schizophrenic people raise philosophical questions directly such as "Is my existence good or bad?" or "To be or not to be?", they seek approval for their existence, assaying to live with "good" intentions. Unfortunately they come to be blamed for harbouring "bad" intentions. When they have an interrogative attitude even to everyday matters, they cannot resolve such questions as "Is the red cup good or bad?", or "Is the green cup good or bad?", and hence "Which cup should I use?". If the projection of the self into the world is essentially the choice of a daily behavior as its own praxis, such indecisiveness thus entails existential conflict. The alternatives of choice appear before them as a tollgate to the world. Wishing admission to the world, they choose the thing that they think "good", but which later turns out to be "bad". These consequences sometimes occur in their inner conflicts and sometimes in their paranoidhallucinatory experiences. We have observed that in these processes, there is an inversion between "good and bad", and "bad" predominates, driving patients to despair. Rethinking E. Bleuler's conception of the ambivalence of schizophrenia, we have found that it is accessible to structuralistic and meta-psychological interpretations. From the viewpoint of linguistic semiology, ambivalence can be considered as a disorder of exclusive differentiation in the associative system resulting from the appearance of antithetical meanings, a phenomenon that is also common in primal words and children's thinking. In the context of psycho-analysis, it is suggested that the dominance of the negative side in ambivalence may be caused by death instinct. These interpretations are consistent with both the philosophical considerations and the clinical observations introduced above, but the problem of schizophrenic specificity is still opened beside the affinity between philosophical conflict and schizophrenic ambivalence. References to ethical and philosophical thinking shed light on the sources of the dichotomous existential conflict and the characteristic inversion between "good and bad" that schizophrenic patients experience. Descriptions of the root of ambivalence can be traced back to ancient times. In the Ecclesiastes of the Apocrypha, Jesus, son of Sirach, elucidates the fundamental ambivalence of will, teaching that the subject has the power of its own choice: at its most extreme, the choice between life and death. In the modern age, L. Wittgenstein offers a strict description of this ambivalence in his "Notebooks 1914-1916". Wittgenstein doubted the possibility of pure subjectivity without individual will and furthermore argued that the will is either good or evil, that is, the bearer of good and evil. In his view, good and evil are somehow connected with the meaning of the world, and meaning ("Sinn" in German) is discerned from significance ("Bedeutung" in German). He went on to write that the meaning does not lie in the world but outside it. As K. Shingu has noted, Wittgenstein's conception is essentially consistent with psycho-analysis. The subject recognizes the world with ambivalent will, the world appears with ambivalent significance, but its ambivalent meaning is given from outside the world, that is, from the meta-level. For E. Husserl's concept of intentionality, it is said that the fundamental disorder of schizophrenia is a preverbal or pre-predicative problem that is connected with intentionality. Yet one wonders whether or not pure, neutral intentionality is really possible. Presumably, intentionality has an intrinsic ambivalence, since the fundamental relationship between the subject and the world may itself be ambivalent. When one becomes conscious of a thing, the potential exists to divide one's intentionality between "good and bad", and the thing thus appears as "good" or "bad". In the healthy psyche, this intrinsic ambivalence emerges only in ethical or philosophical thinking. In schizophrenia, however, the ambivalence of intentionality is explicitly engaged in diverse situations. The inversion of "good and bad" observed in the clinical context signifies that the will of the patient shifts from "good" to "bad", alluding to a contradiction between the subject and the world that is logically inevitable due to the structure of their relationship. The subject objectivfies the world positively, yet is contained by the world passively. That the subject simultaneously announces and is announced in the language system also reflects this paradoxical relationship. Thus, ambivalence of dichotomy between "good and bad" is the very basic phenomenon of consciousness, and the inversion of "good and bad" is a reflection of the structure of the relationship of the subject and the world. If the schizophrenic specificity exists, it may involve the exposure of this intrinsic ambivalence and this paradoxical structure in confrontations with the tellgate into the world under the dominance of the negative side.

2,5-hexanedione induces bone marrow mesenchymal stem cell apoptosis via inhibition of Akt/Bad signal pathway.

PubMed

Sun, Jingsong; Shi, Xiaoxia; Li, Shuangyue; Piao, Fengyuan

2018-04-01

2,5-Hexanedione (HD) is an important bioactive metabolite of n-hexane and mediates the neurotoxicity of parent compound. Studies show that HD induces apoptotic death of neural progenitor cells. However, its underlying mechanism remains unknown. Mesenchymal stem cells (MSCs) are multipotential stem cells with the ability to differentiate into various cell types and have been used as cell model for studying the toxic effects of chemicals on stem cells. In this study, we exposed rat bone marrow MSCs to 0, 10, 20, and 40 mM HD in vitro. Apoptosis and disruption of mitochondrial transmembrane potential were estimated by immunochemistry staining. The expression of Akt, Bad, phosphorylated Akt (p-Akt), and Bad (p-Bad) as well as cytochrome c in mitochondria and cytosol were examined by Western blot. Moreover, caspase 3 activity, viability, and death of cells were measured by spectrophotometry. Our results showed that HD induced cell apoptosis and increased caspase 3 activity. HD down-regulated the expression levels of p-Akt, p-Bad and induced MMP depolarization, followed by cytochrome c release. Moreover, HD led to a concentration-dependent increase in the MSCs death, which was relative to MSCs apoptosis. However, these toxic effects of HD on the MSCs were significantly mitigated in the presence of IGF, which could activate PI3 K/Akt pathway. These results indicated that HD induced mitochondria-mediated apoptosis in the MSCs via inhibiting Akt/Bad signaling pathway and apoptotic death of MSCs via the signaling pathway. These results might provide some clues for studying further the mechanisms of HD-induced stem cell apoptosis and adverse effect on neurogenesis. © 2017 Wiley Periodicals, Inc.

Preferences and attitudes of the Saudi population toward receiving medical bad news: A primary study from Riyadh city

PubMed Central

Alrukban, Mohammed O.; Albadr, Badr O.; Almansour, Mohammed; Sami, Waqas; Alshuil, Mussab; Aldebaib, Abulrahman; Algannam, Tamim; Alhafaf, Faisal; Almohanna, Abdulaziz; Alfifi, Tariq; Alshehri, Abdullah; Alshahrani, Muhannad

2014-01-01

Background: Breaking bad news is one of the most stressful and difficult things a physician has to do. Good communication skills are required in order to ensure that bad news is delivered in a humane but effective way. Objectives: This study was designed to explore the preferences and attitude of the Saudi population toward receiving bad news. Second, it was to identify the associations between preferences, attitudes, and sociodemographic characteristics. Materials and Methods: This was a cross-sectional study conducted during the month of April 2009 in Riyadh. Data were collected from 1013 adult Saudis. Stratified random sampling technique was used through a self-administered questionnaire. Results: In this study, 474 (46.8%) were males and 539 (53.2%) were females. Almost two-third of the participants preferred to be the first to receive the bad news. A majority of the participants 695 (68.6%) preferred to be told the bad news at a private place, whereas, 441 (43.5%) preferred to be told by the head of the medical team. Moreover, almost half of the participants would like the one who breaks the bad news to remain with them to give them some more information about the disease. Significant associations were observed between participants' perception and attitude with age, marital status, gender, and education (P < 0.001), respectively. Conclusion: Factors such as marital status, age, and gender, and education play significant roles in how bad news is received. Understanding what is important in the process of breaking bad news may help in determining how best to perform this challenging task. PMID:24987276

'BREAKS' Protocol for Breaking Bad News.

PubMed

Narayanan, Vijayakumar; Bista, Bibek; Koshy, Cheriyan

2010-05-01

Information that drastically alters the life world of the patient is termed as bad news. Conveying bad news is a skilled communication, and not at all easy. The amount of truth to be disclosed is subjective. A properly structured and well-orchestrated communication has a positive therapeutic effect. This is a process of negotiation between patient and physician, but physicians often find it difficult due to many reasons. They feel incompetent and are afraid of unleashing a negative reaction from the patient or their relatives. The physician is reminded of his or her own vulnerability to terminal illness, and find themselves powerless over emotional distress. Lack of sufficient training in breaking bad news is a handicap to most physicians and health care workers. Adherence to the principles of client-centered counseling is helpful in attaining this skill. Fundamental insight of the patient is exploited and the bad news is delivered in a structured manner, because the patient is the one who knows what is hurting him most and he is the one who knows how to move forward. Six-step SPIKES protocol is widely used for breaking bad news. In this paper, we put forward another six-step protocol, the BREAKS protocol as a systematic and easy communication strategy for breaking bad news. Development of competence in dealing with difficult situations has positive therapeutic outcome and is a professionally satisfying one.

‘BREAKS’ Protocol for Breaking Bad News

PubMed Central

Narayanan, Vijayakumar; Bista, Bibek; Koshy, Cheriyan

2010-01-01

Information that drastically alters the life world of the patient is termed as bad news. Conveying bad news is a skilled communication, and not at all easy. The amount of truth to be disclosed is subjective. A properly structured and well-orchestrated communication has a positive therapeutic effect. This is a process of negotiation between patient and physician, but physicians often find it difficult due to many reasons. They feel incompetent and are afraid of unleashing a negative reaction from the patient or their relatives. The physician is reminded of his or her own vulnerability to terminal illness, and find themselves powerless over emotional distress. Lack of sufficient training in breaking bad news is a handicap to most physicians and health care workers. Adherence to the principles of client-centered counseling is helpful in attaining this skill. Fundamental insight of the patient is exploited and the bad news is delivered in a structured manner, because the patient is the one who knows what is hurting him most and he is the one who knows how to move forward. Six-step SPIKES protocol is widely used for breaking bad news. In this paper, we put forward another six-step protocol, the BREAKS protocol as a systematic and easy communication strategy for breaking bad news. Development of competence in dealing with difficult situations has positive therapeutic outcome and is a professionally satisfying one. PMID:21811349

Egyptian mothers' preferences regarding how physicians break bad news about their child's disability: a structured verbal questionnaire.

PubMed

Abdelmoktader, Ahmed Mahmoud; Abd Elhamed, Khalil A

2012-07-02

Breaking bad news to mothers whose children has disability is an important role of physicians. There has been considerable speculation about the inevitability of parental dissatisfaction with how they are informed of their child's disability. Egyptian mothers' preferences for how to be told the bad news about their child's disability has not been investigated adequately. The objective of this study was to elicit Egyptian mothers' preferences for how to be told the bad news about their child's disability. Mothers of 100 infants recently diagnosed with Down syndrome were interviewed regarding their preferences for how to be told bad news. Mothers were recruited through outpatient clinics of the Pediatric Genetics Department at Fayoum University Hospital (located 90 km southwest of Cairo, Egypt) from January to June 2011. Questionnaire analyses revealed nine themes of parental preferences for how to be told information difficult to hear. Mothers affirmed previously reported recommendations for conveying bad medical news to parents, including being told early, being told of others with a similar condition, and being informed of the prognosis. Mothers affirmed communication themes previously discussed in the literature, such as being told early, and being informed of the prognosis. Although more research is needed in this important area, we hope that our findings will stimulate future search and help health care providers in different societies establish guidelines for effectively communicating bad news.

A surface plasmon resonance study of the intermolecular interaction between Escherichia coli topoisomerase I and pBAD/Thio supercoiled plasmid DNA

PubMed Central

Tiwari, Purushottam Babu; Annamalai, Thirunavukkarasu; Cheng, Bokun; Narula, Gagandeep; Wang, Xuewen; Tse-Dinh, Yuk-Ching; He, Jin; Darici, Yesim

2014-01-01

To date, the bacterial DNA topoisomerases are one of the major target biomolecules for the discovery of new antibacterial drugs. DNA topoisomerase regulates the topological state of DNA, which is very important for replication, transcription and recombination. The relaxation of negatively supercoiled DNA is catalyzed by bacterial DNA topoisomerase I (topoI) and this reaction requires Mg2+. In this report, we first quantitatively studied the intermolecular interactions between Escherichia coli topoisomerase I (EctopoI) and pBAD/Thio supercoiled plasmid DNA using surface plasmon resonance (SPR) technique. The equilibrium dissociation constant (Kd) for EctopoI-pBAD/Thio interactions is determined to be about 8 nM. We then studied the effect of Mg2+ on the catalysis of EctopoI-pBAD/Thio reaction. A slightly higher equilibrium dissociation constant (~15 nM) was obtained for Mg2+ coordinated EctopoI (Mg2+EctopoI)-pBAD/Thio interactions. In addition, we observed a larger dissociation rate constant (kd) for Mg2+EctopoI-pBAD/Thio interactions (~0.043 s−1), compared to EctopoI-pBAD/Thio interactions (~0.017 s−1). These results suggest that enzyme turnover during plasmid DNA relaxation is enhanced due to the presence of Mg2+ and furthers the understanding of importance of the Mg2+ ion for bacterial topoisomerase I catalytic activity. PMID:24530905

The BCL2 antagonist of cell death pathway influences endometrial cancer cell sensitivity to cisplatin.

PubMed

Chon, Hye Sook; Marchion, Douglas C; Xiong, Yin; Chen, Ning; Bicaku, Elona; Stickles, Xiaomang Ba; Bou Zgheib, Nadim; Judson, Patricia L; Hakam, Ardeshir; Gonzalez-Bosquet, Jesus; Wenham, Robert M; Apte, Sachin M; Lancaster, Johnathan M

2012-01-01

To identify pathways that influence endometrial cancer (EC) cell sensitivity to cisplatin and to characterize the BCL2 antagonist of cell death (BAD) pathway as a therapeutic target to increase cisplatin sensitivity. Eight EC cell lines (Ishikawa, MFE296, RL 95-2, AN3CA, KLE, MFE280, MFE319, HEC-1-A) were subjected to Affymetrix Human U133A GeneChip expression analysis of approximately 22,000 probe sets. In parallel, endometrial cell line sensitivity to cisplatin was quantified by MTS assay, and IC(50) values were calculated. Pearson's correlation test was used to identify genes associated with response to cisplatin. Genes associated with cisplatin responsiveness were subjected to pathway analysis. The BAD pathway was identified and subjected to targeted modulation, and the effect on cisplatin sensitivity was evaluated. Pearson's correlation analysis identified 1443 genes associated with cisplatin resistance (P<0.05), which included representation of the BAD-apoptosis pathway. Small interfering RNA (siRNA) knockdown of BAD pathway protein phosphatase PP2C expression was associated with increased phosphorylated BAD (serine-155) levels and a parallel increase in cisplatin resistance in Ishikawa (P=0.004) and HEC-1-A (P=0.02) cell lines. In contrast, siRNA knockdown of protein kinase A expression increased cisplatin sensitivity in the Ishikawa (P=0.02) cell line. The BAD pathway influences EC cell sensitivity to cisplatin, likely via modulation of the phosphorylation status of the BAD protein. The BAD pathway represents an appealing therapeutic target to increase EC cell sensitivity to cisplatin. Copyright © 2011 Elsevier Inc. All rights reserved.

Breaking bad news of cancer diagnosis - Perception of the cancer patients in a rural community in Malaysia.

PubMed

Bain, Mathew Gabriel; Lian, Cheah Whye; Thon, Chang Ching

2014-04-01

Breaking of bad news is an important component in the management of cancer patients. This study aimed to assess the perceptions of breaking bad news of cancer diagnosis. It was a cross-sectional study using Breaking Bad News Assessment Schedule (BAS) questionnaire on cancer patients in Serian district. Using snowballing sampling method, a total of 134 patients were interviewed face-to-face after the consent was obtained from each of the respondents. Data was entered and analyzed using SPSS version 19.0. Majority were comfortable with the current method of breaking bad news. The main aspects found to be the areas of concern were the importance of the usage of body language, management of time and identifying patients' key area of concerns. There were significant difference between sex and "information giving" (P = 0.028) and "general consideration" (P = 0.016) and also between "the age and setting the scene" (P = 0.042). Significant difference was also found between the types of cancer and "the setting of scene" (P = 0.018), "breaking bad news technique" (P = 0.010), "eliciting concerns" (P = 0.003) and "information giving" (P = 0.004). Good and effective communication skill of breaking bad news is vital in the management of cancer patients. As the incidence of new cases of cancer increase every year, breaking of bad news has become a pertinent to the medical professionals' role. Specific aspects of communication skills based on local characteristics should be more emphasized in the formulation of training for doctors.

An Overview of Teaching Communication of Bad News in Medical School: Should a Lecture be Adequate to Address the Topic?

PubMed

Coutinho, Filipe; Ramessur, Anisha

2016-12-30

Delivering bad news is very common in medical daily practice. Several studies have shown a lack of effective communication skills amongst medical students, particularly concerning how to deliver bad news. The SPIKES protocol allows communicating bad news in a 6-step method. The aim of this study is to investigate the perspective of students related to this subject. A 45 minute lecture "Breaking Bad News" was given to 160 students in the fifth and sixth years of the Medicine course, using the SPIKES' protocol training. After the lecture, an online survey was given to all students, and a cross-sectional and descriptive analysis of data extracted from survey was undertaken. Fifty-four students (21% of overall) answered the online survey. Eighty three percent said that theme should have an important role in their further daily medical practice, and most of students rated the physicians' role as challenging. Sixty percent of students expressed that communicating bad news was an integral part of the medical course curriculum. Regarding the SPIKES´ protocol, 48% felt that the first step would be the easiest to put in practice, and 40% felt that the fifth step related to "Emotions" would be the most difficult. In general, the students would like to gain competencies in breaking bad news using a practical approach Conclusions: Students highly valued theoretical and practical approaches in teaching of communication of bad news. Therefore, we encourage a combination approach in pre-graduate medical education.

The stigma and prejudice of leprosy: influence on the human condition.

PubMed

Garbin, Cléa Adas Saliba; Garbin, Artênio José Ísper; Carloni, Maria Emília Oliveira Gomes; Rovida, Tânia Adas Saliba; Martins, Ronald Jefferson

2015-01-01

To analyze the knowledge, feelings and perceptions involving patients affected by leprosy, as a better understanding of these factors may be useful to decrease the stigma and prejudice associated with the condition. The study cohort consisted of 94 patients who underwent treatment for leprosy at the Health Units in the City of Cuiabá, Mato Grosso (MT), Brazil. The study questionnaire included items to collect information on socio-demographic data, knowledge about the disease, stigma, prejudice, self-esteem and quality of life of leprosy patients. Bivariate analyses were used to assess the data based on the chi-square test with a 5% significance threshold. The results revealed that the study population consisted predominantly of males (55.3%) with an income between 1 and 3 times the minimum wage (67%). The survey respondents reported that the most significant difficulties related to the treatment were the side effects (44.7%) and the duration of the treatment (28.7%). A total of 72.3% of the subjects were knowledgeable about the disease, of whom 26.6% had the leprosy reaction. Stigma and prejudice were cited by 93.6% of the participants. Based on the responses, 40.4% of patients reported being depressed and sad, and 69.1% of the subjects encountered problems at work after being diagnosed. A total of 45.7% of the patients rated their quality of life between bad and very bad. Our results suggest that leprosy causes suffering in patients beyond pain and discomfort and greatly influences social participation.

Washing away your (good or bad) luck: physical cleansing affects risk-taking behavior.

PubMed

Xu, Alison Jing; Zwick, Rami; Schwarz, Norbert

2012-02-01

Many superstitious practices entail the belief that good or bad luck can be "washed away." Consistent with this belief, participants who recalled (Experiment 1) or experienced (Experiment 2) an episode of bad luck were more willing to take risk after having as opposed to not having washed their hands, whereas participants who recalled or experienced an episode of good luck were less willing to take risk after having as opposed to not having washed their hands. Thus, the psychological effects of physical cleansings extend beyond the domain of moral judgment and are independent of people's motivation: incidental washing not only removes undesirable traces of the past (such as bad luck) but also desirable ones (such as good luck), which people would rather preserve.

Visual improvement for bad handwriting based on Monte-Carlo method

NASA Astrophysics Data System (ADS)

Shi, Cao; Xiao, Jianguo; Xu, Canhui; Jia, Wenhua

2014-03-01

A visual improvement algorithm based on Monte Carlo simulation is proposed in this paper, in order to enhance visual effects for bad handwriting. The whole improvement process is to use well designed typeface so as to optimize bad handwriting image. In this process, a series of linear operators for image transformation are defined for transforming typeface image to approach handwriting image. And specific parameters of linear operators are estimated by Monte Carlo method. Visual improvement experiments illustrate that the proposed algorithm can effectively enhance visual effect for handwriting image as well as maintain the original handwriting features, such as tilt, stroke order and drawing direction etc. The proposed visual improvement algorithm, in this paper, has a huge potential to be applied in tablet computer and Mobile Internet, in order to improve user experience on handwriting.

Hunger-induced finickiness in humans.

PubMed

Kauffman, N A; Herman, C P; Polivy, J

1995-06-01

Two experiments were conducted to examine the effect of hunger on finickiness in humans. Subjects (a total of 157 undergraduate female dieters and non-dieters) were food-deprived and then subsequently either given a snack (not-hungry group) or left food-deprived (hungry group) before being given ad libitum access to either good-tasting or bad-tasting (quinine-adultered) milkshake. Common sense predicted that hungry subjects would drink more milkshake than would not-hungry subjects, regardless of milkshake palatability. Hungry subjects did in fact drink more of the good-tasting milkshake than did not-hungry subjects, but they also drank less of the bad-tasting milkshake. We discuss possible reasons why hunger might increase rejection of bad-tasting food, as well as the limiting conditions of the effect.

Enhanced CAR T cell therapy: A novel approach for head and neck cancers.

PubMed

Wang, Songlin; Zhu, Zhao

2018-05-05

Head and neck cancer that presents in locally advanced stages often results in a bad prognosis with an increased recurrence rate even after curative resections. Radiation therapy is then applied, with multiple side effects, as adjuvant regional therapy. Because of the high rate of recurrence and mortality, new therapies are needed for patients suffering from head and neck malignant tumors.CAR (chimeric antigen receptor) T cell therapy, which was first devised about 25 years ago, causes the killing or apoptosis of target tumor cells through inducing the secretion of cytokines and granzymes by T cells (Cheadle et al., 2014). CARs are comprised of three canonical domains for antigen recognition, T cell activation, and co-stimulation, and are synthetic receptors that reprogram immune cells for therapeutic treatment of multiple tumors (Sadelain, 2017). This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The Effects of Bad and Good News on Newspaper Image and Community Image. A Report from the Communications Research Center.

ERIC Educational Resources Information Center

Haskins , Jack B.

A study tested the hypotheses that the relative amount of bad news and good news in a newspaper would have corresponding effects on perceptions of the newspaper's community of origin and of the newspaper itself. Five different versions of a realistic four-page newspaper were created, in which treatment of the news stories ranged from an…

Postmarketing comparison of labetalol and propranolol in hypertensive patients.

PubMed

Due, D L; Giguere, G C; Plachetka, J R

1986-01-01

A survey was conducted to compare the safety and effectiveness of labetalol and propranolol under routine conditions of clinical use. Patients received either labetalol (n = 805) or propranolol (n = 135) twice daily, according to package insert instructions, for six weeks. Every two weeks the patients were evaluated and weight, heart rate, blood pressure, dose, and adverse symptoms were recorded. Both treatment groups experienced a significant decline in blood pressure at six weeks; blood pressure decreased by 24/15 mmHg in the labetalol patients and by 20/14 mmHg in the propranolol patients. Heart rate decreased significantly in both groups, but the drop in the propranolol group was greater than in the labetalol group. Significantly more propranolol-treated patients reported fatigue (15.2% versus 6.3%), impotence (9.0% versus 3.2%), bad dreams (2.3% versus 0.3%), and cold extremities (2.3% versus 0%). Dizziness was reported more frequently by the labetalol group (9.1% versus 3.8%). Overall, both drugs were safe and effective in treating hypertension, but complaints of beta-blocker-associated side effects were more frequent with propranolol.

Recent Research in Antihypertensive Activity of Food Protein-derived Hydrolyzates and Peptides.

PubMed

Saleh, Ahmed S M; Zhang, Qing; Shen, Qun

2016-01-01

Year to year obesity prevalence, reduced physical activities, bad habits/or stressful lifestyle, and other environmental and physiological impacts lead to increase in diseases such as coronary heart disease, stroke, cancer, diabetes, and hypertension worldwide. Hypertension is considered as one of the most common serious chronic diseases; however, discovery of medications with high efficacy and without side effects for treatment of patients remains a challenge for scientists. Recent trends in functional foods have evidenced that food bioactive proteins play a major role in the concepts of illness and curing; therefore, nutritionists, biomedical scientists, and food scientists are working together to develop improved systems for the discovery of peptides with increased potency and therapeutic benefits. This review presents a recent research carried out to date for the purpose of isolation and identification of bioactive hydrolyzates and peptides with angiotensin I converting enzyme inhibitory activity and antihypertensive effect from animal, marine, microbial, and plant food proteins. Effects of food processing and hydrolyzation conditions as well as some other impacts on formation, activity, and stability of these hydrolyzates and peptides are also presented.

Using an Inductive Learning Algorithm to Improve Antibody Generation in a Single Packet Computer Defense Immune System

DTIC Science & Technology

2002-03-01

allow the network to perform as a much better classifier. Another disadvantage of neural networks is that it is difficult to know what is going on...could be shown to have a cause and effect relationship in producing bad antibodies, the next phase of the research was destined to go more smoothly...Number Bad 2,402 1,803 80 253 266 Training File Number Good 1,201 316 307 312 266 Number Bad 1,201 901 40 127 133 Testing File Number Good 1,201 322 333

[Atypical antipsychotics and sexual dysfunction: five case-reports associated with risperidone].

PubMed

Haefliger, T; Bonsack, C

2006-01-01

Sexual and reproductive function side effects of atypical antipsychotics are frequent, often underestimated and badly tolerated. They contribute to the 50% rate of non-compliance reported for treated patients. Prevalence of sexual dysfunction associated with atypical antipsychotic treatment is high, varying from 18 to 96%. Atypical antipsychotics aren't, as a group, much better than typical antipsychotics, and among them, risperidone seems to induce more and quetiapine less sexual dysfunction. Most atypicals are non-selective, and have actions on multiple central and peripheral receptors. Among these, dopaminergic blockade could have a direct - altering motivation (desire) and reward (orgasm) - and an indirect negative influence on sexuality. Actually, the secondary hyperprolactinemia induced by some antipsychotics (typical antipsychotics, risperidone and amisulpiride), is dose-dependent, more pronounced for female patients, and may have a detrimental effect on sexual function. It also may result in hypogonadism, particularly for female patients. The long-term consequences of this secondary hypogonadism are subject to debate but potentially severe. Furthermore, the blocking and/or modulating actions of atypical antipsychotics on adrenaline, serotonine, histamine or acetyl-choline receptors all have the potential to contribute to secondary sexual problems. The pharmacological profile of risperidone, characterized by a strong affinity for D2 and alpha1 receptors, correlates with his tendency to significantly elevate prolactin levels and to produce ejaculatory disturbances. FIVE CASE-REPORTS: We describe five case-reports of sexual or hormonal disturbances associated with risperidone treatment: two cases of ejaculatory disturbance, one case of galactorrhea and two cases of amenorrhea. Alberto and David are two young male schizophrenic patients, treated with risperidone, and complaining of a total absence of ejaculation despite a preserved orgasm. Many recent case-reports describe the occurrence of retrograde ejaculation associated with risperidone but the exact prevalence is unknown. Retrograde ejaculation is thought to be related to the strong adrenolytic activity of risperidone. Alberto refused his medication because the ejaculatory dysfunction was unbearable for him. A switch to haloperidol depot was eventually well tolerated, without any sexual complaints. His case emphasizes the importance of sexual function for self-esteem and how this may amplify the intolerance to side-effects. David is on depot-risperidone in a setting of a legally forced treatment. Though he - reluctantly - accepts his medication, this side effect exacerbates his pre-existing delusions, strongly focused on sexual themes. His case illustrates how intolerance to sexual side-effects may be amplified by nature of delusions. Mireille is a 58 year old psychotic female patient, whose 2 mg risperidone treatment produced a unilateral galactorrhea. This sign became problematic because potentially visible at a time when Mireille started an activity in a sheltered occupation in town. Lowering dosage of antipsychotic allowed disappearance of the problem. Subjective responses to galactorrhea have been reported to be highly individual. Apart being a potentially visible side-effect, it may be misinterpreted as evidence of pregnancy or of a tumoral process. The cases of Ermina and Denise illustrate two contrasted situations in terms of subjective tolerability of reproductive function side-effects. Both were pre-menopausal patients with hyperprolactinemia secondary to risperidone treatment, resulting in amenorrhea. This was unbearable for Ermina. A switch to olanzapine allowed, one month later, the menses to resume. For Denise, on the other hand, the amenorrhea was a positive event, freeing her of unpleasant menses. Amenorrhea occurs in about 30% of pre-menopausal women treated with risperidone. It is a consequence of hyperprolactinemia, which, although often silent, is not devoid of potential negative consequences (ie increased risk of osteoporosis or neoplasia, worsening of psychopathology) (34). When hyperprolactinemia is symptomatic, lowering of the dose of the antipsychotic, or switching to a prolactin-sparing agent (olanzapine, quetiapine, aripiprazole and clozapine) is recommended. Before this, women with amenorrhea secondary to antipsychotic-induced hyperprolactinemia should be advised that menses may resume. Especially after long-standing amenorrhea they may assume being menopaused, hence may believe birth control measures are no longer required. The prevalence of antipsychotic-induced sexual and reproductive function side-effects is high. Clinicians should be aware of them, because they are often badly tolerated, are associated with a low satisfaction and may therefore result in low adherence with treatment. This implies for the clinician to overtly discuss with the patient of his sexuality and the potential negative impact of antipsychotic treatment on it. The recognition of these problems allows the searching together for a solution. The described cases indicate that solving the problem is often possible, provided that individual preferences and subjective impact are taken in account. Antipsychotic treatment is often prescribed for very long periods. A better knowledge of - and attention to - the associated side effects, particularly on the sexual and reproductive functions, is necessary in order to reduce some potentially negative long-term effects and to improve the adherence to treatment of our patients.

Breaking bad news of cancer diagnosis – Perception of the cancer patients in a rural community in Malaysia

PubMed Central

Bain, Mathew Gabriel; Lian, Cheah Whye; Thon, Chang Ching

2014-01-01

Context: Breaking of bad news is an important component in the management of cancer patients. Aims: This study aimed to assess the perceptions of breaking bad news of cancer diagnosis. Settings and Design: It was a cross-sectional study using Breaking Bad News Assessment Schedule (BAS) questionnaire on cancer patients in Serian district. Materials and Methods: Using snowballing sampling method, a total of 134 patients were interviewed face-to-face after the consent was obtained from each of the respondents. Statistical Analysis Used: Data was entered and analyzed using SPSS version 19.0. Results: Majority were comfortable with the current method of breaking bad news. The main aspects found to be the areas of concern were the importance of the usage of body language, management of time and identifying patients’ key area of concerns. There were significant difference between sex and “information giving” (P = 0.028) and “general consideration” (P = 0.016) and also between “the age and setting the scene” (P = 0.042). Significant difference was also found between the types of cancer and “the setting of scene” (P = 0.018), “breaking bad news technique” (P = 0.010), “eliciting concerns” (P = 0.003) and “information giving” (P = 0.004). Conclusion: Good and effective communication skill of breaking bad news is vital in the management of cancer patients. As the incidence of new cases of cancer increase every year, breaking of bad news has become a pertinent to the medical professionals’ role. Specific aspects of communication skills based on local characteristics should be more emphasized in the formulation of training for doctors. PMID:24818107

The Do It Wrong Approach to Writing.

ERIC Educational Resources Information Center

Grow, Gerald

Deliberately writing badly can be an effective way to learn to write better because knowing when writing is bad is an essential element in knowing when it's good. There are distinct advantages to encouraging students to learn the rules by breaking them. Deliberately doing it wrong removes the threat of failure. Students are playing; they are…

Breaking bad news: A guide for effective and empathetic communication

PubMed Central

Rosenzweig, Margaret Quinn

2017-01-01

Breaking negative news to patients is a common occurrence for nurse practitioners. This difficult task requires patience and refined communication skills, and must be approached with empathy for all parties involved. There are several ways to deliver bad news to patients successfully using patient-centered communication techniques and methods. PMID:22252021

Varying the Order in which Positive and Negative Information Is Presented: Effects on Counselors' Judgments of Clients' Mental Health.

ERIC Educational Resources Information Center

Pain, Michelle D.; Sharpley, Christopher F.

1989-01-01

Studied ratings by Australian counseling psychology graduate students (N=38) and practicing counseling psychologists (N=40) of four hypothetical clients' mental health. Presented "good,""bad," and "neutral" information on each client and asked subjects to rate clients' on Global Assessment Scale. Found bad information…

BAD, a Proapoptotic Protein, Escapes ERK/RSK Phosphorylation in Deguelin and siRNA-Treated HeLa Cells

PubMed Central

Hafeez, Samra; Urooj, Mahwish; Saleem, Shamiala; Gillani, Zeeshan; Shaheen, Sumaira; Qazi, Mahmood Husain; Naseer, Muhammad Imran; Iqbal, Zafar; Ansari, Shakeel Ahmed; Haque, Absarul; Asif, Muhammad; Mir, Manzoor Ahmad; Ali, Ashraf; Pushparaj, Peter Natesan; Jamal, Mohammad Sarwar; Rasool, Mahmood

2016-01-01

This study has been undertaken to explore the therapeutic effects of deguelin and specific siRNAs in HeLa cells. The data provided clearly show the silencing of ERK 1/2 with siRNAs and inhibition of ERK1/2 with deguelin treatment in HeLa cells. Additionally, we are providing information that deguelin binds directly to anti-apoptotic Bcl-2, Bcl-xl and Mcl-1 in the hydrophobic grooves, thereby releasing BAD and BAX from dimerization with these proteins. This results in increased apoptotic activity through the intrinsic pathway involved in rupture of mitochondrial membrane and release of cytochrome C. Evidence for inhibition of ERK1/2 by deguelin and escape of BAD phosphorylation at serine 112 through ERK/RSK pathway has been further fortified by obtaining similar results by silencing ERK 1/2 each with specific siRNAs. Increase in BAD after treatment with deguelin or siRNAs has been interpreted to mean that deguelin acts through several alternative pathways and therefore can be used as effective therapeutic agent. PMID:26745145

Behavioral stress accelerates prostate cancer development in mice

PubMed Central

Hassan, Sazzad; Karpova, Yelena; Baiz, Daniele; Yancey, Dana; Pullikuth, Ashok; Flores, Anabel; Register, Thomas; Cline, J. Mark; D’Agostino, Ralph; Danial, Nika; Datta, Sandeep Robert; Kulik, George

2013-01-01

Prostate cancer patients have increased levels of stress and anxiety. Conversely, men who take beta blockers, which interfere with signaling from the stress hormones adrenaline and noradrenaline, have a lower incidence of prostate cancer; however, the mechanisms underlying stress–prostate cancer interactions are unknown. Here, we report that stress promotes prostate carcinogenesis in mice in an adrenaline-dependent manner. Behavioral stress inhibited apoptosis and delayed prostate tumor involution both in phosphatase and tensin homolog–deficient (PTEN-deficient) prostate cancer xenografts treated with PI3K inhibitor and in prostate tumors of mice with prostate-restricted expression of c-MYC (Hi-Myc mice) subjected to androgen ablation therapy with bicalutamide. Additionally, stress accelerated prostate cancer development in Hi-Myc mice. The effects of stress were prevented by treatment with the selective β2-adrenergic receptor (ADRB2) antagonist ICI118,551 or by inducible expression of PKA inhibitor (PKI) or of BCL2-associated death promoter (BAD) with a mutated PKA phosphorylation site (BADS112A) in xenograft tumors. Effects of stress were also blocked in Hi-Myc mice expressing phosphorylation-deficient BAD (BAD3SA). These results demonstrate interactions between prostate tumors and the psychosocial environment mediated by activation of an adrenaline/ADRB2/PKA/BAD antiapoptotic signaling pathway. Our findings could be used to identify prostate cancer patients who could benefit from stress reduction or from pharmacological inhibition of stress-induced signaling. PMID:23348742

Hospital consultants breaking bad news with simulated patients: an analysis of communication using the Roter Interaction Analysis System.

PubMed

Vail, Laura; Sandhu, Harbinder; Fisher, Joanne; Cooke, Heather; Dale, Jeremy; Barnett, Mandy

2011-05-01

To explore how experienced clinicians from wide ranging specialities deliver bad news, and to investigate the relationship between physician characteristics and patient centredness. Consultations involving 46 hospital consultants from 22 different specialties were coded using the Roter Interaction Analysis System. Consultants mainly focussed upon providing biomedical information and did not discuss lifestyle and psychosocial issues frequently. Doctor gender, age, place of qualification, and speciality were not significantly related to patient centredness. Hospital consultants from wide ranging specialities tend to adopt a disease-centred approach when delivering bad news. Consultant characteristics had little impact upon patient centredness. Further large-scale studies are needed to examine the effect of doctor characteristics on behaviour during breaking bad news consultations. It is possible to observe breaking bad news encounters by video-recording interactions between clinicians and simulated patients. Future training programmes should focus on increasing patient-centred behaviours which include actively involving patients in the consultation, initiating psychosocial discussion, and providing patients with opportunities to ask questions. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Seizure-like activity leads to the release of BAD from 14-3-3 protein and cell death in hippocampal neurons in vitro.

PubMed

Meller, R; Schindler, C K; Chu, X P; Xiong, Z G; Cameron, J A; Simon, R P; Henshall, D C

2003-05-01

Seizure-induced neuronal death may involve engagement of the BCL-2 family of apoptosis-regulating proteins. In the present study we examined the activation of proapoptotic BAD in cultured hippocampal neurons following seizures induced by removal of chronic glutamatergic transmission blockade. Kynurenic acid withdrawal elicited an increase in seizure-like electrical activity, which was inhibited by blockers of AMPA (CNQX) and NMDA (MK801 and AP5) receptor function. However, only NMDA receptor antagonists inhibited calcium entry as assessed by fura-2, and cell death of hippocampal neurons. Seizures increased proteolysis of caspase-3 and terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) of cells. Seizure-like activity induced dephosphorylation of BAD and the disruption of its constitutive interaction with 14-3-3 proteins. In turn, BAD dimerized with antiapoptotic BCL-Xl after seizures. However, the absence of neuroprotective effects of pathway intervention suggests that BAD may perform a reinforcement rather than instigator role in cell death following seizures in vitro.

Future Directions in the Study of Close Relationships: Conflict Is Bad (Except when It's Not)

ERIC Educational Resources Information Center

Laursen, Brett; Hafen, Christopher A.

2010-01-01

Beneficial and detrimental correlates of interpersonal disagreement have been postulated and documented. The conclusion: conflict is both bad and good. The evidence for these paradoxical effects is summarized. In this article, we argue that the consequences of conflict for individuals depend on its frequency, the way in which it is managed, and…

Is Materialism All That Bad? Effects on Satisfaction with Material Life, Life Satisfaction, and Economic Motivation

ERIC Educational Resources Information Center

Sirgy, M. Joseph; Gurel-Atay, Eda; Webb, Dave; Cicic, Muris; Husic-Mehmedovic, Melika; Ekici, Ahmet; Herrmann, Andreas; Hegazy, Ibrahim; Lee, Dong-Jin; Johar, J. S.

2013-01-01

The literature in economic psychology and quality-of-life studies alludes to a negative relationship between materialism and life satisfaction. In contrast, the macroeconomic literature implies a positive relationship between material consumption and economic growth. That is, materialism may be both good and bad. We develop a model that reconciles…

Risky Disclosures on "Facebook": The Effect of Having a Bad Experience on Online Behavior

ERIC Educational Resources Information Center

Christofides, Emily; Muise, Amy; Desmarais, Serge

2012-01-01

Social network websites are widely used by adolescents, but disclosing in this environment has inherent risks, as does connecting with others online. In a sample of 256 adolescent "Facebook" users, the authors explore the relationship between having a negative experience, privacy knowledge, and behavior. Their reports of bad experiences on…

Medical training for communication of bad news: A literature review

PubMed Central

Alelwani, Somia M.; Ahmed, Yasar A.

2014-01-01

In recent years, medical guidelines for communicating bad news to patients have been published. Training for this task was included in the curricula of undergraduate medical courses, specialization, and continuing medical education. The objective of this review is to evaluate the existing evidence in the literature on the effectiveness of such training. Only seven controlled trials were found, four of which were randomized, and these four indicate an improvement in the trainees. These findings suggest that training undergraduate and postgraduate doctors in skills for communicating bad news may be beneficial but there are important limitations to reach a definitive conclusion. These limitations are discussed in this article. PMID:25077144

A Response to Robert Maranto's Review of "Bad Students, Not Bad Schools"

ERIC Educational Resources Information Center

Weissberg, Robert

2012-01-01

This article presents the author's response to Robert Maranto's review of "Bad Students, Not Bad Schools". The author begins by thanking Professor Maranto for his thoughtful review of his "Bad Students, Not Bad Schools" (2010). Professor Maranto is the first professional educator to acknowledge the book's existence, a fact that says much about…

Debating Robert Weissberg: Why We Should Read but Not Accept "Bad Students, Not Bad Schools"

ERIC Educational Resources Information Center

Maranto, Robert

2012-01-01

This article presents the author's critique on Robert Weissberg's book titled "Bad Students, Not Bad Schools". The author argues that Weissberg's readable, controversial "Bad Students, Not Bad Schools" (2010) is funny, acerbic, bold, and slaughters more than a few sacred cows of what Weissberg calls the "failed educational industrial complex." As…

Video games: good, bad, or other?

PubMed

Prot, Sara; McDonald, Katelyn A; Anderson, Craig A; Gentile, Douglas A

2012-06-01

Video games are a pervasive pastime among children and adolescents. The growing popularity of video games has instigated a debate among parents, researchers, video game producers, and policymakers concerning potential harmful and helpful effects of video games on children. This article provides an overview of research findings on the positive and negative effects of video games, thus providing an empirical answer to the question, are video games good or bad? The article also provides some guidelines to help pediatricians, parents, and other caregivers protect children from negative effects and to maximize positive effects of video games. Copyright © 2012 Elsevier Inc. All rights reserved.

Young Single Soldiers and Relationships. Appendix with Crosstabulations

DTIC Science & Technology

1994-03-01

Extremely Bad 21.4 20.4 20.0 12.9 Quite Bad 11.5 10.3 9.5 9.5 Slightly Bad 8.0 8.7 6.7 8.3 Not Good or Bad 24.1 21.7 27.0 21.5 Slightly Good 9.3 10.3 10.2...Slightly Bad 8.2 8.9 5.8 8.2 Not Good or Bad 23.3 21.8 28.0 21.1 Slightly Good 9.2 9.7 9.9 11.2 Quite Good 16.6 19.1 16.6 22.2 Extremely Good 8.4 10.3 9.8...14.4 Female Extremely Bad 9.9 21.5 14.6 10.6 Quite Bad 5.7 12.6 12.3 9.3 Slightly Bad 5.5 7.3 11.8 8.9 Not Good or Bad 33.9 20.9 21.4 23.2 Slightly Good

Creation and Assessment of a Bad News Delivery Simulation Curriculum for Pediatric Emergency Medicine Fellows.

PubMed

Chumpitazi, Corrie E; Rees, Chris A; Chumpitazi, Bruno P; Hsu, Deborah C; Doughty, Cara B; Lorin, Martin I

2016-05-01

Background  Bad news in the context of health care has been broadly defined as significant information that negatively alters people's perceptions of the present or future. Effectively delivering bad news (DBN) in the setting of the emergency department requires excellent communication skills. Evidence shows that bad news is frequently given inadequately. Studies show that trainees need to devote more time to developing this skill through formalized training. This program's objectives were to utilize trained standardized patients in a simulation setting to assist pediatric emergency medicine (PEM) fellows in the development of effective, sensitive, and compassionate communication with patients and family members when conveying bad news, and to recognize and respond to the patient/parent's reaction to such news. Methods PEM fellows participated in a novel curriculum utilizing simulated patients (SPs) acting as the patient's parent and immersive techniques in a realistic and supportive environment. A baseline survey was conducted to ascertain participant demographics and previous experience with simulation and DBN. Experienced, multi-disciplinary faculty participated in a training workshop with the SPs one week prior to course delivery. Three scenarios were developed for bad news delivery. Instructors watched via remote video feed while the fellows individually interacted with the SPs and then participated in a confidential debriefing. Fellows later joined for group debriefing. Fellow characteristics, experience, and self-perceived comfort pre/post-course were collected.   Results Baseline data demonstrated that 78% of fellows reported DBN two or more times per month. Ninety-three percent of fellows in this study were present during the delivery of news about the death of a child to a parent or family member in the six-month period preceding this course. Fellows' self-reported comfort level in DBN to a patient/family and dealing with patient and parent emotions improved significantly (p=0.034 and p=0.046, respectively). Conclusions Pediatric emergency medicine fellows frequently deliver bad news. A course using SPs was well received by trainees and resulted in improvement in self-assessed skills and comfort. This curriculum provides the opportunity for fellows to receive patient/parent feedback of their communication skills and observations from skilled instructors. This methodology should be considered when creating training curricula for bad news delivery skills.

PEG 3350 (Transipeg) versus lactulose in the treatment of childhood functional constipation: a double blind, randomised, controlled, multicentre trial

PubMed Central

Voskuijl, W; de Lorijn, F; Verwijs, W; Hogeman, P; Heijmans, J; Mäkel, W; Taminiau, J; Benninga, M

2004-01-01

Background: Recently, polyethylene glycol (PEG 3350) has been suggested as a good alternative laxative to lactulose as a treatment option in paediatric constipation. However, no large randomised controlled trials exist evaluating the efficacy of either laxative. Aims: To compare PEG 3350 (Transipeg: polyethylene glycol with electrolytes) with lactulose in paediatric constipation and evaluate clinical efficacy/side effects. Patients: One hundred patients (aged 6 months–15 years) with paediatric constipation were included in an eight week double blinded, randomised, controlled trial. Methods: After faecal disimpaction, patients <6 years of age received PEG 3350 (2.95 g/sachet) or lactulose (6 g/sachet) while children ⩾6 years started with 2 sachets/day. Primary outcome measures were: defecation and encopresis frequency/week and successful treatment after eight weeks. Success was defined as a defecation frequency ⩾3/week and encopresis ⩽1 every two weeks. Secondary outcome measures were side effects after eight weeks of treatment. Results: A total of 91 patients (49 male) completed the study. A significant increase in defecation frequency (PEG 3350: 3 pre v 7 post treatment/week; lactulose: 3 pre v 6 post/week) and a significant decrease in encopresis frequency (PEG 3350: 10 pre v 3 post/week; lactulose: 8 pre v 3 post/week) was found in both groups (NS). However, success was significantly higher in the PEG group (56%) compared with the lactulose group (29%). PEG 3350 patients reported less abdominal pain, straining, and pain at defecation than children using lactulose. However, bad taste was reported significantly more often in the PEG group. Conclusions: PEG 3350 (0.26 (0.11) g/kg), compared with lactulose (0.66 (0.32) g/kg), provided a higher success rate with fewer side effects. PEG 3350 should be the laxative of first choice in childhood constipation. PMID:15479678

BadR and BadM Proteins Transcriptionally Regulate Two Operons Needed for Anaerobic Benzoate Degradation by Rhodopseudomonas palustris

PubMed Central

Hirakawa, Hidetada; Hirakawa, Yuko; Greenberg, E. Peter

2015-01-01

The bacterium Rhodopseudomonas palustris grows with the aromatic acid benzoate and the alicyclic acid cyclohexanecarboxylate (CHC) as sole carbon sources. The enzymatic steps in an oxygen-independent pathway for CHC degradation have been elucidated, but it was unknown how the CHC operon (badHI aliAB badK) encoding the enzymes for CHC degradation was regulated. aliA and aliB encode enzymes for the conversion of CHC to cyclohex-1-enecarboxyl–coenzyme A (CHene-CoA). At this point, the pathway for CHC degradation merges with the pathway for anaerobic benzoate degradation, as CHene-CoA is an intermediate in both degradation pathways. Three enzymes, encoded by badK, badH, and badI, prepare and cleave the alicyclic ring of CHene-CoA to yield pimelyl-CoA. Here, we show that the MarR transcription factor family member, BadR, represses transcription of the CHC operon by binding near the transcription start site of badH. 2-Ketocyclohexane-1-carboxyl–CoA, an intermediate of CHC and benzoate degradation, interacts with BadR to abrogate repression. We also present evidence that the transcription factor BadM binds to the promoter of the badDEFGAB (Bad) operon for the anaerobic conversion of benzoate to CHene-CoA to repress its expression. Contrary to previous reports, BadR does not appear to control expression of the Bad operon. These data enhance our view of the transcriptional regulation of anaerobic benzoate degradation by R. palustris. PMID:25888170

Breaking Bad News: Patient Preferences and the Role of Family Members when Delivering a Cancer Diagnosis.

PubMed

Rao, Abha; Ekstrand, Maria; Heylen, Elsa; Raju, Girish; Shet, Arun

2016-01-01

Western physicians tend to favour complete disclosure of a cancer diagnosis to the patient, while non-Western physicians tend to limit disclosure and include families in the process; the latter approach is prevalent in clinical oncology practice in India. Few studies, however, have examined patient preferences with respect to disclosure or the role of family members in the process. Structured interviews were conducted with patients (N=127) in the medical oncology clinic of a tertiary referral hospital in Bangalore, India. Patients ranged in age from 18-88 (M=52) and were mostly male (59%). Most patients (72%) wanted disclosure of the diagnosis cancer, a preference significantly associated with higher education and English proficiency. A majority wanted their families to be involved in the process. Patients who had wanted and not wanted disclosure differed with respect to their preferences regarding the particulars of disclosure (timing, approach, individuals involved, role of family members). Almost all patients wanted more information concerning their condition, about immediate medical issues such as treatments or side effects, rather than long-term or non-medical issues. While most cancer patients wanted disclosure of their disease, a smaller group wished that their cancer diagnosis had not been disclosed to them. Regardless of this difference in desire for disclosure, both groups sought similar specific information regarding their cancer and largely favoured involvement of close family in decision making. Additional studies evaluating the influence of factors such as disease stage or family relationships could help guide physicians when breaking bad news.

The effect of cigarette smoking on cancer treatment-related side effects.

PubMed

Peppone, Luke J; Mustian, Karen M; Morrow, Gary R; Dozier, Ann M; Ossip, Deborah J; Janelsins, Michelle C; Sprod, Lisa K; McIntosh, Scott

2011-01-01

Cigarette smoking has long been implicated in cancer development and survival. However, few studies have investigated the impact of smoking on symptom burden in cancer survivors during treatment and at survivorship stage. This study examines the influence of cigarette smoking on side effects among 947 cancer patients during and 6 months following treatment. Patients diagnosed with cancer and scheduled to receive chemotherapy and/or radiation therapy reported on current smoking status (yes, no) and total symptom burden [the sum of 12 common symptoms (fatigue, hair loss, memory, nausea, depression, sleep, pain, concentration, hot flashes, weight loss, skin problems, and dyspnea) scored on an 11-point scale ranging from 0 = "not present" to 10 = "as bad as you can imagine"] during treatment and at 6-month follow-up. The adjusted mean total symptom burden by smoking status was determined by analysis of covariance controlling for age, gender, race, education, occupation, treatment, cancer site, and Karnofsky performance score. During treatment, smokers (S) had a significantly higher total symptom burden than nonsmokers (NS) (S = 46.3 vs. NS = 41.2; p < 0.05). At 6-month follow-up, smokers continued to report a higher total symptom burden than nonsmokers (S = 27.7 vs. NS = 21.9; p < 0.05). Participants who quit smoking before treatment levels had a total symptom burden similar to nonsmokers. Smoking was associated with an increased symptom burden during and following treatments for cancer. Targeted cessation efforts for smokers to decrease symptom burden may limit the likelihood of treatment interruptions and increase quality of life following treatment.

Oncology Communication Skills Training: Bringing Science to the Art of Delivering Bad News

PubMed Central

Stovall, Mady C.

2015-01-01

Review of "Effect of communication skills training program for oncologists based on patient preferences for communication when receiving bad news: A randomized controlled trial" by Fujimori et al. (2014), Journal of Clinical Oncology, 32, 2166–2172. For a further discussion of survey research, please see the related article by Julie Ponto starting on page 168. PMID:26649249

Oncology Communication Skills Training: Bringing Science to the Art of Delivering Bad News.

PubMed

Stovall, Mady C

2015-01-01

Review of "Effect of communication skills training program for oncologists based on patient preferences for communication when receiving bad news: A randomized controlled trial" by Fujimori et al. (2014), Journal of Clinical Oncology, 32, 2166-2172. For a further discussion of survey research, please see the related article by Julie Ponto starting on page 168.

Insular and hippocampal contributions to remembering people with an impression of bad personality.

PubMed

Tsukiura, Takashi; Shigemune, Yayoi; Nouchi, Rui; Kambara, Toshimune; Kawashima, Ryuta

2013-06-01

Our impressions of other people are formed mainly from the two possible factors of facial attractiveness and trustworthiness. Previous studies have shown the importance of orbitofrontal-hippocampal interactions in the better remembering of attractive faces, and psychological data have indicated that faces giving an impression of untrustworthiness are remembered more accurately than those giving an impression of trustworthiness. However, the neural mechanisms of the latter effect are largely unknown. To investigate this issue, we investigated neural activities with event-related fMRI while the female participants rated their impressions of the personalities of men in terms of trustworthiness. After the rating, memory for faces was tested to identify successful encoding activity. As expected, faces that gave bad impressions were remembered better than those that gave neutral or good impressions. In fMRI data, right insular activity reflected an increasing function of bad impressions, and bilateral hippocampal activities predicted subsequent memory success. Additionally, correlation between these insular and hippocampal regions was significant only in the encoding of faces associated with a bad impression. Better memory for faces associated with an impression of bad personality could reflect greater interaction between the avoidance-related insular region and the encoding-related hippocampal region.

Insular and hippocampal contributions to remembering people with an impression of bad personality

PubMed Central

Shigemune, Yayoi; Nouchi, Rui; Kambara, Toshimune; Kawashima, Ryuta

2013-01-01

Our impressions of other people are formed mainly from the two possible factors of facial attractiveness and trustworthiness. Previous studies have shown the importance of orbitofrontal–hippocampal interactions in the better remembering of attractive faces, and psychological data have indicated that faces giving an impression of untrustworthiness are remembered more accurately than those giving an impression of trustworthiness. However, the neural mechanisms of the latter effect are largely unknown. To investigate this issue, we investigated neural activities with event-related fMRI while the female participants rated their impressions of the personalities of men in terms of trustworthiness. After the rating, memory for faces was tested to identify successful encoding activity. As expected, faces that gave bad impressions were remembered better than those that gave neutral or good impressions. In fMRI data, right insular activity reflected an increasing function of bad impressions, and bilateral hippocampal activities predicted subsequent memory success. Additionally, correlation between these insular and hippocampal regions was significant only in the encoding of faces associated with a bad impression. Better memory for faces associated with an impression of bad personality could reflect greater interaction between the avoidance-related insular region and the encoding-related hippocampal region. PMID:22349799

Development of casting investment preventing blackening of noble metal alloys part 3. Effect of reducing agent addition on the strength and expansion of the investments.

PubMed

Meng, Yukun; Nakai, Akira; Ogura, Hideo

2004-06-01

Different reducing agents (B, Al, Si and Ti) were individually added to two gypsum-bonded investments to prepare investments preventing surface blackening of some noble cast alloys. The effect of different additive contents on green-body and burnout compressive strength, setting and thermal expansion of the investments were evaluated. The strength and expansion of the investments were changed by the additives. The compressive strength of Al-, Si- and Ti-added investments decreased with the increase of additive contents. The burnout strength of B-added investments significantly increased while green-body strength remained unchanged. The setting expansion of the B-added investments increased while those of the Al-, Si- and Ti-added investments decreased with the increase of additive contents. The thermal expansion of the Si- and Ti-added investments decreased, and that of the Al- and B-added investments remained unchanged. Further study is necessary to evaluate the effects of these additives on the accuracy of dental castings.

Loss of Bad expression confers poor prognosis in non-small cell lung cancer.

PubMed

Huang, Yi; Liu, Dan; Chen, Bojiang; Zeng, Jing; Wang, Lei; Zhang, Shangfu; Mo, Xianming; Li, Weimin

2012-09-01

Proapoptotic BH-3-only protein Bad (Bcl-Xl/Bcl-2-associated death promoter homolog, Bad) initiates apoptosis in human cells, and contributes to tumorigenesis and chemotherapy resistant in malignancies. This study explored association between the Bad expression level and prognosis in patients with non-small cell lung cancer (NSCLC). In our study, a cohort of 88 resected primary NSCLC cases were collected and analyzed. Bad expression level was determined via immunohistochemical staining assay. The prognostic significances of Bad expression were evaluated with univariate and multivariate survival analysis. The results showed that compared with normal lung tissues, Bad expression level significantly decreased in NSCLC (P < 0.05). Bad expression was associated with adjuvant therapy status. Loss of Bad independently predicted poor prognosis in whole NSCLC cohort and early stage subjects (T1 + T2 and N0 + N1) (all P < 0.05). Overall survival time was also drastically shortened for Bad negative phenotype in NSCLC patients with smoking history, especially lung squamous cell carcinoma (all P < 0.05). In conclusion, this study provided clinical evidence that loss of Bad is an independent and powerful predictor of adverse prognosis in NSCLC. Bad protein could be a new biomarker for selecting individual therapy strategies and predicting therapeutic response in subjects with NSCLC.

[Halitosis: a multidisciplinary problem].

PubMed

Bollen, C M; Rompen, E H; Demanez, J P

1999-01-01

Bad breath, or halitosis, affects between 50 and 65% of the population. Despite its frequency, this problem is often unaccepted and declared taboo. In about 8% of the cases, bad breath is related to an ENT pathology (sinusitis, tonsillitis, ...). More rarely it is caused by a metabolic (diabetes, trimethylaminuremia, ...) or gastric dysfunction. Ninety percent of the cases however, are associated to an oral disease: either gingivitis due to an inadequate removal of dental plaque, especially from interdental spaces, or periodontitis (alveolar bone destruction), or bacterial accumulation on the dorsum of the tongue. In most cases, an intensive disinfection of the mouth by scaling and root planing and/or instruction of a perfect oral hygiene will be sufficient to solve the problem. Perfumed mouthwashes or toothpastes will only give a short-term masking effect. An effective collaboration between a dentist or a periodontist and an ENT specialist is of great importance to dealt with bad breath.

Human development of the ability to learn from bad news.

PubMed

Moutsiana, Christina; Garrett, Neil; Clarke, Richard C; Lotto, R Beau; Blakemore, Sarah-Jayne; Sharot, Tali

2013-10-08

Humans show a natural tendency to discount bad news while incorporating good news into beliefs (the "good news-bad news effect"), an effect that may help explain seemingly irrational risk taking. Understanding how this bias develops with age is important because adolescents are prone to engage in risky behavior; thus, educating them about danger is crucial. We reveal a striking valence-dependent asymmetry in how belief updating develops with age. In the ages tested (9-26 y), younger age was associated with inaccurate updating of beliefs in response to undesirable information regarding vulnerability. In contrast, the ability to update beliefs accurately in response to desirable information remained relatively stable with age. This asymmetry was mediated by adequate computational use of positive but not negative estimation errors to alter beliefs. The results are important for understanding how belief formation develops and might help explain why adolescents do not respond adequately to warnings.

Selectively altering belief formation in the human brain

PubMed Central

Sharot, Tali; Kanai, Ryota; Marston, David; Korn, Christoph W.; Rees, Geraint; Dolan, Raymond J.

2012-01-01

Humans form beliefs asymmetrically; we tend to discount bad news but embrace good news. This reduced impact of unfavorable information on belief updating may have important societal implications, including the generation of financial market bubbles, ill preparedness in the face of natural disasters, and overly aggressive medical decisions. Here, we selectively improved people’s tendency to incorporate bad news into their beliefs by disrupting the function of the left (but not right) inferior frontal gyrus using transcranial magnetic stimulation, thereby eliminating the engrained “good news/bad news effect.” Our results provide an instance of how selective disruption of regional human brain function paradoxically enhances the ability to incorporate unfavorable information into beliefs of vulnerability. PMID:23011798

Age-specific doses of lormetazepam as a night sedative in cases of chronic sleep disturbance.

PubMed

Jovanović, U J; Ott, H; Heidrich, H; Stephan, K; Schratzer, M

1980-01-01

Lormetazepam, a new benzodiazepine derivative, was tested under double blind conditions in order to find the optimal dosage for different age groups of out-patients. 120 patients suffering from chronic sleep disturbance were included in the study: a younger group (age 20 to 55) and an older group (age 56 to 85 years). Four different doses were given to each age group: 0.5, 1.0, 2.0, and 3.0 mg to the younger group and 0.5, 1.0, 1.5, and 2.0 mg to the older group. A pre-placebo week (i.e. when all patients received placebo) in which baseline data were recorded preceded the two verum weeks, and these were followed by a post-placebo or withdrawal week (again all patients receiving placebo). The level of significance accepted for statistical decisions was alpha = 0.05. No differences in effects between the different doses were observed with regard to sleep pattern variables (sleep latency, sleep duration, frequency of awakenings, sleep quality, occurrence of 'bad' dreams) with the exception of sleep quality which was better in the older group than in the younger group after 0.5 mg in week 2. Considerable differences with regard to hangover feelings the next morning and during the next day (morning feelings, tranquility, alertness, and concentration), comparison of the effects of discontinuing therapy upon the above-mentioned sleep pattern variables and small differences in side effects--which were few--led to the following conclusion: --0.5 mg stood out as the best dose for the older group. --None of the dosages given to the younger group emerged clearly as superior. However, it would seem that the 1 mg dose should be the dose recommended, since fewer unfavourable scores and side effects appeared after this dose.

A standardized patient model to teach and assess professionalism and communication skills: the effect of personality type on performance.

PubMed

Lifchez, Scott D; Redett, Richard J

2014-01-01

Teaching and assessing professionalism and interpersonal communication skills can be more difficult for surgical residency programs than teaching medical knowledge or patient care, for which many structured educational curricula and assessment tools exist. Residents often learn these skills indirectly, by observing the behavior of their attendings when communicating with patients and colleagues. The purpose of this study was to assess the results of an educational curriculum we created to teach and assess our residents in professionalism and communication. We assessed resident and faculty prior education in delivering bad news to patients. Residents then participated in a standardized patient (SP) encounter to deliver bad news to a patient's family regarding a severe burn injury. Residents received feedback from the encounter and participated in an education curriculum on communication skills and professionalism. As a part of this curriculum, residents underwent assessment of communication style using the Myers-Briggs type inventory. The residents then participated in a second SP encounter discussing a severe pulmonary embolus with a patient's family. Resident performance on the SP evaluation correlated with an increased comfort in delivering bad news. Comfort in delivering bad news did not correlate with the amount of prior education on the topic for either residents or attendings. Most of our residents demonstrated an intuitive thinking style (NT) on the Myers-Briggs type inventory, very different from population norms. The lack of correlation between comfort in delivering bad news and prior education on the subject may indicate the difficulty in imparting communication and professionalism skills to residents effectively. Understanding communication style differences between our residents and the general population can help us teach professionalism and communication skills more effectively. With the next accreditation system, residency programs would need to demonstrate that residents are acquiring these skills in their training. SP encounters are effective in teaching and assessing these skills. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

Executive brain functions after exposure to nocturnal traffic noise: effects of task difficulty and sleep quality.

PubMed

Schapkin, Sergei A; Falkenstein, Michael; Marks, Anke; Griefahn, Barbara

2006-04-01

The after-effects of nocturnal traffic noise on cognitive performance and inhibitory brain activity were investigated. Twenty participants (18-30 years) performed an easy and a difficult visual Go/Nogo task with simultaneous EEG recording after a quiet night and then during three nights when aircraft noise was presented with equivalent noise levels of 39, 44, and 50 dBA, respectively, between 11 p.m. to 7 a.m. Based on subjective sleep quality rating, participants were separated into "good" versus "bad" sleepers. The performance and inhibition-related components (N2, P3) of event-related potentials were analysed. The N2 and P3 amplitudes were smaller and latencies were prolonged in the difficult than in the easy task. This effect was more pronounced for Nogo than for Go trials. The Nogo-P3 amplitude was smaller in Noise than in "Quiet" conditions in the difficult task only. In the difficult task, the Nogo-P3 latency was prolonged in bad sleepers than in good sleepers. The Nogo-P3 amplitude was reduced in Noise as compared to "Quiet" conditions in bad sleepers only. Sleep quality in bad sleepers worsened steadily with increasing noise levels. No effects of noise or subjective sleep quality on performance were found. Inhibitory processes appear to be selectively impaired after nocturnal noise exposure. The task difficulty and perceived sleep quality are important factors modulating noise effects. The results suggest that nocturnal traffic noise increase physiological costs for inhibitory functioning on the day even if no overt performance decrement is observed.

Evaluation of the impact of a simulation-enhanced breaking bad news workshop in pediatrics.

PubMed

Tobler, Kathleen; Grant, Estee; Marczinski, Cecile

2014-08-01

Our goal was to develop and evaluate the effectiveness of a simulation-based workshop for teaching pediatric trainees' communication skills in breaking bad news. A simulation-based workshop was developed to teach skills in breaking bad news. After a classroom-based introduction, small groups of residents participated in 3 scenarios, each starting with a simulated resuscitation, followed by 2 conversations with the patient's parent, played by actors. Each conversation was observed through a 1-way mirror and was followed by a debriefing. After the workshop, the residents completed workshop evaluations and a self-assessment. Before and after the workshop, residents were evaluated in Objective Structured Clinical Examination stations where they were required to give bad news. Two physician experts and 2 parents who personally experienced receiving bad news about their child evaluated resident performance using a previously validated communication evaluation tool. Residents' ratings of the workshop were very high for all items, and 100% of the residents reported improvement in their ability to deliver bad news after the workshop. Statistically significant improvement was found in 14 of 17 items of the evaluation tool used by experts and parents, with the parents reporting greater improvement than the experts. This reflective, simulation-based workshop successfully improved pediatric trainees' skills in having difficult conversations with families, as evaluated by the participants, by physician experts, and, most importantly, by parents who have experienced these conversations in real life.

26 CFR 1.166-1 - Bad debts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Bad debts. 1.166-1 Section 1.166-1 Internal... TAXES (CONTINUED) Itemized Deductions for Individuals and Corporations § 1.166-1 Bad debts. (a... shall be allowed in respect of bad debts owed to the taxpayer. For this purpose, bad debts shall...

Amoxicillin for acute lower respiratory tract infection in primary care: subgroup analysis of potential high-risk groups

PubMed Central

Moore, Michael; Stuart, Beth; Coenen, Samuel; Butler, Chris C; Goossens, Herman; Verheij, Theo JM; Little, Paul

2014-01-01

Background Antibiotics are of limited overall clinical benefit for uncomplicated lower respiratory tract infection (LRTI) but there is uncertainty about their effectiveness for patients with features associated with higher levels of antibiotic prescribing. Aim To estimate the benefits and harms of antibiotics for acute LRTI among those producing coloured sputum, smokers, those with fever or prior comorbidities, and longer duration of prior illness. Design and setting Secondary analysis of a randomised controlled trial of antibiotic placebo for acute LRTI in primary care. Method Two thousand and sixty-one adults with acute LRTI, where pneumonia was not suspected clinically, were given amoxicillin or matching placebo. The duration of symptoms, rated moderately bad or worse (primary outcome), symptom severity on days 2–4 (0–6 scale), and the development of new or worsening symptoms were analysed in pre-specified subgroups of interest. Evidence of differential treatment effectiveness was assessed in prespecified subgroups by interaction terms. Results No subgroups were identified that were significantly more likely to benefit from antibiotics in terms of symptom duration or the development of new or worsening symptoms. Those with a history of significant comorbidities experienced a significantly greater reduction in symptom severity between days 2 and 4 (interaction term −0.28, P = 0.003; estimated effect of antibiotics among those with a past history −0.28 [95% confidence interval = −0.44 to −0.11], P = 0.001), equivalent to three people in 10 rating symptoms as a slight rather than a moderately bad problem. For subgroups not specified in advance antibiotics provided a modest reduction in symptom severity for non-smokers and for those with short prior illness duration (<7 days), and a modest reduction in symptom duration for those with short prior illness duration. Conclusion There is no clear evidence of clinically meaningful benefit from antibiotics in the studied high-risk groups of patients presenting in general practice with uncomplicated LRTIs where prescribing is highest. Any possible benefit must be balanced against the side-effects and longer-term effects on antibiotic resistance. PMID:24567620

[An evaluation of some of the relationships between thought-action fusion, attributional styles, and depressive and obsessive-compulsive symptoms].

PubMed

Piri, Serap; Kabakçi, Elif

2007-01-01

Thought-action fusion (TAF) is a cognitive bias presumed to underlie the development of obsessional problems. Two domains of TAF have been identified. The first, TAF-moral, is characterized by the belief that having morally unacceptable thoughts is as bad as actually carrying them out. The second, TAF-likelihood, refers to the belief that certain thoughts cause particular events. The event can be related to one's self (likelihood-self) or to someone else (likelihood-others). The other cognitive variable of the study is attributional style. The theory of attributional styles, in terms of the causes of good and bad events, is taken into account especially in the context of depression and has four dimensions: internality-externality, stability-instability, globality-specifity, and importance-unimportance. The first objective of the present study was to investigate the relationships between TAF, and attributional style, and depressive and obsessive-compulsive symptoms. The second objective was to determine the predictors of TAF when the effects of depressive and obsessive-compulsive symptoms are statistically controlled. The sample consisted of 312 students randomly selected from different departments at Hacettepe University. The Thought-Action Fusion Scale (TAFS), Attributional Style Questionnaire (ASQ), Maudsley Obsessive-Compulsive Inventory (MOCI), and Beck Depression Inventory (BDI) were administered to these students. The correlations among all the subtypes of TAF (TAF-moral, likelihood-self, and likelihood-others), and the global attributions for bad events, BDI, and MOCI were significant. In addition, the correlation between TAF-moral and the importance of the attribution for bad events was significant. TAF-likelihood-others and TAF-likelihood-self were predicted by global attributions for bad events and TAF-moral was predicted by the importance of the attributions for bad events. TAF, and attributional styles, and depressive and obsessive-compulsive symptoms may be related to each other. The results also suggest a possible effect of other variables not controlled in this study, both on TAF and the dimensions of attributional styles.

A research on epidemiology of multiple anterior malocclusions of children.

PubMed

Li, S Y

1991-01-01

So far there are few report of large sample on epidemiology of children's multiple-anterior cross-bite malocclusions (MACBM) in China. We investigated the epidemiology of MACBM in 10075 3-11 years old children in Beijing Western District by random sampling. MACBM was confined to cross-bite malocclusions of (not including cross-bite on one side or on one individual tooth). The procedure of sampling was general survey in kindergarten and primary school, then the meeting of parents of suffering children, followed by checking their name, sex, age, cause, feed, bad habit and history of family in each teeth-age group (baby teeth group, the first stage group and later stage group of substituting teeth). All data were calculated by statistical analysis and T-Test. The statistical data showed that in the sample of 10,075 children the incidence of MACBM was 5.04% (the rate of male was 5.73%; the female 4.32%); the baby teeth stage group 7.15%; the first stage of substituting teeth group 5.74%; the later stage 2.99%. One third of suffering children were caused by genetic factor. Two third were acquired. Among those postnatal caused, which was ground insufficient was the main cause (31.1) 17.9% and 14.5% of suffering children were caused by bad habits and bad feeding posture, respectively. It is worth paying attention to the fact that only 2% of suffering children went to see dentists and no one of 119 cases of baby teeth stage was treated by a orthodontists in the place like Beijing Western District where the medical conditions and cultural background are much better than other places in China.(ABSTRACT TRUNCATED AT 250 WORDS)

Breaking bad news: issues relating to nursing practice.

PubMed

Warnock, Clare

2014-07-15

The breaking of bad news was traditionally regarded to be the time when a doctor and nurse sat down with a patient and family members to provide information about, for example, a life-limiting diagnosis or a poor prognosis. However, breaking bad news is now generally accepted as a process, not a one-off event, and is considered to refer to any bad, sad or difficult information that alters patients' perceptions of their present and future. Nurses have an important role in the process of providing information and helping patients prepare for, receive, understand and cope with the bad news they have been given. This article aims to help nurses understand the process of breaking bad news and discuss the challenges and difficulties that nurses can face when they are involved with patients who have been given bad news. It also provides guidance with regard to preparing for breaking bad news, giving difficult information, responding to possible reactions, and supporting patients and their relatives after they have received bad news.

["Truth at the bedside"--continuing medical education and breaking bad news].

PubMed

Schildmann, Jan; Herrmann, Eva; Klambeck, Amelie; Ortwein, Heiderose; Schwarz, Carsten; Vollmann, Jochen

2005-01-01

Discussions with seriously-ill patients are part of the physicians' tasks. These discussions demand good communication skills. In this paper we present the concept of a postgraduate course for physicians on ethics and breaking bad news, as well as the results of the course evaluation. Questionnaire distributed before and immediately after the course using closed-ended questions and Likert scales. 37 physicians (response rate: 84.1%) from seven specialties completed the questionnaires. Twenty-eight respondents (75.6%) had been involved in breaking bad news more than 5 times per month. Approximately half of the respondents (N = 18; 48.6%) rated the discussions on the limits of curative treatment as particularly difficult communication situations. With one exception, all physicians denied the existence of guidelines on breaking bad news in their institutions. Compared with the beginning of the course, the respondents rated their communication skills to be improved at the end of the course. Positive evaluations were obtained for practice relevance, teaching methods, and organisation of the course. The interest in this optional postgraduate course and the feedback of the participants indicate the necessity of professional training on difficult communication situations. The self-rating of improved communication skills may be interpreted as a positive effect of the course. Observational studies are required to confirm the effects of the training.

Nicotinamide attenuates the ischemic brain injury-induced decrease of Akt activation and Bad phosphorylation.

PubMed

Koh, Phil-Ok

2011-07-08

Nicotinamide protects cortical neuronal cells against cerebral ischemic injury through activation of various cytoprotective mechanisms. Here, this study confirmed the neuroprotective effects of nicotinamide in focal cerebral ischemic injury and investigated whether nicotinamide modulates a crucial survival pathway, Akt and its downstream targets. Adult male rats were treated with vehicle or nicotinamide (500 mg/kg) 2h after the onset of middle cerebral artery occlusion (MCAO). Brains were collected 24h after MCAO and infarct volumes were analyzed. Nicotinamide significantly reduced the infarct volume in the cerebral cortex. Potential activation was measured by phosphorylation of PDK1 at Ser(241), Akt at Ser(473), and Bad at Ser(136) using Western blot analysis. Nicotinamide prevented the injury-induced decrease of pPDK1, pAkt, and pBad levels. 14-3-3 levels were not different between vehicle- and nicotinamide-treated animals. However, pBad and 14-3-3 interaction levels decreased during MCAO, but were maintained in the presence of nicotinamide, compared to levels in control animals. These findings suggest that nicotinamide attenuates cell death due to focal cerebral ischemic injury and that neuroprotective effects are mediated through the Akt signaling pathway, thus enhancing neuronal survival. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

The application of the Practitioners in Applied Practice Model during breaking bad news communication training for medical students: a case study.

PubMed

Dunning, Rose; Laidlaw, Anita

2015-11-01

Breaking bad news is a key skill within clinical communication and one which can impact outcomes for both the patient and practitioner. The evidence base for effective clinical communication training in breaking bad news is scarce. Frameworks have been found to assist the practitioner, such as SPIKES; however, the pedagogical approach used alongside such frameworks can vary. This study sought to examine the impact of utilising the Practitioners in Applied Practice Model (PAPM) alongside the SPIKES framework for training undergraduate medical students in breaking bad news. A case study approach is used to highlight the impact of training based on the PAPM and SPIKES on patient-centred communication and simulated patient satisfaction with the clinical communication behaviour. Results showed that following training, both patient-centred behaviour and patient satisfaction improved. With detailed communication behaviour changes, a balance was established between rapport building behaviour, lifestyle and psychosocial talk alongside biomedical information. This case study shows how the PAPM could be utilised alongside the SPIKES framework to improve breaking bad news communication in medical undergraduate students and describes the behavioural basis of the improvement. Further research is required to show the generalisability of this training intervention. © The Author(s) 2015.

26 CFR 1.593-7 - Establishment and treatment of reserves for bad debts.

Code of Federal Regulations, 2010 CFR

2010-04-01

....593-10. (2) Bad debt losses. Any bad debt in respect of a nonqualifying loan shall be charged against the reserve for losses on nonqualifying loans, and any bad debt in respect of a qualifying real... option of the taxpayer, however, any bad debt in respect of either class of loans may be charged in whole...

Incidence and predictive factors for positive 75SeHCAT test: improving the diagnosis of bile acid diarrhoea.

PubMed

Murray, Iain Alexander; Murray, Linzi Karen; Woolson, Kathy Louise; Sherfi, Hisham; Dixon, Ivor; Palmer, Joanne; Sulkin, Tom

To determine the value of 75 SeHCAT retention in determining bile acid diarrhoea (BAD), treatment response and predictors of a positive result. Retrospective casenote review of consecutive patients undergoing 75 SeHCAT from 2008 to 2014, including gender, age, history, clinical, and laboratory parameters. This included diseases associated with Type 1 BAD (ileal resection, Crohn's disease) and Type 3 BAD. Chi-squared test and logistic regression determined factors predictive of BAD. Subjective response to treatment with bile acid sequestrants (BAS) was analysed with respect to the 75 SeHCAT result. Of 387 patients, 154 (39.7%) were male and average age was 50 years. Ninety-five patients (24.5%) were investigated for Type 1 BAD, 86 (22.2%) for Type 3, and 206 patients (53.2%) for Type 2 or idiopathic BAD. There was a large increase in the number performed with time but no difference in percentage positive tests. One hundred and seventy-nine patients (46.2%) had BAD. Positive result was commonest in possible Type 1 and they had most severe BAD. Ninety-nine patients had severe BAD (<5% 75 SeHCAT retention), 47 moderate BAD (5% to <10% retention), and 33 mild BAD (10% to <15% retention). Predictors of a positive 75 SeHCAT were right hemicolectomy (OR 4.88), cholecystectomy (OR 2.44), and Crohn's (OR 1.86). A positive 75 SeHCAT predicted a good or partial response to BAS of 66.7% (mild), 78.6% (moderate), or 75.9% (severe BAD). 75 SeHCAT test use increased in 2008-2014, with high positive results throughout. Ileal resection, Crohn's, and cholecystectomy independently predict BAD. 75 SeHCAT predicted response to BAS.

BAD phosphorylation determines ovarian cancer chemo-sensitivity and patient survival

PubMed Central

Marchion, Douglas C.; Cottrill, Hope M.; Xiong, Yin; Chen, Ning; Bicaku, Elona; Fulp, William J.; Bansal, Nisha; Chon, Hye Sook; Stickles, Xiaomang B.; Kamath, Siddharth G.; Hakam, Ardeshir; Li, Lihua; Su, Dan; Moreno, Carolina; Judson, Patricia L.; Berchuck, Andrew; Wenham, Robert M.; Apte, Sachin M.; Gonzalez-Bosquet, Jesus; Bloom, Gregory C.; Eschrich, Steven A.; Sebti, Said; Chen, Dung-Tsa; Lancaster, Johnathan M.

2011-01-01

Purpose Despite initial sensitivity to chemotherapy, ovarian cancers (OVCA) often develop drug-resistance, which limits patient survival. Using specimens and/or genomic data from 289 patients and a panel of cancer cell lines, we explored genome-wide expression changes that underlie the evolution of OVCA chemo-resistance and characterized the BCL2 antagonist of cell death (BAD) apoptosis pathway as a determinant of chemo-sensitivity and patient survival. Experimental Design Serial OVCA cell cisplatin treatments were performed in parallel with measurements of genome-wide expression changes. Pathway analysis was performed on genes associated with increasing cisplatin-resistance (EC50). BAD-pathway expression and BAD-protein phosphorylation were evaluated in patient samples and cell lines as determinants of chemo-sensitivity and/or clinical outcome and as therapeutic targets. Results Induced in vitro OVCA cisplatin-resistance was associated with BAD-pathway expression (P < 0.001). In OVCA cell lines and primary specimens, BAD-protein phosphorylation was associated with platinum-resistance (n = 147, P < 0.0001) and also with overall patient survival (n = 134, P = 0.0007). Targeted modulation of BAD-phosphorylation levels influenced cisplatin sensitivity. A 47-gene BAD-pathway score was associated with in vitro phosphorylated-BAD levels and with survival in 142 patients with advanced-stage (III/IV) serous OVCA. Integration of BAD-phosphorylation or BAD-pathway score with OVCA surgical cytoreductive status was significantly associated with overall survival by log-rank test (P = 0.004 and <0.0001, respectively). Conclusion The BAD apoptosis pathway influences OVCA chemo-sensitivity and overall survival, likely via modulation of BAD-phosphorylation. The pathway has clinical relevance as a biomarker of therapeutic response, patient survival, and as a promising therapeutic target. PMID:21849418

How to Effectively Use Bismuth Quadruple Therapy: The Good, the Bad, and the Ugly

PubMed Central

Graham, David Y.; Lee, Sun-Young

2015-01-01

Bismuth triple therapy was the first truly effective Helicobacter pylori eradication therapy. The addition of a proton pump inhibitor largely overcame the problem of metronidazole resistance. Resistance to its being the primary first line therapy have centered on convenience (the large number of tablets required) and side effects causing difficulties with patient adherence. Understanding why the regimen is less successful in some regions remains unexplained in part because of the lack of studies including susceptibility testing. A number of modifications have been proposed such as twice-a-day therapy which addresses both major criticism but the studies with susceptibility testing required to prove its effectiveness in high metronidazole resistance areas are lacking. Most publications lack the data required to understand why they were successful or failed (e.g., detailed resistance and adherence data) and are therefore of little value. We discuss and provide recommendations regarding variations including substitution of doxycycline, amoxicillin, and twice a day therapy. We describe what is known and unknown and provide suggestions regarding what is needed to rationally and effectively use bismuth quadruple therapy. Its primary use is when penicillin cannot be used or when clarithromycin and metronidazole resistance is common. Durations of therapy less than 14 days are not recommended. PMID:26314667

Bad phosphorylation as a target of inhibition in oncology.

PubMed

Bui, Ngoc-Linh-Chi; Pandey, Vijay; Zhu, Tao; Ma, Lan; Basappa; Lobie, Peter E

2018-02-28

Bcl-2 agonist of cell death (BAD) is a BH3-only member of the Bcl-2 family which possesses important regulatory function in apoptosis. BAD has also been shown to possess many non-apoptotic functions closely linked to cancer including regulation of glycolysis, autophagy, cell cycle progression and immune system development. Interestingly, BAD can be either pro-apoptotic or pro-survival depending on the phosphorylation state of three specific serine residues (human S75, S99 and S118). Expression of BAD and BAD phosphorylation patterns have been shown to influence tumor initiation and progression and play a predictive role in disease prognosis, drug response and chemosensitivity in various cancers. This review aims to summarize the current evidence on the functional role of BAD phosphorylation in human cancer and evaluate the potential utility of modulating BAD phosphorylation in cancer. Copyright © 2017 Elsevier B.V. All rights reserved.

AMP-activated protein kinase confers protection against TNF-{alpha}-induced cardiac cell death.

PubMed

Kewalramani, Girish; Puthanveetil, Prasanth; Wang, Fang; Kim, Min Suk; Deppe, Sylvia; Abrahani, Ashraf; Luciani, Dan S; Johnson, James D; Rodrigues, Brian

2009-10-01

Although a substantial role for 5' adenosine monophosphate-activated protein kinase (AMPK) has been established in regulating cardiac metabolism, a less studied action of AMPK is its ability to prevent cardiac cell death. Using established AMPK activators like dexamethasone (DEX) or metformin (MET), the objective of the present study was to determine whether AMPK activation prevents tumour necrosis factor-alpha (TNF-alpha) induced apoptosis in adult rat ventricular cardiomyocytes. Cardiomyocytes were incubated with DEX, MET, or TNF-alpha for varying durations (0-12 h). TNF-alpha-induced cell damage was evaluated by measuring caspase-3 activity and Hoechst staining. Protein and gene estimation techniques were employed to determine the mechanisms mediating the effects of AMPK activators on TNF-alpha-induced cardiomyocyte apoptosis. Incubation of myocytes with TNF-alpha for 8 h has increased caspase-3 activation and apoptotic cell death, an effect that was abrogated by DEX and MET. The beneficial effect of DEX and MET was associated with stimulation of AMPK, which led to a rapid and sustained increase in Bad phosphorylation. This event reduced the interaction between Bad and Bcl-xL, limiting cytochrome c release and caspase-3 activation. Addition of Compound C to inhibit AMPK reduced Bad phosphorylation and prevented the beneficial effects of AMPK against TNF-alpha-induced cytotoxicity. Our data demonstrate that although DEX and MET are used as anti-inflammatory agents or insulin sensitizers, respectively, their common property to phosphorylate AMPK promotes cardiomyocyte cell survival through its regulation of Bad and the mitochondrial apoptotic mechanism.

Bad habits and bad genes: early 20th-century eugenic attempts to eliminate syphilis and associated "defects" from the United States.

PubMed

Wilson, Philip K

2003-01-01

American eugenists in the early 20th century distinguished "degenerates," including syphilitics, prostitutes, alcoholics and criminals, from the "normal" population by their particular bad habits. From eugenists' viewpoint, these bad habits were derived from bad character, a flaw that stemmed from an individual's bad genes. This essay explores how eugenists during this period characterized syphilitics and those with associated character "defects" in terms of heredity. Additionally, it examines the methods eugenists most frequently advocated to rectify these bad habits. These methods included marriage restriction, immigration control and reproductive sterilization. Overall, eugenists directed their efforts not so much at the "degenerate" as at his or her germ line.

Breaking Bad Habits | NIH MedlinePlus the Magazine

MedlinePlus

... of this page please turn Javascript on. Feature: Bad Habits Breaking Bad Habits: Why It's So Hard to Change Past Issues / ... News in Health ( http://newsinhealth.nih.gov/ ) Break Bad Habits Avoid temptations. If you always stop for a ...

A Bayesian comparative effectiveness trial in action: developing a platform for multisite study adaptive randomization.

PubMed

Brown, Alexandra R; Gajewski, Byron J; Aaronson, Lauren S; Mudaranthakam, Dinesh Pal; Hunt, Suzanne L; Berry, Scott M; Quintana, Melanie; Pasnoor, Mamatha; Dimachkie, Mazen M; Jawdat, Omar; Herbelin, Laura; Barohn, Richard J

2016-08-31

In the last few decades, the number of trials using Bayesian methods has grown rapidly. Publications prior to 1990 included only three clinical trials that used Bayesian methods, but that number quickly jumped to 19 in the 1990s and to 99 from 2000 to 2012. While this literature provides many examples of Bayesian Adaptive Designs (BAD), none of the papers that are available walks the reader through the detailed process of conducting a BAD. This paper fills that gap by describing the BAD process used for one comparative effectiveness trial (Patient Assisted Intervention for Neuropathy: Comparison of Treatment in Real Life Situations) that can be generalized for use by others. A BAD was chosen with efficiency in mind. Response-adaptive randomization allows the potential for substantially smaller sample sizes, and can provide faster conclusions about which treatment or treatments are most effective. An Internet-based electronic data capture tool, which features a randomization module, facilitated data capture across study sites and an in-house computation software program was developed to implement the response-adaptive randomization. A process for adapting randomization with minimal interruption to study sites was developed. A new randomization table can be generated quickly and can be seamlessly integrated in the data capture tool with minimal interruption to study sites. This manuscript is the first to detail the technical process used to evaluate a multisite comparative effectiveness trial using adaptive randomization. An important opportunity for the application of Bayesian trials is in comparative effectiveness trials. The specific case study presented in this paper can be used as a model for conducting future clinical trials using a combination of statistical software and a web-based application. ClinicalTrials.gov Identifier: NCT02260388 , registered on 6 October 2014.

The Strategic and Political Impacts of Collateral Damage from Strike Warfare

DTIC Science & Technology

2015-03-01

damage from strike warfare focuses on legal, humanitarian, and moral issues . To oversimplify, killing non-combatants is bad, but it happens, and not...humanitarian, and moral issues . To oversimplify, killing non- combatants is bad, but it happens, and not always by accident. Therefore, it is instructive...method of bombing. A significant amount of research on the effects of collateral damage from strike warfare focuses on humanitarian and moral issues

Notch3-specific inhibition using siRNA knockdown or GSI sensitizes paclitaxel-resistant ovarian cancer cells.

PubMed

Kang, Haeyoun; Jeong, Ju-Yeon; Song, Ji-Ye; Kim, Tae Heon; Kim, Gwangil; Huh, Jin Hyung; Kwon, Ah-Young; Jung, Sang Geun; An, Hee Jung

2016-07-01

Notch signaling plays an important role in ovarian cancer chemoresistance, which is responsible for recurrence. Gamma-secretase inhibitor (GSI) is a broad-spectrum Notch inhibitor, but it has serious side effects. The efficacy of Notch3-specific inhibition in paclitaxel-resistant ovarian cancers was assessed in this study, which has not yet been evaluated relative to GSI. To analyze the effect of Notch3-specific inhibition on paclitaxel-resistant ovarian cancers, we compared cell viability, apoptosis, cell migration, angiogenesis, cell cycle, and spheroid formation after treatment with either Notch3 siRNA or GSI in paclitaxel-resistant SKpac cells and parental SKOV3 cells. Expression levels of survival, cell cycle, and apoptosis-related proteins were measured and compared between groups. Notch3 was significantly overexpressed in chemoresistant cancer tissues and cell lines relative to chemosensitive group. In paclitaxel-resistant cancer cells, Notch inhibition significantly reduced viability, migration, and angiogenesis and increased apoptosis, thereby boosting sensitivity to paclitaxel. Spheroid formation was also significantly reduced. Both Notch3 siRNA-treated cells and GSI-treated cells arrested in the G2/M phase of the cell cycle. Proteins of cell survival, cyclin D1 and cyclin D3 were reduced, whereas p21 and p27 were elevated. Both GSI and Notch3 siRNA treatment reduced expression of anti-apoptotic proteins (BCL-W, BCL2, and BCL-XL) and increased expression of pro-apoptotic proteins (Bad, Bak, Bim, Bid, and Bax). These results indicate that Notch3-specific inhibition sensitizes paclitaxel-resistant cancer cells to paclitaxel treatment, with an efficacy comparable to that of GSI. This approach would be likely to avoid the side effects of broad-spectrum GSI treatment. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Improved packing of protein side chains with parallel ant colonies.

PubMed

Quan, Lijun; Lü, Qiang; Li, Haiou; Xia, Xiaoyan; Wu, Hongjie

2014-01-01

The accurate packing of protein side chains is important for many computational biology problems, such as ab initio protein structure prediction, homology modelling, and protein design and ligand docking applications. Many of existing solutions are modelled as a computational optimisation problem. As well as the design of search algorithms, most solutions suffer from an inaccurate energy function for judging whether a prediction is good or bad. Even if the search has found the lowest energy, there is no certainty of obtaining the protein structures with correct side chains. We present a side-chain modelling method, pacoPacker, which uses a parallel ant colony optimisation strategy based on sharing a single pheromone matrix. This parallel approach combines different sources of energy functions and generates protein side-chain conformations with the lowest energies jointly determined by the various energy functions. We further optimised the selected rotamers to construct subrotamer by rotamer minimisation, which reasonably improved the discreteness of the rotamer library. We focused on improving the accuracy of side-chain conformation prediction. For a testing set of 442 proteins, 87.19% of X1 and 77.11% of X12 angles were predicted correctly within 40° of the X-ray positions. We compared the accuracy of pacoPacker with state-of-the-art methods, such as CIS-RR and SCWRL4. We analysed the results from different perspectives, in terms of protein chain and individual residues. In this comprehensive benchmark testing, 51.5% of proteins within a length of 400 amino acids predicted by pacoPacker were superior to the results of CIS-RR and SCWRL4 simultaneously. Finally, we also showed the advantage of using the subrotamers strategy. All results confirmed that our parallel approach is competitive to state-of-the-art solutions for packing side chains. This parallel approach combines various sources of searching intelligence and energy functions to pack protein side chains. It provides a frame-work for combining different inaccuracy/usefulness objective functions by designing parallel heuristic search algorithms.

Safety of a topical insect repellent (picaridin) during community mass use for malaria control in rural Cambodia

PubMed Central

Heng, Somony; Sluydts, Vincent; Durnez, Lies; Mean, Vanna; Polo, Koh; Tho, Sochantha; Coosemans, Marc; van Griensven, Johan

2017-01-01

Background While community distribution of topical repellents has been proposed as an additional malaria control intervention, the safety of this intervention at the population level remains poorly evaluated. We describe the safety of mass distribution of the picaridin repellent during a cluster-randomised trial in rural Cambodia in 2012–2013. Methods The repellent was distributed among 57 intervention villages with around 25,000 inhabitants by a team of village distributors. Information on individual adverse events, reported by phone by the village distributors, was obtained through home visits. Information on perceived side effects, reported at the family level, was obtained during two-weekly bottle exchange. Adverse events were classified as adverse reactions (events likely linked to the repellent), cases of repellent abuse and events not related to the repellent use, and classified as per Common Terminology Criteria for Adverse Events. Findings Of the 41 adverse events notified by phone by the village distributors, there were 22 adverse reactions, 11 cases of repellent abuse (6 accidental, 5 suicide attempts) and 8 non-related events. All adverse reactions were mild, occurred in the first few months of use, and mainly manifested as skin conditions. Of the 11 cases of abuse, 2 were moderate and 2 life-threatening. All cases with adverse reactions and repellent abuse recovered completely. 20% of families reported perceived side effects, mainly itching, headache, dizziness and bad smell, but few discontinued repellent use. Conclusions Adverse reactions and abuse during mass use of picaridin were uncommon and generally mild, supporting the safety of the picaridin repellent for malaria control. PMID:28339462

Safety of a topical insect repellent (picaridin) during community mass use for malaria control in rural Cambodia.

PubMed

Heng, Somony; Sluydts, Vincent; Durnez, Lies; Mean, Vanna; Polo, Koh; Tho, Sochantha; Coosemans, Marc; van Griensven, Johan

2017-01-01

While community distribution of topical repellents has been proposed as an additional malaria control intervention, the safety of this intervention at the population level remains poorly evaluated. We describe the safety of mass distribution of the picaridin repellent during a cluster-randomised trial in rural Cambodia in 2012-2013. The repellent was distributed among 57 intervention villages with around 25,000 inhabitants by a team of village distributors. Information on individual adverse events, reported by phone by the village distributors, was obtained through home visits. Information on perceived side effects, reported at the family level, was obtained during two-weekly bottle exchange. Adverse events were classified as adverse reactions (events likely linked to the repellent), cases of repellent abuse and events not related to the repellent use, and classified as per Common Terminology Criteria for Adverse Events. Of the 41 adverse events notified by phone by the village distributors, there were 22 adverse reactions, 11 cases of repellent abuse (6 accidental, 5 suicide attempts) and 8 non-related events. All adverse reactions were mild, occurred in the first few months of use, and mainly manifested as skin conditions. Of the 11 cases of abuse, 2 were moderate and 2 life-threatening. All cases with adverse reactions and repellent abuse recovered completely. 20% of families reported perceived side effects, mainly itching, headache, dizziness and bad smell, but few discontinued repellent use. Adverse reactions and abuse during mass use of picaridin were uncommon and generally mild, supporting the safety of the picaridin repellent for malaria control.

Effects of conventional and a novel colonic-release bile acid sequestrant, A3384, on fibroblast growth factor 19 and bile acid metabolism in healthy volunteers and patients with bile acid diarrhoea.

PubMed

Appleby, R N; Bajor, A; Gillberg, P-G; Graffner, H; Simrén, M; Ung, K A; Walters, Jrf

2017-04-01

Primary bile acid diarrhoea (BAD) is associated with increased bile acid synthesis and low fibroblast growth factor 19 (FGF19). Bile acid sequestrants are used as therapy, but are poorly tolerated and may exacerbate FGF19 deficiency. The purpose of this study was to evaluate the pharmacological effects of conventional sequestrants and a colonic-release formulation preparation of colestyramine (A3384) on bile acid metabolism and bowel function in patients with BAD. Patients with seven-day 75 selenium-homocholic acid taurine (SeHCAT) scan retention <10% were randomised in a double-blind protocol to two weeks treatment with twice-daily A3384 250 mg ( n  = 6), 1 g ( n  = 7) or placebo ( n  = 6). Thirteen patients were taking conventional sequestrants at the start of the study. Symptoms were recorded and serum FGF19 and 7α-hydroxy-4-cholesten-3-one (C4) measured. Median serum FGF19 on conventional sequestrant treatment was 28% lower than baseline values in BAD ( p  < 0.05). C4 on conventional sequestrant treatment was 58% higher in BAD ( p  < 0.001). No changes were seen on starting or withdrawing A3384. A3384 improved diarrhoeal symptoms, with a median reduction of 2.2 points on a 0-10 Likert scale compared to placebo, p  < 0.05. Serum FGF19 was suppressed and bile acid production up-regulated on conventional bile acid sequestrants, but not with A3384. This colonic-release formulation of colestyramine produced symptomatic benefit in patients with BAD.

Effects of conventional and a novel colonic-release bile acid sequestrant, A3384, on fibroblast growth factor 19 and bile acid metabolism in healthy volunteers and patients with bile acid diarrhoea

PubMed Central

Bajor, A; Gillberg, P-G; Graffner, H; Simrén, M; Ung, KA; Walters, JRF

2016-01-01

Background Primary bile acid diarrhoea (BAD) is associated with increased bile acid synthesis and low fibroblast growth factor 19 (FGF19). Bile acid sequestrants are used as therapy, but are poorly tolerated and may exacerbate FGF19 deficiency. Aim The purpose of this study was to evaluate the pharmacological effects of conventional sequestrants and a colonic-release formulation preparation of colestyramine (A3384) on bile acid metabolism and bowel function in patients with BAD. Methods Patients with seven-day 75selenium-homocholic acid taurine (SeHCAT) scan retention <10% were randomised in a double-blind protocol to two weeks treatment with twice-daily A3384 250 mg (n = 6), 1 g (n = 7) or placebo (n = 6). Thirteen patients were taking conventional sequestrants at the start of the study. Symptoms were recorded and serum FGF19 and 7α-hydroxy-4-cholesten-3-one (C4) measured. Results Median serum FGF19 on conventional sequestrant treatment was 28% lower than baseline values in BAD (p < 0.05). C4 on conventional sequestrant treatment was 58% higher in BAD (p < 0.001). No changes were seen on starting or withdrawing A3384. A3384 improved diarrhoeal symptoms, with a median reduction of 2.2 points on a 0–10 Likert scale compared to placebo, p < 0.05. Conclusions Serum FGF19 was suppressed and bile acid production up-regulated on conventional bile acid sequestrants, but not with A3384. This colonic-release formulation of colestyramine produced symptomatic benefit in patients with BAD. PMID:28507750

Effects of Anxiety and Depression on Arterial Elasticity of Subjects With Suboptimal Physical Health.

PubMed

Sun, Ningling; Xi, Yang; Zhu, Zhiming; Yin, Huijun; Tao, Qiushan; Wang, Hongyi; Wang, Luyan; Ma, Zhiyi; Chen, Yuanyuan; Yao, Dan

2015-10-01

The authors investigated the effects of suboptimal health status (SHS; high-normal blood pressure, blood glucose, and blood lipids) on arterial elasticity in subjects with or without anxiety or depression. Suboptimal physical health status and anxiety or depression increase the risk of cardiovascular diseases. This was a cross-sectional, observational, multicenter study. Among 1520 subjects who underwent physical examination between May 2009 and December 2012 in Beijing and Chongqing, China, 955 were included. All subjects completed anxiety and depression questionnaires. Systemic vascular compliance (SVC), systemic vascular resistance, and brachial artery distensibility (BAD) were measured during arterial elasticity evaluation. Of 955 participants, 633 were classified as having SHS and 322 were classified as healthy. Systemic vascular compliance and BAD were worse in SHS subjects than in healthy subjects (SVC: 1.23 ± 0.22 vs 1.29 ± 0.25 mL/mm Hg; BAD: 6.26 ± 1.32 vs 6.61 ± 1.24%/mm Hg, respectively; both P < 0.05). Of 955 subjects, 37.7% and 43.9% had anxiety and depression, respectively. Systemic vascular compliance and BAD in SHS subjects with concomitant anxiety or depression were significantly lower than in SHS subjects without anxiety or depression (SVC: 1.22 ± 0.23 vs 1.23 ± 0.20 mL/mm Hg; BAD: 6.10 ± 1.36 vs 6.33 ± 1.20 %/mm Hg, respectively; both P < 0.05) and even lower than in healthy subjects. Though anxiety and depression had less impact on arterial elasticity in a healthy population, they may be involved in pathogenesis of vascular damage in the population with SHS. © 2015 Wiley Periodicals, Inc.

Breaking bad news-what patients want and what they get: evaluating the SPIKES protocol in Germany.

PubMed

Seifart, C; Hofmann, M; Bär, T; Riera Knorrenschild, J; Seifart, U; Rief, W

2014-03-01

Evaluation of the SPIKES protocol, a recommended guideline for breaking bad news, is sparse, and information about patients' preferences for bad-news delivery in Germany is lacking. Being the first actual-theoretical comparison of a 'breaking bad news' guideline, the present study evaluates the recommended steps of the SPIKES protocol. Moreover, emotional consequences and quality of bad-news delivery are investigated. A total of 350 cancer patients answered the MABBAN (Marburg Breaking Bad News Scale), a questionnaire representing the six SPIKES subscales, asking for the procedure, perception and satisfaction of the first cancer disclosure and patient's assign to these items. Only 46.2% of the asked cancer patients are completely satisfied with how bad news had been broken to them. The overall quality is significantly related to the emotional state after receiving bad news (r = -0.261, P < 0.001). Patients' preferences differ highly significantly from the way bad news were delivered, and the resulting rang list of patients' preferences indicates that the SPIKES protocol do not fully meet the priorities of cancer patients in Germany. It could be postulated that the low satisfaction of patients observed in this study reflects the highly significant difference between patients' preferences and bad-news delivery. Therefore, some adjunctions to the SPIKES protocol should be considered, including a frequent reassurance of listeners' understanding, the perpetual possibility to ask question, respect for prearrangement needs and the conception of bad-news delivery in a two-step procedure.

Is under the ground under the big blue water named for the land next to us good for putting away bad air?

NASA Astrophysics Data System (ADS)

Hills, D. J.

2017-12-01

Putting bad air under the ground in rocks can help the world be safe from hotter air and keep people happy. A lot of the bad air is made near the big blue water named for the land next to us so we are looking at the ground under that big blue water to see if the rocks will hold the bad air for a very, very, very long time. There are a lot of rocks that are good to put the bad air in with other good rocks on top of them to hold the bad air in under the ground under the big blue water. We are helping decide what good rocks are the best to put the bad air in with the best rocks on top of them to hold it in. We are figuring out how much bad air these rocks can hold in to keep people safe from hotter air and keep them happy. Some of these rocks are not far under the ground, but that might worry some people that the bad air is too close. Some of these good rocks are really far under the ground, but that might take a lot of money to put in the bad air. We are trying to figure out what will be best to keep the bad air under the ground and make the most people happy.

Elevation of cAMP Levels Inhibits Doxorubicin-Induced Apoptosis in Pre- B ALL NALM- 6 Cells Through Induction of BAD Phosphorylation and Inhibition of P53 Accumulation.

PubMed

Fatemi, Ahmad; Kazemi, Ahmad; Kashiri, Meysam; Safa, Majid

2015-01-01

Recognition of the molecular mechanisms of cAMP action against DNA damage-induced apoptosis can be useful to improve the efficacy of DNA damaging therapeutic agents. Considering the critical role of bcl-2-associated death promoter (BAD) and p53 proteins in DNA damage -induced apoptosis, the aim of this study was to assess the effect of cAMP-elevating agents on these proteins in doxorubicin-treated pre-B acute lymphoblastic leukemia (pre-B ALL) NALM-6 cells.The pre-B ALL cell line NALM-6 was cultured and treated with doxorubicin in combination with or without cAMP-elevating agents forskolin and 3-isobutyl-1-methylxanthine (IBMX). Cell viability was measured by trypan blue staining and MTT assay. For evaluation of apoptosis, annexin-V staining by flow cytometry and caspase-3 activity assay were used. Protein expression of p53, BAD and phoshorylated BAD was detected by western blotting analysis.cAMP-increasing agents diminished the doxorubicin-mediated cytotoxicity in NALM-6 cells as indicated by the viability assays. Annexin-V apoptosis assay showed that the cAMP-elevating agents decreased doxorubicin-induced apoptosis. Moreover, doxorubicin-induced caspase-3 activity was attenuated in the presence of cAMP-increasing agents. Western blot results revealed the reduced expression of p53 protein in cells treated with combination of cAMP-elevating agents and doxorubicin in contrast to cells treated with doxorubicin alone. Expression of total BAD protein was not affected by doxorubicin and cAMP-elevating agents. However, phosphorylation of BAD protein was induced in the presence of cAMP-elevating agents. Our study suggests that elevated cAMP levels inhibit doxorubicin-induced apoptosis in pre-B ALL cells through induction of BAD phosphorylation and abrogation of p53 accumulation.

Breaking Bad News Training Program Based on Video Reviews and SPIKES Strategy: What do Perinatology Residents Think about It?

PubMed

Setubal, Maria Silvia Vellutini; Gonçalves, Andrea Vasconcelos; Rocha, Sheyla Ribeiro; Amaral, Eliana Martorano

2017-10-01

Objective  Resident doctors usually face the task to communicate bad news in perinatology without any formal training. The impact on parents can be disastrous. The objective of this paper is to analyze the perception of residents regarding a training program in communicating bad news in perinatology based on video reviews and setting, perception, invitation, knowledge, emotion, and summary (SPIKES) strategy. Methods  We performed the analysis of complementary data collected from participants in a randomized controlled intervention study to evaluate the efficacy of a training program on improving residents' skills to communicate bad news. Data were collected using a Likert scale. Through a thematic content analysis we tried to to apprehend the meanings, feelings and experiences expressed by resident doctors in their comments as a response to an open-ended question. Half of the group received training, consisting of discussions of video reviews of participants' simulated encounters communicating a perinatal loss to a "mother" based on the SPIKES strategy. We also offered training sessions to the control group after they completed participation. Twenty-eight residents who were randomized to intervention and 16 from the control group received training. Twenty written comments were analyzed. Results  The majority of the residents evaluated training highly as an education activity to help increase knowledge, ability and understanding about breaking bad news in perinatology. Three big categories emerged from residents' comments: SPIKES training effects; bad news communication in medical training; and doctors' feelings and relationship with patients. Conclusions  Residents took SPIKES training as a guide to systematize the communication of bad news and to amplify perceptions of the emotional needs of the patients. They suggested the insertion of a similar training in their residency programs curricula. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

PKC-ι promotes glioblastoma cell survival by phosphorylating and inhibiting BAD through a phosphatidylinositol 3-kinase pathway.

PubMed

Desai, S; Pillai, P; Win-Piazza, H; Acevedo-Duncan, M

2011-06-01

The focus of this research was to investigate the role of protein kinase C-iota (PKC-ι) in regulation of Bad, a pro-apoptotic BH3-only molecule of the Bcl-2 family in glioblastoma. Robust expression of PKC-ι is a hallmark of human glioma and benign and malignant meningiomas. The results were obtained from the two human glial tumor derived cell lines, T98G and U87MG. In these cells, PKC-ι co-localized and directly associated with Bad, as shown by immunofluorescence, immunoprecipitation, and Western blotting. Furthermore, in-vitro kinase activity assay showed that PKC-ι directly phosphorylated Bad at phospho specific residues, Ser-112, Ser-136 and Ser-155 which in turn induced inactivation of Bad and disruption of Bad/Bcl-XL dimer. Knockdown of PKC-ι by siRNA exhibited a corresponding reduction in Bad phosphorylation suggesting that PKC-ι may be a Bad kinase. PKC-ι knockdown also induced apoptosis in both the cell lines. Since, PKC-ι is an essential downstream mediator of the PI (3)-kinase, we hypothesize that glioma cell survival is mediated via a PI (3)-kinase/PDK1/PKC-ι/Bad pathway. Treatment with PI (3)-kinase inhibitors Wortmannin and LY294002, as well as PDK1 siRNA, inhibited PKC-ι activity and subsequent phosphorylation of Bad suggesting that PKC-ι regulates the activity of Bad in a PI (3)-kinase dependent manner. Thus, our data suggest that glioma cell survival occurs through a novel PI (3)-kinase/PDK1/PKC-ι/BAD mediated pathway. Published by Elsevier B.V.

Bovine adenovirus 3 core protein precursor pVII localizes to mitochondria, and modulates ATP synthesis, mitochondrial Ca2+ and mitochondrial membrane potential.

PubMed

Anand, Sanjeev K; Gaba, Amit; Singh, Jaswant; Tikoo, Suresh K

2014-02-01

Viruses modulate the functions of mitochondria by translocating viral proteins to the mitochondria. Subcellular fractionation and sensitivity to proteinase K/Triton X-100 treatment of mitochondrial fractions of bovine adenovirus (BAdV)-3-infected/transfected cells suggested that core protein pVII localizes to the mitochondria and contains a functional mitochondrial localization signal. Moreover, mitochondrial localization of BAdV-3 pVII appears to help in the retention of mitochondrial Ca(2+), inducing a significant increase in the levels of ATP and maintaining the mitochondrial membrane potential (MMP) in transfected cells. In contrast, mitochondrial localization of BAdV-3 pVII has no significant effect on the levels of cytoplasmic Ca(2+) and reactive oxygen species production in the transfected cells. Consistent with these results, expression of pVII in transfected cells treated with staurosporine decreased significantly the activation of caspase-3. Our results suggested that BAdV-3 pVII localizes to mitochondria, and interferes with apoptosis by inhibiting loss of the MMP and by increasing mitochondrial Ca(2+) and ATP production.

Cleavage of bovine adenovirus type 3 non-structural 100K protein by protease is required for nuclear localization in infected cells but is not essential for virus replication.

PubMed

Makadiya, Nirajkumar; Gaba, Amit; Tikoo, Suresh K

2015-09-01

The L6 region of bovine adenovirus type 3 (BAdV-3) encodes a non-structural protein named 100K. Rabbit antiserum raised against BAdV-3 100K recognized a protein of 130 kDa at 12-24 h and proteins of 130, 100, 95 and 15 kDa at 36-48 h after BAdV-3 infection. The 100K species localized to the nucleus and the cytoplasm of BAdV-3-infected cells. In contrast, 100K localized predominantly to the cytoplasm of the transfected cells. However, BAdV-3 infection of cells transfected with 100K-enhanced yellow fluorescent protein-expressing plasmid detected fluorescent protein in the nucleus of the cells, suggesting that other viral proteins may be required for the nuclear localization of 100K. Interaction of BAdV-3 100K with BAdV-3 33K protein did not alter the cytoplasmic localization of 100K. However, co-expression of BAdV-3 100K and BAdV-3 protease localized 100K to the nucleolus of the transfected cells. Subsequent analysis suggested that BAdV-3 protease cleaves 100K at two identified potential protease cleavage sites (aa 740-745 and 781-786) in transfected or BAdV-3-infected cells. The cleaved C terminus (107 aa) was localized to the nucleolus of the transfected cells. Further analysis suggested that the cleaved C terminus contains a bipartite nuclear localization signal and utilizes import receptor importin-α3 of the classical importin-α/β transport pathway for nuclear transport. Successful isolation of recombinant BAdV-3 expressing mutant 100K (substitution of alanine for glycine in the potential protease cleavage site) suggested that cytoplasmic cleavage of BAdV-3 100K by adenoviral protease is not essential for virus replication.

48 CFR 31.205-3 - Bad debts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Bad debts. 31.205-3... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 31.205-3 Bad debts. Bad debts, including actual or estimated losses arising from uncollectible accounts receivable due...

7 CFR 51.1535 - Badly misshapen.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 2 2012-01-01 2012-01-01 false Badly misshapen. 51.1535 Section 51.1535 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Fresh Plums and Prunes Definitions § 51.1535 Badly misshapen. “Badly misshapen...

7 CFR 51.1535 - Badly misshapen.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 2 2011-01-01 2011-01-01 false Badly misshapen. 51.1535 Section 51.1535 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Fresh Plums and Prunes Definitions § 51.1535 Badly misshapen. “Badly misshapen...

7 CFR 51.1535 - Badly misshapen.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Badly misshapen. 51.1535 Section 51.1535 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... Standards for Grades of Fresh Plums and Prunes Definitions § 51.1535 Badly misshapen. “Badly misshapen...

Flood of July 2016 in northern Wisconsin and the Bad River Reservation

USGS Publications Warehouse

Fitzpatrick, Faith A.; Dantoin, Eric D.; Tillison, Naomi; Watson, Kara M.; Waschbusch, Robert J.; Blount, James D.

2017-06-06

Heavy rain fell across northern Wisconsin and the Bad River Reservation on July 11, 2016, as a result of several rounds of thunderstorms. The storms caused major flooding in the Bad River Basin and nearby tributaries along the south shore of Lake Superior. Rainfall totals were 8–10 inches or more and most of the rain fell in an 8-hour period. A streamgage on the Bad River near Odanah, Wisconsin, rose from 300 cubic feet per second to a record peak streamflow of 40,000 cubic feet per second in only 15 hours. Following the storms and through September 2016, personnel from the U.S. Geological Survey and Bad River Tribe Natural Resources Department recovered and documented 108 high-water marks near the Bad River Reservation. Many of these high-water marks were used to create three flood-inundation maps for the Bad River, Beartrap Creek, and Denomie Creek for the Bad River Reservation in the vicinity of the community of Odanah.

Sun exposure: what molecular photodermatology tells us about its good and bad sides.

PubMed

Krutmann, Jean; Morita, Akimichi; Chung, Jin Ho

2012-03-01

The health consequences of sun exposure have concerned mankind for more than 100 years. Recent molecular studies in photodermatology have greatly advanced our understanding of this important topic. We will illustrate this progress by focusing on the following selected topics: (i) the nature of the DNA damage-independent part of the UVB response of human skin and the role of the arylhydrocarbon receptor in cutaneous biology, (ii) the contribution of wavelengths beyond the UV spectrum to solar radiation-induced skin damage, (iii) the emerging evidence that subcutaneous fat is a target tissue for sunlight, and (iv) the most recent insight into the mode of action of phototherapy.

uPAR and Cathepsin B Downregulation Induces Apoptosis by Targeting Calcineurin A to BAD via Bcl-2 in Glioma

PubMed Central

Malla, Rama Rao; Gopinath, Sreelatha; Gondi, Christopher S.; Alapati, Kiranmai; Dinh, Dzung H.; Tsung, Andrew J.; Rao, Jasti S.

2011-01-01

Cathepsin B and urokinase plasminogen activator receptor (uPAR) are postulated to play key roles in glioma invasion. Calcineurin is one of the key regulators of mitochondrial-dependent apoptosis, but its mechanism is poorly understood. Hence, we studied subcellular localization of calcineurin after transcriptional downregulation of uPAR and cathepsin B in glioma. In the present study, efficient downregulation of uPAR and cathepsin B increased the translocation of calcineurin A from the mitochondria to the cytosol, decreased pBAD (S136) expression and its interaction with 14-3-3ζ, and increased the interaction of BAD with Bcl-Xl. Co-depletion of uPAR and cathepsin B induced mitochondrial translocation of BAD and caspase 3 as well as PARP activation, cytochrome c and SMAC release. These effects were inhibited by FK506 (10 μM), a specific inhibitor of calcineurin. Calcineurin A was co-localized and also co-immunoprecipitated with Bcl-2. This interaction decreased with co-depletion of uPAR and cathepsin B and also with Bcl-2 inhibitor, HA 14-1 (20 μg/mL). Altered localization and interaction of calcineurin A with Bcl-2 was also observed in vivo when uPAR and cathepsin B were downregulated. In conclusion, downregulation of uPAR and cathepsin B induced apoptosis by targeting calcineurin A to BAD via Bcl-2 in glioma. PMID:21964739

Delivering Bad News: Attitudes, Feelings, and Practice Characteristics Among Speech-Language Pathologists.

PubMed

Gold, Rinat; Gold, Azgad

2018-02-06

The purpose of this study was to examine the attitudes, feelings, and practice characteristics of speech-language pathologists (SLPs) in Israel regarding the subject of delivering bad news. One hundred and seventy-three Israeli SLPs answered an online survey. Respondents represented SLPs in Israel in all stages of vocational experience, with varying academic degrees, from a variety of employment settings. The survey addressed emotions involved in the process of delivering bad news, training on this subject, and background information of the respondents. Frequency distributions of the responses of the participants were determined, and Pearson correlations were computed to determine the relation between years of occupational experience and the following variables: frequency of delivering bad news, opinions regarding training, and emotions experienced during the process of bad news delivery. Our survey showed that bad news delivery is a task that most participants are confronted with from the very beginning of their careers. Participants regarded training in the subject of delivering bad news as important but, at the same time, reported receiving relatively little training on this subject. In addition, our survey showed that negative emotions are involved in the process of delivering bad news. Training SLPs on specific techniques is required for successfully delivering bad news. The emotional burden associated with breaking bad news in the field of speech-language pathology should be noticed and addressed.

Breaking bad news–what patients want and what they get: evaluating the SPIKES protocol in Germany

PubMed Central

Seifart, C.; Hofmann, M.; Bär, T.; Riera Knorrenschild, J.; Seifart, U.; Rief, W.

2014-01-01

Background Evaluation of the SPIKES protocol, a recommended guideline for breaking bad news, is sparse, and information about patients' preferences for bad-news delivery in Germany is lacking. Being the first actual–theoretical comparison of a ‘breaking bad news’ guideline, the present study evaluates the recommended steps of the SPIKES protocol. Moreover, emotional consequences and quality of bad-news delivery are investigated. Patients and methods A total of 350 cancer patients answered the MABBAN (Marburg Breaking Bad News Scale), a questionnaire representing the six SPIKES subscales, asking for the procedure, perception and satisfaction of the first cancer disclosure and patient’s assign to these items. Results Only 46.2% of the asked cancer patients are completely satisfied with how bad news had been broken to them. The overall quality is significantly related to the emotional state after receiving bad news (r = −0.261, P < 0.001). Patients’ preferences differ highly significantly from the way bad news were delivered, and the resulting rang list of patients’ preferences indicates that the SPIKES protocol do not fully meet the priorities of cancer patients in Germany. Conclusions It could be postulated that the low satisfaction of patients observed in this study reflects the highly significant difference between patients’ preferences and bad-news delivery. Therefore, some adjunctions to the SPIKES protocol should be considered, including a frequent reassurance of listeners’ understanding, the perpetual possibility to ask question, respect for prearrangement needs and the conception of bad-news delivery in a two-step procedure. PMID:24504443

42 CFR 413.89 - Bad debts, charity, and courtesy allowances.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Specific... allowable costs. (e) Criteria for allowable bad debt. A bad debt must meet the following criteria to be... amount of allowable bad debt (as defined in paragraph (e) of this section) is reduced: (i) For cost...

42 CFR 413.89 - Bad debts, charity, and courtesy allowances.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Specific... allowable costs. (e) Criteria for allowable bad debt. A bad debt must meet the following criteria to be... amount of allowable bad debt (as defined in paragraph (e) of this section) is reduced: (i) For cost...

Duck "beak atrophy and dwarfism syndrome" disease complex: Interplay of novel goose parvovirus-related virus and duck circovirus?

PubMed

Li, P; Li, J; Zhang, R; Chen, J; Wang, W; Lan, J; Xie, Z; Jiang, S

2018-04-01

As a newly emerged infectious disease, duck "beak atrophy and dwarfism syndrome (BADS)" disease has caused huge economic losses to waterfowl industry in China since 2015. Novel goose parvovirus-related virus (NGPV) is believed the main pathogen of BADS disease; however, BADS is rarely reproduced by infecting ducks with NGPV alone. As avian circovirus infection causes clinical symptoms similar to BADS, duck circovirus (DuCV) is suspected the minor pathogen of BADS disease. In this study, an investigation was carried out to determine the coinfection of NGPV and DuCV in duck embryos and in ducks with BADS disease. According to our study, the coinfection of emerging NGPV and DuCV was prevalent in East China (Shandong, Jiangsu and Anhui province) and could be vertical transmitted, indicating their cooperative roles in duck BADS disease. © 2018 Blackwell Verlag GmbH.

Antisocial features and "faking bad": A critical note.

PubMed

Niesten, Isabella J M; Nentjes, Lieke; Merckelbach, Harald; Bernstein, David P

2015-01-01

We critically review the literature on antisocial personality features and symptom fabrication (i.e., faking bad; e.g., malingering). A widespread assumption is that these constructs are intimately related. Some studies have, indeed, found that antisocial individuals score higher on instruments detecting faking bad, but others have been unable to replicate this pattern. In addition, studies exploring whether antisocial individuals are especially talented in faking bad have generally come up with null results. The notion of an intrinsic link between antisocial features and faking bad is difficult to test and research in this domain is sensitive to selection bias. We argue that research on faking bad would profit from further theoretical articulation. One topic that deserves scrutiny is how antisocial features affect the cognitive dissonance typically induced by faking bad. We illustrate our points with preliminary data and discuss their implications. Copyright © 2015 Elsevier Ltd. All rights reserved.

42 CFR 413.89 - Bad debts, charity, and courtesy allowances.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Bad debts, charity, and courtesy allowances. 413.89... Categories of Costs § 413.89 Bad debts, charity, and courtesy allowances. Link to an amendment published at 75 FR 49198, Aug. 12, 2010. (a) Principle. Bad debts, charity, and courtesy allowances are deductions...

42 CFR 413.178 - Bad debts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Bad debts. 413.178 Section 413.178 Public Health...) Services and Organ Procurement Costs § 413.178 Bad debts. Link to an amendment published at 75 FR 49199, Aug. 12, 2010. (a) CMS will reimburse each facility its allowable Medicare bad debts, as defined in...

Anomalous Hall effect in the van der Waals bonded ferromagnet Fe3 -xGeTe2

NASA Astrophysics Data System (ADS)

Liu, Yu; Stavitski, Eli; Attenkofer, Klaus; Petrovic, C.

2018-04-01

We report the anomalous Hall effect (AHE) in single crystals of a quasi-two-dimensional Fe3 -xGeTe2 (x ≈0.36 ) ferromagnet grown by the flux method which induces defects on the Fe site and bad metallic resistivity. Fe K-edge x-ray absorption spectroscopy was measured to provide information on the local atomic environment in such crystals. The dc and ac magnetic susceptibility measurements indicate a second-stage transition below 119 K in addition to the paramagnetic to ferromagnetic transition at 153 K. A linear scaling behavior between the modified anomalous Hall resistivity ρx y/μ0Heff and longitudinal resistivity ρxx 2M /μ0Heff implies that the AHE in Fe3 -xGeTe2 should be dominated by the intrinsic Karplus-Luttinger mechanism rather than the extrinsic skew-scattering and side-jump mechanisms. The observed deviation in the linear-M Hall conductivity σxy A below 30 K is in line with its transport characteristic at low temperatures, implying the scattering of conduction electrons due to magnetic disorder and the evolution of the Fermi surface induced by a possible spin-reorientation transition.

Bad split during bilateral sagittal split osteotomy of the mandible with separators: a retrospective study of 427 patients.

PubMed

Mensink, Gertjan; Verweij, Jop P; Frank, Michael D; Eelco Bergsma, J; Richard van Merkesteyn, J P

2013-09-01

An unfavourable fracture, known as a bad split, is a common operative complication in bilateral sagittal split osteotomy (BSSO). The reported incidence ranges from 0.5 to 5.5%/site. Since 1994 we have used sagittal splitters and separators instead of chisels for BSSO in our clinic in an attempt to prevent postoperative hypoaesthesia. Theoretically an increased percentage of bad splits could be expected with this technique. In this retrospective study we aimed to find out the incidence of bad splits associated with BSSO done with splitters and separators. We also assessed the risk factors for bad splits. The study group comprised 427 consecutive patients among whom the incidence of bad splits was 2.0%/site, which is well within the reported range. The only predictive factor for a bad split was the removal of third molars at the same time as BSSO. There was no significant association between bad splits and age, sex, class of occlusion, or the experience of the surgeon. We think that doing a BSSO with splitters and separators instead of chisels does not increase the risk of a bad split, and is therefore safe with predictable results. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

BAD-LAMP defines a subset of early endocytic organelles in subpopulations of cortical projection neurons.

PubMed

David, Alexandre; Tiveron, Marie-Catherine; Defays, Axel; Beclin, Christophe; Camosseto, Voahirana; Gatti, Evelina; Cremer, Harold; Pierre, Philippe

2007-01-15

The brain-associated LAMP-like molecule (BAD-LAMP) is a new member of the family of lysosome associated membrane proteins (LAMPs). In contrast to other LAMPs, which show a widespread expression, BAD-LAMP expression in mice is confined to the postnatal brain and therein to neuronal subpopulations in layers II/III and V of the neocortex. Onset of expression strictly parallels cortical synaptogenesis. In cortical neurons, the protein is found in defined clustered vesicles, which accumulate along neurites where it localizes with phosphorylated epitopes of neurofilament H. In primary neurons, BAD-LAMP is endocytosed, but is not found in classical lysosomal/endosomal compartments. Modification of BAD-LAMP by addition of GFP revealed a cryptic lysosomal retention motif, suggesting that the cytoplasmic tail of BAD-LAMP is actively interacting with, or modified by, molecules that promote its sorting away from lysosomes. Analysis of BAD-LAMP endocytosis in transfected HeLa cells provided evidence that the protein recycles to the plasma membrane through a dynamin/AP2-dependent mechanism. Thus, BAD-LAMP is an unconventional LAMP-like molecule and defines a new endocytic compartment in specific subtypes of cortical projection neurons. The striking correlation between the appearance of BAD-LAMP and cortical synatogenesis points towards a physiological role of this vesicular determinant for neuronal function.

Novel associations of bile acid diarrhoea with fatty liver disease and gallstones: a cohort retrospective analysis.

PubMed

Appleby, Richard N; Nolan, Jonathan D; Johnston, Ian M; Pattni, Sanjeev S; Fox, Jessica; Walters, Julian Rf

2017-01-01

Bile acid diarrhoea (BAD) is a common cause of chronic diarrhoea with a population prevalence of primary BAD around 1%. Previous studies have identified associations with low levels of the ileal hormone fibroblast growth factor 19 (FGF19), obesity and hypertriglyceridaemia. The aim of this study was to identify further associations of BAD. A cohort of patients with chronic diarrhoea who underwent 75 selenohomocholic acid taurate (SeHCAT) testing for BAD was further analysed retrospectively. Additional clinical details available from the electronic patient record, including imaging, colonoscopy, chemistry and histopathology reports were used to calculate the prevalence of fatty liver disease, gallstones, colonic neoplasia and microscopic colitis, which was compared for BAD, the primary BAD subset and control patients with diarrhoea. Of 578 patients, 303 (52%) had BAD, defined as a SeHCAT 7d retention value <15%, with 179 (31%) having primary BAD. 425 had an alanine aminotransferase (ALT) recorded, 184 had liver imaging and 176 had both. Overall, SeHCAT values were negatively associated with ALT (r s =-0.19, p<0.0001). Patients with BAD had an OR of 3.1 for an ALT >31 ng/mL with imaging showing fatty liver (p<0.001); similar figures occurred in the primary BAD group. FGF19 was not significantly related to fatty liver but low levels were predictive of ALT >40 IU/L. In 176 subjects with gallbladder imaging, 27% had gallstones, 7% had a prior cholecystectomy and 34% either of these. The median SeHCAT values were lower in those with gallstones (3.8%, p<0.0001), or gallstones/cholecystectomy (7.2%, p<0.001), compared with normal gallbladder imaging (14%). Overall, BAD had an OR of 2.0 for gallstones/cholecystectomy (p<0.05). BAD was not significantly associated with colonic adenoma/carcinoma or with microscopic colitis. The diagnosis of BAD is associated with fatty liver disease and with gallstones. The reasons for these associations require further investigation into potential metabolic causes.

Novel associations of bile acid diarrhoea with fatty liver disease and gallstones: a cohort retrospective analysis

PubMed Central

Appleby, Richard N; Nolan, Jonathan D; Johnston, Ian M; Pattni, Sanjeev S; Fox, Jessica; Walters, Julian RF

2017-01-01

Background Bile acid diarrhoea (BAD) is a common cause of chronic diarrhoea with a population prevalence of primary BAD around 1%. Previous studies have identified associations with low levels of the ileal hormone fibroblast growth factor 19 (FGF19), obesity and hypertriglyceridaemia. The aim of this study was to identify further associations of BAD. Methods A cohort of patients with chronic diarrhoea who underwent 75selenohomocholic acid taurate (SeHCAT) testing for BAD was further analysed retrospectively. Additional clinical details available from the electronic patient record, including imaging, colonoscopy, chemistry and histopathology reports were used to calculate the prevalence of fatty liver disease, gallstones, colonic neoplasia and microscopic colitis, which was compared for BAD, the primary BAD subset and control patients with diarrhoea. Findings Of 578 patients, 303 (52%) had BAD, defined as a SeHCAT 7d retention value <15%, with 179 (31%) having primary BAD. 425 had an alanine aminotransferase (ALT) recorded, 184 had liver imaging and 176 had both. Overall, SeHCAT values were negatively associated with ALT (rs=−0.19, p<0.0001). Patients with BAD had an OR of 3.1 for an ALT >31 ng/mL with imaging showing fatty liver (p<0.001); similar figures occurred in the primary BAD group. FGF19 was not significantly related to fatty liver but low levels were predictive of ALT >40 IU/L. In 176 subjects with gallbladder imaging, 27% had gallstones, 7% had a prior cholecystectomy and 34% either of these. The median SeHCAT values were lower in those with gallstones (3.8%, p<0.0001), or gallstones/cholecystectomy (7.2%, p<0.001), compared with normal gallbladder imaging (14%). Overall, BAD had an OR of 2.0 for gallstones/cholecystectomy (p<0.05). BAD was not significantly associated with colonic adenoma/carcinoma or with microscopic colitis. Interpretation The diagnosis of BAD is associated with fatty liver disease and with gallstones. The reasons for these associations require further investigation into potential metabolic causes. PMID:29119003

[Pickled food, fish, seafood intakes and oral squamous cell carcinoma: a case-control study].

PubMed

Huang, J F; Qiu, Y; Cai, L; Liu, F P; Chen, F; Yan, L J; Wu, J F; Bao, X D; Liu, F Q; Zheng, X Y; Lin, L S; He, B C

2017-08-06

Objective: To investigate the effects between fish, seafood and pickled food intakes on oral squamous cell carcinoma (OSCC). Methods: A case-control study was carried out in Fujian area during September 2010 to December 2016, in which 604 newly diagnosed primary OSCC cases confirmed by pathological diagnosis were collected from hospital and 1 343 control subjects were enrolled from community and healthy hospital population. Demographic data, history of smoking drinking and tea drinking, oral hygiene status and dietary behaviors (fish, seafood and pickled food intakes) were collected by in-person interviews using a standard questionnaire.Using unconditional logistic regression to estimate adjusted odds ratios ( ORs ) and corresponding 95% confidence intervals ( CIs ) to assess the effects of fish, seafood and pickled food intakes on OSCC. Analysis stratified by smoking, alcohol drinking and bad prosthesis to explore the possible difference in association between subgroups. Multiplicative interactions and additive interactions between fish and bad prosthesis, seafood and alcohol drinking, pickled food and bad prosthesis were assessed by unconditional logistic regression, relative excess risk due to interaction ( RERI ), attributable proportion due to interaction ( AP ) and synergy index (S). Results: The average age of case group and control group were separately (58.69±13.92) years old and (59.27±11.37) years old (χ(2)=4.75, P= 0.191). The people whose fish and seafood intakes ≥3 times/week had the lower risk of OSCC, the adjusted OR (95 %CI ) values were 0.63 (0.52-0.77) and 0.51 (0.41-0.64); The stratified analysis indicated that the people having bad prosthesis had the lower risk of OSCC if they eating fish ≥3 times/week, and the adjusted OR (95 %CI ) values was 0.53 (0.39-0.71); the people having bad prosthesis had the higher risk of OSCC if they eating pickled food ≥3 times/week, the adjusted OR (95 %CI ) values was 1.37 (1.02-1.88). Regularly eating seafood can decrease the risk of OSCC for non-smokers, smokers, non-drinkers, drinkers, people without bad prosthesis and had bad prosthesis, the adjusted OR (95 %CI ) values were 0.49 (0.36-0.68), 0.52 (0.37-0.73), 0.41 (0.31-0.55), 0.77 (0.51-0.96), 0.49 (0.36-0.67), 0.59 (0.42-0.83). Crossover analysis showed fish and bad prosthesis exist multiplication interaction relationship (adjusted OR= 0.66, 95 %CI: 0.44-0.97) and additional interaction relationship ( RERI =-0.81, 95 %CI: -1.43--0.19; AP= -0.76, 95 %CI: -1.35--0.17; S =0.08, 95 %CI: 0.01-0.98); pickled food and bad prosthesis exist multiplication interaction relationship (adjusted OR= 1.63, 95 %CI: 1.06-2.51) and addition interaction relationship ( RERI =0.65, 95 %CI: 0.08-1.22; AP= 0.36, 95 %CI: 0.10-0.62; S =5.19, 95 %CI: 1.32-54.49). Conclusion: Reducing the consumption of pickled food, quitting smoking and limiting alcohol consumption, and regularly eating fish and seafood can prevent the occurrence of OSCC.

The learning effects of different presentations of worked examples on medical students' breaking-bad-news skills: A randomized and blinded field trial.

PubMed

Schmitz, Felix Michael; Schnabel, Kai Philipp; Bauer, Daniel; Bachmann, Cadja; Woermann, Ulrich; Guttormsen, Sissel

2018-02-24

Effective instructional approaches are needed to enable undergraduates to optimally prepare for the limited training time they receive with simulated patients (SPs). This study examines the learning effects of different presentation formats of a worked example on student SP communication. Sixty-seven fourth-year medical students attending a mandatory communication course participated in this randomized field trial. Prior to the course, they worked through an e-learning module that introduced the SPIKES protocol for delivering bad news to patients. In this module, a single worked example was presented to one group of students in a text version, to a second group in a video version, and to a third group in a video version enriched with text hints denoting the SPIKES steps. The video-with-hints group broke bad news to SPs significantly more appropriately than either of the other groups. Although no further condition-related effects were revealed, students who learned from the text version most frequently (although non-significantly) ignored unpleasant emotions (standardised emotional cues and concerns) expressed by the SPs. The learning effect was strongest when the video-based worked example was accompanied by hints. Video-related learning approaches that embed attention-guiding hints can effectively prepare undergraduates for SP encounters. Copyright © 2018 Elsevier B.V. All rights reserved.

26 CFR 1.593-5 - Addition to reserves for bad debts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Addition to reserves for bad debts. 1.593-5... bad debts. (a) Amount of addition. As an alternative to a deduction from gross income under section... a deduction under section 166(c) for a reasonable addition to a reserve for bad debts. In the case...

19 CFR 125.34 - Countersigning of documents and notation of bad order or discrepancy.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Countersigning of documents and notation of bad... and Receipt § 125.34 Countersigning of documents and notation of bad order or discrepancy. When a... and shall note thereon any bad order or discrepancy. When available, the importing carrier's tally...

"Serving Time": The Relationship of Good and Bad Teaching

ERIC Educational Resources Information Center

Jackson, Michael

2006-01-01

Purpose: The argument is that good and bad teaching are asymmetrical. Eradicating what is readily thought of as bad teaching does not leave behind the purse gold of good teaching. Good teaching is that which promotes student learning. The purpose of this paper is to explore the relationship between bad teaching and good teaching in graduate…

Bad Breath

MedlinePlus

... cabbage. And of course smoking causes its own bad smell. Some diseases and medicines can cause a specific breath odor. Having good dental habits, like brushing and flossing regularly, help fight bad ...

[Relation between dose, plasma concentration and therapeutic effect of theophylline in children with sleep apnea].

PubMed

Rodríguez-Palomares, C; Ugartechea, J C; Palma-Aguirre, J A; Juárez-Olguín, H; Calderón-Mandujano, B

1989-12-01

The plasma concentration of theophylline was determined in twelve children with infantile sleep apnea (average age 48.5 days). The purpose of the study was to correlate concentrations with the dosages given, the therapeutic response and any adverse effects which could arise. In addition, other pharmacokinetic values were found, half-life (t 1/2) and clearance concentrations (Clss). The oral maintenance dose used was 4 mg/kg/24 h. The serum concentration of theophylline was determined by a homogeneous immunoassay enzyme technique (EMIT). A bad correlation was found (r = 0.45) between the oral dosage given and the plasma concentrations found. This was probably due to variations in the clearance of the drug. Yet, plasma concentrations fell between 3.0 and 12.6 micrograms/mL, enough to satisfactorily control apneic episodes in all the children included in the study without undesirable side-effects. Only one patient had some trouble in falling asleep and showed signs of irritability. The half-life was 13.30 +/- 7.46 hours and Clss was 36.64 +/- 12.98 mL/h/kg. In general, our results correlate with those reported in the literature. The accuracy of the pharmacokinetic parameters with two samples is reliable, therefore avoiding the use of multiple sampling in this group of children.

Expression and prognostic relevance of MET and phospho-BAD in non-small cell lung cancer.

PubMed

Sun, Wenze; Ai, Ting; Gao, Ying; Zhang, Yingbing; Cui, Jie; Song, Liping

2013-01-01

MET is involved in the progression of several types of human cancers, while phospho-BAD(Ser-136) is a key molecule in apoptosis and might be regulated by MET. The aim of this study was to investigate the correlation between altered expression of MET and phospho-BAD in non-small cell lung cancer (NSCLC) and their association with clinicopathologic parameters and overall survival. MET and phospho-BAD(Ser-136) proteins were evaluated by immunohistochemical analysis in 183 paraffin-embedded specimens and were also assessed by Western blotting analysis in 12 frozen tumor tissue samples, which were representative examples of immunohistochemical staining. Positive expression of MET and phospho-BAD(Ser-136) occurred in 67.2% and 49.2% of the 183 cases of NSCLC, respectively. However, neither MET expression nor phospho-BAD(Ser-136) expression was associated with any clinicopathologic parameter. A significant correlation was found between MET and phospho-BAD(Ser-136) expression levels evaluated by immunohistochemistry (r = 0.268, P < 0.001). Overexpression of MET was significantly associated with shortened overall survival in univariate analysis (P < 0.001). Moreover, patients with a MET+/phospho-BAD(Ser-136)+ phenotype had a poorer prognosis than others (P < 0.001). Multivariate Cox proportional hazard analysis confirmed that MET expression is a prognostic factor for NSCLC. MET expression might be correlated with phospho-BAD(Ser-136) expression, and may be an adverse predictor for NSCLC. Activation of the MET/phospho-BAD(Ser-136) signaling pathway might play a role in the development and progression of NSCLC.

How to deal with morning bad breath: A randomized, crossover clinical trial.

PubMed

Oliveira-Neto, Jeronimo M; Sato, Sandra; Pedrazzi, Vinícius

2013-11-01

The absence of a protocol for the treatment of halitosis has led us to compare mouthrinses with mechanical oral hygiene procedures for treating morning breath by employing a hand-held sulfide monitor. To compare the efficacy of five modalities of treatment for controlling morning halitosis in subjects with no dental or periodontal disease. This is a five-period, randomized, crossover clinical trial. Twenty volunteers were randomly assigned to the trial. Testing involved the use of a conventional tongue scraper, a tongue scraper joined to the back of a toothbrush's head, two mouthrinses (0.05% cetylpyridinium chloride and 0.12% chlorhexidine digluconate) and a soft-bristled toothbrush and fluoride toothpaste for practicing oral hygiene. Data analysis was performed using SPSS version 17 for Windows and NCSS 2007 software (P < 0.05). The products and the periods were compared with each other using the Friedman's test. When significant differences (P < 0.05) were determined, the products and periods were compared in pairs by using the Wilcoxon's test and by adjusting the original significance level (0.05) for multiple comparisons by using the Bonferroni's method. The toothbrush's tongue scraper was able to significantly reduce bad breath for up to 2 h. Chlorhexidine reduced bad breath only at the end of the second hour, an effect that lasted for 3 h. Mechanical tongue cleaning was able to immediately reduce bad breath for a short period, whereas chlorhexidine and mechanical oral hygiene reduced bad breath for longer periods, achieving the best results against morning breath.

Thematic and Content Analysis of Idiopathic Nightmares and Bad Dreams

PubMed Central

Robert, Geneviève; Zadra, Antonio

2014-01-01

Study Objectives: To conduct a comprehensive and comparative study of prospectively collected bad dream and nightmare reports using a broad range of dream content variables. Design: Correlational and descriptive. Setting: Participants' homes. Participants: Three hundred thirty-one adult volunteers (55 men, 275 women, 1 not specified; mean age = 32.4 ± 14.8 y). Interventions: N/A. Measurement and Results: Five hundred seventy-two participants kept a written record of all of their remembered dreams in a log for 2 to 5 consecutive weeks. A total of 9,796 dream reports were collected and the content of 253 nightmares and 431 bad dreams reported by 331 participants was investigated. Physical aggression was the most frequently reported theme in nightmares, whereas interpersonal conflicts predominated in bad dreams. Nightmares were rated by participants as being substantially more emotionally intense than were bad dreams. Thirty-five percent of nightmares and 55% of bad dreams contained primary emotions other than fear. When compared to bad dreams, nightmares were more bizarre and contained substantially more aggressions, failures, and unfortunate endings. Conclusions: The results have important implications on how nightmares are conceptualized and defined and support the view that when compared to bad dreams, nightmares represent a somewhat rarer—and more severe—expression of the same basic phenomenon. Citation: Robert G; Zadra A. Thematic and content analysis of idiopathic nightmares and bad dreams. SLEEP 2014;37(2):409-417. PMID:24497669

The prevalence of bad headaches including migraine in a multiethnic community.

PubMed

Thomson, A N; White, G E; West, R

1993-11-10

Overall and ethnic specific prevalences of bad headache including migraine, for the New Zealand population, are unknown. A study was carried out in South Auckland to estimate prevalence and to explore ethnic differences in doctor attendance for the diagnosis and management of bad headaches. Telephone interviews were administered to respondents selected by random digit dialing of households. 40.6% of the respondents suffered from bad headaches. 54.5% of these had the characteristics of bad headache with features symptomatic of migraine. Trends in the prevalence of bad headache with features symptomatic of common migraine, peaked between the ages of 30-49 years in both men and women. A difference was seen in the prevalence of bad headache with aura, with or without common migraine features, when ethnic groups and gender were examined. The difference in prevalence of aura was particularly noticeable between Pacific Island men and women. Although there was no difference between ethnic groups in doctor attendance, headaches were more likely to be labelled as migraine in Europeans than in the Polynesian groups. Ways in which people perceive and report their bad headaches have a bearing on management by general practitioners. Although no overall ethnic predominance was seen, there was a gender difference amongst Pacific Island people in reporting bad headaches with aura. The labelling process, and thus the management by general practitioners does demonstrate likely ethnic differences.

Bad Luck or Bad Decisions: College Students' Perceptions of the Reasons for and Consequences of Their Alcohol Overdose

ERIC Educational Resources Information Center

Reis, Janet

2007-01-01

Reasons for and immediate consequences of an alcohol overdose were explored for 217 undergraduate students requiring a medical emergency transport because of excessive alcohol consumption. The sample was categorized into 26 students attributing their overdose solely to bad luck and 191 students citing bad decision making as an explanation. A…

Thematic and content analysis of idiopathic nightmares and bad dreams.

PubMed

Robert, Geneviève; Zadra, Antonio

2014-02-01

To conduct a comprehensive and comparative study of prospectively collected bad dream and nightmare reports using a broad range of dream content variables. Correlational and descriptive. Participants' homes. Three hundred thirty-one adult volunteers (55 men, 275 women, 1 not specified; mean age = 32.4 ± 14.8 y). N/A. Five hundred seventy-two participants kept a written record of all of their remembered dreams in a log for 2 to 5 consecutive weeks. A total of 9,796 dream reports were collected and the content of 253 nightmares and 431 bad dreams reported by 331 participants was investigated. Physical aggression was the most frequently reported theme in nightmares, whereas interpersonal conflicts predominated in bad dreams. Nightmares were rated by participants as being substantially more emotionally intense than were bad dreams. Thirty-five percent of nightmares and 55% of bad dreams contained primary emotions other than fear. When compared to bad dreams, nightmares were more bizarre and contained substantially more aggressions, failures, and unfortunate endings. The results have important implications on how nightmares are conceptualized and defined and support the view that when compared to bad dreams, nightmares represent a somewhat rarer-and more severe-expression of the same basic phenomenon.

A synthesis of the literature on breaking bad news or truth telling: potential for research in India.

PubMed

Martis, Lawrence; Westhues, Anne

2013-01-01

The high incidence of fatal diseases, inequitable access to health care, and socioeconomic disparities in India generate plentiful clinical bad news including diagnosis of a life-limiting disease, poor prognosis, treatment failure, and impending death. These contexts compel health care professionals to become the messengers of bad news to patients and their families. In global literature on breaking bad news, there is very little about such complex clinical interactions occurring in India or guiding health care providers to do it well. The purpose of this article is to identify the issues for future research that would contribute to the volume, comprehensiveness, and quality of empirical literature on breaking bad news in clinical settings across India. Towards this end, we have synthesized the studies done across the globe on breaking bad news, under four themes: (a) deciding the amount of bad news to deliver; (b) attending to cultural and ethical issues; (c) managing psychological distress; and (d) producing competent messengers of bad news. We believe that robust research is inevitable to build an indigenous knowledge base, enhance communicative competence among health care professionals, and thereby to improve the quality of clinical interactions in India.

A Synthesis of the Literature on Breaking Bad News or Truth Telling: Potential for Research in India

PubMed Central

Martis, Lawrence; Westhues, Anne

2013-01-01

The high incidence of fatal diseases, inequitable access to health care, and socioeconomic disparities in India generate plentiful clinical bad news including diagnosis of a life-limiting disease, poor prognosis, treatment failure, and impending death. These contexts compel health care professionals to become the messengers of bad news to patients and their families. In global literature on breaking bad news, there is very little about such complex clinical interactions occurring in India or guiding health care providers to do it well. The purpose of this article is to identify the issues for future research that would contribute to the volume, comprehensiveness, and quality of empirical literature on breaking bad news in clinical settings across India. Towards this end, we have synthesized the studies done across the globe on breaking bad news, under four themes: (a) deciding the amount of bad news to deliver; (b) attending to cultural and ethical issues; (c) managing psychological distress; and (d) producing competent messengers of bad news. We believe that robust research is inevitable to build an indigenous knowledge base, enhance communicative competence among health care professionals, and thereby to improve the quality of clinical interactions in India. PMID:23766589

Good days and bad days in dementia: a qualitative chart review of variable symptom expression.

PubMed

Rockwood, Kenneth; Fay, Sherri; Hamilton, Laura; Ross, Elyse; Moorhouse, Paige

2014-08-01

Despite its importance in the lived experience of dementia, symptom fluctuation has been little studied outside Lewy body dementia. We aimed to characterize symptom fluctuation in patients with Alzheimer's disease (AD) and mixed dementia. A qualitative analysis of health records that included notations on good days and bad days yielded 52 community-dwelling patients (women, n = 30; aged 39-91 years; mild dementia, n = 26, chiefly AD, n = 36). Good days/bad days were most often described as changes in the same core set of symptoms (e.g. less/more verbal repetition). In other cases, only good or only bad days were described (e.g., no bad days, better sense of humor on good days). Good days were typically associated with improved global cognition, function, interest, and initiation. Bad days were associated with frequent verbal repetition, poor memory, increased agitation and other disruptive behaviors. Clinically important variability in symptoms appears common in AD and mixed dementia. Even so, what makes a day "good" is not simply more (or less) of what makes a day "bad". Further investigation of the factors that facilitate or encourage good days and mitigate bad days may help improve quality of life for patients and caregivers.

Effects of baking-soda-containing dentifrices on oral malodor.

PubMed

Brunette, D M

1997-01-01

Oral malodor, also known as bad breath or halitosis, is an extremely common problem. Bad breath can arise from many sources in the body, but most frequently is produced in the mouth by the action of gram-negative anaerobic bacteria on sulfur-containing proteinaceous substrates in the saliva, such as debris and plaque. The primary molecules responsible for oral malodor are volatile sulfur compounds (VSC), such as hydrogen sulfide and methylmercaptan. Increased malodor production is related to greater bacterial numbers, reducing conditions, availability of protein substrates, and a pH above neutral. Bad breath is more common in the elderly, as well as those with unhygienic mouths, gingivitis, and periodontitis, but bad breath can also be found in some individuals who are periodontally healthy. The major source of oral malodor is the tongue. Approaches to controlling malodor have included masking, oral hygiene, antibacterial agents, conversion of VSC to nonodorous forms, oxidizing agents, and traditional approaches, including the use of backing soda. Results of controlled double-blind crossover studies, using both organoleptic (sensory) and gas chromatographic analysis of mouth air VSC, indicate that two dentifrices with high baking-soda concentrations, Arm & Hammer Dental Care and Arm & Hammer PeroxiCare, reduce oral malodor.

[Pitfalls within the cancer-related doctor-patient communication].

PubMed

Muszbek, Katalin; Gaal, Ilona

2016-04-24

There is a "confusion of tongues" in the communication between patient and physician that hinders mutual understanding. Cancer - because of its malignant and often chronic nature - accentuates the communication problems and emphasizes the importance of human relationship. The confusion of tongues can only be resolved through understanding of the situation and motivations of the other person. Thus our aim is to help medical doctors to recognize and understand the most important communication characteristics of the doctor-patient interactions that are strained by the burden of cancer. Interviews with directly concerned professionals and non-professionals were recorded in order to reveal the most common communication disturbances. The majority of the "communication vacuum" arose when bad news should be disclosed for the patient, as bad news is bad for the physician as well. It is emotionally burdening to perceive bad news, and a big challenge for the physician to break it gently, to be tactful, while he/she has no possibility to pay attention with regard to his/her own emotional stability. Medical doctors can cope with this challenge if they are acquainted with the psychological difficulties of the patients that block the effective medical communication.

BAD knockout provides metabolic seizure resistance in a genetic model of epilepsy with sudden unexplained death in epilepsy.

PubMed

Foley, Jeannine; Burnham, Veronica; Tedoldi, Meghan; Danial, Nika N; Yellen, Gary

2018-01-01

Metabolic alteration, either through the ketogenic diet (KD) or by genetic alteration of the BAD protein, can produce seizure protection in acute chemoconvulsant models of epilepsy. To assess the seizure-protective role of knocking out (KO) the Bad gene in a chronic epilepsy model, we used the Kcna1 -/- model of epilepsy, which displays progressively increased seizure severity and recapitulates the early death seen in sudden unexplained death in epilepsy (SUDEP). Beginning on postnatal day 24 (P24), we continuously video monitored Kcna1 -/- and Kcna1 -/- Bad -/- double knockout mice to assess survival and seizure severity. We found that Kcna1 -/- Bad -/- mice outlived Kcna1 -/- mice by approximately 2 weeks. Kcna1 -/- Bad -/- mice also spent significantly less time in seizure than Kcna1 -/- mice on P24 and the day of death, showing that BadKO provides seizure resistance in a genetic model of chronic epilepsy. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

Delivering Bad News: An Approach According to Jewish Scriptures

PubMed Central

Naimer, Sody A.; Prero, Moshe

2014-01-01

Despite a preoccupation in the medical literature with developing an effective approach for breaking bad news, the sources are based on personal opinion alone and only in some instances on qualitative research. Recognizing the gravity of this topic coupled with respect for the wisdom of the written and oral Jewish scriptures, this work is an attempt to delve into the diverse ancient writings to draw conclusions regarding a recommended methodology to guide and inform this task. It is interesting to learn that most elements related to this topic have previously been raised in various forms in the scriptures. The issues range from where, when, and how the bearer of bad news should undertake this duty, to details such as the environment, the format, the speed, and depth of the details to be disclosed. The essence of this paper is to enrich the reader using both positive and negative examples found in the Jewish heritage. Adopting these principles will hopefully provide an effective method for performing this unpleasant obligation, with the goal of limiting harmful consequences as much as possible. PMID:25120920

The Effect of Bad News and CEO Apology of Corporate on User Responses in Social Media

PubMed Central

Cha, Meeyoung; Jeong, Jaeseung

2015-01-01

While social media has become an important platform for social reputation, the emotional responses of users toward bad news have not been investigated thoroughly. We analyzed a total of 20,773 Twitter messages by 15,513 users to assess the influence of bad news and public apology in social media. Based on both computerized, quantitative sentiment analysis and in-depth qualitative analysis, we found that rapid public apology effectively and immediately reduced the level of negative sentiment, where the degree of change in sentiments differed by the type of interactions users engaged in. The majority of users who directly conversed with corporate representatives on the new media were not typical consumers, but experts and practitioners. We extend the existing cognitive model and suggest the audiences’ psychological reaction model to describe the information processing process during and after an organizational crisis and response. We also discuss various measures through which companies can respond to a crisis properly in social media in a fashion that is different from conventional mass media. PMID:25951231

The Effect of Bad News and CEO Apology of Corporate on User Responses in Social Media.

PubMed

Kim, Hoh; Park, Jaram; Cha, Meeyoung; Jeong, Jaeseung

2015-01-01

While social media has become an important platform for social reputation, the emotional responses of users toward bad news have not been investigated thoroughly. We analyzed a total of 20,773 Twitter messages by 15,513 users to assess the influence of bad news and public apology in social media. Based on both computerized, quantitative sentiment analysis and in-depth qualitative analysis, we found that rapid public apology effectively and immediately reduced the level of negative sentiment, where the degree of change in sentiments differed by the type of interactions users engaged in. The majority of users who directly conversed with corporate representatives on the new media were not typical consumers, but experts and practitioners. We extend the existing cognitive model and suggest the audiences' psychological reaction model to describe the information processing process during and after an organizational crisis and response. We also discuss various measures through which companies can respond to a crisis properly in social media in a fashion that is different from conventional mass media.

Delivering bad news: an approach according to jewish scriptures.

PubMed

Naimer, Sody A; Prero, Moshe

2014-07-01

Despite a preoccupation in the medical literature with developing an effective approach for breaking bad news, the sources are based on personal opinion alone and only in some instances on qualitative research. Recognizing the gravity of this topic coupled with respect for the wisdom of the written and oral Jewish scriptures, this work is an attempt to delve into the diverse ancient writings to draw conclusions regarding a recommended methodology to guide and inform this task. It is interesting to learn that most elements related to this topic have previously been raised in various forms in the scriptures. The issues range from where, when, and how the bearer of bad news should undertake this duty, to details such as the environment, the format, the speed, and depth of the details to be disclosed. The essence of this paper is to enrich the reader using both positive and negative examples found in the Jewish heritage. Adopting these principles will hopefully provide an effective method for performing this unpleasant obligation, with the goal of limiting harmful consequences as much as possible.

Computer Supported Collaborative Rocketry: Teaching students to distinguish good and bad data like expert physicists

NASA Astrophysics Data System (ADS)

d'Alessio, Matthew; Lundquist, Loraine

2013-10-01

Each year our physical science class for pre-service elementary teachers launches water-powered rockets based on the activity from NASA. We analyze the rocket flight using data from frame-by-frame video analysis of the launches. Before developing the methods presented in this paper, we noticed our students were mired in calculation details while losing sight of physical concepts. Sloppy measurements and calculations (even when using spreadsheets with formulas provided) sometimes led to such poor results that physical concepts could not be reliably taught from the data, but students were unmotivated to either notice or correct their errors. We adopted a collaborative, computer supported approach using simple and easily available functions in Google Spreadsheets to pool observations, provide instant feedback, and publicly display results from all teams side-by-side in real time. These instant comparisons promote student accountability and engagement, inspiring them to think more carefully about why answers may be different and notice sloppy data or unlikely outcomes—in short, to facilitate and motivate expert thinking about data.

Numerical investigation for one bad-behaved flow in a Pelton turbine

NASA Astrophysics Data System (ADS)

Wei, X. Z.; Yang, K.; Wang, H. J.; Gong, R. Z.; Li, D. Y.

2015-01-01

The gas-liquid two-phase flow in pelton turbines is very complicated, there are many kinds of bad-behaved flow in pelton turbines. In this paper, CFD numerical simulation for the pelton turbine was conducted using VOF two-phase model. One kind of bad-behaved flow caused by the two jets was captured, and the bad-behaved flow was analysed by torque on buckets. It can be concluded that the angle between the two jets and the value of ratio of runner diameter and jet diameter are important parameters for the bad-behaved flow. Furthermore, the reason why the efficiency of some multi-jet type turbines is very low can be well explained by the analysis of bad-behaved flow. Finally, some suggestions for improvement were also provided in present paper.

The Sidebar Computer Program, a seismic-shaking intensity meter: users' manual and software description

USGS Publications Warehouse

Evans, John R.

2003-01-01

The SideBar computer program provides a visual display of seismic shaking intensity as recorded at one specific seismograph. This software allows a user to tap into the seismic data recorded on that specific seismograph and to display the overall level of shaking at the single location where that seismograph resides (usually the same place the user is). From this shaking level, SideBar also estimates the potential for damage nearby. SideBar cannot tell you the “Richter magnitude” of the earthquake (see box), only how hard the ground shook locally and this estimate of how much damage is likely in the neighborhood. This combination of local effects is called the “seismic intensity”. SideBar runs on a standard desktop or laptop PC, and is intended for the media, schools, emergency responders, and any other group hosting a seismograph and who want to know immediately after an earthquake the levels of shaking measured by that instrument. These local values can be used to inform the public and help initiate appropriate local emergency response activities in the minutes between the earthquake and availability of the broader coverage provided by the USGS over the Web, notably by ShakeMap. For example, for instruments installed in schools, the level of shaking and likely damage at the school could immediately be Web broadcast and parents could quickly determine the likely safety of their children—their biggest postearthquake concern. Also, in the event of a Web outage, SideBar may be a continuing primary source of local emergency response information for some additional minutes. Specifically, SideBar interprets the peak level of acceleration (that is, the force of shaking, as a percentage of the force of gravity) as well as the peak velocity, or highest speed, at which the ground moves. Using these two basic measurements, SideBar computes what is called Instrumental Intensity—a close approximation of the Modified Mercalli Intensity scale, or “MMI” (using the Wald et al., 1999a, relationships between acceleration, velocity, and shaking intensity). Intensity is a measure of local shaking strength and the potential for damage—of how bad the earthquake effects were locally. The intensity level is what SideBar displays most prominently on the PC monitor. Intensity is shown as a large, colored bar that gets taller and changes color up a rainbow from blues toward reds as the shaking level increases. As opposed to earthquake magnitudes, which are reported as decimal values (like “7.6”), intensity is traditionally given as a Roman numeral, with “I” to “X+” assigned to levels of potential damage and perceived shaking strength. For good measure, SideBar shows the actual values of the force of shaking (peak ground acceleration as a percentage of gravity) and the speed of ground motion (peak ground velocity in inches per second, by default, or in centimeters per second, if you wish), both these values as decimal numbers. SideBar also remembers the most recent earthquakes (for up to one week), and can store as many of these previous earthquakes as the user allows (and as the user’s PC has room for)—typically thousands. SideBar also remembers forever the three largest earthquakes it has seen and all earthquakes over intensity IV so that one never loses particularly important events.

New information and social trust: asymmetry and perseverance of attributions about hazard managers.

PubMed

Cvetkovich, George; Siegrist, Michael; Murray, Rachel; Tragesser, Sarah

2002-04-01

It has been argued that news about negative events has a much stronger effect on decreasing social trust than does news about positive events on increasing it. This asymmetry principle of trust was investigated in two surveys that also investigated the perseverance of trust. The possibility that established trust attributions persevere in the face of new information raises questions about the limits of trust asymmetry. The two studies yielded evidence that both type of news (good versus bad) and initial general trust in the nuclear power industry or the food supply industry affected level of trust. Compared to individuals trusting the industry, those distrusting the industry exhibited less trust following both bad and good news events. Study I also found that judged informativeness and judged positiveness of news events were affected by type of news and general trust of the industry. Individuals low in general trust of the nuclear power industry judged both bad news and good news as less positive than did those high in general trust. Those low in general trust judged bad news as more informative than good news and than did those high in general trust. An important implication of the perseverance of trust is to focus attention on including not only the effects of information about specific events and actions, but also on the judgment processes underlying social trust. The Salient Value Similarity model is suggested as one way of accounting for these psychological processes.

H2S-releasing nanoemulsions: a new formulation to inhibit tumor cells proliferation and improve tissue repair

PubMed Central

Carotenuto, Felicia; Khashoggi, Haneen A.; Nanni, Francesca; Melino, Sonia

2016-01-01

The improvement of solubility and/or dissolution rate of poorly soluble natural compounds is an ideal strategy to make them optimal candidates as new potential drugs. Accordingly, the allyl sulfur compounds and omega-3 fatty acids are natural hydrophobic compounds that exhibit two important combined properties: cardiovascular protection and antitumor activity. Here, we have synthesized and characterized a novel formulation of diallyl disulfide (DADS) and α-linolenic acid (ALA) as protein-nanoemulsions (BAD-NEs), using ultrasounds. BAD-NEs are stable over time at room temperature and show antioxidant and radical scavenging property. These NEs are also optimal H2S slow-release donors and show a significant anti-proliferative effect on different human cancer cell lines: MCF-7 breast cancer and HuT 78 T-cell lymphoma cells. BAD-NEs are able to regulate the ERK1/2 pathway, inducing apoptosis and cell cycle arrest at the G0/G1 phase. We have also investigated their effect on cell proliferation of human adult stem/progenitor cells. Interestingly, BAD-NEs are able to improve the Lin– Sca1+ human cardiac progenitor cells (hCPC) proliferation. This stem cell growth stimulation is combined with the expression and activation of proteins involved in tissue-repair, such as P-AKT, α-sma and connexin 43. Altogether, our results suggest that these antioxidant nanoemulsions might have potential application in selective cancer therapy and for promoting the muscle tissue repair. PMID:27741519

β3 integrin promotes chemoresistance to epirubicin in MDA-MB-231 through repression of the pro-apoptotic protein, BAD

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nair, Madhumathy G.; Desai, Krisha; Prabhu, Jyothi S.

Resistance to anthracycline based chemotherapy is a major limitation in the treatment of breast cancer, particularly of the triple negative sub-type that lacks targeted therapies. Resistance that arises from tumor-stromal interaction facilitated by integrins provides the possibility of targeted disruption. In the present study, we demonstrate that integrin β3 signaling inhibits apoptosis induced by a DNA-damaging chemotherapeutic agent, epirubicin, in MDA-MB-231 breast cancer cells. Drug efflux based mechanisms do not contribute to this effect. We show that integrin β3 employs the PI3K-Akt and the MAPK pathway for enabling cell survival and proliferation. Further, our results indicate that integrin β3 helpsmore » inhibit epirubicin induced cytotoxicity by repression of the pro-apoptotic protein BAD, thus promoting an anti-apoptotic response. Myristoylated RGT peptide and a monoclonal antibody against integrin β3 brought about a reversal of this effect and chemosensitized the cells. These results identify β3 integrin signaling via repression of BAD as an important survival pathway used by breast cancer cells to evade chemotherapy induced stress. - Highlights: • Integrin β3 signaling promotes chemoresistance to epirubicin in breast cancer cells. • Integrin β3 promotes cell survival and proliferation in drug treated cells through the PI3K and MAPK pathways. • Integrin signaling helps evade drug induced cytotoxicity by repression of pro-apoptotic molecule; BAD.« less

Direct observation of backbone planarization via side-chain alignment in single bulky-substituted polythiophenes

NASA Astrophysics Data System (ADS)

Raithel, Dominic; Simine, Lena; Pickel, Sebastian; Schötz, Konstantin; Panzer, Fabian; Baderschneider, Sebastian; Schiefer, Daniel; Lohwasser, Ruth; Köhler, Jürgen; Thelakkat, Mukundan; Sommer, Michael; Köhler, Anna; Rossky, Peter J.; Hildner, Richard

2018-03-01

The backbone conformation of conjugated polymers affects, to a large extent, their optical and electronic properties. The usually flexible substituents provide solubility and influence the packing behavior of conjugated polymers in films or in bad solvents. However, the role of the side chains in determining and potentially controlling the backbone conformation, and thus the optical and electronic properties on the single polymer level, is currently under debate. Here, we investigate directly the impact of the side chains by studying the bulky-substituted poly(3-(2,5-dioctylphenyl)thiophene) (PDOPT) and the common poly(3-hexylthiophene) (P3HT), both with a defined molecular weight and high regioregularity, using low-temperature single-chain photoluminescence (PL) spectroscopy and quantum-classical simulations. Surprisingly, the optical transition energy of PDOPT is significantly (˜2,000 cm‑1 or 0.25 eV) red-shifted relative to P3HT despite a higher static and dynamic disorder in the former. We ascribe this red shift to a side-chain induced backbone planarization in PDOPT, supported by temperature-dependent ensemble PL spectroscopy. Our atomistic simulations reveal that the bulkier 2,5-dioctylphenyl side chains of PDOPT adopt a clear secondary helical structural motif and thus protect conjugation, i.e., enforce backbone planarity, whereas, for P3HT, this is not the case. These different degrees of planarity in both thiophenes do not result in different conjugation lengths, which we found to be similar. It is rather the stronger electronic coupling between the repeating units in the more planar PDOPT which gives rise to the observed spectral red shift as well as to a reduced calculated electron‑hole polarization.

Communication skills training on how to break bad news for Japanese nurses in oncology: effects of training on nurses' confidence and perceived effectiveness.

PubMed

Fukui, Sakiko; Ogawa, Keiko; Fukui, Naoshi

2010-03-01

Delivering bad news is an important communication skill for oncology nurses. No Asian study has developed a communication skills training program. We investigated the effect of such a program on the confidence and practical competence of Japanese oncology nurses. Thirty-one nurses participated, based on Western work in a 6-h workshop; the effect was assessed for 3 months. We evaluated the program effect by measuring nurse-rated confidence regarding communication with patients three times (before, immediately after, and 3 months after the program), in addition to interviewing them on the perception of the program at T3. On nurse-rated confidence in communication, 16/21 items were significantly increased 3 months after the program, and almost all nurses were positive about the course effectiveness. Communication skills training increased Japanese nurses' confidence as well as being perceived as effective.

Effects of stress on immune function: the good, the bad, and the beautiful.

PubMed

Dhabhar, Firdaus S

2014-05-01

Although the concept of stress has earned a bad reputation, it is important to recognize that the adaptive purpose of a physiological stress response is to promote survival during fight or flight. While long-term stress is generally harmful, short-term stress can be protective as it prepares the organism to deal with challenges. This review discusses the immune effects of biological stress responses that can be induced by psychological, physiological, or physical (including exercise) stressors. We have proposed that short-term stress is one of the nature's fundamental but under-appreciated survival mechanisms that could be clinically harnessed to enhance immunoprotection. Short-term (i.e., lasting for minutes to hours) stress experienced during immune activation enhances innate/primary and adaptive/secondary immune responses. Mechanisms of immuno-enhancement include changes in dendritic cell, neutrophil, macrophage, and lymphocyte trafficking, maturation, and function as well as local and systemic production of cytokines. In contrast, long-term stress suppresses or dysregulates innate and adaptive immune responses by altering the Type 1-Type 2 cytokine balance, inducing low-grade chronic inflammation, and suppressing numbers, trafficking, and function of immunoprotective cells. Chronic stress may also increase susceptibility to some types of cancer by suppressing Type 1 cytokines and protective T cells and increasing regulatory/suppressor T cell function. Here, we classify immune responses as being protective, pathological, or regulatory, and discuss "good" versus "bad" effects of stress on health. Thus, short-term stress can enhance the acquisition and/or expression of immunoprotective (wound healing, vaccination, anti-infectious agent, anti-tumor) or immuno-pathological (pro-inflammatory, autoimmune) responses. In contrast, chronic stress can suppress protective immune responses and/or exacerbate pathological immune responses. Studies such as the ones discussed here could provide mechanistic targets and conceptual frameworks for pharmacological and/or biobehavioral interventions designed to enhance the effects of "good" stress, minimize the effects of "bad" stress, and maximally promote health and healing.

26 CFR 1.593-2 - Additions to reserve for bad debts where surplus, reserves, and undivided profits equal or exceed...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Additions to reserve for bad debts where surplus... bad debts where surplus, reserves, and undivided profits equal or exceed 12 percent of deposits or... profits, and reserves at the beginning of the taxable year, a reasonable addition to the reserve for bad...

The risks and rights of sexualization: an appreciative commentary on Lerum and Dworkin's "bad girls rule".

PubMed

Vanwesenbeeck, Ine

2009-01-01

This commentary wholeheartedly supports the critical observations by Kari Lerum and Shari L. Dworkin in this issue of the Journal of Sex Research with regard to the 2007 Report of the APA (American Psychological Association) Task Force on the Sexualization of Girls. The APA task force makes an overwhelmingly strong point for the dangers of the sexualization of women and girls and the self-objectification connected to it. However, their discussion of the evidence is noteworthy for being one-sided, generalizing, and negatively toned. Among the arguments presented in this commentary are notions about the rather diverse and often ambiguous nature of sexualized imagery and about the all too often ignored complexity of its presumed "effects." In addition, the issue of female sexual power and the case of sex workers are discussed. When sexualization is defined as only negative, both sex worker's rights and, more generally, women's rights to be sexual, get into a tight corner. The main contention is that sexualization is associated with risks, as well as with rights, and that any productive analysis will have to consider both.

Bad and Bid - potential background players in preneoplastic to neoplastic shift in human endometrium.

PubMed

Driak, D; Dvorska, M; Bolehovska, P; Svandova, I; Novotny, J; Halaska, M

2014-01-01

The most common malignancies of the female genital tract are endometrial carcinomas, whose are generally proceeded by hyperplasia. The maintenance of tissue homeostasis is to great extent governed by apoptosis, whose defects can lead to the preneoplastic and/or cancerous changes. Endometrial apoptosis involves among others three groups of proteins of the Bcl-2 family. First group contains anti-apoptotic proteins (e. g. Bcl-2, Bcl-xL). The other two groups belong to the pro-apoptotic proteins with three (e. g. Bax, Bak) or one (e. g. Bad, Bid) so-called BH domains. Bad and Bid trigger the oligomerization of Bak and Bax protein, which permeabilize the outer mitochondrial wall. Unlike Bid, Bad cannot directly trigger apoptosis. Instead, Bad lowers the threshold at which apoptosis is induced, by binding anti-apoptotic Bcl-2 proteins. However, their mutual counterbalance or synergism in the human endometrium has not been reported yet.In this study, the levels of Bid and Bad were measured using SDS-PAGE and Western blotting with specific antibodies, with the aim to analyse expression of Bid and Bad proteins in normal (NE), hyperplastic (HE) and cancerous (CE) endometrium. We demonstrated that Bid expression in CE reached only 47% and 50% of this observed in NE and HE. Conversely, Bad expression in HE reached only 40% and 36% of this observed in NE and CE, respectively. We detected no significant changes of Bid expression between HE and NE, and levels of Bad protein were not different between CE and NE.Trend of Bid and Bad protein expression is clearly opposite in HE and CE. We hypothesise that disrupted apoptotic program in CE seems to be reduced further by lowering levels of direct apoptotic trigger protein Bid. We suggest that the adenocarcinoma tissue of human endometrium thus tries to strengthen its apoptotic effort by lowering the apoptotic threshold via higher Bad levels.

Breast cancer in young families: a qualitative interview study of fathers and their role and communication with their children following the diagnosis of maternal breast cancer.

PubMed

Forrest, Gillian; Plumb, Caroline; Ziebland, Sue; Stein, Alan

2009-01-01

To explore father-child communication following the diagnosis of maternal breast cancer, examine disparities in their understandings of the impact of the illness, and identify gaps in their need for support and information. The design is the qualitative interview study with thematic analysis. The interviews were home-based with fathers and children in Oxfordshire, UK. The participants were 26 fathers whose partners had early breast cancer and 31 of their children aged between 6 and 18 years. Fathers described graphically their reaction to news of their partner's breast cancer and their attempts to provide support for their partners and maintain normal family life for their children. Fathers were keen to reassure and protect children but often said that they lacked sufficient information about breast cancer-especially side effects of treatments. Fathers sometimes did not recognise the extent of their children's distress and some interpreted their children's reactions as 'bad behaviour' or 'rudeness'. Children were often acutely aware of the father's emotional state, and expressed a wish to protect him. Some fathers would have liked an opportunity to talk to a clinician directly about the children but did not want to claim clinical time for themselves or their children. This study suggests that clinicians could improve their care of breast cancer patients by being more family-centred. Fathers routinely need more information and preparation about the likely impact of the illness and its treatment (especially side effects) on the mother, and how children of different ages may react to the emotional strain. Clinicians need to be prepared to offer to talk to teenagers. (c) 2008 John Wiley & Sons, Ltd.

[Double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament at stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V].

PubMed

Hu, Wen-yue; Yu, Chong; Huang, Zhong-ming; Han, Lei

2015-06-01

To explore clinical efficacy of double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I in treating acromioclavicular dislocation with Rockwood type III - V . From January 2010 to September 2013, 56 patients with Rockwood type III - V acromioclavicular dislocation were treated by operation, including 20 males and 36 femlaes, aged from 32 to 52 years old with an average of 38.5 years old. Twenty-five patients were on the left side and 31 cases on the right side. The time from injury to operation was from 3 to 14 days, averaged 7 days. All patients were diagnosed as acromioclavicular dislocation with Rockwood type III - V, and double Endobutto were used to reconstituting coracoclavicular ligament, line metal anchors were applied for repairing acromioclavicular ligament. Postoperative complications were observed, Karlsson and Constant-Murley evaluation standard were used to evaluate clinical effects. All patients were followed up from 8 to 24 months with average of 11 months. According to Karlsson evaluation standard at 6 months after operation,42 cases were grade A, 13 were grade B and 1 was grade C. Constant-Murley score were improved from (42.80±5.43) before operation to (91.75±4.27) at 6 months after operation. All items at 6 months after operation were better than that of preoperative items. Forty-eight patients got excellent results, 7 were moderate and only 1 with bad result. No shoulder joint adhesion, screw loosening or breakage were occurred during following up. Double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V could obtain early staisfied clinical effects, and benefit for early recovery of shoulder joint function.

The Alternative Omen Effect: Illusory negative correlation between the outcomes of choice options.

PubMed

Marciano-Romm, Déborah; Romm, Assaf; Bourgeois-Gironde, Sacha; Deouell, Leon Y

2016-01-01

In situations of choice between uncertain options, one might get feedback on both the outcome of the chosen option and the outcome of the unchosen option ("the alternative"). Extensive research has shown that when both outcomes are eventually revealed, the alternative's outcome influences the way people evaluate their own outcome. In a series of experiments, we examined whether the outcome of the alternative plays an additional role in the decision-making process by creating expectations regarding the outcome of the chosen option. Specifically, we hypothesized that people see a good (bad) alternative's outcome as a bad (good) sign regarding their own outcome when the two outcomes are in fact uncorrelated, a phenomenon we call the "Alternative Omen Effect" (ALOE). Subjects had to repeatedly choose between two boxes, the outcomes of which were then sequentially revealed. In Experiments 1 and 2 the alternative's outcome was presented first, and we assessed the individual's prediction of their own outcome. In Experiment 3, subjects had to predict the alternative's outcome after seeing their own. We find that even though the two outcomes were in fact uncorrelated, people tended to see a good (bad) alternative outcome as a bad (good) sign regarding their own outcome. Importantly, this illusory negative correlation affected subsequent behavior and led to irrational choices. Furthermore, the order of presentation was critical: when the outcome of the chosen option was presented first, the effect disappeared, suggesting that this illusory negative correlation is influenced by self-relevance. We discuss the possible sources of this illusory correlation as well as its implications for research on counterfactual thinking. Copyright © 2015 Elsevier B.V. All rights reserved.

Improving Electronic Sensor Reliability by Robust Outlier Screening

PubMed Central

Moreno-Lizaranzu, Manuel J.; Cuesta, Federico

2013-01-01

Electronic sensors are widely used in different application areas, and in some of them, such as automotive or medical equipment, they must perform with an extremely low defect rate. Increasing reliability is paramount. Outlier detection algorithms are a key component in screening latent defects and decreasing the number of customer quality incidents (CQIs). This paper focuses on new spatial algorithms (Good Die in a Bad Cluster with Statistical Bins (GDBC SB) and Bad Bin in a Bad Cluster (BBBC)) and an advanced outlier screening method, called Robust Dynamic Part Averaging Testing (RDPAT), as well as two practical improvements, which significantly enhance existing algorithms. Those methods have been used in production in Freescale® Semiconductor probe factories around the world for several years. Moreover, a study was conducted with production data of 289,080 dice with 26 CQIs to determine and compare the efficiency and effectiveness of all these algorithms in identifying CQIs. PMID:24113682

Improving electronic sensor reliability by robust outlier screening.

PubMed

Moreno-Lizaranzu, Manuel J; Cuesta, Federico

2013-10-09

Electronic sensors are widely used in different application areas, and in some of them, such as automotive or medical equipment, they must perform with an extremely low defect rate. Increasing reliability is paramount. Outlier detection algorithms are a key component in screening latent defects and decreasing the number of customer quality incidents (CQIs). This paper focuses on new spatial algorithms (Good Die in a Bad Cluster with Statistical Bins (GDBC SB) and Bad Bin in a Bad Cluster (BBBC)) and an advanced outlier screening method, called Robust Dynamic Part Averaging Testing (RDPAT), as well as two practical improvements, which significantly enhance existing algorithms. Those methods have been used in production in Freescale® Semiconductor probe factories around the world for several years. Moreover, a study was conducted with production data of 289,080 dice with 26 CQIs to determine and compare the efficiency and effectiveness of all these algorithms in identifying CQIs.

Evaluation of two videotape instruction programmes on how to break bad news--for Cantonese-speaking medical students in Hong Kong.

PubMed

Betson, C L; Fielding, R; Wong, G; Chung, S F; Nestel, D F

1997-12-01

To evaluate a culture-specific videotape on how to 'break bad news' and another videotape produced by a western university, and to determine if the language of presentation influenced the students' perceived abilities to execute basic skills. Third year medical students at the Faculty of Medicine, the University of Hong Kong. Longitudinal study with experimental design. Two instructional tapes on breaking bad news; one using Chinese speaking role models and one using English. In both groups, self-efficacy summed scores increased from 26.8 (95% CI = 25.9-27.7) at the pre-test to 29.0 (95% CI = 28.4-29.6). The biggest changes occurred in perceived self-efficacy regarding specific skills. However, students using the Chinese tape rated skills as more useful than those using the English tape. The videotapes were useful in teaching communication skills. Culturally relevant audiovisual materials were more effective.

Human development of the ability to learn from bad news

PubMed Central

Moutsiana, Christina; Garrett, Neil; Clarke, Richard C.; Lotto, R. Beau; Blakemore, Sarah-Jayne; Sharot, Tali

2013-01-01

Humans show a natural tendency to discount bad news while incorporating good news into beliefs (the “good news–bad news effect”), an effect that may help explain seemingly irrational risk taking. Understanding how this bias develops with age is important because adolescents are prone to engage in risky behavior; thus, educating them about danger is crucial. We reveal a striking valence-dependent asymmetry in how belief updating develops with age. In the ages tested (9–26 y), younger age was associated with inaccurate updating of beliefs in response to undesirable information regarding vulnerability. In contrast, the ability to update beliefs accurately in response to desirable information remained relatively stable with age. This asymmetry was mediated by adequate computational use of positive but not negative estimation errors to alter beliefs. The results are important for understanding how belief formation develops and might help explain why adolescents do not respond adequately to warnings. PMID:24019466

Biological and Agricultural Studies on Application of Discharge Plasma and Electromagnetic Fields 7. Fog Dissipation and Bad Odor Abatement by Using Corona Discharge Plasma

NASA Astrophysics Data System (ADS)

Jyumonji, Masanori; Uchiyama, Haruo

The so-called “Yamase” accompanied by very low temperatures and dense fog results in not only bad crop harvests especially rice, but also traffic confusion and accidents during the summer season from the Sanriku Coast to Shimokita Peninsula in the part of northern Japan facing the Pacific Ocean. Effective counterplots against these disasters are strongly expected to be realized by farmers and many citizens. We have invented an electrostatic fog-liquefier in order to solve these problems by dissipating fog artificially. In this paper, we describe the principle of fog dissipation by means of corona discharge, and demonstrate fog and white vapor dissipation experiments not only in a laboratory, but in the field also. Bad odor abatement by means of this newly invented apparatus is also related in detail.

Self injury of extremities leading to amputation while handling local bomb.

PubMed

Bhadani, Umesh Kumar

2013-05-01

Self injury while making material which has a tendency to blast is dangerous- whether it is fire cracker or local bomb. Some villagers living nearby forest make bomb to scare wild animals to protect their pet animals. A 22-year old girl while making this kind of local bomb, got injured badly. The injury was sustained while making bomb in a sitting position with face down as it is evident form type of injury. There was lacerated injury of both hands leading to amputation of both hands above wrists. Lacerated injury was present on medial sides of both thighs and gun powder marks on face. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Quantum chemical calculations, molecular dynamic (MD) simulations and experimental studies of using some azo dyes as corrosion inhibitors for iron. Part 2: Bis-azo dye derivatives

NASA Astrophysics Data System (ADS)

Madkour, Loutfy H.; Kaya, Savaş; Guo, Lei; Kaya, Cemal

2018-07-01

The adsorption behavior and inhibition mechanism of five synthesized bis-azo dye (BAD) derivatives on the corrosion of iron in aerated HNO3 and NaOH were investigated by performing potentiostatic polarization, weight loss (WL), thermometric and UV-visible spectra measurements. DFT calculations is applied to study the correlation between corrosion inhibition and global reactivity descriptors such as: EHOMO, ELUMO, molecular gap (ΔE), the dipole moment (μ), the global hardness (η), softness(S), electronegativity (χ), proton affinity (PA), electrophilicity (ω), nucleophilicity (ɛ), electrons transferred from inhibitors to metal surface (ΔN), initial molecule-metal interaction energy (Δψ), total electronic energy (E) and the energy change during electronic back-donation process (ΔEb-d). To mimic the real environment of corrosion inhibition, molecular dynamic (MD) simulations in aqueous phase have also been modelled consisting of all concerned species (inhibitor molecule, H2O, H3O+ ion, NO3- ion, OH- and Fe surface). The results confirmed that BAD molecules inhibit iron by adsorption behavior through donating and accepting electrons together with the formation of [Fe (II) and Fe (III)-BAD] chelate complex compounds. BAD's behavior is mainly chemisorption with some physisorption obeyed Frumkin and that of El-Awady adsorption isotherm. Kinetic parameters such as: (Kb, 1/y, Kads, f, ΔG°ads) have been determined and discussed. Binding energies of BAD molecules on Fe (110) surface followed the order: BAD_ 2 > BAD_ 1 > BAD_ 3 > BAD_ 4 > BAD_ 5. Theoretical results were found to be consistent with the experimental data reported. Our results provide important atomic/molecular insights into the anticorrosive mechanism of inhibitor molecules, which could help in understanding the organic-metal interface and designing more appropriate organic corrosion inhibitors.

Regional imbalanced activation of the calcineurin/BAD apoptotic pathway and the PI3K/Akt survival pathway after myocardial infarction.

PubMed

Li, Tieluo; Kilic, Ahmet; Wei, Xufeng; Wu, Changfu; Schwartzbauer, Gary; Yankey, G Kwame; DeFilippi, Christopher; Bond, Meredith; Wu, Zhongjun J; Griffith, Bartley P

2013-06-05

The underlying molecular mechanisms of the remodeling after myocardial infarction (MI) remain unclear. The purpose of this study was to investigate the role of a survival pathway (PI3K/Akt) and an apoptosis pathway (calcineurin/BAD) in the remodeling after MI in a large animal model. Ten Dorset hybrid sheep underwent 25% MI in the left ventricle (LV, n=10). Five sheep were used as sham control. The regional strain was calculated from sonomicrometry. Apoptosis and the activation of the PI3K/Akt and calcineurin/BAD pathways were evaluated in the non-ischemic adjacent zone and the remote zone relative to infarct by immunoblotting, immunoprecipitation, and immunofluorescence staining. Dilation and dysfunction of LV were present at 12 weeks after MI. The regional strain in the adjacent zone was significantly higher than in the remote zone at 12 weeks (36.6 ± 4.0% vs 9.5 ± 3.6%, p<0.05). Apoptosis was more severe in the adjacent zone than in the remote zone. The PI3K/Akt and calcineurin/BAD pathways were activated in the adjacent zone. Dephosphorylation and translocation of BAD were evident in the adjacent zone. Regional correlation between the strain and the expression of calcineurin/BAD indicated that the activation was strain-related (R(2)=0.46, 0.48, 0.39 for calcineurin, BAD, mitochondrial BAD, respectively, p<0.05). The PI3K/Akt survival and calcineurin/BAD apoptotic pathways were concomitantly activated in the non-ischemic adjacent zone after MI. The calcineurin/BAD pathway is strain related and its imbalanced activation may be one of the causes of progressive remodeling after MI. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Regional imbalanced activation of the calcineurin/BAD apoptotic pathway and the PI3K/Akt survival pathway after myocardial infarction

PubMed Central

Li, Tieluo; Kilic, Ahmet; Wei, Xufeng; Wu, Changfu; Schwartzbauer, Gary; Yankey, G. Kwame; DeFilippi, Christopher; Bond, Meredith; Wu, Zhongjun J; Griffith, Bartley P

2011-01-01

Background The underlying molecular mechanisms of the remodeling after myocardial infarction (MI) remain unclear. The purpose of this study was to investigate the role of a survival pathway (PI3K/Akt) and an apoptosis pathway (calcineurin/BAD) in the remodeling after MI in a large animal model. Methods Ten Dorset hybrid sheep underwent 25% MI in the left ventricle (LV, n=10). Five sheep were used as sham control. The regional strain was calculated from sonomicrometry. Apoptosis and the activation of the PI3K/Akt and calcineurin/BAD pathways were evaluated in the non-ischemic adjacent zone and the remote zone relative to infarct by immunoblotting, immunoprecipitation, and immunofluorescence staining. Results Dilation and dysfunction of LV were present at 12 weeks after MI. The regional strain in the adjacent zone was significantly higher than in the remote zone at 12 weeks (36.6 ± 4.0% vs 9.5 ± 3.6%, p < 0.05). Apoptosis was more severe in the adjacent zone than in the remote zone. The PI3K/Akt and calcineurin/BAD pathways were activated in the adjacent zone. Dephosphorylation and translocation of BAD were evident in the adjacent zone. Regional correlation between the strain and the expression of calcineurin/BAD indicated that the activation was strain-related (R2 = 0.46, 0.48, 0.39 for calcineurin, BAD, mitochondrial BAD, respectively, p < 0.05). Conclusions The PI3K/Akt survival and calcineurin/BAD apoptotic pathways were concomitantly activated in the non-ischemic adjacent zone after MI. The calcineurin/BAD pathway is strain related and its imbalanced activation may be one of the causes of progressive remodeling after MI. PMID:22088220

GLP-1 mediates antiapoptotic effect by phosphorylating Bad through a beta-arrestin 1-mediated ERK1/2 activation in pancreatic beta-cells.

PubMed

Quoyer, Julie; Longuet, Christine; Broca, Christophe; Linck, Nathalie; Costes, Safia; Varin, Elodie; Bockaert, Joël; Bertrand, Gyslaine; Dalle, Stéphane

2010-01-15

Strategies based on activating GLP-1 receptor (GLP-1R) are intensively developed for the treatment of type 2 diabetes. The exhaustive knowledge of the signaling pathways linked to activated GLP-1R within the beta-cells is of major importance. In beta-cells, GLP-1 activates the ERK1/2 cascade by diverse pathways dependent on either Galpha(s)/cAMP/cAMP-dependent protein kinase (PKA) or beta-arrestin 1, a scaffold protein. Using pharmacological inhibitors, beta-arrestin 1 small interfering RNA, and islets isolated from beta-arrestin 1 knock-out mice, we demonstrate that GLP-1 stimulates ERK1/2 by two temporally distinct pathways. The PKA-dependent pathway mediates rapid and transient ERK1/2 phosphorylation that leads to nuclear translocation of the activated kinases. In contrast, the beta-arrestin 1-dependent pathway produces a late ERK1/2 activity that is restricted to the beta-cell cytoplasm. We further observe that GLP-1 phosphorylates the cytoplasmic proapoptotic protein Bad at Ser-112 but not at Ser-155. We find that the beta-arrestin 1-dependent ERK1/2 activation engaged by GLP-1 mediates the Ser-112 phosphorylation of Bad, through p90RSK activation, allowing the association of Bad with the scaffold protein 14-3-3, leading to its inactivation. beta-Arrestin 1 is further found to mediate the antiapoptotic effect of GLP-1 in beta-cells through the ERK1/2-p90RSK-phosphorylation of Bad. This new regulatory mechanism engaged by activated GLP-1R involving a beta-arrestin 1-dependent spatiotemporal regulation of the ERK1/2-p90RSK activity is now suspected to participate in the protection of beta-cells against apoptosis. Such signaling mechanism may serve as a prototype to generate new therapeutic GLP-1R ligands.

Influenza virus induces apoptosis via BAD-mediated mitochondrial dysregulation.

PubMed

Tran, Anh T; Cortens, John P; Du, Qiujiang; Wilkins, John A; Coombs, Kevin M

2013-01-01

Influenza virus infection results in host cell death and major tissue damage. Specific components of the apoptotic pathway, a signaling cascade that ultimately leads to cell death, are implicated in promoting influenza virus replication. BAD is a cell death regulator that constitutes a critical control point in the intrinsic apoptosis pathway, which occurs through the dysregulation of mitochondrial outer membrane permeabilization and the subsequent activation of downstream apoptogenic factors. Here we report a novel proviral role for the proapoptotic protein BAD in influenza virus replication. We show that influenza virus-induced cytopathology and cell death are considerably inhibited in BAD knockdown cells and that both virus replication and viral protein production are dramatically reduced, which suggests that virus-induced apoptosis is BAD dependent. Our data showed that influenza viruses induced phosphorylation of BAD at residues S112 and S136 in a temporal manner. Viral infection also induced BAD cleavage, late in the viral life cycle, to a truncated form that is reportedly a more potent inducer of apoptosis. We further demonstrate that knockdown of BAD resulted in reduced cytochrome c release and suppression of the intrinsic apoptotic pathway during influenza virus replication, as seen by an inhibition of caspases-3, caspase-7, and procyclic acidic repetitive protein (PARP) cleavage. Our data indicate that influenza viruses carefully modulate the activation of the apoptotic pathway that is dependent on the regulatory function of BAD and that failure of apoptosis activation resulted in unproductive viral replication.

Breaking bad news in cancer patients.

PubMed

Konstantis, Apostolos; Exiara, Triada

2015-01-01

In a regional hospital, many patients are newly diagnosed with cancer. Breaking the bad news in these patients and their relatives is a tough task. Many doctors are not experienced in talking to patients about death or death-related diseases. In recent years, there have been great efforts to change the current situation. The aim of this study was to investigate the experience and education of medical personnel in breaking bad news in a secondary hospital. 59 doctors from General Hospital of Komotini, Greece were included in the study. All the doctors were in clinical specialties that treated cancer patients. A brief questionnaire was developed based on current guidelines such as Baile/SPIKES framework and the ABCDE mnemonic. Residents are involved in delivering bad news less frequently than specialists. Only 21 doctors (35.59%) had specific training on breaking bad news. 20 doctors (33.90%) were aware of the available techniques and protocols on breaking bad news. 47 doctors (79.66%) had a consistent plan for breaking bad news. 57 (96.61%) delivered bad news in a quiet place, 53 (89.83%) ensured no interruptions and enough time, 53 (89.83%) used simple words and 54 (91.53%) checked for understanding and did not rush through the news. 46 doctors (77.97%) allowed relatives to determine patient's knowledge about the disease. There were low rates of specific training in breaking bad news. However, the selected location, the physician's speech and their plan were according to current guidelines.

Influenza Virus Induces Apoptosis via BAD-Mediated Mitochondrial Dysregulation

PubMed Central

Tran, Anh T.; Cortens, John P.; Du, Qiujiang; Wilkins, John A.

2013-01-01

Influenza virus infection results in host cell death and major tissue damage. Specific components of the apoptotic pathway, a signaling cascade that ultimately leads to cell death, are implicated in promoting influenza virus replication. BAD is a cell death regulator that constitutes a critical control point in the intrinsic apoptosis pathway, which occurs through the dysregulation of mitochondrial outer membrane permeabilization and the subsequent activation of downstream apoptogenic factors. Here we report a novel proviral role for the proapoptotic protein BAD in influenza virus replication. We show that influenza virus-induced cytopathology and cell death are considerably inhibited in BAD knockdown cells and that both virus replication and viral protein production are dramatically reduced, which suggests that virus-induced apoptosis is BAD dependent. Our data showed that influenza viruses induced phosphorylation of BAD at residues S112 and S136 in a temporal manner. Viral infection also induced BAD cleavage, late in the viral life cycle, to a truncated form that is reportedly a more potent inducer of apoptosis. We further demonstrate that knockdown of BAD resulted in reduced cytochrome c release and suppression of the intrinsic apoptotic pathway during influenza virus replication, as seen by an inhibition of caspases-3, caspase-7, and procyclic acidic repetitive protein (PARP) cleavage. Our data indicate that influenza viruses carefully modulate the activation of the apoptotic pathway that is dependent on the regulatory function of BAD and that failure of apoptosis activation resulted in unproductive viral replication. PMID:23135712

The impact of delivery style on doctors' experience of stress during simulated bad news consultations.

PubMed

Shaw, Joanne; Brown, Rhonda; Dunn, Stewart

2015-10-01

The purpose of this study was to investigate the relationship between doctors' bad news delivery style and their experience of physiological stress during simulated bad news consultations. 31 doctors participated in two simulated breaking bad news (BBN) consultations. Delivery style was categorized as either blunt, forecasting or stalling (i.e. avoidant), based on the time to deliver the bad news and qualitative analysis of the interaction content and doctor's language style. Doctors' heart rate (HR) and skin conductance (SC) were recorded in consecutive 30s epochs. Doctors experienced a significant decrease in HR (F(1,36)=44.9, p<.0001) and SC (F(1,48)=5.6, p<.001) between the pre- and post-news delivery phases of the consultation. Between-group comparisons for the three delivery styles did not identify any significant differences in HR (F(2,36)=2.2, p>.05) or SC (F(2,48)=.66, p>.05). Doctors experience heightened stress in the pre-news delivery phase of breaking bad news interactions. Delaying the delivery of bad news exposes doctors to a longer period of increased stress.This suggests that medical students and doctors should be taught to deliver bad news without delay, to help mitigate their response to this stressful encounter. Copyright © 2015. Published by Elsevier Ireland Ltd.

HDL (Good), LDL (Bad) Cholesterol and Triglycerides

MedlinePlus

... Thromboembolism Aortic Aneurysm More HDL (Good), LDL (Bad) Cholesterol and Triglycerides Updated:May 3,2018 Cholesterol isn’ ... be measured by a blood test. LDL (Bad) Cholesterol LDL cholesterol is called “bad” cholesterol. Think of ...

Autophagy postpones apoptotic cell death in PRRSV infection through Bad-Beclin1 interaction.

PubMed

Zhou, Ao; Li, Shuaifeng; Khan, Faheem Ahmed; Zhang, Shujun

2016-01-01

Autophagy and apoptosis play significant roles in PRRSV infection and replication. However, the interaction between these 2 processes in PRRSV replication is still far from been completely understood. In our studies, the exposure of MARC-145 cells to PRRSV confirmed the activation of autophagy and subsequent induction of apoptosis. The inhibition of autophagy by 3-methyladenine (3-MA) caused a significant increase in PRRSV-induced apoptosis, showing a potential connection between both mechanisms. Moreover, we observed an increase in Bad expression (a pro-apoptotic protein) and Beclin1 (an autophagy regulator) in virus-infected cells up to 36h. Co-immunoprecipitation assays showed the formation of Bad and Beclin1 complex in PRRSV infected cells. Accordingly, Bad co-localized with Beclin1 in MARC-145 infected cells. Knockdown of Beclin1 significantly decreased PRRSV replication and PRRSV-induced autophagy, while Bad silencing resulted in increased autophagy and enhanced viral replication. Furthermore, PRRSV infection phosphorylated Bad (Ser112) to promote cellular survival. These results demonstrate that autophagy can favor PRRSV replication by postponing apoptosis through the formation of a Bad-Beclin1 complex.

Autophagy postpones apoptotic cell death in PRRSV infection through Bad-Beclin1 interaction

PubMed Central

Zhou, Ao; Li, Shuaifeng; Khan, Faheem Ahmed; Zhang, Shujun

2016-01-01

Autophagy and apoptosis play significant roles in PRRSV infection and replication. However, the interaction between these 2 processes in PRRSV replication is still far from been completely understood. In our studies, the exposure of MARC-145 cells to PRRSV confirmed the activation of autophagy and subsequent induction of apoptosis. The inhibition of autophagy by 3-methyladenine (3-MA) caused a significant increase in PRRSV-induced apoptosis, showing a potential connection between both mechanisms. Moreover, we observed an increase in Bad expression (a pro-apoptotic protein) and Beclin1 (an autophagy regulator) in virus-infected cells up to 36h. Co-immunoprecipitation assays showed the formation of Bad and Beclin1 complex in PRRSV infected cells. Accordingly, Bad co-localized with Beclin1 in MARC-145 infected cells. Knockdown of Beclin1 significantly decreased PRRSV replication and PRRSV-induced autophagy, while Bad silencing resulted in increased autophagy and enhanced viral replication. Furthermore, PRRSV infection phosphorylated Bad (Ser112) to promote cellular survival. These results demonstrate that autophagy can favor PRRSV replication by postponing apoptosis through the formation of a Bad-Beclin1 complex. PMID:26670824

Improved packing of protein side chains with parallel ant colonies

PubMed Central

2014-01-01

Introduction The accurate packing of protein side chains is important for many computational biology problems, such as ab initio protein structure prediction, homology modelling, and protein design and ligand docking applications. Many of existing solutions are modelled as a computational optimisation problem. As well as the design of search algorithms, most solutions suffer from an inaccurate energy function for judging whether a prediction is good or bad. Even if the search has found the lowest energy, there is no certainty of obtaining the protein structures with correct side chains. Methods We present a side-chain modelling method, pacoPacker, which uses a parallel ant colony optimisation strategy based on sharing a single pheromone matrix. This parallel approach combines different sources of energy functions and generates protein side-chain conformations with the lowest energies jointly determined by the various energy functions. We further optimised the selected rotamers to construct subrotamer by rotamer minimisation, which reasonably improved the discreteness of the rotamer library. Results We focused on improving the accuracy of side-chain conformation prediction. For a testing set of 442 proteins, 87.19% of X1 and 77.11% of X12 angles were predicted correctly within 40° of the X-ray positions. We compared the accuracy of pacoPacker with state-of-the-art methods, such as CIS-RR and SCWRL4. We analysed the results from different perspectives, in terms of protein chain and individual residues. In this comprehensive benchmark testing, 51.5% of proteins within a length of 400 amino acids predicted by pacoPacker were superior to the results of CIS-RR and SCWRL4 simultaneously. Finally, we also showed the advantage of using the subrotamers strategy. All results confirmed that our parallel approach is competitive to state-of-the-art solutions for packing side chains. Conclusions This parallel approach combines various sources of searching intelligence and energy functions to pack protein side chains. It provides a frame-work for combining different inaccuracy/usefulness objective functions by designing parallel heuristic search algorithms. PMID:25474164

[Effects of Buzhong Yiqi decoction on expression of Bad, NF-κB, caspase-9, Survivin, and mTOR in nude mice with A549/DDP transplantation tumors].

PubMed

Liu, Ya-Li; Yi, Jia-Li; Liu, Chun-Ying

2017-02-01

This study was aimed to explore the effects of Buzhong Yiqi decoction on the expression levels of Bad, NF-κB, caspase-9, Survivin, and mTOR in nude mice with A549/DDP transplantation tumors.Sixty BALB/C mice were randomly divided into blank control group, tumor-bearing control group, cisplatin group and Buzhong Yiqi decoction of high, medium and low doses+cisplatin groups (hereinafter referred to as the high,medium and low combined groups). A549/DDP cells (concentration of 5×106 cells/mL)were cultured and inoculated in various groups, then the tumor-forming situations were observed. Corresponding treatment was given in all groups. Fourteen days later, immunohistochemistry and Real-time PCR methods were used to detect the expression levels of Bad, NF-κB, caspase-9, Survivin, mTOR protein and mRNA in tumors.Results showed that Buzhong Yiqi decoction combined with cisplatin could reduce the volume of transplanted tumors, and there was significant difference between medium combined group and high combined group(P<0.05). As compared with the tumor-bearing control group, the expression levels of Bad, NF-κB, Survivin and mTOR were significantly reduced in medium and high combined groups(P<0.05); the protein and mRNA expression levels of caspase-9 were gradually increased in medium combined and high combined groups(P<0.05), with statistical difference with tumor-bearing control group(P<0.05). There were statistical difference in mRNA expression of Bad, NF-κB and caspase-9 between medium combined group, high combined group and cisplatin group, low-combined group, tumor-bearing control group(P<0.05), but there was no statistical difference between cisplatin group, low-combined group, and tumor-bearing control group. In addition, there was no statistical difference between medium combined group and high combined group in protein and mRNA expression levels of various factors. Experimental results showed that Buzhong Yiqi decoction combined with cisplatin can inhibit the growth of A549/DDP transplanted tumors, and the mechanism may be associated with regulating Bad, NF-κB, caspase-9, Survivin, and mTOR levels as well as promoting apoptosis. Copyright© by the Chinese Pharmaceutical Association.

A New Efficient Algorithm for the All Sorting Reversals Problem with No Bad Components.

PubMed

Wang, Biing-Feng

2016-01-01

The problem of finding all reversals that take a permutation one step closer to a target permutation is called the all sorting reversals problem (the ASR problem). For this problem, Siepel had an O(n (3))-time algorithm. Most complications of his algorithm stem from some peculiar structures called bad components. Since bad components are very rare in both real and simulated data, it is practical to study the ASR problem with no bad components. For the ASR problem with no bad components, Swenson et al. gave an O (n(2))-time algorithm. Very recently, Swenson found that their algorithm does not always work. In this paper, a new algorithm is presented for the ASR problem with no bad components. The time complexity is O(n(2)) in the worst case and is linear in the size of input and output in practice.

Variety and intensity of emotions in nightmares and bad dreams.

PubMed

Zadra, Antonio; Pilon, Mathieu; Donderi, Don C

2006-04-01

Nightmares are usually defined as frightening dreams that awaken the sleeper. This study uses the waking criterion to distinguish between nightmares and bad dreams and investigated the variety and intensity of emotions reported in each form of disturbing dream. Ninety participants recorded their dreams for 4 consecutive weeks and, for each dream recalled, noted the emotions present and their intensities on a 9-point scale. Thirty-six participants reported at least one nightmare and one bad dream over the 4 weeks covered by the log, while 29 reported having had at least one bad dream but no nightmares. Nightmares were rated as being significantly (p < 0.001) more intense than bad dreams. Thirty percent of nightmares and 51% of bad dreams contained primary emotions other than fear. The findings support the claim that awakening can serve as an indirect measure of nightmare intensity and raise important implications for the operational definition of nightmares.

How to deal with morning bad breath: A randomized, crossover clinical trial

PubMed Central

Oliveira-Neto, Jeronimo M.; Sato, Sandra; Pedrazzi, Vinícius

2013-01-01

Context: The absence of a protocol for the treatment of halitosis has led us to compare mouthrinses with mechanical oral hygiene procedures for treating morning breath by employing a hand-held sulfide monitor. Aims: To compare the efficacy of five modalities of treatment for controlling morning halitosis in subjects with no dental or periodontal disease. Settings and Design: This is a five-period, randomized, crossover clinical trial. Materials and Methods: Twenty volunteers were randomly assigned to the trial. Testing involved the use of a conventional tongue scraper, a tongue scraper joined to the back of a toothbrush's head, two mouthrinses (0.05% cetylpyridinium chloride and 0.12% chlorhexidine digluconate) and a soft-bristled toothbrush and fluoride toothpaste for practicing oral hygiene. Statistical Analysis Used: Data analysis was performed using SPSS version 17 for Windows and NCSS 2007 software (P < 0.05). The products and the periods were compared with each other using the Friedman's test. When significant differences (P < 0.05) were determined, the products and periods were compared in pairs by using the Wilcoxon's test and by adjusting the original significance level (0.05) for multiple comparisons by using the Bonferroni's method. Results: The toothbrush's tongue scraper was able to significantly reduce bad breath for up to 2 h. Chlorhexidine reduced bad breath only at the end of the second hour, an effect that lasted for 3 h. Conclusions: Mechanical tongue cleaning was able to immediately reduce bad breath for a short period, whereas chlorhexidine and mechanical oral hygiene reduced bad breath for longer periods, achieving the best results against morning breath. PMID:24554886

Bayesian reconstruction of transmission within outbreaks using genomic variants.

PubMed

De Maio, Nicola; Worby, Colin J; Wilson, Daniel J; Stoesser, Nicole

2018-04-01

Pathogen genome sequencing can reveal details of transmission histories and is a powerful tool in the fight against infectious disease. In particular, within-host pathogen genomic variants identified through heterozygous nucleotide base calls are a potential source of information to identify linked cases and infer direction and time of transmission. However, using such data effectively to model disease transmission presents a number of challenges, including differentiating genuine variants from those observed due to sequencing error, as well as the specification of a realistic model for within-host pathogen population dynamics. Here we propose a new Bayesian approach to transmission inference, BadTrIP (BAyesian epiDemiological TRansmission Inference from Polymorphisms), that explicitly models evolution of pathogen populations in an outbreak, transmission (including transmission bottlenecks), and sequencing error. BadTrIP enables the inference of host-to-host transmission from pathogen sequencing data and epidemiological data. By assuming that genomic variants are unlinked, our method does not require the computationally intensive and unreliable reconstruction of individual haplotypes. Using simulations we show that BadTrIP is robust in most scenarios and can accurately infer transmission events by efficiently combining information from genetic and epidemiological sources; thanks to its realistic model of pathogen evolution and the inclusion of epidemiological data, BadTrIP is also more accurate than existing approaches. BadTrIP is distributed as an open source package (https://bitbucket.org/nicofmay/badtrip) for the phylogenetic software BEAST2. We apply our method to reconstruct transmission history at the early stages of the 2014 Ebola outbreak, showcasing the power of within-host genomic variants to reconstruct transmission events.

Doctors' Perceptions and Practices of Breaking Bad News: A Qualitative Study From Greece.

PubMed

Oikonomidou, Despoina; Anagnostopoulos, Fotios; Dimitrakaki, Christine; Ploumpidis, Dimitrios; Stylianidis, Stylianos; Tountas, Yannis

2017-06-01

There is limited information about doctors' communication behaviors and their salient beliefs with regard to bad news disclosure in Greece. In this qualitative study we investigated the self-reported practices of doctors on breaking bad news, their perceptions about the factors affecting the delivery of such news, and their beliefs about the most appropriate disclosure manner. A focus group discussion and individual interviews were conducted. Twenty-five resident and specialist doctors from primary health care and hospital settings participated. We analyzed the collected data with content analysis techniques. Participants were found to acknowledge the importance of appropriate and effective delivery of bad news; however, none of them reported the implementation of empirically informed communication practices. They described communication patterns mainly formed by their work experience and often guided by the patient's family requests. Doctor, patient, and family characteristics and organizational features and resources were reported to affect the delivery of bad news. Participants perceived the most appropriate disclosure manner as an individualized approach to each patient's unique needs. They suggested an interdisciplinary, collaborative management of the delivery process and the establishment of formal supportive services. These findings may provide useful information for the development of tailored, empirically informed curriculum interventions and educational programs in order to address several barriers to communication. Sociocultural characteristics that influence the disclosure practice, as well as physicians' perceptions that are consistent with the optimal information delivery, should be taken into account. System-level strategies that focus on the development of patient-centered communication also need to be prioritized.

The fundamental closed-form solution of control-related states of kth order S3PR system with left-side non-sharing resource places of Petri nets

NASA Astrophysics Data System (ADS)

Chao, Daniel Yuh; Yu, Tsung Hsien

2016-01-01

Due to the state explosion problem, it has been unimaginable to enumerate reachable states for Petri nets. Chao broke the barrier earlier by developing the very first closed-form solution of the number of reachable and other states for marked graphs and the kth order system. Instead of using first-met bad marking, we propose 'the moment to launch resource allocation' (MLR) as a partial deadlock avoidance policy for a large, real-time dynamic resource allocation system. Presently, we can use the future deadlock ratio of the current state as the indicator of MLR due to which the ratio can be obtained real-time by a closed-form formula. This paper progresses the application of an MLR concept one step further on Gen-Left kth order systems (one non-sharing resource place in any position of the left-side process), which is also the most fundamental asymmetric net structure, by the construction of the system's closed-form solution of the control-related states (reachable, forbidden, live and deadlock states) with a formula depending on the parameters of k and the location of the non-sharing resource. Here, we kick off a new era of real-time, dynamic resource allocation decisions by constructing a generalisation formula of kth order systems (Gen-Left) with r* on the left side but at arbitrary locations.

Epstein-Barr virus miR-BART20-5p regulates cell proliferation and apoptosis by targeting BAD.

PubMed

Kim, Hyoji; Choi, Hoyun; Lee, Suk Kyeong

2015-01-28

Although Epstein-Barr virus (EBV) BamHI A rightward transcript (BART) microRNAs (miRNAs) are ubiquitously expressed in EBV-associated tumors, the role of most BART miRNAs is unclear. In this study, we showed that Bcl-2-associated death promoter (BAD) expression was significantly lower in EBV-infected AGS-EBV cells than in EBV-negative AGS cells and investigated whether BART miRNAs target BAD. Using bioinformatics analysis, five BART miRNAs showing seed match with the 3' untranslated region (3'-UTR) of BAD were selected. Of these, only miR-BART20-5p reduced BAD expression when individually transfected into AGS cells. A luciferase assay revealed that miR-BART20-5p directly targets BAD. The expression of BAD mRNA and protein was decreased by miR-BART20-5p and increased by an inhibitor of miR-BART20-5p. PE-Annexin V staining and cell proliferation assays showed that miR-BART20-5p reduced apoptosis and enhanced cell growth. Furthermore, miR-BART20-5p increased chemoresistance to 5-fluorouracil and docetaxel. Our data suggest that miR-BART20-5p contributes to tumorigenesis of EBV-associated gastric carcinoma by directly targeting the 3'-UTR of BAD. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Teaching midwife students how to break bad news using the cinema: an Italian qualitative study.

PubMed

Fieschi, Laura; Burlon, Barbara; De Marinis, Maria Grazia

2015-03-01

Delivering bad news is a difficult task that involves all healthcare professionals, including midwives. The hypothesis is that, in order to learn how to disclose and to discuss bad news, students need a phase of personal reflection, of awareness of their own emotional processes. The use of films in healthcare education can foster this process evoking different emotions concerning suffering and disease, in a "safety zone". This study examines the effects that a course, which uses reflection as a method of learning and the cinema as a teaching tool, produces on a little group of Italian third-year Midwifery students. From the content analysis (supported by Atlas-Ti(®) software) of the texts produced by the students after the vision of two entire films, it appears that they correctly identified many elements related to good and poor communication of bad news and that they were able to describe the emotions felt while watching the film, but still revealed a certain difficulty to interpret them. The course helped students to recognize the value of reflection on their emotions to better understand others, to empathize with people who suffer, but also to recognize their difficulties and compete with their own limits. Copyright © 2015 Elsevier Ltd. All rights reserved.

Abraham's discovery of the 'bad mother'. A contribution to the history of the theory of depression.

PubMed

May, U

2001-04-01

The author shows how, after Freud struggled in vain from the 1890s to develop a theory of depression, Abraham succeeded for the first time in finding an approach to the understanding of depression a few years before the publication of Freud's 'Mourning and melancholia'. It is contained in his study of the painter Giovanni Segantini (1911), which also includes a description, imbued with a new atmospheric quality, of the mother-son relationship that centres on the concept of the 'bad mother'. The author points out that Abraham's 'good/bad' dimension is effectively absent from Freud's published work up to 1911 and is also at variance with his view of the relationship between son and mother. In later contributions, too, Abraham maintained that unconscious hate directed at the mother, who is experienced as 'bad' but longed for as 'good', was a central factor in the aetiology of depression, a view he had to defend vis-à-vis Freud. The author contends that in the Segantini paper Abraham was describing an inner world similar to that evinced by the work of Melanie Klein and significantly different from Freud's. It is characterised by hate, revenge, death wishes and guilt feelings on the one hand and tranquillity and inner peace on the other.

A pitfall of muting and removing bad traces in surface-wave analysis

NASA Astrophysics Data System (ADS)

Hu, Yue; Xia, Jianghai; Mi, Binbin; Cheng, Feng; Shen, Chao

2018-06-01

Multi-channel analysis of surface/Love wave (MASW/MALW) has been widely used to construct the shallow shear (S)-wave velocity profile. The key step in surface-wave analysis is to generate accurate dispersion energy and pick the dispersive curves for inversion along the peaks of dispersion energy at different frequencies. In near-surface surface-wave acquisition, bad traces are very common and inevitable due to the imperfections in the recording instruments or others. The existence of bad traces will cause some artifacts in the dispersion energy image. To avoid the interference of bad traces on the surface-wave analysis, the bad traces should be alternatively muted (zeroed) or removed (deleted) from the raw surface-wave data before dispersion measurement. Most geophysicists and civil engineers, however, are not aware of the differences and implications between muting and removing of bad traces in surface-wave analysis. A synthetic test and a real-world example demonstrate the potential pitfalls of applying muting and removing on bad traces when using different dispersion-imaging methods. We implement muting and removing on bad traces respectively before dispersion measurement, and compare the influence of the two operations on three dispersion-imaging methods, high-resolution linear Radon transform (HRLRT), f-k transformation, and phase shift method. Results indicate that when using the HRLRT to generate the dispersive energy, muting bad traces will cause an even more complicated and discontinuous dispersive energy. When f-k transformation is utilized to conduct dispersive analysis, bad traces should be muted instead of removed to generate an accurate dispersion image to avoid the uneven sampling problem in the Fourier transform. As for the phase shift method, the difference between the two operations is slight, but we suggest that removal should be chosen because the integral for the phase-shift operator of the zeroed traces would bring in the sloped aliasing. This study provides a pre-process guidance for the real-world surface-wave data processing when the recorded shot gather contains inevitable bad traces.

How do trees and the small life forms under the ground talk to each other and other outside things: Can they make our world hot (or cool) again?

NASA Astrophysics Data System (ADS)

Sihi, D.

2017-12-01

Trees use water and a bad stuff in air as food with the help of sun light and store the bad stuff in it's body parts (both the parts above the ground and under the ground). However, trees (both above and under ground parts) also return part of the same bad stuff stored in their food to air as it grows. After death, these trees become part of the dead things under the ground and a large part of the bad stuff can be locked under the ground for quite a long time. But, small life forms living under the ground, eat these dead things and return part of the bad stuff locked in these dead things under the ground to the air. The small life forms living under the ground can also make two other stuff (which are even more bad) while eating these dead things under the ground and return them to the air. All of these bad stuffs returned to the air make the air hot. Different things (like sun light, rain, water in the air and under the ground) could make it easier or harder in either storing or returning each of these bad stuffs by the trees or life forms living under the ground in different ways. We study how trees and the small life forms living under the ground talk to each other and to other things mentioned above, and decide how much of those bad stuffs to store and return. But, we do not know well how each of these things can change one another and how trees and small life forms living under the ground will respond to these changes. So, we are yet to understand how much the air will be hotter (if more bad stuff are returned to the air than stored in trees and under the ground) or cooler (if less bad stuffs are returned to the air than stored in trees and under the ground) in tomorrow's world.

Developing Effective Performance Measures

DTIC Science & Technology

2014-10-14

University When Performance Measurement Goes Bad Laziness Vanity Narcissism Too Many Pettiness Inanity 52 Developing Effective...Kasunic, October 14, 2014 © 2014 Carnegie Mellon University Narcissism Measuring performance from the organization’s point of view, rather than from

How Bad is That?

ERIC Educational Resources Information Center

Brey, Rebecca A.; Clark, Susan E.

2015-01-01

This teaching technique asks students to evaluate the "badness" of 5-7 health-related behavioral statements of a specific health topic. Following the presentation of each statement, each students selects one of five choices: "Really Bad", "No Big Deal", "It Depends", "Go for It", or…

Cholesterol: The Good, the Bad, and the Unhealthy | NIH MedlinePlus the Magazine

MedlinePlus

... Good, the Bad, and the Unhealthy Follow us Cholesterol: The Good, the Bad, and the Unhealthy We ... and Blood Institute and MedlinePlus. What is good cholesterol? There are two main types of cholesterol: “good” ...

BAD Modulates Counterregulatory Responses to Hypoglycemia and Protective Glucoprivic Feeding

PubMed Central

Osundiji, Mayowa A.; Godes, Marina L.; Evans, Mark L.; Danial, Nika N.

2011-01-01

Hypoglycemia or glucoprivation triggers protective hormonal counterregulatory and feeding responses to aid the restoration of normoglycemia. Increasing evidence suggests pertinent roles for the brain in sensing glucoprivation and mediating counterregulation, however, the precise nature of the metabolic signals and molecular mediators linking central glucose sensing to effector functions are not fully understood. Here, we demonstrate that protective hormonal and feeding responses to hypoglycemia are regulated by BAD, a BCL-2 family protein with dual functions in apoptosis and metabolism. BAD-deficient mice display impaired glycemic and hormonal counterregulatory responses to systemic glucoprivation induced by 2-deoxy-D-glucose. BAD is also required for proper counterregulatory responses to insulin-induced hypoglycemia as evident from significantly higher glucose infusion rates and lower plasma epinephrine levels during hyperinsulinemic hypoglycemic clamps. Importantly, RNA interference-mediated acute knockdown of Bad in the brain provided independent genetic evidence for its relevance in central glucose sensing and proper neurohumoral responses to glucoprivation. Moreover, BAD deficiency is associated with impaired glucoprivic feeding, suggesting that its role in adaptive responses to hypoglycemia extends beyond hormonal responses to regulation of feeding behavior. Together, these data indicate a previously unappreciated role for BAD in the control of central glucose sensing. PMID:22162752

[Giving bad news in medicine: an exploratory study].

PubMed

Bascuñán, M L; Roizblatt, A; Roizblatt, D

2007-01-01

Giving bad news is inherent to the practice of medicine. Development of guidelines for this task has great value, although the orientations are only general and should be adapted to each case, allowing for the cultural idiosyncrasy of the people involved. the present study aims to explore common practices of giving bad news in different hospital services in Santiago-Chile. a qualitative methodology was applied through three focus groups with a sample of 33 physicians from two hospitals in Santiago-Chile. giving bad news is a frequent practice for which no training is given. It generates preoccupation and interest among professionals. There is no agreed procedure to communicate bad news. Each professional has had to develop his/her own way from his/her experience and observing others. Informing the patient is seen as an ethical duty, but in many cases it is not easy because of family pressure. Comments are made on different types of bad news, strategies for this communicational process and facilitators and barriers for it. Doctors' own professional past experience is a central factor in the way bad news is given, and so self-development mechanisms constitute an important challenge.

Halitosis

MedlinePlus

... can also affect your breath. Common examples of foods and beverages that may cause bad breath include onions, garlic, ... and vegetables every day. Eat less meat. Avoid foods that cause you to have bad breath. Also try to avoid alcoholic beverages, which often cause bad breath. Avoid using tobacco ...

Efficacy of ketamine in improving pain after tonsillectomy in children: meta-analysis.

PubMed

Cho, Hye Kyung; Kim, Kyu Won; Jeong, Yeon Min; Lee, Ho Seok; Lee, Yeon Ji; Hwang, Se Hwan

2014-01-01

The goal of this meta-analysis study was to perform a systematic review of the literature on the effects of ketamine on postoperative pain following tonsillectomy and adverse effects in children. Two authors independently searched three databases (MEDLINE, SCOPUS, Cochrane) from their inception of article collection to February 2014. Studies that compared preoperative ketamine administration (ketamine groups) with no treatment (control group) or opioid administration (opioid group) where the outcomes of interest were postoperative pain intensity, rescue analgesic consumption, or adverse effects (sedation, nausea and vomiting, bad dream, worsening sleep pattern, and hallucination) 0-24 hours after leaving the operation room were included in the analysis. The pain score reported by the physician during first 4 hours and need for analgesics during 24 hours postoperatively was significantly decreased in the ketamine group versus control group and was similar with the opioid group. In addition, there was no significant difference between ketamine and control groups for adverse effects during 24 hours postoperatively. In the subgroup analyses (systemic and local administration) regarding pain related measurements, peritonsillar infiltration of ketamine was more effective in reducing the postoperative pain severity and need for analgesics. Preoperative administration of ketamine systemically or locally could provide pain relief without side-effects in children undergoing tonsillectomy. However, considering the insufficient evaluation of efficacy of ketamine according to the administration methods and high heterogeneity in some parameters, further clinical trials with robust research methodology should be conducted to confirm the results of this study.

Tumor Talk and Child Well-Being: Perceptions of "Good" and "Bad" News Among Parents of Children With Advanced Cancer.

PubMed

Feraco, Angela M; Dussel, Veronica; Orellana, Liliana; Kang, Tammy I; Geyer, J Russell; Rosenberg, Abby R; Feudtner, Chris; Wolfe, Joanne

2017-05-01

Little is known about how parents of children with advanced cancer classify news they receive about their child's medical condition. To develop concepts of "good news" and "bad news" in discussions of advanced childhood cancer from parent perspectives. Parents of children with advanced cancer cared for at three children's hospitals were asked to share details of conversations in the preceding three months that contained "good news" or "bad news" related to their child's medical condition. We used mixed methods to evaluate parent responses to both open-ended and fixed-response items. Of 104 enrolled parents, 86 (83%) completed the survey. Six (7%) parents reported discussing neither good nor bad news, 18 (21%) reported only bad news, 15 (17%) reported only good news, and 46 (54%) reported both good and bad news (one missing response). Seventy-six parents (88%) answered free-response items. Descriptions of both good and bad news discussions consisted predominantly of "tumor talk" or cancer control. Additional treatment options featured prominently, particularly in discussions of bad news (42%). Child well-being, an important good news theme, encompassed treatment tolerance, symptom reduction, and quality of life. A majority of parents of children with advanced cancer report discussing both good and bad news in the preceding three months. Although news related primarily to cancer control, parents also describe good news discussions related to their child's well-being. Understanding how parents of children with advanced cancer classify and describe the news they receive may enhance efforts to promote family-centered communication. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

48 CFR 2131.205-3 - Bad debts.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Bad debts. 2131.205-3 Section 2131.205-3 Federal Acquisition Regulations System OFFICE OF PERSONNEL MANAGEMENT, FEDERAL... PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 2131.205-3 Bad debts. Erroneous benefit...

Bad Actors Criticality Assessment for Pipeline system

NASA Astrophysics Data System (ADS)

Nasir, Meseret; Chong, Kit wee; Osman, Sabtuni; Siaw Khur, Wee

2015-04-01

Failure of a pipeline system could bring huge economic loss. In order to mitigate such catastrophic loss, it is required to evaluate and rank the impact of each bad actor of the pipeline system. In this study, bad actors are known as the root causes or any potential factor leading to the system downtime. Fault Tree Analysis (FTA) is used to analyze the probability of occurrence for each bad actor. Bimbaum's Importance and criticality measure (BICM) is also employed to rank the impact of each bad actor on the pipeline system failure. The results demonstrate that internal corrosion; external corrosion and construction damage are critical and highly contribute to the pipeline system failure with 48.0%, 12.4% and 6.0% respectively. Thus, a minor improvement in internal corrosion; external corrosion and construction damage would bring significant changes in the pipeline system performance and reliability. These results could also be useful to develop efficient maintenance strategy by identifying the critical bad actors.

Immunohistochemical expression study of proapoptotic BH3-only protein bad in canine nonneoplastic tissues and canine lymphomas.

PubMed

Dettwiler, M; Croci, M; Vaughan, L; Guscetti, F

2013-09-01

The BH3-only protein Bad is a proapoptotic Bcl-2 family member that acts as a sensitizer in intrinsic apoptosis by inactivating antiapoptotic members through heterodimer formation. Bad has been shown to contribute to tumorigenesis, including lymphoma formation in humans and mice, through alteration in expression or functional status. Here, its immunohistochemical expression was analyzed in canine nonneoplastic and lymphoma tissues using tissue microarrays. Bad was expressed in the cytoplasm of a wide range of nonneoplastic tissues, especially epithelial cells. Nonneoplastic lymph nodes displayed weak immunostaining in the follicular germinal centers only. Immunoblotting supported these observations but also revealed presence of nonspecific labeling in some organs. Of 81 lymphomas, 29 (35.8%) displayed moderate to strong immunohistochemical Bad labeling, and a significant expression increase was found in lymphomas (especially B cell and double negative) compared to nonneoplastic lymph nodes. These findings warrant further investigations of the functional status, the involvement of partner proteins, and a possible impact of Bad on prognosis in canine lymphoma.

Bad apples, bad cases, and bad barrels: meta-analytic evidence about sources of unethical decisions at work.

PubMed

Kish-Gephart, Jennifer J; Harrison, David A; Treviño, Linda Klebe

2010-01-01

As corporate scandals proliferate, practitioners and researchers alike need a cumulative, quantitative understanding of the antecedents associated with unethical decisions in organizations. In this meta-analysis, the authors draw from over 30 years of research and multiple literatures to examine individual ("bad apple"), moral issue ("bad case"), and organizational environment ("bad barrel") antecedents of unethical choice. Findings provide empirical support for several foundational theories and paint a clearer picture of relationships characterized by mixed results. Structural equation modeling revealed the complexity (multidetermined nature) of unethical choice, as well as a need for research that simultaneously examines different sets of antecedents. Moderator analyses unexpectedly uncovered better prediction of unethical behavior than of intention for several variables. This suggests a need to more strongly consider a new "ethical impulse" perspective in addition to the traditional "ethical calculus" perspective. Results serve as a data-based foundation and guide for future theoretical and empirical development in the domain of behavioral ethics. Copyright 2009 APA, all rights reserved.

Bad is not involved in DHA-induced apoptosis in human lung adenocarcinoma ASTC-a-1 cells

NASA Astrophysics Data System (ADS)

Yu, Huai-na; Lu, Ying-ying; Chen, Tong-sheng

2011-03-01

Dihydroartemisinin (DHA), a first-line anti-malarial drug with low toxicity, has been shown to possess promising anticancer activities and induce cancer cell death through apoptotic pathway, but the molecular mechanisms are not well understood. In this paper, we focus on whether Bad, a BH3-only pro-apoptotic protein, is involved in apoptotic cell death in DHA-treated human lung adenocarcinoma (ASTC-a-1) cells. Confocal fluorescence microscope imaging was used to monitor the temporal and spatial distribution of Bad in single living cells. Our results indicate that Bad is still located in cytoplasm and does not translocate to mitochondria after treatment with DHA for 24 h, while only a small proportion of Bad located in cytoplasm in the STS-treated cells for 6 h. These results show for the first time that Bad is not involved in DHA-induced apoptosis in ASTC-a-1 cells, which could give more evidence for the molecular mechanisms of apoptosis induced by DHA.

What is it like to take antipsychotic medication? A qualitative study of patients with first-episode psychosis.

PubMed

Gray, R; Deane, K

2016-03-01

What is known on the subject? Antipsychotic drugs are an important part of treatment for most patients with first episode psychosis. We do not know much about what it is like to take these drugs from the patient's point of view. What this paper adds to existing knowledge? We talked to 20 young people with psychosis about their experiences of taking antipsychotic drugs. Patients relationship with medication was complex, young people found medication often to be both good and bad at the same time. We were interested in how seemingly trivial issues--colour, taste, size, name--could be very important to young people and could result in them stopping. What are the implications for practice? We think our study highlights the complicated internal struggles that people with first episode psychosis have with medication. Our study highlights how Nurses and Doctors need to try and better understand what it is like to take these drugs and work collaboratively with patients to support them to make informed choices about treatment. Low-dose antipsychotic medication is an important part of treatment for people experiencing a first episode of psychosis. Little is known about this group of patients' experiences of taking medication. A qualitative study of purposively sampled young people experiencing a first episode of psychosis was carried out. A mental health nurse working in the early psychosis team interviewed participants using a structured topic guide. Interviews were subjected to thematic analysis. Interviews were completed with 20 young people. Thematic analysis generated six themes: (1) the drugs do work, (2) the drugs don't work (as well as I'd like), (3) side effects, (4) the indirect effects of medication, (5) rage against the machine and (6) the not trivial issues about medication. Our overarching meta-theme was that young people's experience of taking antipsychotics was complex; medication was often considered good and bad at the same time. Our observations underpin the importance of helping patients think through the use of antipsychotic medication in supporting their personal recovery. © 2016 John Wiley & Sons Ltd.

Anomalous Hall effect in the van der Waals bonded ferromagnet Fe 3 − x GeTe 2

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, Yu; Stavitski, Eli; Attenkofer, Klaus

2018-04-09

Here, we report the anomalous Hall effect (AHE) in single crystals of a quasi-two-dimensional Fe 3–xGeTe 2 (x ≈ 0.36) ferromagnet grown by the flux method which induces defects on the Fe site and bad metallic resistivity. Fe K-edge x-ray absorption spectroscopy was measured to provide information on the local atomic environment in such crystals. The dc and ac magnetic susceptibility measurements indicate a second-stage transition below 119 K in addition to the paramagnetic to ferromagnetic transition at 153 K. A linear scaling behavior between the modified anomalous Hall resistivity ρxy/μ0Heff and longitudinal resistivity ρ 2 xxM/μ 0H eff impliesmore » that the AHE in Fe 3–xGeTe 2 should be dominated by the intrinsic Karplus-Luttinger mechanism rather than the extrinsic skew-scattering and side-jump mechanisms. The observed deviation in the linear- M Hall conductivity σ A xy below 30 K is in line with its transport characteristic at low temperatures, implying the scattering of conduction electrons due to magnetic disorder and the evolution of the Fermi surface induced by a possible spin-reorientation transition.« less

Anomalous Hall effect in the van der Waals bonded ferromagnet Fe 3 - x GeTe 2

DOE PAGES

Liu, Yu; Stavitski, Eli; Attenkofer, Klaus; ...

2018-04-09

Here, we report the anomalous Hall effect (AHE) in single crystals of a quasi-two-dimensional Fe 3–xGeTe 2 (x ≈ 0.36) ferromagnet grown by the flux method which induces defects on the Fe site and bad metallic resistivity. Fe K-edge x-ray absorption spectroscopy was measured to provide information on the local atomic environment in such crystals. The dc and ac magnetic susceptibility measurements indicate a second-stage transition below 119 K in addition to the paramagnetic to ferromagnetic transition at 153 K. A linear scaling behavior between the modified anomalous Hall resistivity ρxy/μ0Heff and longitudinal resistivity ρ 2 xxM/μ 0H eff impliesmore » that the AHE in Fe 3–xGeTe 2 should be dominated by the intrinsic Karplus-Luttinger mechanism rather than the extrinsic skew-scattering and side-jump mechanisms. The observed deviation in the linear- M Hall conductivity σ A xy below 30 K is in line with its transport characteristic at low temperatures, implying the scattering of conduction electrons due to magnetic disorder and the evolution of the Fermi surface induced by a possible spin-reorientation transition.« less

Anomalous Hall effect in the van der Waals bonded ferromagnet Fe 3 - x GeTe 2

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, Yu; Stavitski, Eli; Attenkofer, Klaus

Here, we report the anomalous Hall effect (AHE) in single crystals of a quasi-two-dimensional Fe 3–xGeTe 2 (x ≈ 0.36) ferromagnet grown by the flux method which induces defects on the Fe site and bad metallic resistivity. Fe K-edge x-ray absorption spectroscopy was measured to provide information on the local atomic environment in such crystals. The dc and ac magnetic susceptibility measurements indicate a second-stage transition below 119 K in addition to the paramagnetic to ferromagnetic transition at 153 K. A linear scaling behavior between the modified anomalous Hall resistivity ρxy/μ0Heff and longitudinal resistivity ρ 2 xxM/μ 0H eff impliesmore » that the AHE in Fe 3–xGeTe 2 should be dominated by the intrinsic Karplus-Luttinger mechanism rather than the extrinsic skew-scattering and side-jump mechanisms. The observed deviation in the linear- M Hall conductivity σ A xy below 30 K is in line with its transport characteristic at low temperatures, implying the scattering of conduction electrons due to magnetic disorder and the evolution of the Fermi surface induced by a possible spin-reorientation transition.« less

Employee bad behavior: selected thoughts and strategies.

PubMed

Reinholz, Becky; Cash, Jimmie K; Kupperschmidt, Betty

2009-01-01

In summary, bad behavior is prevalent in many acute care settings. Kupperschmidt (2006) once asked if it would take a mandate from a regulatory agency to get nurses to address horizontal hostility. Perhaps the answer to that question is "Yes" and we now have that mandate. Nursing Managers and Executives are challenged to demonstrate competence in effective behavior management. Role modeling integrity by adherence to standards and governing policies motivates employees to follow such examples. Inspiring environments that allow professionals to share talents and skills in a "safe" culture of practice promotes healthy work environments and defines successful behavior management.

How bad is bile acid diarrhoea: an online survey of patient-reported symptoms and outcomes

PubMed Central

Bannaga, Ayman; Kelman, Lawrence; O'Connor, Michelle; Pitchford, Claire; Walters, Julian R F; Arasaradnam, Ramesh P

2017-01-01

Objectives Bile acid diarrhoea (BAD) is an underdiagnosed condition producing diarrhoea, urgency and fear of faecal incontinence. How patients experience these symptoms has not previously been studied. Bile Acid Malabsorption (BAM) Support UK was established in 2015 as a national charity with objectives including to provide details regarding how BAD affects patients, to improve earlier recognition and clinical management. Design, setting and main outcome A questionnaire was collected anonymously by BAM Support UK and the Bile Salt Malabsorption Facebook group over 4 weeks at the end of 2015. It comprised 56 questions and aimed to inform patients and clinicians about how BAD affects the respondents. Results The first 100 responses were analysed. 91% of the respondents reported a diagnosis of BAD. 58% of total respondents diagnosed following a Selenium-homocholic acid taurine scan, 69% were diagnosed by a gastroenterologist, with type 2 and 3 BAD comprising 38% and 37%, respectively, of total respondents. Symptoms had been experienced for more than 5 years before diagnosis in 44% of respondents. Following treatment, usually with bile acid sequestrants, 60% of participants reported improvement of diarrhoea and most reported their mental health has been positively impacted. Just over half of the cohort felt as though their symptoms had been dismissed during clinical consultations and 28% felt their GPs were unaware of BAD. Conclusions BAD requires more recognition by clinicians to address the current delays in diagnosis. Treatment improves physical and mental symptoms in the majority of participants. PMID:28123771

Paediatric SpRs' experiences of breaking bad news.

PubMed

Horwitz, N; Ellis, J

2007-09-01

To ascertain the level of support and training available to paediatric specialist registrars (SpRs) in breaking bad news and their self-reported confidence in this task. A questionnaire-based survey. Paediatric SpRs working in North Thames region. Specialist registrars (n = 206) were sent a questionnaire relating to the level of support and training available to them in breaking bad news and their attitudes to this task. A repeat questionnaire was sent out 2 weeks later. The response rate was 54.9%. The study sample included 78 females and 34 males. The median year of qualification was 1995 [interquartile range (IQR) 1993-1997] and the median year of Calman training was Year 3 (IQR 2-4). Only 15.9% of participants had guidelines where they worked and 91.2% had received training in breaking bad news. Median self-perceived confidence in breaking bad news was rated as 4 out of 5. Only 21.2% of all respondents had both disclosed a diagnosis of Down syndrome and received feedback on their performance from their seniors. Few SpRs were able to adhere to all evidence-based recommendations for breaking bad news. Most SpRs had received training in breaking bad news and self-reported confidence in this skill was high, although their hands-on experience was limited. Recent research shows, however, that parental dissatisfaction with the way in which bad news is broken remains high. The potential discrepancy between self-reported confidence and actual competence casts doubt on the value of self-evaluation.

The Good News About Giving Bad News to Patients

PubMed Central

Farber, Neil J; Urban, Susan Y; Collier, Virginia U; Weiner, Joan; Polite, Ronald G; Davis, Elizabeth B; Boyer, E Gil

2002-01-01

BACKGROUND There are few data available on how physicians inform patients about bad news. We surveyed internists about how they convey this information. METHODS We surveyed internists about their activities in giving bad news to patients. One set of questions was about activities for the emotional support of the patient (11 items), and the other was about activities for creating a supportive environment for delivering bad news (9 items). The impact of demographic factors on the performance of emotionally supportive items, environmentally supportive items, and on the number of minutes reportedly spent delivering news was analyzed by analysis of variance and multiple regression analysis. RESULTS More than half of the internists reported that they always or frequently performed 10 of the 11 emotionally supportive items and 6 of the 9 environmentally supportive items while giving bad news to patients. The average time reportedly spent in giving bad news was 27 minutes. Although training in giving bad news had a significant impact on the number of emotionally supportive items reported (P < .05), only 25% of respondents had any previous training in this area. Being older, a woman, unmarried, and having a history of major illness were also associated with reporting a greater number of emotionally supportive activities. CONCLUSIONS Internists report that they inform patients of bad news appropriately. Some deficiencies exist, specifically in discussing prognosis and referral of patients to support groups. Physician educational efforts should include discussion of prognosis with patients as well as the availability of support groups. PMID:12472927

Use of interactive theater and role play to develop medical students' skills in breaking bad news.

PubMed

Skye, Eric P; Wagenschutz, Heather; Steiger, Jeffrey A; Kumagai, Arno K

2014-12-01

Creative arts have been increasingly implemented in medical education. This study investigated the use of interactive theater and role play with professional actors in teaching breaking bad news to medical students. The objectives were to explore the contexts, approaches, experiences, and reactions in giving and receiving bad news. Second-year medical students participated in a required educational session that utilized interactive theater which helps students learn about the issues of breaking bad news to a patient with cancer. Following the interactive theater piece, professional actors provided students role play experiences in small groups with breaking bad news. Anonymous evaluation surveys were given out to all second-year medical students at the conclusion of the breaking bad news session. Surveys contained quantitative and qualitative responses. Three years of evaluations were analyzed. A total of 451 (88 %) students completed the evaluations. Comments were thematically analyzed. Ninety-four percent agreed that the theater piece prompted reflection on patient-provider communications, and 89 % agreed that it stimulated discussion on complex issues with breaking bad news. The two most common themes in student comments concerned the importance of realism in the theater piece, and the value of experiencing multiple perspectives. Use of professional actors during the role play exercises enhances the realism and pushed the students out of their own "comfort zones" in ways that may more closely approximate real life clinical situations. Interactive theater can be a potentially powerful tool to teach breaking bad news during medical school.

How bad is bile acid diarrhoea: an online survey of patient-reported symptoms and outcomes.

PubMed

Bannaga, Ayman; Kelman, Lawrence; O'Connor, Michelle; Pitchford, Claire; Walters, Julian R F; Arasaradnam, Ramesh P

2017-01-01

Bile acid diarrhoea (BAD) is an underdiagnosed condition producing diarrhoea, urgency and fear of faecal incontinence. How patients experience these symptoms has not previously been studied. Bile Acid Malabsorption (BAM) Support UK was established in 2015 as a national charity with objectives including to provide details regarding how BAD affects patients, to improve earlier recognition and clinical management. A questionnaire was collected anonymously by BAM Support UK and the Bile Salt Malabsorption Facebook group over 4 weeks at the end of 2015. It comprised 56 questions and aimed to inform patients and clinicians about how BAD affects the respondents. The first 100 responses were analysed. 91% of the respondents reported a diagnosis of BAD. 58% of total respondents diagnosed following a Selenium-homocholic acid taurine scan, 69% were diagnosed by a gastroenterologist, with type 2 and 3 BAD comprising 38% and 37%, respectively, of total respondents. Symptoms had been experienced for more than 5 years before diagnosis in 44% of respondents. Following treatment, usually with bile acid sequestrants, 60% of participants reported improvement of diarrhoea and most reported their mental health has been positively impacted. Just over half of the cohort felt as though their symptoms had been dismissed during clinical consultations and 28% felt their GPs were unaware of BAD. BAD requires more recognition by clinicians to address the current delays in diagnosis. Treatment improves physical and mental symptoms in the majority of participants.

Involvement of the Ventrolateral Prefrontal Cortex in Learning Others' Bad Reputations and Indelible Distrust.

PubMed

Suzuki, Atsunobu; Ito, Yuichi; Kiyama, Sachiko; Kunimi, Mitsunobu; Ohira, Hideki; Kawaguchi, Jun; Tanabe, Hiroki C; Nakai, Toshiharu

2016-01-01

A bad reputation can persistently affect judgments of an individual even when it turns out to be invalid and ought to be disregarded. Such indelible distrust may reflect that the negative evaluation elicited by a bad reputation transfers to a person. Consequently, the person him/herself may come to activate this negative evaluation irrespective of the accuracy of the reputation. If this theoretical model is correct, an evaluation-related brain region will be activated when witnessing a person whose bad reputation one has learned about, regardless of whether the reputation is deemed valid or not. Here, we tested this neural hypothesis with functional magnetic resonance imaging (fMRI). Participants memorized faces paired with either a good or a bad reputation. Next, they viewed the faces alone and inferred whether each person was likely to cooperate, first while retrieving the reputations, and then while trying to disregard them as false. A region of the left ventrolateral prefrontal cortex (vlPFC), which may be involved in negative evaluation, was activated by faces previously paired with bad reputations, irrespective of whether participants attempted to retrieve or disregard these reputations. Furthermore, participants showing greater activity of the left ventrolateral prefrontal region in response to the faces with bad reputations were more likely to infer that these individuals would not cooperate. Thus, once associated with a bad reputation, a person may elicit evaluation-related brain responses on their own, thereby evoking distrust independently of their reputation.

The good news about giving bad news to patients.

PubMed

Farber, Neil J; Urban, Susan Y; Collier, Virginia U; Weiner, Joan; Polite, Ronald G; Davis, Elizabeth B; Boyer, E Gil

2002-12-01

There are few data available on how physicians inform patients about bad news. We surveyed internists about how they convey this information. We surveyed internists about their activities in giving bad news to patients. One set of questions was about activities for the emotional support of the patient (11 items), and the other was about activities for creating a supportive environment for delivering bad news (9 items). The impact of demographic factors on the performance of emotionally supportive items, environmentally supportive items, and on the number of minutes reportedly spent delivering news was analyzed by analysis of variance and multiple regression analysis. More than half of the internists reported that they always or frequently performed 10 of the 11 emotionally supportive items and 6 of the 9 environmentally supportive items while giving bad news to patients. The average time reportedly spent in giving bad news was 27 minutes. Although training in giving bad news had a significant impact on the number of emotionally supportive items reported (P <.05), only 25% of respondents had any previous training in this area. Being older, a woman, unmarried, and having a history of major illness were also associated with reporting a greater number of emotionally supportive activities. Internists report that they inform patients of bad news appropriately. Some deficiencies exist, specifically in discussing prognosis and referral of patients to support groups. Physician educational efforts should include discussion of prognosis with patients as well as the availability of support groups.

P-1 truss arrival at KSC

NASA Technical Reports Server (NTRS)

2000-01-01

The P-1 truss, a component of the International Space Station, arrives inside the RLV hangar, located near the Shuttle Landing Facility at KSC. Approaching bad weather caused the detour as a precaution. The truss will eventually be transferred to the Operations and Checkout Building for processing. The P-1 truss, scheduled to fly in spring of 2002, is part of a total 10-truss, girder-like structure on the Station that will ultimately extend the length of a football field. Astronauts will attach the 14-by- 15 foot structure to the port side of the center truss, S0, during the spring assembly flight. The 33,000-pound P-1 will house the thermal radiator rotating joint (TRRJ) that will rotate the Station's radiators away from the sun to increase their maximum cooling efficiency.

48 CFR 1631.205-71 - FEHBP bad debts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true FEHBP bad debts. 1631.205-71 Section 1631.205-71 Federal Acquisition Regulations System OFFICE OF PERSONNEL MANAGEMENT FEDERAL... AND PROCEDURES Contracts With Commercial Organizations 1631.205-71 FEHBP bad debts. Erroneous benefit...

HOW TO MANAGE DATA BADLY (PART 1 & 2)

EPA Science Inventory

In a landmark article in The American Statistician, Howard Wainer (1994) presented ideas for (a) "How to Display Data Badly," wherein good data are ruined by bad graphics. Wainer presumed too much. In this essay, I extend his concept by presenting ideas and examples of how scient...

Deliver a set of tools for resolving bad inductive loops and correcting bad data.

DOT National Transportation Integrated Search

2012-04-01

This project prototyped and demonstrated procedures to find and mitigate loop detector errors, and to derive more valuable data from loops. Specifically, methods were developed to find and isolate out loop data which is "bad" or invalid, so that miti...

Deliver a set of tools for resolving bad inductive loops and correcting bad data

DOT National Transportation Integrated Search

2012-04-10

This project prototyped and demonstrated procedures to find and mitigate loop detector errors, and to derive more valuable data from loops. Specifically, methods were developed to find and isolate out loop data which is "bad" or invalid, so that miti...

Syndecan-1-Dependent Suppression of PDK1/Akt/Bad Signaling by Docosahexaenoic Acid Induces Apoptosis in Prostate Cancer1

PubMed Central

Hu, Yunping; Sun, Haiguo; Owens, Rick T; Gu, Zhennan; Wu, Jansheng; Chen, Yong Q; O'Flaherty, Joseph T; Edwards, Iris J

2010-01-01

Evidence indicates that diets enriched in n-3 polyunsaturated fatty acids (n-3 PUFAs) reduce the risk of prostate cancer, but biochemical mechanisms are unclear. Syndecan-1 (SDC-1), a transmembrane heparan sulfate proteoglycan, supports the integrity of the epithelial compartment. In tumor cells of epithelial lineage, SDC-1 is generally downregulated. This may result in perturbation of homeostasis and lead to progression of malignancy. Our studies have shown that the n-3 PUFA species, docosahexaenoic acid (DHA), increases SDC-1 expression in prostate tissues of Pten knockout (PtenP-/-) mice/cells and human prostate cancer cells. We have now determined that DHA-mediated up-regulation of SDC-1 induces apoptosis. Bovine serum albumin-bound DHA and exogenous human recombinant SDC-1 ecotodomain were delivered to PC3 and LNCaP cells in the presence or absence of SDC-1 small interfering (si)RNA. In the presence of control siRNA, both DHA and SDC-1 ectodomain induced apoptosis, whereas SDC-1 silencing blocked DHA-induced but not SDC-1 ectodomain-induced apoptosis. Downstream effectors of SDC-1 signaling linked to n-3 PUFA-induced apoptosis involved the 3′-phosphoinositide-dependent kinase 1 (PDK1)/Akt/Bad integrating network. A diet enriched in n-3 PUFA decreased phosphorylation of PDK1, Akt (T308), and Bad in prostates of PtenP-/- mice. Similar results were observed in human prostate cancer cells in response to DHA and SDC-1 ectodomain. The effect of DHA on PDK1/Akt/Bad signaling was abrogated by SDC-1 siRNA. These findings define a mechanism by which SDC-1-dependent suppression of phosphorylation of PDK1/Akt/Bad mediates n-3 PUFA-induced apoptosis in prostate cancer. PMID:20927321

Generalized sub-Schawlow-Townes laser linewidths via material dispersion

NASA Astrophysics Data System (ADS)

Pillay, Jason Cornelius; Natsume, Yuki; Stone, A. Douglas; Chong, Y. D.

2014-03-01

A recent S-matrix-based theory of the quantum-limited linewidth, which is applicable to general lasers, including spatially nonuniform laser cavities operating above threshold, is analyzed in various limits. For broadband gain, a simple interpretation of the Petermann and bad-cavity factors is presented in terms of geometric relations between the zeros and poles of the S matrix. When there is substantial dispersion, on the frequency scale of the cavity lifetime, the theory yields a generalization of the bad-cavity factor, which was previously derived for spatially uniform one-dimensional lasers. This effect can lead to sub-Schawlow-Townes linewidths in lasers with very narrow gain widths. We derive a formula for the linewidth in terms of the lasing mode functions, which has accuracy comparable to the previous formula involving the residue of the lasing pole. These results for the quantum-limited linewidth are valid even in the regime of strong line pulling and spatial hole burning, where the linewidth cannot be factorized into independent Petermann and bad-cavity factors.

The global Minmax k-means algorithm.

PubMed

Wang, Xiaoyan; Bai, Yanping

2016-01-01

The global k -means algorithm is an incremental approach to clustering that dynamically adds one cluster center at a time through a deterministic global search procedure from suitable initial positions, and employs k -means to minimize the sum of the intra-cluster variances. However the global k -means algorithm sometimes results singleton clusters and the initial positions sometimes are bad, after a bad initialization, poor local optimal can be easily obtained by k -means algorithm. In this paper, we modified the global k -means algorithm to eliminate the singleton clusters at first, and then we apply MinMax k -means clustering error method to global k -means algorithm to overcome the effect of bad initialization, proposed the global Minmax k -means algorithm. The proposed clustering method is tested on some popular data sets and compared to the k -means algorithm, the global k -means algorithm and the MinMax k -means algorithm. The experiment results show our proposed algorithm outperforms other algorithms mentioned in the paper.

Problems With Using Patient Retention in the Evaluation of Mental Health Providers: Differences in Type of Dropout.

PubMed

Brown, Halley J; Andreason, Hope; Melling, Amy K; Imel, Zac E; Simon, Gregory E

2015-08-01

Retention, or its opposite, dropout, is a common metric of psychotherapy quality, but using it to assess provider performance can be problematic. Differences among providers in numbers of general dropouts, "good" dropouts (patients report positive treatment experiences and outcome), and "bad" dropouts (patients report negative treatment experiences and outcome) were evaluated. Patient records were paired with satisfaction surveys (N=3,054). Binomial mixed-effects models were used to examine differences among providers by dropout type. Thirty-four percent of treatment episodes resulted in dropout. Of these, 14% were bad dropouts and 27% were good dropouts. Providers accounted for approximately 17% of the variance in general dropout and 10% of the variance in both bad dropout and good dropout. The ranking of providers fluctuated by type of dropout. Provider assessments based on patient retention should offer a way to isolate dropout type, given that nonspecific metrics may lead to biased estimates of performance.

The FNS-based analyzing the EEG to diagnose the bipolar affective disorder

NASA Astrophysics Data System (ADS)

Panischev, Yu; Panischeva, S. N.; Demin, S. A.

2015-11-01

Here we demonstrate a capability of method based on the Flicker-Noise Spectroscopy (FNS) in analyzing the manifestation bipolar affective disorder (BAD) in EEG. Generally EEG from BAD patient does not show the visual differences from healthy EEG. Analyzing the behavior of FNS-parameters and the structure of 3D-cross correlators allows to discover the differential characteristics of BAD. The cerebral cortex electric activity of BAD patients have a specific collective dynamics and configuration of the FNS-characteristics in comparison with healthy subjects.

[Breaking bad news in the emergency room: Suggestions and future challenges].

PubMed

Landa-Ramírez, Edgar; López-Gómez, Antonio; Jiménez-Escobar, Irma; Sánchez-Sosa, Juan José

2017-01-01

The aim of this paper is to describe educational programs that reportedly teach how to break bad news in the emergency department. We also suggest some recommendations on how to communicate bad news based on the research of evidence available in the field. The examined evidence points toward six major components with which physicians should familiarize when communicating bad news: 1) doctor-patient empathic communication, 2) establishing a proper space to give the news, 3) identifying characteristics of the person who receives the news, 4) essential aspects for communicating the news; 5) emotional support, and 6) medical and administrative aspects of the encounter. Finally, we point out several limitations in the studies in the field and future challenges identified in the communication of bad news in emergency room facilities.

Application of a Novel Tool for Diagnosing Bile Acid Diarrhoea

PubMed Central

Covington, James A.; Westenbrink, Eric W.; Ouaret, Nathalie; Harbord, Ruth; Bailey, Catherine; O'Connell, Nicola; Cullis, James; Williams, Nigel; Nwokolo, Chuka U.; Bardhan, Karna D.; Arasaradnam, Ramesh P.

2013-01-01

Bile acid diarrhoea (BAD) is a common disease that requires expensive imaging to diagnose. We have tested the efficacy of a new method to identify BAD, based on the detection of differences in volatile organic compounds (VOC) in urine headspace of BAD vs. ulcerative colitis and healthy controls. A total of 110 patients were recruited; 23 with BAD, 42 with ulcerative colitis (UC) and 45 controls. Patients with BAD also received standard imaging (Se75HCAT) for confirmation. Urine samples were collected and the headspace analysed using an AlphaMOS Fox 4000 electronic nose in combination with an Owlstone Lonestar Field Asymmetric Ion Mobility Spectrometer (FAIMS). A subset was also tested by gas chromatography, mass spectrometry (GCMS). Linear Discriminant Analysis (LDA) was used to explore both the electronic nose and FAIMS data. LDA showed statistical differences between the groups, with reclassification success rates (using an n-1 approach) at typically 83%. GCMS experiments confirmed these results and showed that patients with BAD had two chemical compounds, 2-propanol and acetamide, that were either not present or were in much reduced quantities in the ulcerative colitis and control samples. We believe that this work may lead to a new tool to diagnose BAD, which is cheaper, quicker and easier that current methods. PMID:24018955

[Construction and expression of recombinant lentiviral vectors of AKT2,PDK1 and BAD].

PubMed

Zhu, Jing; Chen, Bo-Jiang; Huang, Na; Li, Wei-Min

2014-03-01

To construct human protein kinase B (ATK2), phosphoinositide-dependent kinase 1 (PDK1) and bcl-2-associated death protein (BAD) lentiviral expression vector, and to determine their expressions in 293T cells. Total RNA was extracted from lung cancer tissues. The full-length coding regions of human ATK2, BAD and PDK1 cDNA were amplified via RT-PCR using specific primers, subcloned into PGEM-Teasy and then sequenced for confirmation. The full-length coding sequence was cut out with a specific restriction enzyme digest and subclone into pCDF1-MCS2-EF1-copGFP. The plasmids were transfected into 293T cells using the calcium phosphate method. The over expression of AKT2, BAD and PDK1 were detected by Western blot. AKT2, PDK1 and BAD were subcloned into pCDF1-MCS2-EF1-copGFP, with an efficiency of transfection of 100%, 95%, and 90% respectively. The virus titers were 6.7 x 10(6) PFU/mL in the supernatant. After infection, the proteins of AKT2, PDK1 and BAD were detected by Western blot. The lentivial vector pCDF1-MCS2-EF1-copGFP containing AKT2, BAD and PDK1 were successfully constructed and expressed in 293T cells.

Vranaropaka effect of Laksha Churna with Madhu on wound after removal of Danta Sharkara.

PubMed

Maurya, Mridulata; Maurya, Dinesh K

2012-01-01

According to Sushruta, disease in which plaque formed on teeth and hardened by the action of deranged Vayu, lies in a crystallized form at root of teeth is called as Dantasharkara. According to Vagbhata, accumulation of dirt on teeth by not cleaning them daily or of Kapha dehydrated by Vata adhering to the teeth, becoming hard and emits bad odor is known as Dantasharkara (Tartar). Tartar manifests as a deposit of inorganic salts composed primarily of calcium carbonate and phosphate mixed with food debris, bacteria and desquamated epithelial cells which reduce the quality of whiteness and strength of the teeth. Teeth loss is also not uncommon in tartar sufferers. Such deposits tend to destroy the healthy growth and function of teeth. It should be removed in such a way as not to hurt the roots of the teeth and then parts should be rubbed (Pratisarana) with Laksha Churna and Madhu. In trial group, management of tartar is attempted by local rubbing of Laksha Churna with Madhu on the surface of teeth and gingiva. Regeneration, repair and new attachment are the aspects of periodontal healing that are achieved by gingival physiotherapy on scaling wound. Pratisarana of Laksha Churna with Madhu is easy to apply, cost effective and free from side effects in comparison to systemic use of modern drugs.

Motivations and concerns about adolescent tuberculosis vaccine trial participation in rural Uganda: a qualitative study.

PubMed

Buregyeya, Esther; Kulane, Asli; Kiguli, Juliet; Musoke, Phillipa; Mayanja, Harriet; Mitchell, Ellen Maeve Hanlon

2015-01-01

Research is being carried out to develop and test new potentially more effective tuberculosis vaccines. Among the vaccines being developed are those that target adolescents. This study explored the stakeholders' perceptions about adolescent participation in a hypothetical tuberculosis vaccine trial in Ugandan adolescents. Focus group discussions with adolescents, parents of infants and adolescents, and key informant interviews with community leaders and traditional healers were conducted. The majority of the respondents expressed potential willingness to allow their children participate in a tuberculosis vaccine trial. Main motivations for potential participation would be being able to learn about health-related issues. Hesitations included the notion that trial participation would distract the youths from their studies, fear of possible side effects of an investigational product, and potential for being sexually exploited by researchers. In addition, bad experiences from participation in previous research and doubts about the importance of research were mentioned. Suggested ways to motivate participation included: improved clarity on study purpose, risks, benefits and better scheduling of study procedures to minimize disruption to participants' academic schedules. Findings from this study suggest that the community is open to potential participation of adolescents in a tuberculosis vaccine trial. However, there is a need to communicate more effectively with the community about the purpose of the trial and its effects, including safety data, in a low-literacy, readily understood format. This raises a challenge to researchers, who cannot know all the potential effects of a trial product before it is tested.

Figure-ground asymmetries in the Implicit Association Test (IAT).

PubMed

Rothermund, K; Wentura, D

2001-01-01

Based on the assumption that binary classification tasks are often processed asymmetrically (figure-ground asymmetries), two experiments showed that association alone cannot account for effects observed in the Implicit Association Test (IAT). Experiment 1 (N = 16) replicated a standard version of the IAT effect using old vs. young names as target categories and good and bad words as attribute categories. However, reliable compatibility effects were also found for a modified version of the task in which neutral words vs. nonwords instead of good vs. bad words were used as attribute categories. In Experiment 2 (N = 8), a reversed IAT effect was observed after the figure-ground asymmetry in the target dimension had been inverted by a previous go/nogo detection task in which participants searched for exemplars of the category "young." The experiments support the hypothesis that figure-ground asymmetries produce compatibility effects in the IAT and suggest that IAT effects do not rely exclusively on evaluative associations between the target and attribute categories.

Bad air gets under your skin.

PubMed

Koohgoli, Roxanna; Hudson, Laura; Naidoo, Khimara; Wilkinson, Simon; Chavan, Bhaven; Birch-Machin, Mark A

2017-05-01

Air pollution is increasing beyond previous estimates and is viewed as the world's largest environmental health risk factor. Numerous clinical and epidemiological studies have highlighted the adverse effects of environmental pollutants on health. Although there is comparatively less research investigating the cutaneous effects of ambient pollution, there is growing recognition of the adverse effects on skin. In this article, we provide an overview of the nature of environmental pollution and highlight the current evidence detailing the effects on cutaneous health. There is convincing evidence demonstrating that air pollution has a detrimental impact on skin and can exacerbate skin disease. Further epidemiological and experimental studies are required to assess the short- and long-term deleterious effects of ambient pollutant exposure on skin. The future challenge would be to use this evidence to develop specific strategies to protect against pollution-induced damage and prevent the effects of "bad air getting under our skin." © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

How Top PR Professionals Handle Hearsay: Corporate Rumors, Their Effects, and Strategies to Manage Them.

ERIC Educational Resources Information Center

DiFonzo, Nicholas; Bordia, Prashant

2000-01-01

Investigates types of organizational rumors, their prevalence and effects, effectiveness of rumor management strategies, and associated psychological and situational variables. Finds 3 distinct dimensions of rumor effects: external ramifications (bad press), internal attitudes (lowered morale), and internal behaviors (increased absenteeism). (NH)

Guggulsterone Targets Smokeless Tobacco Induced PI3K/Akt Pathway in Head and Neck Cancer Cells

PubMed Central

Macha, Muzafar A.; Matta, Ajay; Chauhan, Shyam Singh; Siu, K. W. Michael; Ralhan, Ranju

2011-01-01

Background Epidemiological association of head and neck cancer with smokeless tobacco (ST) emphasizes the need to unravel the molecular mechanisms implicated in cancer development, and identify pharmacologically safe agents for early intervention and prevention of disease recurrence. Guggulsterone (GS), a biosafe nutraceutical, inhibits the PI3K/Akt pathway that plays a critical role in HNSCC development. However, the potential of GS to suppress ST and nicotine (major component of ST) induced HNSCC remains unexplored. We hypothesized GS can abrogate the effects of ST and nicotine on apoptosis in HNSCC cells, in part by activation of PI3K/Akt pathway and its downstream targets, Bax and Bad. Methods and Results Our results showed ST and nicotine treatment resulted in activation of PI3K, PDK1, Akt, and its downstream proteins - Raf, GSK3β and pS6 while GS induced a time dependent decrease in activation of PI3K/Akt pathway. ST and nicotine treatment also resulted in induction of Bad and Bax phosphorylation, increased the association of Bad with 14-3-3ζresulting in its sequestration in the cytoplasm of head and neck cancer cells, thus blocking its pro-apoptotic function. Notably, GS pre-treatment inhibited ST/nicotine induced activation of PI3K/Akt pathway, and inhibited the Akt mediated phosphorylation of Bax and Bad. Conclusions In conclusion, GS treatment not only inhibited proliferation, but also induced apoptosis by abrogating the effects of ST / nicotine on PI3K/Akt pathway in head and neck cancer cells. These findings provide a rationale for designing future studies to evaluate the chemopreventive potential of GS in ST / nicotine associated head and neck cancer. PMID:21383988

Guggulsterone targets smokeless tobacco induced PI3K/Akt pathway in head and neck cancer cells.

PubMed

Macha, Muzafar A; Matta, Ajay; Chauhan, Shyam Singh; Siu, K W Michael; Ralhan, Ranju

2011-02-24

Epidemiological association of head and neck cancer with smokeless tobacco (ST) emphasizes the need to unravel the molecular mechanisms implicated in cancer development, and identify pharmacologically safe agents for early intervention and prevention of disease recurrence. Guggulsterone (GS), a biosafe nutraceutical, inhibits the PI3K/Akt pathway that plays a critical role in HNSCC development. However, the potential of GS to suppress ST and nicotine (major component of ST) induced HNSCC remains unexplored. We hypothesized GS can abrogate the effects of ST and nicotine on apoptosis in HNSCC cells, in part by activation of PI3K/Akt pathway and its downstream targets, Bax and Bad. Our results showed ST and nicotine treatment resulted in activation of PI3K, PDK1, Akt, and its downstream proteins--Raf, GSK3β and pS6 while GS induced a time dependent decrease in activation of PI3K/Akt pathway. ST and nicotine treatment also resulted in induction of Bad and Bax phosphorylation, increased the association of Bad with 14-3-3ζresulting in its sequestration in the cytoplasm of head and neck cancer cells, thus blocking its pro-apoptotic function. Notably, GS pre-treatment inhibited ST/nicotine induced activation of PI3K/Akt pathway, and inhibited the Akt mediated phosphorylation of Bax and Bad. In conclusion, GS treatment not only inhibited proliferation, but also induced apoptosis by abrogating the effects of ST/nicotine on PI3K/Akt pathway in head and neck cancer cells. These findings provide a rationale for designing future studies to evaluate the chemopreventive potential of GS in ST/nicotine associated head and neck cancer.

Effects of patient-centered communication on anxiety, negative affect, and trust in the physician in delivering a cancer diagnosis: A randomized, experimental study.

PubMed

Zwingmann, Jelena; Baile, Walter F; Schmier, Johann W; Bernhard, Jürg; Keller, Monika

2017-08-15

When bad news about a cancer diagnosis is being delivered, patient-centered communication (PCC) has been considered important for patients' adjustment and well-being. However, few studies have explored how interpersonal skills might help cancer patients cope with anxiety and distress during bad-news encounters. A prospective, experimental design was used to investigate the impact of the physician communication style during a bad-news encounter. Ninety-eight cancer patients and 92 unaffected subjects of both sexes were randomly assigned to view a video of a clinician delivering a first cancer diagnosis with either an enhanced patient-centered communication (E-PCC) style or a low patient-centered communication (L-PCC) style. Participants rated state anxiety and negative affect before and immediately after the video exposure, whereas trust in the physician was rated after the video exposure only. Main and interaction effects were analyzed with generalized linear models. Viewing the disclosure of a cancer diagnosis resulted in a substantial increase in state anxiety and negative affect among all participants. This emotional response was moderated by the physician's communication style: Participants viewing an oncologist displaying an E-PCC style were significantly less anxious than those watching an oncologist displaying an L-PCC style. They also reported significantly higher trust in the physician. Under a threatening, anxiety-provoking disclosure of bad news, a short sequence of empathic PCC influences subjects' psychological state, insofar that they report feeling less anxious and more trustful of the oncologist. Video exposure appears to be a valuable method for investigating the impact of a physician's communication style during critical encounters. Cancer 2017;123:3167-75. © 2017 American Cancer Society. © 2017 American Cancer Society.

Factors associated with patient preferences for communication of bad news.

PubMed

Fujimori, Maiko; Akechi, Tatsuo; Uchitomi, Yosuke

2017-06-01

Communication based on patient preferences can alleviate their psychological distress and is an important part of patient-centered care for physicians who have the task of conveying bad news to cancer patients. The present study aimed to explore the demographic, medical, and psychological factors associated with patient preferences with regard to communication of bad news. Outpatients with a variety of cancers were consecutively invited to participate in our study after their follow-up medical visit. A questionnaire assessed their preferences regarding the communication of bad news, covering four factors-(1) how bad news is delivered, (2) reassurance and emotional support, (3) additional information, and (4) setting-as well as on demographic, medical, and psychosocial factors. A total of 529 outpatients with a variety of cancers completed the questionnaire. Multiple regression analyses indicated that patients who were younger, female, had greater faith in their physician, and were more highly educated placed more importance on "how bad news is delivered" than patients who were older, male, had less faith in their physician, and a lower level of education. Female patients and patients without an occupation placed more importance on "reassurance and emotional support." Younger, female, and more highly educated patients placed more importance on "additional information." Younger, female, and more highly educated patients, along with patients who weren't undergoing active treatment placed more importance on "setting." Patient preferences with regard to communication of bad news are associated with factors related to patient background. Physicians should consider these characteristics when delivering bad news and use an appropriate communication style tailored to each patient.

The difficulties experienced by nurses and healthcare staff involved in the process of breaking bad news.

PubMed

Warnock, Clare; Buchanan, Jean; Tod, Angela Mary

2017-07-01

The aim of this study was to explore the difficulties experienced by nurses and healthcare professionals when engaging in the process of breaking bad news. The challenges faced by staff when breaking bad news have previously been researched in relation to particular settings or participants. This study involved staff from diverse settings and roles to develop broader insights into the range of difficulties experienced in clinical practice. The study used a descriptive survey design involving self-reported written accounts and framework analysis. Data were collected using a structured questionnaire containing a free text section that asked participants to describe a difficult experience they had encountered when involved in the process of breaking bad news. Data were collected from healthcare staff from hospital, community, hospice and care home settings attending training days on breaking bad news between April 2011 and April 2014. Multiple inter-related factors presented challenges to staff engaging in activities associated with breaking bad news. Traditional subjects such as diagnostic and treatment information were described but additional topics were identified such as the impact of illness and care at the end of life. A descriptive framework was developed that summarizes the factors that contribute to creating difficult experiences for staff when breaking bad news. The framework provides insights into the scope of the challenges faced by staff when they engage in the process of breaking bad news. This provides the foundation for developing interventions to support staff that more closely matches their experiences in clinical practice. © 2017 John Wiley & Sons Ltd.

When bad moods may not be so bad: Valuing negative affect is associated with weakened affect-health links.

PubMed

Luong, Gloria; Wrzus, Cornelia; Wagner, Gert G; Riediger, Michaela

2016-04-01

Bad moods are considered "bad" not only because they may be aversive experiences in and of themselves, but also because they are associated with poorer psychosocial functioning and health. We propose that people differ in their negative affect valuation (NAV; the extent to which negative affective states are valued as pleasant, useful/helpful, appropriate, and meaningful experiences) and that affect-health links are moderated by NAV. These predictions were tested in a life span sample of 365 participants ranging from 14-88 years of age using reports of momentary negative affect and physical well-being (via experience sampling) and assessments of NAV and psychosocial and physical functioning (via computer-assisted personal interviews and behavioral measures of hand grip strength). Our study demonstrated that the more individuals valued negative affect, the less pronounced (and sometimes even nonexistent) were the associations between everyday experiences of negative affect and a variety of indicators of poorer psychosocial functioning (i.e., emotional health problems, social integration) and physical health (i.e., number of health conditions, health complaints, hand grip strength, momentary physical well-being). Exploratory analyses revealed that valuing positive affect was not associated with the analogous moderating effects as NAV. These findings suggest that it may be particularly important to consider NAV in models of affect-health links. (c) 2016 APA, all rights reserved).

Enforcing Academic Policies and Alleviating Student Bad Debt.

ERIC Educational Resources Information Center

Bennett, D. Tyson; Wesley, Homer

1998-01-01

It is more important than ever for colleges and universities to manage the resources they have and guard against unnecessary loss. Student bad debt is one loss that can be resolved. A study identified certain predictors of student bad debt, including academic indicators and student characteristics, and offers suggestions to institutions for…

Just World Responding in 6- and 9-Year-Old Children

ERIC Educational Resources Information Center

Fein, Deborah

1976-01-01

This study examined the responses of kindergarten, first, third, and fourth grade girls to examples of good and bad behaviors followed either by good or bad outcomes. The results indicated that good behavior did not affect judgments of outcome but that a good outcome raised judgments of bad behavior. (JMB)

Bad Kids and Bad Feelings: What Children's Literature Teaches about ADHD, Creativity, and Openness

ERIC Educational Resources Information Center

Stearns, Clio

2015-01-01

This paper uses data from children's literature and classroom narratives to consider hyperactivity, inattention, and other non-normative behaviors in children. It encourages educational thinkers and childhood mental health professionals to take a historical perspective on children's badness rather than consigning it to the realm of pathology.…

Mentoring Graduate Students: The Good, Bad, and Gray

ERIC Educational Resources Information Center

Ballantine, Jeanne H.; Jolly-Ballantine, John-Andrew

2015-01-01

Good mentoring of graduate students influences their perseverance and success to completion, whereas bad mentoring can result in negative outcomes, including delayed degree completion or non-completion. What the authors refer to as the gray zone is that which falls between good and bad mentoring. Examples are partial mentoring or changes in…

25 CFR 11.421 - Bad checks.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Bad checks. 11.421 Section 11.421 Indians BUREAU OF... Criminal Offenses § 11.421 Bad checks. (a) A person who issues or passes a check or similar sight order for..., and the issuer failed to make good within 10 days after receiving notice of that refusal. ...

13 CFR 134.407 - Evidence beyond the record and discovery.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Agency determination in question may have resulted from bad faith or improper behavior. (1) Prior to any... allegations of bad faith or improper behavior. (2) Upon a determination by the Administrative Law Judge that... specifically limited to the alleged bad faith or improper behavior. (b) A determination by the Administrative...

13 CFR 134.407 - Evidence beyond the record and discovery.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Agency determination in question may have resulted from bad faith or improper behavior. (1) Prior to any... allegations of bad faith or improper behavior. (2) Upon a determination by the Administrative Law Judge that... specifically limited to the alleged bad faith or improper behavior. (b) A determination by the Administrative...

13 CFR 134.407 - Evidence beyond the record and discovery.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Agency determination in question may have resulted from bad faith or improper behavior. (1) Prior to any... allegations of bad faith or improper behavior. (2) Upon a determination by the Administrative Law Judge that... specifically limited to the alleged bad faith or improper behavior. (b) A determination by the Administrative...

13 CFR 134.407 - Evidence beyond the record and discovery.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Agency determination in question may have resulted from bad faith or improper behavior. (1) Prior to any... allegations of bad faith or improper behavior. (2) Upon a determination by the Administrative Law Judge that... specifically limited to the alleged bad faith or improper behavior. (b) A determination by the Administrative...

Developing guidelines for disclosure or non-disclosure of bad news around life-limiting illness and death to people with intellectual disabilities.

PubMed

Tuffrey-Wijne, Irene; Giatras, Nikoletta; Butler, Gary; Cresswell, Amanda; Manners, Paula; Bernal, Jane

2013-05-01

There is insufficient evidence to guide decisions around (non-)disclosure of bad news of life-limiting illness and death to people with intellectual disabilities. The aim of this study was to develop guidelines for decisions about (non-)disclosure of bad news around life-limiting illness and death to people with intellectual disabilities, by examining stakeholders' preferences (and reasons) around disclosure and non-disclosure. Focus groups and interviews were held with 109 participants: people with intellectual disabilities, family carers, intellectual disabilities professionals and medical healthcare professionals. People with intellectual disabilities had wide-ranging views about disclosure. Reasons for non-disclosure included: preventing distress; too difficult for the bearer of bad news; the bearer of bad news lacks knowledge; inability to understand; no sense of time; conflicting views among stakeholders. Reasons for disclosure included: a right to know; knowledge helps the person cope; need for involvement. Disclosure of bad news could cause harm in some situations, but this needs careful assessment. The authors present guidelines for disclosure that now need to be tested in practice. © 2013 Blackwell Publishing Ltd.

Patients' Attitude toward Breaking Bad News; a Brief Report.

PubMed

Aminiahidashti, Hamed; Mousavi, Seyed Jaber; Darzi, Mohammad Mehdi

2016-01-01

Delivering bad news is a stressful moment for both physicians and patients. The purpose of this investigation was to explore the patients' preferences and attitudes toward being informed about the bad news. This cross-sectional study was done on patients admitted to Imam Khomeini Hospital, Sari, Iran, from September 2014 to February 2015. Patient attitude regarding breaking bad news was evaluated using a reliable and valid questionnaire. 130 patients were evaluated (61.5% male, mean age = 46.21 ± 12.1 years). 118 (90.76%) participants believed that the patient himself/herself should be informed about the disease's condition. 120 (92.30%) preferred to hear the news from a skillful physician and 105 (80.76%) believed that emergency department is not a proper place for breaking bad news. Based on the results of the present study, most participants believed that the most experienced and skillful physician should inform them completely regarding their medical condition. At the same time they declared that, it is best to hear bad news in a calm and suitable place and time rather than emergency department or hospital corridors during teaching rounds.

Bad splits in bilateral sagittal split osteotomy: systematic review of fracture patterns.

PubMed

Steenen, S A; Becking, A G

2016-07-01

An unfavourable and unanticipated pattern of the mandibular sagittal split osteotomy is generally referred to as a 'bad split'. Few restorative techniques to manage the situation have been described. In this article, a classification of reported bad split pattern types is proposed and appropriate salvage procedures to manage the different types of undesired fracture are presented. A systematic review was undertaken, yielding a total of 33 studies published between 1971 and 2015. These reported a total of 458 cases of bad splits among 19,527 sagittal ramus osteotomies in 10,271 patients. The total reported incidence of bad split was 2.3% of sagittal splits. The most frequently encountered were buccal plate fractures of the proximal segment (types 1A-F) and lingual fractures of the distal segment (types 2A and 2B). Coronoid fractures (type 3) and condylar neck fractures (type 4) have seldom been reported. The various types of bad split may require different salvage approaches. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Fasting mediated increase in p-BAD(ser155) and p-AKT(ser473) in the prefrontal cortex of mice.

PubMed

Pitchaimani, Vigneshwaran; Arumugam, Somasundaram; Thandavarayan, Rajarajan Amirthalingam; Karuppagounder, Vengadeshprabhu; Sreedhar, Remya; Afrin, Rejina; Harima, Meilei; Suzuki, Hiroshi; Miyashita, Shizuka; Nomoto, Mayumi; Sone, Hirohito; Suzuki, Kenji; Watanabe, Kenichi

2014-09-05

BAD-deficient mice and fasting have several common functional roles in seizures, beta-hydroxybutyrate (BHB) uptake in brain and alteration in counterregulatory hormonal regulation during hypoglycemia. Neuronal specific insulin receptor knockout (NIRKO) mice display impaired counterregulatory hormonal responses during hypoglycemia. In this study we investigated the fasting mediated expression of p-BAD(ser155) and p-AKT(ser473) in different regions of brain (prefrontal cortex, hippocampus, midbrain and hypothalamus). Fasting specifically increases p-BAD(ser155) and p-AKT(ser473) in prefrontal cortex and decreases in other regions of brain. Our results suggest that fasting may increase the uptake BHB by decreasing p-BAD(ser155) in the brain during hypoglycemia except prefrontal cortex and it uncovers specific functional area of p-BAD(ser155) and p-AKT(ser473) that may regulates counter regulatory hormonal response. Overall in support with previous findings, fasting mediated hypoglycemia activates prefrontal cortex insulin signaling which influences the hypothalamic paraventricular nucleus mediated activation of sympathoadrenal hormonal responses. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Colostrum and ideas about bad milk: a case study from Guinea-Bissau.

PubMed

Gunnlaugsson, G; Einarsdóttir, J

1993-02-01

The study aims to explore ideas about bad milk found among women in Guinea-Bissau. Interviews were held with 20 elderly knowledgeable rural women. Interinformant agreement was high within each ethnic group studied. All the informants recognized colostrum but disliked its consistency. Depending on ethnical background, it was considered good, of no special value or harmful to the newborn baby. Further, all the informants held that mature breast milk could turn bad, e.g. in case of mother's sickness or adultery. Suspected bad milk can be diagnosed by putting an ant into it to observe if it dies. The condition of bad milk can be treated by various procedures. The findings are discussed in relation to similar ideas existing in other societies and to views on the quality of maternal milk held in the industrialized countries. It is proposed that the idea of producing bad milk may be an important determinant of breastfeeding performance generally. Restrictions imposed on the breastfeeding woman, with the intention of producing healthier breast milk, may actually contribute to a decline in breastfeeding.

Good and Bad Sleep in Childhood: A Questionnaire Survey amongst School Children in Southern Italy.

PubMed

Ficca, Gianluca; Conte, Francesca; De Padova, Vittoria; Zilli, Iole

2011-01-01

Despite its clinical importance, the issue of subjective sleep quality in children remains unexplored. Here we investigate, in school-aged children, the prevalence of bad sleep perception and its relationships with sleep habits and daytime functioning, to provide hints on its possible determinants. Subjective sleep perception, sleep habits, and daytime functioning were studied through a questionnaire survey in a sample of 482 children (6-12 yrs.). Being "bad sleeper" was reported by 6.9% of the sample. Compared to the "good sleepers", these subjects displayed shorter sleep duration on schooldays, longer sleep latencies, and a more pronounced evening preference, beyond more frequent insufficient sleep. Though no differences emerged in sleepiness, bad sleepers showed higher impairments in daytime functioning, indicated by more frequent depressed mood and impulsivity. These distinctive features might be very important to precociously detect those children who are possibly more vulnerable to sleep disturbances and whose sleep-wake rhythms evolution should be paid particular attention thereafter. "The good people sleep much better at night than the bad people.Of course, the bad people enjoy the waking hours much more"Woody Allen.

Pigeons can discriminate "good" and "bad" paintings by children.

PubMed

Watanabe, Shigeru

2010-01-01

Humans have the unique ability to create art, but non-human animals may be able to discriminate "good" art from "bad" art. In this study, I investigated whether pigeons could be trained to discriminate between paintings that had been judged by humans as either "bad" or "good". To do this, adult human observers first classified several children's paintings as either "good" (beautiful) or "bad" (ugly). Using operant conditioning procedures, pigeons were then reinforced for pecking at "good" paintings. After the pigeons learned the discrimination task, they were presented with novel pictures of both "good" and "bad" children's paintings to test whether they had successfully learned to discriminate between these two stimulus categories. The results showed that pigeons could discriminate novel "good" and "bad" paintings. Then, to determine which cues the subjects used for the discrimination, I conducted tests of the stimuli when the paintings were of reduced size or grayscale. In addition, I tested their ability to discriminate when the painting stimuli were mosaic and partial occluded. The pigeons maintained discrimination performance when the paintings were reduced in size. However, discrimination performance decreased when stimuli were presented as grayscale images or when a mosaic effect was applied to the original stimuli in order to disrupt spatial frequency. Thus, the pigeons used both color and pattern cues for their discrimination. The partial occlusion did not disrupt the discriminative behavior suggesting that the pigeons did not attend to particular parts, namely upper, lower, left or right half, of the paintings. These results suggest that the pigeons are capable of learning the concept of a stimulus class that humans name "good" pictures. The second experiment showed that pigeons learned to discriminate watercolor paintings from pastel paintings. The subjects showed generalization to novel paintings. Then, as the first experiment, size reduction test, grayscale test, mosaic processing test and partial occlusion test were carried out. The results suggest that the pigeons used both color and pattern cues for the discrimination and show that non-human animals, such as pigeons, can be trained to discriminate abstract visual stimuli, such as pictures and may also have the ability to learn the concept of "beauty" as defined by humans.

Intoxication and bad behaviour: understanding cultural differences in the link.

PubMed

Room, R

2001-07-01

Research developments since the appearance of MacAndrew and Edgerton's landmark volume, Drunken Comportment (1969), are summarized. The challenge of moving beyond the book is to understand what lies behind cultural variations in drunken comportment. Four specific factors in variations in drunken comportment are discussed. (1) A common contrast is between "wet" societies, where drinking is banalized everyday, and "dry" societies, where alcohol is set apart as a special commodity. Problems with this contrast are discussed, and the need for cross-cultural studies comparing expectancies from intoxication. (2) There is a need to study variations in the definition of intoxication as a "time out" state. In some societies, intoxication is likened to possession by spirits; a rationalistic version of this can be found in Canadian court decisions viewing extreme intoxication as potentially "akin to automatism". (3) If bad behaviour is a foreseeable consequence of drinking, why do some societies nevertheless not hold the drinker responsible'? In Anglo-American and similar societies, drunkenness has some excuse value, but it is not a very good excuse. Compromises like this seem to be found also in other cultures. (4) Pseudointoxication is fairly widespread, and seems to mark social situations where alcohol has enhanced excuse value. It appears to be a stratagem of the weaker side across cultural boundaries, and of the young where age-grading favours older groups. Concerning the possibility of cultural changes in drunken comportment, it is argued that there are historical examples, but such a shift requires a substantial social change.

Teaching dental students how to deliver bad news: S-P-I-K-E-S model.

PubMed

Curtin, Sharon; McConnell, Mary

2012-03-01

Delivering bad news has traditionally been associated with life-threatening illness, the imminence of death, or communicating about the death of a loved one to a family member. The delivery of bad news in dentistry is rarely about life-threatening circumstances. However, the impact of the bad news such as the loss of an anterior tooth can be devastating for the patient. This article outlines the S-P-I-K-E-S protocol and discusses the teaching aims and methodology in applying the model in an undergraduate dental program in Ireland.

[Significance of bad habits in orthodontics].

PubMed

Tarján, Ildikó

2002-08-01

The author is concerned with the etiological role of bad habits in the development. Disturbances caused by pacifier habits, finger sucking, various forms of swallowing habits and their therapeutical possibilities are discussed. The role of mouth breathing, nail biting, bruxism and self-mutilation in development of anomalies and their therapy are also mentioned. The attention is called to the fact that dentists have responsibility and task to diagnose as early as can be the oral bad habits and that the adequate therapy in time in co-operation with other specialists helping the child get out of bad habits, preventing the development of severe anomaly.

Breaking bad news in the emergency department: a comparative analysis among residents, patients and family members' perceptions.

PubMed

Toutin-Dias, Gabriela; Daglius-Dias, Roger; Scalabrini-Neto, Augusto

2018-02-01

Our main objective was to assess patient and family members' perception of bad news communication in the emergency department (ED) and compare these with physicians' perceptions. This is a cross-sectional study carried out at the ED of a tertiary teaching hospital. To compare physicians' and receivers' (patient and/or family member) perceptions, we created a survey based on the six attributes derived from the SPIKES protocol. The surveys were applied immediately after communication of bad news occurred in the ED. We analyzed agreement among participants using κ-statistics and the χ-test to compare proportions. A total of 73 bad news communication encounters were analyzed. The survey respondents were 73 physicians, 69 family members, and four patients. In general, there is a low level of agreement between physicians' and receivers' perceptions of how breaking bad news transpired. The satisfaction level of receivers, in terms of breaking bad news by doctors, presented a mean of 3.7±0.6 points. In contrast, the physicians' perception of the communication was worse (2.9±0.6 points), with P value less than 0.001. Doctors and receivers disagree in relation to what transpired throughout bad news communications. Discrepancies were more evident in issues involving emotion, invitation, and privacy. An important agreement between perceptions was found in technical and knowledge-related aspects of the communication.

History of the German Cardiac Society (DGHKF).

PubMed

Schaper, W

2002-01-01

1927 Foundation of the DGHKF by Prof. A. Weber and Prof. B. Kisch in Bad Nauheim. The first executive board of the DGHKF consists of A. Weber, Bad Nauheim, H. E. Hering, Köln, J. Rihl, Prag, B. Kisch, Köln, and H. Eppinger, Freiburg. Registered office was William-G. Kerckhoff-Herzforschungsinstitut, Bad Nauheim, under direction of Prof. F. Groedel. 1933 Emigration of F. Groedel to the United States of America. 1933-1941 Prof. E. Koch becomes acting chairman but Groedel remains director and influences fate and finances from his New York domicile and practice. 1938 Emigration of B. Kisch to the United States of America. 1948 Foundation of the "American College of Cardiology" in the United States. (Executive board: Groedel and Kisch). 1948 Prof. H. Schäfer is the new executive secretary of the society (executive board: K. Matthes, Erlangen, F. Hildebrandt, Bad Nauheim/Giessen, C. Oelemann, Bad Nauheim, A. Weber, Bad Nauheim, E. Wollheim, Lund). 1952 Incorporation of the Kerckhoff-Institute into the Max-Planck-Society, Appointment of Prof. R. Thauer to the directorship of the Kerckhoff-Institute and election to the position of the executive secretary until 1976. 1972 Appointment of Prof. W. Schaper to the Kerckhoff-Institute, Bad Nauheim. 1976 Election of Prof. Wolfgang Schaper to the executive board of the society and assumption of the office of the executive secretary until 1989.

Can the meaning of multiple words be integrated unconsciously?

PubMed

van Gaal, Simon; Naccache, Lionel; Meuwese, Julia D I; van Loon, Anouk M; Leighton, Alexandra H; Cohen, Laurent; Dehaene, Stanislas

2014-05-05

What are the limits of unconscious language processing? Can language circuits process simple grammatical constructions unconsciously and integrate the meaning of several unseen words? Using behavioural priming and electroencephalography (EEG), we studied a specific rule-based linguistic operation traditionally thought to require conscious cognitive control: the negation of valence. In a masked priming paradigm, two masked words were successively (Experiment 1) or simultaneously presented (Experiment 2), a modifier ('not'/'very') and an adjective (e.g. 'good'/'bad'), followed by a visible target noun (e.g. 'peace'/'murder'). Subjects indicated whether the target noun had a positive or negative valence. The combination of these three words could either be contextually consistent (e.g. 'very bad - murder') or inconsistent (e.g. 'not bad - murder'). EEG recordings revealed that grammatical negations could unfold partly unconsciously, as reflected in similar occipito-parietal N400 effects for conscious and unconscious three-word sequences forming inconsistent combinations. However, only conscious word sequences elicited P600 effects, later in time. Overall, these results suggest that multiple unconscious words can be rapidly integrated and that an unconscious negation can automatically 'flip the sign' of an unconscious adjective. These findings not only extend the limits of subliminal combinatorial language processes, but also highlight how consciousness modulates the grammatical integration of multiple words.

Ferulic acid attenuates the down-regulation of MEK/ERK/p90RSK signaling pathway in focal cerebral ischemic injury.

PubMed

Koh, Phil-Ok

2015-02-19

Ferulic acid provides neuroprotective effects against a middle cerebral artery occlusion (MCAO)-induced cerebral ischemia. Mitogen-activated protein kinases can regulate extensive intracellular processes including cell differentiation, growth, and death. This study further investigated whether ferulic acid modulates a protective mechanism through the activation of Raf-MEK-ERK and its downstream targets, including 90 ribosomal S6 kinase (p90RSK) and Bad during cerebral ischemic injury. Male Sprague-Dawley rats were treated with ferulic acid (100mg/kg) or vehicle after the onset of MCAO and brain tissues were collected 24h after MCAO. These results indicated that ferulic acid decreases the volume of the infarct area and the number of cells positive in terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining. Although MCAO injury induces a decrease in the phosphorylation of Raf-1, MEK1/2, and ERK1/2, ferulic acid treatment prevents the injury-induced decrease in these phosphorylation levels. Ferulic acid also attenuates the injury-induced decrease in p90RSK and Bad phosphorylation levels. These findings suggest that ferulic acid prevents MCAO-induced neuronal cell death and that the MEK-ERK-p90RSK-Bad signaling pathway is involved in these neuroprotective effects. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Sexual Violence, Bodily Pain, and Trauma: A History.

PubMed

Bourke, Joanna

2012-05-01

Psychological trauma is a favoured trope of modernity. It has become commonplace to assume that all 'bad events' - and particularly those which involve violence - have a pathological effect on the sufferer's psyche, as well as that of the perpetrators. This essay explores the ways victims of rape and sexual assault were understood in psychiatric, psychological, forensic, and legal texts in Britain and America from the 19th to the late 20th century. It argues that, unlike most other 'bad events', which were incorporated within trauma narratives from the 1860s, the ascription of psychological trauma was only applied to rape victims a century later. Why and what were the consequences?

78 FR 283 - 2013 Rate Changes for the Basetime, Overtime, Holiday, and Laboratory Services Rates

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-03

... rate, plus the allowance for bad debt rate. The calculation for the 2013 basetime rate per hour per...)) = $28.36 + $8.96(benefits rate) + $.70 (travel and operating rate) + $17.15 (overhead rate) + $.01 (bad... travel and operating rate, plus the overhead rate, plus the allowance for bad debt rate. The calculation...

76 FR 80326 - 2012 Rate Changes for the Basetime, Overtime, Holiday, and Laboratory Services Rates

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-23

..., plus the travel and operating rate, plus the overhead rate, plus the allowance for bad debt rate. The... and operating rate) + $16.68 (overhead rate) + $.02 (bad debt allowance rate) = $54.24. Overtime Rate... rate, plus the allowance for bad debt rate. The calculation for the 2012 overtime rate per hour per...

The Dodo Didn't Make It: Survival and Betterment

ERIC Educational Resources Information Center

Boulding, Kenneth E.

1971-01-01

Examines survival as related to the theory of betterment: that is how things go from bad to better instead of from bad to worse." Identifies a number of deteriorating systems in the society: consumption-production system, overload, joint production of good and bad, the accumulation of small evils associated with good, failure in the knowledge…

Interdependence of Bad and Puma during ionizing-radiation-induced apoptosis.

PubMed

Toruno, Cristhian; Carbonneau, Seth; Stewart, Rodney A; Jette, Cicely

2014-01-01

Ionizing radiation (IR)-induced DNA double-strand breaks trigger an extensive cellular signaling response that involves the coordination of hundreds of proteins to regulate DNA repair, cell cycle arrest and apoptotic pathways. The cellular outcome often depends on the level of DNA damage as well as the particular cell type. Proliferating zebrafish embryonic neurons are highly sensitive to IR-induced apoptosis, and both p53 and its transcriptional target puma are essential mediators of the response. The BH3-only protein Puma has previously been reported to activate mitochondrial apoptosis through direct interaction with the pro-apoptotic Bcl-2 family proteins Bax and Bak, thus constituting the role of an "activator" BH3-only protein. This distinguishes it from BH3-only proteins like Bad that are thought to indirectly promote apoptosis through binding to anti-apoptotic Bcl-2 family members, thereby preventing the sequestration of activator BH3-only proteins and allowing them to directly interact with and activate Bax and Bak. We have shown previously that overexpression of the BH3-only protein Bad in zebrafish embryos supports normal embryonic development but greatly sensitizes developing neurons to IR-induced apoptosis. While Bad has previously been shown to play only a minor role in promoting IR-induced apoptosis of T cells in mice, we demonstrate that Bad is essential for robust IR-induced apoptosis in zebrafish embryonic neural tissue. Moreover, we found that both p53 and Puma are required for Bad-mediated radiosensitization in vivo. Our findings show the existence of a hierarchical interdependence between Bad and Puma whereby Bad functions as an essential sensitizer and Puma as an essential activator of IR-induced mitochondrial apoptosis specifically in embryonic neural tissue.

Social worker assessment of bad news delivery by emergency medicine residents: a novel direct-observation milestone assessment.

PubMed

Min, Alice Ann; Spear-Ellinwood, Karen; Berman, Melissa; Nisson, Peyton; Rhodes, Suzanne Michelle

2016-09-01

The skill of delivering bad news is difficult to teach and evaluate. Residents may practice in simulated settings; however, this may not translate to confidence or competence during real experiences. We investigated the acceptability and feasibility of social workers as evaluators of residents' delivery of bad news during patient encounters, and assessed the attitudes of both groups regarding this process. From August 2013 to June 2014, emergency medicine residents completed self-assessments after delivering bad news. Social workers completed evaluations after observing these conversations. The Assessment tools were designed by modifying the global Breaking Bad News Assessment Scale. Residents and social workers completed post-study surveys. 37 evaluations were received, 20 completed by social workers and 17 resident self-evaluations. Social workers reported discussing plans with residents prior to conversations 90 % of the time (18/20, 95 % CI 64.5, 97.8). Social workers who had previously observed the resident delivering bad news reported that the resident was more skilled on subsequent encounters 90 % of the time (95 % CI 42.2, 99). Both social workers and residents felt that prior training or experience was important. First-year residents valued advice from social workers less than advice from attending physicians, whereas more experienced residents perceived advice from social workers to be equivalent with that of attending physicians (40 versus 2.9 %, p = 0.002). Social worker assessment of residents' abilities to deliver bad news is feasible and acceptable to both groups. This formalized self-assessment and evaluation process highlights the importance of social workers' involvement in delivery of bad news, and the teaching of this skill. This method may also be used as direct-observation for resident milestone assessment.

Tumor Talk and Child Well-Being: Perceptions of “good” and “bad” news among parents of children with advanced cancer

PubMed Central

Feraco, Angela M.; Dussel, Veronica; Orellana, Liliana; Kang, Tammy I.; Geyer, J. Russell; Rosenberg, Abby R.; Feudtner, Chris; Wolfe, Joanne

2017-01-01

Context Little is known about how parents of children with advanced cancer classify news they receive about their child’s medical condition. Objective To develop concepts of “good news” and “bad news” in discussions of advanced childhood cancer from parent perspectives. Methods Parents of children with advanced cancer cared for at three children’s hospitals were asked to share details of conversations in the preceding 3 months that contained “good news” or “bad news” related to their child’s medical condition. We used mixed methods to evaluate parent responses to both open-ended and fixed response items. Results Of 104 enrolled parents, 86 (83%) completed the survey. Six (7%) parents reported discussing neither good nor bad news, 18 (21%) reported only bad news, 15 (17%) reported only good news, and 46 (54%) reported both good and bad news (1 missing response). Seventy-six parents (88%) answered free response items. Descriptions of both good and bad news discussions consisted predominantly of “tumor talk” or cancer control. Additional treatment options featured prominently, particularly in discussions of bad news (42%). Child well-being, an important good news theme, encompassed treatment tolerance, symptom reduction, and quality of life. Conclusion A majority of parents of children with advanced cancer report discussing both good and bad news in the preceding 3 months. While news related primarily to cancer control, parents also describe good news discussions related to their child’s well-being. Understanding how parents of children with advanced cancer classify and describe the news they receive may enhance efforts to promote family-centered communication. PMID:28062345

Interrelationships Among Flow-Mediated Vasodilation, Nitroglycerine-Induced Vasodilation, Baseline Brachial Artery Diameter, Hyperemic Shear Stress, and Cardiovascular Risk Factors.

PubMed

Maruhashi, Tatsuya; Iwamoto, Yumiko; Kajikawa, Masato; Oda, Nozomu; Kishimoto, Shinji; Matsui, Shogo; Hashimoto, Haruki; Aibara, Yoshiki; Yusoff, Farina Mohamad; Hidaka, Takayuki; Kihara, Yasuki; Chayama, Kazuaki; Noma, Kensuke; Nakashima, Ayumu; Goto, Chikara; Hida, Eisuke; Higashi, Yukihito

2017-12-29

Flow-mediated vasodilation (FMD) of the brachial artery has been used for the assessment of endothelial function. Considering the mechanism underlying the vasodilatory response of the brachial artery to reactive hyperemia, hyperemic shear stress (HSS), a stimulus for FMD; nitroglycerine-induced vasodilation (NID), an index of endothelium-independent vasodilation; and baseline brachial artery diameter (BAD) are also involved in vasodilatory response. The purpose of this study was to investigate the interrelationships among FMD, HSS, NID, baseline BAD, and cardiovascular risk factors. We measured FMD, HSS, NID, and baseline BAD simultaneously in 1033 participants (633 men and 400 women; mean age: 58.6±17.0 years). Framingham risk score was negatively correlated with FMD, HSS, and NID and was positively correlated with baseline BAD. HSS and NID were positively correlated with FMD, and baseline BAD was negatively correlated with FMD. In participants with normal NID, FMD was correlated with HSS, NID, and baseline BAD, all of which were independent variables of FMD in multivariate analysis. In participants with impaired NID, FMD was correlated with NID and baseline BAD, both of which were independent variables of FMD in multivariate analysis, but there was no association between FMD and HSS. NID and baseline BAD were independent variables of FMD regardless of the status of endothelium-independent vasodilation, whereas there was a significant association between FMD and HSS in participants with normal NID but not in those with impaired NID. The influence of HSS on FMD seems to be dependent on the status of endothelium-independent vasodilation. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Advances in understanding of bile acid diarrhea

PubMed Central

Camilleri, Michael

2014-01-01

Bile acids (BA) are actively reabsorbed in the terminal ileum by the apical Na+-dependent bile salt transporter. This review addresses the epidemiology, pathophysiology, diagnosis and treatment of BA diarrhea (BAD). BAD is typically caused by ileal resection or disease; 25–33% of patients with chronic functional diarrhea or irritable bowel syndrome-diarrhea (IBS-D) have BAD, possibly from deficiency in the ileal hormone, FGF-19, which normally provides feedback inhibition of BA synthesis. Diagnosis of BAD is typically based on reduced BA retention of radiolabeled BA (75SeHCAT), increased BA synthesis (serum C4) or increased fecal BA loss. In clinical practice, diagnosis is often based on response to BA sequestrants (e.g., cholestyramine or colesevelam). Diagnostic tests for BA malabsorption (BAM) need to be used more extensively in clinical practice. In the future, farnesoid X receptor agonists that stimulate ileal production of FGF-19 may be alternative treatments of BAD. PMID:24410472

Keeping It Real: Exploring an Interdisciplinary Breaking Bad News Role-Play as an Integrative Learning Opportunity

ERIC Educational Resources Information Center

Sweeney, Catherine; O'Sullivan, Eleanor; McCarthy, Marian

2015-01-01

Palliative care is a complex area of healthcare best delivered by an interdisciplinary team approach. Breaking bad news is an inherent part of caring for people with life-limiting conditions. This study aims to explore an interdisciplinary breaking bad news role-play in a palliative care module. Participants were undergraduate medical and nursing…

The Art of Breaking Bad News: Lessons Learned at a Large Public University

ERIC Educational Resources Information Center

Head, Joe F.

2010-01-01

The purpose of this article is to reflect on how to break bad news. The style in which one breaks bad news at the collegiate level has implications both for the individual and for the institution. If not managed well by enrollment professionals, negative news can taint prospects, applicants, parents, and current students, blemishing the…

77 FR 19287 - Change in Bank Control Notices; Acquisitions of Shares of a Bank or Bank Holding Company

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-30

... thereby indirectly retain control of Northstar Bank, both in Bad Axe, Michigan, and Seaway Community Bank... Bad Axe, Michigan, and certain of their minor children as a group acting in concert, to retain voting... in Bad Axe, Michigan, and Seaway Community Bank, St. Clair, Michigan. In addition, Lynette Drake, as...

43 CFR 4.1294 - Who may receive an award.

Code of Federal Regulations, 2010 CFR

2010-10-01

... or revoked, in bad faith and for the purpose of harassing or embarrassing the permittee; or (d) To a... section 525 of the Act or participated in such a proceeding in bad faith for the purpose of harassing or... section 525 of the Act or that any party participated in such a proceeding in bad faith and for the...

26 CFR 1.166-8 - Losses of guarantors, endorsers, and indemnitors incurred on agreements made before January 1, 1976.

Code of Federal Regulations, 2010 CFR

2010-04-01

... bad debt. A payment during the taxable year by a taxpayer other than a corporation in discharge of.... (3) Other applicable provisions. Other provisions of the internal revenue laws relating to bad debts, such as section 111, relating to the recovery of bad debts, shall be deemed to apply to any payment...

When Good People Happen to Bad Things: Student Learning in Unfortunate Times

ERIC Educational Resources Information Center

Shushok, Frank, Jr.

2010-01-01

Everyone at some point has asked the question "Why do bad things happen to good people? Even while asking it, most know that finding an answer to this question is not likely in their future. People's best responsible action, then, is to manage their risks to prevent future bad things from occurring, to the greatest extent possible. Risk…

Self-Deception in the Classroom: Educational Manifestations of Sartre's Concept of Bad Faith

ERIC Educational Resources Information Center

Blenkinsop, Sean; Waddington, Tim

2014-01-01

This article explores an important section of Jean-Paul Sartre's famous early work, "Being and Nothingness." In that section Sartre proposes that part of the human condition is to actively engage in a particular kind of self-deception he calls bad faith. Bad faith is recognized by the obvious inconsistency between the purported…

Faking Bad: Do High-Ability Elementary Students Intentionally Underachieve When Their Work Is Peer-Reviewed?

ERIC Educational Resources Information Center

Black, Kasey M. K.

2012-01-01

While faking bad, or the intentional distortion of assessment results, has been studied extensively with self-report measures (Lim & Butcher, 1996; Roskes, 2009), the possible presence of this behavior on direct measures has only just begun to be examined. Previous studies of faking bad on academic measures have been limited to students at the…

26 CFR 1.381(c)(12)-1 - Recovery of bad debts, prior taxes, or delinquency amounts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... delinquency amounts. 1.381(c)(12)-1 Section 1.381(c)(12)-1 Internal Revenue INTERNAL REVENUE SERVICE...(c)(12)-1 Recovery of bad debts, prior taxes, or delinquency amounts. (a) Carryover requirement. (1... corporation is entitled to the recovery of a bad debt, prior tax, or delinquency amount on account of which a...

Perceptions of good and bad death among Korean social workers in elderly long-term care facilities.

PubMed

Kim, Eunkyung

2018-06-20

This qualitative study explored the perception of good and bad death among 15 social workers serving in elderly care facilities in Korea. A good death involved dying peacefully without much suffering, dying with family members present, death following a good life, and believing in a better afterlife. A bad death involved burdening children in the dying process, dying after extensive illness, dying isolated from family, and death from suicide. To ensure a good death and avoid a bad death for elders, social workers are encouraged to closely engage with not only elders but also their families.

Breaking bad news in spinal cord injury; a qualitative study assessing the perspective of spinal cord injury survivors in Turkey.

PubMed

Ozyemisci-Taskiran, Ozden; Coskun, Ozlem; Budakoglu, Isil Irem; Demirsoy, Nesrin

2018-05-01

Prior abstract publication: 2 nd Medical Rehabilitation Congress; Nov 4-7, 2010; Ankara, Turkey Objective: This study aims to investigate the process of breaking bad news from the perspective of spinal cord injury survivors. A cross sectional, qualitative study. Community. Fourteen spinal cord injury survivors. Subjects participated in a semi-structured interview about 'when', 'where' 'by whom' and 'how' they received and 'would' prefer to receive bad news. Answers to 'how' questions were coded according to SPIKES protocol (Setting, Perception, Invitation, Knowledge, Empathizing, Summary). Eight participants (57%) reported that they received bad news from a physician, mostly during rehabilitation. All would prefer to be informed by a physician and majority preferred to be gradually informed during rehabilitation. Half were not satisfied with the content of information. Only half felt that his/her physiatrist understood his/her emotional distress. Majority of participants who received bad news from physicians reported that the setting was private and their family members accompanied them. Most spinal cord injury survivors were unsatisfied with knowledge and emotional support provided by rehabilitation physicians. Participants would prefer to receive bad news by a senior physiatrist in a planned meeting during rehabilitation.

Is screening of TORCH worthwhile in women with bad obstetric history: an observation from eastern Nepal.

PubMed

Kumari, Namrata; Morris, Norman; Dutta, Renu

2011-02-01

This pilot case-control study at a tertiary-care hospital over a four-month period was aimed at evaluating the possible usefulness of screening of TORCH (Toxoplasma gondii, rubella virus, cytomegalovirus, and Herpes simplex virus) in females with bad obstetric history. The study included 12 women with bad obstetric history and a similar number of matched controls with previous normal pregnancies. A serological evaluation of TORCH infections was carried out by detecting IgG and IgM antibodies against these infections by ELISA test-kit. Statistical analysis was not done to compare the results relating to the two groups due to a small number of cases and controls included in the study. Ten (83.3%) of the 12 cases with bad obstetric history and two (16.7%) of the 12 healthy controls were serologically positive at least for one of the TORCH agents. The seropositivity rate in women with bad obstetric history was quite high compared to that in the normal healthy controls. The results suggest that a previous history of pregnancy wastage and the serological evaluation of TORCH infections during current pregnancy must be considered while managing cases with bad obstetric history.

Mood state dependency of dysfunctional attitudes in bipolar affective disorder.

PubMed

Babakhani, Anet; Startup, Mike

2012-01-01

Studies of cognitive styles among euthymic people with bipolar affective disorder (BAD) without use of mood induction techniques to access those cognitive styles give misleading impressions of normality of those cognitions. The aim of this study was to assess dysfunctional attitudes of participants with BAD, and control participants with no previous psychiatric histories, after mood inductions. Sad and happy moods were induced within 49 BAD and 37 controls. Dysfunctional attitudes were measured following mood inductions using the Dysfunctional Attitude Scale-short form (DAS-24), which has three subscales of achievement, interpersonal, and goal attainment. It was hypothesised that within BAD the sad mood induction would help in accessing dysfunctional attitudes in all three domains relative to the happy mood induction. This was supported. It was also hypothesised that the mood inductions would not affect dysfunctional attitudes within controls. This was supported. When diagnosis was entered as a between group variable, achievement dysfunctional attitudes were significantly higher in BAD compared to controls after a happy induction. Both sad and happy moods provoked higher levels of dysfunctional attitudes within BAD. Euphoria may be related to elevated achievement dysfunctional attitudes, raising risk for mania.

Good and Bad Sleep in Childhood: A Questionnaire Survey amongst School Children in Southern Italy

PubMed Central

Ficca, Gianluca; Conte, Francesca; De Padova, Vittoria; Zilli, Iole

2011-01-01

Despite its clinical importance, the issue of subjective sleep quality in children remains unexplored. Here we investigate, in school-aged children, the prevalence of bad sleep perception and its relationships with sleep habits and daytime functioning, to provide hints on its possible determinants. Subjective sleep perception, sleep habits, and daytime functioning were studied through a questionnaire survey in a sample of 482 children (6–12 yrs.). Being “bad sleeper” was reported by 6.9% of the sample. Compared to the “good sleepers”, these subjects displayed shorter sleep duration on schooldays, longer sleep latencies, and a more pronounced evening preference, beyond more frequent insufficient sleep. Though no differences emerged in sleepiness, bad sleepers showed higher impairments in daytime functioning, indicated by more frequent depressed mood and impulsivity. These distinctive features might be very important to precociously detect those children who are possibly more vulnerable to sleep disturbances and whose sleep-wake rhythms evolution should be paid particular attention thereafter. “The good people sleep much better at night than the bad people. Of course, the bad people enjoy the waking hours much more” Woody Allen PMID:23509633

P-1 truss moved to O&C Building

NASA Technical Reports Server (NTRS)

2000-01-01

Cranes place the P-1 truss, a component of the International Space Station, on a transport vehicle that will move it to the Operations and Checkout Building for processing. The truss had been temporarily stored in the RLV hangar in the background as a precaution against approaching bad weather. The P-1 truss, scheduled to fly in spring of 2002, is part of a total 10-truss, girder-like structure on the Station that will ultimately extend the length of a football field. Astronauts will attach the 14-by- 15 foot structure to the port side of the center truss, S0, during the spring assembly flight. The 33,000-pound P-1 will house the thermal radiator rotating joint (TRRJ) that will rotate the Station's radiators away from the sun to increase their maximum cooling efficiency.

The adverse effects of tobacco smoking on reproduction and health: a review from the literature.

PubMed

Tuormaa, T E

1995-01-01

This paper compromises a short literary review of the adverse consequences of tobacco smoking on reproduction, as well as on infant and adult health. Furthermore, attention is drawn to the bad effects of smoking on the nutritional status.

Role, perspective and knowledge of Iranian critical care nurses about breaking bad news.

PubMed

Imanipour, Masoomeh; Karim, Zahra; Bahrani, Naser

2016-05-01

Given the issue of caring critically ill patients, nurses are involved in the process of breaking bad news in critical care units, while little research has been conducted on this challenging issue. The purpose of this study was to determine the role, perspective and knowledge of Iranian critical care nurses regarding breaking bad news. This descriptive study was conducted on a sample of 160 nurses working in critical care units of hospitals affiliated to Tehran University of Medical Sciences. Stratified and quota sampling methods were used. The data collection tool was a four-part questionnaire with validity and reliability confirmed via content validity and test-retest, respectively. The study showed that most critical care nurses were involved in breaking bad news, with different roles. The majority of participants (91.2%) had a positive attitude towards involvement of nurses in breaking bad news. In this study, 78.8% of nurses had moderate knowledge about how to break bad news, and only a few had good level of knowledge (16.2%). According to the findings, while critical care nurses took different roles in the process of breaking bad news and they had positive attitude towards participation in this process, yet their knowledge about this process was inadequate. Thus, designing educational programmes to enhance critical care nurses' knowledge and skills in this area seems necessary. Copyright © 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Impact of functional status on 6-month mortality in elderly patients with acute venous thromboembolism: results from a prospective cohort.

PubMed

Gómez-Cuervo, Covadonga; Díaz-Pedroche, Carmen; Pérez-Jacoiste Asín, María Asunción; Lalueza, Antonio; Del Pozo, Roberto; Díaz-Simón, Raquel; Trapiello, Francisco; Paredes, Diana; Lumbreras, Carlos

2018-06-05

Functional status linked to a poor outcome in a broad spectrum of medical disorders. Barthel Activities of Daily Life Index (BADLI) is one of the most extended tools to quantify functional dependence. Whether BADLI can help to predict outcomes in elderly patients with acute venous thromboembolism (VTE) is unknown. The current study aimed to ascertain the influence of BADLI on 6-month all-cause mortality in aged patients with VTE. This is a prospective observational study. We included consecutive patients older than 75-year-old with an acute VTE between April 2015 and April 2017. We analyzed several variables as mortality predictors, including BADLI-measured functional status. Afterward, we performed a multivariate analysis, using logistic regression, to identify all-cause mortality independent predictive factors. Two hundred and two subjects were included. Thirty-five (17%) patients died in the first 6 months. The leading cause of death was cancer (59%). After multivariable logistic regression, we identified BADLI and Charlson index as independent predictors for 6-months mortality [BADLI (every decrease of 10 points) OR 1.21 95% CI (1.03-1.42) and Charlson index OR 1.71 95% CI (1.21-2.43)]. Body mass index (BMI) values were inversely related to mortality [OR 0.85 95% CI (0.75-0.95)]. In conclusion, BADLI, BMI, and Charlson index scores are independent predictive factors for 6-month all-cause mortality in old patients with VTE.

Efficacy of Ketamine in Improving Pain after Tonsillectomy in Children: Meta-Analysis

PubMed Central

Cho, Hye Kyung; Kim, Kyu Won; Jeong, Yeon Min; Lee, Ho Seok; Lee, Yeon Ji; Hwang, Se Hwan

2014-01-01

Background and objectives The goal of this meta-analysis study was to perform a systematic review of the literature on the effects of ketamine on postoperative pain following tonsillectomy and adverse effects in children. Subjects and Methods Two authors independently searched three databases (MEDLINE, SCOPUS, Cochrane) from their inception of article collection to February 2014. Studies that compared preoperative ketamine administration (ketamine groups) with no treatment (control group) or opioid administration (opioid group) where the outcomes of interest were postoperative pain intensity, rescue analgesic consumption, or adverse effects (sedation, nausea and vomiting, bad dream, worsening sleep pattern, and hallucination) 0–24 hours after leaving the operation room were included in the analysis. Results The pain score reported by the physician during first 4 hours and need for analgesics during 24 hours postoperatively was significantly decreased in the ketamine group versus control group and was similar with the opioid group. In addition, there was no significant difference between ketamine and control groups for adverse effects during 24 hours postoperatively. In the subgroup analyses (systemic and local administration) regarding pain related measurements, peritonsillar infiltration of ketamine was more effective in reducing the postoperative pain severity and need for analgesics. Conclusion Preoperative administration of ketamine systemically or locally could provide pain relief without side-effects in children undergoing tonsillectomy. However, considering the insufficient evaluation of efficacy of ketamine according to the administration methods and high heterogeneity in some parameters, further clinical trials with robust research methodology should be conducted to confirm the results of this study. PMID:24979227

Physiological and psychological effects of delivering medical news using a simulated physician-patient scenario.

PubMed

Cohen, Lorenzo; Baile, Walter F; Henninger, Evelyn; Agarwal, Sandeep K; Kudelka, Andrzej P; Lenzi, Renato; Sterner, Janet; Marshall, Gailen D

2003-10-01

We examined the acute stress response associated with having to deliver either bad or good medical news using a simulated physician-patient scenario. Twenty-five healthy medical students were randomly assigned to a bad medical news (BN), a good medical news (GN), or a control group that read magazines during the session. Self-report measures were obtained before and after the task. Blood pressure and heart rate were measured throughout the task period. Four blood samples were obtained across the task period. The BN and GN tasks produced significant increases in self-reported distress and cardiovascular responses compared with the control group. There was also a significant increase in natural killer cell function 10 min into the task in the BN group compared with the control group. The BN task was also somewhat more stressful than the GN task, as shown by the self-report and cardiovascular data. These findings suggest that a simulated physician-patient scenario produces an acute stress response in the "physician," with the delivery of bad medical news more stressful than the delivery of good medical news.

Toward the optimization of control of unsteady separation

NASA Technical Reports Server (NTRS)

Shen, S. F.; Xiao, Zheng-Hua

1992-01-01

Regardless of our understanding of the complicated physical process, means can always be found to alter the occurrence and development of unsteady separation. To be able to optimize the control of separation, however, requires the identification of the critical aspects to which the intervention may be focused and achieve the desired result with minimum waste of effort. The Lagrangian analysis of unsteady boundary-layer traces the trajectories of individual fluid particles and reveals the 'bad seeds' that, through extreme deformation in the direction normal to the wall, eventually develop into a virtual barrier and cause the ejection of boundary-layer material into the main stream. It follows logically that separation can be triggered or delayed most effectively by targeting these 'bad seeds.' Since they are normally interior points of the boundary layer, attempts to influence them through the boundary conditions are necessarily indirect. Furthermore, as the strategy has to be the modification of the growing process of the 'bad seeds,' whatever may be the intervention scheme, it needs to be strong enough and early enough. In Shen and Wu, examples of how acceleration/deceleration of the two dimensional body, as well as the moving wall of a rotating cylinder, may affect the development of the bad seed toward separation are shown. In fact it was mentioned therein that the results might be the first step for a feasibility study of the control of unsteady separation. Presented are additional results of applying suction to an impulsively started circular cylinder.

Inhibition of Bim Enhances Replication of Varicella-Zoster Virus and Delays Plaque Formation in Virus-Infected Cells

PubMed Central

Liu, XueQiao

2014-01-01

Programmed cell death (apoptosis) is an important host defense mechanism against intracellular pathogens, such as viruses. Accordingly, viruses have evolved multiple mechanisms to modulate apoptosis to enhance replication. Varicella-zoster virus (VZV) induces apoptosis in human fibroblasts and melanoma cells. We found that VZV triggered the phosphorylation of the proapoptotic proteins Bim and BAD but had little or no effect on other Bcl-2 family members. Since phosphorylation of Bim and BAD reduces their proapoptotic activity, this may prevent or delay apoptosis in VZV-infected cells. Phosphorylation of Bim but not BAD in VZV-infected cells was dependent on activation of the MEK/extracellular signal-regulated kinase (ERK) pathway. Cells knocked down for Bim showed delayed VZV plaque formation, resulting in longer survival of VZV-infected cells and increased replication of virus, compared with wild-type cells infected with virus. Conversely, overexpression of Bim resulted in earlier plaque formation, smaller plaques, reduced virus replication, and increased caspase 3 activity. Inhibition of caspase activity in VZV-infected cells overexpressing Bim restored levels of virus production similar to those seen with virus-infected wild-type cells. Previously we showed that VZV ORF12 activates ERK and inhibits apoptosis in virus-infected cells. Here we found that VZV ORF12 contributes to Bim and BAD phosphorylation. In summary, VZV triggers Bim phosphorylation; reduction of Bim levels results in longer survival of VZV-infected cells and increased VZV replication. PMID:24227856

Developing Guidelines for Disclosure or Non-Disclosure of Bad News around Life-Limiting Illness and Death to People with Intellectual Disabilities

ERIC Educational Resources Information Center

Tuffrey-Wijne, Irene; Giatras, Nikoletta; Butler, Gary; Cresswell, Amanda; Manners, Paula; Bernal, Jane

2013-01-01

Background: There is insufficient evidence to guide decisions around (non-)disclosure of bad news of life-limiting illness and death to people with intellectual disabilities. Aim: The aim of this study was to develop guidelines for decisions about (non-)disclosure of bad news around life-limiting illness and death to people with intellectual…

Good Teachers (the Movie You Will Never See)

ERIC Educational Resources Information Center

Gillard, Colleen

2012-01-01

It began with a trip to the cinema to see Cameron Diaz in her new comedy, "Bad Teacher." It was a bad choice. Not a great flick, but as a parody of bad employees, in terms of things that can get one fired--drugs, alcohol , cheating, foul language, inappropriate sexual behavior--Diaz slams pedal to the metal. She nips out of airline booze bottles…

Epinephrine-Induced and Antiapoptotic Signaling in Prostate Cancer

DTIC Science & Technology

2009-05-01

Phosphorylation of ectopically expressed HA-BAD mirrors endogenous BAD phosphorylation, thus analysis of HA-BAD allows adequately interpret modifications...subjected to emotional stress (Fig.2 A). However, more extensive analysis of CREB phosphorylation in C42Luc xenografts showed that in some cases...data indicate that assignment of tumor samples for analysis of signaling pathways should be done based on blood epinephrine measurements. Given

Reconsiderations: We Got the Wrong Gal--Rethinking the "Bad" Academic Writing of Judith Butler

ERIC Educational Resources Information Center

Birkenstein, Cathy

2010-01-01

It is hard to think of a writer whose work has been more prominently upheld as an example of bad academic writing than the philosopher and literary theorist Judith Butler. In 1998, Butler was awarded first prize in the annual Bad Writing Contest established by the journal "Philosophy and Literature," and early in 1999, was lampooned in an…

Sage on the Stage: Is Lecturing Really All that Bad?

ERIC Educational Resources Information Center

Schwerdt, Guido; Wuppermann, Amelie C.

2011-01-01

In recent years, a consensus has emerged among researchers that teacher quality matters enormously for student performance. Students taught by more-effective teachers learn substantially more over the course of the year than students taught by less-effective teachers. Yet little is known about what makes for a more-effective teacher. Most research…

Genuine Progress, Greater Challenges: A Decade of Teacher Effectiveness Reforms

ERIC Educational Resources Information Center

Rotherham, Andrew J.; Mitchel, Ashley LiBetti

2014-01-01

For years, the debate about American education was like a bad marriage. The arguments were about everything but the core issue--instructional quality. The other issues--education finance, school choice, standards--all matter, but are secondary to the importance of effective instruction. In the labor-intensive education field, effective instruction…

The effect of chronic progressive-dose sodium bicarbonate ingestion on CrossFit-like performance: A double-blind, randomized cross-over trial.

PubMed

Durkalec-Michalski, Krzysztof; Zawieja, Emilia E; Podgórski, Tomasz; Łoniewski, Igor; Zawieja, Bogna E; Warzybok, Marta; Jeszka, Jan

2018-01-01

Sodium bicarbonate (SB) has been proposed as an ergogenic aid, as it improves high-intensity and resistance exercise performance. However, no studies have yet investigated SB application in CrossFit. This study examined the effects of chronic, progressive-dose SB ingestion on CrossFit-like performance and aerobic capacity. In a randomized, double-blind, cross-over trial, 21 CrossFit-trained participants were randomly allocated to 2 groups and underwent 2 trials separated by a 14-day washout period. Participants ingested either up to 150 mg∙kg-1 of SB in a progressive-dose regimen or placebo for 10 days. Before and after each trial, Fight Gone Bad (FGB) and incremental cycling (ICT) tests were performed. In order to examine biochemical responses, blood samples were obtained prior to and 3 min after completing each exercise test. No gastrointestinal (GI) side effects were reported during the entire protocol. The overall FGB performance improved under SB by ~6.1% (p<0.001) and it was ~3.1% higher compared to post placebo (PLApost) (p = 0.040). The number of repetitions completed in each round also improved under SB (mean from baseline: +5.8% to +6.4%). Moreover, in ICT, the time to ventilatory threshold (VT) (~8:25 min SBpost vs. ~8:00 min PLApost, p = 0.020), workload at VT (~218 W SBpost vs. ~208 W PLApost, p = 0.037) and heart rate at VT (~165 bpm SBpost vs. ~161 bpm PLApost, p = 0.030) showed higher SBpost than PLApost. Furthermore, the maximum carbon dioxide production increased under SB by ~4.8% (from ~3604 mL∙min-1 to ~3776 mL∙min-1, p = 0.049). Pyruvate concentration and creatine kinase activity before ICT showed higher SBpost than PLApost (~0.32 mmol∙L-1 vs. ~0.26 mmol∙L-1, p = 0.001; ~275 U∙L-1 vs. ~250 U∙L-1, p = 0.010, respectively). However, the small sample size limits the wide-application of our results. Progressive-dose SB ingestion regimen eliminated GI side effects and improved CrossFit-like performance, as well as delayed ventilatory threshold occurrence.

Feedback Valence Affects Auditory Perceptual Learning Independently of Feedback Probability

PubMed Central

Amitay, Sygal; Moore, David R.; Molloy, Katharine; Halliday, Lorna F.

2015-01-01

Previous studies have suggested that negative feedback is more effective in driving learning than positive feedback. We investigated the effect on learning of providing varying amounts of negative and positive feedback while listeners attempted to discriminate between three identical tones; an impossible task that nevertheless produces robust learning. Four feedback conditions were compared during training: 90% positive feedback or 10% negative feedback informed the participants that they were doing equally well, while 10% positive or 90% negative feedback informed them they were doing equally badly. In all conditions the feedback was random in relation to the listeners’ responses (because the task was to discriminate three identical tones), yet both the valence (negative vs. positive) and the probability of feedback (10% vs. 90%) affected learning. Feedback that informed listeners they were doing badly resulted in better post-training performance than feedback that informed them they were doing well, independent of valence. In addition, positive feedback during training resulted in better post-training performance than negative feedback, but only positive feedback indicating listeners were doing badly on the task resulted in learning. As we have previously speculated, feedback that better reflected the difficulty of the task was more effective in driving learning than feedback that suggested performance was better than it should have been given perceived task difficulty. But contrary to expectations, positive feedback was more effective than negative feedback in driving learning. Feedback thus had two separable effects on learning: feedback valence affected motivation on a subjectively difficult task, and learning occurred only when feedback probability reflected the subjective difficulty. To optimize learning, training programs need to take into consideration both feedback valence and probability. PMID:25946173

[Relief of upper urinary tract obstruction in patients with cancer of the prostate].

PubMed

Kraemer, Pia Charlotte; Borre, Michael

2009-03-09

Hydronephrosis in patients with prostate cancer can be relieved by nephrostomia or internal urinary diversion by a double-J ureteral stent. The latter can be placed either retrograde or antegrade by means of an already established nephrostomy. The purpose of the present study was to summarize the use of the different kinds of catheters and to explore differences in use and functional durability. Furthermore, the number of days of hospitalization was recorded. We retrospectively reviewed 51 journals from prostate cancer patients who had undergone external and/or internal relief during the 10-year period from 1997-2007. All patients were admitted to Aarhus University Hospital, Skejby, Denmark. A total of 237 procedures were performed. In the acute situation, the patient typically underwent external catheter relief with either one-sided or - more frequently - two-sided nephrostomy. At the time of death three out of four patients had nephrostomies as well. Most patients underwent internal stent relief in the period from first relief by nephrostomy to the time of death (median: seven months). The number of catheter-related infections was lower than expected. Double-J urethral stents lasted longer than nephrostomies, but half of those relieved by internal stents only survived one or two catheter replacements before dying. Malignant extrinsic ureteral obstruction in prostate cancer patients is frequent and both types of relief are safe and efficient. Nephrostomies should be preferred in patients who are in bad health or infected while double-J stents - especially antegrade - should be offered to healthier or stronger patients. Successful placement and positive effect of a double-J stent is furthermore dependent on well-functioning kidneys and bladder.

Mast cells and IgE in defense against venoms: Possible "good side" of allergy?

PubMed

Galli, Stephen J; Starkl, Philipp; Marichal, Thomas; Tsai, Mindy

2016-01-01

Physicians think of mast cells and IgE primarily in the context of allergic disorders, including fatal anaphylaxis. This 'bad side' of mast cells and IgE is so well accepted that it can be difficult to think of them in other contexts, particularly those in which they may have beneficial functions. However, there is evidence that mast cells and IgE, as well as basophils (circulating granulocytes whose functions partially overlap with those of mast cells), can contribute to host defense as components of adaptive type 2 immune responses to helminths, ticks and certain other parasites. Accordingly, allergies often are conceptualized as "misdirected" type 2 immune responses, in which IgE antibodies are produced against any of a diverse group of apparently harmless antigens, as well as against components of animal venoms. Indeed, certain unfortunate patients who have become sensitized to venoms develop severe IgE-associated allergic reactions, including fatal anaphylaxis, upon subsequent venom exposure. In this review, we will describe evidence that mast cells can enhance innate resistance to reptile or arthropod venoms during a first exposure to such venoms. We also will discuss findings indicating that, in mice which survive an initial encounter with venom, acquired type 2 immune responses, IgE antibodies, the high affinity IgE receptor (FcɛRI), and mast cells can contribute to acquired resistance to the lethal effects of both honeybee venom and Russell's viper venom. These findings support the hypothesis that mast cells and IgE can help protect the host against venoms and perhaps other noxious substances. Copyright © 2015 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Patient satisfaction in Caucasian and Mediterranean open rhinoplasty using the tongue-in-groove technique: prospective statistical analysis of change in subjective body image in relation to nasal appearance following aesthetic rhinoplasty.

PubMed

Lohuis, Peter J F M; Datema, Frank R

2015-04-01

Tongue-in-groove (TIG) is a conservative but powerful surgical suture technique to control shape, rotation, and projection of the nasal tip. In this study, statistical analyses were performed to determine the aesthetical and functional effectiveness of TIG rhinoplasty. Prospective cohort study including 110 Caucasian or Mediterranean aesthetic rhinoplasty patients treated by one surgeon between 2007 and 2012, with a 1-year follow-up. Data were collected using the Utrecht Questionnaire, a validated instrument routinely offered to our patients before and 1 year after surgery. Aesthetic results were reflected by change in subjective body image in relation to nasal appearance, scored on five aesthetic questions and a 10-cm visual analog scale (VAS). Functional results were determined by change in subjective nasal airway patency, scored on a 10-cm VAS for both sides. The mean aesthetic sum score (5, low burden-25, high burden) significantly improved from 14.01 to 6.54 (P <.01). The mean aesthetic VAS score (0, very ugly-10, very nice) significantly improved from 3.35 to 7.78 (P < .01). The mean functional VAS score (0, very bad-10, very good) showed a small but significant improvement on both sides (left, 6.83-7.96; right, 6.88-7.80; P <.01). Statistical analysis of quantified subjective data on nasal aesthetics and function show that TIG is a reliable technique that can help to deliver consistently good results in Caucasian and Mediterranean patients seeking aesthetic rhinoplasty. A small additional functional improvement can be expected. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Biomarkers for bile acid diarrhoea in functional bowel disorder with diarrhoea: a systematic review and meta-analysis.

PubMed

Valentin, Nelson; Camilleri, Michael; Altayar, Osama; Vijayvargiya, Priya; Acosta, Andres; Nelson, Alfred D; Murad, M Hassan

2016-12-01

There is no universally available laboratory test to diagnose bile acid diarrhoea (BAD). To conduct a systematic review and meta-analysis to identify a biomarker for idiopathic BAD in patients with functional bowel disorder (FBD) with diarrhoea. We searched multiple databases through 15 May 2015. Data were only available to estimate the diagnostic yield of each test (the prevalence of a positive test). Estimates were pooled across studies using the random effects model. We included 36 studies, enrolling 5028 patients (24 using 75 selenium homotaurocholic acid test ( 75 SeHCAT) retention of <10%, 6 using fasting serum C4, 3 using fasting serum fibroblast growth factor 19 (FGF19) and 2 based on total faecal bile acid (BA) excretion over 48 h). The diagnostic yields (and 95% CI) of abnormal tests were: 0.308 (0.247 to 0.377) for 75 SeHCAT retention (<10%), 0.171 (0.134 to 0.217) for serum C4, 0.248 (0.147 to 0.385) for serum FGF19 and 0.255 (0.071 to 0.606) for total faecal BA excretion over 48 h. The majority of the analyses were associated with substantial heterogeneity. Performance characteristics relative to a gold standard test could not be estimated. Overall, the test with the highest diagnostic yield conducted in the largest number of studies was 75 SeHCAT retention, which is not widely available in many countries outside Europe and Canada. Using different diagnostic tests, 25% (average) of patients with lower FBD with diarrhoea has evidence of idiopathic BAD. These tests serve to identify idiopathic BAD among patients with FBD with diarrhoea. Further studies are required to appraise the performance characteristics of tests for idiopathic BAD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

SU-E-T-479: IMRT Plan Recalculation in Patient Based On Dynalog Data and the Effect of a Single Failing MLC Motor

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morcos, M; Mitrou, E

2015-06-15

Purpose: Using Linac dynamic logs (Dynalogs) we evaluate the impact of a single failing MLC motor on the deliverability of an IMRT plan by assessing the recalculated dose volume histograms (DVHs) taking the delivered MLC positions and beam hold-offs into consideration. Methods: This is a retrospective study based on a deteriorating MLC motor (leaf 36B) which was observed to be failing via Dynalog analysis. To investigate further, Eclipse-importable MLC files were generated from Dynalogs to recalculate the actual delivered dose and to assess the clinical impact through DVHs. All deliveries were performed on a Varian 21EX linear accelerator equipped withmore » Millennium-120 MLC. The analysis of Dynalog files and subsequent conversion to Eclipse-importable MLC files were all performed by in-house programming in Python. Effects on plan DVH are presented in the following section on a particular brain-IMRT plan which was delivered with a failing MLC motor which was then replaced. Results: Global max dose increased by 13.5%, max dose to the brainstem PRV increased by 8.2%, max dose to the optic chiasm increased by 7.6%, max dose to optic nerve increased by 8.8% and the mean dose to the PTV increased by 7.9% when comparing the original plan to the fraction with the failing MLC motor. The reason the dose increased was due to the failure being on the B-bank which is the lagging side on a sliding window delivery, therefore any failures on this side will cause an over-irradiation as the B-bank leaves struggles to keep the window from growing. Conclusion: Our findings suggest that a single failing MLC motor may jeopardize the entire delivery. This may be due to the bad MLC motor drawing too much current causing all MLCs on the same bank to underperform. This hypothesis will be investigated in a future study.« less

Mothers' Anxieties Versus the Effects of Long Distance Move on Children

ERIC Educational Resources Information Center

Barrett, Curtis L.; Noble, Helen

1973-01-01

Families moved long distances by a major interstate mover, reported on the effect of the moves on their 318 children using a questionnaire and the Louisville Behavior Check List (LBCL). No effect'' or a good'' effect of moving was reported for 81 per cent of the children. Parents with a bad'' attitude toward moving saw a negative effect on…

Future Directions in the Study of Close Relationships: Conflict is Bad (Except When It’s Not)

PubMed Central

Laursen, Brett; Hafen, Christopher

2009-01-01

Beneficial and detrimental correlates of interpersonal disagreement have been postulated and documented. The conclusion: Conflict is both bad and good. The evidence for these paradoxical effects is summarized. In this essay, we argue that the consequences of conflict for individuals depends on its frequency, the way in which it is managed, and the quality of the relationship in which it arises. Nonlinear patterns of association are hypothesized such that constructive conflicts, particularly those arising in supportive relationships, should (up to a limit) predict more beneficial and fewer detrimental outcomes. In contrast, coercive conflicts, particularly those arising in unsupportive relationships, should predict more adverse and fewer favorable outcomes. PMID:20953335

Sexual Violence, Bodily Pain, and Trauma: A History

PubMed Central

Bourke, Joanna

2014-01-01

Psychological trauma is a favoured trope of modernity. It has become commonplace to assume that all ‘bad events’ – and particularly those which involve violence – have a pathological effect on the sufferer’s psyche, as well as that of the perpetrators. This essay explores the ways victims of rape and sexual assault were understood in psychiatric, psychological, forensic, and legal texts in Britain and America from the 19th to the late 20th century. It argues that, unlike most other ‘bad events’, which were incorporated within trauma narratives from the 1860s, the ascription of psychological trauma was only applied to rape victims a century later. Why and what were the consequences? PMID:24790284

Breaking bad news: A communication competency for ophthalmology training programs.

PubMed

Hilkert, Sarah M; Cebulla, Colleen M; Jain, Shelly Gupta; Pfeil, Sheryl A; Benes, Susan C; Robbins, Shira L

As the ophthalmology accreditation system undergoes major changes, training programs must evaluate residents in the 6 core competencies, including appropriately communicating bad news. Although the literature is replete with recommendations for breaking bad news across various non-ophthalmology specialties, no formal training programs exist for ophthalmology. There are many valuable lessons to be learned from our colleagues regarding this important skill. We examine the historic basis for breaking bad news, explore current recommendations among other specialties, and then evaluate a pilot study in breaking bad news for ophthalmology residents. The results of this study are limited by a small number of residents at a single academic center. Future studies from multiple training programs should be conducted to further evaluate the need and efficacy of formal communication skills training in this area, as well as the generalizability of our pilot training program. If validated, this work could serve as a template for future ophthalmology resident training and evaluation in this core competency. Copyright © 2016 Elsevier Inc. All rights reserved.

Breaking bad news: a communication competency for ophthalmology training programs

PubMed Central

Hilkert, Sarah M.; Cebulla, Colleen M.; Jain, Shelly Gupta; Pfeil, Sheryl A.; Benes, Susan C.; Robbins, Shira L.

2016-01-01

As the ophthalmology accreditation system undergoes major changes, training programs must evaluate residents in the 6 core competencies, including appropriately communicating bad news. Although the literature is replete with recommendations for breaking bad news across various non-ophthalmology specialties, no formal training programs exist for ophthalmology. There are many valuable lessons to be learned from our non-ophthalmology colleagues regarding this important skill. We examine the historic basis for breaking bad news, explores current recommendations among other specialties, and then evaluate a pilot study to teach breaking bad news to ophthalmology residents. The results of this study are limited by a small number of residents at a single academic center. Future studies from multiple training programs should be conducted to further evaluate the need and efficacy of formal communication skills training in this area, as well as the generalizability of our pilot training program. If validated, this work could serve as a template for future ophthalmology resident training and evaluation in this core competency. PMID:27134009

Association of Pro-apoptotic Bad Gene Expression Changes with Benign Thyroid Nodules.

PubMed

Gül, Nurdan; Temel, Berna; Ustek, Duran; Sirma-Ekmekçi, Sema; Kapran, Yersu; Tunca, Fatih; Giles-Şenyürek, Yasemin; Özbek, Uğur; Alagöl, Faruk

2018-01-01

This study aimed to investigate the role of the mitochondrial apoptotic pathway in benign thyroid nodules. Paired samples of nodular and normal tissues were collected from 26 patients with nodular goiters undergoing thyroidectomy. Variable expression of Bcl-2, Bax and Bad genes were evaluated by quantitative PCR. Expression level of Bad gene in nodules was found to be significantly decreased compared to normal tissues (p=0.049). A positive correlation was observed between nodule size and Bad expression levels (correlation coefficient=0.563, p=0.004); and this correlation was stronger in hot nodules (n=18, correlation coefficient=0.689, p=0.003). No significant difference was observed between nodular and normal tissue expressions of Bax and Bcl-2. These results suggest that Bad expression correlates with the size of benign thyroid nodules and also its relatively lower expression in nodules, warrant further investigation. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Reactionary responses to the Bad Lot Objection.

PubMed

Dellsén, Finnur

2017-02-01

As it is standardly conceived, Inference to the Best Explanation (IBE) is a form of ampliative inference in which one infers a hypothesis because it provides a better potential explanation of one's evidence than any other available, competing explanatory hypothesis. Bas van Fraassen famously objected to IBE thus formulated that we may have no reason to think that any of the available, competing explanatory hypotheses are true. While revisionary responses to the Bad Lot Objection concede that IBE needs to be reformulated in light of this problem, reactionary responses argue that the Bad Lot Objection is fallacious, incoherent, or misguided. This paper shows that the most influential reactionary responses to the Bad Lot Objection do nothing to undermine the original objection. This strongly suggests that proponents of IBE should focus their efforts on revisionary responses, i.e. on finding a more sophisticated characterization of IBE for which the Bad Lot Objection loses its bite. Copyright © 2017 Elsevier Ltd. All rights reserved.

Is Waiting the Hardest Part? Comparing the Emotional Experiences of Awaiting and Receiving Bad News.

PubMed

Sweeny, Kate; Falkenstein, Angelica

2015-11-01

Awaiting uncertain news is stressful, but is it more stressful than receiving bad news? We compared these emotional experiences in two studies. Participants in Study 1 reflected on a personal experience awaiting news that ultimately turned out badly, and participants in Study 2 were law graduates awaiting their results on the bar exam who ultimately failed the exam. In Study 1, participants were ambivalent as to whether awaiting or receiving bad news was more difficult, and emotion ratings in both studies confirmed this ambivalence. Anxiety was higher in anticipation of bad news (at least at the moment of truth) than in the face of it, whereas other negative emotions were more intense following the news than during the waiting period. Thus, whether waiting is "the hardest part" depends on whether one prefers to be racked with anxiety or afflicted with other negative emotions such as anger, disappointment, depression, and regret. © 2015 by the Society for Personality and Social Psychology, Inc.

Do People Prefer to Pass Along Good or Bad News? Valence and Relevance of News as Predictors of Transmission Propensity

PubMed

Heath

1996-11-01

Anecdotal evidence seems to indicate that exaggeratedly bad news may propagate in the marketplace of ideas. Three studies investigate whether people prefer to pass along pieces of bad news or good news that are equated for "surprisingness." People typically prefer to pass along central rather than extreme information (i.e., news that is less surprising rather than more surprising). However, when confronted with extreme information, the results support a preference for congruence, that is, people prefer to pass along news that is congruent with the emotional valence of the domain in question. This means that in emotionally negative domains, contrary to some theoretical predictions, people are willing to pass along bad news even when it is exaggeratedly bad. At the same time, however, people transmit exaggeratedly good news in emotionally positive domains. The general discussion indicates how these results may inform research on word of mouth for consumer products and social relations in organizations.

Automatic tracking of wake vortices using ground-wind sensor data

DOT National Transportation Integrated Search

1977-01-03

Algorithms for automatic tracking of wake vortices using ground-wind anemometer : data are developed. Methods of bad-data suppression, track initiation, and : track termination are included. An effective sensor-failure detection-and identification : ...

Aggressive Behavior

MedlinePlus

... be outlined. Not all methods work on all children, so there will be a certain amount of trial and reassessment. Once several effective ways are found to reward good behavior and discourage bad, they can be used in establishing an approach ...

Side-effects of a bad attitude: How GNSS spacecraft orientation errors affect solar radiation pressure modelling

NASA Astrophysics Data System (ADS)

Dilssner, Florian; Springer, Tim; Schönemann, Erik; Zandbergen, Rene; Enderle, Werner

2015-04-01

Solar radiation pressure (SRP) is the largest non-gravitational perturbation for Global Navigation Satellite System (GNSS) satellites, and can therefore have substantial impact on their orbital dynamics. Various SRP force models have been developed over the past 30 years for the purpose of precise orbit determination. They all rely upon the assumption that the satellites continuously maintain a Sun-Nadir pointing attitude with the navigation antenna boresight (body-fixed z-axis) pointing towards Earth center, and the solar panel rotation axis (body-fixed y-axis) being normal to the Sun direction. However, in reality, this is not perfectly the case. Reasons for a non-nominal spacecraft attitude may be eclipse maneuvers, commanded attitude biases and Sun/horizon sensor measurement errors, for example due to mounting misalignment or incorrectly calibrated sensor electronics. In this work the effect of GNSS spacecraft orientation errors on SRP modelling is investigated. Simplified mathematical functions describing the SRP force acting on the solar arrays in the presence of yaw-, pitch- and roll-biases are derived. Special attention is paid to the yaw-bias and its relationship to the SRP dynamics, particular in direction of the spacecraft y-axis ("y-bias force"). Analytical and experimental results gathered from orbit and attitude analyses of GPS Block II/IIA/IIF satellites demonstrate how sensitive the SRP coefficients are to changes in yaw.

To be seen, confirmed and involved - a ten year follow-up of perceived health and cardiovascular risk factors in a Swedish community intervention programme

PubMed Central

Emmelin, Maria; Weinehall, Lars; Stenlund, Hans; Wall, Stig; Dahlgren, Lars

2007-01-01

Background Public health interventions are directed towards social systems and it is difficult to foresee all consequences. While targeted outcomes may be positively influenced, interventions may at worst be counterproductive. To include self-reported health in an evaluation is one way of addressing possible side-effects. This study is based on a 10 year follow-up of a cardiovascular community intervention programme in northern Sweden. Methods Both quantitative and qualitative approaches were used to address the interaction between changes in self-rated health and risk factor load. Qualitative interviews contributed to an analysis of how the outcome was influenced by health related norms and attitudes. Results Most people maintained a low risk factor load and a positive perception of health. However, more people improved than deteriorated their situation regarding both perceived health and risk factor load. "Ideal types" of attitude sets towards the programme, generated from the interviews, helped to interpret an observed polarisation for men and the lower educated. Conclusion Our observation of a socially and gender differentiated intervention effect suggests a need to test new intervention strategies. Future community interventions may benefit from targeting more directly those who in combination with high risk factor load perceive their health as bad and to make all participants feel seen, confirmed and involved. PMID:17672911

Disclosing bad news to patients with life-threatening illness: differences in attitude between physicians and nurses in Israel.

PubMed

Ben Natan, Merav; Shahar, Irit; Garfinkel, Doron

2009-06-01

Scant attention has been paid to the decision-making process of caregivers in disclosing bad news to patients. The purpose of this study was to describe factors influencing this process and to ascertain whether physicians and nurses behave differently, based on Ajzen and Fishbein's (1980) theory of reasoned action (TRA). In this correlational quantitative research study, a validated anonymous questionnaire was administered to a convenience sample comprising 100 physicians and 200 nurses employed in several Israeli hospitals. The results indicate that only around 30% of physicians always disclosed bad news in the past, and that future decisions would be made on an individual basis. In contrast, more than 76% of nurses said that they would disclose bad news to their patients in the future. Caregivers find it difficult to disclose terminal status information to all types of patients, although most find it relatively easier in the elderly. TRA may help to predict disclosure of bad news by physicians and nurses. Behavioural beliefs, subjective attitudes and prior clinical experience with disclosure of bad news were the main factors influencing caregivers' disclosure. The main predictors among nurses were behavioural beliefs and prior experience, and among physicians were subjective norms and prior experience.

Breaking bad news: doctors' skills in communicating with patients.

PubMed

Ferreira da Silveira, Francisco José; Botelho, Camila Carvalho; Valadão, Carolina Cirino

2017-01-01

Breaking bad news is one of doctors' duties and it requires them to have some skills, given that this situation is difficult and distressful for patients and their families. Moreover, it is also an uncomfortable condition for doctors. The aim of this study was to evaluate doctors' capacity to break bad news, ascertain which specialties are best prepared for doing this and assess the importance of including this topic within undergraduate courses. Observational cross-sectional quantitative study conducted at a university hospital in Belo Horizonte (MG), Brazil. This study used a questionnaire based on the SPIKES protocol, which was answered by 121 doctors at this university hospital. This questionnaire investigated their attitudes, posture, behavior and fears relating to breaking bad news. The majority of the doctors did not have problems regarding the concept of bad news. Nevertheless, their abilities diverged depending on the stage of the protocol and on their specialty and length of time since graduation. Generally, doctors who had graduated more than ten years before this survey felt more comfortable and confident, and thus transmitted the bad news in a better conducted manner. Much needs to be improved regarding this technique. Therefore, inclusion of this topic in undergraduate courses is necessary and proposals should be put forward and verified.

Fracture patterns after bilateral sagittal split osteotomy of the mandibular ramus according to the Obwegeser/Dal Pont and Hunsuck/Epker modifications.

PubMed

Möhlhenrich, Stephan Christian; Kniha, Kristian; Peters, Florian; Ayoub, Nassim; Goloborodko, Evgeny; Hölzle, Frank; Fritz, Ulrike; Modabber, Ali

2017-05-01

The aim of this study was to compare the fracture patterns after sagittal split osteotomy according to Obwegeser/Dal Pont (ODP) and Hunsuck/Epker (HE), as well as to investigate the relationship between lateral bone cut ending or angle and the incidence of unfavorable/bad splits. Postoperative cone-beam computed tomograms of 124 splits according to ODP and 60 according to HE were analyzed. ODP led to 75.8% and HE led to 60% lingual fractures with mandibular foramen contact. Horizontal fractures were found in 9.7% and 6.7%, respectively, and unfavorable/bad splits were found in 11.3% and 10%, respectively. The lateral osteotomy angle was 106.22° (SD 12.03)° for bad splits and 106.6° (SD 13.12)° for favorable splits. Correlations were found between favorable fracture patterns and split modifications and between buccal ending of the lateral bone cut and bad splits (p < 0.001). No relationship was observed between split modifications (p = 0.792) or the osteotomy angle (p = 0.937) and the incidence of unfavorable/bad splits. Split modifications had no influence on the incidence of unfavorable/bad splits, but the buccal ending of the lateral bone cut did have an influence. More lingual fractures with mandibular foramen contact are expected with the ODP modification. The osteotomy angle did not differ between favorable and bad splits. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Longitudinal study of bad dreams in preschool-aged children: prevalence, demographic correlates, risk and protective factors.

PubMed

Simard, Valérie; Nielsen, Tore A; Tremblay, Richard E; Boivin, Michel; Montplaisir, Jacques Y

2008-01-01

To (1) clarify the epidemiology of bad dreams in children and investigate risk and protective factors related to (2) the child's sleep, (3) parental sleep-enabling practices, and (4) the child's temperament. Longitudinal with 6 time points from 5 months to 6 years. Subjects' homes. Representative sample of 987 children in the Province of Quebec. None. Longitudinal logistic regression analysis models with primary endpoints of presence or absence of parent-rated bad dreams at 29 months, 41 months, 50 months, 5 years, and 6 years and predictor variables of demographic characteristics, parent ratings of child's sleep characteristics, parental sleep-enabling practices (e.g., cosleeping), and child's psychological characteristics at 5 and 17 months (anxiousness, temperament). Mothers' ratings indicated lower than expected prevalence of frequent bad dreams (1.3% to 3.9%). Demographic correlates of bad dreams were high family income, absence of siblings at 29 months, and a non-immigrant mother. The best predictor at 41 and 50 months was the presence of bad dreams the preceding year, whereas at 5 and 6 years, it was their earlier presence at 29 months. Early protective factors were parental practices favoring emotional nurturance after night awakenings (29 and 41 months); early risk factors were sleep-onset emotional nurturance (29 months), difficult temperament (5 months), and anxiousness (17 months). Bad dreams in preschoolers are less prevalent than thought but, when present, are trait-like in nature and associated with personality characteristics measured as early as 5 months. A stress-diathesis model may best account for the observed pattern of predictive factors.

Evaluation of Mandibular Anatomy Associated With Bad Splits in Sagittal Split Ramus Osteotomy of Mandible.

PubMed

Wang, Tongyue; Han, Jeong Joon; Oh, Hee-Kyun; Park, Hong-Ju; Jung, Seunggon; Park, Yeong-Joon; Kook, Min-Suk

2016-07-01

This study aimed to identify risk factors associated with bad splits during sagittal split ramus osteotomy by using three-dimensional computed tomography. This study included 8 bad splits and 47 normal patients without bad splits. Mandibular anatomic parameters related to osteotomy line were measured. These included anteroposterior width of the ramus at level of lingula, distance between external oblique ridge and lingula, distance between sigmoid notch and inferior border of mandible, mandibular angle, distance between inferior outer surface of mandibular canal and inferior border of mandible under distal root of second molar (MCEM), buccolingual thickness of the ramus at level of lingula, and buccolingual thickness of the area just distal to first molar (BTM1) and second molar (BTM2). The incidence of bad splits in 625 sagittal split osteotomies was 1.28%. Compared with normal group, bad split group exhibited significantly thinner BTM2 and shorter sigmoid notch and inferior border of mandible (P <0.05). However, for BTM1 and buccolingual thickness of the ramus at level of lingula, there was no statistical difference between the 2 groups. Mandibular angle, anteroposterior width of the ramus at level of lingula, external oblique ridge and lingula, and MCEM were not significantly different between the groups. This study suggests that patients with shorter ramus and low thickness of the buccolingual alveolar region distal to the second molar had a higher risk of bad splits. These anatomic data may help surgeons to choose the safest surgical techniques and best osteotomy sites.

Are we there yet? The state of the evidence base for guidelines on breaking bad news to cancer patients.

PubMed

Paul, C L; Clinton-McHarg, T; Sanson-Fisher, R W; Douglas, H; Webb, G

2009-11-01

The way clinicians break bad news to cancer patients has been retrospectively associated with poor psychosocial outcomes for patients. Education and practice in breaking bad news may be ineffective for improving patients' well-being unless it is informed by a sound evidence base. In the health field, research efforts are expected to advance evidence over time to inform evidence-based practice. Key characteristics of an advancing evidence base are a predominance of new data, and rigorous intervention studies which prospectively demonstrate improved outcomes. This review aimed to examine the progress of the evidence base in breaking bad news to cancer patients. Manual and computer-based searches (Medline and PsycINFO) were performed to identify publications on the topic of breaking bad news to cancer patients published between January 1995 and March 2009. Relevant publications were coded in terms of whether they provided new data, examined psychosocial outcomes for patients or tested intervention strategies and whether intervention studies met criteria for design rigour. Of the 245 relevant publications, 55.5% provided new data and 16.7% were intervention studies. Much of the intervention effort was directed towards improving provider skills rather than patient outcomes (9.8% of studies). Less than 2% of publications were rigorous intervention studies which addressed psychosocial outcomes for patients. Rigorous intervention studies which evaluate strategies for improving psychosocial outcomes in relation to breaking bad news to cancer patients are needed. Current practice and training regarding breaking bad news cannot be regarded as evidence-based until further research is completed.

Attempts to avoid NEPA: Is it bad faith?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tuckfield, D.J.

1995-12-01

The National Environmental Policy Act (NEPA) imposes procedural requirements on federal agencies that undertake {open_quotes}major Federal actions significantly affecting the quality of the human environment.{close_quotes} Determining whether a project is a major federal action, subject to NEPA, is not always an easy task. When a determination is made that a project is not subject to NEPA, opponents of the project and environmental organizations occasionally cry foul. Often there are allegations that the federal agency of the project proponent (or both) acted in bad faith to avoid NEPA. The question of whether bad faith is relevant in NEPA inquiries has beenmore » the subject litigation for many of years. In that time, courts have addressed a number of bad faith questions. A common question is whether it is appropriate for a non-federal project proponent to structure a project to maintain eligibility for federal funding, but at the last minute withdraw the project from eligibility for the sole purpose of avoiding NEPA. More difficult questions arise when the federal government allocates some federal money to the project for preliminary design work before the project is withdrawn from eligibility for additional federal construction funds. Still other questions arise with respect to whether project proponents must reimburse the federal government for funds allocated to a project before the determination is made that it will not be a federal project. This paper will trace the evolution of the courts` struggle with bad faith NEPA claims. It will then show how courts have recently begun to develop a workable and appropriate test for determining when bad faith is an issue in NEPA litigation. This issue is important for project proponents and federal agency officials so they will not unwittingly take steps others might construe as bad faith. It is important for members of environmental organizations so they may recognize and properly assert bad faith claims when appropriate.« less

Interrater Reliability and Diagnostic Performance of Subjective Evaluation of Sublingual Microcirculation Images by Physicians and Nurses: A Multicenter Observational Study.

PubMed

Lima, Alexandre; López, Alejandra; van Genderen, Michel E; Hurtado, Francisco Javier; Angulo, Martin; Grignola, Juan C; Shono, Atsuko; van Bommel, Jasper

2015-09-01

This was a cross-sectional multicenter study to investigate the ability of physicians and nurses from three different countries to subjectively evaluate sublingual microcirculation images and thereby discriminate normal from abnormal sublingual microcirculation based on flow and density abnormalities. Forty-five physicians and 61 nurses (mean age, 36 ± 10 years; 44 males) from three different centers in The Netherlands (n = 61), Uruguay (n = 12), and Japan (n = 33) were asked to subjectively evaluate a sample of 15 microcirculation videos randomly selected from an experimental model of endotoxic shock in pigs. All videos were first analyzed offline using the A.V.A. software by an independent, experienced investigator and were categorized as good, bad, or very bad microcirculation based on the microvascular flow index, perfused capillary density, and proportion of perfused capillaries. Then, the videos were randomly assigned to the examiners, who were instructed to subjectively categorize each image as good, bad, or very bad. An interrater analysis was performed, and sensitivity and specificity tests were calculated to evaluate the proportion of A.V.A. score abnormalities that the examiners correctly identified. The κ statistics indicated moderate agreement in the evaluation of microcirculation abnormalities using three categories, i.e., good, bad, or very bad (κ = 0.48), and substantial agreement using two categories, i.e., normal (good) and abnormal (bad or very bad) (κ = 0.66). There was no significant difference between the κ three and κ two statistics. We found that the examiner's subjective evaluations had good diagnostic performance and were highly sensitive (84%; 95% confidence interval, 81%-86%) and specific (87%; 95% confidence interval, 84%-90%) for sublingual microcirculatory abnormalities as assessed using the A.V.A. software. The subjective evaluations of sublingual microcirculation by physicians and nurses agreed well with a conventional offline analysis and were highly sensitive and specific for sublingual microcirculatory abnormalities.

Longitudinal Study of Bad Dreams in Preschool-Aged Children: Prevalence, Demographic Correlates, Risk and Protective Factors

PubMed Central

Simard, Valérie; Nielsen, Tore A.; Tremblay, Richard E.; Boivin, Michel; Montplaisir, Jacques Y.

2008-01-01

Study objectives: To (1) clarify the epidemiology of bad dreams in children and investigate risk and protective factors related to (2) the child's sleep, (3) parental sleep-enabling practices, and (4) the child's temperament. Design: Longitudinal with 6 time points from 5 months to 6 years. Setting: Subjects' homes. Participants: Representative sample of 987 children in the Province of Quebec. Interventions: None. Measurements and Results: Longitudinal logistic regression analysis models with primary endpoints of presence or absence of parent-rated bad dreams at 29 months, 41 months, 50 months, 5 years, and 6 years and predictor variables of demographic characteristics, parent ratings of child's sleep characteristics, parental sleep-enabling practices (e.g., cosleeping), and child's psychological characteristics at 5 and 17 months (anxiousness, temperament). Mothers' ratings indicated lower than expected prevalence of frequent bad dreams (1.3% to 3.9%). Demographic correlates of bad dreams were high family income, absence of siblings at 29 months, and a non-immigrant mother. The best predictor at 41 and 50 months was the presence of bad dreams the preceding year, whereas at 5 and 6 years, it was their earlier presence at 29 months. Early protective factors were parental practices favoring emotional nurturance after night awakenings (29 and 41 months); early risk factors were sleep-onset emotional nurturance (29 months), difficult temperament (5 months), and anxiousness (17 months). Conclusions: Bad dreams in preschoolers are less prevalent than thought but, when present, are trait-like in nature and associated with personality characteristics measured as early as 5 months. A stress-diathesis model may best account for the observed pattern of predictive factors. Citation: Simard V; Nielsen TA; Tremblay RE; Boivin M; Montplaisir JY. Longitudinal study of bad dreams in preschool-aged children: prevalence, demographic correlates, risk and protective factors. SLEEP 2008;31(1):62-70. PMID:18220079

RNA-binding proteins with basic-acidic dipeptide (BAD) domains self-assemble and aggregate in Alzheimer's disease.

PubMed

Bishof, Isaac; Dammer, Eric B; Duong, Duc M; Kundinger, Sean; Gearing, Marla; Lah, James J; Levey, Allan I; Seyfried, Nicholas T

2018-05-25

U1 small nuclear ribonucleoprotein 70 kDa (U1-70K) and other RNA-binding proteins (RBPs) are mislocalized to cytoplasmic neurofibrillary tau aggregates in Alzheimer's disease (AD), yet the co-aggregation mechanisms are incompletely understood. U1-70K harbors two disordered low-complexity domains (LC1 and LC2) that are necessary for aggregation in AD brain extracts. The LC1 domain contains highly repetitive basic (R/K) and acidic (D/E) residues, referred to as a basic-acidic dipeptide (BAD) domain. We report here that this domain shares many of the properties of the Q/N-rich LC domains in RBPs that also aggregate in neurodegenerative disease. These properties included self-assembly into oligomers and localization to nuclear granules. Co-immunoprecipitations of recombinant U1-70K and deletions lacking the LC domain(s) followed by quantitative proteomic analyses were used to resolve functional classes of U1-70K-interacting proteins that depend on the BAD domain for their interaction. Within this interaction network, we identified a class of RBPs with BAD domains nearly identical to that found in U1-70K. Two members of this class, LUC7L3 and RBM25, required their respective BAD domains for reciprocal interactions with U1-70K and nuclear granule localization. Strikingly, a significant proportion of RBPs with BAD domains had elevated insolubility in the AD brain proteome. Furthermore, we show that the BAD domain of U1-70K can interact with tau from AD brains, but not from other tauopathies. These findings highlight a mechanistic role for BAD domains in stabilizing RBP interactions and in potentially mediating co-aggregation with pathological, AD-specific tau isoforms. Published under license by The American Society for Biochemistry and Molecular Biology, Inc.

Relationship between mandibular anatomy and the occurrence of a bad split upon sagittal split osteotomy.

PubMed

Aarabi, Mohammadali; Tabrizi, Reza; Hekmat, Mina; Shahidi, Shoaleh; Puzesh, Ayatollah

2014-12-01

A bad split is a troublesome complication of the sagittal split osteotomy (SSO). The aim of this study was to evaluate the relation between the occurrence of a bad split and mandibular anatomy in SSO using cone-beam computed tomography. The authors designed a cohort retrospective study. Forty-eight patients (96 SSO sites) were studied. The buccolingual thickness of the retromandibular area (BLR), the buccolingual thickness of the ramus at the level of the lingula (BLTR), the height of the mandible from the alveolar crest to the inferior border of the mandible, (ACIB), the distance between the sigmoid notch and the inferior border of the mandible (SIBM), and the anteroposterior width of the ramus (APWR) were measured. The independent t test was applied to compare anatomic measurements between the group with and the group without bad splits. The receiver operating characteristic (ROC) test was used to find a cutoff point in anatomic size for various parts of the mandible related to the occurrence of bad splits. The mean SIBM was 47.05±6.33 mm in group 1 (with bad splits) versus 40.66±2.44 mm in group 2 (without bad splits; P=.01). The mean BLTR was 5.74±1.11 mm in group 1 versus 3.19±0.55 mm in group 2 (P=.04). The mean BLR was 14.98±2.78 mm in group 1 versus 11.21±1.29 mm in group 2 (P=.001). No statistically significant difference was found for APWR and ACIB between the 2 groups. The ROC test showed cutoff points of 10.17 mm for BLR, 36.69 mm for SIBM, and 4.06 mm for BLTR. This study showed that certain mandibular anatomic differences can increase the risk of a bad split during SSO surgery. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Eggs: good or bad?

PubMed

Griffin, Bruce A

2016-08-01

Eggs have one of the lowest energy to nutrient density ratios of any food, and contain a quality of protein that is superior to beef steak and similar to dairy. From a nutritional perspective, this must qualify eggs as 'good'. The greater burden of proof has been to establish that eggs are not 'bad', by increasing awareness of the difference between dietary and blood cholesterol, and accumulating sufficient evidence to exonerate eggs from their associations with CVD and diabetes. After 60 years of research, a general consensus has now been reached that dietary cholesterol, chiefly from eggs, exerts a relatively small effect on serum LDL-cholesterol and CVD risk, in comparison with other diet and lifestyle factors. While dietary guidelines have been revised worldwide to reflect this view, associations between egg intake and the incidence of diabetes, and increased CVD risk in diabetes, prevail. These associations may be explained, in part, by residual confounding produced by other dietary components. The strength of evidence that links egg intake to increased CVD risk in diabetes is also complicated by variation in the response of serum LDL-cholesterol to eggs and dietary cholesterol in types 1 and 2 diabetes. On balance, the answer to the question as to whether eggs are 'bad', is probably 'no', but we do need to gain a better understanding of the effects of dietary cholesterol and its association with CVD risk in diabetes.

Breaking Bad News to Patients with Cancer: A Randomized Control Trial of a Brief Communication Skills Training Module Incorporating the Stories and Preferences of Actual Patients

PubMed Central

Gorniewicz, James; Floyd, Michael; Krishnan, Koyamangalath; Bishop, Thomas W.; Tudiver, Fred; Lang, Forrest

2017-01-01

Objective This study tested the effectiveness of a brief, learner-centered, breaking bad news (BBN) communication skills training module using objective evaluation measures. Methods This randomized control study (N=66) compared intervention and control groups of students (n=28) and residents' (n=38) objective structured clinical examination (OSCE) performance of communication skills using Common Ground Assessment and Breaking Bad News measures. Results Follow-up performance scores of intervention group students improved significantly regarding BBN (colon cancer (CC), p=.007, r=-.47; breast cancer (BC), p=.003, r=-.53), attention to patient responses after BBN (CC, p < .001, r=-.74; BC, p=.001, r=-.65), and addressing feelings (BC, p=.006, r=-.48). At CC follow-up assessment, performance scores of intervention group residents improved significantly regarding BBN (p=.004, r=-.43), communication related to emotions (p=.034, r=-.30), determining patient's readiness to proceed after BBN and communication preferences (p=.041, r=-.28), active listening (p=011, r=-.37), addressing feelings (p<.001, r=-.65), and global interview performance (p=.001, r=-.51). Conclusion This brief BBN training module is an effective method of improving BBN communication skills among medical students and residents. Practice Implications Implementation of this brief individualized training module within health education programs could lead to improved communication skills and patient care. PMID:27876220

Pulsed electromagnetic fields promote survival and neuronal differentiation of human BM-MSCs.

PubMed

Urnukhsaikhan, Enerelt; Cho, Hyunjin; Mishig-Ochir, Tsogbadrakh; Seo, Young-Kwon; Park, Jung-Kueg

2016-04-15

Pulsed electromagnetic fields (PEMF) are known to affect biological properties such as differentiation, regulation of transcription factor and cell proliferation. However, the cell-protective effect of PEMF exposure is largely unknown. The aim of this study is to understand the mechanisms underlying PEMF-mediated suppression of apoptosis and promotion of survival, including PEMF-induced neuronal differentiation. Treatment of induced human BM-MSCs with PEMF increased the expression of neural markers such as NF-L, NeuroD1 and Tau. Moreover, treatment of induced human BM-MSCs with PEMF greatly decreased cell death in a dose- and time-dependent manner. There is evidence that Akt and Ras are involved in neuronal survival and protection. Activation of Akt and Ras results in the regulation of survival proteins such as Bad and Bcl-xL. Thus, the Akt/Ras signaling pathway may be a desirable target for enhancing cell survival and treatment of neurological disease. Our analyses indicated that PEMF exposure dramatically increased the activity of Akt, Rsk, Creb, Erk, Bcl-xL and Bad via phosphorylation. PEMF-dependent cell protection was reversed by pretreatment with LY294002, a specific inhibitor of phosphatidylinositol 3-kinase (PI3K). Our data suggest that the PI3K/Akt/Bad signaling pathway may be a possible mechanism for the cell-protective effects of PEMF. Copyright © 2016 Elsevier Inc. All rights reserved.

Shine-Dalgarno sequence enhances the efficiency of lacZ repression by artificial anti-lac antisense RNAs in Escherichia coli.

PubMed

Stefan, Alessandra; Schwarz, Flavio; Bressanin, Daniela; Hochkoeppler, Alejandro

2010-11-01

Silencing of the lacZ gene in Escherichia coli was attempted by means of the expression of antisense RNAs (asRNAs) in vivo. A short fragment of lacZ was cloned into the pBAD expression vector, in reverse orientation, using the EcoRI and PstI restriction sites. This construct (pBAD-Zcal1) was used to transform E. coli cells, and the antisense transcription was induced simply by adding arabinose to the culture medium. We demonstrated that the Zcal1 asRNA effectively silenced lacZ using β-galactosidase activity determinations, SDS-PAGE, and Western blotting. Because the concentration of the lac mRNA was always high in cells that expressed Zcal1, we hypothesize that this antisense acts by inhibiting messenger translation. Similar analyses, performed with a series of site-specific Zcal1 mutants, showed that the Shine-Dalgarno sequence, which is conferred by the pBAD vector, is an essential requisite for silencing competence. Indeed, the presence of the intact Shine-Dalgarno sequence positively affects asRNA stability and, hence, silencing effectiveness. Our observations will contribute to the understanding of the main determinants of silencing as exerted by asRNAs as well as provide useful support for the design of robust and efficient prokaryotic gene silencers. Copyright © 2010 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

Teaching Effective Communication Skills with ACE: Analyzing, Composing, & Evaluating

ERIC Educational Resources Information Center

Snyder, Lisa Gueldenzoph; Shwom, Barbara

2011-01-01

Most business communication classes teach students to use a writing process to compose effective documents. Students practice the process by applying it to various types of writing with various purposes-reports, presentations, bad news letters, persuasive memos, etc. However, unless students practice that process in other contexts outside of the…

Listening Skills. Instructor/Lesson Guide.

ERIC Educational Resources Information Center

Decker, Carol; And Others

This instructor/lesson guide provides instructional materials for a 4-hour course in listening skills in the workplace. Stated objectives are to help students to become more effective listeners, to assist students in obtaining an understanding of how effective they are as listeners, and to assist students in identifying bad listening habits. Two…

Bad news: The influence of news coverage and Google searches on Gardasil adverse event reporting.

PubMed

Faasse, Kate; Porsius, Jarry T; Faasse, Jonathan; Martin, Leslie R

2017-12-14

Human papilloma virus vaccines are a safe and effective tool for reducing HPV infections that can cause cervical cancer. However, uptake of these vaccines has been suboptimal, with many people holding negative beliefs and misconceptions. Such beliefs have been linked with the experience of unpleasant side effects following medical treatment, and media coverage may heighten such concerns. The present study sought to assess the influence of news coverage (number of news articles per month) on adverse event reporting in response to Gardasil vaccination in New Zealand over a 7.5-year period, and whether the influence of news coverage was mediated by internet search activity (Google search volumes). Multiple linear regression analyses and simple mediation analyses were used, controlling for year and number of vaccinations delivered. News coverage in the previous month, and Google search volumes in the same month, were significant predictors of adverse event reporting, after accounting for vaccination rates and year. Concurrent Google search volumes partially mediated the effect of prior news coverage. The results suggest that some of the adverse events reported were not related to the vaccination itself, but to news coverage and internet search volumes, which may have contributed to public concerns about potentially unpleasant or harmful outcomes. These findings have implications for the importance of psychological and social factors in adverse event reporting, and the role of the news media in disseminating health information. Copyright © 2017 Elsevier Ltd. All rights reserved.

Depression and sickness behavior are Janus-faced responses to shared inflammatory pathways

PubMed Central

2012-01-01

It is of considerable translational importance whether depression is a form or a consequence of sickness behavior. Sickness behavior is a behavioral complex induced by infections and immune trauma and mediated by pro-inflammatory cytokines. It is an adaptive response that enhances recovery by conserving energy to combat acute inflammation. There are considerable phenomenological similarities between sickness behavior and depression, for example, behavioral inhibition, anorexia and weight loss, and melancholic (anhedonia), physio-somatic (fatigue, hyperalgesia, malaise), anxiety and neurocognitive symptoms. In clinical depression, however, a transition occurs to sensitization of immuno-inflammatory pathways, progressive damage by oxidative and nitrosative stress to lipids, proteins, and DNA, and autoimmune responses directed against self-epitopes. The latter mechanisms are the substrate of a neuroprogressive process, whereby multiple depressive episodes cause neural tissue damage and consequent functional and cognitive sequelae. Thus, shared immuno-inflammatory pathways underpin the physiology of sickness behavior and the pathophysiology of clinical depression explaining their partially overlapping phenomenology. Inflammation may provoke a Janus-faced response with a good, acute side, generating protective inflammation through sickness behavior and a bad, chronic side, for example, clinical depression, a lifelong disorder with positive feedback loops between (neuro)inflammation and (neuro)degenerative processes following less well defined triggers. PMID:22747645

BEDA FOMM: An Operational Analysis

DTIC Science & Technology

1994-06-03

Germany’s. The Italians launched their attack into Greece from Albania on 28 October. Through a combination of bad weather and unexpected Greek resistance...attacked Italian airfields at Benina and Berka . 7 1 The infantry attacked at 0540 and were able to pass the tanks through before 0700. There was...escaped to the north into the Jebel Akhdar. Bad weather and bad road conditions contributed to 7th Armoured’s failure to pursue along with the

[Bad habits and dysgnathia: epidemiological study].

PubMed

Cordasco, G; Lo Giudice, G; Dolci, E; Romeo, U; Lafronte, G

1989-01-01

The authors refer about an epidemiological survey in 651 children in the school-age. The aim of study is to investigate about the frequency of the bad habits and the pathogenetic relations between these and the development of the dento-maxillo-facial deformities. They point out an incidence of these bad habits in the 35,48% with a predominance of mouth breathers (45,45%). After they discuss the necessity of an early detection of anomalous neuromuscular attitudes.

Libros bilingues, traducciones desparpajadas y traducciones pobres: libros en espanol publicados en los Estados Unidos (Bilingual Books, Careless Translations, and Bad Translations: Books in Spanish Published in the United States).

ERIC Educational Resources Information Center

Schon, Isabel

2003-01-01

Discusses the importance of providing Spanish-speaking students with high-quality reading materials in Spanish and avoiding materials that have been badly translated into Spanish. Provides an annotated list of 10 books recommended for young children and a Spanish grammar for more advanced readers. Lists 29 badly translated books. Describes a Web…

Income levels of bad-debt and free-care patients in Massachusetts hospitals.

PubMed

Weissman, J S; Dryfoos, P; London, K

1999-01-01

This study disputes the common notion that many hospitalized patients whose expenses are written off to bad debt are able to pay their bills. By matching 1996 state tax returns to more than 350,000 bad-debt and free-care claims at seven Massachusetts hospitals, we found that most patients involved had incomes below the federal poverty level and thus were presumably eligible for either public programs or hospital-based free care. This suggests that hospitals and public officials need to investigate further why low-income, uninsured patients are not receiving benefits for which they are eligible. Our results also suggest that measurements of indigent care levels in hospitals for purposes of research or regulation should include some portion of bad debt.

Collaborative Practice Model: Improving the Delivery of Bad News.

PubMed

Bowman, Pamela N; Slusser, Kim; Allen, Deborah

2018-02-01

Ideal bad news delivery requires skilled communication and team support. The literature has primarily focused on patient preferences, impact on care decisions, healthcare roles, and communication styles, without addressing systematic implementation. This article describes how an interdisciplinary team, led by advanced practice nurses, developed and implemented a collaborative practice model to deliver bad news on a unit that had struggled with inconsistencies. Using evidence-based practices, the authors explored current processes, role perceptions and expectations, and perceived barriers to developing the model, which is now the standard of care and an example of interprofessional team collaboration across the healthcare system. This model for delivering bad news can be easily adapted to meet the needs of other clinical units.
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Study on the heterodyning scattering of retroreflective free-space optical communication with optical heterodyning.

PubMed

Jia, Honghui; Yin, Hongwei; Zhang, Hailiang; Wang, Xiaofeng; Chang, Shengli; Yang, Juncai

2013-11-01

Retroreflective free-space optical communication is important because of advantages such as small volume, low weight, and low power consumption. Link failure caused by bad weather conditions will occur because of the attenuated retroreflective signal and the increased scattering of the transmitted light. The scattering effect can be reduced because the physical properties (including polarization, wavefront, and phase) of the scattering signal are different from those of the retroreflective signal. The physical properties of the scattering signal are obtained using a polarization-sensitive Monte Carlo model, and the heterodyning scattering signal is obtained using heterodyning theory. Results show that, with optical heterodyning, the scattering effect is efficiently reduced, and advantages such as better adaptability to bad weather conditions, longer communication range, more compact transceiver design, larger covering area of the optical receiver, and easier target acquisition for the retromodulator than before can also be obtained.

Can't control yourself? Monitor those bad habits.

PubMed

Quinn, Jeffrey M; Pascoe, Anthony; Wood, Wendy; Neal, David T

2010-04-01

What strategies can people use to control unwanted habits? Past work has focused on controlling other kinds of automatic impulses, especially temptations. The nature of habit cuing calls for certain self-control strategies. Because the slow-to-change memory trace of habits is not amenable to change or reinterpretation, successful habit control involves inhibiting the unwanted response when activated in memory. In support, two episode-sampling diary studies demonstrated that bad habits, unlike responses to temptations, were controlled most effectively through spontaneous use of vigilant monitoring (thinking "don't do it," watching carefully for slipups). No other strategy was useful in controlling strong habits, despite that stimulus control was effective at inhibiting responses to temptations. A subsequent experiment showed that vigilant monitoring aids habit control, not by changing the strength of the habit memory trace but by heightening inhibitory, cognitive control processes. The implications of these findings for behavior change interventions are discussed.

Reflectance calibration and shadow effect of VNIS spectra acquired by the Yutu rover

NASA Astrophysics Data System (ADS)

Hu, Sen; Lin, Yang-Ting; Liu, Bin; Yang, Wei; He, Zhi-Ping; Xing, Wei-Fan

2015-09-01

Yutu is the first lunar rover after the Apollo program and Luna missions. One of the payloads on the Yutu rover, the Visible and Near-infrared Imaging Spectrometer (VNIS), has acquired four VIS/NIR images and SWIR spectra near its landing site in Mare Imbrium. The radiance images were reduced through repairing bad lines and bad points, and applying flat field correction, and then were converted into reflectance values based on the solar irradiance and angles of incidence. A significant shadow effect was observed in the VIS/NIR image. The shadowed regions show lower reflectance with a darkening trend compared with illuminated regions. The reflectance increased by up to 24% for entire images and 17% for the VIS/NIR-SWIR overlapping regions after shadow correction. The correction for the shadow effect will remarkably decrease the estimate of FeO content, by up to 4.9 wt.% in this study. The derived FeO contents of CD-005∼008 after shadow correction are around 18.0 wt.%.

Ethics skills laboratory experience for surgery interns.

PubMed

Moon, Margaret R; Hughes, Mark T; Chen, Jiin-Yu; Khaira, Kiran; Lipsett, Pamela; Carrese, Joseph A

2014-01-01

Ethics curricula are nearly universal in residency training programs, but the content and delivery methods are not well described, and there is still a relative paucity of literature evaluating the effect of ethics curricula. Several commentators have called for more ethics curriculum development at the postgraduate level, and specifically in surgery training. We detail our development and implementation of a clinical ethics curriculum for surgery interns. We developed curricula and simulated patient cases for 2 core clinical ethics skills--breaking bad news and obtaining informed consent. Educational sessions for each topic included (1) framework development (discussion of interns' current experience, development of a consensus framework for ethical practice, and comparison with established frameworks) and (2) practice with simulated patient followed by peer and faculty feedback. At the beginning and end of each session, we administered a test of confidence and knowledge about the topics to assess the effect of the sessions. A total of 98 surgical interns participated in the ethics skills laboratory from Spring 2008 to Spring 2011. We identified significant improvement in confidence regarding the appropriate content of informed consent (<0.001) and capacity to break bad news (<0.001). We also identified significant improvement in overall knowledge regarding informed consent (<0.01), capacity assessment (<0.05), and breaking bad news (0.001). Regarding specific components of informed consent, capacity assessment, and breaking bad news, significant improvement was shown in some areas, while we failed to improve knowledge in others. Through faculty-facilitated small group discussion, surgery interns were able to develop frameworks for ethical practice that paralleled established frameworks. Skills-based training in clinical ethics resulted in an increase in knowledge scores and self-reported confidence. Evaluation of 4 annual cohorts of surgery interns demonstrates significant successes and some areas for improvement in this educational intervention. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Suffering with dementia: the other side of "living well''.

PubMed

Bartlett, Ruth; Windemuth-Wolfson, Lore; Oliver, Keith; Dening, Tom

2017-02-01

In this editorial, we challenge the current understanding of "Living Well with Dementia." Such discourse introduces the possibility of not living well with the condition or even of "living badly with dementia." Numerous words might be relevant here - grief, pain, anguish, depression - but in this editorial we consciously use the word "suffering." This term is used for two reasons; one, because it captures the attributes of other more limited words, and, two because the language of "suffering" is contentious, making it suitable for debate. We speak of suffering, not to deny the positive aspects of life with dementia or to concentrate just on the negative, but to redress the balance that is disturbed by a relentlessly positive view of living with the condition. Our aim is to promote a more realistic understanding of the dementia experience, one based on actualities and evidence rather than presumption and sentiment.

P-1 truss arrival at KSC

NASA Technical Reports Server (NTRS)

2000-01-01

The P-1 truss, a component of the International Space Station, is moved from the Shuttle Landing Facility toward the newly constructed RLV hangar (viewed here from inside the hangar) as precaution against bad weather approaching the Center (background). The truss will eventually be transferred to the Operations and Checkout Building for processing. In the background is the Super Guppy transport that brought it to KSC. The P-1 truss, scheduled to fly in spring of 2002, is part of a total 10-truss, girder-like structure on the Station that will ultimately extend the length of a football field. Astronauts will attach the 14-by-15 foot structure to the port side of the center truss, S0, during the spring assembly flight. The 33,000-pound P- 1 will house the thermal radiator rotating joint (TRRJ) that will rotate the Station's radiators away from the sun to increase their maximum cooling efficiency.

Assessment of infection control practices in teaching hospitals of Quetta.

PubMed

Anwar, Muhammad; Majeed, Abdul; Saleem, Rana Muhammad; Manzoor, Farkhanda; Sharif, Saima

2016-08-01

To identify the gaps in infection control and prevention practices in teaching hospitals. This cross-sectional study was conducted at Bolan Medical Complex and Sandeman Medical College Hospital, Quetta, from August 2012 to January 2013.The study comprised members (n=7) of infection control committee who were interviewed through a self-developed, closed-ended questionnaire and their perception regarding infection control and prevention was recorded. Data was analysed using SPSS 16. Only 3(42.9%) of the committee members believed that the administrative factors for causing hospital-acquired infections were nurse-patient ratio. On the patient care side, 1(14.3%) participants at one of the hospitals attributed infections to antibiotic use, 5(71.4%) to invasive medical device and 1(14.3%) to other factors. Poor perception held by the members of infection control committee was the basic cause of bad outcome. Capacity-building of all the stakeholders is required.

Looking on the bright side: children's knowledge about the benefits of positive versus negative thinking.

PubMed

Bamford, Christi; Lagattuta, Kristin Hansen

2012-01-01

Five- to 10-year-olds (N = 90) listened to 6 illustrated scenarios featuring 2 characters that jointly experience the same positive event (and feel good), negative event (and feel bad), or ambiguous event (and feel okay). Afterward, one character thinks a positive thought and the other thinks a negative thought. Children predicted and explained each character's emotions. Results showed significant development between 5 and 10 years in children's understanding that thinking positively improves emotions and thinking negatively makes one feel worse, with earliest knowledge demonstrated when reasoning about ambiguous and positive events. Individual differences in child and parental optimism and hope predicted children's knowledge about thought-emotion connections on some measures, including their beliefs about the emotional benefits of thinking positively in negative situations. © 2011 The Authors. Child Development © 2011 Society for Research in Child Development, Inc.

A mapping of people's positions regarding the breaking of bad news to patients.

PubMed

Igier, Valérie; Muñoz Sastre, María Teresa; Sorum, Paul Clay; Mullet, Etienne

2015-01-01

The objective of this study was to map people's positions regarding the breaking of bad news to patients. One hundred forty adults who had in the past received bad medical news or whose elderly relatives had in the past received bad news, 25 nurses, and 28 nurse's aides indicated the acceptability of physicians' conduct in 72 vignettes of giving bad news to elderly patients. Vignettes were all combinations of five factors: (a) the severity of the disease (severe but not lethal, extremely severe and possibly lethal, or incurable), (b) the patient's wishes (insists on knowing the full truth vs. does not insist), (c) the level of social support during hospitalization, (d) the patient's psychological robustness, and (e) the physician's decision about communicating bad news (tell the patient that the illness is not severe and minimize the severity of the illness when talking to the patient's relatives, tell the full truth to her relatives, or tell the full truth to both the elderly patient and her relatives). Four qualitatively different positions were found. Twenty-eight percent of participants preferred the full truth to be told; 36% preferred the truth to be told but understood that the physician would inform the family first; 13% did not think that telling the full truth is best for patients; and 23% understood that the full truth would be told in some cases and not in others, depending on the physician's perception of the situation. The present mapping could be used to detect the position held by each patient and act accordingly. This would be made easier if breaking bad news was conceived as a communication process involving a range of health care professionals, rather than as a single occurrence in time.

Breaking bad news to cancer patients in palliative care: A comparison of national cross-sectional surveys from 2006 and 2012.

PubMed

Ichikura, Kanako; Matsuda, Ayako; Kobayashi, Mika; Noguchi, Wataru; Matsushita, Toshiko; Matsushima, Eisuke

2015-12-01

Most cancer patients experience the time when a doctor must "break the bad news" to them, a time when it is necessary for patients to call upon their self-determination to aid in the battle with cancer. The purpose of our study was to clarify the percentage of times doctors deliver bad news to patients at the end of life in each of four different situations, and to define the most common recipients of this bad news. We compare these results for two timepoints: 2006 and 2012. The study had a national cross-sectional design consisting of self-completed questionnaires sent to all hospitals that provide cancer care. We mailed them to hospital directors in January and February of 2012, requesting a reply. The results of the same survey in 2006 were employed as a point for comparison. A total of 1224 questionnaires were returned during 2012. 1499 responses collected in 2006 were employed as reference data. Some hospital characteristics had changed over that interval; however, the new data obtained were representative for patients being treated in Japanese cancer care hospitals. In hospitals with 300-499, there were significant differences between 2006 and 2012 in the providing information about ("disclosure of cancer diagnosis," "therapeutic options for treatment," and "a life-prolonging treatment"). In addition, the likelihood of doctors delivering bad news to patients and family members (as opposed to family members only) at the end of life increased from 2006 to 2012. Our results suggest that the overall incidence of bad news being disclosed has increased, especially in hub medical institutions for cancer care. Advanced treatment options or domestic legislation may have influenced the frequency or type of bad news.

Good Exemplars of Natural Scene Categories Elicit Clearer Patterns than Bad Exemplars but Not Greater BOLD Activity

PubMed Central

Torralbo, Ana; Walther, Dirk B.; Chai, Barry; Caddigan, Eamon; Fei-Fei, Li; Beck, Diane M.

2013-01-01

Within the range of images that we might categorize as a “beach”, for example, some will be more representative of that category than others. Here we first confirmed that humans could categorize “good” exemplars better than “bad” exemplars of six scene categories and then explored whether brain regions previously implicated in natural scene categorization showed a similar sensitivity to how well an image exemplifies a category. In a behavioral experiment participants were more accurate and faster at categorizing good than bad exemplars of natural scenes. In an fMRI experiment participants passively viewed blocks of good or bad exemplars from the same six categories. A multi-voxel pattern classifier trained to discriminate among category blocks showed higher decoding accuracy for good than bad exemplars in the PPA, RSC and V1. This difference in decoding accuracy cannot be explained by differences in overall BOLD signal, as average BOLD activity was either equivalent or higher for bad than good scenes in these areas. These results provide further evidence that V1, RSC and the PPA not only contain information relevant for natural scene categorization, but their activity patterns mirror the fundamentally graded nature of human categories. Analysis of the image statistics of our good and bad exemplars shows that variability in low-level features and image structure is higher among bad than good exemplars. A simulation of our neuroimaging experiment suggests that such a difference in variance could account for the observed differences in decoding accuracy. These results are consistent with both low-level models of scene categorization and models that build categories around a prototype. PMID:23555588

Biochemical changes of salivary gland adenoid cystic carcinoma cells induced by SGI-1776

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hou, Xiuxiu, E-mail: show-1989@163.com; The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000; Yu, Yunfang, E-mail: yyf_8247425@163.com

Provirus integration site for Moloney murine leukemia virus 1 (Pim-1) has proved to be an oncogene and it is known that to depress Pim-1 activity may be a novel oncological treatment strategy. SGI-1776, a small molecule, is the first clinically tested inhibitor of the Pim kinase family. Here, we aimed to explore the effect of SGI-1776 on salivary adenoid cystic carcinoma (SACC). Expression of Pim-1 was confirmed in SACC and control tissues by qRT-PCR. After SGI-1776 treatment, the Pim-1 expressions and Pim-1 kinase activity in both SACC-83 and SACC-LM cell lines were measured. Cell proliferation, cell invasion, cell cycle, apoptosismore » and mitochondrial membrane potential were analyzed. Also, the expression of FOXO3a, p-FOXO3a, RUNX3, Bcl-2, BAD, p-BAD, Bim and p-Bim were detected by Western blot. The results showed that Pim-1 was significantly overexpressed in SACC tissues. SGI-1776 down-regulated the Pim-1 expression, inhibited Pim-1 kinase activity, reduced cell proliferation, decreased invasive ability, increased caspase-3 activity and induced apoptosis, cell cycle arrest and mitochondrial depolarization. Reduced expression was also seen in p-FOXO3a, RUNX3, Bcl-2, p-BAD and p-Bim, whereas no significant changes were observed from FOXO3a, BAD and Bim. These results confirm the pivotal role of Pim-1 in SACC and suggest that targeting Pim-1 kinase signal pathway by SGI-1776 might be a promising therapeutic modality for SACC.« less

Biochemical changes of salivary gland adenoid cystic carcinoma cells induced by SGI-1776.

PubMed

Hou, Xiuxiu; Yu, Yunfang; Feng, Jianguo; Wang, Jiafeng; Zheng, Chuanming; Ling, Zhiqiang; Ge, Minghua; Zhu, Xin

2017-03-15

Provirus integration site for Moloney murine leukemia virus 1 (Pim-1) has proved to be an oncogene and it is known that to depress Pim-1 activity may be a novel oncological treatment strategy. SGI-1776, a small molecule, is the first clinically tested inhibitor of the Pim kinase family. Here, we aimed to explore the effect of SGI-1776 on salivary adenoid cystic carcinoma (SACC). Expression of Pim-1 was confirmed in SACC and control tissues by qRT-PCR. After SGI-1776 treatment, the Pim-1 expressions and Pim-1 kinase activity in both SACC-83 and SACC-LM cell lines were measured. Cell proliferation, cell invasion, cell cycle, apoptosis and mitochondrial membrane potential were analyzed. Also, the expression of FOXO3a, p-FOXO3a, RUNX3, Bcl-2, BAD, p-BAD, Bim and p-Bim were detected by Western blot. The results showed that Pim-1 was significantly overexpressed in SACC tissues. SGI-1776 down-regulated the Pim-1 expression, inhibited Pim-1 kinase activity, reduced cell proliferation, decreased invasive ability, increased caspase-3 activity and induced apoptosis, cell cycle arrest and mitochondrial depolarization. Reduced expression was also seen in p-FOXO3a, RUNX3, Bcl-2, p-BAD and p-Bim, whereas no significant changes were observed from FOXO3a, BAD and Bim. These results confirm the pivotal role of Pim-1 in SACC and suggest that targeting Pim-1 kinase signal pathway by SGI-1776 might be a promising therapeutic modality for SACC. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Hsp20 Interacting with Phosphorylated Akt Reduces Doxorubicin-Triggered Oxidative Stress and Cardiotoxicity

PubMed Central

Fan, Guo-Chang; Zhou, Xiaoyang; Wang, Xiaohong; Song, Guojie; Qian, Jiang; Nicolaou, Persoulla; Chen, Guoli; Ren, Xiaoping; Kranias, Evangelia G.

2009-01-01

Doxorubicin (DOX) is a widely used antitumor drug, but its application is limited due to its cardiotoxic side effects. Hsp20 has been recently shown to protect cardiomyocytes against apoptosis, induced by ischemia/reperfusion injury or by prolonged β-agonist stimulation. However, it is not clear whether Hsp20 would exert similar protective effects against DOX-induced cardiac injury. Actually, DOX-treatment was associated with down-regulation of Hsp20 in the heart. To elucidate the role of Hsp20 in DOX-triggered cardiac toxicity, Hsp20 was first overexpressed ex vivo by adenovirus-mediated gene delivery. Increased Hsp20 levels conferred higher resistance to DOX-induced cell death, compared to GFP-control. Furthermore, cardiac-specific overexpression of Hsp20 in vivo significantly ameliorated acute DOX-triggered cardiomyocyte apoptosis and animal mortality. Hsp20-transgenic mice also showed improved cardiac function and prolonged survival after chronic administration of DOX. The mechanisms underlying these beneficial effects were associated with preserved Akt phosphorylation/activity and attenuation of DOX-induced oxidative stress. Co-immunoprecipitation studies revealed an interaction between Hsp20 and phosphorylated Akt. Accordingly, BAD phosphorylation was preserved and cleaved caspase-3 was decreased in DOX-treated Hsp20-TG hearts, consistent with the Hsp20's anti-apoptotic effects. Parallel ex vivo experiments showed that either infection with a dominant-negative Akt adenovirus or pre-incubation of cardiomyocytes with the PI3-kinase inhibitors significantly attenuated the protective effects of Hsp20. Taken together, our findings indicate that overexpression of Hsp20 inhibits DOX-triggered cardiac injury, and these beneficial effects appear to be dependent on Akt activation. Thus, Hsp20 may constitute a new therapeutic target in ameliorating the cardiotoxic effects of DOX-treatment in cancer patients. PMID:18948619

The goals of communicating bad news in health care: do physicians and patients agree?

PubMed Central

Sweeny, Kate; Shepperd, James A.; Han, Paul K. J.

2011-01-01

Abstract Background  Communicating bad news serves different goals in health care, and the extent to which physicians and patients agree on the goals of these conversations may influence their process and outcomes. However, we know little about what goals physicians and patients perceive as important and how the perceptions of physicians and patients compare. Objective  To compare physicians’ and patients’ perceptions of the importance of different communication goals in bad news conversations. Design  Survey‐based descriptive study. Participants  Physicians in California recruited via a medical board mailing list (n = 67) and patients (n = 77) recruited via mailing lists and snowball recruitment methods. Measurements  Physicians reported their experience communicating bad news, the extent to which they strive for various goals in this task and their perceptions of the goals important to patients. Patients reported their experience receiving bad news, the goals important to them and their perceptions of the goals important to physicians. Main results  Physicians and patients were quite similar in how important they personally rated each goal. However, the two groups perceived differences between their values and the values of the other group. Conclusions  Physicians and patients have similar perceptions of the importance of various goals of communicating bad news, but inaccurate perceptions of the importance of particular goals to the other party. These findings raise important questions for future research and clinical practice. PMID:21771225

Automatic bad channel detection in intracranial electroencephalographic recordings using ensemble machine learning.

PubMed

Tuyisenge, Viateur; Trebaul, Lena; Bhattacharjee, Manik; Chanteloup-Forêt, Blandine; Saubat-Guigui, Carole; Mîndruţă, Ioana; Rheims, Sylvain; Maillard, Louis; Kahane, Philippe; Taussig, Delphine; David, Olivier

2018-03-01

Intracranial electroencephalographic (iEEG) recordings contain "bad channels", which show non-neuronal signals. Here, we developed a new method that automatically detects iEEG bad channels using machine learning of seven signal features. The features quantified signals' variance, spatial-temporal correlation and nonlinear properties. Because the number of bad channels is usually much lower than the number of good channels, we implemented an ensemble bagging classifier known to be optimal in terms of stability and predictive accuracy for datasets with imbalanced class distributions. This method was applied on stereo-electroencephalographic (SEEG) signals recording during low frequency stimulations performed in 206 patients from 5 clinical centers. We found that the classification accuracy was extremely good: It increased with the number of subjects used to train the classifier and reached a plateau at 99.77% for 110 subjects. The classification performance was thus not impacted by the multicentric nature of data. The proposed method to automatically detect bad channels demonstrated convincing results and can be envisaged to be used on larger datasets for automatic quality control of iEEG data. This is the first method proposed to classify bad channels in iEEG and should allow to improve the data selection when reviewing iEEG signals. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

BAD-LAMP controls TLR9 trafficking and signalling in human plasmacytoid dendritic cells.

PubMed

Combes, Alexis; Camosseto, Voahirana; N'Guessan, Prudence; Argüello, Rafael J; Mussard, Julie; Caux, Christophe; Bendriss-Vermare, Nathalie; Pierre, Philippe; Gatti, Evelina

2017-10-13

Toll-like receptors (TLR) are essential components of the innate immune system. Several accessory proteins, such as UNC93B1, are required for transport and activation of nucleic acid sensing Toll-like receptors in endosomes. Here, we show that BAD-LAMP (LAMP5) controls TLR9 trafficking to LAMP1 + late endosomes in human plasmacytoid dendritic cells (pDC), leading to NF-κB activation and TNF production upon DNA detection. An inducible VAMP3 +/ LAMP2 +/ LAMP1 - endolysosome compartment exists in pDCs from which TLR9 activation triggers type I interferon expression. BAD-LAMP-silencing enhances TLR9 retention in this compartment and consequent downstream signalling events. Conversely, sustained BAD-LAMP expression in pDCs contributes to their lack of type I interferon production after exposure to a TGF-β-positive microenvironment or isolation from human breast tumours. Hence, BAD-LAMP limits interferon expression in pDCs indirectly, by promoting TLR9 sorting to late endosome compartments at steady state and in response to immunomodulatory cues.TLR9 is highly expressed by plasmacytoid dendritic cells and detects nucleic acids, but to discriminate between host and microbial nucleic acids TLR9 is sorted into different endosomal compartments. Here the authors show that BAD-LAMP limits type 1 interferon responses by sorting TLR9 to late endosomal compartments.

Main communication barriers in the process of delivering bad news to oncological patients - medical perspective.

PubMed

Zielińska, Paulina; Jarosz, Magdalena; Kwiecińska, Agnieszka; Bętkowska-Korpała, Barbara

2017-01-01

Delivering bad news is a major aspect of a doctor's work. The literature most often refers to patient's expectations or needs, and methods of delivering bad news, while medical perspective is often skipped. The purpose of this paper is to examine competencies (knowledge, skills and experience) in delivering bad news by medical specialists in the areas related to the causal and symptomatic treatment of oncological patients; identification of major communication problems and obstacles in this specific situation and evaluation of teaching needs for delivering bad news. The study was performed on a group of 61 medical specialists in the areas related to the causal and symptomatic treatment of oncological patients, using a self-generated questionnaire based on other studies in the literature. Topics that are considered most demanding are: delivering news on the termination of causal treatment and preparing the patient/ close ones for death. The most difficult aspect of such discussions for the respondents was associated with the emotions manifested by the patient. On the other hand, doctors were mostly distressed by the feeling of taking the patient's hope away. The study points to the need for education of doctors in the eld of techniques for delivering bad news, particularly in the area of dealing with the emotions manifested by the patient and giving them real hope. The results encourage to conduct studies on a larger group of doctors.

Basic Information about Ozone

EPA Pesticide Factsheets

Learn the difference between good (stratospheric) and bad (tropospheric) ozone, how bad ozone affects our air quality, health, and environment, and what EPA is doing about it through regulations and standards.

Severe acute respiratory syndrome (SARS) and the rhetorical construction of "bad" scientific work.

PubMed

Attenborough, Frederick Thomas

2012-02-01

How are secondary accounts of "bad" scientific practice constructed? How do they engage with the primary data produced by "bad" scientists? And what happens to those primary data as generations of secondary accounts purporting to describe them accumulate? This paper addresses such questions via a case study of Dr. Hong, a microbiologist accused of "bad" scientific practice by numerous secondary accounts of the 2003 SARS outbreak. Bringing Hong's own account of his own actions into dialogue with one of the most influential secondary accounts of his actions, the paper highlights the gross disparity between the two. Having argued that the rhetorical structuring of the secondary account is, ultimately, responsible for Hong's characterisation as a "bad" scientist, it then moves to explore how subsequent accounts developed their own characterisations. What becomes clear is that as secondary accounts began feeding off one another, references to Hong's account disappeared. Aided by the concepts of the "vanishing" and the "phantasm", the paper concludes with a consideration of how this process left Hong's work with a very peculiar form of existence.

[Pediatrician's experience in announcing bad news].

PubMed

Crosnier-Schoedel, C; Trocmé, N; Carbajal, R; Leverger, G

2018-02-01

Few studies are available on pediatricians' experience with announcing bad news. Announcing bad news is an important component of medical practice and is even more complex in pediatrics because parents must be associated. We had 20 hospital pediatricians complete a questionnaire containing 30 questions about their own experience announcing bad news to a child or a teenager. In spite of their experience and the time they have spent practicing medicine, there are many limitations stemming from different factors concerning children, teenagers, their families, and themselves. The difficulties encountered by pediatricians are mainly related to the timing of the announcement, the location, the choice of the words used, and the poor understanding of children and families, due to intellectual, cultural, or psychological limitations. Pediatricians question their own capacity to make such an announcement, wondering if the information has actually been well understood. They indicate that they are themselves affected. Most of them develop and implement strategies to refute the emotional instability caused by the announcement of bad news. Yet many of them feel weak, even talking about a deep sense of loneliness and guilt. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

E1A promoter of bovine adenovirus type 3.

PubMed

Xing, Li; Tikoo, Suresh Kumar

2006-12-01

Conserved motifs of eukaryotic gene promoters, such as TATA box and CAAT box sequences, of E1A of human adenoviruses (e.g human adenovirus 5) lie between the left inverted terminal repeat (ITR) and the ATG of E1A. However, analysis of the left end of the bovine adenovirus 3 (BAdV-3) genome revealed that the conserved sequences of the E1A promoter are present only in the ITR. As such, the promoter activity of ITR was tested in the context of a BAdV-3 vector or a plasmid-based system. Different regions of the left end of the BAdV-3 genome initiated transcription of the red fluorescent protein gene in a plasmid-based system. Moreover, BAdV-3 mutants in which the open reading frame of E1A was placed immediately downstream of the ITR produced E1A transcript and could be propagated in non-E1A-complementing Madin-Darby bovine kidney cells. These results suggest that the left ITR contains the sole BAdV-3 E1A promoter.

Facework and uncertain reasoning in health communication.

PubMed

Pighin, Stefania; Bonnefon, Jean-François

2011-11-01

Health care professionals often need to convey good and bad prospects to patients, and these news can be qualified by various uncertainty terms. Based on a sociolinguistic analysis of the way these uncertainty terms are used, we predicted that they would be interpreted differently by patients as a function of whether they qualified good news or bad news. Two studies investigating causal inferences were conducted among a sample of French university students (Study 1, N=50), and among a sample of Italian pregnant women (Study 2, N=532). Participants felt greater confidence in the conclusions they derived when the news were bad, as compared to the conclusions they derived when the news were good. The findings have implications for health care professionals who communicate good and bad prospects to patients, and who need to qualify the certainty of these prospects. Professionals should be aware that when the news are bad, any hedging term such as "possible" can be misunderstood as an attempt to sugar-coat the pill, and that this misinterpretation can lead patient to inferences that are not shared by the professional. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Breaking bad news revisited: the push for negotiated disclosure and changing practice implications.

PubMed

Arber, Anne; Gallagher, Ann

2003-04-01

This article revisits the ethical, legal, professional and emotional issues involved with disclosing bad news. The authors examine the push for disclosure that has come from a number of quarters in the UK, including ethical and legal challenges, in particular the Bristol Royal Inquiry Report, professional codes of conduct, health policy and the expectations of the public. The contribution of nurses to breaking bad news is not widely discussed in the literature. With the development of new nursing roles and evidence-based practice it is timely to consider the role of nurses in this process. The article highlights some limitations with current guidelines for breaking bad news, in particular, that these guidelines tend to be constructed from a professional standpoint and lack patient-centred evidence. The issue of emotional labour and how it relates to giving bad news is discussed with respect to professional staff and patients. The article concludes by raising some practice implications, including: the importance of context and continuity; the significance of information and support; the desirable qualities of the professional; and issues to consider in determining patient preferences.

Health Effects of Air Pollution

MedlinePlus

... of time exercising on a day with bad air quality, you may cough, your throat may feel scratchy, and you may have chest pain. This is because of the particles in the air. Ear infections. Kids who breathe secondhand smoke and ...

Effectiveness of partially soluble photosensitizer in photodynamic microbiological inactivation: a curcumin example

NASA Astrophysics Data System (ADS)

Pratavieira, Sebastião.; Matroodi, Fatima; Pinto-Júnior, Fabio Francisco; Rastelli, Alessandra Nara Souza; Bagnato, Vanderlei S.; Guimarães, Francisco E. G.

2017-07-01

We show that partial solubility of a photosensitizer is not necessarily a bad property when dealing with microbiological control. The presence of curcumin aggregates in solution may present advantages with respect the photoand chemical stability.

THE EXPERIMENTAL DEVELOPMENT OF ASSOCIATED INFECTIONS OF TUBERCULOSIS AND BRUCELLOSIS IN THE GUINEA PIG

DTIC Science & Technology

The association of the two diseases generally has an unfavorable effect in the subject. This association is especially bad when one inoculates Koch’s bacilli into guinea pigs which have brucellosis.

Bad Breath

MedlinePlus

... a lot, you may need to visit your dentist or doctor . What Causes Bad Breath? Here are ... particles wedged between your teeth. Also, visit your dentist twice a year for regular checkups and cleanings. ...

T-18, a stemonamide synthetic intermediate inhibits Pim kinase activity and induces cell apoptosis, acting as a potent anticancer drug.

PubMed

Wang, Zhen; Li, Xing-Min; Shang, Kun; Zhang, Peng; Wang, Chao-Fu; Xin, Yu-Hu; Zhou, Lu; Li, Ying-Yi

2013-03-01

Pim-3 kinase has been shown to be aberrantly expressed in premalignant and malignant lesions of endoderm-derived organs such as the liver, pancreas, colon and stomach. Pim-3 kinase inactivates the Bad protein, a proapoptotic molecule, and improves the expression of Bcl-xL, an antiapoptotic molecule, to promote cell proliferation. Thus, blocking Pim-3 kinase activity may be a new strategy for the treatment of pancreatic cancer. In this study, we screened low molecular compounds and observed that the stemonamide synthetic intermediate, T-18, potently inhibited Pim kinase activity. Moreover, T-18 inhibited the proliferation of human pancreatic, as well as that of hepatocellular and colon cancer cells in vitro. It also induced the apoptosis of human pancreatic carcinoma cells in vitro by decreasing the levels of phospho-Ser112-Bad; the levels of Pim-3 kinase and total Bad protein were not altered. Furthermore, T-18 inhibited the growth of human pancreatic cancer cells in nude mice without apparent adverse effects when the tumor was palpable. These observations indicate that stemonamide synthetic intermediates may be novel drugs for the treatment of gastrointestinal cancers, particularly pancreatic cancer.

When food is neither good nor bad: children's evaluations of transformed and combined food products.

PubMed

Thompson, Kirrilly; Blunden, Sarah; Brindal, Emily; Hendrie, Gilly

2011-12-01

This study examined children's subjective perceptions of 'good' and 'bad' foods. Four interactive focus groups were conducted with 27 children aged 5-9 in South Australia. Each focus group was engaged in a food picture sorting activity. Whilst most children were able to discriminate good and bad whole foods or ingredients, they were less able to agree at a group level on the categorization of combined and transformed food products with which they are most likely to be presented in their 'everyday' lives. We discuss this confusion using Mary Douglas's (1966) theory of 'matter out of place'. Accordingly, health promotion messages should cultivate the skills required to reconcile the co-presence of 'good' and 'bad' ingredients in one product or meal.

The Sign Effect in Emerging Markets: the Inherent Instability of Bad News

NASA Astrophysics Data System (ADS)

Tenenbaum, Joel; Podobnik, Boris; Horvatic, Davor; Bajic, Slavica; Pehlivanovic, Beco; Stanley, H. Eugene

2011-03-01

In developed economy market indices, the sign of a term in a series influences the volatility in an asymmetric fashion --- bad news results in larger subsequent fluctuations while good news results in smaller fluctuations. We study this phenomenon of volatility asymmetry using a stochastic process, exploring whether this asymmetry manifests in emerging markets, and if so, how such asymmetry changes over time as economies develop, mature, and react to crises such as the present one. We find that while both developed and emerging markets show distinctive behavior with respect to volatility asymmetry during times of economic tumult, they do so in ways that could be viewed either as universal or qualitatively different, posing interesting questions for further research.

Effects of Model Characterization on Preschool Children's Evaluative, Imitative and Nonimitative Responses.

ERIC Educational Resources Information Center

Whitman, Thomas L.; Taub, Susan Ilene

This study examined the effects of differentially characterizing a model as "good", "bad", or "neutral" on preschool children's subsequent evaluation and imitation of the model. The model's aggressive and motor behaviors were more frequently imitated than were his non-aggressive and verbal behaviors. Instructions influenced the Ss' evaluation of…

Systems thinking in practice: the current status of the six WHO building blocks for health system strengthening in three BHOMA intervention districts of Zambia: a baseline qualitative study.

PubMed

Mutale, Wilbroad; Bond, Virginia; Mwanamwenge, Margaret Tembo; Mlewa, Susan; Balabanova, Dina; Spicer, Neil; Ayles, Helen

2013-08-01

The primary bottleneck to achieving the MDGs in low-income countries is health systems that are too fragile to deliver the volume and quality of services to those in need. Strong and effective health systems are increasingly considered a prerequisite to reducing the disease burden and to achieving the health MDGs. Zambia is one of the countries that are lagging behind in achieving millennium development targets. Several barriers have been identified as hindering the progress towards health related millennium development goals. Designing an intervention that addresses these barriers was crucial and so the Better Health Outcomes through Mentorship (BHOMA) project was designed to address the challenges in the Zambia's MOH using a system wide approach. We applied systems thinking approach to describe the baseline status of the Six WHO building blocks for health system strengthening. A qualitative study was conducted looking at the status of the Six WHO building blocks for health systems strengthening in three BHOMA districts. We conducted Focus group discussions with community members and In-depth Interviews with key informants. Data was analyzed using Nvivo version 9. The study showed that building block specific weaknesses had cross cutting effect in other health system building blocks which is an essential element of systems thinking. Challenges noted in service delivery were linked to human resources, medical supplies, information flow, governance and finance building blocks either directly or indirectly. Several barriers were identified as hindering access to health services by the local communities. These included supply side barriers: Shortage of qualified health workers, bad staff attitude, poor relationships between community and health staff, long waiting time, confidentiality and the gender of health workers. Demand side barriers: Long distance to health facility, cost of transport and cultural practices. Participating communities seemed to lack the capacity to hold health workers accountable for the drugs and services. The study has shown that building block specific weaknesses had cross cutting effect in other health system building blocks. These linkages emphasised the need to use system wide approaches in assessing the performance of health system strengthening interventions.

Charitable intentions. CHA, VHA unveil community-benefit guidelines developed to help not-for-profit hospitals justify their tax exemptions.

PubMed

Becker, Cinda

2006-06-05

With new guidelines from the CHA and VHA on reporting community benefits, not-for-profit hospitals are being advised to drop bad debt and Medicare shortfalls from their accounting of how they fulfill their mission. While the AHA doesn't agree, some experts do. MedPAC member Nancy Kane, right, says bad debt "is a tough one, but I don't think a lot of bad debt is a community benefit.

HDL: The "Good" Cholesterol

MedlinePlus

... and LDL (bad) cholesterol: HDL stands for high-density lipoproteins. It is called the "good" cholesterol because ... cholesterol from your body. LDL stands for low-density lipoproteins. It is called the "bad" cholesterol because ...

LDL: The "Bad" Cholesterol

MedlinePlus

... and HDL (good) cholesterol: LDL stands for low-density lipoproteins. It is called the "bad" cholesterol because ... cholesterol in your arteries. HDL stands for high-density lipoproteins. It is called the "good" cholesterol because ...

The badness of death and priorities in health.

PubMed

Solberg, Carl Tollef; Gamlund, Espen

2016-04-14

The state of the world is one with scarce medical resources where longevity is not equally distributed. Given such facts, setting priorities in health entails making difficult yet unavoidable decisions about which lives to save. The business of saving lives works on the assumption that longevity is valuable and that an early death is worse than a late death. There is a vast literature on health priorities and badness of death, separately. Surprisingly, there has been little cross-fertilisation between the academic fields of priority setting and badness of death. Our aim is to connect philosophical discussions on the badness of death to contemporary debates in health priorities. Two questions regarding death are especially relevant to health priorities. The first question is why death is bad. Death is clearly bad for others, such as family, friends and society. Many philosophers also argue that death can be bad for those who die. This distinction is important for health priorities, because it concerns our fundamental reasons for saving lives. The second question is, 'When is the worst time to die?' A premature death is commonly considered worse than a late death. Thus, the number of good life years lost seems to matter to the badness of death. Concerning young individuals, some think the death of infants is worse than the death of adolescents, while others have contrary intuitions. Our claim is that to prioritise between age groups, we must consider the question of when it is worst to die. Deprivationism provides a more plausible approach to health priorities than Epicureanism. If Deprivationism is accepted, we will have a firmer basis for claiming that individuals, in addition to having a health loss caused by morbidity, will have a loss of good life years due to mortality. Additionally, Deprivationism highlights the importance of age and values for health priorities. Regarding age, both variants of Deprivationism imply that stillbirths are included in the Global Burden of Disease. Finally, we suggest that the Time-Relative Interest Account may serve as an alternative to the discounting and age weighting previously applied in the Global Burden of Disease.

[Breaking Bad News to Cancer Patients: Content, Communication Preferences and Psychological Distress].

PubMed

Gebhardt, Claudia; Gorba, Claudia; Oechsle, Karin; Vehling, Sigrun; Koch, Uwe; Mehnert, Anja

2017-07-01

Objectives Breaking bad news can be a very distressing situation for both patients and physicians. Physician communication behavior should therefore match patients' communication preferences. The aim of this study was to characterize the content of bad news from the patients' perspective. Patients' preferences for communication of bad news as well as the fit to communication behavior displayed by physicians were also investigated. Finally, consequences of a mismatch between patients' preferences and physician communication were investigated in relation to psychological distress in patients. Methods The sample consisted of N=270 cancer patients (mean age=56.8 years, 48% female) with various cancer entities and different stages of disease (n=115 patients with early stage of cancer, n=155 patients with advanced cancer). The content of bad news was assessed with a specifically developed list of questions. The Measure of Patients' Preferences Scale (MPP) was used to assess patients' preferences for communication of bad news. Patients further completed the NCCN Distress Thermometer (cancer specific distress), the Hospital Anxiety and Depression Scale (HADS- anxiety and depression) and the Demoralization Scale (DS-Scale) to gain information about psychological distress. Results Patients with early stage breast cancer received bad news M=1.6 times (SD=1.1, range: 1-5), patients with advanced cancers M=2.1 times (SD=1.6, range: 1-12). For 77% of early stage cancer patients and 70% of advanced cancer patients, the subjectively worst consultation was receiving the diagnosis and discussing treatment options. Patients' most important communication preferences were physicians' clinical competence and patient-centered communication, clear and direct communication and asking about patients information preferences. Patients in advanced stages report significantly more (29%) unmet communication needs than patients' in early stages (20%; p<0.01). Breaking bad news without considering patients' preferences was associated with higher psychological distress in patients. Conclusion Physicians should communicate in a patient-centered way to reduce mismatch with patients' preferences and thereby potentially reduce patients' psychological distress. © Georg Thieme Verlag KG Stuttgart · New York.

Epstein-Barr Virus MicroRNA miR-BART20-5p Suppresses Lytic Induction by Inhibiting BAD-Mediated caspase-3-Dependent Apoptosis

PubMed Central

Kim, Hyoji; Choi, Hoyun

2015-01-01

ABSTRACT Epstein-Barr virus (EBV) is a human gammaherpesvirus associated with a variety of tumor types. EBV can establish latency or undergo lytic replication in host cells. In general, EBV remains latent in tumors and expresses a limited repertoire of latent proteins to avoid host immune surveillance. When the lytic cycle is triggered by some as-yet-unknown form of stimulation, lytic gene expression and progeny virus production commence. Thus far, the exact mechanism of EBV latency maintenance and the in vivo triggering signal for lytic induction have yet to be elucidated. Previously, we have shown that the EBV microRNA miR-BART20-5p directly targets the immediate early genes BRLF1 and BZLF1 as well as Bcl-2-associated death promoter (BAD) in EBV-associated gastric carcinoma. In this study, we found that both mRNA and protein levels of BRLF1 and BZLF1 were suppressed in cells following BAD knockdown and increased after BAD overexpression. Progeny virus production was also downregulated by specific knockdown of BAD. Our results demonstrated that caspase-3-dependent apoptosis is a prerequisite for BAD-mediated EBV lytic cycle induction. Therefore, our data suggest that miR-BART20-5p plays an important role in latency maintenance and tumor persistence of EBV-associated gastric carcinoma by inhibiting BAD-mediated caspase-3-dependent apoptosis, which would trigger immediate early gene expression. IMPORTANCE EBV has an ability to remain latent in host cells, including EBV-associated tumor cells hiding from immune surveillance. However, the exact molecular mechanisms of EBV latency maintenance remain poorly understood. Here, we demonstrated that miR-BART20-5p inhibited the expression of EBV immediate early genes indirectly, by suppressing BAD-induced caspase-3-dependent apoptosis, in addition to directly, as we previously reported. Our study suggests that EBV-associated tumor cells might endure apoptotic stress to some extent and remain latent with the aid of miR-BART20-5p. Blocking the expression or function of BART20-5p may expedite EBV-associated tumor cell death via immune attack and apoptosis. PMID:26581978

Differing trends in the association between obesity and self-reported health in Portugal and Switzerland. Data from national health surveys 1992-2007.

PubMed

Marques-Vidal, Pedro; Ravasco, Paula; Paccaud, Fred

2012-08-01

The escalating prevalence of obesity might prompt obese subjects to consider themselves as normal, as this condition is gradually becoming as frequent as normal weight. In this study, we aimed to assess the trends in the associations between obesity and self-rated health in two countries. Data from the Portuguese (years 1995-6, 1998-6 and 2005-6) and Swiss (1992-3, 1997, 2002 and 2007) National Health Surveys were used, corresponding to more than 130,000 adults (64,793 for Portugal and 65,829 for Switzerland). Body mass index and self-rated health were derived from self-reported data. Obesity levels were higher in Portugal (17.5% in 2005-6 vs. 8.9% in 2007 in Switzerland, p < 0.001) and increased in both countries. The prevalence of participants rating their health as "bad" or "very bad" was higher in Portugal than in Switzerland (21.8% in 2005-6 vs 3.9% in 2007, p < 0.001). In both countries, obese participants rated more frequently their health as "bad" or "very bad" than participants with regular weight. In Switzerland, the prevalence of "bad" or "very bad" rates among obese participants, increased from 6.5% in 1992-3 to 9.8% in 2007, while in Portugal it decreased from 41.3% to 32.3%. After multivariate adjustment, the odds ratio (OR) of stating one self's health as "bad" or "very bad" among obese relative to normal weight participants, almost doubled in Switzerland: from 1.38 (95% confidence interval, CI: 1.01-1.87) in 1992-3 to 2.64 (95% CI: 2.14-3.26) in 2007, and similar findings were obtained after sample weighting. Conversely, no such trend was found in Portugal: 1.35 (95% CI: 1.23-1.48) in 1995-6 and 1.52 (95% CI: 1.37-1.70) in 2005-6. Obesity is increasing in Switzerland and Portugal. Obesity is increasingly associated with poorer self-health ratings in Switzerland but not in Portugal.

Tangeretin alters neuronal apoptosis and ameliorates the severity of seizures in experimental epilepsy-induced rats by modulating apoptotic protein expressions, regulating matrix metalloproteinases, and activating the PI3K/Akt cell survival pathway.

PubMed

Guo, Xiao-Qian; Cao, Yu-Ling; Hao, Fang; Yan, Zhong-Rui; Wang, Mei-Ling; Liu, Xue-Wu

2017-09-01

Epilepsy is complex neural disarray categorized by recurring seizures. Despite recent advances in pharmacotherapies for epilepsy, its treatment remains a challenge due to the contrary effects of the drugs. As a result, the identification of novel anti-epileptic drugs (AEDs) with neuroprotective properties and few side effects is of great value. Thus, the present study assessed the treatment effects of tangeretin using a rat model of pilocarpine-induced epilepsy. Separate groups of male Wistar rats received oral administrations of tangeretin at 50, 100, or 200mg/kg for 10 days and then, on the 10th day, they received an intraperitoneal injection of pilocarpine (30mg/kg). Subsequently, neuronal degeneration and apoptosis were assessed using Nissl staining and terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) assay procedures. Additionally, the expressions of phosphatidylinositol-3-kinase (PI3K/Akt) pathway proteins, cleaved caspase-3, Bad, Bcl-2, Bcl-xL, and Bax were determined using Western blot analyses. Tangeretin reduced the seizure scores and latency to first seizure of the rats and effectively activated the pilocarpine-induced suppression of PI3K/Akt signaling. Additionally, tangeretin effectively regulated the levels of apoptosis-inducing factor (AIF) in mitochondria as well as the expressions of apoptotic pathway proteins. Seizure-induced elevations in the activities and expressions of matrix metalloproteinases (MMPs)-2 and -9 were also modulated. The present results indicate that tangeretin exerted potent neuroprotective effects against pilocarpine-induced seizures via the activation of PI3K/Akt signaling and the regulation of MMPs. Copyright © 2017 Medical University of Bialystok. Published by Elsevier B.V. All rights reserved.

Infrared and Skin: Friend or Foe

PubMed Central

Barolet, Daniel; Christiaens, François; Hamblin, Michael R

2016-01-01

In the last decade, it has been proposed that the sun's IR-A wavelengths might be deleterious to human skin and that sunscreens, in addition to their desired effect to protect against UV-B and UV-A, should also protect against IR-A (and perhaps even visible light). Several studies showed that NIR may damage skin collagen content via an increase in MMP-1 activity in the same manner as is known for UVR. Unfortunately, the artificial NIR light sources used in such studies were not representative of the solar irradiance. Yet, little has been said about the other side of the coin. This article will focus on key information suggesting that IR-A may be more beneficial than deleterious when the skin is exposed to the appropriate irradiance/dose of IR-A radiation similar to daily sun exposure received by people in real life. IR-A might even precondition the skin – a process called photoprevention - from an evolutionary standpoint since exposure to early morning IR-A wavelengths in sunlight may ready the skin for the coming mid-day deleterious UVR. Consequently IR-A appears to be the solution, not the problem. It does more good than bad for the skin. It is essentially a question of intensity and how we can learn from the sun. PMID:26745730

Prevalence of bucco-dental pathologies in patients with psychiatric disorders

PubMed Central

Rueda-Delgado, Yusthin M.; Peña-Orozco, David A.

2014-01-01

Introduction: Oral diseases in psychiatric patients are usually a result of bad oral hygiene and psychopharmaceutical side-effects. Objective: The aim of this study was to detect the most prevalent oral lesions in patients hospitalized in a psychiatric institution in Caracas, Venezuela with the confirmed diagnosis of psychiatric illness. Material and Methods: A transversal study consisted of 65 hospitalized patients with psychiatric disorders out of whom 50 were males and 15 females. Patients were aged from 19 to 80 years, mean age 50.2 years. Data on oral lesions were obtained within history and clinical examination of the oral cavity. Other medical data were collected from medical documentation. Statistical analysis was performed by SPSS version 17.0. Results: 56.92% of patients had caries in at least one tooth, 29.23% presented gingivitis and 56.92% periodontal disease. In relation to Temporomandibular joint, 36.92% presented articular sounds and 10.76% muscular pain. Between the most prevalent parafunctional habits were found cigarette habit, bruxism, onychophagia and cheek bite. Conclusion: Results imply that psychiatric patients are more frequently involved with oral lesions than healthy persons. It is necessary to organize specific preventive and educational oral health programmes with these patients, in a multidisciplinary group. Key words:Phychiatric patients, schizophrenia, medication, periodontal diseases. PMID:24596639

Prescriptions and proscriptions: moralising sleep medicines.

PubMed

Gabe, Jonathan; Coveney, Catherine M; Williams, Simon J

2016-05-01

The pharmaceuticalisation of sleep is a contentious issue. Sleep medicines get a 'bad press' due to their potential for dependence and other side effects, including studies reporting increased mortality risks for long-term users. Yet relatively little qualitative social science research has been conducted into how people understand and negotiate their use/non-use of sleep medicines in the context of their everyday lives. This paper draws on focus group data collected in the UK to elicit collective views on and experiences of prescription hypnotics across different social contexts. Respondents, we show, drew on a range of moral repertoires which allowed them to present themselves and their relationships with hypnotics in different ways. Six distinct repertoires about hypnotic use are identified in this regard: the 'deserving' patient, the 'responsible' user, the 'compliant' patient, the 'addict', the 'sinful' user and the 'noble' non user. These users and non-users are constructed drawing on cross-cutting themes of addiction and control, ambivalence and reflexivity. Such issues are in turn discussed in relation to recent sociological debates on the pharmaceuticalisation/de-pharmaceuticalisation of everyday life and the consumption of medicines in the UK today. © 2015 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

Perceptions of rural women about contraceptive usage in district Khushab, Punjab.

PubMed

Tabassum, Aqeela; Manj, Yasir Nawaz; Gunjial, Tahira Rehman; Nazir, Salma

2016-12-01

To identify the perceptions of rural women about modern contraceptive methods and to ascertain the psycho-social and economic attitude of women about family planning methods. This cross-sectional study was conducted at the University of Sargodha, Sargodha, Pakistan, from December 2014 to March 2015, and comprised married women. The sample was selected using multistage sampling technique through Fitzgibbon table. They were interviewed regarding use of family planning methods. . SPSS 16 was used for data analysis. Of the 500 women, 358(71.6%) were never-users and 142(28.4%) were past-users of family planning methods. Moreover, 52(14.5%) of never-users did not know about a single modern contraceptive method. Of the past-users, 43(30.3%) knew about 1-3 methods and 99(69.7%) about 4 or more methods. Furthermore, 153(30.6%) respondents graded condoms as good, 261(55.2%) agreed that family planning helped in improving one's standard of living to a great extent while 453(90.6%) indicated that family planning methods were not expensive. Besides, 366(71.2%) respondents believed that using contraceptive method caused infertility. Dissatisfaction with methods, method failure, bad experiences with side effects, privacy concerns and different myths associated to the methods were strongly related to the non-usage of modern contraceptive methods.

Rebuilding the Food Pyramid.

ERIC Educational Resources Information Center

Willet, Walter C.; Stampfer, Meir J.

2003-01-01

Discusses the old food guide pyramid released in 1992 by the U.S. Department of Agriculture. Contradicts the message that fat is bad, which was presented to the public by nutritionists, and the effects of plant oils on cholesterol. Introduces a new food pyramid. (YDS)

Historical "Bad Guys": Biography as a Teaching Tool.

ERIC Educational Resources Information Center

Dietrich, Donald J.

1987-01-01

Describes a history course on the college level that uses biographies to help students connect important political leaders, such as Hitler and Machiavelli, to the time and place that shaped their actions. Reports on the effectiveness of the class. (RKM)

Misconception About Population Matters and Black Folks

ERIC Educational Resources Information Center

Austin, B. William

1975-01-01

Discusses family planning, genocide, policy implementation, blacks as human guinea-pigs, and the effect of liberalized abortion laws. Family-planning information and services are said to be abundant but comprehensive health care is badly needed. A series of recommendations are made. (AM)

Bad Breath

MedlinePlus

... for lunch. But certain strong-smelling foods like onions and garlic can cause bad breath. So can ... leave behind strong smells, like cabbage, garlic, raw onions, and coffee. If you’re trying to lose ...

The effect of acute tyrosine phenylalanine depletion on emotion-based decision-making in healthy adults.

PubMed

Vrshek-Schallhorn, Suzanne; Wahlstrom, Dustin; White, Tonya; Luciana, Monica

2013-04-01

Despite interest in dopamine's role in emotion-based decision-making, few reports of the effects of dopamine manipulations are available in this area in humans. This study investigates dopamine's role in emotion-based decision-making through a common measure of this construct, the Iowa Gambling Task (IGT), using Acute Tyrosine Phenylalanine Depletion (ATPD). In a between-subjects design, 40 healthy adults were randomized to receive either an ATPD beverage or a balanced amino acid beverage (a control) prior to completing the IGT, as well as pre- and post-manipulation blood draws for the neurohormone prolactin. Together with conventional IGT performance metrics, choice selections and response latencies were examined separately for good and bad choices before and after several key punishment events. Changes in response latencies were also used to predict total task performance. Prolactin levels increased significantly in the ATPD group but not in the control group. However, no significant group differences in performance metrics were detected, nor were there sex differences in outcome measures. However, the balanced group's bad deck latencies speeded up across the task, while the ATPD group's latencies remained adaptively hesitant. Additionally, modulation of latencies to the bad decks predicted total score for the ATPD group only. One interpretation is that ATPD subtly attenuated reward salience and altered the approach by which individuals achieved successful performance, without resulting in frank group differences in task performance. Copyright © 2013 Elsevier Inc. All rights reserved.

Time outs

MedlinePlus

... When you yell and nag, you give your children's bad behavior too much attention. Some children may go into ... to their activities. Do not lecture about the bad behavior. Children eventually get the message with the time out.

42 CFR 413.194 - Appeals.

Code of Federal Regulations, 2010 CFR

2010-10-01

... facility that disputes the amount of its allowable Medicare bad debts reimbursed by CMS under § 413.178 may... prior to seeking judicial review of a dispute regarding the amount of allowable Medicare bad debts. (b...