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Sample records for change empiric treatment

  1. Identity: empirical contribution. Changes in the identity integration of adolescents in treatment for personality disorders.

    PubMed

    Feenstra, Dine J; Hutsebaut, Joost; Verheul, Roel; van Limbeek, Jacques

    2014-02-01

    A renewed interest in identity as one of the core markers of personality disorders has been introduced by the DSM-5 Level of Personality Functioning Scale. However, little is known about the utility of the construct of identity in children and adolescents. This study aimed to broaden the knowledge of identity integration as a core component of personality functioning in adolescents. The authors investigated levels of identity integration, as measured by the Severity Indices of Personality Problems (SIPP-118; Verheul et al., 2008), in adolescents in both normal (n = 406) and clinical populations (n = 285). Furthermore, changes in levels of identity integration during treatment were investigated in a clinical subsample (n = 76). Levels of identity integration were not associated with age. They were, however, associated with the absence or presence of personality pathology. Most adolescents receiving inpatient psychotherapy gradually changed toward more healthy levels of identity integration; a significant number, however, remained at maladaptive levels of identity functioning after intensive psychotherapy.

  2. Evaluation of psychic change through the application of empirical and clinical techniques for a 2-year treatment: a single case study.

    PubMed

    Moreno, Clara M López; Schalayeff, Cristina; Acosta, Silvia R; Vernengo, Pía; Roussos, Andrés J; Lerner, Beatríz Dorfman

    2005-07-01

    Abstract The authors present results obtained by a combination of clinical and empirical methods used in the evaluation of psychic change involving a single case study carried out during 2 years of nonmanualized psychodynamic psychotherapy (Barber & Crits-Christoph, 1993 ; Barber, Foltz, DeRubeis, & Landis, 2002 ). A multidimensional definition of change that includes clinical (psychoanalytic) and empirical perspectives is provided. The authors used material from supervision sessions and clinical meetings to assess the psychodynamic diagnosis and evolution. The following empirical techniques and instruments were used: core conflictual relationship theme (Luborsky & Crits-Christoph, 1990), Symptom Checklist-90-Revised (Derogatis, 1983), and Differential Elements for a Psychodynamic Diagnostic (C. M. López Moreno et al., 1998 ). Several markers of psychic change along the therapeutic process were found. The instruments proved to be sensitive to the changes obtained during the psychotherapy. Used together, the instruments allowed an integrated evaluation of the patient's evolution during the treatment.

  3. Empirically supported treatments for panic disorder.

    PubMed

    McHugh, R Kathryn; Smits, Jasper A J; Otto, Michael W

    2009-09-01

    This article provides an empirical review of the elements and efficacy of both pharmacologic and psychosocial treatments for panic disorder. Both monotherapies and combination treatment strategies are considered. The available evidence suggests that both cognitive behavioral therapy (CBT) and pharmacotherapy (prominently, selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors) are effective first-line agents and that CBT offers particular cost efficacy relative to both pharmacotherapy alone and combined pharmacotherapy and CBT. Predictors of non-response and mechanisms of action are considered, as are novel treatment strategies, including the use of memory enhancers to improve CBT outcome.

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

    ERIC Educational Resources Information Center

    Coleman, Hardin L. K.

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

  5. Treatments for Sleep Changes

    MedlinePlus

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

  6. Issues and Controversies that Surround Recent Texts on Empirically Supported and Empirically Based Treatments

    ERIC Educational Resources Information Center

    Paul, Howard A.

    2004-01-01

    Since the 1993 APA task force of the Society of Clinical Psychology developed guidelines to apply data-based psychology to the identification of effective psychotherapy, there has been an increasing number of texts focussing on Empirically based Psychotherapy and Empirically Supported Treatments. This manuscript examines recent key texts and…

  7. Empirical Treatment Effectiveness Models for Binary Outcomes.

    PubMed

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

    Foley, Jessica M.

    2004-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  12. Empiric treatment of neonatal sepsis in developing countries.

    PubMed

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

    2015-06-01

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

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

    ERIC Educational Resources Information Center

    Wilkins, Victoria; Chambliss, Catherine

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

  14. Individual Worker-Level Attitudes Toward Empirically Supported Treatments.

    PubMed

    Patterson, David A; Wolf Adelv Unegv Waya, Silver; Maguin, Eugene; Dulmus, Catherine N; Nisbet, Bruce C

    2013-01-01

    OBJECTIVES: There is a growing literature indicating that organizational and individual worker-level factors affect decisions about whether or not empirically supported treatments (ESTs) are adopted within health care agencies. The purpose of this pilot study is to further investigate and measure worker's attitudes within a community organization. METHOD: A small organization participated in the study due to their diversity in services offered. Of the 92 workers eligible for participation in the study, 66 (72%) completed the Evidence-Based Practice Attitude scale survey. RESULTS: Multivariate analyses revealed that female workers scored higher on both Openness and total score; workers with nursing, education, or psychology majors scored lower than workers with other (excluding social work) majors on both Divergence and total score; and that older workers scored higher on Divergence. CONCLUSION: Although small, this study identifies individual characteristics that are most likely to fit the profile of an EST adopter.

  15. Individual Worker-Level Attitudes Toward Empirically Supported Treatments

    PubMed Central

    Patterson, David A.; Wolf (Adelv unegv Waya), Silver; Maguin, Eugene; Dulmus, Catherine N.; Nisbet, Bruce C.

    2012-01-01

    Objectives There is a growing literature indicating that organizational and individual worker-level factors affect decisions about whether or not empirically supported treatments (ESTs) are adopted within health care agencies. The purpose of this pilot study is to further investigate and measure worker’s attitudes within a community organization. Method A small organization participated in the study due to their diversity in services offered. Of the 92 workers eligible for participation in the study, 66 (72%) completed the Evidence-Based Practice Attitude scale survey. Results Multivariate analyses revealed that female workers scored higher on both Openness and total score; workers with nursing, education, or psychology majors scored lower than workers with other (excluding social work) majors on both Divergence and total score; and that older workers scored higher on Divergence. Conclusion Although small, this study identifies individual characteristics that are most likely to fit the profile of an EST adopter. PMID:23243380

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

    PubMed

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

    2012-11-01

    OBJECTIVES: With the continued push to implement empirically supported treatments (ESTs) into community-based organizations, it is important to investigate whether working condition disruptions occur during this process. While there are many studies investigating best practices and how to adopt them, the literature lacks studies investigating the working conditions in programs that currently use ESTs. METHOD: This study compared the culture and climate scores of a large organization's programs that use ESTs and those programs indicating no EST usage. RESULTS: Of the total 55 different programs (1,273 frontline workers), 27 programs used ESTs. Results indicate that the programs offering an EST had significantly more rigid and resistant cultures, compared to those without any ESTs. In regard to climate, programs offering an EST were significantly less engaged, less functional, and more stressed. CONCLUSION: Outcomes indicate a significant disruption in organizational culture and climate for programs offering ESTs.

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

    NASA Astrophysics Data System (ADS)

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

    2015-04-01

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

  18. Multiresistant bacterial infections in liver cirrhosis: Clinical impact and new empirical antibiotic treatment policies

    PubMed Central

    Acevedo, Juan

    2015-01-01

    Recently, important changes have been reported regarding the epidemiology of bacterial infections in liver cirrhosis. There is an emergence of multiresistant bacteria in many European countries and also worldwide, including the United States and South Korea. The classic empirical antibiotic treatment (third-generation cephalosporins, e.g., ceftriaxone, cefotaxime or amoxicillin-clavulanic acid) is still effective in infections acquired in the community, but its failure rate in hospital acquired infections and in some health-care associated infections is high enough to ban its use in these settings. The current editorial focuses on the different epidemiology of bacterial infections in cirrhosis across countries and on its therapeutic implications. PMID:25954474

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

    PubMed

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

    2009-02-01

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

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

    PubMed

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

    2009-02-01

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

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

    ERIC Educational Resources Information Center

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

    2000-01-01

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

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

    ERIC Educational Resources Information Center

    Wilkins, Victoria; Chambliss, Catherine

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

    Palsson, Olafur S

    2015-10-01

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

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

    PubMed

    Palsson, Olafur S

    2015-10-01

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

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

    PubMed

    O'connor, K

    1984-08-01

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

  7. The role of empirical albendazole treatment in idiopathic hypereosinophilia – a case series

    PubMed Central

    Vaisben, Eleonora; Brand, Ronen; Kadakh, Anas; Nassar, Faris

    2015-01-01

    Hypereosinophilia is usually defined as a blood eosinophil count >1500/μL. A broad variety of conditions are associated with hypereosinophilia. The present report describes three cases of hypereosinophilia, in which a thorough history, physical examination, laboratory and imaging investigations were unable to detect any abnormalities. Albendazole was empirically administered in all three cases, with complete normalization of eosinophil counts thereafter. Empirical treatment with albendazole for patients presenting with hypereosinophilia should be strongly considered. PMID:26744590

  8. Drug-induced handwriting changes: an empirical review.

    PubMed

    Gross, L J

    1975-01-01

    Since handwriting is a highly complex, coordinated motor activity, handwrits of pharmacological agents. Its potential has been most evident in research involving therapeutic administrations of anti-psychotic an anti-Parkinsonian drugs, from which consistent and systematic handwriting changes have been observed. This relationship has been found to be particularly significant among the anti-psychotics, since the onset of these graphomotor alterations appear to mark the optmal dose of the drug. Consistent and systematic handwriting changes have not been as evident in inivestigations of drugs used in a nontherapeutic atmosphere. Psychiatric assessments of subjects in ths type of research provided data which indicated that psychological stability may be a factor influencing the susceptibility of one's handwriting to drug induced changes.

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

    ERIC Educational Resources Information Center

    Wilkins, Victoria; Chambliss, Catherine

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

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

    ERIC Educational Resources Information Center

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

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

  11. Mechanisms of change in adolescent substance use treatment: How does treatment work?

    PubMed Central

    Black, Jessica J.; Chung, Tammy

    2014-01-01

    Background Adolescent substance use treatment outcome research generally shows small to moderate effects in reducing substance use, with no specific “brand” of treatment emerging as clearly superior to any other, and treatment gains that fade over time. The relatively weak and temporary effects of treatment call for improving the potency and durability of intervention effects. In response to this call, this critical narrative review summarizes research on mechanisms of change for both adults and adolescents in substance use treatment, with a particular focus on reviewing what is known regarding “how” adolescent substance use treatment works. Methods A comprehensive review of the adolescent (ages 11–18) substance use treatment literature was conducted to identify empirical studies that examined mediators of intervention effects. Relevant databases (e.g., PsychINFO, Medline) were searched using key words (e.g., “mediator”), and relevant articles from reference sections of identified studies and review papers were considered. Results Studies of mechanisms of psychotherapy change are rare in the adult, and particularly adolescent, substance use treatment outcome literature. The four adolescent studies that examined substance use treatment mechanisms found that positive social support, motivation to abstain, and positive parenting behaviors mediated treatment effects. To date, research has not supported therapy-specific mechanisms of change, finding instead that “common” processes of change largely account for improvements in outcome across distinct “brands” of treatment. Conclusions The lack of empirical support for treatment-specific mechanisms of change may be due to the need for greater precision in defining and measuring treatment-specific causal chains. Future directions include neuroscience approaches to examining changes in brain functioning that are associated with treatment response and recovery and examining mechanisms in adaptive

  12. Empirical Examination of a Multicomponent Treatment for Pediatric Food Refusal.

    ERIC Educational Resources Information Center

    Hoch, Theodore A.; Babbitt, Roberta L.; Farrar-Schneider, Debra; Berkowitz, Merrill J.; Owens, J. Carl; Knight, Terry L.; Snyder, Angela M.; Rizol, Laura M.; Wise, David T.

    2001-01-01

    This paper reports on assessment and treatment of food refusal for four inpatient boys (ages 2,3,3, and 9) receiving tube feedings. It used a contingency contacting procedure extended by a component analysis. Data suggest that food refusal appeared to be maintained primarily by negative reinforcement contingencies. Caregiver responses indicated a…

  13. Empiric validation of a process for behavior change.

    PubMed

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

    2016-09-01

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

  14. Training addiction professionals in empirically-supported treatments: Perspectives from the treatment community

    PubMed Central

    Hartzler, Bryan; Rabun, Carl

    2014-01-01

    Background Large-scale dissemination efforts seek to expand opportunities for the addiction treatment community to receive training in empirically supported treatments (ESTs). Prospective consumers of such training are valuable sources of input about content of interest, preferences for how training events are structured, and obstacles that deter receipt of training. Methods In this mixed method study, data were collected in 64 semi-structured individual interviews with personnel during site visits to 16 community opioid treatment programs (OTPs). At each OTP, interviews were completed with the executive director, a clinical supervisor, and two direct-service clinicians. Topical interests were analyzed qualitatively in a cultural domain analysis. Likert ratings of training event preferences were analyzed via generalized linear mixed models (GLMM), and unstructured interviewee comments were analyzed via narrative analysis. Obstacles to training receipt were analyzed qualitatively with both content coding and narrative analysis. Results Based on topics of reported interest, cultural domain analysis suggests as ESTs of note: Multidimensional Family Therapy, Motivational Enhancement Therapy, Relapse Prevention Therapy, ‘Seeking Safety,’ and broad addiction-focused pharmacotherapy. Regarding training event preferences, GLMM and narrative analysis revealed clear preferences for time-distributed trainings and use of participatory activities (e.g., trainer demonstrations, role plays, small group exercises). Content coding identified cost as the primary obstacle to receipt of EST trainings, followed by lack of time, logistical challenges, and disinterest, and narrative analysis elaborated on contextual issues underlying these obstacles. Conclusions As primary consumers of EST technologies, the treatment community has valuable input to offer. Dissemination efforts may be enhanced by greater consideration of their preferences for training content and event structure, as

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

    PubMed

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

    2016-07-01

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

  16. Empirically Derived Consequences: A Data-Based Method for Prescribing Treatments for Destructive Behavior.

    ERIC Educational Resources Information Center

    Fisher, Wayne; And Others

    1994-01-01

    This study used a data-based assessment to identify reinforcers and punishers for successful treatment of two children with severe destructive behaviors. Results suggested that empirically derived consequences may be useful in decreasing destructive behavior when a functional assessment is inconclusive or suggests that internal stimuli are…

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

    ERIC Educational Resources Information Center

    Jennett, Heather K.; Hagopian, Louis P.

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Saxe, Brenda J.; Johnson, Susan M.

    1999-01-01

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

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

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

    ERIC Educational Resources Information Center

    Sheridan, Susan M.

    2000-01-01

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

  1. Changing Heterosexuals' Attitudes toward Homosexuals: A Systematic Review of the Empirical Literature

    ERIC Educational Resources Information Center

    Tucker, Edmon W.; Potocky-Tripodi, Miriam

    2006-01-01

    Objective: This article systematically reviews evidence for interventions that change attitudes toward homosexuals. Method: In all, 17 empirical studies using college and/or university student samples and interventions intended to improve heterosexuals' attitudes toward lesbian, gay, or bisexual individuals are reviewed. Characteristics of the…

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed

    Williams, Izaak L

    2016-01-01

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

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

    PubMed Central

    Dierssen, Heidi M.

    2010-01-01

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

  7. Hazwaste treatment services weather changes

    SciTech Connect

    Melody, M.

    1993-06-01

    The hazardous waste treatment market traditionally has been influenced by numerous factors, such as technology, available capacity, regulatory compliance, and the costs of transportation, treatment, disposal and potential liability. Additional market influences have arisen recently, including industry waste reduction efforts, the Clinton administration's environmental philosophy, renewed political pressure from environmental and community groups, and potential shifts in public opinion about environmental management. The array of traditional market factors remains relatively constant, while the range of newer influences tends to depend on the directions taken by industrial, political and economic trends. All of the factors influencing the hazardous waste treatment market directly affect generators by determining available treatment options and costs for various services. However, a bleak forecast for the treatment market can mean favorable conditions for generators.

  8. Sodium thiosulfate or hydroxocobalamin for the empiric treatment of cyanide poisoning?

    PubMed

    Hall, Alan H; Dart, Richard; Bogdan, Gregory

    2007-06-01

    Cyanide poisoning must be seriously considered in victims of smoke inhalation from enclosed space fires; it is also a credible terrorism threat agent. The treatment of cyanide poisoning is empiric because laboratory confirmation can take hours or days. Empiric treatment requires a safe and effective antidote that can be rapidly administered by either out-of-hospital or emergency department personnel. Among several cyanide antidotes available, sodium thiosulfate and hydroxocobalamin have been proposed for use in these circumstances. The evidence available to assess either sodium thiosulfate or hydroxocobalamin is incomplete. According to recent safety and efficacy studies in animals and human safety and uncontrolled efficacy studies, hydroxocobalamin seems to be an appropriate antidote for empiric treatment of smoke inhalation and other suspected cyanide poisoning victims in the out-of-hospital setting. Sodium thiosulfate can also be administered in the out-of-hospital setting. The efficacy of sodium thiosulfate is based on individual case studies, and there are contradictory conclusions about efficacy in animal models. The onset of antidotal action of sodium thiosulfate may be too slow for it to be the only cyanide antidote for emergency use. Hydroxocobalamin is being developed for potential introduction in the United States and may represent a new option for emergency personnel in cases of suspected or confirmed cyanide poisoning in the out-of-hospital setting. PMID:17098327

  9. An Empirical Bayes Framework for Assessing Changes in the Hydrological Cycle

    NASA Astrophysics Data System (ADS)

    Cheng, L.; AghaKouchak, A.

    2014-12-01

    Greenhouse gases in the atmosphere have been increasing since the industrial revolution, leading to the warming of the Earth through an increase in downwelling infrared radiation. Warming of the atmosphere increases its water holding capacity and could intensify the hydrological cycle. Several methods have been developed for evaluating changes in climatic variables. On the other hand, numerous indices have been developed for monitoring changes in climatic variables. Most change detection methods, indices, and trend studies focus on changes in one variable at the time. However, hydrologic variables are dependent, and a change in one variable can alter extreme and non-extreme values of other variables. In this study, a new approach for modeling multivariate extreme values through a conditional distribution framework using the empirical Bayes approach is proposed. This study highlights the value of empirical Bayes conditional extreme value analysis as a tool for simulating and assessing conditional extremes (e.g., changes in the distribution of precipitation conditioned on extreme temperature). The model has been applied to several locations across the world. This presentation will summarize the findings on changes in the hydrological cycle over the United States and Australia.

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

    PubMed Central

    2013-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Moore, F.; Burke, M.

    2015-12-01

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

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

    PubMed

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

    2008-03-01

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

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

    PubMed

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

    2008-03-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2013-01-01

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

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

    PubMed

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

    2013-01-01

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

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

    PubMed Central

    Vickerman, Katrina A.; Margolin, Gayla

    2009-01-01

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

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

    SciTech Connect

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

    2000-04-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2000-04-01

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

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

    PubMed

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

    2016-05-01

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

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

    PubMed

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

    2016-05-01

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

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

    PubMed

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

    2016-01-01

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

  4. Body Composition Changes Associated With Methadone Treatment

    PubMed Central

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

    2016-01-01

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

  5. Pharmacoeconomic evaluation of voriconazole vs. liposomal amphotericin B in empiric treatment of invasive fungal infections in Turkey

    PubMed Central

    2013-01-01

    Background Invasive fungal infections (IFI) are associated with considerable expense and mortality on healthcare systems. There is a need to provide evidence of both clinical efficacy and value for money with any health technology. The current pharmacoeconomic evaluation investigated the use of liposomal amphotericin B (LAmB) and voriconazole for the empiric treatment of IFI in the Turkish setting. Methods Decision analytic modelling was used to create a pathway for patient treatment with a 5-point composite outcome measure. The data was obtained from a major non-inferiority multicentre randomised controlled study, with an expert panel of clinicians in Turkey providing transition probabilities and cost not available in the literature. Sensitivity analyses were performed on the inputs from the clinical trial and the expert panel. Results As per the base case analysis, voriconazole was preferred by Turkish Lira (TL) 2,523 per patient treated and TL2,520 per surviving patient. LAmB was the preferred alternative by TL5,362 per successfully treated patient. Removing fever resolution as part of the composite outcome measure resulted in voriconazole being the preferred alternative per successfully treated patient. Univariate sensitivity analysis highlighted that increasing the duration of voriconazole by >1.2 days or decreasing LAmB by >1.0 days changes the result. Monte Carlo Simulation resulted in 69.4% of simulations favouring voriconazole per patient treated. Conclusion There is a strong likelihood that voriconazole is economically more favourable than LAmB in the empiric treatment of IFI in Turkey. PMID:24279677

  6. AN EMPIRICAL METHOD FOR MATERIALITY: WOULD CONFLICT OF INTEREST DISCLOSURES CHANGE PATIENT DECISIONS?

    PubMed

    Spece, Roy; Yokum, David; Okoro, Andrea-Gale; Robertson Christopher

    2014-01-01

    The law has long been concerned with the agency problems that arise when advisors, such as attorneys or physicians, put themselves in financial relationships that create conflicts of interest. If the financial relationship is "material" to the transactions proposed by the advisor, then non-disclosure of the relationship may be pertinent to claims of malpractice, informed consent, and even fraud, as well as to professional discipline. In these sorts of cases, materiality is closely related to the question of causation, roughly turning on whether the withheld information might have changed the decision of a reasonable advisee (i.e., a patient). The injured plaintiff will predictably testify that the information would have impacted his or her choice, but that self-serving testimony may be unreliable. The fact finder is left to speculate about the counterfactual world in which the information was disclosed. This Article shows how randomized vignette-based experimentation may create a valuable form of evidence to address these questions, for both litigation and policymaking. To demonstrate this method and investigate conflicts of interest in healthcare in particular, we recruited 691 human subjects and asked them to imagine themselves as patients facing a choice about whether to undergo a cardiac stenting procedure recommended by a cardiologist. We manipulated the vignettes in a 2 x 3 between-subjects design, where we systematically varied the appropriateness of the proposed treatment, which was described in terms of patient risk without the procedure (low or high), and manipulated the type of disclosure provided by the physician (none, standard, or enhanced). We used physician ownership of the specialty hospital where the surgery would be performed as the conflict of interest, disclosed or not, and the "enhanced" disclosure included notice that such relationships have been associated with biases in prescribing behavior. We found that the mock patients were

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

    PubMed Central

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

    2015-01-01

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

  8. Adolescents with attention-deficit/hyperactivity disorder: an overview of empirically based treatments.

    PubMed

    Barkley, Russell A

    2004-01-01

    The author first presents an overview of attention-deficit/hyperactivity disorder (ADHD) as it presents in adolescents. He reviews what is known about the predominantly inattentive subtype in adolescents, the persistence of symptoms into this developmental phase, and comorbid disorders in adolescent patients with ADHD. The author then reviews treatments for adolescents with ADHD for which there is some empirical support in the scientific literature. He first discusses common assumptions concerning the treatment of ADHD and evidence for or against these assumptions. Information on therapies that have been shown to be ineffective or the benefit of which is unproven are then described. These include cognitive-behavioral therapy and social skills training. The author then presents an overview of what is known about the medication treatment of ADHD and discusses how this information is applicable to adolescents with the disorder. Four main classes of drugs are discussed: stimulants, noradrenergic reuptake inhibitors, tricyclic antidepressants, and antihypertensive agents. The author then reviews the use of several psychosocial interventions, including contingency management strategies, parent training in behavior management methods, and teacher training in classroom management, and discusses how these strategies can best be used for adolescents with ADHD. The author then discusses the use of combined treatment with psychosocial interventions and medication. Finally, information on the use of physical exercise as therapy for adolescents with ADHD is discussed.

  9. Moving empirically supported practices to addiction treatment programs: recruiting supervisors to help in technology transfer.

    PubMed

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

    2010-05-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  12. Empirical Model for Predicting Concentrations of Refractory Hydrophobic Organic Compounds in Digested Sludge from Municipal Wastewater Treatment Plants

    PubMed Central

    Deo, Randhir P.; Halden, Rolf U.

    2009-01-01

    An empirical model is presented allowing for the prediction of concentrations of hydrophobic organic compounds (HOCs) prone to accumulate and persist in digested sludge (biosolids) generated during conventional municipal wastewater treatment. The sole input requirements of the model are the concentrations of the individual HOCs entering the wastewater treatment plant in raw sewage, the compound’s respective pH-dependent octanol-water partitioning coefficient (DOW), and an empirically determined fitting parameter (pfit) that reflects persistence of compounds in biosolids after accounting for all potential removal mechanisms during wastewater treatment. The accuracy of the model was successfully confirmed at the 99% confidence level in a paired t test that compared predicted concentrations in biosolids to empirical measurements reported in the literature. After successful validation, the resultant model was applied to predict levels of various HOCs for which occurrence data in biosolids thus far are lacking. PMID:20161626

  13. Financial incentives and psychiatric services in Australia: an empirical analysis of three policy changes.

    PubMed

    Doessel, D P; Scheurer, Roman W; Chant, David C; Whiteford, Harvey

    2007-01-01

    Australia has a national, compulsory and universal health insurance scheme, called Medicare. In 1996 the Government changed the Medicare Benefit Schedule Book in such a way as to create different financial incentives for consumers or producers of out-of-hospital private psychiatric services, once an individual consumer had received 50 such services in a 12-month period. The Australian Government introduced a new Item (319) to cover some special cases that were affected by the policy change. At the same time, the Commonwealth introduced a 'fee-freeze' for all medical services. The purpose of this study is two-fold. First, it is necessary to describe the three policy interventions (the constraints on utilization, the operation of the new Item and the general 'fee-freeze'.) The new Item policy was essentially a mechanism to 'dampen' the effect of the 'constraint' policy, and these two policy changes will be consequently analysed as a single intervention. The second objective is to evaluate the policy intervention in terms of the (stated) Australian purpose of reducing utilization of psychiatric services, and thus reducing financial outlays. Thus, it is important to separate out the different effects of the three policies that were introduced at much the same time in November 1996 and January 1997. The econometric results indicate that the composite policy change (constraining services and the new 319 Item) had a statistically significant effect. The analysis of the Medicare Benefit (in constant prices) indicates that the 'fee-freeze' policy also had a statistically significant effect. This enables separate determination of the several policy changes. In fact, the empirical results indicate that the Commonwealth Government underestimated the 'savings' that would arise from the 'constraint' policy. PMID:18634669

  14. Modes of response to environmental change and the elusive empirical evidence for bet hedging

    PubMed Central

    Simons, Andrew M.

    2011-01-01

    Uncertainty is a problem not only in human decision-making, but is a prevalent quality of natural environments and thus requires evolutionary response. Unpredictable natural selection is expected to result in the evolution of bet-hedging strategies, which are adaptations to long-term fluctuating selection. Despite a recent surge of interest in bet hedging, its study remains mired in conceptual and practical difficulties, compounded by confusion over what constitutes evidence for its existence. Here, I attempt to resolve misunderstandings about bet hedging and its relationship with other modes of response to environmental change, identify the challenges inherent to its study and assess the state of existing empirical evidence. The variety and distribution of plausible bet-hedging traits found across 16 phyla in over 100 studies suggest their ubiquity. Thus, bet hedging should be considered a specific mode of response to environmental change. However, the distribution of bet-hedging studies across evidence categories—defined according to potential strength—is heavily skewed towards weaker categories, underscoring the need for direct appraisals of the adaptive significance of putative bet-hedging traits in nature. PMID:21411456

  15. Empirical prediction of the temporal change of hydraulic conductivity in tilled Mediterranean vineyard

    NASA Astrophysics Data System (ADS)

    Paré, N.; Andrieux, P.; Louchart, X.; Biarnès, A.; Voltz, M.

    2009-04-01

    The use of distributed runoff models for the evaluation of hydrological impacts of crop management practices in cultivated catchments (e.g erosion, water pollution) requires recognition of the temporal change of soil hydraulic parameters as influenced by tillage operations and subsequent reconsolidation of the tilled layer under the influence of climatic factors. The more numerous the tillages are during the cultural cycle, the more complicated this recognition is. That is the case of crops with small soil cover like vineyards for which soil tillage is operated several times between the vines rows troughout the vegetative cycle. The objective of this study was to predict with only few parameters the temporal change of hydraulic conductivity at the plot-scale in a viticultural Mediterranean catchment in southern France. Hydraulic conductivity was evaluated through 4 classes of soil surface caracteristics (SSC) which differ by different levels of soil crusting, roughness and porosity. A previous experiment showed that each class has a significantly different infiltration property as measured by rainfall simulation. A number of 600 observations of SSC were performed on 59 tilled plots from which 480 from march to july 2007 and 120 from february 2004 to february 2007. The dates of tillages were known thanks to weekly observations and to farmer's declarations. Rainfall was measured by a rain gauge. A discriminant analysis was applied to the observed data in order to derive an empirical equation that predicts the temporal change of SSC. The results showed that during the vegetative cycle, with regular tillages operations between the vines rows, the temporal change of SSC was well predicted by two parameters : total amount of rainfall and cumulative rainfall kinetic energy since last tillage. Then, each SSC was linked to an hydraulic conductivity, and consequently, the evolution of the soil hydraulic conductivity could be predicted from the evolution of SSC.

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

    Juel, Morgen Joray

    2012-01-01

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

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

    PubMed

    Ballesteros, Francisco; Labrador, Francisco J

    2014-01-01

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

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

    PubMed

    Ballesteros, Francisco; Labrador, Francisco J

    2014-01-01

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

  20. Interpersonal Change Following Intensive Inpatient Treatment

    PubMed Central

    Clapp, Joshua D.; Grubaugh, Anouk L.; Allen, Jon G.; Oldham, John M.; Fowler, J. Christopher; Hardesty, Susan; Frueh, B. Christopher

    2014-01-01

    Objective: Persons admitted for inpatient psychiatric care often present with interpersonal difficulties that disrupt adaptive social relations and complicate the provision of treatment. Whereas domains of psychosocial functioning in this population demonstrate clear growth in response to intervention, the impact of treatment on more complex patterns of interpersonal behavior has been largely overlooked within the existing literature. Interpersonal profiles characteristic of psychiatric inpatients were identified in the current study to determine rates of transition to adaptive functioning following hospitalization. Methods: Personality disturbance was assessed in 513 psychiatric inpatients using the Inventory of Interpersonal Problems. Scores were analyzed within a series of latent profile models to isolate unique interpersonal profiles at admission and at discharge. Longitudinal modeling was then employed to determine rates of transition from dysfunctional to adaptive profiles. Relationships with background characteristics, clinical presentation, and treatment response were explored. Results: Normative, Submissive, and Hostile/Withdrawn profiles emerged at both admission and discharge. Patients in the Normative profile demonstrated relatively moderate symptoms. Submissive and Hostile/Withdrawn profiles were related to known risk factors and elevated psychopathology. Approximately half of patients identified as Submissive or Hostile/Withdrawn transitioned to the Normative profile by discharge. Transition status evidenced modest associations with background characteristics and clinical presentation. Treatment engagement and reduction of clinical symptoms were strongly associated with adaptive transition. Conclusion: Maladaptive interpersonal profiles characteristic of psychiatric inpatients demonstrated categorical change following inpatient hospitalization. Enhanced therapeutic engagement and overall reductions in psychiatric symptoms appear to increase potential

  1. Organizational Readiness for Change and Opinions toward Treatment Innovations

    PubMed Central

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

    2007-01-01

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

  2. Organizational Readiness for Change and opinions toward treatment innovations.

    PubMed

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

    2007-09-01

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

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

    PubMed Central

    Henggeler, Scott W.; Sheidow, Ashli J.

    2011-01-01

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

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

    PubMed Central

    Thomson, Hilary; Thomas, Sian

    2015-01-01

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

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

    PubMed

    Thomson, Hilary; Thomas, Sian

    2015-01-01

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

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

    PubMed

    Thomson, Hilary; Thomas, Sian

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  8. Changes in anatomy instruction and USMLE performance: empirical evidence on the absence of a relationship.

    PubMed

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

    2013-01-01

    Anatomy instruction has evolved over the past two decades as many medical schools have undergone various types of curricular reform. To provide empirical evidence about whether or not curricular changes impact the acquisition and retention of anatomy knowledge, this study investigated the effect of variation in gross anatomy course hours, curricular approach (stand-alone versus integrated), and laboratory experience (dissection versus dissection and prosection) on USMLE Steps 1 and 2 Clinical Knowledge (CK) scores. Gross anatomy course directors at 54 United States schools provided information about their gross anatomy courses via an online survey (response rate of 42%). Survey responses were matched with USMLE scores for 6,411 examinees entering LCME-accredited schools in 2007 and taking Step 1 for the first time in 2009. Regression analyses were conducted to examine relationships between gross anatomy instructional characteristics and USMLE performance. Step 1 total scores, Step 1 gross anatomy sub-scores, and Step 2 CK scores were unrelated to instructional hours, controlling for MCAT scores. Examinees from schools with integrated curricula scored slightly lower on Steps 1 and 2 CK than those from stand-alone courses (effect sizes of 2.1 and 1.9 on score scales with SDs of 22 and 20, respectively). Examinees with dissection and prosection experience performed slightly better on Step 2 CK than examinees in courses with dissection only laboratories (effect size of 1.2). Results suggest variation in course hours is unrelated to performance on Steps 1 and 2 CK. Although differences were observed in relation to curricular approach and laboratory experience, effect sizes were small.

  9. Routine Treatment of Cervical Cytological Cell Changes

    PubMed Central

    Huber, J.; Pötsch, B.; Gantschacher, M.; Templ, M.

    2016-01-01

    Introduction: Diagnosis and treatment of vaginal and cervical cytological cell changes are described in European and national guidelines. The aim of this data collection was to evaluate the remission rates of PAP III and PAP III D cytological findings in patients over a period of 3–4 months. Method: The current state of affairs in managing suspicious and cytological findings (PAP III, and III D) in gynecological practice was assessed in the context of a data collection survey. An evaluation over a period of 24 months was conducted on preventative measures, the occurrence and changes to normal/suspect/pathological findings and therapy management (for suspicious or pathological findings). Results: 307 female patients were included in the analysis. At the time of the survey 186 patients (60.6 %) had PAP III and 119 (38.8 %) had PAP III D findings. The spontaneous remission rate of untreated PAP III patients was 6 % and that of untreated PAP III D patients was 11 %. The remission rates of patients treated with a vaginal gel were 77 % for PAP III and 71 % for PAP III D. Conclusion: A new treatment option was used in gynecological practice on patients with PAP III and PAP III D findings between confirmation and the next follow-up with excellent success. PMID:27761030

  10. Mindfulness-based treatment to prevent addictive behavior relapse: theoretical models and hypothesized mechanisms of change.

    PubMed

    Witkiewitz, Katie; Bowen, Sarah; Harrop, Erin N; Douglas, Haley; Enkema, Matthew; Sedgwick, Carly

    2014-04-01

    Mindfulness-based treatments are growing in popularity among addiction treatment providers, and several studies suggest the efficacy of incorporating mindfulness practices into the treatment of addiction, including the treatment of substance use disorders and behavioral addictions (i.e., gambling). The current paper provides a review of theoretical models of mindfulness in the treatment of addiction and several hypothesized mechanisms of change. We provide an overview of mindfulness-based relapse prevention (MBRP), including session content, treatment targets, and client feedback from participants who have received MBRP in the context of empirical studies. Future research directions regarding operationalization and measurement, identifying factors that moderate treatment effects, and protocol adaptations for specific populations are discussed.

  11. Optimal climate change signal detection using space-time empirical orthogonal functions

    NASA Astrophysics Data System (ADS)

    Wu, Qigang

    2000-10-01

    Space-time optimal filtering is used to estimate the response of the Earth's surface temperature to both natural and anthropogenic climate forcings over the past century. In this study, a variety of site/record-length configurations is used to represent the climate change signals, natural variability and observational data streams. The hypothesized space-time patterns of the response to the climate forcings are generated from an energy balance climate model (EBCM) and four coupled ocean/atmosphere general circulation models (GCMs). The natural variability statistics are estimated from 1000- year control runs from four coupled GCMs and then such natural variability is represented precisely in terms of the space-time empirical orthogonal functions (EOFs), obtained directly from the lagged space-time covariance matrix on the approximate time interval. Optimal filters are constructed using the hypothesized space-time patterns along with the EOF-represented natural variability. The constructed filters are then applied to the observational surface temperature data. With a proposed orthogonalization process, signals `not- of-interest' are optimally removed from the data stream in the estimation process. Comparisons show that the responses to the anthropogenic climate forcings generated from the EBCM and four GCMs are very similar to each other. A robust greenhouse-gas signal is detected in the observational surface temperature data, but with a weak amplitude only about 60-70% of that expected from the hypothesized signal patterns. An anthropogenic aerosol signal is very weak and not statistically significant. The estimated amplitude of aerosol indicates that four GCMs in this study might overpredict the response to greenhouse gas- plus-aerosol forcing by a factor of two to five. A volcanic signal is also robust but with about 65% expected amplitude. A solar-cycle signal is significant at a level of 90% and somewhat stronger than the amplitude of the EBCM

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  15. An empirical description of phases of maintenance following treatment for alcohol dependence.

    PubMed

    Murphy, S A; Hoffman, A L

    1993-01-01

    This article reports two longitudinal prospective studies conducted sequentially to describe participants' maintenance of abstinence experiences up to 36 months posttreatment. Study 1 reports responses of 102 subjects who maintained alcohol abstinence following treatment and who were assessed for duration and intensity of symptoms associated with postacute withdrawal at baseline, 3, 6, and 12 months. A decreasing linear trend of symptoms was found as time of alcohol abstinence increased. Study 2 obtained interview and survey data from 23 successful abstainers from Study 1 at 12, 18, and 36 months posttreatment to describe coping strategies, perceptions of relapse risk, extent and duration of "aftercare," and substitute addictions as these phenomena developed and changed over time. Multiple occasions of data collection supported the description of three phases of maintenance: symptom stabilization/management accompanied by a cognitive paradigm shift, distancing self from alcohol-dependent behavior, and normalization of life processes.

  16. Behavior Change Outcomes of Marathon Group Treatment

    ERIC Educational Resources Information Center

    Uhlemann, Max R.; Weigel, Richard G.

    1977-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  19. Economic evaluation of linezolid, flucloxacillin and vancomycin in the empirical treatment of cellulitis in UK hospitals: a decision analytical model.

    PubMed

    Vinken, A; Li, Z; Balan, D; Rittenhouse, B; Wilike, R; Nathwani, D

    2001-12-01

    Standard antibiotic treatment of infections has become more difficult and costly due to treatment failure associated with the rise in bacterial resistance. New antibiotics that can overcome such resistant pathogens have the potential for great clinical and economic impact. Linezolid is a new antibiotic that is effective in the treatment of both antibiotic-susceptible and antibiotic-resistant Gram-positive bacterial infections, including those resistant to other available antibiotics. This breadth of activity is unique in existing antibiotics for Gram-positive bacteria and serves as the rationale for exploring the hypothesis that linezolid is an appropriate choice when considering empirical treatment of cellulitis in complicated or compromised patients in the nosocomial setting. A decision-modelling approach was used to compare the predicted first-line treatment efficacy and direct medical costs of linezolid with standard treatment of cellulitis among hospitalized patients. For the purposes of this analysis, standard care is defined along two main pathways: (1) initiating care with intravenous (iv) flucloxacillin, switching to vancomycin if the pathogen is found to be resistant to flucloxacillin, or maintaining flucloxacillin if the pathogen is found susceptible, or when culture and sensitivity analysis is inconclusive; or (2) initiating care with vancomycin, switching to iv flucloxacillin if the pathogen is found susceptible to flucloxacillin, maintaining vancomycin if the infection is found resistant, or when culture and sensitivity are inconclusive. For those patients taking iv flucloxacillin, a switch to oral flucloxacillin was allowed when clinically appropriate. We hypothesized that the cost of care of initiating treatment with linezolid would be less than that for both vancomycin and flucloxacillin in resistance risk ranges typically encountered in UK hospitals. In addition, while the registration trials showed equivalence of linezolid with the comparators in

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    PubMed Central

    Castelnuovo, Gianluca

    2010-01-01

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

  2. Is preemptive antifungal therapy a good alternative to empirical treatment in prolonged febrile neutropenia?

    PubMed

    Koch, Erica; Rada, Gabriel

    2016-06-09

    Patients with prolonged febrile neutropenia are at high risk of invasive fungal infection, so it has been standard practice to initiate empirical antifungal therapy in these cases. However, this strategy is associated with important toxicity, so diagnostic test-guided preemptive antifungal therapy has been proposed as an alternative. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified three systematic reviews including twelve studies overall. Four randomized controlled trials addressed the question of this article. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded it is not clear whether preemptive strategy affects mortality because the certainty of the evidence is very low, but it might slightly decrease the use of antifungal agents in patients with prolonged febrile neutropenia.

  3. Is preemptive antifungal therapy a good alternative to empirical treatment in prolonged febrile neutropenia?

    PubMed

    Koch, Erica; Rada, Gabriel

    2016-01-01

    Patients with prolonged febrile neutropenia are at high risk of invasive fungal infection, so it has been standard practice to initiate empirical antifungal therapy in these cases. However, this strategy is associated with important toxicity, so diagnostic test-guided preemptive antifungal therapy has been proposed as an alternative. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified three systematic reviews including twelve studies overall. Four randomized controlled trials addressed the question of this article. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded it is not clear whether preemptive strategy affects mortality because the certainty of the evidence is very low, but it might slightly decrease the use of antifungal agents in patients with prolonged febrile neutropenia. PMID:27280389

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Henggeler, Scott W.; Sheidow, Ashli J.

    2012-01-01

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

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

    SciTech Connect

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

    2016-01-01

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

  7. Treatment Fidelity: Relation to Treatment Acceptability and Change over Time

    ERIC Educational Resources Information Center

    Tanol, Gizem

    2010-01-01

    The purpose of this study was: (a) to examine the relation between acceptability and fidelity of an intervention package in natural classroom settings, and (b) to examine how fidelity of implementation varies in relation to high vs. low treatment acceptability over the course of an academic school year. Participants were 44 teachers, from 15…

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

    ERIC Educational Resources Information Center

    Crew, Robert E., Jr.; And Others

    1994-01-01

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

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

    ERIC Educational Resources Information Center

    Butts, Aaron Michael

    2013-01-01

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

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

    PubMed

    Howkins, Adrian

    2011-01-01

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

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

    PubMed

    López-Costas, Olalla; Müldner, Gundula

    2016-09-01

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

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

    PubMed

    López-Costas, Olalla; Müldner, Gundula

    2016-09-01

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

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

    PubMed Central

    Gøtzsche, P. C.; Johansen, H. K.

    1997-01-01

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

  14. Cultural change and traditional ecological knowledge. An empirical analysis from the Tsimane’ in the Bolivian Amazon

    PubMed Central

    Reyes-García, Victoria; Paneque-Gálvez, Jaime; Luz, Ana C.; Gueze, Maximilien; Macía, Manuel J.; Orta-Martínez, Martí; Pino, Joan

    2016-01-01

    Among the different factors associated to change in traditional ecological knowledge, the study of the relations between cultural change and traditional ecological knowledge has received scan and inadequate scholarly attention. Using data from indigenous peoples of an Amazonian society facing increasing exposure to the mainstream Bolivian society, we analyzed the relation between traditional ecological knowledge, proxied with individual plant use knowledge (n=484), and cultural change, proxied with individual- and village-level (n=47) measures of attachment to traditional beliefs and values. We found that both the individual level of detachment to traditional values and the village level of agreement in detachment to traditional values were associated with individual levels of plant use knowledge, irrespective of other proxy measures for cultural change. Because both the individual- and the village-level variables bear statistically significant associations with plant use knowledge, our results suggest that both the individual- and the supra-individual level processes of cultural change are related to the erosion of plant use knowledge. Results from our work highlight the importance of analyzing processes that happen at intermediary social units -the village in our case study- to explain changes in traditional ecological knowledge.

  15. Cultural change and traditional ecological knowledge. An empirical analysis from the Tsimane’ in the Bolivian Amazon

    PubMed Central

    Reyes-García, Victoria; Paneque-Gálvez, Jaime; Luz, Ana C.; Gueze, Maximilien; Macía, Manuel J.; Orta-Martínez, Martí; Pino, Joan

    2016-01-01

    Among the different factors associated to change in traditional ecological knowledge, the study of the relations between cultural change and traditional ecological knowledge has received scan and inadequate scholarly attention. Using data from indigenous peoples of an Amazonian society facing increasing exposure to the mainstream Bolivian society, we analyzed the relation between traditional ecological knowledge, proxied with individual plant use knowledge (n=484), and cultural change, proxied with individual- and village-level (n=47) measures of attachment to traditional beliefs and values. We found that both the individual level of detachment to traditional values and the village level of agreement in detachment to traditional values were associated with individual levels of plant use knowledge, irrespective of other proxy measures for cultural change. Because both the individual- and the village-level variables bear statistically significant associations with plant use knowledge, our results suggest that both the individual- and the supra-individual level processes of cultural change are related to the erosion of plant use knowledge. Results from our work highlight the importance of analyzing processes that happen at intermediary social units -the village in our case study- to explain changes in traditional ecological knowledge. PMID:27642188

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

    PubMed Central

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

    2011-01-01

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

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

    SciTech Connect

    Sathaye, Jayant A.

    2000-04-01

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

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

    PubMed

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

    2010-01-15

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

  19. Valuing climate change impacts on human health: empirical evidence from the literature.

    PubMed

    Markandya, Anil; Chiabai, Aline

    2009-02-01

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

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

    PubMed Central

    Markandya, Anil; Chiabai, Aline

    2009-01-01

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

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

    USGS Publications Warehouse

    Cannon, S.H.

    1993-01-01

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

  2. Biochemical changes and treatment in glaucoma.

    PubMed

    Ciotu, I M; Stoian, I; Gaman, L; Popescu, M V; Atanasiu, V

    2015-01-01

    Glaucoma is the second cause of blindness worldwide. This disease is a neurodegenerative disorder characterized by high intraocular pressure, loss of retinal ganglion cells (apoptosis). Even though there is much research done in this field, the results have not yet managed to stop the progression of glaucoma or to heal this pathology. Free oxygen radicals play a major role; they are formed in the aqueous humor and in the vitreous and they produce apoptosis of the neurons in the optic nerve head, degradation of the trabecular meshwork cells. The purpose of the article is to help in trying to understand the physiopathology of glaucoma and the efficacy of its treatments.

  3. Changes in coping moderate substance abuse outcomes differentially across behavioral treatment modality

    PubMed Central

    Kuper, Laura E.; Gallop, Robert; Greenfield, Shelly F.

    2010-01-01

    In this secondary data analytic study we examined whether the relationship between changes in coping and treatment outcome differed between women enrolled in either the Women's Recovery Group (N=29), a new manualized group treatment for women with substance use disorders, or Group Drug Counseling (N=7), an empirically supported mixed-gender group treatment. We examined subscales of the Ways of Coping questionnaire and found that while changes in coping did not differ significantly across treatment groups, the association of changes in coping with substance abuse outcome was related to treatment condition. Increases in problem focused coping were associated with decreased drinking days in WRG, but paradoxically with increased drinking days in GDC. For both groups, increases in wishful thinking were associated with increases in substance use, and increases in social support coping associated with decreases in use, but these associations were greater GDC. Our results highlight the importance of examining the impact of treatment modality on coping, as well as contextual factors that may help to explain the specific pattern of results. PMID:20958851

  4. An Empirical Study of the Distributional Changes in Higher Education among East, Middle and West China

    ERIC Educational Resources Information Center

    Jiang, Chunjiao; Li, Song

    2008-01-01

    Based on the quantitative research and comparative study method, this paper attempts to make a systematic study and analysis of regional differences which have existed since 1949 in higher education among East, Middle and West China. The study is intended to explore the causes, regional differences, social changes, and their co-related…

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

    ERIC Educational Resources Information Center

    Neirotti, Paolo; Paolucci, Emilio

    2013-01-01

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

  6. Total factor productivity change in dairy farming: Empirical evidence from southern Chile.

    PubMed

    Moreira, Víctor H; Bravo-Ureta, Boris E

    2016-10-01

    Despite the importance of productivity growth, many studies carried out at the farm level focus primarily on the technical efficiency (TE) component of farm productivity. Therefore, the general purpose of this paper is to measure total factor productivity change and then to decompose this change into several distinct elements. The data were an unbalanced panel for the period from 2005 to 2010 containing 477 farms and 1,426 observations obtained from TODOAGRO, a farm-management center created in 1996 in the southern part of Chile. The region where the data come from accounts for 20% of the total milk processed in the country. Stochastic production frontiers along with the translog functional form were used to analyze total factor productivity change. The econometric evidence indicates that farms exhibit decreasing returns to size implying that costs of production rise as farm size increases, which suggests that the motivation for farm growth stems from the search for income rather than from lowering costs. The main results indicated that productivity gains through TE improvements are limited, with an average TE for the whole sample of 91.0%, and average technical efficiency change of 0.05% per year. By contrast, average technological progress at the sample mean was rather high at 1.90%, which suggests that additional investments in research and subsequent adoption of improved technologies would have a positive effect on productivity growth. The findings also revealed that farm size is not associated with productivity growth for the dairy farms in the sample. PMID:27448859

  7. Total factor productivity change in dairy farming: Empirical evidence from southern Chile.

    PubMed

    Moreira, Víctor H; Bravo-Ureta, Boris E

    2016-10-01

    Despite the importance of productivity growth, many studies carried out at the farm level focus primarily on the technical efficiency (TE) component of farm productivity. Therefore, the general purpose of this paper is to measure total factor productivity change and then to decompose this change into several distinct elements. The data were an unbalanced panel for the period from 2005 to 2010 containing 477 farms and 1,426 observations obtained from TODOAGRO, a farm-management center created in 1996 in the southern part of Chile. The region where the data come from accounts for 20% of the total milk processed in the country. Stochastic production frontiers along with the translog functional form were used to analyze total factor productivity change. The econometric evidence indicates that farms exhibit decreasing returns to size implying that costs of production rise as farm size increases, which suggests that the motivation for farm growth stems from the search for income rather than from lowering costs. The main results indicated that productivity gains through TE improvements are limited, with an average TE for the whole sample of 91.0%, and average technical efficiency change of 0.05% per year. By contrast, average technological progress at the sample mean was rather high at 1.90%, which suggests that additional investments in research and subsequent adoption of improved technologies would have a positive effect on productivity growth. The findings also revealed that farm size is not associated with productivity growth for the dairy farms in the sample.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  12. Physiological changes in the treatment of acrophobia (fear of height).

    PubMed

    Takeya, T; Ohno, Y; Matsubara, H; Yasuda, K; Watanabe, S; Shinzato, R; Tanaka, Y; Noda, S

    1979-06-01

    In order to investigate the physiological changes produced by the treatment of acrophobic patients body movement and Microvibration were measured before and after treatment. Eighteen acrophobic patients were assigned at random to 1 of the 2 groups: a treatment group (n = 8) and a non-treatment group (n = 10). The control group consisted of 16 healthy volunteers. Body movement area while viewing a slide of a high place or imagining a high place in the treatment group decreased significantly after treatment. Body movement of the control group showed almost no changes, and that of the non-treatment group was situated between the above-mentioned 2 groups. Simple body movements of the acrophobic patients without any stimulation of height were bigger than those of the control subjects. MV pattern of the treatment group had a tendency to improve under psycho-therapy. Acrophobic patients had more abnormal MV patterns than the normal subjects.

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

    PubMed

    Braithwaite, Jeffrey

    2006-12-01

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

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

    PubMed

    Clemens, B

    2001-06-01

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

  15. Stopping long-term dialysis. An empirical study of withdrawal of life-supporting treatment.

    PubMed

    Neu, S; Kjellstrand, C M

    1986-01-01

    Dialysis was discontinued in 155 (9 percent) of 1766 patients being treated for end-stage renal disease, accounting for 22 percent of all deaths. Treatment was withdrawn more frequently in older than in younger non-diabetic patients, and more often in young diabetic patients than in young nondiabetic patients. Withdrawal was twice as common in nondiabetic patients with other degenerative disorders (P less than 0.005); in patients receiving intermittent peritoneal dialysis (P less than 0.025); and in patients living in nursing homes (P less than 0.025). Half the patients were competent when the decision to withdraw was made, and 39 percent of this group had no new preceding medical complications. Among incompetent patients, the physician initiated the decision for withdrawal in 73 percent, and the patient's family in 27 percent; all patients had recent medical complications. In the early 1970s the physician initiated the decision in 66 percent of all patients; in the early 1980s this figure had decreased to 30 percent (P less than 0.0005). We conclude that stopping treatment is a common mode of death in patients receiving long-term dialysis, particularly in those who are old and those who have complicating degenerative diseases. Because of the increasing age of patients on dialysis, withdrawal of treatment will probably become more common in the future.

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

    NASA Astrophysics Data System (ADS)

    Jacobsen, Grant Douglas

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

  17. The Serengeti food web: empirical quantification and analysis of topological changes under increasing human impact.

    PubMed

    de Visser, Sara N; Freymann, Bernd P; Olff, Han

    2011-03-01

    1. To address effects of land use and human overexploitation on wildlife populations, it is essential to better understand how human activities have changed species composition, diversity and functioning. Theoretical studies modelled how network properties change under human-induced, non-random species loss. However, we lack data on realistic species-loss sequences in threatened, real-world food webs to parameterize these models. 2. Here, we present a first size-structured topological food web of one of the most pristine terrestrial ecosystems in the world, the Serengeti ecosystem (Tanzania). The food web consists of 95 grouped nodes and includes both invertebrates and vertebrates ranging from body masses between 10(-7) and 10(4) kg. 3. We study the topological changes in this food web that result from the simulated IUCN-based species-loss sequence representing current species vulnerability to human disturbances in and around this savanna ecosystem. We then compare this realistic extinction scenario with other extinction sequences based on body size and connectance and perform an analysis of robustness of this savanna food web. 4. We demonstrate that real-world species loss in this case starts with the biggest (mega) herbivores and top predators, causing higher predator-prey mass ratios. However, unlike theoretically modelled linear species deletion sequences, this causes poor-connected species to be lost first, while more highly connected species become lost as human impact progresses. This food web shows high robustness to decreasing body size and increasing connectance deletion sequences compared with a high sensitivity to the decreasing connectance deletion scenario. 5. Furthermore, based on the current knowledge of the Serengeti ecosystem, we discuss how the focus on food web topology alone, disregarding nontrophic interactions, may lead to an underestimation of human impacts on wildlife communities, with the number of trophic links affected by a

  18. The Serengeti food web: empirical quantification and analysis of topological changes under increasing human impact.

    PubMed

    de Visser, Sara N; Freymann, Bernd P; Olff, Han

    2011-03-01

    1. To address effects of land use and human overexploitation on wildlife populations, it is essential to better understand how human activities have changed species composition, diversity and functioning. Theoretical studies modelled how network properties change under human-induced, non-random species loss. However, we lack data on realistic species-loss sequences in threatened, real-world food webs to parameterize these models. 2. Here, we present a first size-structured topological food web of one of the most pristine terrestrial ecosystems in the world, the Serengeti ecosystem (Tanzania). The food web consists of 95 grouped nodes and includes both invertebrates and vertebrates ranging from body masses between 10(-7) and 10(4) kg. 3. We study the topological changes in this food web that result from the simulated IUCN-based species-loss sequence representing current species vulnerability to human disturbances in and around this savanna ecosystem. We then compare this realistic extinction scenario with other extinction sequences based on body size and connectance and perform an analysis of robustness of this savanna food web. 4. We demonstrate that real-world species loss in this case starts with the biggest (mega) herbivores and top predators, causing higher predator-prey mass ratios. However, unlike theoretically modelled linear species deletion sequences, this causes poor-connected species to be lost first, while more highly connected species become lost as human impact progresses. This food web shows high robustness to decreasing body size and increasing connectance deletion sequences compared with a high sensitivity to the decreasing connectance deletion scenario. 5. Furthermore, based on the current knowledge of the Serengeti ecosystem, we discuss how the focus on food web topology alone, disregarding nontrophic interactions, may lead to an underestimation of human impacts on wildlife communities, with the number of trophic links affected by a

  19. Anaemia and cancer treatment: a conceptual change.

    PubMed

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

    2008-10-01

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

  20. Changing the public perception of physiotherapeutic treatment.

    PubMed

    Sheppard, L

    1994-01-01

    Market research was undertaken to establish the public perception of physiotherapy. Using this market research strategic recommendations for the future marketing of physiotherapy are made within the professional context. Marketing will be used to contribute to changing the public perception of physiotherapy. The market research involved a qualitative study of five focus groups of the general public and one focus group of physiotherapists. The responses from the focus groups were used to construct an appropriate questionnaire for the qualitative study. A random sample of 510 members of the general public were then surveyed. The market research results yielded the following key features: The best known conditions treated by physiotherapists are musculoskeletal. The least known are women and children. Client-centered care is sought. The importance of location gives potential for physiotherapists to capitalise on tailoring to clients in their area. Doctors are important for referral and communication about physiotherapy. Marketing should be used to inform doctors of what physiotherapy has to offer. A marketing orientation has begun within physiotherapy; however, it must 'fit' the culture initially to be successful. A marketing strategy should be developed on national, state and individual levels based on a strategic intent. At the state level, strategies must be responsive to area or regional needs. Marketing needs to target identified market segments such as workers compensation organisations. Individual physiotherapists must promote themselves within their region, particularly to doctors and clients with the use of relationship marketing. Informal presentations to community groups and school students about physiotherapy will increase their profile.

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

    NASA Astrophysics Data System (ADS)

    Kaufman, A. J.

    2011-12-01

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

  2. Response in the water quality of the Salton Sea, California, to changes in phosphorus loading: An empirical modeling approach

    USGS Publications Warehouse

    Robertson, D.M.; Schladow, S.G.

    2008-01-01

    Salton Sea, California, like many other lakes, has become eutrophic because of excessive nutrient loading, primarily phosphorus (P). A Total Maximum Daily Load (TMDL) is being prepared for P to reduce the input of P to the Sea. In order to better understand how P-load reductions should affect the average annual water quality of this terminal saline lake, three different eutrophication programs (BATHTUB, WiLMS, and the Seepage Lake Model) were applied. After verifying that specific empirical models within these programs were applicable to this saline lake, each model was calibrated using water-quality and nutrient-loading data for 1999 and then used to simulate the effects of specific P-load reductions. Model simulations indicate that a 50% decrease in external P loading would decrease near-surface total phosphorus concentrations (TP) by 25-50%. Application of other empirical models demonstrated that this decrease in loading should decrease near-surface chlorophyll a concentrations (Chl a) by 17-63% and increase Secchi depths (SD) by 38-97%. The wide range in estimated responses in Chl a and SD were primarily caused by uncertainty in how non-algal turbidity would respond to P-load reductions. If only the models most applicable to the Salton Sea are considered, a 70-90% P-load reduction is required for the Sea to be classified as moderately eutrophic (trophic state index of 55). These models simulate steady-state conditions in the Sea; therefore, it is difficult to ascertain how long it would take for the simulated changes to occur after load reductions. ?? 2008 Springer Science+Business Media B.V.

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

    PubMed

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

    2016-01-01

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

  4. The right to treatment suit as an agent of change.

    PubMed

    Kaufman, E

    1979-11-01

    Right to treatment suits can serve as agents of change in the standards and function of psychiatric institutions. The author evaluated five state psychiatric institutions as an expert witness in right to treatment suits. He found that changes for the better were made in most of these institutions as a result of the suit, whether it was settled or unsettled. Although he enumerates the problems caused by such suits, he concludes that they can be a positive force for improving mental health care.

  5. Decision Thresholds and Changes in Risk for Preventive Treatment.

    PubMed

    Courbage, Christophe; Rey, Béatrice

    2016-01-01

    This paper investigates the notion of treatment threshold for preventive treatment with potential side effects in the context of changes in risk. Changes in risk are defined by the concept of nth-order stochastic dominance and concern the effectiveness of preventive treatment, side effects, severity of the potential disease, and comorbidity risk. The impact of a riskier environment on the probability of disease threshold above which the preferable decision is to undergo preventive treatment is shown to depend on both mixed risk averse individual preferences and the configuration of increase in risk considered. These results suggest that neglecting differences between risks when evaluating the treatment threshold is likely to lead to substantial errors in most cost-benefit applications for preventive treatment.

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

    PubMed Central

    Volling, Brenda L.

    2012-01-01

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

  7. Perception of appetite and weight change during treatment for depression.

    PubMed

    Fernstrom, M H; McConaha, C; Kupfer, D J

    1989-08-01

    As part of the Pittsburgh Appetite Test, 50 depressed outpatients reported their perceptions of appetite and weight change prior to and during chronic treatment with imipramine and psychotherapy. At the end of 4 months, as a group, patients were significantly more conscious of what they were eating, and reported a significant change in the frequency of regular meal consumption. No group changes were noted in frequency of snacking or late night eating, although weight change during treatment and obesity status modified these responses. Clinical response was unrelated to eating behavior. Perception of weight change varied with treatment: a 5 pound weight gain became highly problematic during recovery compared to the depressive episode. The interaction of these factors and antidepressant-induced weight gain are discussed.

  8. The Dimensions of Change in Therapeutic Community Treatment Instrument

    ERIC Educational Resources Information Center

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

    2006-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  10. Motivating Batterers to Change in the Treatment Context.

    ERIC Educational Resources Information Center

    Murphy, Christopher M.; Baxter, Victoria A.

    1997-01-01

    Describes how confrontational treatment programs for batterers may increase client resistance. Suggests an alternative approach to working with unmotivated clients which relies on a comprehensive model of the change process, with supportive clinical strategies tailored to the client's stage of change. Focuses on the importance of a collaborative…

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    PubMed Central

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

    2009-01-01

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

  13. Balancing fidelity and adaptation in the dissemination of empirically-supported treatments: The promise of transdiagnostic interventions.

    PubMed

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

    2009-11-01

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

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

    PubMed Central

    2012-01-01

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

  15. Active Ingredients of Treatment and Client Mechanisms of Change in Behavioral Treatments for Alcohol Use Disorders: Progress 10 Years Later

    PubMed Central

    Magill, M.; Kiluk, B.D.; McCrady, B.; Tonigan, J.S.; Longabaugh, R.

    2015-01-01

    Background The current review revisits the article entitled: Active Ingredients of Behavioral Treatments for Alcohol Use Disorders (AUDs) published in Alcoholism: Clinical and Experimental Research. This work summarized proceedings from a 2004 Symposium of the same name that was held at the Annual Meeting of the Research Society on Alcoholism (RSA). A decade has passed, which provides occasion for an evaluation of progress. In 2014, an RSA symposium titled Active Treatment Ingredients and Client Mechanisms of Change in Behavioral Treatments for Alcohol Use Disorders: Progress 10 Years Later did just that. Overview The current review revisits state-of-the-art research on the three treatments examined 10 years ago: Cognitive Behavioral Therapy (CBT), Alcohol Behavior Couples Therapy (ABCT), and Twelve Step Facilitation (TSF). Because of its empirically-validated effectiveness and robust research agenda on the study of process-outcome, Motivational Interviewing (MI) has been selected as the fourth treatment modality to be discussed. For each of these four treatments, the reviewers provide a critical assessment of current theory and research with a special emphasis on key recommendations for the future. Conclusions Noteworthy progress has been made in identifying AITs and MOBCs in these four behavioral interventions for alcohol and other drug use disorders. Not only have we established some of the mechanisms through which these evidence-based treatments work, but we have also uncovered some of the limitations in our existing frameworks and methods. Further progress in this area will require a broader view with respect to conceptual frameworks, analytic methods, and measurement instrumentation. PMID:26344200

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  18. Empirical estimates of the dominant environmental forcings on the relative sea level change of river delta systems

    NASA Astrophysics Data System (ADS)

    Tessler, Z. D.; Vorosmarty, C. J.

    2012-12-01

    A global, empirically derived projection of river delta systems at risk of future relative sea level rise is presented based on a set of global environmental risk indicators. Indicators are drawn from upstream basin, coastal zone, and oceanic domains. They include human dimension variables such as population density, urban development, and water engineering, as well as biogeophysical variables such as the local wave environment and cyclone risk. All indicators are hypothesized to have a significant level of direct or indirect control on the local rate of relative sea level rise, commonly through changes in sediment delivery and deposition on the delta plain. Indicators are statistically weighted based on observed rates of relative sea level rise in the literature. These weightings, applied to time series of risk indicators from river network and ocean models and the satellite record, enable identification of regions at greatest risk as a function of time and space. We find regional differences in the dominant sources of sea level rise risk, with higher latitude sites along the Arctic Ocean and in southern Africa and Australia dominated by oceanic risks. In Southeast Asia, the coastal zones with large deltaic megacities dominate ocean and basin source risks, while broadly developed river basins in East Asia and parts of Europe contribute strongly to sea level rise risk in those regions. Future work that will enable rigorous testing of alternative weighting schemes from which overall risk is determined will be discussed.

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

    SciTech Connect

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

    2011-04-08

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

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

    SciTech Connect

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

    2011-04-08

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

  1. Changes in Coping Following Treatment for Child Molesters

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2010-12-01

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

  3. Changing patterns of treatment for chronic anal fissure.

    PubMed

    Farouk, R; Gunn, J; Duthie, G S

    1998-05-01

    To assess changing patterns of treatment for chronic anal fissure, a retrospective analysis of treatment for chronic anal fissure within one hospital between January 1990 and December 1996 was undertaken. A total of 221 patients received treatment for a chronic anal fissure in this period, of whom 209 had a surgical procedure. Manual dilatation of the anus was performed in 21 patients (10%) and has not been performed since 1995. Lateral internal sphincterotomy was performed in 183 patients (88%) and continues to be the mainstay of treatment. Five female patients (2%) were identified as having a sphincter defect by anal manometry combined with endoanal ultrasound and were treated by an anal advancement flap. From 1996 onwards, 15 patients (7%) were treated by topical glyceryl trinitrate (GTN) paste as the first line of treatment. Of these patients, nine have experienced healing of their fissure, and three have had relief of pain without healing of the fissure. Three have gone on to have a lateral internal sphincterotomy. Lateral internal sphincterotomy remains the primary form of treatment for chronic anal fissure. GTN cream has increasingly been offered as preliminary treatment over the last 12 months. Perioperative use of endoanal ultrasound allowed identification of patients who may be at high risk of postoperative incontinence from a sphincterotomy. An anal advancement flap has been used as an alternative surgical approach for these patients.

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

    PubMed Central

    Styła, Rafał

    2015-01-01

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

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

    PubMed

    Nattrass, Nicoli; Hodes, Rebecca; Cluver, Lucie

    2016-01-01

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

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

    PubMed

    Nattrass, Nicoli; Hodes, Rebecca; Cluver, Lucie

    2016-01-01

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

  7. Transcranial Doppler ultrasonographic changes after treatment for arteriovenous malformations.

    PubMed

    Petty, G W; Massaro, A R; Tatemichi, T K; Mohr, J P; Hilal, S K; Stein, B M; Solomon, R A; Duterte, D I; Sacco, R L

    1990-02-01

    We performed transcranial Doppler ultrasonography on 15 patients with arteriovenous malformations before and after embolization or surgical resection to compare quantitatively the hemodynamic effects of these two treatments. Changes in mean blood velocity and pulsatility index were analyzed in 19 treated feeding arteries. Blood velocity decreased by a mean of 38.1% or 46.5 cm/sec (p less than 0.0001, two-tailed paired t test); decreases were greater for surgically resected arteries (46.2% or 55.9 cm/sec, p less than 0.003) than for embolized arteries (30.8% or 38.0 cm/sec, p less than 0.0003). Pulsatility index increased by a mean of 54.7% or 0.25 (p = 0.0001); increases were greater for surgically resected arteries (65.8% or 0.29, p = 0.0045) than for embolized arteries (44.8% or 0.20, p less than 0.001). The differences in the changes in blood velocity and pulsatility index between treatment groups were not significant. These data demonstrate that embolization results in hemodynamic changes that are qualitatively similar to those occurring after surgical resection of arteriovenous malformations. Transcranial Doppler ultrasonography is a reliable and convenient noninvasive method for monitoring hemodynamic effects of treatments for arteriovenous malformations. PMID:2406994

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

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

    SciTech Connect

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

    2007-12-15

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  12. CO2 laser microsurgeries in treatment of larynx pathological changes

    NASA Astrophysics Data System (ADS)

    Kus, Jan; Osmolski, Antoni; Kubiczek-Jagielska, Marzena; Frenkiel, Zofia; Milczarek, Katarzyna

    1996-03-01

    The results of the laser microsurgical treatment of the 273 patients with different pathological changes in the larynx are presented in the paper. In this number are included cases with tumors (80), precancers (40), papillomatosis (17), and stenosis of the larynx (71). Patients were treated with carbon-dioxide surgical laser with the laser beam power ranging from 12 to 28 watts depending on the pathology and its advance. Positive results of the treatment were observed in 73% to 100% of cases in different groups of patients. The authors suggest that in some cases the carbon-dioxide laser is only an alternative tool but in many cases, e.g., in papillomatosis, it is much better than traditional equipment. There are also cases such as hemangioma where the laser is an unreplaceable surgical technique.

  13. Change trajectories for the Youth Outcome Questionnaire self-report: identifying youth at risk for treatment failure.

    PubMed

    Cannon, Jennifer A N; Warren, Jared S; Nelson, Philip L; Burlingame, Gary M

    2010-01-01

    This study used longitudinal youth outcome data in routine mental health services to test a system for identifying cases at risk for treatment failure. Participants were 2,715 youth (M age = 14) served in outpatient managed care and community mental health settings. Change trajectories were developed using multilevel modeling of archival data. Expected change trajectories served as the basis for a warning system designed to identify cases at risk for treatment failure. Tests of the predictive accuracy of the warning system yielded moderately high sensitivity rates for both youth self-report and parent-report measures. Incorporating data from multiple sources (youth, parents, and others) yielded the highest sensitivity in identifying at-risk cases. Results emphasize the importance of using empirically derived methods for identifying youth at risk for negative outcomes in usual care. PMID:20419571

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

    PubMed

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

    2015-10-15

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-05-01

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

  16. Changes in rat hippocampal CA1 synapses following imipramine treatment.

    PubMed

    Chen, Fenghua; Madsen, Torsten M; Wegener, Gregers; Nyengaard, Jens R

    2008-01-01

    Neuronal plasticity in hippocampus is hypothesized to play an important role in both the pathophysiology of depressive disorders and the treatment. In this study, we investigated the consequences of imipramine treatment on neuroplasticity (including neurogenesis, synaptogenesis, and remodelling of synapses) in subregions of the hippocampus by quantifying number of neurons and synapses. Adult male Sprague-Dawley rats were injected with imipramine or saline (i.p.) daily for 14 days. Unbiased stereological methods were used to quantify the number of neurons and synapses. No differences in the volume and number of neurons of hippocampal subregions following imipramine treatment were found. However, the number and percentage of CA1 asymmetric spine synapses increased significantly and, conversely, the percentage of asymmetric shaft synapses significantly decreased in the imipramine treated group. Our results indicate that administration of imipramine for 14 days in normal rats could significantly increase the excitatory spine synapses, and change the relative distribution of spine and shaft synapses. We speculate that the present findings may be explained by the establishment of new synaptic connections and by remodelling or transformation of existing synapses.

  17. Impact of ivermectin on onchocerciasis transmission: assessing the empirical evidence that repeated ivermectin mass treatments may lead to elimination/eradication in West-Africa

    PubMed Central

    Borsboom, Gerard JJM; Boatin, Boakye A; Nagelkerke, Nico JD; Agoua, Hyacinthe; Akpoboua, Komlan LB; Alley, E William Soumbey; Bissan, Yeriba; Renz, Alfons; Yameogo, Laurent; Remme, Jan HF; Habbema, J Dik F

    2003-01-01

    Background The Onchocerciasis Control Program (OCP) in West Africa has been closed down at the end of 2002. All subsequent control will be transferred to the participating countries and will almost entirely be based on periodic mass treatment with ivermectin. This makes the question whether elimination of infection or eradication of onchocerciasis can be achieved using this strategy of critical importance. This study was undertaken to explore this issue. Methods An empirical approach was adopted in which a comprehensive analysis was undertaken of available data on the impact of more than a decade of ivermectin treatment on onchocerciasis infection and transmission. Relevant entomological and epidemiological data from 14 river basins in the OCP and one basin in Cameroon were reviewed. Areas were distinguished by frequency of treatment (6-monthly or annually), endemicity level and additional control measures such as vector control. Assessment of results were in terms of epidemiological and entomological parameters, and as a measure of inputs, therapeutic and geographical coverage rates were used. Results In all of the river basins studied, ivermectin treatment sharply reduced prevalence and intensity of infection. Significant transmission, however, is still ongoing in some basins after 10–12 years of ivermectin treatment. In other basins, transmission may have been interrupted, but this needs to be confirmed by in-depth evaluations. In one mesoendemic basin, where 20 rounds of four-monthly treatment reduced prevalence of infection to levels as low as 2–3%, there was significant recrudescence of infection within a few years after interruption of treatment. Conclusions Ivermectin treatment has been very successful in eliminating onchocerciasis as a public health problem. However, the results presented in this paper make it almost certain that repeated ivermectin mass treatment will not lead to the elimination of transmission of onchocerciasis from West Africa. Data

  18. Evaluation of treatment and posttreatment changes of protraction facemask treatment using the PAR index.

    PubMed

    Ngan, P; Yiu, C

    2000-10-01

    The purpose of this study was to use the Peer Assesment Rating (PAR) index score to evaluate the treatment and posttreatment changes of Class III patients treated by protraction facemask. The sample consisted of 20 Chinese children, 6 to 11 years old, with Class III skeletal malocclusion who had been treated with maxillary expansion and a protraction facemask. The average treatment time was 8.2 months, followed by 1 year of retention with a Class III functional appliance. Study casts were taken pretreatment (T1), posttreatment (T2), 1 year follow-up (T3), and 2 years follow-up (T4). After treatment, PAR scores were calculated for each time period. Differences among the 4 time periods were analyzed with the Wilcoxin matched-pairs test. Significant reductions in PAR scores were found at T2 (56%), T3 (70%), and T4 (63%) compared with T1. Immediately posttreatment (T2), 17 (85%) of 20 patients had improved PAR scores by a reduction of at least 30%. Reductions were caused primarily by correction of the anterior crossbite. One year after treatment (T3), further reductions in PAR score were noted (P <.01) as a result of better alignment of the anterior segment, improvement of the buccal occlusion, and overbite and midline corrections. Two years after treatment (T4), PAR scores were higher than at the previous time period. The increases were due to relapses in overjet (4 of 20 patients), overbite, and centerline corrections. These results indicate that significant reductions in the severity of Class III malocclusion can be achieved with early orthopedic facemask treatment. In most cases, further improvement in the PAR score can be expected 1 and 2 years after treatment. In a few patients, the benefits of early treatment are negated by relapses in overjet, overbite, and centerline corrections during the follow-up period.

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

    PubMed Central

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

    2014-01-01

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

  20. The Changing Landscape of Lung Cancer Research and Treatment

    Cancer.gov

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

  1. Taurine treatment protects against chronic nicotine-induced oxidative changes.

    PubMed

    Sener, Göksel; Ozer Sehirli, A; Ipçi, Yeşim; Cetinel, Sule; Cikler, Esra; Gedik, Nursal; Alican, Inci

    2005-04-01

    Experiments have shown that chronic nicotine administration caused oxidative damage in various organs by increasing lipid peroxidation products and decreasing the activity of endogenous antioxidants. The aim of this study was to investigate the effects of taurine treatment on nicotine-induced oxidative changes in rat thoracic aorta and heart and to explore the possible mechanisms of action. Male Wistar albino rats (200-250 g) were injected with nicotine hydrogen bitartrate (0.6 mg/kg; i.p.) or saline for 21 days. Taurine was administered (50 mg/kg; i.p.) alone or along with nicotine injections. After decapitation, the thoracic aorta and heart tissues were excised. The aorta was used for in vitro contractility studies or stored along with the heart samples for the measurement of malondialdehyde (MDA) and glutathione (GSH) levels, myeloperoxidase (MPO) activity and collagen content. Tissue samples were also examined histologically. Serum samples were stored for the measurement of MDA, GSH and lactate dehydrogenase (LDH) activity. Chronic nicotine treatment impaired both the contraction and relaxation responses of the aortic rings to phenylephrine and acetylcholine, respectively. It increased lipid peroxidation, MPO levels and tissue collagen content of both aorta and heart samples. Taurine supplementation to nicotine-treated animals reversed the contractile dysfunction and restored the endogenous GSH levels and decreased high lipid peroxidation and MPO activities in both tissues. These data suggest that taurine supplementation effectively attenuates the oxidative damage because of chronic nicotine administration possibly by its antioxidant effects.

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

    PubMed

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

    2016-05-15

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

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

    PubMed

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

    2016-05-15

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

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  6. Brain electrical activity changes in treatment refractory schizophrenics after olanzapine treatment.

    PubMed

    Cerdán, Luis F; Guevara, Miguel A; Sanz, Araceli; Amezcua, Claudia; Ramos-Loyo, Julieta

    2005-06-01

    The aim of the present study was to identify brain electrical activity changes generated by olanzapine (OLZ) in treatment refractory schizophrenics (TRS). 14 paranoid TRS (31.5+/-8.39 years old) were evaluated before and after 8 weeks of OLZ treatment. Psychopathology was evaluated by means of total BPRS and PANSS scores. Resting EEG was recorded in the pre (under typical neuroleptics) and post (under OLZ) sessions. A good response to OLZ was observed in 57% of TRS. A significant reduction in positive and negative symptoms scales of PANSS was found. Absolute power of theta1, theta2, alpha1 bands increased after treatment, while beta2 power showed a decrease. Intrahemispheric correlation increased between different zones of the frontal areas and between frontal and posterior areas, while interhemispheric correlation decreased in theta2. EEG changes were more evident in those patients who had a better response to OLZ. OLZ showed to be effective in TRS, improving psychiatric symptoms and increasing activity synchronization between different areas within each hemisphere that may indicate a functional reorganization, particularly in good responders.

  7. Changes in Women's Sexual Risk Behaviors after Therapeutic Community Treatment

    ERIC Educational Resources Information Center

    Cooperman, Nina A.; Falkin, Gregory P.; Cleland, Charles

    2005-01-01

    This study examines sexual risk behaviors among 197 women mandated to substance abuse treatment in therapeutic communities. The women's risk behaviors after treatment are compared with their behaviors prior to treatment, and risk behaviors among those who completed treatment are compared with those who did not. The women had a high prevalence of…

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

    NASA Astrophysics Data System (ADS)

    Abid, Muhammad; Scheffran, Jürgen

    2016-04-01

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

  9. Multidisciplinary approach to the treatment of invasive fungal infections in adult patients. Prophylaxis, empirical, preemptive or targeted therapy, which is the best in the different hosts?

    PubMed Central

    Zaragoza, Rafael; Pemán, Javier; Salavert, Miguel; Viudes, Ángel; Solé, Amparo; Jarque, Isidro; Monte, Emilio; Romá, Eva; Cantón, Emilia

    2008-01-01

    The high morbidity, mortality, and health care costs associated with invasive fungal infections, especially in the critical care setting and immunocompromised host, have made it an excellent target for prophylactic, empiric, and preemptive therapy interventions principally based on early identification of risk factors. Early diagnosis and treatment are associated with a better prognosis. In the last years there have been important developments in antifungal pharmacotherapy. An approach to the new diagnosis tools in the clinical mycology laboratory and an analysis of the use new antifungal agents and its application in different clinical situations has been made. Furthermore, an attempt of developing a state of the art in each clinical scenario (critically ill, hematological, and solid organ transplant patients) has been performed, trying to choose the best strategy for each clinical situation (prophylaxis, pre-emptive, empirical, or targeted therapy). The high mortality rates in these settings make mandatory the application of early de-escalation therapy in critically ill patients with fungal infection. In addition, the possibility of antifungal combination therapy might be considered in solid organ transplant and hematological patients. PMID:19337433

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2014-01-01

    This paper describes the changes in transformational leadership and quality outcomes that occurred between 2008 and 2011 in a Finnish university hospital that is aiming to meet the Magnet standards. Measurements were conducted in 2008-2009 and subsequently in 2010-2011 by surveying nursing staff and patients. Nursing staff were surveyed using web-based surveys to collect data on transformational leadership (n 1 = 499, n 2 = 498) and patient safety culture (n 1 = 234, n 2 = 512) and using both postal and web-based surveys to gather information on job satisfaction (n 1 = 1176, n 2 = 779). Questionnaires were used to collect data on care satisfaction from patients (n 1 = 678, n 2 = 867). Transformational leadership was measured using the 54-item TLS, job satisfaction with the 37-item KUHJSS, patient safety culture with the 42-item HSPSC, and patient satisfaction using the 42-item RHCS questionnaire. Transformational leadership, which was the weakest area, was at the same level between the two measurement occasions. Job satisfaction scores increased between 2008 and 2010, although they were generally excellent in 2008. The scores for nonpunitive responses to errors and events reported were also higher in the 2010-2011 surveys. The highest empirical outcome scores related to patient satisfaction. The project and the development initiatives undertaken since 2008 seem to have had positive effects on empirical quality outcomes.

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

    PubMed Central

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

    2014-01-01

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

  13. Oral health changes during early phase of orthodontic treatment.

    PubMed

    Sudarević, Karlo; Jurela, Antonija; Repić, Dario; Jokić, Dražen; Mikić, Ivana Medvedec; Pejda, Slavica

    2014-12-01

    The aim of the study was to assess the influence of fixed orthodontic appliance on Streptococcus (S.) mutans and S. sobrinus counts in orthodontic patients with regard to their previous caries experience (Decayed, Missing and Filled Teeth (DMFT) index) during the first 12 weeks of orthodontic treatment. Twenty-two patients that satisfied inclusion criteria (healthy systemic and periodontal condition, avoidance of antibiotic therapy and antiseptic mouthwashes in the past three months) were included. All clinical measurements took place prior to and 12 weeks after fixed orthodontic appliance placement, in the following order: 1) stimulated saliva flow (SS); 2) Simplified Oral Hygiene Index (OHI-S); and 3) DMFT. The method of polymerase chain reaction (PCR) was used to detect the presence of S. mutans and S. sobrinus at T1 and T2. T-test showed significant increase in DMFT index and SS between T1 and T2. Results also indicated significant improvement in OHI-S index. By use of the PCR method, S. mutans was detected in two patients at T1. At T2, two more patients had S. mutans, but the increase was not statistically significant. Using the same method, S. sobrinus was detected only in two patients at T2. In conclusion, fixed orthodontic appliances did not induce statistically significant changes in caries microflora even in the presence of enhanced oral hygiene habits.

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

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

    ERIC Educational Resources Information Center

    Caldas, Stephen J.

    2008-01-01

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

  16. Lack of Concordance between Empirical Scores and Physician Assessments of Stroke and Bleeding Risk in Atrial Fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) Registry

    PubMed Central

    Steinberg, Benjamin A.; Kim, Sunghee; Thomas, Laine; Fonarow, Gregg C.; Hylek, Elaine; Ansell, Jack; Go, Alan S.; Chang, Paul; Kowey, Peter; Gersh, Bernard J.; Mahaffey, Kenneth W.; Singer, Daniel E; Piccini, Jonathan P.; Peterson, Eric D.

    2014-01-01

    Background Physicians treating patients with atrial fibrillation (AF) must weigh the benefits of anticoagulation in preventing stroke versus the risk of bleeding. While empirical models have been developed to predict such risks, the degree to which these coincide with clinicians’ estimates is unclear. Methods and Results We examined 10,094 AF patients enrolled in the Outcomes Registry for Better Informed Treatment of AF (ORBIT-AF) registry between June, 2010 and August, 2011. Empirical stroke and bleeding risks were assessed using the CHADS2 and ATRIA scores, respectively. Separately, physicians were asked to categorize their patients’ stroke and bleeding risks: low- (<3%); intermediate- (3-6%); and high-risk (>6%). Overall, 72% (n=7251) in ORBIT-AF had high-risk CHADS2 scores (≥2). However, only 16% were assessed as high stroke risk by physicians. While 17% (n=1749) had high ATRIA bleeding risk (score ≥5), only 7% (n=719) were considered so by physicians. The associations between empirical and physician-estimated stroke and bleeding risks were low (weighted Kappa 0.1 and 0.11, respectively). Physicians weighed hypertension, heart failure, and diabetes less significantly than empirical models in estimating stroke risk; physicians weighted anemia and dialysis less significantly than empirical models when estimating bleeding risks. Anticoagulation use was highest among patients with high stroke risk, assessed by either empirical model or physician estimates. In contrast, physician and empirical estimates of bleeding had limited impact on treatment choice. Conclusions There is little agreement between provider-assessed risk and empirical scores in AF. These differences may explain, in part, current divergence of anticoagulation treatment decisions from guideline recommendations. PMID:24682387

  17. ASSOCIATION BETWEEN CHANGE IN DEPRESSION AND CHANGE IN WEIGHT AMONG WOMEN ENROLLED IN WEIGHT LOSS TREATMENT

    PubMed Central

    Simon, Gregory E; Rohde, Paul; Ludman, Evette J; Jeffery, Robert W; Linde, Jennifer A; Operskalski, Belinda H; Arterburn, David

    2010-01-01

    Objective To examine the association between improvement in depression and loss of weight among women with depressive symptoms entering a behavioral weight loss program. Methods Women aged 40 to 65 with Body Mass Index (BMI) of 30 or more and co-occurring symptoms of depression were identified by a population-based survey. 203 of these women were enrolled in one of two behavioral treatment programs: one focused on weight loss and another on both weight loss and depression. Both programs included up to 26 group sessions over 12 months. Assessments at baseline, 6 months, 12 months, and 24 months included measurement of weight, depressive symptoms, self-reported physical activity, and estimated caloric intake (via food frequency questionnaire). Results Over the first six months, women with a decrease in depression score were more likely to lose 5kg or more than women without a significant decrease in depression (38% vs. 22%, Odds ratio = 2.20, 95% CI = 1.09 to 4.44). Over the same period, improvement in depression was associated with increase in physical activity but not with change in caloric intake. Change in depression and change in weight were not significantly associated over later intervals (between six and 12 months or between 12 and 24 months). Conclusions Among women with co-occurring obesity and depression, short-term improvement in depression is associated with weight loss. PMID:21112449

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

    ERIC Educational Resources Information Center

    Erickson, Elizabeth; Sivasankar, Mahalakshmi

    2010-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    USGS Publications Warehouse

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

    2008-01-01

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

  1. Multimodality treatment strategies have changed prognosis of peritoneal metastases

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-15

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

  3. Treatment Retention and Changes in Motivation among Drug Court Probationers

    ERIC Educational Resources Information Center

    Kinlock, Timothy W.; Sears, Emily A.; O'Grady, Kevin E.; Callaman, Jason M.; Brown, Barry S.

    2009-01-01

    This study examined whether Motivational Interviewing (MI), found effective with voluntary entrants to drug treatment, would improve intrinsic motivation and treatment retention among drug court probationers. Probationers were randomly assigned to receive either a two-session MI intervention or a two-session Drug Education (DE) intervention…

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

    PubMed

    Paul, Parneet; Jones, Franck Anderson

    2016-01-05

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

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

    PubMed Central

    Paul, Parneet; Jones, Franck Anderson

    2016-01-01

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

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

    PubMed

    Paul, Parneet; Jones, Franck Anderson

    2016-01-01

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

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

    PubMed

    Jodzio, K

    1993-01-01

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

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

    PubMed

    Csaba, G; Lajkó, Eszter; Pállinger, Eva

    2010-12-01

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

  9. Changing Profile of Abused Substances by Older Persons Entering Treatment

    PubMed Central

    Lofwall, Michelle R.; Schuster, Alyson; Strain, Eric C.

    2009-01-01

    This study evaluated whether there were increasing admissions for illicit drug abuse treatment among older persons from 1992 to 2005 in the United States and describes the characteristics, number, and type of substances most commonly abused in this population over this 14-year period. Analyses used public data files from the Treatment Episode Data Set, which tracks federally and state funded substance abuse treatment admissions. From 1992 to 2005, admissions for illicit drug abuse increased significantly; in 2005, 61% of admissions age 50 to 54 years old and 45% of admissions age 55 years and older reported some type of illicit drug abuse, most commonly heroin or cocaine abuse. Criminal justice referrals for drug abuse admissions have increased over time and daily substance use remains high. Efforts to determine best practices for prevention, identification, and treatment of illicit drug abuse in older persons are indicated. PMID:19077857

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

    EPA Science Inventory

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

  11. Mechanisms of change in mentalization-based treatment of BPD.

    PubMed

    Fonagy, Peter; Bateman, Anthony W

    2006-04-01

    There are very few less contentious issues than the role of attachment in psychotherapy. Concepts such as the therapeutic alliance speak directly to the importance of activating the attachment system, normally in relation to the therapist in individual therapy and in relation to other family members in family-based intervention, if therapeutic progress is to be made. In group therapy the attachment process may be activated by group membership. The past decade of neuroscientific research has helped us to understand some key processes that attachment entails at brain level. The article outlines this progress and links it to recent findings on the relationship between the neural systems underpinning attachment and other processes such as making of social judgments, theory of mind, and access to long-term memory. These findings allow intriguing speculations, which are currently undergoing empirical tests on the neural basis of individual differences in attachment as well as the nature of psychological disturbances associated with profound disturbances of the attachment system. In this article, we explore the crucial paradoxical brain state created by psychotherapy with powerful clinical implications for the maximization of therapeutic benefit from the talking cure.

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

    PubMed

    McQuaid, Thomas; Savini, Carolyn; Seyedkazemi, Star

    2015-03-01

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

  13. Treatment-related alteration of cortisol predicts change in neuropsychological function during acute treatment of late-life anxiety disorder

    PubMed Central

    Lenze, Eric J.; Dixon, David; Mantella, Rose C.; Dore, Peter M.; Andreescu, Carmen; Reynolds, Charles F.; Newcomer, John W.; Butters, Meryl A.

    2012-01-01

    Objective Older adults with anxiety disorders are burdened by impairment in neurocognition, which may be mediated by elevated circulating cortisol levels. In a randomized controlled trial of acute serotonin-reuptake inhibitor treatment for late-life anxiety disorder, we examined whether change in salivary cortisol concentrations during treatment predicted improvements in measures of memory and executive function. Methods We examined 60 adults aged 60 and older, who took part in a 12-week trial of escitalopram vs. placebo for Generalized Anxiety Disorder. All subjects had pre- and post-treatment assessments that included monitoring of peak and total daily cortisol and a comprehensive neuropsychological evaluation. Results Salivary cortisol changes during treatment showed significant associations with changes in immediate and delayed memory, but no association with executive tasks (measures of working memory and set-shifting). Analyses suggested that a decrease in cortisol due to serotonin-reuptake inhibitor treatment was responsible for the memory changes: memory improvement was seen with cortisol reduction among patients receiving escitalopram, but not among patients receiving placebo. Conclusion Serotonin-reuptake inhibitor-induced alteration in circulating cortisol during treatment of Generalized Anxiety Disorder predicted changes in immediate and delayed memory. This finding suggests a novel treatment strategy in late-life anxiety disorders: targeting HPA axis dysfunction to improve memory. PMID:21681817

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

    PubMed

    Shi, Yibing; Nusholtz, Guy S

    2015-11-01

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

  15. Using dreams to assess clinical change during treatment.

    PubMed

    Glucksman, Myron L; Kramer, Milton

    2004-01-01

    This article describes several studies that examine the relationship between the manifest content of selected dreams reported by patients and their clinical progress during psychoanalytic and psychodynamically oriented treatment. There are a number of elements that dreaming and psychotherapy have in common: affect regulation; conflict resolution; problem-solving; self-awareness; mastery and adaptation. Four different studies examined the relationship between the manifest content of selected dreams and clinical progress during treatment. In each study, the ratings of manifest content and clinical progress by independent observers were rank-ordered and compared. In three of the four studies there was a significant correlation between the rankings of manifest content and the rankings of clinical progress. This finding suggests that the manifest content of dreams can be used as an independent variable to assess clinical progress during psychoanalytic and psychodynamically oriented treatment.

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

    PubMed Central

    Gates, Brian J.; Walker, Kevin M.

    2014-01-01

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

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

    PubMed

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

    2016-04-15

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

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

    PubMed

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

    2011-01-01

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

  19. A Changing Landscape in Castration-Resistant Prostate Cancer Treatment

    PubMed Central

    Felici, A.; Pino, M. S.; Carlini, Paolo

    2012-01-01

    Prostate cancer (PC) is the leading cause of cancer and the second leading cause of cancer-death among men in the Western world. About 10–20% of men with PC present with metastatic disease at diagnosis, while 20–30% of patients diagnosed with localized disease will eventually develop metastases. Although most respond to initial androgen-deprivation therapy (ADT), progression to castration-resistant PC (CRPC) is universal. In 2004 the docetaxel/prednisone regimen was approved for the management of patients with metastatic CRPC, becoming the standard first-line therapy. Recent advances have now led to an unprecedented number of new drug approvals within the past years, providing many new treatment options for patients with metastatic CRPC. Four new drugs have received U.S. Food and Drug Administration (FDA)-approval in 2010 and 2011: sipuleucel-T, an immunotherapeutic agent; cabazitaxel, a novel microtubule inhibitor; abiraterone acetate, a new androgen biosynthesis inhibitor; and denosumab, a bone-targeting agent. The data supporting the approval of each of these agents are described in this review, as are current approaches in the treatment of metastatic CRPC and ongoing clinical trials of novel treatments and strategies. PMID:22826702

  20. Common misconceptions about cognitive mediation of treatment change: a commentary to Longmore and Worrell (2007).

    PubMed

    Hofmann, Stefan G

    2008-01-01

    The article by Richard J. Longmore and Michael Worrell [Clinical Psychology Review, Volume 27, 2007, pp. 173-187] reviews a selection of studies showing no significant difference between treatment conditions that include formal cognitive restructuring techniques and other behavioral treatment modalities that do not include techniques to directly challenge cognitions. Based on this literature, Longmore and Worrell question the validity of the cognitive behavioral treatment model and argue that changes in symptoms are not mediated by changes in cognitions. Longmore and Worrell's arguments are based on common misconceptions about mediation models of treatment change. This commentary discusses and clarifies these misconceptions.

  1. Changes in vitamin D metabolites during teriparatide treatment

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  2. Treatment Ideology and Correctional Bureaucracy: A Study of Organizational Change.

    ERIC Educational Resources Information Center

    Martinson, Robert Magnus

    A study was made of organizational change induced by a staff training project in six correctional institutions for youth in the California system, which is currently engaged in introducing "therapeutic community" into correctional facilities. Part I described and evaluated a federally financed training project. The "resource model" of training was…

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

    ERIC Educational Resources Information Center

    Wechsberg, Wendee M.; And Others

    1994-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    PubMed

    Papakostas, George I

    2016-08-01

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

  6. Depressed smokers and stage of change: implications for treatment interventions.

    PubMed

    Prochaska, Judith J; Rossi, Joseph S; Redding, Colleen A; Rosen, Amy B; Tsoh, Janice Y; Humfleet, Gary L; Eisendrath, Stuart J; Meisner, Marc R; Hall, Sharon M

    2004-11-11

    Tobacco Dependence among smokers with psychiatric disorders has been under-addressed by the mental health, addictions, and tobacco control communities. This study examined depressed smokers' readiness to quit and the applicability of the Stages of Change framework to a psychiatric sample. Currently depressed smokers (N=322) were recruited from four outpatient psychiatric clinics. Participants averaged 16 cigarettes per day (S.D.=10) and 24 years (S.D.=13) of smoking. The majority (79%) reported intention to quit smoking with 24% ready to take action in the next 30 days. Individuals in the preparation stage reported more prior quit attempts, a greater commitment to abstinence, increased recognition of the cons of smoking, and greater use of the processes of change. Precontemplators were least likely to identify a goal related to their smoking behavior. Depressive symptom severity and history of recurrent depressive episodes were unrelated to readiness to quit. This study is one of the first to examine the smoking behaviors of currently depressed psychiatric outpatients. The level and longevity of their tobacco use underscore the need for cessation interventions. The consistency in hypothesized patterns among theoretical constructs of the Stages of Change model supports the transfer of stage-tailored interventions to this clinical population. PMID:15488338

  7. Measurements of Nb3Sn conductor dimension changes during heat treatment

    NASA Astrophysics Data System (ADS)

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

    2012-06-01

    During the heat treatment of Nb3Sn coils the conductor material properties change significantly. These effects together with the changes of the conductor dimensions during heat treatment may introduce large strains in the coils for accelerator magnets. The US LHC Accelerator Research Program (LARP) has initiated a study aiming at understanding the thermal expansion and contraction of Nb3Sn strands, cables and coils during heat treatment. Several measurements on OST RRP 54/61 and OST RRP 108/127 strands were performed, and a few more are in progress, in order to have sufficient inputs for finite element simulation of the dimensional changes during heat treatment. Three strand quantities were measured: diameter change, length change and twist change. The measured types of strands (OST RRP 54/61 and OST RRP 108/127) demonstrated diameter change by +2.15% and +1.88%, and length change by +0.035% and -0.045% respectively. The measured twist change after reaction was about 4%. In this paper an impact of twist change on strand length change was studied, as well. The results of measurements show a significant contribution of twist change to the strand length change.

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

    PubMed

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

    2013-10-01

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

  9. The changing spectrum of treatment for variceal bleeding.

    PubMed Central

    Rikkers, L F

    1998-01-01

    OBJECTIVE: The objective of this study was to assess the impact of endoscopic therapy, liver transplantation, and transjugular intrahepatic portosystemic shunt (TIPS) on patient selection and outcome of surgical treatment for this complication of portal hypertension, as reflected in a single surgeon's 18-year experience with operations for variceal hemorrhage. SUMMARY BACKGROUND DATA: Definitive treatment of patients who bleed from portal hypertension has been progressively altered during the past 2 decades during which endoscopic therapy, liver transplantation, and TIPS have successively become available as alternative treatment options to operative portosystemic shunts and devascularization procedures. METHODS: Two hundred sixty-three consecutive patients who were surgically treated for portal hypertensive bleeding between 1978 and 1996 were reviewed retrospectively. Four Eras separated by the dates when endoscopic therapy (January 1981), liver transplantation (July 1985), and TIPS (January 1993) became available in our institution were analyzed. Throughout all four Eras, a selective operative approach, using the distal splenorenal shunt (DSRS), nonselective shunts, and esophagogastric devascularization, was taken. The most common indications for nonselective shunts and esophagogastric devascularization were medically intractable ascites and splanchnic venous thrombosis, respectively. Most other patients received a DSRS. RESULTS: The risk status (Child's class) of patients undergoing surgery progressively improved (p = 0.001) throughout the 4 Eras, whereas the need for emergency surgery declined (p = 0.002). The percentage of nonselective shunts performed decreased because better options to manage acute bleeding episodes (sclerotherapy, TIPS) and advanced liver disease complicated by ascites (liver transplantation, TIPS) became available (p = 0.009). In all Eras, the operative mortality rate was directly related to Child's class (A, 2.7%; B, 7.5%; and C, 26

  10. Towards empirical identification of a clinically meaningful indicator of treatment outcome: Features of candidate indicators and evaluation of sensitivity to treatment effects and relationship to one year follow up cocaine use outcomes

    PubMed Central

    Carroll, Kathleen M.; Kiluk, Brian D.; Nich, Charla; DeVito, Elise E.; Decker, Suzanne; LaPaglia, Donna; Duffey, Dianne; Babuscio, Theresa A.; Ball, Samuel A.

    2014-01-01

    Background Selection of an appropriate indictor of treatment response in clinical trials is complex, particularly for the various illicit drugs of abuse. Most widely-used indicators have been selected based on expert group recommendation or convention rather than systematic empirical evaluation. Absence of an evidence-based, clinically meaningful index of treatment outcome hinders cross-study evaluations necessary for progress in addiction treatment science. Method Fifteen candidate indicators used in multiple clinical trials as well as some proposed recently are identified and discussed in terms of relative strengths and weaknesses (practicality, cost, verifiability, sensitivity to missing data). Using pooled data from five randomized controlled trials of cocaine dependence (N = 434), the indicators were compared in terms of sensitivity to the effects of treatment and relationship to cocaine use and general functioning during follow-up. Results Commonly used outcome measures (percent negative urine screens; percent days of abstinence) performed relatively well in that they were sensitive to the effects of the therapies evaluated. Others, including complete abstinence and reduction in frequency of use, were less sensitive to effects of specific therapies and were very weakly related to cocaine use or functioning during follow-up. Indicators more strongly related to cocaine use during follow-up were those that reflected achievement of sustained periods of abstinence, particularly at the end of treatment. Conclusions These analyses did not demonstrate overwhelming superiority of any single indicator, but did identify several that performed particularly poorly. Candidates for elimination included retention, complete abstinence, and indicators of reduced frequency of cocaine use. PMID:24556275

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

    PubMed

    Shi, Yibing; Nusholtz, Guy S

    2015-11-01

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

  12. The family in Italy: cultural changes and implications for treatment.

    PubMed

    Luciano, Mario; Sampogna, Gaia; del Vecchio, Valeria; Giacco, Domenico; Mulè, Alice; de Rosa, Corrado; Fiorillo, Andrea; Maj, Mario

    2012-04-01

    In Italy family is characterized by strong ties and is based on mutual aid of all its members. In the last 20 years, the structure of families has been significantly influenced by demographic, economic and professional changes, determining a transition from a patriarchal to a nuclear family model, with a higher number of single-parent families, single-person households, childless couples, same-sex couples. However, this transition has been slower than that occurring in other countries, probably as an ongoing impact of prevalent Catholic ideology. Major demographic changes in Italian families include, 1) a decrease in the number of marriages, delays in getting married and an high number of civil ceremonies, 2) a reduced birth rate; Italy is becoming one of the European countries with lowest growth rate, and with an increasing number of births out of wedlock, 3) an increased marital instability, with a constantly growing number of legal separations. Like many countries, relatives in Italy are highly involved in the care of patients with physical and mental disorders. There are a number of psychosocial interventions used in Italy including the 'Milan Systemic Approach' and family psycho-educational interventions. However, there are difficulties in implementing these interventions which are highlighted in this paper. We recommend research strategies to identify the best options to involve families in the care of mentally ill patients and to adequately support them.

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

    2014-01-01

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

  15. Effectiveness of the Treatment Readiness and Induction Program for Increasing Adolescent Motivation for Change

    PubMed Central

    Becan, Jennifer E.; Knight, Danica K.; Crawley, Rachel D.; Joe, George W.; Flynn, Patrick M.

    2014-01-01

    Success in substance abuse treatment is improved by problem recognition, desire to seek help, and readiness to engage in treatment, all of which are important aspects of motivation. Interventions that facilitate these at treatment induction for adolescents are especially needed. The purpose of this study is to assess the effectiveness of TRIP (Treatment Readiness and Induction Program) in promoting treatment motivation. Data represent 519 adolescents from 6 residential programs who completed assessments at treatment intake (Time 1) and 35 days after admission (Time 2). The design consisted of a comparison sample (n = 281) that had enrolled in treatment prior to implementation of TRIP (standard operating practice) and a sample of clients that had entered treatment after TRIP began and received standard operating practice enhanced by TRIP (n = 238). Repeated measures ANCOVAs were conducted using each Time 2 motivation scale as a dependent measure. Motivation scales were conceptualized as representing sequential stages of change. LISREL was used to test a structural model involving TRIP participation, gender, drug use severity, juvenile justice involvement, age, race-ethnicity, prior treatment, and urgency as predictors of the stages of treatment motivation. Compared to standard practice, adolescents receiving TRIP demonstrated greater gains in problem recognition, even after controlling for the other variables in the model. The model fit was adequate, with TRIP directly affecting problem recognition and indirectly affecting later stages of change (desire for help and treatment readiness). Future studies should examine which specific components of TRIP affect change in motivation. PMID:25456094

  16. Effectiveness of the Treatment Readiness and Induction Program for increasing adolescent motivation for change.

    PubMed

    Becan, Jennifer E; Knight, Danica K; Crawley, Rachel D; Joe, George W; Flynn, Patrick M

    2015-03-01

    Success in substance abuse treatment is improved by problem recognition, desire to seek help, and readiness to engage in treatment, all of which are important aspects of motivation. Interventions that facilitate these at treatment induction for adolescents are especially needed. The purpose of this study is to assess the effectiveness of TRIP (Treatment Readiness and Induction Program) in promoting treatment motivation. Data represent 519 adolescents from 6 residential programs who completed assessments at treatment intake (time 1) and 35 days after admission (time 2). The design consisted of a comparison sample (n=281) that had enrolled in treatment prior to implementation of TRIP (standard operating practice) and a sample of clients that had entered treatment after TRIP began and received standard operating practice enhanced by TRIP (n=238). Repeated measures ANCOVAs were conducted using each time 2 motivation scale as a dependent measure. Motivation scales were conceptualized as representing sequential stages of change. LISREL was used to test a structural model involving TRIP participation, gender, drug use severity, juvenile justice involvement, age, race-ethnicity, prior treatment, and urgency as predictors of the stages of treatment motivation. Compared to standard practice, adolescents receiving TRIP demonstrated greater gains in problem recognition, even after controlling for the other variables in the model. The model fit was adequate, with TRIP directly affecting problem recognition and indirectly affecting later stages of change (desire for help and treatment readiness). Future studies should examine which specific components of TRIP affect change in motivation.

  17. Self-focused attention and mechanisms of change in mindfulness-based treatment.

    PubMed

    Baer, Ruth A

    2009-01-01

    The empirical literature provides increasing support for the efficacy of mindfulness training in the treatment of numerous problems and disorders. However, fewer studies have examined the mechanisms through which these beneficial outcomes are obtained. This article summarizes recent research examining three primary questions related to the mechanisms underlying mindfulness-based treatments: do people who practice mindfulness learn to be more mindful of the experiences of daily life? Is an increased general tendency to be mindful related to reduced symptoms and increased well-being? If so, then what psychological processes account for the beneficial effects of increased mindfulness? Recent studies suggest that the practice of mindfulness develops the ability to observe and describe present-moment experiences nonjudgmentally and nonreactively and to participate with awareness in ongoing activity. Increased mindfulness, in turn, appears to mediate improvement in psychological functioning, probably by cultivating an adaptive form of self-focused attention that reduces rumination and emotional avoidance and improves behavioral self-regulation.

  18. Neural changes after phonological treatment for anomia: An fMRI study.

    PubMed

    Rochon, Elizabeth; Leonard, Carol; Burianova, Hana; Laird, Laura; Soros, Peter; Graham, Simon; Grady, Cheryl

    2010-09-01

    Functional magnetic resonance imaging (fMRI) was used to investigate the neural processing characteristics associated with word retrieval abilities after a phonologically-based treatment for anomia in two stroke patients with aphasia. Neural activity associated with a phonological and a semantic task was compared before and after treatment with fMRI. In addition to the two patients who received treatment, two patients with aphasia who did not receive treatment and 10 healthy controls were also scanned twice. In the two patients who received treatment, both of whose naming improved after treatment, results showed that activation patterns changed after treatment on the semantic task in areas that would have been expected (e.g., left hemisphere frontal and temporal areas). For one control patient, there were no significant changes in brain activation at the second scan; a second control patient showed changes in brain activation at the second scan, on the semantic task, however, these changes were not accompanied with improved performance in naming. In addition, there appeared to be bilateral, or even more right than left hemisphere brain areas activated in this patient than in the treated patients. The healthy control group showed no changes in activation at the second scan. These findings are discussed with reference to the literature on the neural underpinnings of recovery after treatment for anomia in aphasia.

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

    PubMed

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

    2016-02-01

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

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

    PubMed

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

    2016-02-01

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

  1. Attachment-Based Family Therapy: A Review of the Empirical Support.

    PubMed

    Diamond, Guy; Russon, Jody; Levy, Suzanne

    2016-09-01

    Attachment-based family therapy (ABFT) is an empirically supported treatment designed to capitalize on the innate, biological desire for meaningful and secure relationships. The therapy is grounded in attachment theory and provides an interpersonal, process-oriented, trauma-focused approach to treating adolescent depression, suicidality, and trauma. Although a process-oriented therapy, ABFT offers a clear structure and road map to help therapists quickly address attachment ruptures that lie at the core of family conflict. Several clinical trials and process studies have demonstrated empirical support for the model and its proposed mechanism of change. This article provides an overview of the clinical model and the existing empirical support for ABFT.

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

    PubMed

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

    2015-11-01

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

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

    PubMed

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

    2015-11-01

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

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

    PubMed

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

    2016-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  6. Readiness for Change and Treatment Outcome among Individuals with Alcohol Dependency.

    ERIC Educational Resources Information Center

    Hewes, Robert L.; Janikowski, Timothy P.

    1998-01-01

    Uses the Addiction Severity Index and Stage of Change Readiness and Treatment Eagerness Scale to evaluate individuals with primary alcohol-abuse problems involved in treatment programs. Results indicate that participants showed significant improvement in problems related to alcohol use. No significant differences were found between participants…

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  10. Long-term changes in arch form after orthodontic treatment and retention.

    PubMed

    de la Cruz, A; Sampson, P; Little, R M; Artun, J; Shapiro, P A

    1995-05-01

    The purpose of this study was to evaluate the long-term stability of orthodontically induced changes in maxillary and mandibular arch form. Dental casts were evaluated before treatment, after treatment, and a minimum of 10 years after retention for 45 patients with Class I and 42 Class II, Division 1 malocclusions who received four first premolar extraction treatment. Computer generated arch forms were used to assess changes in arch shape over time. Buccal cusp tips of first molars, premolars, and canines plus mesial, distal, and central incisal aspects of incisors were marked, photocopied, and digitized in a standardized manner. An algorithm was used to fit conic sections to the digitized points. The shape of the fitted conics at each time period was described by calculating the parameter eccentricity; a small value represented a more rounded shape and a larger value represented a more tapered shape. Findings demonstrated a rounding of arch form during treatment followed by a change to more tapered. Arch form tended to return toward the pretreatment shape after retention. The greater the treatment change, the greater the tendency for postretention change. However, individual variation was considerable. The patient's pretreatment arch form appeared to be the best guide to future arch form stability, but minimizing treatment change was no guarantee of postretention stability.

  11. [Imipenem combined with teicoplanin or vancomycin in the initial empirical treatment of febrile neutropenia. Analysis of the primary response and of a global sequential strategy in 126 episodes].

    PubMed

    Figuera, A; Tomás, J F; Hernández, L; Jiménez, M L; Peñarrubia, M J; del Rey, M C; Arranz, R; Cámara, R; López-Lorenzo, J L; Fernández-Rañada, J M

    1996-08-01

    The results of empiric antibiotic therapy in 126 episodes of febrile neutropenia in patients with hematologic neoplasms postchemotherapy and bone marrow transplantation are presented. The main objective of this work was the study of the initial control of infection comparing two glycopeptidic antibiotics: vancomycin and teicoplanin combined with imipenem in first line of empiric therapy. The secondary objective was to analyze the overall control of infection during the complete episode of neutropenia using a sequential empiric antibiotic therapy course which included the addition of amikacin followed by intravenous amphotericin B when fever persisted or recurred without microbiological documentation. Both initial courses (no guidelines), imipenem + vancomycin (arm A) and imipenem + teicoplanin (arm B) resulted in a similar percentage of response at 72 hours, both in episodes of fever of unknown origin (FUO) (55% and 68%, respectively; p = NS) and in those microbiologically documented (54% and 34.5%, p = NS); 58% and 79% of these episodes, respectively, were caused by gram-positive organisms. About 60% of patients in both arm ultimately required the empiric addition of amikacin, with or without amphotericin B, because of persistence or recurrence of fever; the percentage of overall responses in both arm did not differ significantly, both in FUO (70% and 86%, p = NS) and in microbiologically documented episodes (71% and 45%, p = NS). The overall infectious mortality for the whole group was 1.58%. In conclusion, no significant differences were observed in the clinical response or in toxicity between the combination of imipenem with any of the two glycopeptides: vancomycin or teicoplanin, for the initial empiric therapy of febrile neutropenia. The sequential empiric use of amikacin followed by amphotericin B assured an adequate overall control of infection in a group of patients with prolonged severe neutropenia.

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  14. Directionality of Change in Youth Anxiety Treatment Involving Parents: An Initial Examination

    PubMed Central

    Silverman, Wendy K.; Kurtines, William M.; Jaccard, James; Pina, Armando A.

    2009-01-01

    This randomized clinical trial compared cognitive-behavioral therapy (CBT) with minimal parent involvement versus CBT with active parent involvement in a sample of 119 youth (7–16 years; 33.6% Caucasian; 61.3% Latino) with anxiety disorders. The dynamics of change between youth anxiety and parent variables (positive/negative behaviors toward the child, conflict in the parent-youth relationship, and parental anxiety) in both treatment conditions over pretreatment, posttreatment, and 12-month follow-up also were examined. Results indicated that youth anxiety was significantly reduced with both treatments and that the dynamics of change may not solely flow from parent to youth but also from youth to parent. Findings highlight the need for research on directionality and mechanisms of change in order to move from evidence-based treatments toward evidence-based explanations of treatment outcome. PMID:19485589

  15. Measurements of Nb3Sn conductor dimension changes during heat treatment

    SciTech Connect

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

    2011-06-01

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

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

    SciTech Connect

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

    2015-06-15

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

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

    PubMed Central

    Simpson, D. Dwayne; Flynn, Patrick M.

    2007-01-01

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

  18. Pre-treatment Anxiety Predicts Patterns of Change in Cognitive Behavioral Therapy and Medications for Depression

    PubMed Central

    Forand, Nicholas R.; DeRubeis, Robert J.

    2014-01-01

    Objective Some studies report that initial anxiety is associated with equivocal or negative effects in depression treatment. In contrast, at least four studies of cognitive behavioral therapy (CBT) report that anxiety predicts greater or more rapid change in depression. Further exploration is needed to clarify the relationship between initial anxiety and depression change. Questions include the relationship between anxiety and patterns of change and time to relapse, as well the specificity effects to CBT. Method The study assessed the relation of Beck Anxiety Inventory anxiety scores to early rapid change and overall change in Beck Depression Inventory-II depression scores during acute depression treatment. Participants were 178 individuals enrolled in a randomized controlled trial of CBT versus medications (ADM) for moderate to severe depression. They were 58% female and 83% Caucasian, with an average age of 40 (SD = 11.5). Thirty four percent (34%) were married or cohabitating. Hierarchical linear models including quadratic growth parameters were used to model change. The relation of anxiety to the probability of post-treatment relapse was also examined. Results Findings indicate that higher levels of anxiety predict early rapid change, but not overall change, in both CBT and ADM. However, patients with higher levels of intake anxiety evidenced increased risk for relapse after CBT. Conclusions Early rapid change predicted by anxiety occurs across different treatment conditions, but this early rapid response is not indicative of positive overall outcome in all cases. These findings might indicate that anxiety predicts a response to non-specific “common factors” of treatment. PMID:23647285

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Baltacıoğlu, Hande; Bayındırlı, Alev; Severcan, Feride

    2017-01-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2009-10-01

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

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

    PubMed

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

    2015-03-01

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

  5. Changes of wood cell walls in response to hygro-mechanical steam treatment.

    PubMed

    Guo, Juan; Song, Kunlin; Salmén, Lennart; Yin, Yafang

    2015-01-22

    The effects of compression combined with steam treatment (CS-treatment), i.e. a hygro-mechanical steam treatment on Spruce wood were studied on a cell-structure level to understand the chemical and physical changes of the secondary cell wall occurring under such conditions. Specially, imaging FT-IR microscopy, nanoindentation and dynamic vapour absorption were used to track changes in the chemical structure, in micromechanical and hygroscopic properties. It was shown that CS-treatment resulted in different changes in morphological, chemical and physical properties of the cell wall, in comparison with those under pure steam treatment. After CS-treatment, the cellular structure displayed significant deformations, and the biopolymer components, e.g. hemicellulose and lignin, were degraded, resulting in decreased hygroscopicity and increased mechanical properties of the wood compared to both untreated and steam treated wood. Moreover, CS-treatment resulted in a higher degree of degradation especially in earlywood compared to a more uniform behaviour of wood treated only by steam.

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

    PubMed Central

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

    2016-01-01

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

  7. Anxiety disorders in persons with developmental disabilities: empirically informed diagnosis and treatment. Reviews literature on anxiety disorders in DD population with practical take-home messages for the clinician.

    PubMed

    Davis, Ervin; Saeed, Sy Atezaz; Antonacci, Diana J

    2008-09-01

    Anxiety disorders are common in individuals with developmental disabilities (DDs), although they may not be diagnosed and treated as often as they are in patients without DDs. Patients with mental retardation, autism, and other pervasive developmental disorders may exhibit comorbid anxiety disorders, such as generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), phobias, and other anxiety symptoms at much higher rates than in the general population, but identification of these comorbid anxiety disorders may be made more difficult by the presence of the DD and concurrent difficulties with communication, other behavior problems, the lack of standardized assessments specific to diagnosing patients with DDs and psychiatric comorbidities, and the need for greater collateral sources of assessment information. In addition, systematic study of the treatment of anxiety in patients with DD is limited to a relatively small number of empirical studies done specifically in these patients along with case reports and theoretical reviews on the extension and modification of more well-studied treatments used for anxiety in patients without DDs. The present article reviews the literature on the prevalence, features, assessment and diagnosis of anxiety disorders in individuals with DDs, and also reviews empirical studies of pharmacological and psychological treatment of patients with comorbid anxiety and DD and summarizes the findings. Recommendations are made to guide treatment and further research in this area.

  8. Decisional balance proportion: quantifying qualitative data to represent motivation to change among treatment-seeking smokers.

    PubMed

    Collins, Susan E; Eck, Sandra; Torchalla, Iris; Schröter, Martina; Batra, Anil

    2010-09-01

    This study tested a new measure of motivation to change as a predictor of smoking behavior following smoking cessation treatment. Participants were adult, regular smokers (N=191) who took part in a randomized smoking cessation trial in southwestern Germany (Batra et al., 2010). Participants completed smoking and psychological self-report measures before and after a 6-week smoking cessation treatment. Among these measures, the open-ended decisional balance worksheet elicited participant-generated pros and cons of smoking versus abstinence. Counts of the pros and cons were combined into the decisional balance proportion (DBP), which reflected participants' current balance towards smoking behavior change. Additional smoking assessments were conducted up to the 12-month follow-up. After controlling for group effects and baseline smoking, DBP change scores (posttreatment-pretreatment) reflecting greater movement towards change during treatment predicted time to first smoking lapse as well as abstinence up to the 12-month follow-up. Higher DBP change scores also predicted lower frequency and intensity of smoking lapses during the 12-month follow-up. Findings indicated that participant-generated, qualitative data from a decisional balance worksheet can be quantified to produce a valid measure of motivation to change among smokers. This measure can inform intervention content and may potentially be used to match smokers to appropriate treatments.

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

    NASA Astrophysics Data System (ADS)

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

    2013-11-01

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

  10. Morphological changes to early stage Taenia solium cysticerci following oxfendazole treatment.

    PubMed

    Liu, Yong-Jie; Li, Qing-Zhang; Hao, Yan-Hong

    2003-01-01

    The progressive morphological changes to early stage Taenia solium cysticerci following the treatment of pigs with a single therapeutic dose of oxfendazole (30 mg/kg), are described. On Day 1 after treatment, no obvious changes occurred in the general appearance of the larvae but alternations were seen by electron microscope, with an apparent reduction in the number of microtriches, and a complete disappearance of the tegument. Numerous granules were seen to have accumulated in the tegument cells. As treatment progressed, damage to the cysticerci was more serious and, by five days, all cysticerci were seen to be in an advanced stage of degeneration. By 45 days post-treatment, all cysts were calcified. These results suggest that oxfendazole is a highly effective drug against T. solium cysticerci in the early stages of development.

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

    PubMed Central

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

    2009-01-01

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

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

    PubMed

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

    2009-01-01

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

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

    PubMed

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

    2009-01-01

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

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

    PubMed Central

    Sastry, Narayan; Burgard, Sarah

    2010-01-01

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

  15. Change in Plasma Cytokine Levels During Risperidone Treatment in Children with Autism

    PubMed Central

    Choi, Jae Eun; Widjaja, Felicia; Careaga, Milo; Bent, Stephen; Ashwood, Paul

    2014-01-01

    Abstract Background: Atypical antipsychotics decrease irritability in autism. They also affect the cytokine network. Psychological stress, depression, and, possibly, autism spectrum disorder (ASD) are associated with the production of pro-inflammatory cytokines. We sought to determine if risperidone treatment led to changes in plasma cytokine levels. Methods: Forty-five subjects from an open-label study of risperidone treatment of children and adolescents with ASD, ages 4–18 years, had an analysis of 27 different cytokines at baseline and after 8 weeks of treatment using multiplex assays (Millipore) and read on the Luminex 100™ platform. We examined changes in each of the cytokine levels in the entire group, and also compared changes in cytokines in responders versus nonresponders. Results: After 8 weeks of risperidone treatment, 2 of the 27 plasma cytokines showed statistically significant decreases in median levels: Eotaxin (p=0.0003) and monocyte chemoattractant protein-1 (MCP-1) (p=0.0024). Six of the 48 subjects met two criteria for responders to risperidone, and the median values of interleukin (IL)-5 were significantly higher (p=0.005) in the overall responder group than in nonresponders. Conclusions: Two cytokines, eotaxin and MCP-1, which have previously been identified as abnormally elevated in children with autism, decreased during treatment with risperidone. This suggests a possible mechanism of action of risperidone treatment and a balancing of the immune system in affected subjects in this very preliminary study. PMID:24828014

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

    PubMed

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

    2012-01-01

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

  17. Analysis of physiological responses associated with emotional changes induced by viewing video images of dental treatments.

    PubMed

    Sekiya, Taki; Miwa, Zenzo; Tsuchihashi, Natsumi; Uehara, Naoko; Sugimoto, Kumiko

    2015-01-01

    Since the understanding of emotional changes induced by dental treatments is important for dentists to provide a safe and comfortable dental treatment, we analyzed physiological responses during watching video images of dental treatments to search for the appropriate objective indices reflecting emotional changes. Fifteen healthy young adult subjects voluntarily participated in the present study. Electrocardiogram (ECG), electroencephalogram (EEG) and corrugator muscle electromyogram (EMG) were recorded and changes of them by viewing videos of dental treatments were analyzed. The subjective discomfort level was acquired by Visual Analog Scale method. Analyses of autonomic nervous activities from ECG and four emotional factors (anger/stress, joy/satisfaction, sadness/depression and relaxation) from EEG demonstrated that increases in sympathetic nervous activity reflecting stress increase and decreases in relaxation level were induced by the videos of infiltration anesthesia and cavity excavation, but not intraoral examination. The corrugator muscle activity was increased by all three images regardless of video contents. The subjective discomfort during watching infiltration anesthesia and cavity excavation was higher than intraoral examination, showing that sympathetic activities and relaxation factor of emotion changed in a manner consistent with subjective emotional changes. These results suggest that measurement of autonomic nervous activities estimated from ECG and emotional factors analyzed from EEG is useful for objective evaluation of subjective emotion. PMID:26111531

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

    PubMed Central

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

    2009-01-01

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

  19. Changes in circulating immunosuppressive cytokine levels of cancer patients after high intensity focused ultrasound treatment.

    PubMed

    Zhou, Qiang; Zhu, Xue-Qiang; Zhang, Jun; Xu, Zhong-Lin; Lu, Pei; Wu, Feng

    2008-01-01

    Immunosuppression in a patient with malignant tumor is a major obstacle in cancer treatment. In this study, we investigated changes in the circulating level of all measured immunosuppressive cytokines in patients with malignancy before and after high intensity focused ultrasound (HIFU) treatment. Fifteen patients with solid malignancy were enrolled in this study and an enzyme-linked immunoabsorbent assay (ELISA) method was used to measure serum level of vascular endothelial growth factor (VEGF), transforming growth factor-beta1 (TGF-beta1), transforming growth factor-beta2 (TGF-beta2), interleukin 6 (IL-6) and interleukin 10 (IL-10), respectively before and 1 wk after HIFU treatment. Among them, seven patients had distant metastasis and the remaining eight had no metastasis. All patients received one-session HIFU treatment for primary cancer, including complete ablation in eight patients without metastasis, and partial ablation in seven patients with metastases. The results showed that serum immunosuppressive cytokine levels decreased after HIFU treatment, and there were significant decreases of VEGF, TGF-beta1, and TGF-beta2 before and after HIFU treatment. Compared with the values in the metastatic patients, serum levels of immunosuppressive cytokines were significantly lower in the nonmetastatic patients after HIFU treatment. It is concluded that HIFU can decrease tumor-secreted immunosuppressive cytokine production in addition to its direct tumor destruction. This change may lessen tumor-induced immunosuppression and renew antitumor immunity after HIFU in cancer patients.

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

    PubMed

    Cosden, Merith; Koch, Lauren M

    2015-01-01

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

  1. Psychoanalysis and empirical research.

    PubMed

    Giannoni, Massimo

    2003-11-01

    At the beginning of the nineteenth century, the idea of reason began to lose its universal and absolute value, undermining the view of science as a form of objective knowledge that reveals a fundamental reality. These changes have also had an impact on psychoanalysis, leading to a proliferation of theories and the end of a positivistic approach, epitomized by a 'neutral' analyst who knows the contents of the patient's mind. Hermeneutic philosophy provides a tool with which to explore both theoretical multiplicity and the contribution of the analyst's subjectivity to the analytic process. Furthermore, a hermeneutic approach does not have to be hostile to empirical science, but can be integrated with it in a 'scientific-hermeneutic model' in which historical and biological principles are given equal value.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-08-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2011-12-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

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

    PubMed

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

    2012-10-01

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

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

    ERIC Educational Resources Information Center

    Callan, Laurence Brian

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

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

    ERIC Educational Resources Information Center

    Rains, Jeanetta C.; Lohr, Jeffrey M.

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

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

    ERIC Educational Resources Information Center

    Vegas, Monica

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

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

    PubMed Central

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

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

    PubMed

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

    2016-03-30

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

  15. 75 FR 46901 - Changes to Treatments for Sweet Cherries from Australia and Irradiation Dose for Mediterranean...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-04

    ... ). On October 19, 2009, we published in the Federal Register (74 FR 53424-53430, Docket No. APHIS-2008... FR 4228-4253, Docket No. APHIS-2008-0022, published January 26, 2010, and effective February 25, 2010... Animal and Plant Health Inspection Service Changes to Treatments for Sweet Cherries from Australia...

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

    EPA Science Inventory

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

  17. 76 FR 17617 - Changes to Treatments for Citrus Fruit From Australia

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-30

    ... cherries and citrus fruit. We considered those comments and, in a notice dated August 4, 2010 (75 FR 46901..., 2009, we published in the Federal Register (74 FR 53424-53430, Docket No. APHIS-2008-0140) a proposal...; ] DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service Changes to Treatments for Citrus...

  18. Neural changes associated with appetite information processing in schizophrenic patients after 16 weeks of olanzapine treatment

    PubMed Central

    Stip, E; Lungu, O V; Anselmo, K; Letourneau, G; Mendrek, A; Stip, B; Lipp, O; Lalonde, P; Bentaleb, L A

    2012-01-01

    There is evidence that some atypical antipsychotics, including olanzapine, can produce unwanted metabolic side effects, weight gain and diabetes. However, neuronal correlates of change related to food information processing have not been investigated with these medications. We studied the effect of a pharmacological manipulation with an antipsychotic known to cause weight gain on metabolites, cognitive tasks and neural correlates related to food regulation. We used functional magnetic resonance imaging in conjunction with a task requiring visual processing of appetitive stimuli in schizophrenic patients and healthy controls before and after 16 weeks of antipsychotic medication with olanzapine. In patients, the psychological and neuronal changes associated following the treatment correlated with appetite control measures and metabolite levels in fasting blood samples. After 16 weeks of olanzapine treatment, the patients gained weight, increased their waist circumference, had fewer positive schizophrenia symptoms, a reduced ghrelin plasma concentration and an increased concentration of triglycerides, insulin and leptin. In premotor area, somatosensory cortices as well as bilaterally in the fusiform gyri, the olanzapine treatment increased the neural activity related to appetitive information in schizophrenic patients to similar levels relative to healthy individuals. However, a higher increase in sensitivity to appetitive stimuli after the treatment was observed in insular cortices, amygdala and cerebellum in schizophrenic patients as compared with healthy controls. Furthermore, these changes in neuronal activity correlated with changes in some metabolites and cognitive measurements related to appetite regulation. PMID:22714121

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  20. Opioid use in Albuquerque, New Mexico: a needs assessment of recent changes and treatment availability

    PubMed Central

    2014-01-01

    Background New Mexico has consistently high rates of drug-induced deaths, and opioid-related treatment admissions have been increasing over the last two decades. Youth in New Mexico are at particular risk: they report higher rates of nonmedical prescription opioid use than those over age 25, are more likely than their national counterparts to have tried heroin, and represent an increasing proportion of heroin overdoses. Methods Commissioned by the City of Albuquerque, semistructured interviews were conducted from April to June of 2011 with 24 substance use treatment agencies and eight key stakeholders in Albuquerque to identify recent changes in the treatment-seeking population and gaps in treatment availability. Themes were derived using template analysis and data were analyzed using NVivo 9 software. Results Respondents reported a noticeable increase in youth seeking treatment for opioid use and a general increase in nonmedical prescription opioid use. Most noted difficulties with finding buprenorphine providers and a lack of youth services. Additionally, stigma, limited interagency communication and referral, barriers to prescribing buprenorphine, and a lack of funding were noted as preventing opioid users from quickly accessing effective treatment. Conclusions Recommendations for addressing these issues include developing youth-specific treatment programs, raising awareness about opioid use among youth, increasing the availability of buprenorphine through provider incentives and education, developing a resource guide for individuals seeking treatment in Albuquerque, and prioritizing interagency communication and referrals. PMID:24942534

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

    PubMed Central

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

    2008-01-01

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

  2. Changes in plasma cytokines after treatment of ascaris lumbricoides infection in individuals with HIV-1 infection.

    PubMed

    Blish, Catherine A; Sangaré, Laura; Herrin, Bradley R; Richardson, Barbra A; John-Stewart, Grace; Walson, Judd L

    2010-06-15

    Albendazole treatment of individuals with human immunodeficiency virus type 1 (HIV-1) and Ascaris lumbricoides co-infection has led to significantly improved CD4(+) cell counts and a trend for lower plasma HIV-1 RNA levels in a previous randomized placebo-controlled trial. To define mechanisms by which deworming contributed to changes in markers of HIV-1 disease progression, plasma cytokine levels were evaluated. Albendazole treatment, compared with placebo, was associated with significantly decreased plasma interleukin (IL) 10 levels (P = .01)ot associated with significant changes in levels of IL-1beta, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-12p70, IL-13, interferon gamma, tumor necrosis factor alpha, or thymic stromal lymphopoietin. Treatment of A. lumbricoides co-infection may delay HIV-1 disease progression by reducing helminth-induced, IL-10-mediated immunosuppression.

  3. Physico-chemical changes in tomato with modified atmosphere storage and UV treatment.

    PubMed

    Vunnam, R; Hussain, A; Nair, G; Bandla, R; Gariepy, Y; Donnelly, D J; Kubow, S; Raghavan, G S V

    2014-09-01

    Physico-chemical changes in ripe tomato (Lycopersicon esculentum Mill.) were analyzed on day 0 and 2 weeks after ultraviolet-C (UV-C) light treatment or modified atmosphere (MA) storage and combined UV-C + MA storage at 10 °C. Modified atmosphere packaging (MAP) film was used to create MA conditions. The tomatoes were evaluated for surface colour, mass loss, firmness, respiration rate, total soluble solids and antioxidant capacity. The tomatoes treated with UV-C and MA storage underwent least changes in their physico-chemical properties, indicating that combination of UV-C and MA storage was successful in retaining the attributes of the fresh product. The increase in antioxidant capacity of the tomatoes during UV-C treatment suggested that UV treatment during post harvest handling may be successfully combined with MA storage, resulting in a product with better nutritive value. PMID:25190870

  4. Changes in plasma cytokines after treatment of ascaris lumbricoides infection in individuals with HIV-1 infection.

    PubMed

    Blish, Catherine A; Sangaré, Laura; Herrin, Bradley R; Richardson, Barbra A; John-Stewart, Grace; Walson, Judd L

    2010-06-15

    Albendazole treatment of individuals with human immunodeficiency virus type 1 (HIV-1) and Ascaris lumbricoides co-infection has led to significantly improved CD4(+) cell counts and a trend for lower plasma HIV-1 RNA levels in a previous randomized placebo-controlled trial. To define mechanisms by which deworming contributed to changes in markers of HIV-1 disease progression, plasma cytokine levels were evaluated. Albendazole treatment, compared with placebo, was associated with significantly decreased plasma interleukin (IL) 10 levels (P = .01)ot associated with significant changes in levels of IL-1beta, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-12p70, IL-13, interferon gamma, tumor necrosis factor alpha, or thymic stromal lymphopoietin. Treatment of A. lumbricoides co-infection may delay HIV-1 disease progression by reducing helminth-induced, IL-10-mediated immunosuppression. PMID:20441516

  5. Early treatment outcomes of class II malocclusion with twin-block facial profile and cephalometric changes

    PubMed Central

    Singh, Mousumi Goswami; Vashisth, Pallavi; Chaudhary, Seema; Sinha, Ashish

    2012-01-01

    Esthetic improvement is highly valued by patients seeking orthodontic treatment. Subjects with a class II malocclusion are a good example of patients who seek treatment primarily for esthetic improvement. A young growing child with convex profile due to a small, retropositioned mandible, normal midface and lower tip trap is more suitable for functional appliance treatment. Functional appliances encourage adaptive skeletal growth by maintaining the mandible in a corrected forward position for a sufficient period of time to allow adaptive skeletal changes to occur in response to a functional stimulus. The aim of this article is to describe two cases of class II malocclusion in late mixed dentition period treated with twin-block. The cephalometric and facial profile changes have been discussed PMID:25756036

  6. Treatment and posttreatment craniofacial changes after rapid maxillary expansion and facemask therapy.

    PubMed

    Baccetti, T; Franchi, L; McNamara, J A

    2000-10-01

    The aim of this study was to evaluate treatment and posttreatment dentoskeletal changes in 2 groups of subjects with Class III malocclusions. Subjects were treated with a bonded acrylic-splint expander and a face mask, and the optimal timing for this treatment protocol was assessed. The treated sample (29 subjects) was divided into 2 groups according to the stage of dental development. The early treatment group consisted of 16 subjects in the early mixed dentitional (erupting permanent incisors and/or first molars), whereas the late treatment group consisted of 13 subjects in the late mixed dentition (erupting permanent canines and premolars). Cephalograms were available at 3 time periods: T(1), pretreatment, T(2), end of active treatment, and T(3), posttreatment. The mean T(1)-T(2) interval (active treatment period) and the mean T(2)-T(3) interval (posttreatment period) were approximately 1 year each in both treatment groups. None of the patients wore any skeletal retention appliance during the posttreatment period (T(2)-T(3)). Groups of subjects with untreated Class III malocclusion were used as controls at both observation intervals. A significant increase in the sagittal growth of the maxilla was seen only when treatment was performed in the early mixed dentition. A restraining effect on mandibular growth rate associated with a more upward and forward direction of condylar growth was found in both treatment groups. An increase in vertical intermaxillary relationships was observed in Class III patients treated in the late mixed dentition. Posttreatment, the Class III craniofacial growth pattern was re-established in the absence of any skeletal retention appliance. Relapse tendency affects the sagittal growth of the maxilla in the early treated subjects and the sagittal position of the mandible in the late treated subjects. Orthopedic treatment of Class III malocclusion in the early mixed dentition is able to induce more favorable craniofacial adaptations than

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

    PubMed

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

    1997-01-01

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

  8. Changes at an activated sludge sewage treatment plant alter the numbers of airborne aerobic microorganisms.

    PubMed

    Fernando, Nadeesha L; Fedorak, Phillip M

    2005-11-01

    In 1976, the activated sludge sewage treatment plant in Edmonton, Canada, was surveyed to determine the numbers of culturable airborne microorganisms. Many changes have been made at the plant to reduce odors and improve treatment efficiency, so in 2004 another survey was done to determine if these changes had reduced the bioaerosols. Covering the grit tanks and primary settling tanks greatly reduced the numbers of airborne microbes. Changing the design and operation of indoor automated sampling taps and sinks also reduced bioaerosols. The secondary was expanded and converted from a conventional activated sludge process using coarse bubble aeration to a biological nutrient removal system using fine bubble aeration. Although the surface area of the secondary more than doubled, the average number of airborne microorganisms in this part of the plant in 2004 was about 1% of that in 1976.

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

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

    PubMed Central

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

    2013-01-01

    This study investigated whether undifferentiated germ and/or somatic stem cells remain in the differentiated ovary of a species that does not undergo sex changes under natural conditions and retain their sexual plasticity. The effect of aromatase inhibitor (AI)-treatment on sexually mature female zebrafish was examined. A 5-month AI treatment caused retraction of the ovaries after which testes-like organs appeared, and cyst structures filled with spermatozoa-like cells were observed in sections of these tissues. Electron microscopic observations revealed that these cells appeared as large sperm heads without tails. Sperm formation was re-examined after changing the diet to an AI-free food. A large number of normal sperm were obtained after eight weeks, and no formation of ovarian tissue was observed. Artificial fertilization using sperm from the sex-changed females was successful. These results demonstrated that sex plasticity remains in the mature ovaries of this species. PMID:24292399

  11. Analysis of general facial growth, maxillary and mandibular growth and treatment changes ("Structural analysis").

    PubMed

    Nielsen, Ib Leth

    2011-12-01

    General facial growth has in the past mostly been analyzed by superimposing on the nasion-sella line using the so-called "best fit" technique. Best fit approaches have also been used to analyze maxillary and mandibular growth and treatment changes. In this article we shall present a more reliable method for analyzing the changes that occur as a result of growth and treatment using the so-called "Structural technique" developed by Björk et al. This technique is based on the results of studies of facial growth using metallic implants over more than 25years. We will discuss how this technique can be applied without the benefit of implants to provide a better and more reliable understanding of the skeletal and dental changes in treated cases.

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

    PubMed Central

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

    2016-01-01

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

  13. Changes in visual evoked potentials in children on chronic dialysis treatment.

    PubMed

    Ducati, A; Cattarelli, D; Cenzato, M; Landi, A; Edefonti, A; Capitanio, L; Pavani, M; Villani, R

    1985-01-01

    Visual evoked potentials (VEP) were recorded in 20 children undergoing dialysis for chronic renal failure. VEP before treatment (72 h after last dialysis) were pathological in 17 patients (85%); responses obtained 3 h after treatment were abnormal in only 6 cases (30%). Furthermore, all patients improved after treatment, except two who were unchanged. However, VEP recorded immediately after dialysis were worse in 4 of 7 patients than before treatment, probably as an effect of the dysequilibrium syndrome; they improved spontaneously afterwards. The acute changes caused by dialysis seem to be more evident in children than in adults. No correlations have been found between blood chemistry indexes and VEP modifications. Finally, VEP have proved to be more sensitive than EEG in identifying a central nervous system (CNS) dysfunction in these uremic patients.

  14. Compositional Change of Silicon Carbide Surface due to Oxygen Adsorption and Heat Treatment

    NASA Astrophysics Data System (ADS)

    Minagawa, Hideki; Vina, Raul Oscar; Kadowaki, Tohru; Mizuno, Seigi; Tochihara, Hiroshi; Hayakawa, Kazunobu; Toyoshima, Isamu

    1992-12-01

    The compositional change of the 6H-SiC(10\\bar{1}0) surface was studied under heat treatment and adsorption of oxygen. X-ray photoelectron spectroscopy (XPS) was used for the analysis of the depth composition profile and chemical binding state. After heat treatment, the carbon concentration of the surface was increased due to the surface segregation of the graphite type carbon. When the adsoption of oxygen was performed with heat treatment, the carbon concentration of the surface was increased, but the amount of segregated carbon was less than that of the sample after only heat treatment. The segregated carbon seemed to react with oxygen preferentialy and to desorb from the surface as a carbon monoxide or carbon dioxide.

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

    PubMed

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

    2015-01-01

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

  16. Social desirability and change following substance abuse treatment in male offenders.

    PubMed

    Davis, Christopher G; Doherty, Sherri; Moser, Andrea E

    2014-09-01

    The efficacy of cognitive-behavioral treatment for substance abuse is contingent on changing clients' attitudes, beliefs, and expectancies. Assessing such change with self-report instruments may be problematic in offenders to the extent that they perceive that treatment success may secure privileges. This study assesses the extent to which increases in social desirability predict improvement in self-efficacy, perceptions of control, and perceived ability to cope and resist use of drugs. Male offenders in a moderate-intensity (N = 1,431) and a high-intensity (N = 316) substance abuse program were assessed before and after treatment on a range of beliefs and attitudes targeted in treatment, along with a measure of social desirability. Regression analyses indicate that those reporting the greatest increase in social desirability also reported the greatest improvement in attitudes and beliefs about drug and alcohol use, thereby suggesting that such self-report measures of change should be regarded with a degree of skepticism. PMID:25222175

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  19. Growth hormone (GH) and atherosclerosis: changes in morphology and function of major arteries during GH treatment.

    PubMed

    Pfeifer, M; Verhovec, R; Zizek, B

    1999-04-01

    Patients with hypopituitarism have increased carotid artery intima-media thickness and reduced arterial distensibility. The effect of 2 years of growth hormone (GH) replacement therapy on these parameters was studied in 11 GH-deficient men (age range, 24-49 years) with hypopituitarism and compared with 12 healthy, age-matched men with no evidence of pituitary or vascular disease. Before treatment the intima-media of the common carotid arteries and the carotid bifurcations were significantly thicker in patients (P < 0.001) than in the control group. Treatment with GH normalized the intima-media thickness of the common carotid artery within 6 months and of the carotid bifurcation within 3 months. The changes in intima-media thickness of the carotid artery were negatively correlated with changes in serum levels of insulin-like growth factor I during treatment. There was a significant improvement in flow-mediated, endothelium-dependent dilation of the brachial artery at 3 months, which was sustained at 6, 18 and 24 months of GH treatment (P < 0.05). Thus, GH replacement therapy in GH-deficient men reverses early morphological and functional atherosclerotic changes in major arteries, and may reduce rates of vascular morbidity and mortality.

  20. Change of Voice Handicap Index after treatment of benign laryngeal disorders.

    PubMed

    Stuut, Marijn; Tjon Pian Gi, Robin E A; Dikkers, Frederik G

    2014-05-01

    Voice disorders can have major impact on quality of life. Problems caused by these disorders can be experienced in different domains. The Voice Handicap Index (VHI) is a well-known voice-related quality of life instrument to measure physical, emotional and functional complaints. VHI change after treatment in seven separate benign laryngeal disorders was studied. In addition, correlation between the three domains was examined. VHI forms were completed before and 3 months after treatment. In a 5-year-period, 143 patients with seven specific diagnoses were retrospectively included. VHI improved for six diagnoses polyp (p < 0.000), cyst (p = 0.001), unilateral paralysis (p = 0.001), Reinke edema (p = 0.016), papillomatosis (p = 0.001), nodules (p = 0.002). Sulcus glottidis did not change (p = 0.897). Mean VHI after treatment was higher for females (p = 0.021). The values of the three domains correlate statistically significant. For each diagnosis, the mean VHI after treatment remained higher than in subjects with a healthy voice. Because the domains are interdependent, their absolute values could not be compared. After treatment, VHI improved in six of the seven diagnoses. The scores on the physical, emotional, and functional domain are interdependent. Scores of the different domains cannot be compared.

  1. Changes in water quality in agricultural catchments after deployment of wastewater treatment plant.

    PubMed

    Langhammer, Jakub; Rödlová, Sylva

    2013-12-01

    Insufficient wastewater remediation in small communities and nonpoint source pollution are the key factors in determining the water quality of small streams in an agricultural landscape. Despite the current extensive construction of municipal wastewater treatment facilities in small communities, the level of organic substances and nutrients in the recipient catchments has not decreased in many areas. This paper analyzes the changes in the water quality of the small streams after the deployment of wastewater treatment plants that were designed to address sources of pollution from small municipalities. The analysis is based on the results from a water quality monitoring network in the small watersheds in the Czech Republic. Five rural catchments with one dominant municipal pollution source, where a wastewater treatment plant was deployed during the monitoring period, were selected according to a predefined set of criteria, from a series of 317 profiles. Basic water quality indicators were selected for the assessment: O₂, BOD-5, COD, TOC, conductivity, NH₄-N, NO₂-N, NO₃-N, PT, and PO₄-P. Results of the analysis showed that the simple deployment of the water treatment facilities at these streams often did not lead to a reduction of contamination in the streams. The expected post-deployment changes, namely, a significant and permanent reduction of stream contamination, occurred only in one catchment, whereas in the remainder of the catchments, only marginal changes or even increased concentrations of the contaminants were detected. As the critical factors that determined the efficiency of wastewater treatment were studied, the need for the consideration of the local conditions during the design of the facility, particularly regarding the size of the catchments, initial level of contamination, proper system of operation, and process optimization of the treatment facility, emerged as the important factor.

  2. Sensitivity to change of oral and general health-related quality of life during prosthodontic treatment.

    PubMed

    Wickert, Melanie; John, Mike T; Schierz, Oliver; Hirsch, Christian; Aarabi, Ghazal; Reissmann, Daniel R

    2014-02-01

    The literature presents conflicting findings on whether health-related quality of life (HRQoL) measures have sufficient evaluative properties to assess changes caused by dental interventions. The aim of our study was to compare sensitivity to change in HRQoL and OHRQoL in prosthodontic patients. In this prospective intervention study, a total of 165 consecutively recruited patients completed the Short Form-36 (SF-36) and the 49-item Oral Health Impact Profile (OHIP), as self-administered questionnaires, before prosthodontic treatment and 1 month after treatment was finished. Differences in SF-36 and OHIP scores between baseline and follow up were tested for statistical significance using paired t-tests. Effect sizes (Cohen's d) were calculated. Health-related quality of life improved during prosthodontic treatment, indicated by a slight, but statistically significant, increase in the SF-36 physical component (difference: 1.0 points), whereas perceived mental health did not change substantially (difference: −0.5 points). Improvement in OHRQoL (difference in OHIP sum score: −6.7 points) was statistically significant. Although the OHIP effect size (of 0.2) was considered as small, according to guidelines, it was greater than for the SF-36 component scores (physical: 0.1; mental: 0.1). Sensitivity to change in quality of life measures was greater for OHRQoL than for HRQoL, limiting the usefulness of HRQoL as an outcome measure in dentistry.

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

    PubMed

    Naqvi, Nasir H; Morgenstern, Jon

    2015-01-01

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

  4. The implications of starvation induced psychological changes for the ethical treatment of hunger strikers

    PubMed Central

    Fessler, D

    2003-01-01

    Design: Electronic databases were searched for (a) editorials and ethical proclamations on hunger strikers and their treatment; (b) studies of voluntary and involuntary starvation, and (c) legal cases pertaining to hunger striking. Additional studies were gathered in a snowball fashion from the published material cited in these databases. Material was included if it (a) provided ethical or legal guidelines; (b) shed light on psychological changes accompanying starvation, or (c) illustrated the practice of hunger striking. Authors' observations, opinions, and conclusions were noted. Conclusions: Although the heterogeneous nature of the sources precluded statistical analysis, starvation appears to be accompanied by marked psychological changes. Some changes clearly impair competence, in which case physicians are advised to follow advance directives obtained early in the hunger strike. More problematic are increases in impulsivity and aggressivity, changes which, while not impairing competence, enhance the likelihood that patients will starve themselves to death. PMID:12930863

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

    PubMed Central

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

    2012-01-01

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

  6. [ERPs changes during neuroleptic treatment in schizophrenia--a vulnerability marker in schizophrenia].

    PubMed

    Asato, N; Hirayasu, Y; Hiramatsu, K; Ohta, H

    1999-01-01

    P300 amplitude reduction and P300 latency prolongation are consistent findings in schizophrenia, but it is unclear if these abnormalities were the effect of current or past neuroleptic treatment or were present at the onset of illness. We previously recorded ERPs in drug free schizophrenic patients (45 neuroleptic-naive and 56 previously treated with neuroleptics). In that study, P300 amplitude reduction was observed in both the neuroleptic-naive and the previously treated patients. However, both N200 and P300 latencies were prolonged only in the previously treated schizophrenic patients. In this study, we investigated ERPs in 60 drug free schizophrenic patients before and after neuroleptic treatment was begun. According to DSM-IV, schizophrenia subtype classification, 26 cases were paranoid type, 14 were disorganized, 2 catatonic and 18 undifferentiated. Twenty six of the patients were neuroleptic-naive and 34 had been previously treated. Sixty gender- and age-matched healthy controls were also investigated. ERPs were recorded during an auditory oddball task. The scalp EEGs were recorded from AgAgCl electrodes at 16 sites according to the international 10-20 system. Clinical symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS). Before treatment, all schizophrenic patients displayed larger N200 amplitudes than the controls; however, increases in N200 amplitudes were not observed after neuroleptic treatment was begun. Both N200 and P300 latencies in the patients before treatment were prolonged only in those previously treated. Neuroleptic-naive patients demonstrated prolongation of both N200 and P300 latencies only after treatment. P300 amplitudes in patients were increased by neuroleptic treatment; but patients had smaller P300 amplitudes than the controls even after treatment. The change in P300 amplitudes (Pz) and the change in total BPRS scores by neuroleptic treatment were positively correlated in the patients whose duration of illness was six

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

    USGS Publications Warehouse

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

    2012-01-01

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

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

    PubMed

    Andersen, Ditte

    2015-06-01

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

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

    PubMed

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

    2012-09-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

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

  11. Changes of tongue position and oropharynx following treatment with functional appliance.

    PubMed

    Yassaei, S; Bahrololoomi, Z; Sorush, M

    2007-01-01

    The aim of this study was to determine changes of tongue position and oropharyngeal space following treatment with functional appliance in patients with class II div I malocclusion. In this before-after clinical trial, 28 patients with class II div I malocclusion were investigated. The range of age of females was 10-13 years and males 11-14 years. These samples were treated for II months. McNamara analysis and some linear variables were used to determine positional changes of tongue and oropharyngeal space. In this study, tongue moved significantly (P. value < 0.05) forwards in the horizontal dimension and non-significantly downwards in the vertical dimension. Treatment with functional appliance leads to significant alterations in tongue position and significantly increases the extent of oropharyngeal space.

  12. Degradation and toxicity change of 4-chlorophenol in aqueous solution during CGDE treatment.

    PubMed

    Jin, Xing-long; Zhao, Xiao-qing; Wang, Xiao-yan; Wang, Zhi-rong

    2013-01-01

    This study focused on the degradation and toxicity change of 4-chlorophenol (4-CP) in aqueous solution by contact glow discharge electrolysis (CGDE) with and without Fe(2+). It was found that the addition of Fe(2+) increased the degradation rate of 4-CP and decreased the toxicity of the solution. After 90 min CGDE treatment, only 28.0% 4-CP was removed and EC50 increased from 33.8 to 63.1 mg/L. With 25.0 mg/L Fe(2+) in solution, the degradation rate of 4-CP reached 93.3% and EC50 changed from 35.9 to 93.9 mg/L after 90 min CGDE treatment. PMID:23676387

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

    PubMed

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

    2013-11-01

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

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

    PubMed

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

    2013-11-01

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

  15. Chronic acarbose treatment alleviates age-related behavioral and biochemical changes in SAMP8 mice.

    PubMed

    Tong, Jing-Jing; Chen, Gui-Hai; Wang, Fang; Li, Xue-Wei; Cao, Lei; Sui, Xu; Tao, Fei; Yan, Wen-Wen; Wei, Zhao-Jun

    2015-05-01

    The administration of maintaining the homeostasis of insulin/insulin-like growth factor 1 (IGF-1) signaling and/or glucose metabolism may reverse brain aging. In the present study, we investigated the effect of acarbose, an inhibitor of α-glucosidase, on age-related behavioral and biochemical changes. The SAMP8 mice were randomly divided into old control group and acarbose-treatment group. The mice in the acarbose group were administered acarbose (20 mg/kg/d, dissolved in drinking water) orally from 3 to 9 months of age when a new group of 3-month-old mice was added as young controls. The results showed that the aged controls exhibited declines in sensorimotor ability, open field anxiety, spatial and non-spatial memory abilities, decreased serum insulin levels, increased IGF-1 receptor and synaptotagmin 1 (Syt1) levels and decreased insulin receptor, brain-derived neurotrophic factor (BDNF) and syntaxin 1 (Stx1) levels in the hippocampal layers. The age-related behavioral deficits correlated with the serological and histochemical data. Chronic acarbose treatment relieved these age-related changes, especially with respect to learning and memory abilities. This protective effect of acarbose on age-related behavioral impairments might be related to changes in the insulin system and the levels of BDNF, IGF-1R, and the pre-synaptic proteins Syt1 and Stx1. In conclusion, long-term treatment with acarbose ameliorated the behavioral deficits and biochemical changes in old SAMP8 mice and promoted successful aging. This study provides insight into the potential of acarbose for the treatment of brain aging.

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed Central

    Hilton, Thomas F.; Pilkonis, Paul A.

    2015-01-01

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

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

    PubMed

    Hilton, Thomas F; Pilkonis, Paul A

    2015-01-01

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

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

    PubMed Central

    2013-01-01

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

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

    PubMed Central

    Lu, Ning; Lin, Fangyu; Huang, Zhu; He, Qin

    2016-01-01

    Purpose. To evaluate the corneal aberration changes in dry eye patients after treatment with artificial eye drops. Methods. Thirty mild to moderate dry eye patients treated with artificial eye drops and twenty comparable dry eye patients were recruited as controls. Anterior corneal aberrations over 3 mm and 5 mm analytical zones including total, 3rd to 5th high order aberrations (HOAs), spherical aberration (SA), and vertical (V-coma) and horizontal coma (H-coma) obtained from corneal topography data at baseline and 2 weeks after treatment were evaluated. Results. For 3 mm zone, trefoils, V-coma, H-coma terms, and 3rd and 5th HOAs were significantly decreased (p < 0.05) in the treatment group. For 5 mm zone, instillation of eye drops reduced H-coma, SA terms, 3rd to 5th orders, and total HOAs all showed a significant decrease (p < 0.05). The root mean square analysis of the Zernike terms also showed similar statistical results. For control group, all individual terms and total HOAs did not have significant changes over 3 mm and 5 mm zones (p > 0.05). Conclusions. Treatment with artificial eye drops can effectively improve the corneal optical quality of dry eye patients by ameliorating the HOAs of anterior corneal surface. PMID:27051526

  1. Changes in Protein Synthesis in Rapeseed (Brassica napus) Seedlings during a Low Temperature Treatment 1

    PubMed Central

    Meza-Basso, Luis; Alberdi, Miren; Raynal, Monique; Ferrero-Cadinanos, Maria-Luz; Delseny, Michel

    1986-01-01

    Changes induced by cold treatment in young rapeseed (Brassica napus) seedlings were investigated at the molecular level. Following germination at 18°C for 48 hours, one half of the seedlings was transferred to 0°C for another 48 hour period, the other half being kept at 18°C as a control. Newly synthesized proteins were labeled for the last 6 hours of incubation with [35S]methionine. The different polypeptides were separated by two-dimensional electrophoresis in polyacrylamide gels. Newly synthesized proteins were revealed by fluorography. Protein synthesis clearly continues at 0°C and some polypeptides preferentially accumulate at this temperature. On the other hand, synthesis of several others is repressed while many are insensitive to cold treatment. Similar changes are also observed when mRNA is prepared from cold treated seedlings, translated in vitro in a reticulocyte cell free system and compared with the products of mRNA extracted from control samples. Among the genes which are repressed we identified the small subunit of ribulose 1,6-bisphosphate carboxylase. These changes are also detectable after shorter treatments. Images Fig. 1 Fig. 2 Fig. 3 PMID:16665102

  2. Empirically Derived Subtypes of Adolescent Depression: Latent Profile Analysis of Co-Occurring Symptoms in the Treatment for Adolescents with Depression Study (TADS)

    ERIC Educational Resources Information Center

    Herman, Keith C.; Ostrander, Rick; Walkup, John T.; Silva, Susan G.; March, John S.

    2007-01-01

    A latent profile analysis was conducted on the co-occurring symptoms of 423 adolescents diagnosed with major depressive disorder as part of the Treatment for Adolescents with Depression Study (TADS), a multisite, randomized treatment trial. The participants had a mean (SD) age of 14.6 (1.5) years; of the sample, 45.6% was male and 73.8% was white.…

  3. Cyclosporin A treatment in children with minimal change nephrotic syndrome and focal segmental glomerulosclerosis.

    PubMed

    Brodehl, J; Brandis, M; Helmchen, U; Hoyer, P F; Burghard, R; Ehrich, J H; Zimmerhackl, R B; Klein, W; Wonigeit, K

    1988-11-15

    In a pilot study 23 children with nephrotic syndrome were treated with cyclosporin A (Cs) for 6-45 months. 8 children suffered from steroid dependent minimal change nephrotic syndrome (MCNS) and had experienced at least one course with cytotoxic drugs, but had relapsed thereafter. 2 children had diabetes mellitus type I with nephrotic syndrome and 13 children had steroid resistant focal segmental glomerulosclerosis (FSGS). Cs was started with 100 mg/m2/day in two doses and increased stepwise to obtain a Cs whole blood trough level of 200-400 ng/ml. In steroid dependent MCNS treatment with Cs reduced relapse rate significantly, and prednisone therapy could be stopped completely. After discontinuation of Cs, relapses reoccurred as frequently as before. Renal function remained unimpaired despite repeated Cs treatment courses up to 38 months. In cases of nephrotic syndrome with diabetes type I Cs treatment led to complete remission without changing the insulin requirement. However, after discontinuation of Cs relapses reoccurred. In steroid resistant FSGS 6 children benefited from Cs treatment: 4 went into complete remission, 2 into partial remission. The 2 children with complete remission relapsed but remained Cs responsive. The remaining 7 children with FSGS did not respond to Cs but continued the course of their disease, with two patients rapidly progressing to terminal renal failure. Side-effects of Cs treatment were mild. It is concluded that Cs is an effective agent in steroid dependent MCNS and can be used as an alternative drug in specific cases like steroid toxicity or diabetes mellitus. In steroid resistant FSGS a trial with Cs seems to be warranted since some cases do respond favorably. To avoid nephrotoxicity treatment with Cs should always be monitored closely by determination of blood levels and renal function.

  4. The role of empirical research in bioethics.

    PubMed

    Kon, Alexander A

    2009-01-01

    There has long been tension between bioethicists whose work focuses on classical philosophical inquiry and those who perform empirical studies on bioethical issues. While many have argued that empirical research merely illuminates current practices and cannot inform normative ethics, others assert that research-based work has significant implications for refining our ethical norms. In this essay, I present a novel construct for classifying empirical research in bioethics into four hierarchical categories: Lay of the Land, Ideal Versus Reality, Improving Care, and Changing Ethical Norms. Through explaining these four categories and providing examples of publications in each stratum, I define how empirical research informs normative ethics. I conclude by demonstrating how philosophical inquiry and empirical research can work cooperatively to further normative ethics. PMID:19998120

  5. The Role of Empirical Research in Bioethics

    PubMed Central

    Kon, Alexander A.

    2010-01-01

    There has long been tension between bioethicists whose work focuses on classical philosophical inquiry and those who perform empirical studies on bioethical issues. While many have argued that empirical research merely illuminates current practices and cannot inform normative ethics, others assert that research-based work has significant implications for refining our ethical norms. In this essay, I present a novel construct for classifying empirical research in bioethics into four hierarchical categories: Lay of the Land, Ideal Versus Reality, Improving Care, and Changing Ethical Norms. Through explaining these four categories and providing examples of publications in each stratum, I define how empirical research informs normative ethics. I conclude by demonstrating how philosophical inquiry and empirical research can work cooperatively to further normative ethics. PMID:19998120

  6. Changes in repeating earthquake slip behavior following the 2004 Parkfield main shock from waveform empirical Green's functions finite-source inversion

    NASA Astrophysics Data System (ADS)

    Kim, Ahyi; Dreger, Douglas S.; Taira, Taka'aki; Nadeau, Robert M.

    2016-03-01

    Finite-source inversions are performed using small earthquake waveforms as empirical Green's functions (eGf) to investigate the rupture process of repeating earthquakes along the San Andreas Fault in Parkfield, California. The eGf waveform inversion method is applied to a repeating Mw 2.1 Parkfield earthquake sequence using three-component velocity waveforms recorded by an array of borehole seismometers. The obtained models show a circular slip distribution with a ~20 m radius, a 3.0-4.2 cm average slip of the main asperity, and peak displacement of 10.6-13.5 cm. The static stress drop distribution shows that the main asperity has a peak stress drop of 69.5-94.7 MPa. The inversion results support an earlier finding by Dreger et al. (2007) that high-strength asperities exist in the rupture areas of the Mw 2.1 events at Parkfield. In addition, notable temporal peak slip and stress drop reduction was observed after the 2004 Parkfield event while the average value remains constant (~12 MPa) over time. These events may represent mechanically strong sections of the fault, surrounded by regions that are undergoing continuous deformation (creep), Given repeated loading of the strong asperities, it would be expected that these similar repeating earthquakes should also have very similar slip distributions since surrounding regions are deforming aseismically. There are small differences in the waveforms of these repeating earthquakes, and this could be because of rupture nucleation points not being in exactly the same location within the region of the fault that is capable of stick-slip behavior. Our result indicates that waveform slip inversion is needed to reveal spatial and temporal variations of the stress drop within the rupture area to improve understanding of fault healing and rupture mechanics.

  7. Changes in patients’ symptoms and gastric emptying after Helicobacter pylori treatment

    PubMed Central

    Zhang, Chun-Ling; Geng, Chang-Hui; Yang, Zhi-Wei; Li, Yan-Lin; Tong, Li-Quan; Gao, Ping; Gao, Yue-Qiu

    2016-01-01

    AIM: To investigate the changes in clinical symptoms and gastric emptying and their association in functional dyspepsia (FD) patients. METHODS: Seventy FD patients were enrolled and divided into 2 groups Helicobacter pylori (H. pylori)-negative group (28 patients), and H. pylori-positive group (42 patients). Patients in the H. pylori-positive group were further randomly divided into groups: H. pylori-treatment group (21 patients) and conventional treatment group (21 patients). Seventy two healthy subjects were selected as the control group. The proximal and distal stomach area was measured by ultrasound immediately after patients took the test meal, and at 20, 40, 60 and 90 min; then, gastric half-emptying time was calculated. The incidence of symptoms and gastric half-emptying time between the FD and control groups were compared. The H. pylori-negative and conventional treatment groups were given conventional treatment: domperidone 0.6 mg/(kg/d) for 1 mo. The H. pylori-treatment group was given H. pylori eradication treatment + conventional treatment: lansoprazole 30 mg once daily, clarithromycin 0.5 g twice daily and amoxicillin 1.0 g twice daily for 1 wk, then domperidone 0.6 mg/(kg/d) for 1 mo. The incidence of symptoms and gastric emptying were compared between the FD and control groups. The relationship between dyspeptic symptoms and gastric half-emptying time in the FD and control groups were analyzed. Then total symptom scores before and after treatment and gastric half-emptying time were compared among the 3 groups. RESULTS: The incidence of abdominal pain, epigastric burning sensation, abdominal distension, nausea, belching, and early satiety symptoms in the FD group were significantly higher than in the control group (50.0% vs 20.8%; 37.1% vs 12.5%; 78.6% vs 44.4%; 45.7% vs 22.2%; 52.9% vs 15.3%; 57.1% vs 19.4%; all P < 0.05). The gastric half-emptying times of the proximal end, distal end, and the whole stomach in the FD group were slower than in the

  8. Proteome changes in banana fruit peel tissue in response to ethylene and high-temperature treatments.

    PubMed

    Du, Lina; Song, Jun; Forney, Charles; Palmer, Leslie Campbell; Fillmore, Sherry; Zhang, ZhaoQi

    2016-01-01

    Banana (Musa AAA group) is one of the most consumed fruits in the world due to its flavor and nutritional value. As a typical climacteric fruit, banana responds to ethylene treatment, which induces rapid changes of color, flavor (aroma and taste), sweetness and nutritional composition. It has also been reported that ripening bananas at temperatures above 24 °C inhibits chlorophyll breakdown and color formation but increases the rate of senescence. To gain fundamental knowledge about the effects of high temperature and ethylene on banana ripening, a quantitative proteomic study employing multiplex peptide stable isotope dimethyl labeling was conducted. In this study, green (immature) untreated banana fruit were subjected to treatment with 10 μL L(-1) of ethylene for 24 h. After ethylene treatment, treated and untreated fruit were stored at 20 or 30 °C for 24 h. Fruit peel tissues were then sampled after 0 and 1 day of storage, and peel color and chlorophyll fluorescence were evaluated. Quantitative proteomic analysis was conducted on the fruit peels after 1 day of storage. In total, 413 common proteins were identified and quantified from two biological replicates. Among these proteins, 91 changed significantly in response to ethylene and high-temperature treatments. Cluster analysis on these 91 proteins identified 7 groups of changed proteins. Ethylene treatment and storage at 20 °C induced 40 proteins that are correlated with pathogen resistance, cell wall metabolism, ethylene biosynthesis, allergens and ribosomal proteins, and it repressed 36 proteins that are associated with fatty acid and lipid metabolism, redox-oxidative responses, and protein biosynthesis and modification. Ethylene treatment and storage at 30 °C induced 32 proteins, which were mainly similar to those in group 1 but also included 8 proteins in group 3 (identified as chitinase, cinnamyl alcohol dehydrogenase 1, cysteine synthase, villin-2, leucine-transfer RNA ligase, CP47

  9. Proteome changes in banana fruit peel tissue in response to ethylene and high-temperature treatments

    PubMed Central

    Du, Lina; Song, Jun; Forney, Charles; Palmer, Leslie Campbell; Fillmore, Sherry; Zhang, ZhaoQi

    2016-01-01

    Banana (Musa AAA group) is one of the most consumed fruits in the world due to its flavor and nutritional value. As a typical climacteric fruit, banana responds to ethylene treatment, which induces rapid changes of color, flavor (aroma and taste), sweetness and nutritional composition. It has also been reported that ripening bananas at temperatures above 24 °C inhibits chlorophyll breakdown and color formation but increases the rate of senescence. To gain fundamental knowledge about the effects of high temperature and ethylene on banana ripening, a quantitative proteomic study employing multiplex peptide stable isotope dimethyl labeling was conducted. In this study, green (immature) untreated banana fruit were subjected to treatment with 10 μL L−1 of ethylene for 24 h. After ethylene treatment, treated and untreated fruit were stored at 20 or 30 °C for 24 h. Fruit peel tissues were then sampled after 0 and 1 day of storage, and peel color and chlorophyll fluorescence were evaluated. Quantitative proteomic analysis was conducted on the fruit peels after 1 day of storage. In total, 413 common proteins were identified and quantified from two biological replicates. Among these proteins, 91 changed significantly in response to ethylene and high-temperature treatments. Cluster analysis on these 91 proteins identified 7 groups of changed proteins. Ethylene treatment and storage at 20 °C induced 40 proteins that are correlated with pathogen resistance, cell wall metabolism, ethylene biosynthesis, allergens and ribosomal proteins, and it repressed 36 proteins that are associated with fatty acid and lipid metabolism, redox–oxidative responses, and protein biosynthesis and modification. Ethylene treatment and storage at 30 °C induced 32 proteins, which were mainly similar to those in group 1 but also included 8 proteins in group 3 (identified as chitinase, cinnamyl alcohol dehydrogenase 1, cysteine synthase, villin-2, leucine-transfer RNA ligase, CP47

  10. Rituximab is an efficient and safe treatment in adults with steroid-dependent minimal change disease.

    PubMed

    Munyentwali, Helene; Bouachi, Khedidja; Audard, Vincent; Remy, Philippe; Lang, Philippe; Mojaat, Rachid; Deschênes, Georges; Ronco, Pierre M; Plaisier, Emmanuelle M; Dahan, Karine Y

    2013-03-01

    Development of steroid dependency in patients with nephrotic syndrome may require a long-term multi-drug therapy at risk of drug toxicity and renal failure. Rituximab treatment reduces the steroid dosage and the need for immunosuppressive therapy in pediatric patients. Here we retrospectively analyze the efficacy and safety of rituximab in adult patients with steroid-dependent minimal change disease. To do this, we analyzed the outcome of all adult patients treated with rituximab for steroid-dependent minimal change nephrotic syndrome over a mean follow-up of 29.5 months (range 5.1-82 months). Seventeen patients with steroid-dependent or frequently relapsing minimal change nephrotic syndrome, unresponsive to several immunosuppressive medications, were treated with rituximab. Eleven patients had no relapses after rituximab infusion (mean follow-up 26.7 months, range 5.1-82 months) and nine of them were able to come off all other immunosuppressive drugs and steroids during follow-up. Six patients relapsed at least once after a mean time of 11.9 months (mean follow-up 34.5 months, range 16.9-50.1 months), but their immunosuppressive drug treatment could be stopped or markedly reduced during this time. No adverse events were recorded. Thus, rituximab is efficient and safe in adult patients suffering from severe steroid-dependent minimal change disease. Prospective randomized trials are needed to confirm this study.

  11. Changes in microbial diversity of brined green asparagus upon treatment with high hydrostatic pressure.

    PubMed

    Toledo Del Árbol, Julia; Pérez Pulido, Rubén; La Storia, Antonietta; Grande Burgos, Maria José; Lucas, Rosario; Ercolini, Danilo; Gálvez, Antonio

    2016-01-01

    The application of high hydrostatic pressure (HHP, 600MPa, 8 min) on brined green asparagus and the changes in bacterial diversity after treatments and during storage at 4 °C (30 days) or 22 °C (10 days) were studied. HHP treatments reduced viable cell counts by 3.6 log cycles. The residual surviving population did not increase during storage at 4 °C. However, bacterial counts significantly increased at 22 °C by day 3, leading to rapid spoilage. The microbiota of green asparagus was composed mainly by Proteobacteria (mainly Pantoea and Pseudomonas), followed by Firmicutes (mainly Lactococcus and Enterococcus) and to a less extent Bacteroidetes and Actinobacteria. During chill storage of untreated asparagus, the relative abundance of Proteobacteria as well as Enterococcus and Lactococcus decreased while Lactobacillus increased. During storage of untreated asparagus at 22 °C, the abundance of Bacteroidetes decreased while Proteobacteria increased during late storage. The HHP treatment determined a reduction of the Proteobacteria both early after treatment and during chill storage. In the HHP treated samples stored at 22 °C, the relative abundance of Pseudomonas rapidly decreased at day 1, with an increase of Bacteroidetes. This was followed by a marked increase in Enterobacteriaceae (Escherichia) simultaneously with increase in viable counts and spoilage. Results from the study indicate that the effect of HHP treatments on the viability ofmicrobial populations in foods also has an impact on the dynamics of microbial populations during the storage of the treated foods. PMID:26372734

  12. Changes in microbial diversity of brined green asparagus upon treatment with high hydrostatic pressure.

    PubMed

    Toledo Del Árbol, Julia; Pérez Pulido, Rubén; La Storia, Antonietta; Grande Burgos, Maria José; Lucas, Rosario; Ercolini, Danilo; Gálvez, Antonio

    2016-01-01

    The application of high hydrostatic pressure (HHP, 600MPa, 8 min) on brined green asparagus and the changes in bacterial diversity after treatments and during storage at 4 °C (30 days) or 22 °C (10 days) were studied. HHP treatments reduced viable cell counts by 3.6 log cycles. The residual surviving population did not increase during storage at 4 °C. However, bacterial counts significantly increased at 22 °C by day 3, leading to rapid spoilage. The microbiota of green asparagus was composed mainly by Proteobacteria (mainly Pantoea and Pseudomonas), followed by Firmicutes (mainly Lactococcus and Enterococcus) and to a less extent Bacteroidetes and Actinobacteria. During chill storage of untreated asparagus, the relative abundance of Proteobacteria as well as Enterococcus and Lactococcus decreased while Lactobacillus increased. During storage of untreated asparagus at 22 °C, the abundance of Bacteroidetes decreased while Proteobacteria increased during late storage. The HHP treatment determined a reduction of the Proteobacteria both early after treatment and during chill storage. In the HHP treated samples stored at 22 °C, the relative abundance of Pseudomonas rapidly decreased at day 1, with an increase of Bacteroidetes. This was followed by a marked increase in Enterobacteriaceae (Escherichia) simultaneously with increase in viable counts and spoilage. Results from the study indicate that the effect of HHP treatments on the viability ofmicrobial populations in foods also has an impact on the dynamics of microbial populations during the storage of the treated foods.

  13. Growth hormone (GH) treatment reverses early atherosclerotic changes in GH-deficient adults.

    PubMed

    Pfeifer, M; Verhovec, R; Zizek, B; Prezelj, J; Poredos, P; Clayton, R N

    1999-02-01

    Hypopituitary patients have increased mortality from vascular disease, and in these patients, early markers of atherosclerosis [increased carotid artery intima-media thickness (IMT) and reduced distensibility] are more prevalent. As GH replacement can reverse some risk factors of atherosclerosis, the present study examined the effect of GH treatment on morphological and functional changes in the carotid and brachial arteries of GH-deficient (GHD) adults. Eleven GHD hypopituitary men (24-49 yr old) were treated with recombinant human GH (0.018 U/kg BW x day) for 18 months. IMT of the common carotid artery (CCA) and the carotid bifurcation (CB), and flow-mediated endothelium-dependent dilation (EDD) of the brachial artery were measured by B mode ultrasound before and at 3, 6, 12, and 18 months of treatment, and values were compared with those in 12 age-matched control men. Serum concentrations of lipids, lipoprotein(a), insulin-like growth factor I (IGF-I), and IGF-binding protein-3 (IGFBP-3) were also measured. In GHD men before treatment the IMTs of the CCA [mean(SD), 0.67(0.05) mm] and CB [0.75(0.04) mm] were significantly greater (P < 0.001) than those in control men [0.52(0.07) and 0.65(0.07) mm, respectively]. GH treatment normalized the IMT of the CCA by 6 months [0.53(0.04) mm] and that of the CB by 3 months [0.68(0.05) mm]. The IMT of the carotid artery (CCA and CB) was negatively correlated with serum IGF-I (r = -0.53; P < 0.0001). There was a significant improvement in flow-mediated EDD of the brachial artery at 3 months, which was sustained at 6 and 18 months of GH treatment (P < 0.05). GH treatment increased high density lipoprotein cholesterol at 3 and 6 months, but did not reduce total or low density lipoprotein cholesterol and was without effect on lipoprotein(a). There was no correlation between plasma lipids and changes in IMT or EDD of the arteries examined. In conclusion, GH treatment of hypopituitary GHD men reverses early morphological and

  14. Modeling Manganese Silicate Inclusion Composition Changes during Ladle Treatment Using FactSage Macros

    NASA Astrophysics Data System (ADS)

    Piva, Stephano P. T.; Kumar, Deepoo; Pistorius, P. Chris

    2016-07-01

    This work investigated the use of FactSage macros to simulate steel-slag and steel-inclusion reaction kinetics in silicon-manganese killed steels, and predict oxide inclusion composition changes during ladle treatment. These changes were assessed experimentally using an induction furnace to simulate deoxidation and slag addition. The average steel mass transfer coefficient for the experimental setup was calculated from the analyzed aluminum pick-up by steel. Average oxide inclusion composition was measured using scanning electron microscopy and energy-dispersive X-ray spectroscopy. Confocal laser scanning microscopy was used to assess the physical state (solid or liquid) of oxide inclusions in selected samples. The changes in the chemical compositions of the oxide inclusions and the steel agreed with the FactSage macro simulations.

  15. Change in parent- and child-reported internalizing and externalizing behaviors among substance abusing runaways: the effects of family and individual treatments.

    PubMed

    Slesnick, Natasha; Guo, Xiamei; Feng, Xin

    2013-07-01

    Shelter-recruited adolescents are known to have high rates of substance abuse and co-occurring internalizing and externalizing problem behaviors. Many studies have documented these mental health concerns, but only a small number of studies have tested interventions that may be useful for ameliorating these vulnerabilities. The current study compared three empirically supported psychotherapy interventions, Motivational Interviewing (MI), the Community Reinforcement Approach (CRA), and Ecologically-Based Family Therapy (EBFT) with 179 substance abusing runaway adolescents (47 % female, 74 % minority) and their primary caretaker recruited through a Midwestern runaway crisis shelter. Examining both child and primary caretaker reports, each treatment was associated with significant reductions in internalizing and externalizing behaviors to 24 months post-baseline. However, the trajectory of change differed among the treatments. Adolescents receiving MI showed a quicker reduction in internalizing and externalizing behaviors but also a quicker increase in these behaviors compared to adolescents receiving EBFT, who continued to evidence improvements to 24 months. The findings provide support for continued evaluation of these treatments for use with this vulnerable population of adolescents.

  16. Department of pharmacy-initiated program for streamlining empirical antibiotic therapy.

    PubMed

    Pastel, D A; Chang, S; Nessim, S; Shane, R; Morgan, M A

    1992-07-01

    The outcome of a department of pharmacy-initiated "streamlining" study designed to promote cost-conscious modifications of empirically selected antibiotic therapy is described. Two hundred forty-one evaluable adult patients started on restricted-use antibiotics at this university-affiliated community private teaching hospital were enrolled in a 9-week prospective streamlining study. Patients were alternately assigned to a Control (i.e., no pharmacist-initiated streamlining recommendations offered based on culture and susceptibility reports) or a Pharmacist Intervention group (i.e., pharmacist offers recommendations to streamline therapy). A statistically significant greater number of patients had their empiric antibiotic treatment courses modified to more appropriate antibiotic choices after receipt of culture and susceptibility reports among private prescribers in the Pharmacist Intervention group (83%) than in the Control group (38%) (p = .006). Additionally, pharmacists were overall successful in gaining prescriber acceptance for 64% of recommended changes of empiric antibiotic treatment courses before the receipt of culture and susceptibility reports (e.g., dose and/or frequency changes). There was no program effect observed with respect to improved physician response to microbiologic data that would allow streamlining empirical antibiotic choices in the Housestaff (i.e., medical or surgical residents), or infectious disease consultant prescriber groups. Projected overall annual cost savings that would be achieved as a result of continued efforts by pharmacists directed at streamlining empirical "restricted" antibiotic regimens is approximately +40,000.

  17. Effective treatment with rituximab for the maintenance of remission in frequently relapsing minimal change disease

    PubMed Central

    Shendi, Ali M.; Salama, Alan D.; Khosravi, Maryam; Connolly, John O.; Trompeter, Richard

    2016-01-01

    Abstract Aim Treatment of frequently relapsing or steroid‐dependent minimal change disease (MCD) in children and adults remains challenging. Glucocorticoids and/or other immunosuppressive agents are the mainstay of treatment, but patients often experience toxicity from prolonged exposure and may either become treatment dependent and/or resistant. Increasing evidence suggests that rituximab (RTX) can be a useful alternative to standard immunosuppression and allow withdrawal of maintenance immunosuppressants; however, data on optimal treatment regimens, long‐term efficacy and safety are still limited. Methods We undertook a prospective study of RTX to allow immunosuppression minimization in 15 young adults with frequently relapsing or steroid‐dependent, biopsy‐proven MCD. All patients were in remission at the start of treatment and on a calcineurin inhibitor. Two doses of RTX (1 gr) were given 6 months apart. A subset of patients also received an additional dose 12 months later, in order to examine the benefit of re‐treatment. Biochemical and clinical parameters were monitored over an extended follow‐up period of up to 43 months. Results Median steroid‐free survival after RTX was 25 months (range 4–34). Mean relapse frequency decreased from 2.60 ± 0.28 to 0.4 ± 0.19 (P < 0.001) after RTX. Seven relapses occurred, five of which (71%) when CD19 counts were greater than 100 µ. Immunoglobulin levels remained unchanged, and no major side effects were observed throughout the follow‐up period. Conclusions Rituximab therapy is effective at maintaining prolonged steroid‐free remission and reducing relapse frequency in this group of patients. Our study lends further support for the role of RTX in the treatment of patients with frequently relapsing or steroid‐dependent MCD. PMID:26860320

  18. Correlates of having never been HIV tested among entrants to substance abuse treatment clinics: empiric findings from real-world New England settings.

    PubMed

    Chadwick, Jeanne J; Andrade, Leonardo F; Altice, Frederick L; Petry, Nancy M

    2014-01-01

    Routine testing is the cornerstone to identifying HIV, but not all substance abuse treatment patients have been tested. This study is a real-world evaluation of predictors of having never been HIV tested among patients initiating substance abuse treatment. Participants (N = 614) from six New England clinics were asked whether they had ever been HIV tested. Eighty-five patients (13.8%) reported having never been tested and were compared to those who had undergone testing. Clinic, male gender (adjusted odds ratio (AOR) = 1.91, 95% confidence interval (CI) = 1.07-3.41), and having fewer employment (AOR = 0.31; 95% CI = 0.11-0.88) and medical problems (AOR = 0.40, 95% CI = 0.17-0.99) were independently correlated with having never been HIV tested. Thus, there is still considerable room for improved testing strategies as a clinically significant minority of substance abuse patients have never undergone HIV testing when they initiate treatment.

  19. Changes in the Pelvic Anatomy After an IMRT Treatment Fraction of Prostate Cancer

    SciTech Connect

    Crevoisier, Renaud de; Melancon, Adam D.; Kuban, Deborah A.; Lee, Andrew K.; Cheung, Rex M.; Tucker, Susan L.; Kudchadker, Rajat J.; Newhauser, Wayne D.; Zhang Lifei; Mohan, Radhe; Dong Lei . E-mail: ldong@mdanderson.org

    2007-08-01

    Purpose: To quantify the three-dimensional variations of pelvic anatomy after a single treatment fraction. Methods and Materials: Forty-six prostate cancer patients underwent computed tomography (CT) scanning with an in-room CT-on-rail system, before and immediately after one intensity-modulated radiotherapy (IMRT) session. To study the soft-tissue anatomy changes, the pre- and post-treatment CT images were registered using the bony structure with an in-house image registration software system. The center of volume for both the prostate and seminal vesicles was used to assess the relative displacement of the same structure after the treatment fraction. Results: During one treatment fraction (21 {+-} 4 min), both the prostate and seminal vesicles showed statistically significant systematic trends in the superior and anterior directions of the patient's anatomy. The net increase in bladder volume was huge (127 {+-} 79 cm{sup 3}), yet this change did not translate into large target displacements. Although the population mean displacements in either direction were 1.3 {+-} 2.9 mm for the prostate and 1.2 {+-} 4.1 mm for the seminal vesicles in the anterior direction, a few patients had displacements as large as 8.4 mm and 15.6 mm, respectively. These large displacements correlated strongly (p < 0.001) with large rectal volume increases caused by gaseous build-up in the rectum. Conclusion: The observed intrafraction variations in anatomy during prostate IMRT sessions suggest that, for any given fraction, the organ motion and volume changes can potentially lead to compromised target coverage in about 15% of patients in whom the prostate position shifted >4 mm.

  20. Personality and symptom change in treatment-refractory inpatients: evaluation of the phase model of change using Rorschach,TAT, and DSM-IV Axis V.

    PubMed

    Fowler, J Christopher; Ackerman, Steven J; Speanburg, Stefanie; Bailey, Adrian; Blagys, Matthew; Conklin, Adam C

    2004-12-01

    In this study, we examined global treatment outcomes during 16 months of intensive, psychodynamic treatment for 77 inpatients suffering from treatment-refractory disorders. Hypotheses based on the phase model of treatment change (Howard, Lueger, Maling, & Martinovich, 1993; Howard, Moras, Brill, Martinovich, & Lutz, 1996) were supported in the study results. Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) Axis V scales assessing behavioral functioning demonstrated large and medium effect size change, whereas stable, enduring personality functioning assessed by psychoanalytic Rorschach scales and the Social Cognition and Object Relations Scale (Westen, 1995) for the Thematic Apperception Test (Murray, 1943) demonstrated small and medium effect size change. We also report assessment of reliable change index and clinical significance. The ecological validity of Rorschach measures is supported by significant validity coefficients (in the hypothesized directions) between implicit measures of personality functioning and behavioral ratings.

  1. Personality and symptom change in treatment-refractory inpatients: evaluation of the phase model of change using Rorschach,TAT, and DSM-IV Axis V.

    PubMed

    Fowler, J Christopher; Ackerman, Steven J; Speanburg, Stefanie; Bailey, Adrian; Blagys, Matthew; Conklin, Adam C

    2004-12-01

    In this study, we examined global treatment outcomes during 16 months of intensive, psychodynamic treatment for 77 inpatients suffering from treatment-refractory disorders. Hypotheses based on the phase model of treatment change (Howard, Lueger, Maling, & Martinovich, 1993; Howard, Moras, Brill, Martinovich, & Lutz, 1996) were supported in the study results. Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) Axis V scales assessing behavioral functioning demonstrated large and medium effect size change, whereas stable, enduring personality functioning assessed by psychoanalytic Rorschach scales and the Social Cognition and Object Relations Scale (Westen, 1995) for the Thematic Apperception Test (Murray, 1943) demonstrated small and medium effect size change. We also report assessment of reliable change index and clinical significance. The ecological validity of Rorschach measures is supported by significant validity coefficients (in the hypothesized directions) between implicit measures of personality functioning and behavioral ratings. PMID:15548467

  2. A Review and Empirical Comparison of Three Treatments for Adolescent Males with Conduct and Personality Disorder: Mode Deactivation Therapy, Cognitive Behavior Therapy and Social Skills Training

    ERIC Educational Resources Information Center

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

    2005-01-01

    This treatment research study extended the results of Apsche, Bass, Jennings, Murphy, Hunter, and Siv (2005), from behavioral data to standard measures of psychological distress. In Apsche, et. al. (2005) results suggest that Mode Deactivation Therapy (MDT) was more effective than Cognitive Behavior Therapy (CBT) and Social Skills Therapy (SST) in…

  3. Superimpositional assessment of treatment-associated changes in the temporomandibular joint and the mandibular symphysis.

    PubMed

    Baumrind, S; Korn, E L; Isaacson, R J; West, E E; Molthen, R

    1983-12-01

    This article analyzes differences in the measured displacement of the condyle and of progonion when different vectors of force are delivered to the maxilla in the course of non-full-banded, Phase 1, mixed-dentition treatment for the correction of Class II malocclusion. The 238-case sample is identical to that for which changes in other parameters of facial form have been reported previously. Relative to superimposition on anterior cranial base and measured in a Frankfort-plane-determined coordinate system, we have attempted to identify and quantitate (1) the displacement of each structure which results from local remodeling and (2) the displacement of each structure which occurs as a secondary consequence of changes in other regions of the skull. We have also attempted to isolate treatment effects from those attributable to spontaneous growth and development. At the condyle, we note that in all three treatment groups and in the control group there is a small but real downward and backward displacement of the glenoid fossa. This change is not treatment induced but, rather, is associated with spontaneous growth and development. (See Fig. 5.) Some interesting differences in pattern of "growth at the condyle" were noted between samples. In the intraoral (modified activator) sample, there were small but statistically significant increases in growth rate as compared to the untreated group of Class II controls. To our surprise, similar statistically significant increases over the growth rate of the control group were noted in the cervical sample. (See Table III, variables 17 and 18.) Small but statistically significant differences between treatments were also noted in the patterns of change at pogonion. As compared to the untreated control group, the rate of total displacement in the modified activator group was significantly greater in the forward direction, while the rate of total displacement in the cervical group was significantly greater in the downward direction

  4. Efficacy and safety of tazobactam/piperacillin as an empirical treatment for the patients of adult and child with febrile neutropenia in Japan.

    PubMed

    Tamura, Kazuo; Akiyama, Nobu; Kanda, Yoshinobu; Saito, Masahiro

    2015-09-01

    Tazobactam/piperacillin (4.5 g for adults and 90 mg/kg body weight for children, every 6 h) was administered to Japanese patients with febrile neutropenia to evaluate its defervescence and clinical efficacy and safety. The pharmacokinetics in children were also examined. Defervescence efficacy at day 4 of the treatment was achieved in 50.0% of 94 adult and 62.5% of 8 pediatric patients, respectively. The defervescence efficacy rate in relation to the neutrophil count in adults was 37.5% for the patients with a neutrophil count of less than 100/μL and 62.5% for that between 100 and 500/μL. The clinical efficacy rate at day 7 and at the end or discontinuation of the treatment was 79.6% and 59.1% in adult patients, respectively, and 57.1% and 75.0% in pediatric patients, respectively. Fifteen strains of causative bacteria were isolated in 13 adult patients at baseline. All strains were eradicated within 4 days of the treatment. The side effects that occurred in adult and pediatric patients during the treatment were all known and not specific to febrile neutropenia patients. The pharmacokinetics profiles of tazobactam/piperacillin in children with febrile neutropenia are unlikely to be different from those in children with a common bacterial infection and without any immunosuppressive conditions. The study results in Japanese patients with febrile neutropenia demonstrate that tazobactam/piperacillin treatment is efficacious and safe in adults. As for pediatric patients, given the limited number of cases studied, further investigation is needed (Clinical trial number: Japic CTI-121728).

  5. Changes in nephrogenous cyclic AMP excretion and plasma cyclic AMP following treatment of hyperthyroidism.

    PubMed

    Naafs, M A; van der Velden, P C; Fischer, H R; Koorevaar, G; van Duin, S; Hackeng, W H; Schopman, W; Silberbusch, J

    1984-08-01

    Plasma cyclic AMP (PcAMP) concentration and the excretion of cyclic AMP/dl GF were estimated in 11 thyrotoxic patients before and after medical treatment. PcAMP concentrations were significantly higher during hyperthyroidism (2.30 +/- 0.69 vs 1.88 +/- 0.71 nmol/dl; P less than 0.05), and total urinary cyclic AMP (TcAMP) excretion showed no significant changes (3.24 +/- 0.64 vs 3.44 +/- 1.77 nmol/dl GF). Nephrogenous (NcAMP) excretion rose significantly (1.00 +/- 0.82 vs 1.68 +/- 1.31 mmol/dl GF; P less than 0.025). The increase in NcAMP excretion correlated significantly with the decrease in serum T3 levels (r = -0.46; P less than 0.05). Serum iPTH levels showed no significant change. Both the serum Ca, corrected for serum total protein and TmPO4/GFR declined after treatment (respectively 2.44 +/- 0.13 vs 2.33 +/- 0.08 mmol/l; P less than 0.05 and 1.18 +/- 0.29 vs 1.05 +/- 0.22 mmol/l; P less than 0.05). It is concluded that the rise in NcAMP excretion corroborates the concept of increasing parathyroid activity following the treatment of hyperthyroidism. PMID:6206676

  6. An evaluation of the treatment of risk and uncertainties in the IPCC reports on climate change.

    PubMed

    Aven, Terje; Renn, Ortwin

    2015-04-01

    Few global threats rival global climate change in scale and potential consequence. The principal international authority assessing climate risk is the Intergovernmental Panel on Climate Change (IPCC). Through repeated assessments the IPCC has devoted considerable effort and interdisciplinary competence to articulating a common characterization of climate risk and uncertainties. We have reviewed the assessment and its foundation for the Fifth Assessment Reports published in 2013 and 2014, in particular the guidance note for lead authors of the fifth IPCC assessment report on consistent treatment of uncertainties. Our analysis shows that the work carried out by the ICPP is short of providing a theoretically and conceptually convincing foundation on the treatment of risk and uncertainties. The main reasons for our assessment are: (i) the concept of risk is given a too narrow definition (a function of consequences and probability/likelihood); and (ii) the reports lack precision in delineating their concepts and methods. The goal of this article is to contribute to improving the handling of uncertainty and risk in future IPCC studies, thereby obtaining a more theoretically substantiated characterization as well as enhanced scientific quality for risk analysis in this area. Several suggestions for how to improve the risk and uncertainty treatment are provided.

  7. Determination of optical property changes by laser treatments using inverse adding-doubling method

    NASA Astrophysics Data System (ADS)

    Honda, Norihiro; Ishii, Katsunori; Kimura, Akinori; Sakai, Makoto; Awazu, Kunio

    2009-02-01

    It is widely recognized for the realization of the pre-estimated treatment effects that the knowledge about the optical properties of the target tissues used to understanding the prediction of propagation and distribution of light within tissues would suffer from the technical problem such as the kinetic changes of the optical properties in laser irradiation. In this study, the optical properties of normal and laser coagulated chicken breast tissues and porcine intervertebral disks, normal and laser ablation have been determined in vitro in the spectral range between 350 and 1000 nm. In addition, the optical properties of the normal and photodynamic therapy (PDT) treated tumor, Lewis lung carcinoma, tissues have been determined. Diffuse reflectance and total transmittance of the samples are measured using an integrating-sphere technique. From these experimental data, the absorption coefficients and the reduced scattering coefficients of the samples are determined employing an inverse adding-doubling method. Laser coagulations and ablations have clearly increased the reduced scattering coefficient and slightly reduced the absorption coefficient. PDT treatment has increased absorption and reduced scattering coefficient. It is our expectation that these data will provide fundamental understandings on laser irradiation interactions behavior with tissues. The changes of the optical properties should be accounted for while planning the therapeutic procedure for the realization of safe laser treatments.

  8. The impact of syphilis mass treatment one year later: self-reported behaviour change among participants.

    PubMed

    Rekart, Michael L; Wong, Thomas; Wong, Elsie; Hutchinson, Kylie; Ogilvie, Gina

    2005-08-01

    In 2000, syphilis mass treatment using oral azithromycin was delivered to at-risk British Columbians during a sex trade-related outbreak. The initiative included education, counselling and referral. This cross-sectional, observational study examines knowledge, attitudes and self-reported behaviour after one year among mass treatment participants compared with eligible non-participants. Participants self-reported positive changes: reduction in sexual partners overall (P=0.001) and for sex workers (P<0.01), decrease in unprotected oral sex (P=0.03), knowledge of asymptomatic syphilis (P=0.02), positive attitudes to mass treatment (P=0.02) and to the street nurses (P=0.01). Increased awareness was associated with increased condom use for vaginal sex overall (P=0.02) and for sex workers (P=0.03) and increased condom use for oral sex (P=0.05). There was no difference in syphilis incidence. Syphilis outbreak interventions that include education, support and referral can result in long-term positive behaviour changes. PMID:16105193

  9. Trajectories of change during a randomized controlled trial of internet-delivered psychological treatment for adolescent chronic pain: how does change in pain and function relate?

    PubMed

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

    2015-04-01

    Although pain and function improve at immediate posttreatment for youth receiving cognitive behavioral therapy for chronic pain, limited data are available to understand changes that youth make during psychological treatment. We sought to characterize distinct trajectory patterns of change in pain and function to understand the temporal association of these changes during internet-delivered cognitive behavioral therapy (CBT). Weekly repeated assessments of pain and function were conducted during 8 weeks of treatment among 135 adolescents, aged 11 to 17 years, with chronic pain who were randomized to the cognitive behavioral intervention arm of an ongoing trial of internet-delivered CBT (Web-based management of adolescent pain; Web-MAP2). Using random-effects growth mixture models, we characterized pain and functional disability trajectories finding distinct trajectory groups indicating patterns of both linear and quadratic effects. Trajectories of change showed that some patients' pain and functional disability were improving, others worsened or changed minimally. Paired t tests compared the within-subject relative change rate in pain and function demonstrating similar change range for pain and function during the treatment period. There was no support for improvements in either pain or function to precede changes in the other domain. Findings may be useful in informing future studies of psychosocial treatments for pediatric chronic pain to consider how to target treatment strategies to distinct patient response profiles. This may lead to the development of intervention strategies that can both more effectively target children's pain and function during treatment and lead to sustained changes after treatment.

  10. Mandibular dental arch changes associated with treatment of crowding using self-ligating and conventional brackets.

    PubMed

    Pandis, Nicholas; Polychronopoulou, Argy; Makou, Margarita; Eliades, Theodore

    2010-06-01

    The purpose of this study was to investigate the effect of treatment of mandibular crowding with self-ligating and conventional brackets on dental arch variables. Fifty-six patients were selected from a pool of subjects satisfying the following inclusion criteria: non-extraction treatment in the mandibular or maxillary arches, eruption of all mandibular teeth, no spaces and an irregularity index greater than 2 mm in the mandibular arch, and no adjunct treatment such as etxra- or intraoral appliances. The patients were assigned to two groups: one group received treatment with the self-ligating bracket and the other with a conventional edgewise appliance, both with a 0.022 inch slot. Lateral cephalometric radiographs obtained at the beginning (T1) and end (T2) of treatment were used to assess the alteration in mandibular incisor inclination, and measurements of intercanine and intermolar widths were made on dental casts to investigate changes associated with the correction. The results were analysed with bivariate and multivariate linear regression analysis in order to examine the effect of the bracket systems on arch width or lower incisor inclination, adjusting for the confounding effect of demographic and clinical characteristics. An alignment-induced increase in the proclination of the mandibular incisors was observed for both groups; no difference was identified between self-ligating and conventional brackets with respect to this parameter. Likewise, an increase in intercanine and intermolar widths was noted for both bracket groups; the self-ligating group showed a higher intermolar width increase than the conventional group, whereas the amount of crowding and Angle classification were not significant predictors of post-treatment intermolar width. PMID:19959610

  11. [Personality changes in opioid-dependent subjects in a methadone maintenance treatment program].

    PubMed

    Trémeau, F; Darreye, A; Leroy, B; Renckly, V; Ertlé, S; Weibel, H; Khidichian, F; Macher, J-P

    2003-01-01

    Personality disorders and particularly antisocial personality disorders (APD) are quite frequent in opioid-dependent subjects. They show various personality traits: high neuroticism, high impulsivity, higher extraversion than the general population. Previous studies have reported that some but not all personality traits improved with treatment. In a previous study, we found a low rate of APD in a French population of opioid-dependent subjects. For this reason, we evaluated personality traits at intake and during maintenance treatment with methadone. Methods - The form A of the Eysenck Personality Inventory (EPI) was given to opioid addicts at intake and after 6 and 12 months of methadone treatment. Results - 134 subjects (96 males and 38 females) took the test at intake, 60 completed 12 months of treatment. After 12 months, the EPI Neuroticism (N) and the Extraversion-introversion (E) scale scores decreased significantly. The N score improved in the first 6 months, while the E score improved only during the second 6 months of treatment. Compared to a reference group of French normal controls, male and female opioid addicts showed high N and E scores. Demographic data and EPI scores of patients who stayed in treatment for 12 months did not differ significantly from those of dropouts (n=23). Patients with a history of suicide attempts (SA) started to use heroin at an earlier age and they showed a higher E score and a tendency for a higher N score at intake. Discussion - The two personality dimensions of the EPI changed during MMT, and the N score converged towards the score of normal controls. Opioid addicts differ from normal controls mostly in their N score. The EPI did not help to differentiate 12-month completers from dropouts. Higher E scores in patients with an SA history might reflect a higher impulsivity, which has been linked to suicidality in other patient groups.

  12. Dimensional changes of Nb3Sn Rutherford cables during heat treatment

    DOE PAGES

    Rochepault, E.; Ferracin, P.; Ambrosio, G.; Anerella, M.; Ballarino, A.; Bonasia, A.; Bordini, B.; Cheng, D.; Dietderich, D. R.; Felice, H.; et al

    2016-06-01

    In high field magnet applications, Nb3Sn coils undergo a heat treatment step after winding. During this stage, coils radially expand and longitudinally contract due to the Nb3Sn phase change. In order to prevent residual strain from altering superconducting performances, the tooling must provide the adequate space for these dimensional changes. The aim of this paper is to understand the behavior of cable dimensions during heat treatment and to provide estimates of the space to be accommodated in the tooling for coil expansion and contraction. In addition, this paper summarizes measurements of dimensional changes on strands, single Rutherford cables, cable stacks,more » and coils performed between 2013 and 2015. These samples and coils have been performed within a collaboration between CERN and the U.S. LHC Accelerator Research Program to develop Nb3Sn quadrupole magnets for the HiLumi LHC. The results are also compared with other high field magnet projects.« less

  13. Spectroscopic characterization of changes of DOM deprotonation-protonation properties in water treatment processes.

    PubMed

    Yan, Mingquan; Dryer, Deborah; Korshin, Gregory V

    2016-04-01

    The deprotonation-protonation properties of dissolved organic matter (DOM) in drinking water produced at critical treatment points were quantified using absorbance spectra in combination with DOM fractionation data. Analysis of differential spectra of DOM present in inlet, settled and filtered waters from two large treatment plants and their fractions were obtained. The data demonstrated the presence of six Gaussian bands largely associated with carboxylic and phenolic DOM functionalities. Properties of the protonation-active groups of DOM in raw and treated waters were further examined based on data of potentiometric titrations at pH from 2.5 to 10. Interpretation of the differential log-transformed absorbance at wavelength 350 nm (DlnA350) based on the NICA-Donnan model showed that the normalized concentrations of low- and high-affinity protonation-active groups in residual DOMs increases as a result of water treatment. This was consistent with the results of DOM fractionation. This study demonstrates that changes of the composition and reactivity of DOM found in drinking water treatment sequences can be quantified based on the examination of their optical properties.

  14. Evolution of testosterone treatment over 25 years: symptom responses, endocrine profiles and cardiovascular changes

    PubMed Central

    Carruthers, Malcolm; Cathcart, Paul; Feneley, Mark R.

    2015-01-01

    Abstract Introduction: Testosterone treatment has evolved rapidly over the past 25 years as new, more effective and convenient methods have become available. This study reports experience with seven different methods, introduced on the market in the UK. Aim: To establish the symptom response when testosterone treatment was initiated on the basis of clinical features and symptoms of androgen deficiency, and the resulting endocrine, biochemical and physiological responses. Methods: Of 2693 patients attending the 3 Men’s Health Centers – The UK Androgen Study (UKAS), 2247 were treated. Treatments included pellet implants, oral testosterone undecanoate (Testocaps), mesterolone (Proviron), testosterone gel (Testogel), testosterone scrotal cream (Andromen) and scrotal gel (Tostran). Results: There was no correlation between initial testosterone level, initial symptom score or the success of treatment as defined by adequate resolution of symptoms. Despite the diverse endocrine patterns produced, the testosterone preparations appear equally safe over prolonged periods, with either no change or improvement of cardiovascular risk factors, especially in lowering cholesterol and diastolic blood pressure. Conclusions: It is suggested that because of excessive reliance on laboratory measures of androgens and undue safety concerns, many men who could benefit from symptom relief, improvement in related clinical conditions and given preventive medical benefits remain untreated. PMID:26218766

  15. Treatment of obese children with and without their mothers: changes in weight and blood pressure.

    PubMed

    Brownell, K D; Kelman, J H; Stunkard, A J

    1983-04-01

    Weight and blood pressure changes were evaluated in a 16-month controlled trial comparing three methods of involving mothers in the treatment of their obese adolescents (aged 12 to 16 years). The treatments were: (1) Mother-Child Separately--children and mothers attended separate groups; (2) Mother-Child Together--the children and mothers met together in the same group; and (3) Child Alone--the children met in groups and mothers were not involved. The program consisted of behavior modification, social support, nutrition, and exercise. The Mother-Child Separately group lost more weight (8.4 kg) during treatment than did the other two groups (5.3 and 3.3 kg). Differences between the groups increased at the 1-year follow-up: compared to pretreatment weight, the Mother-Child Separately group lost 7.7 kg compared with gains of approximately 3 kg in the other two groups. Blood pressures of children with the highest initial pressures decreased by 16/9 mm Hg at the end of treatment and by 16/5 mm Hg at the 1-year follow-up. These results suggest that a program of behavior modification and parent involvement can lead to significant weight losses in obese children, and that the nature of parent involvement may be important.

  16. Changes in neuropsychological functioning following treatment for late-life Generalized Anxiety Disorder

    PubMed Central

    Butters, Meryl A.; Bhalla, Rishi K.; Andreescu, Carmen; Wetherell, Julie Loebach; Mantella, Rose; Begley, Amy E.; Lenze, Eric J.

    2013-01-01

    Background Generalized Anxiety Disorder (GAD) in older adults is associated with neuropsychological impairment. Aims We examined neuropsychological functioning in older adults with GAD in comparison to psychiatrically healthy older adults and we examined changes during a 12-week, placebo controlled trial of escitalopram. Method One hundred-sixty non-demented participants aged ≥60 with current GAD and 37 comparison subjects without psychiatric history underwent neuropsychological assessment. One hundred twenty-nine GAD participants were re-assessed post-treatment. Results GAD participants performed worse than comparison subjects in information processing speed, working memory, inhibition, problem-solving (including concept formation and mental flexibility), and immediate and delayed memory. Neuropsychological functioning was correlated with everyday functioning. Low cognitive scorers experienced working memory, delayed memory and visuospatial ability improvement and those who reported clinical improvement in anxiety exhibited improvement in the ability to engage inhibition and episodic recall. These improvements were modest and of similar magnitude in both treatment conditions. Conclusion GAD in older adults is associated with neuropsychological impairments, which are associated with functional impairment. Those with GAD who either have low cognitive performance or report clinical improvement in anxiety post-treatment, show improvement in multiple cognitive domains. These findings underscore the importance of treatments that aid cognition as well as anxiety symptoms. PMID:21727232

  17. Empiric antibiotic treatment of erythema migrans-like skin lesions as a function of geography: a clinical and cost effectiveness modeling study.

    PubMed

    Lantos, Paul M; Brinkerhoff, R Jory; Wormser, Gary P; Clemen, Robert

    2013-12-01

    The skin lesion of early Lyme disease, erythema migrans (EM), is so characteristic that routine practice is to treat all such patients with antibiotics. Because other skin lesions may resemble EM, it is not known whether presumptive treatment of EM is appropriate in regions where Lyme disease is rare. We constructed a decision model to compare the cost and clinical effectiveness of three strategies for the management of EM: Treat All, Observe, and Serology as a function of the probability that an EM-like lesion is Lyme disease. Treat All was found to be the preferred strategy in regions that are endemic for Lyme disease. Where Lyme disease is rare, Observe is the preferred strategy, as presumptive treatment would be expected to produce excessive harm and increased costs. Where Lyme disease is rare, clinicians and public health officials should consider observing patients with EM-like lesions who lack travel to Lyme disease-endemic areas.

  18. Two-sample density-based empirical likelihood ratio tests based on paired data, with application to a treatment study of attention-deficit/hyperactivity disorder and severe mood dysregulation.

    PubMed

    Vexler, Albert; Tsai, Wan-Min; Gurevich, Gregory; Yu, Jihnhee

    2012-07-30

    It is a common practice to conduct medical trials to compare a new therapy with a standard-of-care based on paired data consisted of pre- and post-treatment measurements. In such cases, a great interest often lies in identifying treatment effects within each therapy group and detecting a between-group difference. In this article, we propose exact nonparametric tests for composite hypotheses related to treatment effects to provide efficient tools that compare study groups utilizing paired data. When correctly specified, parametric likelihood ratios can be applied, in an optimal manner, to detect a difference in distributions of two samples based on paired data. The recent statistical literature introduces density-based empirical likelihood methods to derive efficient nonparametric tests that approximate most powerful Neyman-Pearson decision rules. We adapt and extend these methods to deal with various testing scenarios involved in the two-sample comparisons based on paired data. We show that the proposed procedures outperform classical approaches. An extensive Monte Carlo study confirms that the proposed approach is powerful and can be easily applied to a variety of testing problems in practice. The proposed technique is applied for comparing two therapy strategies to treat children's attention deficit/hyperactivity disorder and severe mood dysregulation. PMID:22714114

  19. Solar variation 1979-1987 estimated from an empirical model for changes with time in the sensitivity of the solar backscatter ultraviolet instrument

    NASA Technical Reports Server (NTRS)

    Schlesinger, Barry M.; Cebula, Richard P.

    1992-01-01

    A model is developed that describes changes in the sensitivity of the solar backscatter UV instrument deployed with Nimbus 7 to study variations with time in solar irradiance. The exponential decay of instrument exposure to the sun and that of time are combined, and the product is used to describe the sensitivity change. Measured UV irradiances are employed to develop the values of the exponential decays, and the degradation coefficients for time dependence are found to vary with time at shorter wavelengths. Instrument sensitivity is described in terms of a functional relationship based on exponential decay with time with time-varying time dependence and on exponential decay with exposure with constant exposure dependence. The relationship provides a technique for treating data from the solar backscatter UV instrument both at short- and long-term intervals, and solar irradiance is calculated based on the approach.

  20. Aggregation and conformational change of mushroom (Agaricus bisporus) polyphenoloxidase subjected to thermal treatment.

    PubMed

    Zhou, Lei; Liu, Wei; Zou, Liqiang; Xiong, Zhiqiang; Hu, Xiuting; Chen, Jun

    2017-01-01

    This study investigated changes in the activity, conformation and microstructure of mushroom polyphenoloxidase (PPO) subjected to thermal treatment. The inactivation of PPO can be achieved by high temperature-short time or mild temperature-long time treatment. Circular dichroism and fluorescence spectra suggested that heating process induced the rearrangement of secondary structure and the disruption of tertiary structure. Red shifts of fluorescence spectra showed positive correlations with the inactivation rate of PPO. There were significant differences in the conformation and molecular microstructure among PPO samples with the same relative activity, which were obtained by treating PPO at 45, 55 and 65°C for different times. In summary, PPO molecules were deformed at mild temperature, while higher temperature induced the formation of large aggregates. PPO with the same relative activity might exist in different forms. PMID:27507494

  1. What is changing in radiotherapy for the treatment of locally advanced nonsmall cell lung cancer patients? A review.

    PubMed

    Giaj-Levra, Niccoló; Ricchetti, Francesco; Alongi, Filippo

    2016-01-01

    Radiotherapy treatment continues to have a relevant impact in the treatment of nonsmall cell cancer (NSCLC). Use of concurrent chemotherapy and radiotherapy is considered the gold standard in the treatment of locally advanced NSCLC but clinical outcomes are not satisfactory. Introduction of new radiotherapy technology and chemotherapy regimens are under investigation in this setting with the goal to improve unsatisfactory results. We report how radiotherapy is changing in the treatment of locally advanced NSCLC.

  2. Effects of breastfeeding on weight changes in family-based pediatric obesity treatment.

    PubMed

    Goldfield, Gary S; Paluch, Rocco; Keniray, Karen; Hadjiyannakis, Stasia; Lumb, Andrew B; Adamo, Kristi

    2006-04-01

    Research indicates that breastfeeding may provide protective effects against the development of obesity; however, breastfed children may still become obese because of the obesogenic environment. This study is designed to examine the effects of retrospective recall of breastfeeding on weight changes in children participating in a 6-month behavioral treatment program for childhood obesity. The independent variable of breastfeeding was defined as children who were exclusively breastfed for 4 weeks (excluding water or medication) versus those who were never breastfed. Child percent overweight and body mass index changes during 6 and 12 months were evaluated for 94 families based on mother report of breastfeeding status using analysis of covariance, controlling for socioeconomic status and initial child weight status. Data were compiled for secondary analysis from pediatric obesity randomized controlled outcome studies evaluating core components of family-based treatments. Results showed that, compared with nonbreastfed (formula) children (n = 28), breastfed children (n = 66) showed significantly larger reductions in (mean +/- SEM) percent overweight at 6 months (-15.2 +/- 1.1 vs -10.2 +/- 1.7, p <.05) and 1 year (-10.3 +/- 1.3 vs -5.9 +/- 1.8, p <.05). Similarly, breastfed children showed greater reductions in body mass index at 6 months (-2.1 +/- 0.19 vs -1.1 +/- 0.28) and 1 year (-0.8 +/- 0.23 vs +0.1 +/- 0.32). Findings suggest the beneficial effects of breastfeeding may extend beyond obesity prevention to include improved outcome in family-based pediatric obesity treatment. Potential mechanisms relating breastfeeding, obesity prevention, and enhanced outcome in pediatric obesity treatment are discussed.

  3. Long-term stability of dentoalveolar and skeletal changes after activator-headgear treatment.

    PubMed

    Lerstøl, Magnhild; Torget, Oystein; Vandevska-Radunovic, Vaska

    2010-02-01

    The aim of this study was to analyze the long-term stability of combined activator-headgear treatment on skeletal and dental structures in Class II patients. The material comprised 26 subjects, 10 girls and 16 boys. All had a molar Class II relationship, overjet > or =6 mm, and overbite > or =5 mm. They were treated in one practice with combined activator and headgear appliances. Lateral cephalometric radiographs and dental study casts were taken before treatment (T0, mean age 11.9 years), at the end of activator-headgear treatment (T1, mean age 15.9 years), and 12-15 years out of retention (T2, mean age 28.6 years). Nineteen cephalometric and nine dental cast variables were evaluated using a paired sample t-test between T0-T1, T1-T2, and T0-T2. At T1, the majority of the cephalometric measurements showed statistically significant changes. ANB was significantly reduced by 2.3 degrees due to a significant increase in SNB, but only small changes were observed in SNA. The interincisal angle increased as a result of significant retroclination of both maxillary and mandibular incisors. All patients achieved a Class I molar relationship and a significant reduction in overjet and overbite. At T2, the results showed only slight relapse from T1. However, the relapse did not compromise the significant improvement in almost all the cephalometric and dental variables. Combined activator-headgear treatment improved the skeletal and dental conditions and the results remained stable in the long term.

  4. Changes of HBV DNA After Chemoembolization for Hepatocellular Carcinoma and the Efficacy of Antiviral Treatment.

    PubMed

    Lin, Xiao-Jun; Lao, Xiang-Ming; Shi, Ming; Li, Sheng-Ping

    2016-09-01

    Unlike systemic chemotherapy for hematological malignancies with hepatitis B virus (HBV) infection, transarterial chemoembolization (TACE) for HBV-related hepatocellular carcinoma (HCC) has only recently been reported to cause HBV reactivation and subsequent hepatitis. Most patients with HBV-related HCC have an underlying disease with liver fibrosis or cirrhosis, and TACE may potentially induce HBV reactivation and liver decompensation. Currently, there are no clinical guidelines for managing TACE-caused HBV reactivation. In this review, we summarize the changes of HBV status and liver function after TACE and the effect of antiviral treatment before, during, or after TACE.

  5. Non-Empirical Confirmation

    NASA Astrophysics Data System (ADS)

    Dawid, Richard

    2016-06-01

    In fundamental physics today, some theories are taken to be probably viable despite a lack of strong (or any) empirical confirmation. This situation suggests, I argue, an extension of the concept of theory confirmation that allows for confirmation by observations that are not predicted by the theory in question. "Non-empirical confirmation", as I call the latter form of confirmation, plays a more conspicuous role today than in earlier periods of physics. It has always constituted a significant albeit implicit element of the assessment of physical theory, however, that has not been adequately accounted for in canonical reconstructions of the scientific method. The talk discusses the core argumentative structure of non-empirical confirmation, analyses the concept’s reliance on the empirical testability of the theories in question and addresses some worries that have been raised in its regard.

  6. Structural changes in axillary eccrine glands following long-term treatment with aluminium chloride hexahydrate solution.

    PubMed

    Hölzle, E; Braun-Falco, O

    1984-04-01

    Axillary skin biopsies from fifteen patients with axillary hyperhidrosis who had received long-term treatment with aqueous aluminium chloride solution were examined histologically. The apocrine glands were normal, but the eccrine glands showed conspicuous morphological changes of varying severity. These included vacuolization of the secretory epithelium, dilatation of eccrine acini with atrophy of secretory cells, and accumulation of PAS-positive, diastase-resistant material in the dilated lumen of the secretory coils. The histological changes correlated in most patients with decreased secretion of sweat. We conclude that long-term blockage of the distal acrosyringium due to aluminium salts may lead to functional and structural degeneration of the eccrine acini. PMID:6712884

  7. Hippocampal Neurophysiologic Changes after Mild Traumatic Brain Injury and Potential Neuromodulation Treatment Approaches

    PubMed Central

    Girgis, Fady; Pace, Jonathan; Sweet, Jennifer; Miller, Jonathan P.

    2016-01-01

    Traumatic brain injury (TBI) is the leading cause of death and disability in individuals below age 45, and five million Americans live with chronic disability as a result. Mild TBI (mTBI), defined as TBI in the absence of major imaging or histopathological defects, is responsible for a majority of cases. Despite the lack of overt morphological defects, victims of mTBI frequently suffer lasting cognitive deficits, memory difficulties, and behavioral disturbances. There is increasing evidence that cognitive and memory dysfunction is related to subtle physiological changes that occur in the hippocampus, and these impact both the phenotype of deficits observed and subsequent recovery. Therapeutic modulation of physiological activity by means of medications commonly used for other indications or brain stimulation may represent novel treatment approaches. This review summarizes the present body of knowledge regarding neurophysiologic changes that occur in the hippocampus after mTBI, as well as potential targets for therapeutic modulation of neurologic activity. PMID:26903824

  8. Chronic ethanol treatment changes the number of beta-receptors in rat brain microvessels

    SciTech Connect

    Lucchi, L.; Cazzaniga, A.; Picotti, G.B.; Covelli, V.; Magnoni, M.S.; Borriero, L.; Spano, P.F.; Trabucchi, M.

    1984-01-01

    The effect of chronic ethanol consumption on the binding (125I)-iodohydroxybenzylpindolol to beta-adrenergic receptors in rat brain microvessels has been studied. The results show that chronic ethanol treatment increases the number of beta-receptors present in brain microvessels without changing the binding affinity of the binding site for the beta-adrenoceptor ligand. This effect is apparently not associated with changes in peripheral adrenergic tone, since no differences in platelet epinephrine or norepinephrine concentrations were found between ethanol-treated and control animals. An increase in beta-receptor density in brain microvessels might contribute to the alterations of cerebral blood flow and oxygen consumption reported during chronic ethanol intoxication.

  9. Motivation for Treatment and Motivation for Change in Substance-Dependent Patients with Co-Occurring Psychiatric Disorders.

    PubMed

    de Weert-van Oene, Gerdien H; Gongora, Vanesa; von Sternberg, Kirk; de Jong, Cor A J

    2015-01-01

    The aims of this study were to examine the relationship between motivation for treatment and for change, and to explore their role in the prediction of treatment completion. The sample was composed of 560 predominantly polydrug-using inpatients with co-occurring psychiatric disorders. Motivation for treatment was assessed with the Motivation for Treatment Scales, and motivation for change was measured with the Readiness to Change Questionnaire. Patients indicated strong motivation to change illegal drug and alcohol use. In initial factor analysis, motivation for treatment and for change did not load on the same factors, confirming that these are distinct domains. Four categories were discerned with respect to readiness for treatment and for change, with low agreement between the two. In performing survival analysis, we found that being in readiness category 4 (RT↑RC↑) was associated with a greater chance of remaining in treatment for a period of 105 days without premature attrition (Log Rank chi-sq=5.000; p=0.02). To a limited extent, intake measures of motivation can be used to predict attrition from treatment. Clinicians can use motivation assessment both for clinical purposes and in the prediction of those who need extra monitoring due to increased risk of premature attrition. PMID:26397714

  10. Motivation for Treatment and Motivation for Change in Substance-Dependent Patients with Co-Occurring Psychiatric Disorders.

    PubMed

    de Weert-van Oene, Gerdien H; Gongora, Vanesa; von Sternberg, Kirk; de Jong, Cor A J

    2015-01-01

    The aims of this study were to examine the relationship between motivation for treatment and for change, and to explore their role in the prediction of treatment completion. The sample was composed of 560 predominantly polydrug-using inpatients with co-occurring psychiatric disorders. Motivation for treatment was assessed with the Motivation for Treatment Scales, and motivation for change was measured with the Readiness to Change Questionnaire. Patients indicated strong motivation to change illegal drug and alcohol use. In initial factor analysis, motivation for treatment and for change did not load on the same factors, confirming that these are distinct domains. Four categories were discerned with respect to readiness for treatment and for change, with low agreement between the two. In performing survival analysis, we found that being in readiness category 4 (RT↑RC↑) was associated with a greater chance of remaining in treatment for a period of 105 days without premature attrition (Log Rank chi-sq=5.000; p=0.02). To a limited extent, intake measures of motivation can be used to predict attrition from treatment. Clinicians can use motivation assessment both for clinical purposes and in the prediction of those who need extra monitoring due to increased risk of premature attrition.

  11. An empirical study of the impact of human activity on long-term temperature change in China: A perspective from energy consumption

    NASA Astrophysics Data System (ADS)

    Li, Yan; Zhao, Xinyi

    2012-09-01

    Human activity is an important contributor to local temperature change, especially in urban areas. Energy consumption is treated here as an index of the intensity of human induced local thermal forcing. The relationship between energy consumption and temperature change is analyzed in China by Observation Minus Reanalysis (OMR) method. Temperature trends for observation, reanalysis and OMR are estimated from meteorological records and 2 m-temperature from NCEP/NCAR Reanalysis 1 for the period 1979-2007. A spatial mapping scheme based on the spatial and temporal relationship between energy consumption and Gross Domestic Production (GDP) is developed to derive the spatial distribution of energy consumption of China in 2003. A positive relationship between energy consumption and OMR trends is found in high and mid energy consumption region. OMR trends decline with the decreasing intensity of human activity from 0.20°C/decade in high energy consumption region to 0.13°C/decade in mid energy consumption region. Forty-four stations in high energy consumption region that are exposed to the largest human impact are selected to investigate the impact of energy consumption spatial pattern on temperature change. Results show human impact on temperature trends is highly dependent on spatial pattern of energy consumption. OMR trends decline from energy consumption center to surrounding areas (0.26 to 0.04°C/decade) and get strengthened as the spatial extent of high energy consumption area expands (0.14 to 0.25°C/decade).

  12. Medium-long term soil resilience against different disturbances: wildfires, silvicultural treatments and climate change

    NASA Astrophysics Data System (ADS)

    Hedo de Santiago, Javier; Borja, Manuel Esteban Lucas; de las Heras, Jorge

    2016-04-01

    Soils of semiarid Mediterranean forest ecosystems are very fragile and sensitive to changes due to different anthropogenic and natural disturbances. The increasing vulnerability of semiarid lands within this world framework has generated growing awareness in the field of research, with highly intensified study into soils properties. One of the main problems of Mediterranean forests is wildfire disturbance. Fire should be considered more an ecological factor but, in contrast to the role of fire, it is now a closely related factor to human action. On the other hand, to improve the recovery of forest communities after fire, silvicultural treatments are needed and, for that matter, another disturbance is added to the ecosystem. By last, climate change is also affecting the fire regime increasing fire frequency and burned area, enhancing the destructiveness to Mediterranean ecosystems. After all of these three disturbances, changes in vegetation dynamics and soil properties are expected to occur due to the plant-soil feedback. Soil plays an essential role in the forest ecosystem's fertility and stability and specifically soil microorganisms, which accomplish reactions to release soil nutrients for vegetation development, for that is essential to enlarge knowledge about soil properties resilience in semiarid forest ecosystems. Physico-chemical and microbiological soil properties, and enzyme activities have been studied in two Aleppo pine forest stands that have suffered three disturbances: 1) a wildfire event, 2) silvicultural treatments (thinning) and 3) an artificial drought (simulating climate change) and results showed that soil recovered after 15 years. Final results showed that soils have been recovered from the three disturbances at the medium-long term.

  13. Changes in behavior as side effects in methylphenidate treatment: review of the literature

    PubMed Central

    Konrad-Bindl, Doris Susanne; Gresser, Ursula; Richartz, Barbara Maria

    2016-01-01

    Background Our review of the scientific literature focused on an analysis of studies describing instances of methylphenidate treatment leading (or not) to behavioral changes in the pediatric, adolescent, and adult populations. Materials and methods We conducted a literature search in PubMed, Medline, and Google using the keywords “methylphenidate”, “behavioral changes”, “adverse effects”, and “side effects”. A total of 44 studies were identified as reporting on the effects and adverse effects of methylphenidate administration, and were included in the analysis. Results Five studies specifically set out to study, record, and discuss changes in behavior. Eight studies did not set out to study behavioral effects, but record and discuss them. A total of 28 studies recorded behavioral effects, but failed to discuss these further. Three studies did not include behavioral effects. Conclusion This review records what data have been published in respect of changes in behavior in association with the use of methylphenidate. While there is some evidence to suggest that methylphenidate causes changes in behavior, the majority of the studies reviewed paid little or no attention to this issue. Based on the available data, it is impossible to determine the point at which such behavioral effects occur. The frequency of occurrence of behavioral effects is also impossible to determine with certainty. Based on the available data, it is not possible to rule out whether behavioral effects may persist or not persist once treatment is discontinued. In conclusion, despite countless publications and extensive administration, especially to children, we have insufficient data to judge the long-term effects and risks of methylphenidate taking. PMID:27789952

  14. Seasonal Changes in Bacterial Communities Cause Foaming in a Wastewater Treatment Plant.

    PubMed

    Wang, Ping; Yu, Zhisheng; Zhao, Jihong; Zhang, Hongxun

    2016-04-01

    Bio-foaming is a major problem in solid separation in activated sludge (AS) wastewater treatment systems. Understanding the changes in bacterial communities during sludge foaming is vital for explaining foam formation. Changes in bacterial communities in the foam, corresponding foaming AS, and non-foaming AS in a seasonal foaming wastewater treatment plant (WWTP) in Northern China were investigated by high-throughput pyrosequencing and molecular quantification-based approaches. We found that bacterial communities of the foam and the corresponding foaming AS were similar but markedly different from those of the non-foaming AS. Actinobacteria was the predominant phylum in the foam and the corresponding foaming AS, whereas Proteobacteria was predominant in the non-foaming AS. Similar to the results of most previous studies, our results showed that Candidatus "Microthrix parvicella" was the predominant filamentous bacteria in the foam and the corresponding foaming AS and was significantly enriched in the foam compared to the corresponding foaming AS. Its abundance decreased gradually with a slow disappearance of sludge foaming, indicating that its overgrowth had a direct relationship with sludge foaming. In addition to Candidatus M. parvicella, Tetrasphaera and Trichococcus might play a role in sludge foaming, because they supported the changes in AS microbial ecology for foam formation. The effluent water quality of the surveyed plant remained stable during the period of sludge foaming, but the microbial consortia responsible for nitrogen and phosphorus transformation and removal markedly changed compared to that in the non-foaming AS. This study adds to the previous understanding of bacterial communities causing foaming in WWTPs. PMID:26577577

  15. Changes in the Temperament and Character Inventory dimensions after paroxetine treatment in patients with major depressive disorder.

    PubMed

    Tomita, Tetsu; Kaneda, Ayako; Nakagami, Taku; Kaneko, Sunao; Yasui-Furukori, Norio

    2015-09-01

    Previous studies have reported changes in the dimensions of the Temperament and Character Inventory (TCI) after patients with major depressive disorder are treated. We aimed to investigate the changes in the TCI dimensions after paroxetine treatment in patients with major depressive disorder. Forty-eight patients were enrolled in this study and were treated with 10-40 mg/day of paroxetine for 6 weeks. The TCI was completed twice, at weeks 0 and 6. We used the Montgomery-Asberg Depression Rating Scale (MADRS) to evaluate patients. The participants were divided into three groups (responders, non-responders, and early responders) based on treatment response. The scores of each dimension of the TCI were compared before and after treatment using repeated-measures two-way analyses of variance. In the responders group (n = 24), no TCI dimension scores changed significantly during treatment, but the interaction between sex and MADRS score change was significantly associated with the results. In the non-responders group (n = 15), the self-directedness score increased significantly during the treatment period (p = 0.000), and the change in MADRS score significantly affected the results. In the early responders group (n = 9), no TCI dimension scores changed significantly during treatment. The results of the present study may reveal a possible correlation between paroxetine treatment and changes in personality traits.

  16. Economic analysis of empiric versus diagnostic-driven strategies for immunocompromised patients with suspected fungal infections in the People's Republic of China.

    PubMed

    Mao, Ningying; Lesher, Beth; Liu, Qifa; Qin, Lei; Chen, Yixi; Gao, Xin; Earnshaw, Stephanie R; McDade, Cheryl L; Charbonneau, Claudie

    2016-01-01

    Invasive fungal infections (IFIs) require rapid diagnosis and treatment. A decision-analytic model was used to estimate total costs and survival associated with a diagnostic-driven (DD) or an empiric treatment approach in neutropenic patients with hematological malignancies receiving chemotherapy or autologous/allogeneic stem cell transplants in Shanghai, Beijing, Chengdu, and Guangzhou, the People's Republic of China. Treatment initiation for the empiric approach occurred after clinical suspicion of an IFI; treatment initiation for the DD approach occurred after clinical suspicion and a positive IFI diagnostic test result. Model inputs were obtained from the literature; treatment patterns and resource use were based on clinical opinion. Total costs were lower for the DD versus the empiric approach in Shanghai (¥3,232 vs ¥4,331), Beijing (¥3,894 vs ¥4,864), Chengdu, (¥4,632 vs ¥5,795), and Guangzhou (¥8,489 vs ¥9,795). Antifungal administration was lower using the DD (5.7%) than empiric (9.8%) approach, with similar survival rates. Results from one-way and probabilistic sensitivity analyses were most sensitive to changes in diagnostic test sensitivity and IFI incidence; the DD approach dominated the empiric approach in 88% of scenarios. These results suggest that a DD compared to an empiric treatment approach in the People's Republic of China may be cost saving, with similar overall survival in immunocompromised patients with suspected IFIs. PMID:27366099

  17. Economic analysis of empiric versus diagnostic-driven strategies for immunocompromised patients with suspected fungal infections in the People’s Republic of China

    PubMed Central

    Mao, Ningying; Lesher, Beth; Liu, Qifa; Qin, Lei; Chen, Yixi; Gao, Xin; Earnshaw, Stephanie R; McDade, Cheryl L; Charbonneau, Claudie

    2016-01-01

    Invasive fungal infections (IFIs) require rapid diagnosis and treatment. A decision-analytic model was used to estimate total costs and survival associated with a diagnostic-driven (DD) or an empiric treatment approach in neutropenic patients with hematological malignancies receiving chemotherapy or autologous/allogeneic stem cell transplants in Shanghai, Beijing, Chengdu, and Guangzhou, the People’s Republic of China. Treatment initiation for the empiric approach occurred after clinical suspicion of an IFI; treatment initiation for the DD approach occurred after clinical suspicion and a positive IFI diagnostic test result. Model inputs were obtained from the literature; treatment patterns and resource use were based on clinical opinion. Total costs were lower for the DD versus the empiric approach in Shanghai (¥3,232 vs ¥4,331), Beijing (¥3,894 vs ¥4,864), Chengdu, (¥4,632 vs ¥5,795), and Guangzhou (¥8,489 vs ¥9,795). Antifungal administration was lower using the DD (5.7%) than empiric (9.8%) approach, with similar survival rates. Results from one-way and probabilistic sensitivity analyses were most sensitive to changes in diagnostic test sensitivity and IFI incidence; the DD approach dominated the empiric approach in 88% of scenarios. These results suggest that a DD compared to an empiric treatment approach in the People’s Republic of China may be cost saving, with similar overall survival in immunocompromised patients with suspected IFIs. PMID:27366099

  18. Giant cell tumors of the spine: has denosumab changed the treatment paradigm?

    PubMed

    Goldschlager, Tony; Dea, Nicolas; Boyd, Michael; Reynolds, Jeremy; Patel, Shreyaskumar; Rhines, Laurence D; Mendel, Ehud; Pacheco, Marina; Ramos, Edwin; Mattei, Tobias A; Fisher, Charles G

    2015-05-01

    OBJECT Giant cell tumors (GCTs) of the spine are rare and complex to treat. They have a propensity for local recurrence and the potential to metastasize. Treatment is currently surgical and presents unique challenges due to the proximity of neural structures and the need for reconstruction. Denosumab has been shown in clinical trials to be an effective treatment for GCT, but has not yet been studied specifically in GCT of the spine or as a surgical adjunct. To the authors' knowledge this is the first such reported series. METHODS A multicenter, prospective series of 5 patients with GCT of the spine treated with denosumab were included. Patient demographic data, oncological history, neurological status, tumor staging, treatment details and adverse events, surgical procedure, complications, radiological and histological responses, and patient outcome were analyzed. RESULTS All patients were women, with a mean age of 38 years, and presented with pain; 2 patients had additional neurological signs and symptoms. The mean duration of symptoms was 62 weeks. No patient had a prior tumor or metastatic disease at presentation. All patients had Enneking Stage III tumors and were treated with monthly cycles of 120 mg of denosumab, with initial additional loading doses on Days 8 and 15. Patients were given daily supplements of calcium (500 mg) and vitamin D (400 IU). There were no denosumab-related adverse events. All patients had a radiological response to denosumab. One patient failed to have a histological response to denosumab, with > 90% of tumor cells found to be viable on histological investigation. CONCLUSIONS This study reports the early experience of using denosumab in the treatment of spinal GCT. The results demonstrate a clinically beneficial radiological response and an impressive histological response in most but not all patients. Further experience with denosumab and longer patient follow-up is required. Denosumab has the potential to change the treatment paradigm

  19. Changing the malaria treatment protocol policy in Timor-Leste: an examination of context, process, and actors' involvement.

    PubMed

    Martins, João S; Zwi, Anthony B; Hobday, Karen; Bonaparte, Fernando; Kelly, Paul M

    2013-01-01

    In 2007 Timor-Leste, a malaria endemic country, changed its Malaria Treatment Protocol for uncomplicated falciparum malaria from sulphadoxine-pyrimethamine to artemether-lumefantrine. The change in treatment policy was based on the rise in morbidity due to malaria and perception of increasing drug resistance. Despite a lack of nationally available evidence on drug resistance, the Ministry of Health decided to change the protocol. The policy process leading to this change was examined through a qualitative study on how the country developed its revised treatment protocol for malaria. This process involved many actors and was led by the Timor-Leste Ministry of Health and the WHO country office. This paper examines the challenges and opportunities identified during this period of treatment protocol change. PMID:23672371

  20. Predictors of Staff Turnover and Turnover Intentions within Addiction Treatment Settings: Change Over Time Matters.

    PubMed

    Garner, Bryan R; Hunter, Brooke D

    2014-01-01

    This study examined the extent to which changes over time in clinicians' responses to measures of work attitude (eg, job satisfaction) and psychological climate (eg, supervisor support) could predict actual turnover and turnover intentions above and beyond absolute levels of these respective measures. Longitudinal data for this study were collected from a sample of clinicians (N = 96) being trained to implement an evidence-based treatment for adolescent substance use disorders. Supporting findings from a recent staff turnover study, we found job satisfaction change was able to predict actual turnover above and beyond average levels of job satisfaction. Representing new contributions to the staff turnover literature, we also found that change over time in several other key measures (eg, job satisfaction, role manageability, role clarity) explained a significant amount of variance in turnover intentions above and beyond the absolute level of each respective measure. A key implication of the current study is that organizations seeking to improve their ability to assess risk for staff turnover may want to consider assessing staff at multiple points in time in order to identify systematic changes in key employee attitudes like turnover intentions and job satisfaction. PMID:25336960

  1. Responses of ecosystem carbon cycling to climate change treatments along an elevation gradient

    USGS Publications Warehouse

    Wu, Zhuoting; Koch, George W.; Dijkstra, Paul; Bowker, Matthew A.; Hungate, Bruce A.

    2011-01-01

    Global temperature increases and precipitation changes are both expected to alter ecosystem carbon (C) cycling. We tested responses of ecosystem C cycling to simulated climate change using field manipulations of temperature and precipitation across a range of grass-dominated ecosystems along an elevation gradient in northern Arizona. In 2002, we transplanted intact plant–soil mesocosms to simulate warming and used passive interceptors and collectors to manipulate precipitation. We measured daytime ecosystem respiration (ER) and net ecosystem C exchange throughout the growing season in 2008 and 2009. Warming generally stimulated ER and photosynthesis, but had variable effects on daytime net C exchange. Increased precipitation stimulated ecosystem C cycling only in the driest ecosystem at the lowest elevation, whereas decreased precipitation showed no effects on ecosystem C cycling across all ecosystems. No significant interaction between temperature and precipitation treatments was observed. Structural equation modeling revealed that in the wetter-than-average year of 2008, changes in ecosystem C cycling were more strongly affected by warming-induced reduction in soil moisture than by altered precipitation. In contrast, during the drier year of 2009, warming induced increase in soil temperature rather than changes in soil moisture determined ecosystem C cycling. Our findings suggest that warming exerted the strongest influence on ecosystem C cycling in both years, by modulating soil moisture in the wet year and soil temperature in the dry year.

  2. Depressive symptoms in the Netherlands 1975-1996: a theoretical framework and an empirical analysis of socio-demographic characteristics, gender differences and changes over time.

    PubMed

    Meertens, Vivian; Scheepers, Peer; Tax, Bert

    2003-03-01

    This article examines the longitudinal trend of depressive symptoms in the Netherlands, using large-scale national data recorded over the period 1975-1996. Our analyses showed fluctuations in the overall longitudinal trend. On the basis of a general theoretical framework, we formulated hypotheses concerning which socio-demographic characteristics determine the likelihood of suffering from depressive symptoms and how these associations might have changed over time. Our results revealed that people on low incomes, unemployed people, unmarried people and those who had given up their church membership were associated with depressive symptoms. Some associations between socio-demographic categories and depressive symptoms have changed over time. Divorced people have become progressively less likely to suffer from depressive symptoms compared with married people, whereas the reverse holds for those who were never married. People on low incomes have become more likely to suffer from depressive symptoms over time in comparison to people with the highest incomes. Gender differences in these associations were also found: educational level and church attendance were more beneficial to women in protecting them from depressive symptoms than they were to men.

  3. Final Technical Report for Collaborative Research: Regional climate-change projections through next-generation empirical and dynamical models, DE-FG02-07ER64429

    SciTech Connect

    Smyth, Padhraic

    2013-07-22

    This is the final report for a DOE-funded research project describing the outcome of research on non-homogeneous hidden Markov models (NHMMs) and coupled ocean-atmosphere (O-A) intermediate-complexity models (ICMs) to identify the potentially predictable modes of climate variability, and to investigate their impacts on the regional-scale. The main results consist of extensive development of the hidden Markov models for rainfall simulation and downscaling specifically within the non-stationary climate change context together with the development of parallelized software; application of NHMMs to downscaling of rainfall projections over India; identification and analysis of decadal climate signals in data and models; and, studies of climate variability in terms of the dynamics of atmospheric flow regimes.

  4. Understanding treatment-seeking smokers' motivation to change: content analysis of the decisional balance worksheet.

    PubMed

    Collins, Susan E; Eck, Sandra; Torchalla, Iris; Schröter, Martina; Batra, Anil

    2013-01-01

    The Decisional Balance Worksheet (DBW), an open-ended measure of motivation to change, may be used to record the pros and cons of smoking versus abstinence among treatment-seeking smokers. Recent findings indicated that the open-ended DBW could be quantified to validly reflect people's level of motivation to stop smoking (Collins, Eck, Torchalla, Schröter, & Batra, 2010). The goal of the current study was to enhance our understanding of these participants' motivation to change by examining the qualitative content of their decisional balance. Participants were treatment-seeking smokers (N=268) who had participated in a larger randomized controlled trial of tailored smoking cessation interventions (Batra et al., 2010). Using the DBW, participants recorded their pros and cons of smoking versus abstinence, and content analysis methods were used to extract common themes. Findings indicated that the physical and psychological effects/functions of smoking and abstinence were most commonly mentioned as both pros and cons. Although the decisional balance categories were substantively similar over time, their relative frequency shifted from pre- to posttreatment. For the sample as a whole, the number of pros of smoking generally decreased, whereas the pros of abstinence increased from pre- to posttreatment. Findings suggest that clinicians can expect certain perceived pros and cons to characterize their clients' decision-making process about smoking and abstinence. At the same time, the use of the decisional balance allows for assessment of individuals' unique motivational set.

  5. Searching for the mechanisms of change: a protocol for a realist review of batterer treatment programmes

    PubMed Central

    Cheff, Rebecca; Finn, Debbie; Davloor, Whitney; O'Campo, Patricia

    2016-01-01

    Introduction Conflicting results reported by evaluations of typical batterer intervention programmes leave many judicial officials and policymakers uncertain about the best way to respond to domestic violence, and whether to recommend and fund these programmes. Traditional evaluations and systematic reviews tend to focus predominantly on whether the programmes ‘worked’ (eg, reduced recidivism) often at the exclusion of understanding for whom they may or may not have worked, under what circumstances, and why. Methods and analysis We are undertaking a realist review of the batterer treatment programme literature with the aim of addressing this gap. Keeping with the goals of realist review, our primary aims are to identify the theory that underlies these programmes, highlight the mechanisms that trigger changes in participant behaviour and finally explain why these programmes help some individuals reduce their use of violence and under what conditions they are effective or not effective. We begin by describing the process of perpetrator treatment, and by proposing an initial theoretical model of behaviour change that will be tested by our review. We then describe the criteria for inclusion of an evaluation into the review, the search strategy we will use to identify the studies, and the plan for data extraction and analysis. Ethics and dissemination The results of this review will be written up using the RAMESES Guidelines for Realist Synthesis, and disseminated through peer-reviewed publications aimed at the practitioner community as well as presented at community forums, and at violence against women conferences. Ethics approval was not needed. PMID:27053268

  6. Understanding Treatment-seeking Smokers’ Motivation to Change: Content Analysis of the Decisional Balance Worksheet

    PubMed Central

    Collins, Susan E.; Eck, Sandra; Torchalla, Iris; Schröter, Martina; Batra, Anil

    2012-01-01

    The Decisional Balance Worksheet (DBW), an open-ended measure of motivation to change, may be used to record the pros and cons of smoking versus abstinence among treatment-seeking smokers. Recent findings indicated that the open-ended DBW could be quantified to validly reflect people’s level of motivation to stop smoking (Collins, Eck, Torchalla, Schröter, & Batra, 2010). The goal of the current study was to enhance our understanding of these participants’ motivation to change by examining the qualitative content of their decisional balance. Participants were treatment-seeking smokers (N=268) who had participated in a larger randomized controlled trial of tailored smoking cessation interventions (Batra et al., 2010). Using the DBW, participants recorded their pros and cons of smoking versus abstinence, and content analysis methods were used to extract common themes. Findings indicated that the physical and psychological effects/functions of smoking and abstinence were most commonly mentioned as both pros and cons. Although the decisional balance categories were substantively similar over time, their relative frequency shifted from pre- to posttreatment. For the sample as a whole, the number of pros of smoking generally decreased, whereas the pros of abstinence increased from pre- to posttreatment. Findings suggest clinicians can expect certain perceived pros and cons to characterize their clients’ decision-making process about smoking and abstinence. At the same time, the use of the decisional balance allows for assessment of individuals’ unique motivational set. PMID:23017735

  7. Treatment with teriparatide might be associated with cardiometabolic changes in postmenopausal severe osteoporotic women.

    PubMed

    Passeri, E; Dozio, E; Mendola, M; Costa, E; Bandera, F; Corsi Romanelli, M M; Corbetta, S

    2015-01-01

    Parathormone (PTH) has been suggested to affect the cardiovascular system. Teriparatide (TPT), the hormonally active 1-34 fragment of PTH, provides an anabolic treatment for osteoporosis. The aim of the present study was to evaluate the cardiometabolic effects of 18-month treatment with 20 μg/ die teriparatide subcutaneosly. Fourteen women with postmenopausal severe osteoporosis treated with once-daily sc 20 μg TPT (67.6 ± 2.5 years; BMI 27.7 ± 1.0 kg/m²) and 24 age- and BMI-matched severe osteoporotic women treated with iv yearly 5 mg zoledronate (ZLN) were evaluated at baseline and at 12-18 months of treatment for anthropometric measures, calcium, glucose and lipid metabolic parameters, and assessment of cardiac geometry by conventional echocardiography. TPT was effective in increasing mean lumbar spine bone mineral density with no clinically relevant changes in calcium metabolism parameters. TPT patients experienced an increase of BMI (27.7 ± 1.0 at baseline vs 29.0 ± 1.0 kg/m² at last evaluation, P=0.005) and mean whole body fat percentage (37.0 ± 2.1 vs 40.3 ± 1.9%, P=0.05), associated with increased serum leptin levels (17.3 ± 2.1 vs 22.9 ± 3.0 ng/ml; P=0.049). Glucose and lipid parameters were not affected by TPT as well as by ZLN treatment. Furthermore, TPT was associated with a decrease in systolic blood pressure; a decrease in the fractional shortening (41.2 ± 2.3 vs 36.9 ± 1.2; P=0.05) and an increase in the relative wall thickness (0.39 ± 0.01 vs 0.48 ± 0.01 mm; P=0.002), suggestive for concentric cardiac remodeling, was detected by echocardiographic monitoring. These changes could not be detected in bone active drug-free age- and metabolic-matched controls. In conclusion, long-term TPT therapy might affect cardiometabolic and cardiac geometry parameters in severe osteoporotic women, though changes are not clinically relevant.

  8. The empirical war on drugs.

    PubMed

    Vitellone, Nicole

    2013-05-01

    In a special issue of the journal Addictions (1995) academics, researchers and health care professionals debated the status of the empirical in socially orientated drugs research. A number of researchers noted that our knowledge and understanding of drugs and drug users has changed significantly since the 1990s. Post AIDS this shift is identified as a consequence of the development of qualitative research methods. The qualitative turn in drugs research has involved a shift away form traditional epidemiological approaches and the pursuit of more socially focused methods. Whilst qualitative research has yielded important empirical data on risk behavior the pursuit of these methods has not been without controversy. In addressing the debate on methods in the drugs field this article investigates the effects of social science methods for research on injecting drug use. In so doing I examine what counts and what gets left out of research on injecting beaviour. Drawing on Actor Network Theory (ANT) I suggest Bruno Latour's methodological approach offers critical insights for addressing the empirical objects of injecting drug use. PMID:23528994

  9. Impact of DSM-5 Changes on the Diagnosis and Acute Treatment of Schizophrenia

    PubMed Central

    Mattila, Taina; Koeter, Maarten; Wohlfarth, Tamar; Storosum, Jitschak; van den Brink, Wim; de Haan, Lieuwe; Derks, Eske; Leufkens, Hubertus; Denys, Damiaan

    2015-01-01

    Objective: To examine the consequences and validity of changes in Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 diagnostic criteria for schizophrenia, eg, omission of subtypes, using a large dataset of double-blind, randomized, placebo-controlled schizophrenia trials. Methods: Data from 22 short-term efficacy registration trials of second generation antipsychotics for the treatment of acute psychotic episodes in patients with schizophrenia (N = 5233), submitted to the Dutch regulatory authority were analyzed. We examined whether patients in these pre-DSM-5 trials met the diagnostic criteria for schizophrenia according to DSM-5. Using linear regression, we examined differences in effect size between DSM-IV subtypes and between DSM-5 symptom dimensions. Results: Over 99.5% of the patients met DSM-5 diagnostic criteria for schizophrenia and no differences in effect size were found between schizophrenia subtypes (P = .65). Symptom dimensions that respond best to treatment with second generation antipsychotics were hallucinations, delusions, disorganized speech, and mania (Hedge’s g −0.23 to −0.31). Conclusions: Results of clinical trials in patients with pre-DSM-5 schizophrenia also apply to patients diagnosed with DSM-5 schizophrenia. Omission of the classic subtypes is justified as they are not predictive of response to treatment. The DSM-5 C-RDPSS scale adds valuable information to the categorical diagnosis of schizophrenia, which is relevant for antipsychotic response. PMID:25528758

  10. Cognitive and emotional behavioural changes associated with methylphenidate treatment: a review of preclinical studies.

    PubMed

    Britton, Gabrielle B

    2012-02-01

    There is evidence from animal studies that repeated exposure to methylphenidate (MPH), a widely used psychostimulant for the treatment of attention deficit hyperactivity disorder (ADHD), produces behavioural, structural and neurochemical changes that persist long after drug administration has ended. However, the translational utility of much of this work is compromised by the use of drug doses and routes of administration that produce plasma and brain MPH levels that fall outside the clinical range, i.e. experimental parameters more relevant to drug abuse than ADHD. We used PubMed to identify pre-clinical studies that employed repeated MPH administration at low doses in young rodents and examined long-term effects on cognition, emotion, and brain structure and function. A review of this work suggests that repeated MPH treatment during early development can modify a number of cognitive, behavioural and brain processes, but these are reduced when low therapeutic doses are employed. Moreover, MPH sites of action extend beyond those implicated in ADHD. Studies that combined neurobiological and behavioural approaches provide important insights into the mechanisms underlying MPH-produced effects on cognitive and behavioural processes, which may be relevant to MPH therapeutic efficacy. There is an emerging consensus that pharmacological treatment of childhood psychiatric disorders produces persistent neuroadaptations, highlighting the need for studies that assess long-term effects of early developmental pharmacotherapy. In this regard, studies that mimic clinical therapy with rodents are useful experimental approaches for defining the behavioural and neural plasticity associated with stimulant therapy in paediatric populations.

  11. 78 FR 6316 - Empire Pipeline, Inc. (Empire); Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-30

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Empire Pipeline, Inc. (Empire); Notice of Filing Take notice that on November 29, 2012 Empire Pipeline Company (Empire) submitted a request for a waiver of the...

  12. Raman spectroscopy detects biomolecular changes associated with nanoencapsulated hesperetin treatment in experimental oral carcinogenesis

    NASA Astrophysics Data System (ADS)

    Gurushankar, K.; Gohulkumar, M.; Kumar, Piyush; Krishna, C. Murali; Krishnakumar, N.

    2016-03-01

    Recently it has been shown that Raman spectroscopy possesses great potential in the investigation of biomolecular changes of tumor tissues with therapeutic drug response in a non-invasive and label-free manner. The present study is designed to investigate the antitumor effect of hespertin-loaded nanoparticles (HETNPs) relative to the efficacy of native hesperetin (HET) in modifying the biomolecular changes during 7,12-dimethyl benz(a)anthracene (DMBA)-induced oral carcinogenesis using a Raman spectroscopic technique. Significant differences in the intensity and shape of the Raman spectra between the control and the experimental tissues at 1800-500 cm-1 were observed. Tumor tissues are characterized by an increase in the relative amount of proteins, nucleic acids, tryptophan and phenylalanine and a decrease in the percentage of lipids when compared to the control tissues. Further, oral administration of HET and its nanoparticulates restored the status of the lipids and significantly decreased the levels of protein and nucleic acid content. Treatment with HETNPs showed a more potent antitumor effect than treatment with native HET, which resulted in an overall reduction in the intensity of several biochemical Raman bands in DMBA-induced oral carcinogenesis being observed. Principal component and linear discriminant analysis (PC-LDA), together with leave-one-out cross validation (LOOCV) on Raman spectra yielded diagnostic sensitivities of 100%, 80%, 91.6% and 65% and specificities of 100%, 65%, 60% and 55% for classification of control versus DMBA, DMBA versus DMBA  +  HET, DMBA versus DMBA  +  HETNPs and DMBA  +  HET versus DMBA  +  HETNPs treated tissue groups, respectively. These results further demonstrate that Raman spectroscopy associated with multivariate statistical algorithms could be a valuable tool for developing a comprehensive understanding of the process of biomolecular changes, and could reveal the signatures of the

  13. Detection of Treatment-Induced Changes in Signaling Pathways in Gastrointestinal Stromal Tumors using Transcriptomic Data

    PubMed Central

    Ochs, Michael F.; Rink, Lori; Tarn, Chi; Mburu, Sarah; Taguchi, Takahiro; Eisenberg, Burton; Godwin, Andrew K.

    2009-01-01

    Cell signaling plays a central role in the etiology of cancer. Numerous therapeutics in use or under development target signaling proteins, however off-target effects often limit assignment of positive clinical response to the intended target. As direct measurements of signaling protein activity are not generally feasible during treatment, there is a need for more powerful methods to determine if therapeutics inhibit their targets and when off-target effects occur. We have used the Bayesian Decomposition algorithm and data on transcriptional regulation to create a novel methodology, DESIDE (Differential Expression for SIgnaling DEtermination), for inferring signaling activity from microarray measurements. We applied DESIDE to deduce signaling activity in gastrointestinal stromal tumor cell lines treated with the targeted therapeutic imatinib mesylate (Gleevec). We detected the expected reduced activity in the KIT pathway, as well as unexpected changes in the P53 pathway. Pursuing these findings, we have determined that imatinib-induced DNA damage is responsible for the increased activity of P53, identifying a novel off-target activity for this drug. We then used DESIDE on data from resected, post-imatinib treatment tumor samples and identified a pattern in these tumors similar to that at late time points in the cell lines, and this pattern correlated with initial clinical response. The pattern showed increased activity of ELK1 and STAT3 transcription factors, which are associated with the growth of side population cells. DESIDE infers the global reprogramming of signaling networks during treatment, permitting treatment modification that leverages ongoing drug development efforts, which is crucial for personalized medicine. PMID:19903850

  14. Changes in hypertension prevalence, awareness, treatment, and control rates in Turkey from 2003 to 2012

    PubMed Central

    Sengul, Sule; Akpolat, Tekin; Erdem, Yunus; Derici, Ulver; Arici, Mustafa; Sindel, Sukru; Karatan, Oktay; Turgan, Cetin; Hasanoglu, Enver; Caglar, Sali; Erturk, Sehsuvar

    2016-01-01

    Objectives: The study aimed to assess the current epidemiology of hypertension, including its prevalence, the awareness of the condition and its treatment and control, in Turkey to evaluate changes in these factors over the last 10 years by comparing the results with the prevalence, awareness, treatment, and control of hypertension in Turkey (PatenT) study data (2003), as well as to assess parameters affecting awareness and the control of hypertension. Methods: The PatenT 2 study was conducted on a representative sample of the Turkish adult population (n = 5437) in 2012. Specifically trained staff performed the data collection. Hypertension was defined as mean SBP or DBP at least 140/90 mmHg, previously diagnosed disease or the use of antihypertensive medication. Awareness and treatment were assessed by self-reporting, and control was defined as SBP/DBP less than 140/90 mmHg. Results: Although the prevalence of hypertension in the PatenT and PatenT 2 surveys was stable at approximately 30%, hypertension awareness, treatment, and control rates have improved in Turkey. Overall, 54.7% of hypertensive patients were aware of their diagnosis in 2012 compared with 40.7% in 2003. The hypertension treatment rate increased from 31.1% in 2003 to 47.4% in 2012, and the control rate in hypertensives increased from 8.1% in 2003 to 28.7% in 2012. The rate of hypertension control in treated patients improved between 2003 (20.7%) and 2012 (53.9%). Awareness of hypertension was positively associated with older age, being a woman, residing in an urban area, a history of parental hypertension, being a nonsmoker, admittance by a physician, presence of diabetes mellitus, and being obese or overweight; it was inversely associated with a higher amount of daily bread consumption. Factors associated with better control of hypertension were younger age, female sex, residing in an urban area, and higher education level in Turkey. Conclusion: Although some progress has been made in

  15. Structural Changes of Erythrocyte Surface Glycoconjugates after Treatment with Medicinal Mushrooms.

    PubMed

    Vitak, Taras Y; Wasser, Solomon P; Nevo, Eviatar; Sybirna, Nataliya O

    2015-01-01

    Under conditions of chronic hyperglycemia there is dysregulation of ion homeostasis, violation of redox metabolism and functioning of membrane enzymes, as well as changes in the structural and functional states of erythrocyte membranes. As a result, the aggregation ability of erythrocytes increased and their deformability decreased. These changes lead to complications to microcirculation blood flow and provoke the development of vascular complications caused by diabetes mellitus. This study investigated the effect of the medicinal mushrooms Agaricus brasiliensis and Ganoderma lucidum on the structure of carbohydrate determinants of surface membrane glycoconjugates of rat peripheral blood erythrocytes under both normal conditions and streptozotocin-induced diabetes mellitus. The research was carried out using Wistar outbred white rats. Diabetes was induced by streptozotocin intraperitoneally injected once at a dose of 50 mg/kg body weight. The mushroom preparations were orally administered at a dose of 1 g/kg for 14 days. The treatment of diabetic rats by submerged culture mycelium powder restored the physiological balance between sialylation and desialylation processes, renewed the membrane surface charge of red blood cells, normalized aggregation properties, and caused the structural recovery of oligosaccharide chains of erythrocyte membrane surface glycoconjugates. The discovered changes show an improvement in the erythrocyte functional state and rejuvenation of their population caused by biologically active compounds of the studied medicinal mushrooms.

  16. Changes in the structure and antioxidant properties of onions by high pressure treatment.

    PubMed

    Vázquez-Gutiérrez, José Luis; Plaza, Lucía; Hernando, Isabel; Sánchez-Moreno, Concepción; Quiles, Amparo; de Ancos, Begoña; Cano, M Pilar

    2013-04-25

    Onions have antioxidant properties and they are an important source of bioactive compounds such as phenols. The aim of this work was to study the effect of high hydrostatic pressure (HHP) (100-600 MPa/1-3 min/25 °C) on the microstructure and antioxidant properties of onions (cv. Doux) and its relationship with changes in the extractability of potential health-related compounds. Cryo scanning electron microscopy was used to study the microstructure. Vitamin C, total phenolic content and antioxidant activity (DPPH˙, ABTS˙(+), FRAP) were also analyzed. Tonoplast, plasmalemma and cell walls were affected by the HHP treatment and it favored the diffusion of the cellular content to the intercellular spaces. Vitamin C did not show significant changes, whereas the extracted phenolic content and antioxidant activity increased at pressures of 300 or 600 MPa. Therefore, it could be concluded that HHP produced changes in membrane permeability and disruption of cell walls favoring the release of phenolic compounds from tissue and, in consequence, improving their extractability.

  17. Structural Changes of Erythrocyte Surface Glycoconjugates after Treatment with Medicinal Mushrooms.

    PubMed

    Vitak, Taras Y; Wasser, Solomon P; Nevo, Eviatar; Sybirna, Nataliya O

    2015-01-01

    Under conditions of chronic hyperglycemia there is dysregulation of ion homeostasis, violation of redox metabolism and functioning of membrane enzymes, as well as changes in the structural and functional states of erythrocyte membranes. As a result, the aggregation ability of erythrocytes increased and their deformability decreased. These changes lead to complications to microcirculation blood flow and provoke the development of vascular complications caused by diabetes mellitus. This study investigated the effect of the medicinal mushrooms Agaricus brasiliensis and Ganoderma lucidum on the structure of carbohydrate determinants of surface membrane glycoconjugates of rat peripheral blood erythrocytes under both normal conditions and streptozotocin-induced diabetes mellitus. The research was carried out using Wistar outbred white rats. Diabetes was induced by streptozotocin intraperitoneally injected once at a dose of 50 mg/kg body weight. The mushroom preparations were orally administered at a dose of 1 g/kg for 14 days. The treatment of diabetic rats by submerged culture mycelium powder restored the physiological balance between sialylation and desialylation processes, renewed the membrane surface charge of red blood cells, normalized aggregation properties, and caused the structural recovery of oligosaccharide chains of erythrocyte membrane surface glycoconjugates. The discovered changes show an improvement in the erythrocyte functional state and rejuvenation of their population caused by biologically active compounds of the studied medicinal mushrooms. PMID:26756299

  18. White matter changes in patients with Friedreich ataxia after treatment with erythropoietin

    PubMed Central

    Egger, Karl; Clemm von Hohenberg, Christian; Schocke, Michael F; Guttmann, Charles RG; Wassermann, Demian; Wigand, Marlene C; Nachbauer, Wolfgang; Kremser, Christian; Sturm, Brigitte; Scheiber-Mojdehkar, Barbara; Kubicki, Marek; Shenton, Martha E; Boesch, Sylvia

    2013-01-01

    Background and Purpose Erythropoietin (EPO) has received growing attention because of its neuro-regenerative properties. Preclinical and clinical evidence supports its therapeutic potential in brain conditions like stroke, multiple sclerosis and schizophrenia. Also in Friedreich ataxia, clinical improvement after EPO therapy was shown. The aim of the present study was to assess possible therapy-associated brain white-matter changes in these patients. Methods Nine patients with Friedreich ataxia underwent Diffusion Tensor Imaging (DTI) before and after EPO treatment. Tract-based spatial statistics (TBSS) was used for longitudinal comparison. Results We detected widespread longitudinal increase in fractional anisotropy (FA) and axial diffusivity (D||) in cerebral hemispheres bilaterally (p<0.05, corrected), while no changes were observed within the cerebellum, medulla oblongata and pons. Conclusions To the best of our knowledge, this is the first DTI study to investigate the effects of erythropoietin in a neurodegenerative disease. Anatomically, the diffusivity changes appear disease-unspecific, and their biological underpinnings deserve further study. PMID:24015771

  19. A decade of change in clinical waste treatment and disposal in Scotland.

    PubMed

    Wassermann, D

    1999-12-01

    Ten years ago there were over 150 small incinerators located on hospital premises throughout Scotland. The majority were operated by portering staff, had poor combustion and no gas cleaning equipment. At that time alternatives to incineration were in their infancy and relatively expensive. Funding for major capital projects lay with the Government, and a strategic study suggested the installation of 12 centralised modern incinerators on the mainland and three on the islands: one per Scottish Health Board. Some health boards proceeded with new installations well ahead of dead-lines for closure of old plant. Others adopted a 'wait and see' policy and were overtaken by political changes. These resulted in a cutback in government-funded capital investment and a shift of non-core services to the private sector. Clinical waste disposal was contracted out as a service contract and some private sector companies offered alternative low-temperature technologies for clinical waste treatment. As a result there is now the opportunity to compare the advantages and disadvantages of incineration, sterilization, dry heat disinfection and other techniques. Technological change has also required revised waste segregation methods within the hospitals. In parallel with this there has been an overall reduction in waste quantities. The remaining incinerator operators are now faced with more stringent emission limits to be implemented by June 2000. This is resulting in closures of incinerators that have been operating for a few years. The situation continues to change. PMID:10747462

  20. Changes in brain connectivity related to the treatment of depression measured through fMRI: a systematic review

    PubMed Central

    Gudayol-Ferré, Esteve; Peró-Cebollero, Maribel; González-Garrido, Andrés A.; Guàrdia-Olmos, Joan

    2015-01-01

    Depression is a mental illness that presents alterations in brain connectivity in the Default Mode Network (DMN), the Affective Network (AN) and other cortical-limbic networks, and the Cognitive Control Network (CCN), among others. In recent years the interest in the possible effect of the different antidepressant treatments on functional connectivity has increased substantially. The goal of this paper is to conduct a systematic review of the studies on the relationship between the treatment of depression and brain connectivity. Nineteen studies were found in a systematic review on this topic. In all of them, there was improvement of the clinical symptoms after antidepressant treatment. In 18 out of the 19 studies, clinical improvement was associated to changes in brain connectivity. It seems that both DMN and the connectivity between cortical and limbic structures consistently changes after antidepressant treatment. However, the current evidence does not allow us to assure that the treatment of depression leads to changes in the CCN. In this regard, some papers report a positive correlation between changes in brain connectivity and improvement of depressive symptomatology, particularly when they measure cortical-limbic connectivity, whereas the changes in DMN do not significantly correlate with clinical improvement. Finally, some papers suggest that changes in connectivity after antidepressant treatment might be partly related to the mechanisms of action of the treatment administered. This effect has been observed in two studies with stimulation treatment (one with rTMS and one with ECT), and in two papers that administered three different pharmacological treatments. Our review allows us to make a series of recommendations that might guide future researchers exploring the effect of anti-depression treatments on brain connectivity. PMID:26578927

  1. Attachment-Based Family Therapy: A Review of the Empirical Support.

    PubMed

    Diamond, Guy; Russon, Jody; Levy, Suzanne

    2016-09-01

    Attachment-based family therapy (ABFT) is an empirically supported treatment designed to capitalize on the innate, biological desire for meaningful and secure relationships. The therapy is grounded in attachment theory and provides an interpersonal, process-oriented, trauma-focused approach to treating adolescent depression, suicidality, and trauma. Although a process-oriented therapy, ABFT offers a clear structure and road map to help therapists quickly address attachment ruptures that lie at the core of family conflict. Several clinical trials and process studies have demonstrated empirical support for the model and its proposed mechanism of change. This article provides an overview of the clinical model and the existing empirical support for ABFT. PMID:27541199

  2. CBT for Childhood Anxiety Disorders: Differential Changes in Selective Attention between Treatment Responders and Non-Responders

    ERIC Educational Resources Information Center

    Legerstee, Jeroen S.; Tulen, Joke H. M.; Dierckx, Bram; Treffers, Philip D. A.; Verhulst, Frank C.; Utens, Elisabeth M. W. J.

    2010-01-01

    Background: This study examined whether treatment response to stepped-care cognitive-behavioural treatment (CBT) is associated with changes in threat-related selective attention and its specific components in a large clinical sample of anxiety-disordered children. Methods: Ninety-one children with an anxiety disorder were included in the present…

  3. Treatment-associated changes in body composition, health behaviors, and mood as predictors of change in body satisfaction in obese women: effects of age and race/ethnicity.

    PubMed

    Annesi, James J; Tennant, Gisèle A; Mareno, Nicole

    2014-12-01

    A lack of satisfaction with one's body is common among women with obesity, often prompting unhealthy "dieting." Beyond typically slow improvements in weight and body composition, behavioral factors might also affect change in body satisfaction. Age and race/ethnicity (African American vs. White) might moderate such change. Obese women (N = 246; M(age) = 43 years; M BMI = 39 kg/m(2)) initiating a 6-month cognitive-behaviorally based physical activity and nutrition treatment were assessed on possible predictors of body satisfaction change. At baseline, African American and younger women had significantly higher body satisfaction. The treatment was associated with significant within-group improvements in mood, health behaviors (physical activity and fruit/vegetable intake), and body composition (waist circumference). A multiple regression analysis indicated that mood, health behavior, and body composition changes explained a significant 27% of the variance in body satisfaction change. Of these predictors, changes in mood (β = -.36, p < .001) and health behaviors (β = .18, p = .01) made significant, unique contributions to the variance in change in body satisfaction that was accounted for, while only the measure of actual physiological change (body composition) did not. Neither age nor race/ethnicity was a significant moderator when each was entered separately into the multiple regression equation. Practical implications for leveraging manageable changes in behavioral factors for improving body satisfaction were discussed.

  4. The 2015 hospital treatment choice reform in Norway: Continuity or change?

    PubMed

    Ringard, Ånen; Saunes, Ingrid Sperre; Sagan, Anna

    2016-04-01

    In several European countries, including Norway, polices to increase patient choice of hospital provider have remained high on the political agenda. The main reason behind the interest in hospital choice reforms in Norway has been the belief that increasing choice can remedy the persistent problem of long waiting times for elective hospital care. Prior to the 2013 General Election, the Conservative Party campaigned in favour of a new choice reform: "the treatment choice reform". This article describes the background and process leading up to introduction of the reform in the autumn of 2015. It also provides a description of the content and discusses possible implications of the reform for patients, providers and government bodies. In sum, the reform contains elements of both continuity and change. The main novelty of the reform lies in the increased role of private for-profit healthcare providers. PMID:27005300

  5. Surface profile changes of scuffed bearing surfaces. [before and after acid treatment

    NASA Technical Reports Server (NTRS)

    Lauer, J. L.; Fung, S. S.; Jones, W. R., Jr.

    1982-01-01

    A phase locked interference microscope capable of resolving depth differences to 30 A and planar displacements of 6000 A was constructed for the examination of the profiles of bearing surfaces without physical contact. This instrument was used to determine surface chemical reactivity by applying a drop of dilute alcoholic hydrochloric acid and measuring the profile of the solid surface before and after application of this probe. Scuffed bearing surfaces reacted much faster than unscuffed ones, but bearing surfaces which had been previously exposed to lubricants containing an organic chloride reacted much more slowly. In a separate series of experiments, a number of stainless steel plates were heated in a nitrogen atmosphere to different temperatures and their reactivity examined later at room temperature. The change of surface contour as a result of the probe reaction followed an Arrhenius type relation with respect to heat treatment temperature. This result could have implications on the scuffing mechanism.

  6. Effect of chelation treatment with dimercaptosuccinic acid (DMSA) on lead-related blood pressure changes

    SciTech Connect

    Khalil-Manesh, F.; Gonick, H.C.; Weiler, E.W.J. Univ. of California, Los Angeles ); Prins, B.; Purdy, R. ); Weber, M.A. Univ. of California, Irvine ); Ren, Qing )

    1994-04-01

    An elevation in mean blood pressure was found in rats treated with low lead (0.01%) for 6 months and then only water for an additional 6 months (discontinuous low lead). Not change in blood pressure was found in rats similarly treated with high lead (0.5%) (discontinuous high lead). Administration of DMSA (0.5% in drinking water), for 5 days every 2 months following cessation of lead administration, resulted in a significant lowering of blood pressure in both groups of animals. In the low-lead but not the high-lead group, this was associated with an increase in plasma cyclic GMP (acting as a second messenger for endothelium-derived relaxing factor, EDRF) and a decrease in the plasma concentration of 12-kDa hypertension-associated protein. Plasma endothelin-3 (ET-3) levels were decreased in discontinuous high-lead rats, increased in dicontinuous low-lead rats, but were unaltered by DMSA treatment. We infer that the elevated blood pressure in the discontinuous low-lead rats is related to an increase in the putative vasoconstrictors, ET-3 and the hypertension-associated protein, without a change in the vasodilator, EDRF. With DMSA treatment, plasma cyclic GMP in low-lead rats increased above normal, and the hypertension-associated protein decreased, resulting in lowered blood pressure. DMSA was shown to act as an antioxidant in vitro. Thus the DMSA effect on plasma cGMP (EDRF) may occur via a scavenging effect on EDRF-inactivating reactive oxygen species. 34 refs., 7 figs., 4 tabs.

  7. Changes in Initial Treatment for Prostate Cancer Among Medicare Beneficiaries, 1999-2007

    SciTech Connect

    Dinan, Michaela A.; Robinson, Timothy J.; Zagar, Timothy M.; Scales, Charles D.; Curtis, Lesley H.; Reed, Shelby D.; Lee, W. Robert; Schulman, Kevin A.

    2012-04-01

    Purpose: In the absence of evidence from large clinical trials, optimal therapy for localized prostate cancer remains unclear; however, treatment patterns continue to change. We examined changes in the management of patients with prostate cancer in the Medicare population. Methods and Materials: We conducted a retrospective claims-based analysis of the use of radiation therapy, surgery, and androgen deprivation therapy in the 12 months after diagnosis of prostate cancer in a nationally representative 5% sample of Medicare claims. Patients were Medicare beneficiaries 67 years or older with incident prostate cancer diagnosed between 1999 and 2007. Results: There were 20,918 incident cases of prostate cancer between 1999 and 2007. The proportion of patients receiving androgen deprivation therapy decreased from 55% to 36%, and the proportion of patients receiving no active therapy increased from 16% to 23%. Intensity-modulated radiation therapy replaced three-dimensional conformal radiation therapy as the most common method of radiation therapy, accounting for 77% of external beam radiotherapy by 2007. Minimally invasive radical prostatectomy began to replace open surgical approaches, being used in 49% of radical prostatectomies by 2007. Conclusions: Between 2002 and 2007, the use of androgen deprivation therapy decreased, open surgical approaches were largely replaced by minimally invasive radical prostatectomy, and intensity-modulated radiation therapy replaced three-dimensional conformal radiation therapy as the predominant method of radiation therapy in the Medicare population. The aging of the population and the increasing use of newer, higher-cost technologies in the treatment of patients with prostate cancer may have important implications for nationwide health care costs.

  8. Viability and morphological changes of Acanthamoeba spp. cysts after treatment with Effective microorganisms (EM).

    PubMed

    Sampaotong, Tanitta; Lek-Uthai, Usa; Roongruangchai, Jantima; Roongruangchai, Kosol

    2016-06-01

    Acanthamoeba is a free-living opportunistic protozoan parasite that is found in diverse environments. It can cause keratitis, mostly related to inappropriate use of contact lenses, as well as life threatening diseases including encephalitis, disseminated sinusitis, and skin ulcers. This study investigated morphological changes and fine structures of the cyst form of Acanthamoeba spp. after treatment with effective microorganisms (EM™) using light and scanning electron microscopies. Acanthamoeba cysts treated with 1:2, 1:4, 1:6, and undiluted EM™ showed higher percentages of non-viable cysts than those treated with 1:8, 1:10, 1:100, 1:200, and 1:400 EM™ and at 5 days post-treatment developed from cystic stage to trophozoite stage. Acanthamoeba cysts treated at concentrations of 1:2, 1:4, 1:6, and undiluted EM™ exhibited cytoplasmic clumping and shrinkage of amoeba cells away from cyst walls. The effective EM™ concentration lethal to Acanthamoeba spp. cyst could provide information to monitor the environmental control system. PMID:27413306

  9. Raman spectroscopic evaluation of meat batter structural changes induced by thermal treatment and salt addition.

    PubMed

    Herrero, A M; Carmona, P; López-López, I; Jiménez-Colmenero, F

    2008-08-27

    Raman spectroscopy, texture, proximate composition, and water binding analysis were carried out to evaluate the effect of thermal treatment and/or salt addition to meat batter. For this purpose, different meat batters were elaborated: control meat batter (no salt) and meat batters with low (1.0%) and high (2.5%) NaCl content with and without thermal treatment (70 degrees C/30 min). Increase (P < 0.05) in penetration force and hardness upon heating was observed. Results also showed hardness increasing (P < 0.05) as a function of salt addition in heated meat batter. Raman spectroscopy analysis revealed a significant (P < 0.05) decrease in alpha-helix content accompanied by an increase (P < 0.05) in beta-sheets resulting from heating. Significant (P < 0.05) correlations were found between these secondary structural changes in meat proteins and water binding and textural properties of meat batter. In this way, a significant correlation was found between beta-sheets, salt content, hardness, and chewiness in heated samples.

  10. Anthelmintic Treatment Does Not Change Foraging Strategies of Female Eastern Grey Kangaroos, Macropus giganteus.

    PubMed

    Cripps, Jemma K; Martin, Jennifer K; Coulson, Graeme

    2016-01-01

    Large mammalian herbivores are commonly infected with gastrointestinal helminths. Heavily parasitised hosts are likely to have increased nutritional requirements and would be predicted to increase their food intake to compensate for costs of being parasitised, but experimental tests of the impacts of these parasites on the foraging efficiency of hosts are lacking, particularly in free-ranging wildlife. We conducted a field experiment on a population of free-ranging eastern grey kangaroos (Macropus giganteus) to test this prediction, removing nematodes from one group of adult females using an anthelmintic treatment. We then carried out observations before and following treatment to assess the influence of parasites on foraging behaviour. Contrary to our predictions, the manipulation of parasite burdens did not result in changes in any of the key foraging variables we measured. Our results suggest that despite carrying large burdens of gastrointestinal parasites, the foraging strategy of female kangaroos is likely be driven by factors unrelated to parasitism, and that kangaroos in high nutritional environments may be able acquire sufficient nutrients to offset the costs of parasitism. We conclude that the drivers of forage intake likely differ between domesticated and free-ranging herbivores, and that free-ranging hosts are likely more resilient to parasitism. PMID:26784582

  11. The changing face of acromegaly--advances in diagnosis and treatment.

    PubMed

    Ribeiro-Oliveira, Antônio; Barkan, Ariel

    2012-10-01

    Acromegaly is a chronic disease characterized by the presence of a pituitary growth hormone (GH)-producing tumour, excessive secretion of growth hormone, raised levels of insulin-like growth factor I (IGF-I) and characteristic clinical presentation of acral enlargement. Over the past two decades, major advances have occurred in the understanding of some aspects of acromegaly--such as the biology of pituitary tumours, the physiology, molecular mechanisms of GH secretion and IGF-I generation, and the pathogenesis of comorbidities. Moreover, new approaches to diagnosis and surveillance (both in terms of screening and follow-up) of acromegaly have led to increases in the number of patients diagnosed with active disease, many of whom would previously have been missed. The development of sensitive assays for detecting plasma GH and IGF-I levels, as well as the widespread use of MRI for visualization of small tumours, have been major contributing factors to these improvements. Treatment advances have resulted in improved cure rates and disease control through novel neurosurgical techniques and pharmacological approaches. This Review summarizes and discusses the changes in our understanding of the epidemiology, diagnosis, treatment, and follow-up of acromegaly and its comorbidities.

  12. Anthelmintic Treatment Does Not Change Foraging Strategies of Female Eastern Grey Kangaroos, Macropus giganteus

    PubMed Central

    Cripps, Jemma K.; Martin, Jennifer K.; Coulson, Graeme

    2016-01-01

    Large mammalian herbivores are commonly infected with gastrointestinal helminths. Heavily parasitised hosts are likely to have increased nutritional requirements and would be predicted to increase their food intake to compensate for costs of being parasitised, but experimental tests of the impacts of these parasites on the foraging efficiency of hosts are lacking, particularly in free-ranging wildlife. We conducted a field experiment on a population of free-ranging eastern grey kangaroos (Macropus giganteus) to test this prediction, removing nematodes from one group of adult females using an anthelmintic treatment. We then carried out observations before and following treatment to assess the influence of parasites on foraging behaviour. Contrary to our predictions, the manipulation of parasite burdens did not result in changes in any of the key foraging variables we measured. Our results suggest that despite carrying large burdens of gastrointestinal parasites, the foraging strategy of female kangaroos is likely be driven by factors unrelated to parasitism, and that kangaroos in high nutritional environments may be able acquire sufficient nutrients to offset the costs of parasitism. We conclude that the drivers of forage intake likely differ between domesticated and free-ranging herbivores, and that free-ranging hosts are likely more resilient to parasitism. PMID:26784582

  13. Anthelmintic Treatment Does Not Change Foraging Strategies of Female Eastern Grey Kangaroos, Macropus giganteus.

    PubMed

    Cripps, Jemma K; Martin, Jennifer K; Coulson, Graeme

    2016-01-01

    Large mammalian herbivores are commonly infected with gastrointestinal helminths. Heavily parasitised hosts are likely to have increased nutritional requirements and would be predicted to increase their food intake to compensate for costs of being parasitised, but experimental tests of the impacts of these parasites on the foraging efficiency of hosts are lacking, particularly in free-ranging wildlife. We conducted a field experiment on a population of free-ranging eastern grey kangaroos (Macropus giganteus) to test this prediction, removing nematodes from one group of adult females using an anthelmintic treatment. We then carried out observations before and following treatment to assess the influence of parasites on foraging behaviour. Contrary to our predictions, the manipulation of parasite burdens did not result in changes in any of the key foraging variables we measured. Our results suggest that despite carrying large burdens of gastrointestinal parasites, the foraging strategy of female kangaroos is likely be driven by factors unrelated to parasitism, and that kangaroos in high nutritional environments may be able acquire sufficient nutrients to offset the costs of parasitism. We conclude that the drivers of forage intake likely differ between domesticated and free-ranging herbivores, and that free-ranging hosts are likely more resilient to parasitism.

  14. Structural and biomechanical changes in the Achilles tendon after chronic treatment with statins.

    PubMed

    de Oliveira, L P; Vieira, C P; Guerra, F D; Almeida, M S; Pimentel, E R

    2015-03-01

    Cases of tendinopathy and tendon ruptures have been reported as side effects associated with statin therapy. This work assessed possible changes in the structural and biomechanical properties of the tendons after chronic treatment with statins. Wistar rats were divided into the following groups: treated with atorvastatin (A-20 and A-80), simvastatin (S-20 and S-80) and the group that received no treatment (C). The doses of statins were calculated using allometric scaling, based on the doses of 80 mg/day and 20 mg/day recommended for humans. The morphological aspect of the tendons in A-20, S-20 and S-80 presented signals consistent with degeneration. Both the groups A-80 and S-80 showed a less pronounced metachromasia in the compression region of the tendons. Measurements of birefringence showed that A-20, A-80 and S-80 groups had a lower degree of organization of the collagen fibers. In all of the groups treated with statins, the thickness of the epitenon was thinner when compared to the C group. In the biomechanical tests the tendons of the groups A-20, A-80 and S-20 were less resistant to rupture. Therefore, statins affected the organization of the collagen fibers and decreased the biomechanical strength of the tendons, making them more predisposed to ruptures. PMID:25544391

  15. BnNHL18A shows a localization change by stress-inducing chemical treatments

    SciTech Connect

    Lee, Suk-Bae; Ham, Byung-Kook; Park, Jeong Mee; Kim, Young Jin; Paek, Kyung-Hee . E-mail: khpaek95@korea.ac.kr

    2006-01-06

    The two genes, named BnNHL18A and BnNHL18B, showing sequence homology with Arabidopsis NDR1/HIN1-like (NHL) genes, were isolated from cDNA library prepared with oilseed rape (Brassica napus) seedlings treated with NaCl. The transcript level of BnNHL18A was increased by sodium chloride, ethephon, hydrogen peroxide, methyl jasmonate, or salicylic acid treatment. The coding regions of BnNHL18A and BnNHL18B contain a sarcolipin (SLN)-like sequence. Analysis of the localization of smGFP fusion proteins showed that BnNHL18A is mainly localized to endoplasmic reticulum (ER). This result suggests that the SLN-like sequence plays a role in retaining proteins in ER membrane in plants. In response to NaCl, hydrogen peroxide, ethephon, and salicylic acid treatments, the protein localization of BnNHL18A was changed. Our findings suggest a common function of BnNHL18A in biotic and abiotic stresses, and demonstrate the presence of the shared mechanism of protein translocalization between the responses to plant pathogen and to osmotic stress.

  16. Microstructural changes of Zr702 induced by pulsed laser surface treatment

    NASA Astrophysics Data System (ADS)

    Chai, Linjiang; Chen, Baofeng; Wang, Shuyan; Guo, Ning; Huang, Can; Zhou, Zhiming; Huang, Weijiu

    2016-02-01

    In this work, the surface of a fully recrystallized Zr702 is treated by pulsed laser following which microstructural changes are investigated by use of electron backscatter diffraction and electron channeling contrast imaging techniques. The pulsed laser treatment results in three distinctly different microstructural features from the surface to the substrate: fine α plates with a few hundred nanometers in width (zone I), irregular-shaped grains with varied sizes (zone II), and essentially unchanged equiaxed grains (zone III). The α plates result from rapid phase transformation due to easy heat extraction of the pulsed laser with dense nanoscale twins inside those plates closer to the surface. The origin of the irregular-shaped grains is found to be related to insufficient recrystallization of antecedently formed α plates near the substrate. Hardness tests reveal highest value (∼356.7 HV) near the surface in zone I and the lowest value (∼165.2 HV) in zone II. Reasons accounting for the difference are discussed in terms of various microstructural characteristics induced by the pulsed laser surface treatment.

  17. Adolescent nicotine treatment changes the response of acetylcholine systems to subsequent nicotine administration in adulthood.

    PubMed

    Slotkin, Theodore A; Bodwell, Bethany E; Ryde, Ian T; Seidler, Frederic J

    2008-05-15

    Nicotine alters the developmental trajectory of acetylcholine (ACh) systems in the immature brain, with vulnerability extending from fetal stages through adolescence. We administered nicotine to adolescent rats (postnatal days PN30-47) and then examined the subsequent response to nicotine given in adulthood (PN90-107), simulating plasma levels in smokers, and performing evaluations during nicotine treatment (PN105) and withdrawal (PN110, PN120 and PN130), as well as assessing persistent changes at 6 months of age (PN180). We measured nicotinic acetylcholine receptor (nAChR) binding, choline acetyltransferase (ChAT) activity, a marker for ACh terminals, and hemicholinium-3 (HC3) binding to the choline transporter, an index of ACh presynaptic activity. By itself, adolescent nicotine exposure evoked sex-selective deficits in cerebrocortical HC3 binding while elevating ChAT in young adulthood in striatum and midbrain. Nicotine given in adulthood produced profound nAChR upregulation lasting 2 weeks after discontinuing treatment, and decrements in cerebrocortical and striatal HC3 binding emerged during withdrawal, indicative of reduced ACh synaptic activity. For all three parameters, adolescent nicotine altered the responses to nicotine given in adulthood, producing both sensitization and desensitization that depended on sex and brain region, effects that parallel the disparate behavioral outcomes reported for these treatments. The interaction seen here for the impact of adolescent nicotine exposure on adult nicotine responses was substantially greater than that found previously for the effects of prenatal nicotine exposure on adult responses. Our findings thus reinforce the importance of adolescence as a critical period in which the future responsiveness to nicotine is programmed.

  18. Adolescent nicotine treatment changes the response of acetylcholine systems to subsequent nicotine administration in adulthood.

    PubMed

    Slotkin, Theodore A; Bodwell, Bethany E; Ryde, Ian T; Seidler, Frederic J

    2008-05-15

    Nicotine alters the developmental trajectory of acetylcholine (ACh) systems in the immature brain, with vulnerability extending from fetal stages through adolescence. We administered nicotine to adolescent rats (postnatal days PN30-47) and then examined the subsequent response to nicotine given in adulthood (PN90-107), simulating plasma levels in smokers, and performing evaluations during nicotine treatment (PN105) and withdrawal (PN110, PN120 and PN130), as well as assessing persistent changes at 6 months of age (PN180). We measured nicotinic acetylcholine receptor (nAChR) binding, choline acetyltransferase (ChAT) activity, a marker for ACh terminals, and hemicholinium-3 (HC3) binding to the choline transporter, an index of ACh presynaptic activity. By itself, adolescent nicotine exposure evoked sex-selective deficits in cerebrocortical HC3 binding while elevating ChAT in young adulthood in striatum and midbrain. Nicotine given in adulthood produced profound nAChR upregulation lasting 2 weeks after discontinuing treatment, and decrements in cerebrocortical and striatal HC3 binding emerged during withdrawal, indicative of reduced ACh synaptic activity. For all three parameters, adolescent nicotine altered the responses to nicotine given in adulthood, producing both sensitization and desensitization that depended on sex and brain region, effects that parallel the disparate behavioral outcomes reported for these treatments. The interaction seen here for the impact of adolescent nicotine exposure on adult nicotine responses was substantially greater than that found previously for the effects of prenatal nicotine exposure on adult responses. Our findings thus reinforce the importance of adolescence as a critical period in which the future responsiveness to nicotine is programmed. PMID:18395624

  19. Empirically Based Myths: Astrology, Biorhythms, and ATIs.

    ERIC Educational Resources Information Center

    Ragsdale, Ronald G.

    1980-01-01

    A myth may have an empirical basis through chance occurrence; perhaps Aptitude Treatment Interactions (ATIs) are in this category. While ATIs have great utility in describing, planning, and implementing instruction, few disordinal interactions have been found. Article suggests narrowing of ATI research with replications and estimates of effect…

  20. Changes in bacterial community structure in a full-scale membrane bioreactor for municipal wastewater treatment.

    PubMed

    Hashimoto, Kurumi; Tsutsui, Hirofumi; Takada, Kazuki; Hamada, Hiroshi; Sakai, Kousuke; Inoue, Daisuke; Sei, Kazunari; Soda, Satoshi; Yamashita, Kyoko; Tsuji, Koji; Hashimoto, Toshikazu; Ike, Michihiko

    2016-07-01

    This study investigated changes in the structure and metabolic capabilities of the bacterial community in a full-scale membrane bioreactor (MBR) treating municipal wastewater. Microbial monitoring was also conducted for a parallel-running conventional activated sludge (CAS) process treating the same influent. The mixed-liquor suspended solid concentration in the MBR reached a steady-state on day 73 after the start-up. Then the MBR maintained higher rates of removal of organic compounds and nitrogen than the CAS process did. Terminal restriction fragment length polymorphism analysis revealed that the bacterial community structure in the MBR was similar to that in the CAS process at the start-up, but it became very different from that in the CAS process in the steady state. The bacterial community structure of the MBR continued to change dynamically even after 20 months of the steady-state operation, while that of the CAS process was maintained in a stable condition. By contrast, Biolog assay revealed that the carbon source utilization potential of the MBR resembled that of the CAS process as a whole, although it declined transiently. Overall, the results indicate that the bacterial community of the MBR has flexibility in terms of its phylogenetic structure and metabolic activity to maintain the high wastewater treatment capability.

  1. Reasons for changes in the value of unit pressure of compression products supporting external treatment

    NASA Astrophysics Data System (ADS)

    Kowalski, K.; Ilska, A.; Kłonowska, M.

    2016-07-01

    The paper presents the basics of modelling compression products with intended values of unit pressure for body circumferences with fixed and variable radius of curvature. The derived relationships referring to the dimensions of the fabric's circumferences in a relaxed state of the product were based on Laplace law, local values of the radius of curvature, and the characteristics of stretching and relaxing (deformation) of the knitted fabric, described by experimental relation for the stress and relaxation phase for the 6th hysteresis loop, taking into account confidence intervals. The article indicates the possibilities of using 3D scanning techniques of the human body to identify the radius of curvature of various circumference of the human silhouette, for which the intended value of the unit pressure is designed, and quantitative changes in the body deformation due to compression. Classic method of modelling and design of compression products, based on a cylindrical model of the human body does not provide in each case the intended value of unit pressure, according to specific normative requirements, because it neglects the effect of different values of the radius of curvature of the body circumference and the properties of the viscoelastic knitted fabrics. The model and experimental research allowed for a quantitative and qualitative assessment of the reasons for the changes in the value of unit pressure of compression products supporting the process of external treatment.

  2. Brain Changes Associated with Thromboxane Receptor Antagonist, SQ 29,548, Treatment in a Mouse Model

    PubMed Central

    Rebel, Andrew A.; Urquhart, Siri A.; Puig, Kendra L.; Ghatak, Atreyi; Brose, Stephen A.; Golovko, Mikhail Y.; Combs, Colin K.

    2015-01-01

    The purpose of this study was to characterize behavioral and physiological effects of a selective thromboxane receptor (TP) antagonist, SQ 29,548, in the C57BL/6 mouse model. At six months of age, male mice were given either sham or drug intraperitoneal injections for three days at a dose of 2mg/kg each day. On the day after the final injection mice were subjected to behavioral testing paradigms before brain collection. Left hemisphere hippocampi were collected from all mice for protein analysis via western blot. Right brain hemispheres were fixed and imbedded in gelatin, and serially sectioned. The sections were immunostained using anti-c-Fos antibodies. Prostaglandin analysis was performed from remaining homogenized brain samples, minus the hippocampi. Injection of SQ 29,548 decreased selective brain prostaglandin levels compared to sham controls. This correlated with robust increases in limbic region c-Fos immunoreactivity in the SQ 29,548 injected mice. However, drug treated mice demonstrated no significant changes in relevant hippocampal protein levels compared to sham treatments, as determined by western blots. Surprisingly, injection of SQ 29,548 caused mixed changes in parameters of depression and anxiety-like behavior in the mice. In conclusion, the results indicate that administration of peripheral TP receptor antagonists alters brain levels of prostanoids and influences neuronal activity with only minimal alterations of behavior. Whether the drug affects neurons directly or through a secondary pathway involving endothelium or other tissues remains unclear. PMID:25703023

  3. Differential temporal changes of primary and secondary bacterial symbionts and whitefly host fitness following antibiotic treatments

    PubMed Central

    Zhang, Chang-Rong; Shan, Hong-Wei; Xiao, Na; Zhang, Fan-Di; Wang, Xiao-Wei; Liu, Yin-Quan; Liu, Shu-Sheng

    2015-01-01

    Where multiple symbionts coexist in the same host, the selective elimination of a specific symbiont may enable the roles of a given symbiont to be investigated. We treated the Mediterranean species of the whitefly Bemisia tabaci complex by oral delivery of the antibiotic rifampicin, and then examined the temporal changes of its primary symbiont “Candidatus Portiera aleyrodidarum” and secondary symbiont “Ca. Hamiltonella defensa” as well as host fitness for three generations. In adults treated with rifampicin (F0), the secondary symbiont was rapidly reduced, approaching complete disappearance as adults aged. In contrast, the primary symbiont was little affected until later in the adult life. In the offspring of these adults (F1), both symbionts were significantly reduced and barely detectable when the hosts reached the adult stage. The F1 adults laid few eggs (F2), all of which failed to hatch. Mating experiments illustrated that the negative effects of rifampicin on host fitness were exerted via female hosts but not males. This study provides the first evidence of differential temporal reductions of primary and secondary symbionts in whiteflies following an antibiotic treatment. Studies that disrupt functions of bacterial symbionts must consider their temporal changes. PMID:26510682

  4. Empirical Research without Certainty

    ERIC Educational Resources Information Center

    Floden, Robert E.

    2009-01-01

    In this essay, Robert Floden reviews three recent volumes in the Philosophy, Theory, and Educational Research series that address the philosophical implications of three "isms"-- postpositivism, pragmatism, and poststructuralism--for empirical educational research. These volumes, written by D.C. Phillips, Gert J.J. Biesta, and Michael A. Peters,…

  5. Auditory Imagery: Empirical Findings

    ERIC Educational Resources Information Center

    Hubbard, Timothy L.

    2010-01-01

    The empirical literature on auditory imagery is reviewed. Data on (a) imagery for auditory features (pitch, timbre, loudness), (b) imagery for complex nonverbal auditory stimuli (musical contour, melody, harmony, tempo, notational audiation, environmental sounds), (c) imagery for verbal stimuli (speech, text, in dreams, interior monologue), (d)…

  6. Changing Grains for the Prevention and Treatment of Kashin-Beck Disease in Children: a Meta-analysis.

    PubMed

    Han, Jing; Yu, Fang Fang; Chang, Zai Ping; Yang, Bo; Qu, Cheng Juan; Zhou, Tian Tian; Liu, Rui Yu; Guo, Xiong

    2015-04-01

    To evaluate the efficacy of changing grains on the prevention and treatment of Kashin-Beck Disease (KBD) in children, community-based trials were acquired from seven electronic databases (up to July 2014). As a result, the methodological quality of the six trials that have been included into our analysis was low. The pooled ORs favoring the prevention and treatment effects of changing grains were 0.15 (95% CI: 0.03-0.70) and 2.13 (95% CI: 1.44-3.16) respectively by meta-analysis. Subgroup analysis demonstrated the pooled OR favoring treatment effect of exchanging grains rather than drying grains both compared with endemic grains. The results showed that changing grains had obvious effects on the prevention and treatment of KBD in children. However, the evidences were limited by the potential biases and confounders. Large and well-designed trials are still needed.

  7. Demonstrations to Support Change to the >260 ppm Mercury Treatment Regulations

    SciTech Connect

    Hulet, Gregory Albert; Maio, Vincent Carl; Morris, M. I.; Lewis, J.; Randall, P.; Rieser, L.

    2001-02-01

    The U.S. Department of Energy (DOE) and the U. S. Environmental Protection Agency (EPA) are working together to justify a change in the Land Disposal Restriction for High Mercury (>260 ppm mercury) waste. The present regulation that requires roasting or retorting is based on recovering and recycling the mercury in the waste. However, most of DOE’s High Mercury waste is radioactively contaminated, eliminating the possibility of its recycle. The radioactive mercury recovered must be amalgamated and disposed. In addition, concern over fugitive emissions from retorting and roasting operations has raised the question of whether such processing is environmentally sound. A change to the regulation to allow stabilization and disposal would reduce the overall environmental threat, if the stabilization process can reduce the leachability of the mercury to regulatory levels. Demonstrations are underway to gather data showing that the High Mercury waste can be safely stabilized. At the same time, comparison tests are being conducted using an improved form of the baseline retorting technology to better quantify the fugitive emission problem and determine the full capability of thermal desorption systems. A first round of demonstrations stabilizing mercury in soil from Brookhaven National Laboratory (BNL) has been completed. Four groups demonstrated their process on the waste: 1) BNL demonstrated its Sulfur Polymer Stabilization/Solidification process; 2) Nuclear Fuel Services used their DeHg (de-merk) process, 3) Allied Technology Group used chemical stabilization, and 4) Sepradyne demonstrated their vacuum thermal desorption system. All groups were successful in their tests, reaching regulatory levels for mercury leachability. Data for each group will be presented. DOE, EPA, and the University of Cincinnati are presently working on another series of tests involving treatment of surrogate sludge and soil by commercial vendors. Protocols that better determine the waste form

  8. Prenatal Synthetic Glucocorticoid Treatment Changes DNA Methylation States in Male Organ Systems: Multigenerational Effects

    PubMed Central

    Crudo, Ariann; Petropoulos, Sophie; Moisiadis, Vasilis G.; Iqbal, Majid; Kostaki, Alisa; Machnes, Ziv; Szyf, Moshe

    2012-01-01

    Prenatal synthetic glucocorticoids (sGC) are administered to pregnant women at risk of delivering preterm, approximately 10% of all pregnancies. Animal studies have demonstrated that offspring exposed to elevated glucocorticoids, either by administration of sGC or as a result of maternal stress, are at increased risk of developing behavioral, endocrine, and metabolic abnormalities. DNA methylation is a covalent modification of DNA that plays a critical role in long-lasting programming of gene expression. Here we tested the hypothesis that prenatal sGC treatment has both acute and long-term effects on DNA methylation states in the fetus and offspring and that these effects extend into a subsequent generation. Pregnant guinea pigs were treated with sGC in late gestation, and methylation analysis by luminometric methylation assay was undertaken in organs from fetuses and offspring across two generations. Expression of genes that modify the epigenetic state were measured by quantitative real-time PCR. Results indicate that there are organ-specific developmental trajectories of methylation in the fetus and newborn. Furthermore, these trajectories are substantially modified by intrauterine exposure to sGC. These sGC-induced changes in DNA methylation remain into adulthood and are evident in the next generation. Furthermore, prenatal sGC exposure alters the expression of several genes encoding proteins that modulate the epigenetic state. Several of these changes are long lasting and are also present in the next generation. These data support the hypothesis that prenatal sGC exposure leads to broad changes in critical components of the epigenetic machinery and that these effects can pass to the next generation. PMID:22564977

  9. Molecular and histological changes in cerebral cortex and lung tissues under the effect of tramadol treatment.

    PubMed

    Awadalla, Eatemad A; Salah-Eldin, Alaa-Eldin

    2016-08-01

    Tramadol abuse is one of the most frequent health problems in Egypt and worldwide. In most cases, tramadol abused by men face a problem with premature ejaculation. Tramadol like other opioids induces a decrease in plasma antioxidant levels, which may reflect a failure of the antioxidant defense mechanism against oxidative damage. The present work aimed to study the possible deleterious effects of oral administration of tramadol on brain and lung tissues in rats. Twenty adult male albino rats were divided into two groups; a control administered with normal saline and tramadol-treated (40mg/kg b.w.) group for 20 successive days. At the end of experimental period, blood was collected and specimens from brains and lungs were taken for histopathological and molecular studies. Malondialdehyde (MDA), reduced glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) activities were measured in serum of control and tramadol-treated groups. Brain and lung specimens were histopathological evaluated using light microscopy. The expression levels of apoptotic related genes; Bcl-2, Bax and Caspase-3 were study in brain and lung tissues using RT-PCR analysis. We recorded a significant increase MDA level, while antioxidant enzymes; GSH, SOD and CAT were significantly decreased after tramadol-treatment. The obtained results revealed that tramadol induced a remarkable histomorphological changes in rats' brains (cerebral cortex and hippocampus) and severe histopathological changes in rats' lung when compared to that of control. On molecular level, the expression of the pro-apoptotic Bax and Caspase-3 showed a significant increase whereas the anti-apoptotic Bcl-2 decreased markedly indicating that tramadol is harmful at cellular level and can induce apoptotic changes in brain tissues. Our data confirmed the risk of increased oxidative stress, neuronal and pulmonary damage due to tramadol abuse. Although tramadol is reported to be effective in pain management, its toxicity should

  10. Molecular and histological changes in cerebral cortex and lung tissues under the effect of tramadol treatment.

    PubMed

    Awadalla, Eatemad A; Salah-Eldin, Alaa-Eldin

    2016-08-01

    Tramadol abuse is one of the most frequent health problems in Egypt and worldwide. In most cases, tramadol abused by men face a problem with premature ejaculation. Tramadol like other opioids induces a decrease in plasma antioxidant levels, which may reflect a failure of the antioxidant defense mechanism against oxidative damage. The present work aimed to study the possible deleterious effects of oral administration of tramadol on brain and lung tissues in rats. Twenty adult male albino rats were divided into two groups; a control administered with normal saline and tramadol-treated (40mg/kg b.w.) group for 20 successive days. At the end of experimental period, blood was collected and specimens from brains and lungs were taken for histopathological and molecular studies. Malondialdehyde (MDA), reduced glutathione (GSH), superoxide dismutase (SOD) and catalase (CAT) activities were measured in serum of control and tramadol-treated groups. Brain and lung specimens were histopathological evaluated using light microscopy. The expression levels of apoptotic related genes; Bcl-2, Bax and Caspase-3 were study in brain and lung tissues using RT-PCR analysis. We recorded a significant increase MDA level, while antioxidant enzymes; GSH, SOD and CAT were significantly decreased after tramadol-treatment. The obtained results revealed that tramadol induced a remarkable histomorphological changes in rats' brains (cerebral cortex and hippocampus) and severe histopathological changes in rats' lung when compared to that of control. On molecular level, the expression of the pro-apoptotic Bax and Caspase-3 showed a significant increase whereas the anti-apoptotic Bcl-2 decreased markedly indicating that tramadol is harmful at cellular level and can induce apoptotic changes in brain tissues. Our data confirmed the risk of increased oxidative stress, neuronal and pulmonary damage due to tramadol abuse. Although tramadol is reported to be effective in pain management, its toxicity should

  11. Oestrus synchronization treatment induces histomorphological changes on the uterine tube epithelium of the gilt.

    PubMed

    Juárez-Mosqueda, M L; Anzaldúa Arce, S R; Palma Lara, I; García Dalmán, C; Cornejo Cortés, M A; Córdova Izquierdo, A; Villaseñor Gaona, H; Trujillo Ortega, M E

    2015-12-01

    The aim of this study was to determine the histomorphological changes that occurred in response to two treatments for oestrus synchronization in three different regions of the gilt's uterine tubes epithelium: the ampulla (AMP), ampulla-isthmic junction (AIJ) and isthmus (IST). Nine prepuberal gilts were divided into three groups (n = 3): (1) eCG 400 IU and hCG 200 IU (eCG/hCG), (2) progesterone agonist (P4) and (3) control group. The number of secretory cells (stained with periodic acid-Schiff reaction or PAS-positive cells) decreased in the AMP in the P4 treated group when compared to the control group, whereas, no difference was observed in the number of PAS-negative cells in the AMP of the three groups. A significant decrease in the number of PAS-positive cells was observed in the AIJ and IST of the P4 treated group when compared to the eCG/hCG and control groups. An increase in the number of PAS-negative cells was observed in the AIJ and IST in the P4 treated group. The epithelium height in the AMP and AIJ was increased in the eCG/hCG group when compared to the control and P4 groups. In this last group, we observed a reduced height compared with the other two groups for the AIJ. In the IST, there were no significant changes in the epithelium height of the control or the other two groups (eCG/hCG and P4). The epithelial cells of the P4 treated group had the least amount of cytoplasmic granules and the lowest intensity of PAS staining in the AMP, AIJ and IST. Animals treated with eCG/hCG showed an intermediate number of cytoplasmic granules and intensity in all regions evaluated. These data show that P4 treatment for synchronization induces a significant (P < 0.001) decrease of PAS-positive cells and staining intensity of cytoplasmic granules in the different regions studied and an increased number of PAS-negative cells in the AIJ and IST epithelium. Moreover, eCG/hCG treatment increased the height of the epithelium in the AMP and AIJ, while in this last

  12. Oestrus synchronization treatment induces histomorphological changes on the uterine tube epithelium of the gilt.

    PubMed

    Juárez-Mosqueda, M L; Anzaldúa Arce, S R; Palma Lara, I; García Dalmán, C; Cornejo Cortés, M A; Córdova Izquierdo, A; Villaseñor Gaona, H; Trujillo Ortega, M E

    2015-12-01

    The aim of this study was to determine the histomorphological changes that occurred in response to two treatments for oestrus synchronization in three different regions of the gilt's uterine tubes epithelium: the ampulla (AMP), ampulla-isthmic junction (AIJ) and isthmus (IST). Nine prepuberal gilts were divided into three groups (n = 3): (1) eCG 400 IU and hCG 200 IU (eCG/hCG), (2) progesterone agonist (P4) and (3) control group. The number of secretory cells (stained with periodic acid-Schiff reaction or PAS-positive cells) decreased in the AMP in the P4 treated group when compared to the control group, whereas, no difference was observed in the number of PAS-negative cells in the AMP of the three groups. A significant decrease in the number of PAS-positive cells was observed in the AIJ and IST of the P4 treated group when compared to the eCG/hCG and control groups. An increase in the number of PAS-negative cells was observed in the AIJ and IST in the P4 treated group. The epithelium height in the AMP and AIJ was increased in the eCG/hCG group when compared to the control and P4 groups. In this last group, we observed a reduced height compared with the other two groups for the AIJ. In the IST, there were no significant changes in the epithelium height of the control or the other two groups (eCG/hCG and P4). The epithelial cells of the P4 treated group had the least amount of cytoplasmic granules and the lowest intensity of PAS staining in the AMP, AIJ and IST. Animals treated with eCG/hCG showed an intermediate number of cytoplasmic granules and intensity in all regions evaluated. These data show that P4 treatment for synchronization induces a significant (P < 0.001) decrease of PAS-positive cells and staining intensity of cytoplasmic granules in the different regions studied and an increased number of PAS-negative cells in the AIJ and IST epithelium. Moreover, eCG/hCG treatment increased the height of the epithelium in the AMP and AIJ, while in this last

  13. Study of the change of prolactin and progesterone during dopaminergic agonist treatments in pseudopregnant bitches.

    PubMed

    Gobello, C; de la Sota, R L; Goya, R G

    2001-05-31

    In order to clarify the role of prolactin (PRL) and progesterone (P(4)) in the pathophysiology of canine pseudopregnancy (PSP) we designed an experiment, where we induced an abrupt pharmacological blockade of PRL secretion with dopaminergic agonists (DA) or placebo (PL). Thirty overtly pseudopregnant (PSPT) bitches were randomly allocated to three groups of 10 animals each: PL, bromocriptine (BR), and cabergoline (CA), which were treated with PL, 7.5microg/kg BR and 5microg/kg CA, respectively. On days 1, 7 and 14 (day 0: beginning of the treatment) all the animals were classified into grades of intensity of PSP clinical signs, considering serum or milk secretion and enlargement of the mammary glands. Presence or absence of treatment side effects were recorded and blood samples for PRL and P(4) determinations collected. Serum PRL and P(4) concentrations (ng/ml) of all the animals on day 1 were (least squares means [LSM]+/-S.E.M.) 17.70+/-2.05 and 1.13+/-0.13, respectively. During the experiment, serum PRL and P(4) concentrations decreased (day effect, P<0.05). During the experiment, serum PRL concentrations were lower in the DA treated group (BR and CA) compared with PL group (P<0.05). After a week of treatment, the percentage change of PRL was -62.52 versus 102.16+/-46.20 (P<0.01) for the treated (BR and CA) and PL groups, respectively. Conversely, no significant differences were found in the percent change in PRL between the BR and the CA groups nor in P(4) percentage change among all groups for the same week. Significant differences in the achievement of complete remission between treated and PL groups were found on days 7 (40 versus 0%, P<0.05) and 14 (90 versus 0%, P<0.01). No significant correlation between PRL and P(4) was found on day 1 in any of the animals. However, a significant correlation for the same hormones was found on days 7 and 14 for the DA treated groups (r=0.46, P<0.01). While in the PL group, PRL concentrations and intensity of clinical signs

  14. Assessment of potential climate change impacts on peatland dissolved organic carbon release and drinking water treatment from laboratory experiments.

    PubMed

    Tang, R; Clark, J M; Bond, T; Graham, N; Hughes, D; Freeman, C

    2013-02-01

    Catchments draining peat soils provide the majority of drinking water in the UK. Over the past decades, concentrations of dissolved organic carbon (DOC) have increased in surface waters. Residual DOC can cause harmful carcinogenic disinfection by-products to form during water treatment processes. Increased frequency and severity of droughts combined with and increased temperatures expected as the climate changes, have potentials to change water quality. We used a novel approach to investigate links between climate change, DOC release and subsequent effects on drinking water treatment. We designed a climate manipulation experiment to simulate projected climate changes and monitored releases from peat soil and litter, then simulated coagulation used in water treatment. We showed that the 'drought' simulation was the dominant factor altering DOC release and affected the ability to remove DOC. Our results imply that future short-term drought events could have a greater impact than increased temperature on DOC treatability.

  15. A Review of Empirically Supported Marital Enrichment Programs

    ERIC Educational Resources Information Center

    Jakubowski, Scott F.; Milne, Eric P.; Brunner, Heidi; Miller, Richard B.

    2004-01-01

    Considering the popularity of marriage enrichment programs, it is important for clinicians and marriage educators to know which programs have received empirical support. Using criteria established for determining empirically supported treatments (ESTs), we provide a comprehensive review of the outcome research on 13 specific marital enrichment…

  16. Parent-adolescent conflict: an empirical review.

    PubMed

    Hall, J A

    1987-01-01

    Conflict between parents and adolescents is usually seen as a normal and necessary part of human development. However, treatment approaches for problematic conflict differ depending on several variables including theoretical orientation of the clinician. This article compares and contrasts psychoanalytic, systems, and social learning theories in order to determine the empirical support for each. In addition, several issues inherent in parent-adolescent conflict are reviewed including developmental stage theory, parenting styles, peer pressures, communications skills, marital conflict, drugs, school, and sex. Several studies and reviews of the literature are examined for common conclusions. Finally, an integrated and empirically supported model to explain parent-adolescent conflict is described.

  17. Deterioration of Intellect among Children Surviving Leukemia: IQ Test Changes Modify Estimates of Treatment Toxicity.

    ERIC Educational Resources Information Center

    Mulhern, Raymond, K; And Others

    1992-01-01

    Assessed association of young age at treatment, cranial irradiation, and time since treatment with intellectual deterioration among 49 long-term survivors of childhood leukemia. Found no significant effects of treatment group (low-dose cranial irradiation versus high-dose chemotherapy) or age at treatment. Small but statistically significant…

  18. Diel changes in water chemistry in an arsenic-rich stream and treatment-pond system

    USGS Publications Warehouse

    Gammons, C.H.; Grant, T.M.; Nimick, D.A.; Parker, S.R.; DeGrandpre, M.D.

    2007-01-01

    Arsenic concentrations are elevated in surface waters of the Warm Springs Ponds Operable Unit (WSPOU), located at the head of the upper Clark Fork River Superfund site, Montana, USA. Arsenic is derived from historical deposition of smelter emissions (Mill and Willow Creeks) and historical mining and milling wastes (Silver Bow Creek). Although long-term monitoring has characterized the general seasonal and flow-related trends in As concentrations in these streams and the pond system used to treat Silver Bow Creek water, little is known about solubility controls and sorption processes that influence diel cycles in As concentrations. Diel (24-h) sampling was conducted in July 2004 and August 2005 at the outlet of the treatment ponds, at two locations along a nearby reconstructed stream channel that diverts tributary water around the ponds, and at Silver Bow Creek 2??km below the ponds. Dissolved As concentration increased up to 51% during the day at most of the stream sites, whereas little or no diel change was displayed at the treatment-pond outlet. The strong cycle in streams is explained by pH- and temperature-dependent sorption of As onto hydrous metal oxides or biofilms on the streambed. Concentrations of dissolved Ca2+ and HCO3- at the stream sites showed a diel temporal pattern opposite to that of As, and geochemical modeling supports the hypothesis that the concentrations of Ca2+ and HCO3- were controlled by precipitation of calcite during the warm afternoon hours when pH rose above 9.0. Nightly increases in dissolved Mn and Fe(II) concentrations were out of phase with concentrations of other divalent cations and are more likely explained by redox phenomena. ?? 2007 Elsevier B.V. All rights reserved.

  19. Treatment of depression with the CRH-1-receptor antagonist R121919: endocrine changes and side effects.

    PubMed

    Künzel, Heike E; Zobel, Astrid W; Nickel, Thomas; Ackl, Nibal; Uhr, Manfred; Sonntag, Annette; Ising, Marcus; Holsboer, Florian

    2003-01-01

    A dysregulation of the hypothalamus-pituitary-adrenocortical (HPA) system has been hypothesized to account for a myriad of cardinal symptoms of affective disorders. Specifically, increased CRH signalling via CRH type 1 receptors is thought to be an important factor in the pathogenesis of major depression and anxiety disorders. Consequently, a number of drugs have been developed in order to target the postulated increase in CRH/CRH 1 receptor signalling. One of these compounds, R121919, binds with high affinity to CRH1 receptors antagonising the action of CRH. R121919 was recently tested in an open-label study conceptualized as a safety and tolerability study. As part of this study, a thorough endocrine evaluation and detailed clinical laboratory analysis were assessed several times during 30 days of treatment with two different dose regimens of R121919 (5-40 mg vs. 40-80 mg) in 24 patients with a major depressive episode. During treatment with the experimental drug no serious side effects were noted. In particular, there were no adverse effects or impairment of the hypothalamic-pituitary-gonadal system, the hypothalamic-pituitary-thyroid axis, the renin-angiotensin system, prolactin or vasopressin secretion. Furthermore, no changes in the serum corticotropin and cortisol concentrations and in the responsivity of corticotropin and cortisol following a CRH stimulation test were noted. No effects of R121919 on clinical laboratory parameters including liver enzymes, EEG and ECG were observed. These results encourage the development of other CRH-1-R antagonists as a novel class of antidepressive drugs.

  20. Global changes in STAT target selection and transcription regulation upon interferon treatments

    PubMed Central

    Hartman, Stephen E.; Bertone, Paul; Nath, Anjali K.; Royce, Thomas E.; Gerstein, Mark; Weissman, Sherman; Snyder, Michael

    2005-01-01

    The STAT (signal transducer and activator of transcription) proteins play a crucial role in the regulation of gene expression, but their targets and the manner in which they select them remain largely unknown. Using chromatin immunoprecipitation and DNA microarray analysis (ChIP-chip), we have identified the regions of human chromosome 22 bound by STAT1 and STAT2 in interferon-treated cells. Analysis of the genomic loci proximal to these binding sites introduced new candidate STAT1 and STAT2 target genes, several of which are affiliated with proliferation and apoptosis. The genes on chromosome 22 that exhibited interferon-induced up- or down-regulated expression were determined and correlated with the STAT-binding site information, revealing the potential regulatory effects of STAT1 and STAT2 on their target genes. Importantly, the comparison of STAT1-binding sites upon interferon (IFN)-γ and IFN-α treatments revealed dramatic changes in binding locations between the two treatments. The IFN-α induction revealed nonconserved STAT1 occupancy at IFN-γ-induced sites, as well as novel sites of STAT1 binding not evident in IFN-γ-treated cells. Many of these correlated with binding by STAT2, but others were STAT2 independent, suggesting that multiple mechanisms direct STAT1 binding to its targets under different activation conditions. Overall, our results reveal a wealth of new information regarding IFN/STAT-binding targets and also fundamental insights into mechanisms of regulation of gene expression in different cell states. PMID:16319195

  1. Weight change therapy as a potential treatment for end-stage ovarian carcinoma

    PubMed Central

    Oshakbayev, Kuat Pernekulovich; Alibek, Kenneth; Ponomarev, Igor Olegovich; Uderbayev, Nurlybek Nurlanovich; Dukenbayeva, Bibazhar Abayevna

    2014-01-01

    Patient: Female, 41 Final Diagnosis: Ovarian carcinoma Symptoms: Ascites • hepatomegaly • weight loss Medication: — Clinical Procedure: — Specialty: Oncology Objective: Unusual or unexpected effect of treatment Background: The aim of this case report is to present the results of treatment of end-stage ovarian carcinoma in a 41-year-old women using weight loss therapy. Case Report: We describe the case of a female aged 41 years with epithelial invasive ovarian cancer of III–IV stage, T3N2M1. Concurrent diseases were: abdominal carcinomatosis; hepatomegaly; ascites; condition after laparocentesis and skin-abdominal fistula; condition after 6 courses of neo-adjuvant polychemotherapy; hypertension II stage, risk factor of 3–4; dyslipidemia; and metabolic syndrome. A weight loss method based on a very-low-calorie diet and physical activity was used. Body weight was reduced from 74 kg to 53 due to loss of adipose tissue after 6 months of therapy. At the same time, the percentages of water and muscle tissue were increased significantly. While overweight was reducing, clinical, laboratory, and instrumental results were improving. As a result of the weight loss therapy, about ≈100 mm-sized ovarian cancer was transformed into smaller-sized ovarian cysts. Conclusions: An analgesic effect was also achieved without use of narcotic or non-narcotic analgesics. These cyto-reversible processes were documented by laboratory and instrumental data. The mechanisms behind these differences remain to be elucidated. Future research with a larger study cohort and longer follow-up is needed to further investigate the role of caloric restriction diet in cancer cell changes in ovarian cancer. PMID:24847411

  2. Changes in B and T lymphocytes and chemokines with rituximab treatment in multiple sclerosis

    PubMed Central

    Piccio, Laura; Naismith, Robert T.; Trinkaus, Kathryn; Klein, Robyn S.; Parks, Becky J.; Lyons, Jeri A.; Cross, Anne H.

    2010-01-01

    Background B cells are implicated in the pathogenesis of multiple sclerosis (MS). A beneficial effect of B cell depletion using rituximab has been shown, but the complete mechanism of action for this drug is unclear. Objective To determine the relationship between T cells, B cells, and changes in CSF chemokines with rituximab, a monoclonal antibody that targets CD20. Design Phase II trial of rituximab as an add-on therapy. Setting The John L. Multiple Sclerosis Center, Washington University, St. Louis, Missouri. Patients Thirty relapsing-remitting MS subjects with clinical and MRI activity despite treatment with an immunomodulatory drug received four weekly doses of 375mg/m2 rituximab. Main Outcome Measures Lumbar puncture was performed before and after rituximab infusions in 26 subjects. CSF B and T lymphocytes were enumerated by flow cytometry, and chemoattractants were measured by ELISA. Results After rituximab administration, CSF B cells were decreased or undetectable in all subjects and CSF T cells were reduced in 81% of subjects. The mean reduction in CSF cellularity was 95% for B cells and 50% for T cells. After rituximab infusion, CSF CXCL13 and CCL19 decreased (P= 0.002, P=0.03, respectively). The proportional decline in CSF T cells correlated with the proportional decrease in CXCL13 (r=0.45;P=0.03), suggesting a possible relationship. CSF IgG index, IgG concentration, and oligoclonal band number were unchanged following treatment. Conclusions B cells are critical for T cell trafficking into the CNS in MS patients, and may alter T cell trafficking by influencing chemokine production within the CNS. PMID:20558389

  3. Interaction effect of contingency management and sex on delay-discounting changes among treatment-seeking smokers.

    PubMed

    Weidberg, Sara; Landes, Reid D; García-Rodríguez, Olaya; Yoon, Jin H; Secades-Villa, Roberto

    2015-10-01

    Despite the potential influence of sex on delay-discounting rates, there is no previous evidence with regard to the effect of this variable on the clinical interventions aimed at modifying delay-discounting rates. This study assessed the effect of sex on the association between the type of treatment received (either cognitive-behavioral treatment [CBT] alone or combined with contingency management [CM + CBT]) and delay-discounting changes at end of treatment and 6-month follow-up. This aim was addressed after controlling for the influence of baseline delay discounting. Treatment-seeking smokers (N = 116) were randomly assigned to either CM + CBT (n = 69) or CBT alone (n = 47). Participants completed delay-discounting assessments at intake, at end of treatment, and at 6-month follow-up. Results showed that there was a significant interaction effect of treatment type and sex, such that women who received CM decreased their discounting more than women who did not. However, this effect was not found among men. Participants who discounted most at intake showed the greatest delay-discounting decreases. Lastly, smoking abstinence did not affect changes in delay discounting. The current results suggest that CM intervention may have a differential effect on delay-discounting changes as a function of sex. This finding supports the relevance of considering the effect of individual variables when assessing changes in delay discounting due to clinical interventions.

  4. Change of Mandibular Position during Two-Phase Orthodontic Treatment of Skeletal Class II in the Chinese Population

    PubMed Central

    Hägg, Urban; Wong, Ricky Wing Kit; Liao, Chongshan; Yang, Yanqi

    2015-01-01

    The aim of this study was to evaluate the change in mandibular position during a two-phase orthodontic treatment of skeletal Class II malocclusion. Thirty consecutively treated Chinese male adolescents who had undergone two-phase treatment with Herbst appliance and fixed appliance and fulfilled the specific selection criteria were sampled. Cephalograms taken at T0 (before treatment), T1 (at the end of functional appliance treatment), and T2 (at the end of fixed appliance treatment) were analyzed. The change in sagittal positioning of the mandible was 6.8±3.44 mm in phase I (T0-T1), 0.4±2.79 mm in phase II (T1-T2), and 7.2±4.61 mm in total. The mandible came forward in 100% of the patients at T1. In phase II, it came forward in one-third (positive group) remained unchanged in one-third (stable group) and went backward in one-third (negative group) of the patients. At T2, it came forward twice as much in the positive group compared to the negative group. Mandibular length was significantly increased in 100% of the patients in both phases. In conclusion, during the treatment with functional appliance, the mandibular prognathism increases in all patients, whereas during the treatment with fixed appliance there is no significant change in mandibular prognathism. PMID:25695103

  5. Changes in perception of treatment efficacy are associated to the magnitude of the nocebo effect and to personality traits.

    PubMed

    Corsi, Nicole; Emadi Andani, Mehran; Tinazzi, Michele; Fiorio, Mirta

    2016-01-01

    The nocebo effect in motor performance consists in a reduction of force and increase of fatigue following the application of an inert treatment that the recipient believes to be effective. This effect is variable across individuals and it is usually stronger if conditioning -exposure to the active effect of the treatment- precedes a test session, in which the treatment is inert. In the current explorative study we used a conditioning procedure to investigate whether subjective perception of treatment effectiveness changes between the conditioning and the test session and whether this change is related to dispositional traits and to the nocebo-induced reduction of force. Results showed that 56.1% of participants perceived the treatment as more effective in the test than in the conditioning session, had a more pronounced reduction of force, felt more effort and sense of weakness and were characterized by lower levels of optimism and higher anxiety traits compared to the other 43.9% of participants, who conversely perceived the treatment as less effective in the test session than in the conditioning. These findings highlight for the first time a link between changes in perception of treatment effectiveness, personality traits and the magnitude of the nocebo response in motor performance. PMID:27470917

  6. Pulmonary Changes After Radiotherapy for Conservative Treatment of Breast Cancer: A Prospective Study

    SciTech Connect

    Krengli, Marco Sacco, Mariano; Loi, Gianfranco; Masini, Laura; Ferrante, Daniela; Gambaro, Giuseppina; Ronco, Marco; Magnani, Corrado; Carriero, Alessandro

    2008-04-01

    Purpose: Radiotherapy (RT) after conservative surgery for breast cancer involves part of the pulmonary parenchyma with a potential detrimental effect of reducing the normal functional reserve. Such an effect deserves to be studied in depth, considering the given long life expectancy of these women. We prospectively analyzed high-resolution computed tomography (HRCT) and pulmonary function tests (PFTs) with correlation with dosimetric data from RT. Methods and Materials: Lung HRCT and PFTs were performed in 41 women who had undergone conservative surgery for breast cancer before and 3 and 9 months after postoperative RT. The PFTs included forced vital capacity, forced expiratory volume in 1 s, total lung capacity, maximal expiratory flow at 50% and 25% of vital capacity, and the diffusion capacity of carbon monoxide. HRCT was matched with the RT treatment plan images to analyze the dosimetric correlation. Results: At 3 months after RT, the lung alterations were classified at HRCT as follows: 46.3% were Grade 1, 24.4% Grade 2, and 7.3% Grade 3, and at 9 months, 58.5% were Grade 1, 19.5% Grade 2, and 0% Grade 3. The PFTs showed a significant decrease at 3 months, with only partial recovery at 9 months. Chemotherapy, but not hormonal therapy, was associated with PFT changes. The grade of fibrosis increased with increasing lung volume treated to a dose {>=}25 Gy. Conclusion: Lung changes, mainly related to damage to the alveolar-capillary barrier and smallest airway ramifications, were observed at 3 months, with only partial recovery at 9 months after RT. Minimizing the lung volume receiving {>=}25 Gy could reduce pulmonary toxicity.

  7. Cocaine treatment causes early and long-lasting changes in muscarinic and dopaminergic receptors.

    PubMed

    Macêdo, D S; Correia, E E; Vasconcelos, S M M; Aguiar, L M V; Viana, G S B; Sousa, F C F

    2004-02-01

    1. The study of changes that persist after drug discontinuation could be fundamental to understand the mechanisms involved in craving and relapse. 2. In this work the changes occurring in muscarinic, D1- and D2-like receptors after 30 min (immediate), 1 day (early), 5 and 30 days (late) withdrawal periods were studied, in the striatum of rats treated once a day for 7 days with cocaine 20 and 30 mg/kg, i.p. 3. Binding assays were performed in 10% homogenates and ligands used were [3H]-N-methylscopolamine, [3H]-SCH 23390, and [3H]-spiroperidol for muscarinic (M1 + M2-like), D1-, and D2-like receptors, respectively. 4. Muscarinic receptors presented a downregulation at all doses and discontinuation times, while the dissociation constant (Kd) for this receptor decreased after 30 min, 5 and 30 days abstinence times. In relation to D1-like receptors we found an antagonistic effect with 100% increase in receptor number 30 min after the last cocaine injection, but after 1-day withdrawal a downregulation was observed with both doses that persisted up to 30 days, only with the higher dose. The dissociation constant value (Kd) for this receptor showed a decrease only with 5 and 30 days withdrawal. An increase occurred with D2-like receptors at all doses and withdrawal periods studied, while Kd increased in 30-min, 5, and 30 days withdrawal. 5. In this work we found that the subchronic cocaine treatment produces early and long-lasting modifications in cholinergic muscarinic as well in dopaminergic receptors that persist up to 30 days of cocaine withdrawal. PMID:15049517

  8. Change in Brain Magnetic Resonance Spectroscopy after Treatment during Acute HIV Infection

    PubMed Central

    Sailasuta, Napapon; Ross, William; Ananworanich, Jintanat; Chalermchai, Thep; DeGruttola, Victor; Lerdlum, Sukalaya; Pothisri, Mantana; Busovaca, Edgar; Ratto-Kim, Silvia; Jagodzinski, Linda; Spudich, Serena; Michael, Nelson; Kim, Jerome H.; Valcour, Victor

    2012-01-01

    Objective Single voxel proton magnetic resonance spectroscopy (MRS) can be used to monitor changes in brain inflammation and neuronal integrity associated with HIV infection and its treatments. We used MRS to measure brain changes during the first weeks following HIV infection and in response to antiretroviral therapy (ART). Methods Brain metabolite levels of N-acetyl aspartate (NAA), choline (tCHO), creatine (CR), myoinositol (MI), and glutamate and glutamine (GLX) were measured in acute HIV subjects (n = 31) and compared to chronic HIV+individuals (n = 26) and HIV negative control subjects (n = 10) from Bangkok, Thailand. Metabolites were measured in frontal gray matter (FGM), frontal white matter (FWM), occipital gray matter (OGM), and basal ganglia (BG). Repeat measures were obtained in 17 acute subjects 1, 3 and 6 months following initiation of ART. Results After adjustment for age we identified elevated BG tCHO/CR in acute HIV cases at baseline (median 14 days after HIV infection) compared to control (p = 0.0014), as well as chronic subjects (p = 0.0023). A similar tCHO/CR elevation was noted in OGM; no other metabolite abnormalities were seen between acute and control subjects. Mixed longitudinal models revealed resolution of BG tCHO/CR elevation after ART (p = 0.022) with tCHO/CR similar to control subjects at 6 months. Interpretation We detected cellular inflammation in the absence of measurable neuronal injury within the first month of HIV infection, and normalization of this inflammation following acutely administered ART. Our findings suggest that early ART may be neuroprotective in HIV infection by mitigating processes leading to CNS injury. PMID:23229129

  9. Lifestyle changes as a treatment of gastroesophageal reflux disease: a survey of general practitioners in North Queensland, Australia

    PubMed Central

    Nowak, Madeleine; Büttner, Petra; Raasch, Beverly; Daniell, Kym; McCutchan, Cindy; Harrison, Simone

    2005-01-01

    Background Gastroesophageal reflux disease (GERD) is a common disorder in developed countries, with the usual treatment being medication. Previously, lifestyle modification was the only treatment for GERD; however, its effectiveness has not been assessed. Methods All practicing general practitioner (GP) members of two Divisions of General Practice (n = 193) in North Queensland, Australia, were surveyed in 2001 using a postal questionnaire to determine their views and practices relating to such treatment among adults with GERD. Results The response rate was 70.5%. Of those who responded, 17.6% recommended diet and postural advice as a first line of treatment, with postural advice (89.7%), avoid known precipitants (86.0%), reduce weight if overweight (79.4%), eat a low fat diet (45.6%), and stop smoking (17.6%) being the most common recommendations. Of the nine possible changes, the median number recommended was 3, interquartile range (IQR; 3, 4). Eighty-nine percent of GPs thought ≥ 10% of patients with GERD would benefit from lifestyle changes, but almost half thought ≤ 10% of patients would be prepared to change. Conclusion Most GPs thought lifestyle changes would be beneficial when treating GERD, but did not believe their patients would change. Most GPs recommended fewer than half the lifestyle changes their peers believed effective in treating GERD. PMID:18360562

  10. Changes in the neural correlates of implicit emotional face processing during antidepressant treatment in major depressive disorder.

    PubMed

    Victor, Teresa A; Furey, Maura L; Fromm, Stephen J; Öhman, Arne; Drevets, Wayne C

    2013-11-01

    An emerging hypothesis regarding the mechanisms underlying antidepressant pharmacotherapy suggests that these agents benefit depressed patients by reversing negative emotional processing biases (Harmer, 2008). Neuropsychological indices and functional neuroimaging measures of the amygdala response show that antidepressant drugs shift implicit and explicit processing biases away from the negative valence and toward the positive valence. However, few studies have explored such biases in regions extensively connected with the amygdala, such as the pregenual anterior cingulate cortex (pgACC) area, where pre-treatment activity consistently has predicted clinical outcome during antidepressant treatment. We used functional magnetic resonance imaging (fMRI) to investigate changes in haemodynamic response patterns to positive vs. negative stimuli in patients with major depressive disorder (MDD) under antidepressant treatment. Participants with MDD (n = 10) underwent fMRI before and after 8 wk sertraline treatment; healthy controls (n = 10) were imaged across an equivalent interval. A backward masking task was used to elicit non-conscious neural responses to sad, happy and neutral face expressions. Haemodynamic responses to emotional face stimuli were compared between conditions and groups in the pgACC. The response to masked-sad vs. masked-happy faces (SN-HN) in pgACC in the depressed subjects was higher in the pre-treatment condition than in the post-treatment condition and this difference was significantly greater than the corresponding change across time in the controls. The treatment-associated difference was attributable to an attenuated response to sad faces and an enhanced response to happy faces. Pre-treatment pgACC responses to SN-HN correlated positively with clinical improvement during treatment. The pgACC participates with the amygdala in processing the salience of emotional stimuli. Treatment-associated functional changes in this limbic network may influence

  11. Expert opinion vs. empirical evidence

    PubMed Central

    Herman, Rod A; Raybould, Alan

    2014-01-01

    Expert opinion is often sought by government regulatory agencies when there is insufficient empirical evidence to judge the safety implications of a course of action. However, it can be reckless to continue following expert opinion when a preponderance of evidence is amassed that conflicts with this opinion. Factual evidence should always trump opinion in prioritizing the information that is used to guide regulatory policy. Evidence-based medicine has seen a dramatic upturn in recent years spurred by examples where evidence indicated that certain treatments recommended by expert opinions increased death rates. We suggest that scientific evidence should also take priority over expert opinion in the regulation of genetically modified crops (GM). Examples of regulatory data requirements that are not justified based on the mass of evidence are described, and it is suggested that expertise in risk assessment should guide evidence-based regulation of GM crops. PMID:24637724

  12. Advancing empirical resilience research.

    PubMed

    Kalisch, Raffael; Müller, Marianne B; Tüscher, Oliver

    2015-01-01

    We are delighted by the broad, intense, and fruitful discussion in reaction to our target article. A major point we take from the many comments is a prevailing feeling in the research community that we need significantly and urgently to advance resilience research, both by sharpening concepts and theories and by conducting empirical studies at a much larger scale and with a much more extended and sophisticated methodological arsenal than is the case currently. This advancement can be achieved only in a concerted international collaborative effort. In our response, we try to argue that an explicitly atheoretical, purely observational definition of resilience and a transdiagnostic, quantitative study framework can provide a suitable basis for empirically testing different competing resilience theories (sects. R1, R2, R6, R7). We are confident that it should be possible to unite resilience researchers from different schools, including from sociology and social psychology, behind such a pragmatic and theoretically neutral research strategy. In sections R3 to R5, we further specify and explain the positive appraisal style theory of resilience (PASTOR). We defend PASTOR as a comparatively parsimonious and translational theory that makes sufficiently concrete predictions to be evaluated empirically. PMID:26815844

  13. Proteome Changes in Maize Embryo (Zea mays L) Induced by Ion Beam Implantation Treatment

    NASA Astrophysics Data System (ADS)

    Li, Yongliang; Tang, Jihua; Qin, Guangyong; Huo, Yuping; Tian, Shuangqi

    2009-08-01

    Low energy ion beam implantation was applied to the maize (Zea mays L) embryo proteome using two-dimensional gel electrophoresis. Protein profile analysis detected more than 1100 protein spots, 72 of which were determined to be expressed differently in the treated and control (not exposed to ion beam implantation) embryos. Of the 72 protein spots, 53 were up-regulated in the control and 19 were more abundantly expressed in the ion beam-treated embryos. The spots of up- or down-regulated proteins were identified by matrix assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS). Among the identified proteins, 11 were up-regulated in the treated embryos. Four of these up-regulated proteins were antioxidant molecules, three were related to stress response, two to sugar metabolism and two were associated with heat shock response. Of the five proteins up-regulated in the control embryos, three were functionally related to carbohydrate metabolism; the functions of the remaining two proteins were unknown. The data collected during this study indicate that treatment of maize embryos with low energy ion beam implantation induces changes in stress tolerance enzymes/proteins, possibly as a result of alterations in metabolism.

  14. Sleep In Older Adults: Normative Changes, Sleep Disorders, and Treatment Options

    PubMed Central

    Gooneratne, Nalaka S.; Vitiello, Michael V.

    2014-01-01

    1 Synopsis Sleep disorders are common in older adults: Approximately 5% of older adults meet criteria for clinically significant insomnia disorders and 20% for sleep apnea syndromes. When considering insomnia symptoms, it is important to distinguish age-appropriate changes in sleep from clinically significant insomnia, with the latter distinguished by the presence of significant daytime symptoms such as fatigue. Evaluation with a sleep diary and screening for comorbid conditions, especially mood disorders, is essential. Non-pharmacologic therapies, such as cognitive-behavioral therapy for insomnia, can be highly effective and have sustained benefit. A broad range of pharmacologic therapies are also available but can have unwanted psychomotor effects. If left untreated, insomnia can be associated with increased risk of depression and significant impairments in quality of life. In regards to sleep apnea, a high index of suspicion is crucial for effective diagnosis because symptoms commonly noted in younger patients, such as obesity or loud snoring, may not be present in older patients. Diagnosis and management is fairly similar across age groups, except that a more nuanced approach to weight loss is warranted in older adults. The increasing use of home-based portable polysomnography and auto-titrating positive-airway pressure therapy can reduce barriers to treatment. PMID:25037297

  15. Clinical diseases with thrombotic risk and their pharmacologycal treatment: How they change the therapeutic attitude in dental treatments

    PubMed Central

    Martínez-López, Federico; Arrieta-Blanco, Juan J.; Oñate-Cabrerizo, Daniel; Cabrerizo-Merino, Maria C.

    2013-01-01

    The new antiplatelets and anticoagulant drugs have been recently introduced in the daily medical practices for the control of thromboembolism associated with different diseases. The dental assistance of these patients forces us to know these drugs, understand their action mechanisms and try to decrease the risks that entail ours actions in these patients, making a thorough analysis of the risk of bleeding that is going to be related to our medical intervention, as well as the use of all the control measures of the hemorrhage from our knowledge with these patients, and to be prudent. The communication with the medical specialist that supervises these patients must be maxim, being necessary to make clinic trials for establishing protocols or guides of the handling with these patients during the odontological treatment. Key words:Antiplatelet drugs, anticoagulants drugs, new/classic, thrombotic risk, hemorrhagic risk, dental treatment, caution. PMID:24121924

  16. From methadone to buprenorphine: changes during a 10 year period within a national opioid maintenance treatment programme.

    PubMed

    Riksheim, Marianne; Gossop, Michael; Clausen, Thomas

    2014-03-01

    Opioid maintenance treatment (OMT) is the most widely used treatment for opioid dependence. Maintenance programmes differ in various aspects and may also change over time. This paper investigates the changes in treatment practices within a national OMT programme during a 10 year period (2002-2011), especially with regard to the prescribing of methadone and buprenorphine. Data (n=34,001) were collected by annual assessments questionnaires. In 2002, only 16% of the OMT patients received buprenorphine as their maintenance medication. By 2011 this percentage had increased significantly (p<.001) to 50.3%. In the same period the number of patients more than tripled (from 1,984 to 6,640, p<.001), and programme attrition rates decreased (p=.020). This relatively rapid shift is a part of the increasing reliance of addiction medicine upon a range of medications administered by different routes which has not been previously charted within a national treatment programme.

  17. Changes in the profiles of smokers seeking cessation treatment and in its effectiveness in Galicia (Spain) 2001–10

    PubMed Central

    2014-01-01

    Background In recent years, the prevalence of daily smokers has decreased in all developed countries due to a great variety of factors. Despite this decrease, the effectiveness of clinical treatments has decreased and several studies report a change in smokers’ characteristics. The purpose of the present study is to analyze the changes in the characteristics of Spanish smokers who seek smoking cessation treatment between 2001 and 2010 and the changes in the effectiveness of such treatment. Methods The sample was made up of 870 smokers who sought psychological treatment for giving up smoking at the Smoking Cessation Unit in the Faculty of Psychology of the University of Santiago de Compostela (Spain) during the period 2001 to 2010. Results Smokers in the 2006–2010 group, compared to those in the 2001–2005 group, were older, smoked fewer cigarettes per day and of a brand with fewer mg/nicotine, had been smoking longer, were less motivated to give up smoking, and had more antecedents of depression. Quit rates were validated by testing smokers' carbon monoxide (CO) levels. Percentages of abstinence were higher in the 2001–2005 group than in the 2006–2010 group (58.7% vs. 52.15 at the end of treatment, p = 0.05); 30.8% vs. 24.2% at 6 months follow-up, p = 0.031; 27.5% vs. 22% at 12 months follow-up, p = 0.059). Although abstinence decreased more than 5% in the 2006–2010 group there were no differences between the two groups in nicotine dependence. Those participants who did not assist to the follow-up were considered smokers at pretreatment level. Conclusions In Spain there has been a qualitative change in the profile of the smokers seeking smoking cessation treatment. Treatment effectiveness has decreased, and the variables predicting intervention outcome have changed. PMID:24938635

  18. The curious conversion of Empire Blue Cross.

    PubMed

    Robinson, James C

    2003-01-01

    The for-profit conversion of Empire Blue Cross in New York challenges the case law and conventional policy wisdom that financial assets from formerly nonprofit organizations should be used to endow independent charitable foundations. The appropriation of Empire's assets by state government itself, and their subsequent deployment to subsidize health care institutions and repay political obligations, changes the conversion process from one that pits nonprofits against for-profits to one that pits private, nonprofit organizations against public-sector programs in the competition for new financial resources. PMID:12889758

  19. Subchronic treatment with aldosterone induces depression-like behaviours and gene expression changes relevant to major depressive disorder.

    PubMed

    Hlavacova, Natasa; Wes, Paul D; Ondrejcakova, Maria; Flynn, Marianne E; Poundstone, Patricia K; Babic, Stanislav; Murck, Harald; Jezova, Daniela

    2012-03-01

    The potential role of aldosterone in the pathophysiology of depression is unclear. The aim of this study was to test the hypothesis that prolonged elevation of circulating aldosterone induces depression-like behaviour accompanied by disease-relevant changes in gene expression in the hippocampus. Subchronic (2-wk) treatment with aldosterone (2 μg/100 g body weight per day) or vehicle via subcutaneous osmotic minipumps was used to induce hyperaldosteronism in male rats. All rats (n = 20/treatment group) underwent a modified sucrose preference test. Half of the animals from each treatment group were exposed to the forced swim test (FST), which served both as a tool to assess depression-like behaviour and as a stress stimulus. Affymetrix microarray analysis was used to screen the entire rat genome for gene expression changes in the hippocampus. Aldosterone treatment induced an anhedonic state manifested by decreased sucrose preference. In the FST, depressogenic action of aldosterone was manifested by decreased latency to immobility and increased time spent immobile. Aldosterone treatment resulted in transcriptional changes of genes in the hippocampus involved in inflammation, glutamatergic activity, and synaptic and neuritic remodelling. Furthermore, aldosterone-regulated genes substantially overlapped with genes affected by stress in the FST. This study demonstrates the existence of a causal relationship between the hyperaldosteronism and depressive behaviour. In addition, aldosterone treatment induced changes in gene expression that may be relevant to the aetiology of major depressive disorder. Subchronic treatment with aldosterone represents a new animal model of depression, which may contribute to the development of novel targets for the treatment of depression.

  20. Changes in metabolic profile, iron and ferritin levels during the treatment of metastatic renal cancer - A new potential biomarker?

    PubMed

    Golčić, Marin; Petković, Marija

    2016-09-01

    Metastatic renal cell carcinoma (mRCC) develops in approximately 33% of all renal cancer patients. First line treatment of mRCC includes drugs such as sunitinib, temsirolimus and pazopanib, with overall survival now reaching up to 43,6months in patients with favorable-risk metastatic disease. Several side-effects in mRCC treatment, such as hypothyroidism, can be used as positive prognostic factors and indicate good response to therapy. Hypercholesterolemia and hypertriglyceridemia independent of hypothyroidism are reported as side-effects in temsirolimus treatment and recently in sunitinib treatment, but the exact mechanism and significance of the changes remains elusive. Most likely, metabolic changes are caused by inhibition of mechanistic target of rapamycin (mTOR), a positive target of tumor growth suppression, but also a regulator of iron homeostasis. There are no clinical studies reporting changes in iron and ferritin levels during mRCC biotherapy, but we hypothesize that inhibition of mTOR will also affect iron and ferritin levels. If both lipid and iron changes correlate, there is a high possibility that both changes are primarily caused by mTOR inhibition and the level of change should correlate with the inhibition of mTOR pathway and hence the efficacy of targeted treatment. We lastly hypothesize that mRCC biotherapy causes hypercholesterolemia with a possibly improved cholesterol profile due to increase HDL/LDL ratio, so statins might not have a role as supplementary treatment, whereas a sharp rise in triglyceride levels seems to be the primary target for additional therapy. PMID:27515221

  1. Changes in soft-tissue profiles after treatment of class II/1 patients with bite-jumping appliances.

    PubMed

    Lisson, Jörg Alexander; Mokrys, Kay; Kinzinger, Gero Stefan Michael; Glasl, Bettina; Ludwig, Björn

    2013-03-01

    We performed this study to describe changes in the soft-tissue profile after orthodontic treatment with Tränkmann's bite-jumping appliances. A total of 69 patients thus treated were compared to a control group of 36 age-matched patients based on cephalograms. Statistical analysis included mean values, standard deviations, t-tests, and Pearson's correlation testing. Highly significant (p<0.001) changes in total profile angle (N'-Ns-Pog') were observed over the course of treatment. Furthermore, a mildly significant (p<0.05) correlation with SNA angles was noted. Changes in the soft-tissue profile angle (N'-Sn-Pog') were moderately significant (p<0.001). The profile angles of the upper lip (Sn-SS-Ls) and lower lip (Pog'-Sm-Li) did not reveal significant changes. We observed highly significant (p<0.001) findings in the esthetic line (NsPog') advancement relative to the Ls and Li landmarks and in increases in lower-face height. Midface heights remained unchanged. Our results indicate that treatment with bite-jumping appliances results in increased facial convexity, advancement of the esthetic line, and increased lower-face height. The cumulative effects of growth and treatment do not, however, appear pronounced enough to result in a preference for or against treatment with a bite-jumping appliance.

  2. Neural Rhythms of Change: Long-Term Improvement after Successful Treatment in Children with Disruptive Behavior Problems

    PubMed Central

    Woltering, Steven; Liao, Victoria; Liu, Zhong-Xu; Granic, Isabela

    2015-01-01

    Neural changes were investigated for children with disruptive behavior problems one year after a treatment program ended. Thirty-nine children and their parents visited the research lab before, after, and a year after treatment ended. During those lab visits, electroencephalography (EEG) was recorded during a challenging Go/No-go task. Treatment consisted of intensive 14-week combined cognitive behavioral therapy and parent management training sessions. For the analysis, participants were divided into long-term improvers (IMPs) and long-term nonimprovers (NIMPs) based on changes in their externalizing problem scores. The results showed early no-go theta power (4–8 Hz, 100–250 ms) decreased for long-term IMPs compared to NIMPs. When participants were divided based on changes in their comorbid internalizing symptoms, effects were stronger and reductions in theta power were found for early as well as later phases (250–650 ms). We provided preliminary evidence that theta power is a useful neural measure to trace behavioral change linked to improved self-regulation even up to a year after treatment ended. Results may have implications for the characterization of children with disruptive behavior problems and may lead to the development of novel markers of treatment success. PMID:26257962

  3. Changes in perception of treatment efficacy are associated to the magnitude of the nocebo effect and to personality traits

    PubMed Central

    Corsi, Nicole; Emadi Andani, Mehran; Tinazzi, Michele; Fiorio, Mirta

    2016-01-01

    The nocebo effect in motor performance consists in a reduction of force and increase of fatigue following the application of an inert treatment that the recipient believes to be effective. This effect is variable across individuals and it is usually stronger if conditioning –exposure to the active effect of the treatment– precedes a test session, in which the treatment is inert. In the current explorative study we used a conditioning procedure to investigate whether subjective perception of treatment effectiveness changes between the conditioning and the test session and whether this change is related to dispositional traits and to the nocebo-induced reduction of force. Results showed that 56.1% of participants perceived the treatment as more effective in the test than in the conditioning session, had a more pronounced reduction of force, felt more effort and sense of weakness and were characterized by lower levels of optimism and higher anxiety traits compared to the other 43.9% of participants, who conversely perceived the treatment as less effective in the test session than in the conditioning. These findings highlight for the first time a link between changes in perception of treatment effectiveness, personality traits and the magnitude of the nocebo response in motor performance. PMID:27470917

  4. Empirically Based Psychosocial Therapies for Schizophrenia: The Disconnection between Science and Practice.

    PubMed

    Shean, Glenn D

    2013-01-01

    Empirically validated psychosocial therapies for individuals diagnosed with schizophrenia were described in the report of the Schizophrenia Patient Outcomes Research Team (PORT, 2009). The PORT team identified eight psychosocial treatments: assertive community treatment, supported employment, cognitive behavioral therapy, family-based services, token economy, skills training, psychosocial interventions for alcohol and substance use disorders, and psychosocial interventions for weight management. PORT listings of empirically validated psychosocial therapies provide a useful template for the design of effective recovery-oriented mental health care systems. Unfortunately, surveys indicate that PORT listings have not been implemented in clinical settings. Obstacles to the implementation of PORT psychosocial therapy listings and suggestions for changes needed to foster implementation are discussed. Limitations of PORT therapy listings that are based on therapy outcome efficacy studies are discussed, and cross-cultural and course and outcome studies of correlates of recovery are summarized. PMID:23738068

  5. Darwinism and cultural change.

    PubMed

    Godfrey-Smith, Peter

    2012-08-01

    Evolutionary models of cultural change have acquired an important role in attempts to explain the course of human evolution, especially our specialization in knowledge-gathering and intelligent control of environments. In both biological and cultural change, different patterns of explanation become relevant at different 'grains' of analysis and in contexts associated with different explanatory targets. Existing treatments of the evolutionary approach to culture, both positive and negative, underestimate the importance of these distinctions. Close attention to grain of analysis motivates distinctions between three possible modes of cultural evolution, each associated with different empirical assumptions and explanatory roles.

  6. Changing needs for appropriate excreta disposal and small wastewater treatment methodologies or The future technology of small wastewater treatment systems.

    PubMed

    Randall, C W

    2003-01-01

    Recent developments will strongly influence the design and utilization of small wastewater treatment systems in the future, e.g. population increases in non-sewered rural areas and developing countries; increasing impairment of surface water quality; the construction of occupied high-rise buildings in metropolitan areas; the development of planned but somewhat isolated communities, growing shortages of water that mandate reuse of wastewaters. It is well known that there is a very strong linkage between wastewater disposal methods in rural areas and developing countries and the general health of the population. These problems could be greatly reduced or prevented by the utilization of well known excreta disposal and small wastewater treatment system technologies, but the development of more innovative on-site systems is needed. It is expected that future environmental and public health pressures in developed countries will require increasingly stringent effluent limitations for small and on-site wastewater disposal systems, based primarily on nutrient discharges. Both on-site and small-scale technologies are available for the more stringent requirements, but innovative and more economical designs are needed for wide-spread acceptance. Water reuse should be a consideration for the designs of these systems. Implementation and utilization of well known technologies are needed, but the obstacles are often more social and political than economical.

  7. Evaluating the dosimetric effect of treatment-induced changes in virally mediated head and neck cancer patients

    SciTech Connect

    Brown, Elizabeth; Owen, Rebecca; Mengersen, Kerrie; Harden, Fiona; Porceddu, Sandro

    2013-12-15

    Patients with virally mediated head and neck cancer (VMHNC) often present with advanced nodal disease that is highly radioresponsive as demonstrated by tumour and nodal regression during treatment. The resultant changes may impact on the planned dose distribution and so adversely affect the therapeutic ratio. The aim of this study was to evaluate the dosimetric effect of treatment-induced anatomical changes in VMHNC patients who had undergone a replan. Thirteen patients with virally mediated oropharyngeal or nasopharyngeal cancer who presented for definitive radiotherapy between 2005 and 2010 and who had a replan generated were investigated. The dosimetric effect of anatomical changes was quantified by comparing dose–volume histograms (DVH) of primary and nodal gross target volumes and organs at risk (OAR), including spinal cord and parotid glands, from the original plan and a comparison plan. Eleven three-dimensional conformal radiation therapy (3DCRT) and two intensity modulated radiation therapy (IMRT) plans were evaluated. Dose to the spinal cord and brainstem increased by 4.1% and 2.6%, respectively. Mean dose to the parotid glands also increased by 3.5%. In contrast, the dose received by 98% of the primary and nodal gross tumour volumes decreased by 0.15% and 0.3%, respectively, when comparing the initial treatment plan to the comparison plan. In this study, treatment-induced anatomical changes had the greatest impact on OAR dose with negligible effect on the dose to nodal gross tumour volumes. In the era of IMRT, accounting for treatment-induced anatomical changes is important as focus is placed on minimizing the acute and long-term side effects of treatment.

  8. Changes in quantity and spectroscopic properties of water-extractable organic matter during soil aquifer treatment.

    PubMed

    Xue, S; Zhao, Q L; Wei, L L; Ma, X P; Tie, M

    2013-01-01

    The aim of this study was to identify qualitative and quantitative changes in the character of water-extractable organic matter (WEOM) in soils as a consequence of soil aquifer treatment (SAT). Soil samples were obtained from a soil-column system with a 2-year operation, and divided into seven layers from top to bottom: CS1 (0-12.5 cm), CS2 (12.5-25 cm), CS3 (25-50 cm), CS4 (50-75 cm), CS5 (75-100 cm), CS6 (100-125 cm) and CS7 (125-150 cm). A sample of the original soil used to pack the columns was also analysed to determine the effects of SAT. Following 2 years of SAT operation, both soil organic carbon and water-extractable organic carbon were shown to accumulate in the top soil layer (0-12.5 cm), and to decrease in soil layers deeper than 12.5 cm. The WEOM in the top soil layer was characterized by low aromaticity index (AI), low emission humification index (HIX) and low fluorescence efficiency index (F(eff)). On the other hand, the WEOM in soil layers deeper than 12.5 cm had increased values of HIX and F(eff), as well as decreased AI values relative to the original soil before SAT. In all soil layers, the percentage of hydrophobic and transphilic fractions decreased, while that of the hydrophilic fraction increased, as a result of SAT. The production of the amide-2 functional groups was observed in the top soil layer. SAT operation also led to the enrichment of hydrocarbon and amide-1 functional groups, as well as the depletion of oxygen-containing functional groups in soil layers deeper than 12.5 cm.

  9. Personal network characteristics of youth in substance use treatment: Motivation for and perceived difficulty of positive network change

    PubMed Central

    Chung, Tammy; Sealy, Lauren; Abraham, Margaret; Ruglovsky, Cynthia; Schall, Jacqueline; Maisto, Stephen A.

    2014-01-01

    Background Among youth in substance use treatment, peer substance use consistently predicts worse treatment outcome. This study characterized personal (ego-centric) networks of treated youth, and examined predictors of adolescents’ motivation and perceived difficulty in making changes in the peer network to support recovery. Methods Adolescents (ages 14–18, n=155) recruited from substance use treatment reported on substance use severity, motivation to abstain from substance use, abstinence goals such as “temporary abstinence”, motivation and perceived difficulty in reducing contact with substance using peers, and personal network characteristics. Personal network variables included composition (proportion of abstinent peers); and structure (number of network members, extent of ties among members) for household and non-household (peer) members. Results Although a majority of peer network members were perceived as using alcohol or marijuana, youth in treatment had relatively high motivation to abstain from substance use. However, treated youths’ motivation to reduce contact with substance using peers was relatively low. In particular, a goal of temporary abstinence was associated with lower motivation to change the peer network. For marijuana, specifically, network composition features (proportion of abstinent peers) were associated with motivation and perceived difficulty to change the peer network. For marijuana, in particular, network structural variables (extent of ties among members) were associated only with perceived difficulty of changing the peer network. Conclusions Despite high motivation to abstain from substance use during treatment, adolescents reported low motivation to reduce contact with substance using peers. Personal motivation to abstain and abstinence goal predicted motivation to reduce contact with substance using peers. In contrast, particularly for marijuana, network structure predicted perceived difficulty of network change. Results

  10. Treatment

    MedlinePlus

    ... Prevention Treatment 2003 U.S. Outbreak African Rodent Importation Ban For Clinicians Clinical Recognition Specimen Collection Treatment Smallpox ... Examining Animals with Suspected Monkeypox African Rodent Importation Ban Resources Related Links Poxvirus Molluscum Contagiosum Orf Virus ( ...

  11. Effectiveness of en-masse retraction using midpalatal miniscrews and a modified transpalatal arch: Treatment duration and dentoskeletal changes

    PubMed Central

    Lee, Jungkil; Tabuchi, Masako; Sato, Takuma; Kawaguchi, Misuzu; Goto, Shigemi

    2014-01-01

    Objective The purpose of this study was to compare the treatment duration and dentoskeletal changes between two different anchorage systems used to treat maxillary dentoalveolar protrusion and to examine the effectiveness of en-masse retraction using two miniscrews placed in the midpalatal suture. Methods Fifty-seven patients (9 men, 48 women), who had undergone level anchorage system treatment at Aichi-Gakuin University Dental Hospital (Nagoya, Japan) were divided into two groups according to the method of maxillary posterior anchorage reinforcement: midpalatal miniscrews (25 patients, mean age 22 years) and conventional anchorage (32 patients, mean age 19 years). The en-masse retraction period, overall treatment duration, pre-treatment effective ANB angle, and change in the effective ANB angle were compared with an independent-samples t-test. Results Compared to the headgear group, the duration of en-masse retraction was longer by approximately 4 months in the miniscrew group (p < 0.001). However, we found no significant difference in the total treatment duration between the groups. Moreover, a greater change in the effective ANB angle was observed in patients treated with miniscrews than in those treated with the conventional method (p < 0.05). Conclusions The level anchorage system treatment using miniscrews placed in the midpalatal area will allow orthodontists more time to control the anterior teeth during en-masse retraction, without increasing the total treatment duration. Furthermore, it achieves better dentoskeletal control than does the conventional anchorage method, thereby improving the quality of the treatment results. PMID:24696825

  12. What 'empirical turn in bioethics'?

    PubMed

    Hurst, Samia

    2010-10-01

    Uncertainty as to how we should articulate empirical data and normative reasoning seems to underlie most difficulties regarding the 'empirical turn' in bioethics. This article examines three different ways in which we could understand 'empirical turn'. Using real facts in normative reasoning is trivial and would not represent a 'turn'. Becoming an empirical discipline through a shift to the social and neurosciences would be a turn away from normative thinking, which we should not take. Conducting empirical research to inform normative reasoning is the usual meaning given to the term 'empirical turn'. In this sense, however, the turn is incomplete. Bioethics has imported methodological tools from empirical disciplines, but too often it has not imported the standards to which researchers in these disciplines are held. Integrating empirical and normative approaches also represents true added difficulties. Addressing these issues from the standpoint of debates on the fact-value distinction can cloud very real methodological concerns by displacing the debate to a level of abstraction where they need not be apparent. Ideally, empirical research in bioethics should meet standards for empirical and normative validity similar to those used in the source disciplines for these methods, and articulate these aspects clearly and appropriately. More modestly, criteria to ensure that none of these standards are completely left aside would improve the quality of empirical bioethics research and partly clear the air of critiques addressing its theoretical justification, when its rigour in the particularly difficult context of interdisciplinarity is what should be at stake.

  13. Identifying MRI markers to evaluate early treatment-related changes post-laser ablation for cancer pain management

    NASA Astrophysics Data System (ADS)

    Tiwari, Pallavi; Danish, Shabbar; Madabhushi, Anant

    2014-03-01

    Laser interstitial thermal therapy (LITT) has recently emerged as a new treatment modality for cancer pain management that targets the cingulum (pain center in the brain), and has shown promise over radio-frequency (RF) based ablation which is reported to provide temporary relief. One of the major advantages enjoyed by LITT is its compatibility with magnetic resonance imaging (MRI), allowing for high resolution in vivo imaging to be used in LITT procedures. Since laser ablation for pain management is currently exploratory and is only performed at a few centers worldwide, its short-, and long-term effects on the cingulum are currently unknown. Traditionally treatment effects are evaluated by monitoring changes in volume of the ablation zone post-treatment. However, this is sub-optimal since it involves evaluating a single global parameter (volume) to detect changes pre-, and post-MRI. Additionally, the qualitative observations of LITT-related changes on multi-parametric MRI (MPMRI) do not specifically address differentiation between the appearance of treatment related changes (edema, necrosis) from recurrence of the disease (pain recurrence). In this work, we explore the utility of computer extracted texture descriptors on MP-MRI to capture early treatment related changes on a per-voxel basis by extracting quantitative relationships that may allow for an in-depth understanding of tissue response to LITT on MRI, subtle changes that may not be appreciable on original MR intensities. The second objective of this work is to investigate the efficacy of different MRI protocols in accurately capturing treatment related changes within and outside the ablation zone post-LITT. A retrospective cohort of studies comprising pre- and 24-hour post-LITT 3 Tesla T1-weighted (T1w), T2w, T2-GRE, and T2-FLAIR acquisitions was considered. Our scheme involved (1) inter-protocol as well as inter-acquisition affine registration of pre- and post-LITT MRI, (2) quantitation of MRI parameters

  14. Prostate cancer patients' quality of life assessments across the primary treatment trajectory: 'True' change or response shift?

    PubMed

    Gerlich, Christian; Schuler, Michael; Jelitte, Matthias; Neuderth, Silke; Flentje, Michael; Graefen, Markus; Krüger, Alexander; Mehnert, Anja; Faller, Hermann

    2016-07-01

    Background Self-report questionnaires are widely used to assess changes in quality of life (QoL) during the course of cancer treatment. However, comparing baseline scores to follow-up scores is only justified if patients' internal measurement standards have not changed over time, that is, no response shift occurred. We aimed to examine response shift in terms of reconceptualization, reprioritization and recalibration among prostate cancer patients. Material and methods We included 402 newly diagnosed patients (mean age 65 years) and assessed QoL at the beginning of cancer treatment and three months later. QoL was measured with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). We employed structural equation modeling testing measurement invariance between occasions to disentangle 'true' change and change in the measurement model (response shift). Results We found reprioritization effects for both the Physical Functioning and Role Functioning subscales of the EORTC QLQ-C30, indicating that both had gained importance for representing the latent construct of QoL at follow-up. These effects added to the worsening effect evident in the latent construct, thus rendering observed changes even more pronounced. In addition, we found recalibration effects for both the Emotional Functioning and Cognitive Functioning subscales indicating judgments becoming more lenient over time. These effects counteracted 'true' negative changes thus obscuring any substantial changes on the observed level. Conclusion Our results suggest that changes observed in some subscales of the EORTC QLQ-C30 should not be taken at face value as they may be affected by patients' changed measurement standards. PMID:26882096

  15. Incidence of Changes in Respiration-Induced Tumor Motion and Its Relationship With Respiratory Surrogates During Individual Treatment Fractions

    SciTech Connect

    Malinowski, Kathleen; McAvoy, Thomas J.; George, Rohini; Dietrich, Sonja; D'Souza, Warren D.

    2012-04-01

    Purpose: To determine how frequently (1) tumor motion and (2) the spatial relationship between tumor and respiratory surrogate markers change during a treatment fraction in lung and pancreas cancer patients. Methods and Materials: A Cyberknife Synchrony system radiographically localized the tumor and simultaneously tracked three respiratory surrogate markers fixed to a form-fitting vest. Data in 55 lung and 29 pancreas fractions were divided into successive 10-min blocks. Mean tumor positions and tumor position distributions were compared across 10-min blocks of data. Treatment margins were calculated from both 10 and 30 min of data. Partial least squares (PLS) regression models of tumor positions as a function of external surrogate marker positions were created from the first 10 min of data in each fraction; the incidence of significant PLS model degradation was used to assess changes in the spatial relationship between tumors and surrogate markers. Results: The absolute change in mean tumor position from first to third 10-min blocks was >5 mm in 13% and 7% of lung and pancreas cases, respectively. Superior-inferior and medial-lateral differences in mean tumor position were significantly associated with the lobe of lung. In 61% and 54% of lung and pancreas fractions, respectively, margins calculated from 30 min of data were larger than margins calculated from 10 min of data. The change in treatment margin magnitude for superior-inferior motion was >1 mm in 42% of lung and 45% of pancreas fractions. Significantly increasing tumor position prediction model error (mean {+-} standard deviation rates of change of 1.6 {+-} 2.5 mm per 10 min) over 30 min indicated tumor-surrogate relationship changes in 63% of fractions. Conclusions: Both tumor motion and the relationship between tumor and respiratory surrogate displacements change in most treatment fractions for patient in-room time of 30 min.

  16. Anthropometric, bone age, and bone mineral density changes after a family-based treatment for obese children.

    PubMed

    Bermudez de la Vega, J Antonio; Vázquez, M Angeles; Bernal, Susana; Gentil, F Javier; Gonzalez-Hachero, Jose; Montoya, M Jose; Pérez-Cano, Ramón

    2007-10-01

    Our objective was to identify anthropometric, bone age, and bone mineral density (BMD) changes after a family-based treatment program for obese children. We conducted a longitudinal prospective study of 50 obese children (body mass index percentage [BMI%] > or =120%) aged 9.12 +/- 1.72 years (range 6-13) at baseline. A family-based treatment program, based on inadequate feeding style with progressive modification, aerobic physical exercise increase, active parental involvement, and the use of behavioural strategies (contracting, self-monitoring, social reinforcement), was developed during a 12-month period. Anthropometric data, lumbar spine (L2-L4) BMD by dual-energy X-ray absorptiometry, bone age (BA), bone age to chronological age ratio (BA/CA), and predicted adult height (PAH) were determined at baseline and 12 months. The statistical method used was analysis of variance and the paired Student t-test. Mean BMI standard deviation score (SDS) loss was -0.61 +/- 0.76 and BMI% loss was -5.17 +/- 9.73%. Height SDS significantly decreased, BA/CA ratio also decreased significantly, and PAH change was not significant. Lumbar spine BMD SDS and BMD% did not significantly change. A family-based treatment program was effective in obese children by reducing by 5% the BMI in 1 year and increasing the activity level. Treatment reduced growth velocity and delayed bone maturation rate without affecting PAH, reflecting a situation of previous early maturation. The treatment did not modify gaining bone mass.

  17. Hippocampal Neurometabolite Changes in Hypothyroidism: An In Vivo (1) H Magnetic Resonance Spectroscopy Study Before and After Thyroxine Treatment.

    PubMed

    Singh, S; Rana, P; Kumar, P; Shankar, L R; Khushu, S

    2016-09-01

    The hippocampus is a thyroid hormone receptor-rich region of the brain. A change in thyroid hormone levels may be responsible for an alteration in hippocampal-associated function, such as learning, memory and attention. Neuroimaging studies have shown functional and structural changes in the hippocampus as a result of hypothyroidism. However, the underlying process responsible for this dysfuncti