777 research outputs found
Retrospective US database analysis of drug utilization patterns, health care resource use, and costs associated with adjuvant interferon alfa-2b therapy for treatment of malignant melanoma following surgery
No full textMichelle D Hackshaw,1 Arun Krishna,2 David J Mauro31,2Global Health Outcomes, Merck, Sharpe and Dohme Corporation, Whitehouse Station, NJ, USA; 3Clinical Research, Merck Research Laboratories, Upper Gwynedd, PA, USABackground: The purpose of this study was to identify a real-world US population having undergone surgery for malignant melanoma and describe treatment patterns, health care resource utilization, and costs for patients who subsequently received interferon alfa-2b (IFN) therapy or other standard of care chemotherapies.Methods: A retrospective cohort study was conducted using administrative claims from MarketScan® databases among melanoma patients diagnosed between 2004 and 2008 who had surgery and were subsequently treated with IFN or other chemotherapies. Health care resource utilization and costs of services (converted to 2009 dollars) were evaluated. Cost refers to the amount paid to providers associated with the health service.Results: Of 18,075 subjects with melanoma surgery claims, 1525 (8.4%) were treated with IFN and 1194 (6.6%) with other chemotherapies. Median duration (days) and number of doses of IFN therapy were 29 and 20, respectively. Approximately half of patients who received IFN discontinued therapy within or after the one-month induction phase. For IFN therapy patients, average total cost per patient for the last melanoma-related surgery prior to start of therapy, including costs of the surgery itself, pathology, anesthesia, and hospital care, was 1188; this included costs for drug, office visits, blood work, and infusions. Other chemotherapy costs ranged from 2678.Conclusion: There is an unmet treatment need, considering that this study observed that melanoma patients on IFN therapy post-surgery do not complete the recommended one-year course of treatment which may compromise its full therapeutic benefits. Further study to investigate reasons for discontinuation may be warranted. In addition, costs associated with adjuvant IFN therapy in post-surgical treatment of disease are likely acceptable.Keywords: malignant melanoma, interferon alfa-2b, post-surgery, claims data, costs, resource utilizatio
Genetic influences on level and stability of self-esteem
No full textWe attempted to clarify the relation between self-esteem level (high vs. low) and perceived self-esteem stability (within-person variability) by using a behavioral genetics approach. We tested whether the same or independent genetic and environmental influences impact on level and stability. Adolescent twin siblings (n = 183 pairs) completed level and stability scales at two time points. Heritability for both was substantial. The remaining variance in each was attributable to non-shared environmental influences. Shared environmental influences were not significant. Level and stability of self-esteem shared common antecedents via genetic and non-shared environmental influences. Nonetheless, stability was influenced by substantial unique genetic and non-shared environmental influences. The results validate the notion that level and stability are partially autonomous components of self-esteem
Mitigating Food Insecurity During a National Crisis: Describing Food Banks' Resilience During the Covid-19 Pandemic
No full textFood banks were established to address hunger in the U.S. because of an instability in government laws, federal programs, and community need. Food banks are front-line resources for many populations, especially during catastrophic events. The SARS-CoV-2 (COVID-19) pandemic is no exception. Federal, state, and local laws and guidelines to slow down the transmission of COVID-19, generated national economic instability and a sharp increase in all human welfare issues. Using Community Resilience Theory, this thesis aims to describe food banks’ experiences and resilience during the SARS-CoV-2 pandemic. The author contacted over 25 food banks out of 200 in the Feeding America network for interviews using a stratified design then convenience sampling method. Seven committed to interviews. Community Resilience Theory informed interview questions and coded themes. The author used deductive coding for each transcript using the following themes: initial determinants of program change, persistent pandemic challenges, assets, and program change. The author used inductive coding for subthemes. Policy changes to mitigate the SARS-CoV-2 virus at the local, state, and national levels in the way of “lock down” measures, social distancing procedures, personal protective equipment (PPE), and limitations on the number of people in enclosed spaces, created significant operational challenges for food banks and an increase in community need. Food banks felt they were resilient by overcoming the operational challenges and community need by creating new partnerships and utilizing the abundance of financial resources during the pandemic
Enacting Reasoning-and-Proving in Secondary Mathematics Classrooms through Tasks
No full textProof is the mathematical way of convincing oneself and others of the truth of a claim for all cases in the domain under consideration. As such, reasoning-and-proving is a crucial, formative practice for all students in kindergarten through twelfth grade, which is reflected in the Common Core State Standards in Mathematics. However, students and teachers exhibit many difficulties employing, writing, and understanding reasoning-and-proving. In particular, teachers are challenged by their knowledge base, insufficient resources, and unsupportive pedagogy.
The Cases of Reasoning and Proving (CORP) materials were designed to offer teachers opportunities to engage in reasoning-and-proving tasks, discuss samples of authentic practice, examine research-based frameworks, and develop criteria for evaluating reasoning-and-proving products based on the core elements of proof. A six-week graduate level course was taught with the CORP materials with the goal of developing teachers’ understanding of what constitutes reasoning-and-proving, how secondary students benefit from reasoning-and-proving, and how they can support the development of students’ capacities to reason-and-prove. Research was conducted on four participants of the course during either their first or second year of teaching. The purpose of the research was to study the extent to which the participants selected, implemented, and evaluated students’ work on reasoning-and-proving tasks. The participants’ abilities were examined through an analysis of answers to interview questions, tasks used in class, and samples of student work, and scoring criteria. The results suggest that: 1.) participants were able to overcome some of the limitations of their insufficient resource by modifying and creating some reasoning-and-proving exercises; 2.) participants were able to maintain the level of cognitive demand of proof tasks during implementation; and 3) participants included some if not all of the core elements of proof in their definition of proof and in their evaluation criteria for student products of reasoning-and-proving products
The effect of whole grain rye flour arabinoxylans on the physical and chemical characteristics of a low moisture baked good.:
No full textIn recent years, greater emphasis has been placed on the health benefits of whole grains. Studies have shown that whole grains are a source of fiber, reduce the risk of cardiovascular disease, diabetes and stroke and may help achieve weight loss. Rye, a cereal typically consumed as a whole grain, possesses such benefits.
Arabinoxylans are non-starch polysaccharides comprised of a β-(1,4) linked D-xylopyranosyl backbone with α-L-arabinofuranose units attached as side residues via the α-(1,3) and/or α-(1,2) linkages. These compounds are found in whole grain and are particularly high in whole grain rye flour. These compounds are purported to contributor to the many health benefits associated with whole grain rye. While there are many health benefits attributed to arabinoxylans, they greatly impact dough rheology and baking by binding water, softening the dough and altering gluten functionality.
The removal or alteration of a portion of the arabinoxylans via water extraction or enzymatic degradation will change their functionality significantly. This has been demonstrated in wheat systems including wheat doughs and wheat breads but fewer studies have been conducted utilizing whole grain rye flour in whole grain rye doughs and low moisture baked goods such as cookies. Therefore, it is hypothesized that the chemical structure of arabinoxylans in whole grain rye flour will affect the product attributes of low moisture baked goods such as cookies.
The hypothesis can be tested by characterizing whole grain rye flour arabinoxylans which have been water extracted or enzymatically degraded with a variety of enzymes including Bacillus subtilis, Aspergillus niger and arabinofuranosidase. In model dough systems, it is evident that the use of the enzyme Bacillus subtilis produces a dough which requires less water and is less viscous vs. a control. In a model cookie system, the addition of Bacillus subtilis produces a cookie with a larger geometry. The Aspergillus niger and arabinofuranosidase show some differences vs. the control sample using these test methods as well.Ph.D.Includes bibliographical references (p. 122-127)by Michelle Denine Beave
DNA fusion gene vaccination mobilizes effective anti-leukemic cytotoxic T lymphocytes from a tolerized repertoire
No full textThe majority of known human tumor-associated antigens derive from non-mutated self proteins. T cell tolerance, essential to prevent autoimmunity, must therefore be cautiously circumvented to generate cytotoxic T cell responses against these targets. Our strategy uses DNA fusion vaccines to activate high levels of peptide-specific CTL. Key foreign sequences from tetanus toxin activate tolerance-breaking CD4+ T cell help. Candidate MHC class Ibinding tumor peptide sequences are fused to the C terminus for optimal processing and presentation. To model performance against a leukemia-associated antigen in a tolerized setting, we constructed a fusion vaccine encoding an immunodominant CTL epitopederived from Friend murine leukemia virus gag protein (FMuLVgag) and vaccinated tolerant FMuLVgag-transgenic (gag-Tg) mice. Vaccination with the construct induced epitopespecificIFN-c-producing CD8+ T cells in normal and gag-Tg mice. The frequency and avidity of activated cells were reduced in gag-Tg mice, and no autoimmune injury resulted. However, these CD8+ T cells did exhibit gag-specific cytotoxicity in vitro and in vivo. Also, epitope-specific CTL killed FBL-3 leukemia cells expressing endogenous FMuLVgag antigen and protected against leukemia challenge in vivo. These results demonstrate a simple strategy to engage anti-microbial T cell help to activate epitope-specific polyclonal CD8+ T cell responses from a residual tolerized repertoire
The role of vitamin D in neuroprotection in multiple sclerosis: an update
No full textMultiple sclerosis (MS) is a complex neurological condition that involves both inflammatory demyelinating and neurodegenerative components. MS research and treatments have traditionally focused on immunomodulation, with less investigation of neuroprotection, and this holds true for the role of vitamin D in MS. Researchers have already established that vitamin D plays an anti-inflammatory role in modulating the immune system in MS. More recently, researchers have begun investigating the potential neuroprotective role of vitamin D in MS. The active form of vitamin D, 1,25(OH)2D3, has a range of neuroprotective properties, which may be important in remyelination and/or the prevention of demyelination. The most notable finding relevant to MS is that 1,25(OH)2D3 promotes stem cell proliferation and drives the differentiation of neural stem cells into oligodendrocytes, which carry out remyelination. In addition, 1,25(OH)2D3 counteracts neurodegeneration and oxidative stress by suppressing the activation of reactive astrocytes and M1 microglia. 1,25(OH)2D3 also promotes the expression of various neuroprotective factors, including neurotrophins and antioxidant enzymes. 1,25(OH)2D3 decreases blood–brain barrier permeability, reducing leukocyte recruitment into the central nervous system. These neuroprotective effects, stimulated by 1,25(OH)2D3, all enhance neuronal survival. This review summarizes and connects the current evidence supporting the vitamin D-mediated mechanisms of action for neuroprotection in MS.Peer reviewedvitamin Dmultiple sclerosisneuroprotectionneurodegeneration1,25(OH)2D
Sleep-associated adverse events during the methylphenidate treatment of attention-deficit/hyperactivity disorder: A meta-analysis
No full textObjective: Sleep disturbances are a feature of attention deficit/hyperactivity disorder (ADHD) and an adverse event (AE) of methylphenidate (MPH) treatment. We sought to clarify MPH-associated sleep problems and how studies are affected by confounding factors. Data Sources: Published studies in English collected via online databases and unpublished data from www.clinicaltrials.gov and FDA websites. Sources were searched from inception to August 2017. Study Selection: We included blinded placebo-controlled studies of youth with ADHD conducted in naturalistic settings. This led to 35 studies yielding 75 observations of sleep-related AEs. These studies comprised 3079 drug-exposed and 2606 placebo-treated patients. Data Extraction: Two PhD reviewers reviewed each study for inclusion. Four PhD/PharmD reviewers extracted data in duplicate. Discrepancies were resolved by discussion or, if needed, by the senior author. Results: We found increased pooled relative risks (RRs) for MPH-associated sleep-related AEs for insomnia, initial insomnia, middle insomnia, combined insomnia, and sleep disorder. Several sample or study design features were significantly associated with the RR for sleep-related AEs and the MPH formulation studied. After correcting for confounding, we found significant differences among drugs. We show that the RR, and its interpretation, is constrained by the placebo AE rate. Conclusions: Several types of insomnia and sleep problems are associated with MPH treatment. Study design and sample features influence the RR statistic. By showing that the rate of placebo AEs impacts the RR, we provide the field with a useful covariate for adjusting RR statistics
Ashes col' darg lay dong: Trinidadian students' response to the UK
No full textThis research investigates how Trinidadian students in the United Kingdom (UK) respond to their new environment. The research explores and conceptualises the participants? experiences in the UK. It investigates Trinidadian student adjustment in the UK from a postcolonial perspective. To acquire data on Trinidadian experiences in the UK I created a private, password-protected group blog (interactive webpage) where eight respondents interacted and shared aspects of their everyday life and experiences over six months. After the blogging period follow-up face-to-face individual interviews were conducted with five of the eight participants. The research design was formulated so that the two methods would work together to paint a vivid, multidimensional and dynamic picture of the participants? experiences. These two techniques together are referred to as the blog-interview method. The experiences of three of the participants were captured as in-depth case studies. Grounded Theory was used to analyze the data and generate a working theory of the participants? experiences. A theory of adjustment, called (dis)juncture, was developed. The theory views the students? adjustment as a continuous process of negotiation among simultaneous connecting and disconnecting forces. This can create a student who is a synergy of global experiences, signifying systems, representations, identities, worldviews and perspectives that are not exclusively in one domain: they are hybrid. Unlike much work in this area, (dis)juncture does not view adjustment in stages nor does it assume that adjustment is something that can be achieved. Adjustment is advanced as a process of continuous transformation as a result of constant contact with multiple signifying systems simultaneously. (Dis)Juncture breaks important ground in the field by reconceptualising and re-imaging the process of international student adjustment. The theory thus makes a significant contribution to research on international student experience
The rise and fall of the Labour league of youth
No full textThis thesis charts the rise and fall of the Labour Party’s first and most enduring youth organisation, the Labour League of Youth. The history of the League, from its birth in the early nineteen twenties to its demise in the late nineteen fifties, is placed in the context of the Labour Party’s subsequent fruitless attempts to establish and maintain a vibrant and functional youth organisation. A narrative is incorporated that illuminates the culture, organisation and political activism of the League and establishes it as a predominantly working class radical organisation. The reluctance on the part of the Labour Party to grant autonomy to its youth sections resulted in the history of the League of Youth being one of control, suppression and tension. This state of affairs ensured that subsequent youth groups, the Young Socialists and Young Labour, would be established in an atmosphere of reservation and scepticism.
The thesis places the prime responsibility for the failure of the party’s youth organisations with the party leadership but also considers the contributory factors of changing social and political circumstances. A number of themes are explored which include the impact of structure and agency factors, the power of the Parliamentary Labour Party, the political socialisation of leading figures within the party, the social context in which each of the groups emerged and the extent to which the youth groups were prey to intra-party factionalism.
The thesis redresses the balance of research where most accounts have focussed on the Young Socialists and traces the common characteristics that are prevalent in the way the party leadership has approached its relationship with its youth organisations. Use has been made of previously unpublished primary source material, the major source being the League of Youth members themselves whose recollections have helped to demonstrate the arguments put forward in this thesis
- …
