Emergency Preparedness: Perceptions of People with Disabilities

The prevalence of emergencies and disasters has increased over the past decade which has caused cities, states and countries to routinely develop emergency preparedness and management plans (Turk, 2016). Although these demands have increased, individuals with disabilities have been less represented in the development of the plans (Timmons, 2017; Turk, 2016). According to The World Bank Disaster Risk Management Report (2020), disasters (e.g., infectious disease outbreaks such as COVID-19, hurricanes, earthquakes, industrial accidents.) and post-disaster consequences have increased over recent years. Although individuals with disabilities have become more aware of emergency preparedness and its importance, researchers have noted that there is a huge disparity of awareness and preparedness related to emergencies and disasters in the disability community (UNISDR Global Assessment Report, 2019). Therefore, this issue could adversely affect individuals with disabilities in essential areas of life (e.g., quality of life, employability, mobility, maintaining their home, communication) (Fox, et al., 2010; Twigg, et al., 2018). In addition, most studies seem to focus on disaster recovery and post disaster information rather than prevention and planning strategies that could help alleviate, and at times prevent, post-disaster issues for people with disabilities and elderly. Similarly, a lack of awareness of individualized emergency planning strategies for individuals with specific healthcare needs continues to be a significant reason why individuals with disabilities and elderly are more likely to be negatively affected by emergencies than other populations (Charlton, 2000; UNISDR, 2014). The lack of access to participate in emergency preparedness teams or organizations results in persons without disabilities continuing to exclude people with disabilities in the planning efforts of proper and inclusive emergency plans in their communities at large. The purpose of this study was to measure the self-perceptions of individuals with disabilities related to their level of emergency preparedness as well as access to emergency preparedness information. This study used purposive sampling by recruiting individuals with disabilities who have received services from their local center for independent living (CIL) and reside in the state of Texas. This study utilized the Texas Hazard Mitigation Questionnaire-Revised and a demographic survey that were developed by the researcher to help gain an understanding of general preparedness intentions and behavior as well as personal and demographic factors influencing decision making (e.g., information sources, risk perception, age, dwelling type, socioeconomic status)

Non-Inferiority Trials in Surgical Oncology

The classical randomized controlled clinical trial is designed to prove superiority of an investigational therapy over an established therapy or placebo (here referred to as "superiority trial”). Although the randomized controlled superiority trial has its well-grounded role, clinical trials of non-inferiority are equally important in the advance of medical science. Non-inferiority trials test whether a new intervention is as good as a standard treatment with respect to curing the illness (e.g., overall survival) while offering other benefits over the standard therapy, such as lower toxicity, better side-effect profile, improved ease of administration, or reduced costs. The evaluation of non-inferiority is critical in many settings. In surgical oncology, for instance, treatments often combine advantages (e.g., survival benefit) with disadvantages (e.g., high post-operative morbidity due to extensive surgery, considerable toxic effects of an aggressive chemotherapy regimen). The various aspects of different therapeutic strategies may make a treatment decision difficult, requiring a non-inferiority trial to quantify risks and benefits. However, despite their great importance in clinical cancer research, the concept, design, and objectives of non-inferiority trials remain poorly understood in the surgical community. The goal of this review is to discuss the principles, strengths, and challenges of non-inferiority trials and introduce this highly relevant topic to the surgical reader, using examples from the field of surgical oncolog

Vorstellungen von Schülerinnen und Schülern zu raum-, zeit- und geschichtsbezogenen Themen:eine explorative Studie in Klassen des 1., 3., 5. und 7. Schuljahres im Kanton Bern

In der explorativen Studie wird untersucht, welche Vorstellungen Schülerinnen und Schüler zu raum-, zeit- und geschichtsbezogenen Themen haben und wie different und heterogen diese innerhalb von Klassen und zwischen den Schulstufen sind. Die Studie wird im Kontext fachdidaktischer Forschungen und eines kognitiv-konstruierenden Lehr- und Lernverständnisses verortet. Als Grundlage für die Entwicklung von Aufgaben wird ein theoretisch begründetes Kompetenzmodell skizziert. Die Erhebungen wurden in insgesamt 12 Klassen der Stufen 1., 3., 5. und 7. Schuljahr im Kanton Bern durchgeführt. Die zum Ausdruck gebrachten Vorstellungen zu 17 Aufgaben wurden bezüglich Gehalt, Strukturierung und Differenzierung ausgewertet und Leveln zugewiesen. Für die Lernenden konnte damit ein Kompetenz-Profil zu Vorstellungen erstellt werden. Die Ergebnisse zeigen, dass die Vorstellungen von einem breiten Bündel von Einflüssen geprägt sind und dabei vor allem auch außerschulische Erfahrungen eine Rolle spielen

TAPP or TEP? Population-Based Analysis of Prospective Data on 4,552 Patients Undergoing Endoscopic Inguinal Hernia Repair

Background: Whether total extraperitoneal inguinal hernia repair (TEP) is associated with worse outcomes than transabdominal preperitoneal inguinal hernia repair (TAPP) continues to be a matter of debate. The objective of this large cohort study is to compare outcomes between patients undergoing TEP or TAPP. Methods: Based on prospective data of the Swiss association of laparoscopic and thoracoscopic surgery, all patients undergoing unilateral TEP or TAPP between 1995 and 2006 were included. The following outcomes were compared: conversion rates, intraoperative and postoperative complications, duration of operation. Results: Data on 4,552 patients undergoing TEP (n=3,457) and TAPP (n=1,095) were collected prospectively. Average age and American Society of Anesthesiologists score were similar in the two groups. Patients undergoing TEP had a significantly higher rate of intraoperative complications (TEP 1.9% vs. TAPP 0.9%, p=0.029) and surgical postoperative complications (TEP: 2.3% vs. TAPP: 0.8%, p=0.003). The postoperative length of stay was longer for patients undergoing TAPP (2.9 vs. 2.3days, p=0.002), whereas the duration of the operation was longer for TEP (66.6 vs. 59.0min, p<0.001) and the conversion rate was higher (TEP 1.0% vs. TAPP 0.2%, p=0.011). Conclusions: This study is one of the first population-based analyses comparing TEP and TAPP in a prospective cohort of more than 4,500 patients. Intraoperative and surgical postoperative complications were significantly higher in patients undergoing TEP. TEP is also associated with longer operating times and higher conversion rates. Therefore, on a population-based level, the TAPP technique appears to be superior to the TEP repair in patients undergoing unilateral inguinal hernia repai

Active Antigen-specific Immunotherapy of Melanoma: from Basic Science to Clinical Investigation

Advanced-stage melanoma here dismal prognosis, and novel therapeutic approaches are urgently required. The possibility of taking advantage of the immune response of patients for its treatment has been an appealing concept for almost a century. Only during the last decade, however, has the molecular identification of tumor-associated antigens (TAAs) offered the possibility of vaccinating patients (e.g., active induction of TAA-specific immune responses). Active antigen-specific immunotherapy (AASIT) is currently being investigated in a number of clinical centers as a treatment option for advanced-stage melanoma. A large number of melanoma TAAs have been molecularly characterized and are being used in vaccination trials in various molecular forms and according to various immunization protocols. Here we provide a short overview on melanoma TAAs, the technologies currently in use to induce specific cytotoxic T-lymphocyte (CTL) responses in vivo, and their monitoring. We also propose a tentative AASIT agenda for the next few years, aiming at improving the capacity to induce and monitor TAA-specific immune responses and to verify their clinical effectivenes

Morphometric and functional abnormalities of kidneys in the progeny of mice fed chocolate during pregnancy and lactation.

Even most commonly consumed beverages like tea, coffee, chocolate and cocoa contain methylxanthines, biogenic amines and polyphenols, among them catechins, that exhibit significant biological activity and might profoundly affect the organism homeostasis. We have previously shown that 400 mg of bitter chocolate or 6 mg of theobromine added to the daily diet of pregnant and afterwards lactating mice affected embryonic angiogenesis and caused bone mineralization disturbances as well as limb shortening in 4-weeks old offspring. The aim of the present study was the morphometric and functional evaluation of kidneys in the 4-weeks old progeny mice fed according to the protocol mentioned above. Progeny from the mice fed chocolate presented considerable morphometric abnormalities in the kidney structure, with the lower number of glomeruli per mm2 and their increased diameter. Moreover, higher serum creatinine concentration was observed in that group of offspring. No morphometric or functional irregularities were found in the progeny of mice fed theobromine. Abnormalities demonstrated in the offspring of mice fed chocolate are not related to its theobromine content. Consequently, identification of active compound(s) responsible for the observed effects is of vital importance