66 research outputs found
Short-term effect of different teaching methods on nasopharyngeal carcinoma for general practitioners in Jakarta, Indonesia
No full textIn Indonesia, Nasopharyngeal Carcinoma (NPC) is the most frequent cancer of the head and neck region. At first presentation in the hospital most patients already have advanced NPC. Our previous study showed that general practitioners (GPs) working in Yogyakarta, Indonesia lack the knowledge necessary for early detection of NPC. By providing training on early symptoms of NPC we hope that the diagnosis and referral will occur at an earlier stage. Here we assess the current NPC knowledge levels of GPs in Jakarta, evaluate improvement after training, compare the effectiveness of two training formats, and estimate the loss of recall over a two week period.Maarten A. Wildeman, Renske Fles, Marlinda Adham, Ika D. Mayangsari, Ilse Luirink, Mara Sandberg, Andrew D. Vincent, Faiziah Fardizza, Zanil Musa, Armiyanto, Jaap M. Middeldorp, Geerten Gerritsen, Ronny Suwanto, I. Bing Ta
Towards Quantitative Spatio-Temporal Gene Expression Measurements in Mice
No full textIn this project we tried to answer the question whether it is possible to obtain in vivo quantitative spatiotemporal gene expression data of mice, by making use of the GFP protein and Biofluorence Imaging. The research was driven by a more specific question, being whether it is possible to detect if metastasis to the bone has occurred in cancer progression studies, using GFP cancel cell lines, i.e cancer cells that produce Green Fluorescent Proteins (GFP), at a continuous known rate. We tried to give generic answers by researching the following two subquestions. 1.) Is it possible to register a 3D mouse atlas to 2D Bioluminescense or Fluorescence photographs, based on only those photographs? 2.) Can we make qualitative statements on the location of gene expression, after registration with an atlas? The first question is covered in a paper called: 'Atlas Driven Registration of 3D Voxel Data to Multi-view Photographs Based on 3D Distance Maps.' It explains a method to register a 3D piecewise deformable mouse atlas to 2 or more photographic sideviews of a mouse. Based on a distance map that we generated from multiple backprojections of the sideview, we were able to construct an energy function that resembled a 'goodness of fit' of the registration. Comparisons were made with a gold standard and we obtained good results with our method. The second question is covered in a paper called: 'Testing for Spatial Gene Enrichment in C. Elegans Using Chronograms and a 1D Worm Atlas'. In this paper we did not focus on the registration process, because this was a straightforward procedure. With an atlas registered to an expression dataset, we applied different statistical tests to answer the question that given the atlas and the expression profile, the observed expression shows enrichment in a selected organ or not. In this paper we show that we are able to filter highly enriched signals out of our complete dataset. We further discuss the added value of our atlas since it is difficult to validate the obtained results of our tests.Electrical Engineering, Mathematics and Computer Scienc
Can an online clinical data management service help in improving data collection and data quality in a developing country setting?
No full textBackground: Data collection by Electronic Medical Record (EMR) systems have been proven to be helpful in data collection for scientific research and in improving healthcare. For a multi-centre trial in Indonesia and the Netherlands a web based system was selected to enable all participating centres to easily access data. This study assesses whether the introduction of a Clinical Trial Data Management service (CTDMS) composed of electronic Case Report Forms (eCRF) can result in effective data collection and treatment monitoring. Methods: Data items entered were checked for inconsistencies automatically when submitted online. The data were divided into primary and secondary data items. We analysed both the total number of errors and the change in error rate, for both Primary and Secondary items, over the first five month of the trial. Results: In the first five months 51 patients were entered. The Primary data error rate was 1.6%, whilst that for Secondary data was 2.7% against acceptable error rates for analysis of 1% and 2.5% respectively. Conclusion: The presented analysis shows that after five months since the introduction of the CTDMS the Primary and Secondary data error rates reflect acceptable levels of data quality. Furthermore, these error rates were decreasing over time. The digital nature of the CTDMS, as well as the online availability of that data, gives fast and easy insight in adherence to treatment protocols. As such, the CTDMS can serve as a tool to train and educate medical doctors and can improve treatment protocols.Maarten A Wildeman, Jeroen Zandbergen, Andrew Vincent, Camelia Herdini, Jaap M Middeldorp, Renske Fles, Otilia Dalesio, Emile van der Donk, I Bing Ta
Agonizing Identity in Mental Health Law and Policy (Part I)
No full textIn this two-part paper, the author explores the significance of identity in mental health law and policy. In this as in other socio-legal domains, identity functions to consolidate dissent as well as to effect social control. The author asks: where do legal experts stand in relation to the identity categories that run so deep in this area of law and policy? More broadly, she asks: is “mental health” working on us — on the mental health disabled, legal scholars, all of us — in ways that are impairing our capacity for social justice? In the first part of the paper, the author considers the Foucauldian exhortation to undertake a “critical ontology of ourselves” and asks what it would mean to take this curious exhortation personally, with regard to one’s mental health. In the second part, which will appear in the next issue of the Dalhousie Law Journal, she builds out from these insights toward a political taxonomy of mental health identities
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Agonizing Identity in Mental Health Law and Policy (Part II):A Political Taxonomy of Psychiatric Subjectification
No full textThis is the second part of a two-part essay exploring the function of identity in mental health law and policy or more broadly the function of identity in the politics of mental health. Part one began with the Foucauldian exhortation to undertake a critical ontology of ourselves, and adopted the methodology of autoethnography to explore the construction or constructedness of the authors identity as an expert working in the area of mental health law and policy. That part concluded with a gesture of resistance to identification on one or the other side of the mental health/ illness divide (the divide of reason and madness), affirming instead an aspiration to carve out a space of contemplation-or rather multiple spaces: fleeting, episodic manifestations of what the author terms spectral identity -supportive of reflection on the relational determinants of one\u27s position along a continuum of shared vulnerabilities and capacities, shifting over time and across bio-psychosocial settings in defiance of simplistic binary categories. Part two builds out from these insights toward a political taxonomy of mental health identities. As such it deepens its engagement with the core question raised in part one: namely is mental health working on us-on the mental health disabled, legal scholars, all of us-in ways that are impairing our capacity for social justice
Agonizing Identity in Mental Health Law and Policy (Part II): A Political Taxonomy of Psychiatric Subjectification
No full textThis is the second part of a two-part essay exploring the function of identity in mental health law and policy, or more broadly, the function of identity in the politics of mental health. Part one began with the Foucauldian exhortation to undertake a “critical ontology of ourselves,” and adopted the methodology of autoethnography to explore the construction or constructedness of the author’s identity as an expert working in the area of mental health law and policy. That part concluded with a gesture of resistance to identification on one or the other side of the mental health/ illness divide (the divide of reason and madness), affirming instead an aspiration to carve out a space of contemplation — or rather multiple spaces: fleeting, episodic manifestations of what the author terms “spectral identity” — supportive of reflection on the relational determinants of one’s position along a continuum of shared vulnerabilities and capacities, shifting over time and across bio-psychosocial settings in defiance of simplistic binary categories. Part two builds out from these insights toward a political taxonomy of mental health identities. As such it deepens its engagement with the core question raised in part one: namely, is “mental health” working on us — on the mental health disabled, legal scholars, all of us — in ways that are impairing our capacity for social justice
Defining Death: Law, Language, and Systems
No full textThe definition of death is often referred to as a fiction since brain death was conceived in the mid twentieth century. These observations are generally paired with concern that the fiction depresses the quality of a patient’s consent to post-mortem tissue donation. However, such accounts are theoretically bereft. The author argues that a systems-theoretic account can better explain how fiction contributes to donative practices. He understands fiction as a legal speech act that misrepresents the intentions behind its expressed message. The misrepresentation may induce social behaviour (e.g., consent) consistent with its unstated intentions. In the context of death, these intentions emerge from a system of biopolitics disproportionately concerned with preserving the life of the populace. Determining death early on the continuum of dying may avail more viable tissue and free therapeutic resources to those in need. The operation of fiction will be explored and critiqued from within this socio-legal frame
A matched cohort comparison of mTHPC-mediated photodynamic therapy and trans-oral surgery of early stage oral cavity squamous cell cancer
No full textPhotodynamic therapy (PDT) of early stage oral cavity tumors have been thoroughly reported. However, statistical comparison of PDT to the surgical treatment is not available in published literature. We have identified and matched cohorts of patients with early stage oral cavity cancers undergoing surgery (n = 43) and PDT (n = 55) from a single institute experience. The groups are matched demographically and had the same pre-treatment screening and follow-up schedule. Both groups consisted only of tumors thinner than 5 mm to ensure comparability. The endpoints were local disease free survival, disease free survival, overall survival and response to initial treatment. Local disease free survival at 5 years were 67 and 74 % for PDT and surgery groups, respectively [univariate HR = 1.9 (p = 0.26), multivariable HR = 2.7 (p = 0.13)]. Disease free survival at 5 years are 47 and 53 % for PDT and surgery groups, respectively [univariate HR = 0.8 (p = 0.52), multivariable HR = 0.75 (p = 0.45)]. Overall survival was 83 and 75 % for PDT and surgery groups, respectively [(univariate HR = 0.5 (p = 0.19), multivariable HR = 0.5 (p = 0.17)]. In the PDT group, six patients (11 %) and in the surgery group 11 patients (26 %) had to receive additional treatments after the initial. All of the tested parameters did not have statistical significant difference. Although there is probably a selection bias due to the non-randomized design, this study shows that PDT of early stage oral cavity cancer is comparable in terms of disease control and survival to trans-oral resection and can be offered as an alternative to surgical treatmen
The Aerial Letter
No full textFront Cover -- About the Author -- Title Page -- Copyright -- Dedication -- Contents -- Saying the Unsayable-Susan Hawthorne -- Translator's Introduction-Marlene Wildeman -- Preface 2020 -- Preface 1988 -- Turning-Platform -- Coincidence -- The Aerial Letter -- Critical Appreciation -- Synchrony -- From Radical to Integral -- Kind Skin My Mind -- A Captivating Image -- Lesbians of Lore -- Access to Writing: Rites of Language -- Intercepting What's Real -- Certain WordsDescription based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
Relating to Water: A habitat resilient for flood and drought, maintaining good water quality and using the opportunities water provides
No full textPROJECTThere are flood and drought problems in the Garden Cities of Amsterdam, which will get worse if nothing changes. On top of that, there is a problem with the quality of the open water. Therefore, an approach is needed to cope with these water problems. Besides this, 8000 new dwellings may need to be realised in Amsterdam Nieuw-West and many old dwellings need to be renovated. I propose to combine these topics and investigate the possibilities of creating more housing in the area while also resolving the water issues. Accordingly, the aim of the project is to investigate the possibilities for improving the housing blocks in the Wildeman neighbourhood, and make them function in symbiose with water. Designing the dwellings and neighbourhood with a dynamic relation to water should lead to a habitat which is resilient for flood and drought,maintaining good water quality and using the opportunities open/rain/ground/fresh/etc. -water provides.RESEARCH PAPERTo find out what role architecture could play in future sustainable and climate proof water city (considering the Closed City concept) the following topics are investigated: (1) the urban water system in general, and the Closed City concept in specific, (2) architecture as water machine (WMA) in general, and WMA that can be applied to a Closed City in specific and (3) the post war neighbourhood and its water system in general, and with the Closed City concept applied in specific. The inquiry involves the spatial implications of technical systems applied, researched through literature study, case study and drawing as epistemic. The data is then tested against the characteristics and requirements of the Closed City concept. It is concluded that WMA could play a role in five out of six characteristics of the Closed City when the concept is applied to a post war neighbourhood. Twelve possible forms are identified, fulfilling the role of rainwater collection, water treatment, heating system, reducing water use and water storage.Architecture, Urbanism and Building Science
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