Still's disease - juvenile arthritis with systemic onset

Peer reviewe

Barriers and Facilitators in Continuous Medical Education Related to Allogeneic Stem Cell Transplantation: A Qualitative Study of Physicians

Introduction: This study explored qualitatively, in a sample of German hematologists working in clinical allogeneic hematopoietic stem cell transplantation (alloHSCT), perceptions of barriers and facilitators to participate in continuous medical education (CME), to provide detailed information on how to improve participation in CME activities related to alloHSCT, which may also be applicable to other areas of medicine. Methods: Based on a recruitment campaign of the German Association for Hematopoietic Stem Cell Transplantation (DAG-HSZT), 21 semi-structured telephone interviews were conducted, transcribed, and analyzed using framework analysis. Results: Three clusters of barriers were identified that explain why alloHSCT physicians may or may not participate in CME: individual constraints (e.g., better networking, young physicians being overwhelmed by the complexity of alloHSCT), structural constraints (e.g., time and financial issues, tailoring CME courses according to the targeted audience), and content-related constraints (e.g., requirement of CME sessions, provision of an overview of CME courses, more flexible offers). We discuss the ten most frequently raised issues, including the use of incentives and the need for support at the start of residency, staff shortages, and requirements for learning sessions. Conclusion: There is a need for a paradigm shift in CME related to alloHSCT toward a more individualized and needs-based approach. Close monitoring of residents’ needs and learning progress, as well as feedback systems, could help identify appropriate CME courses that should be integrated into a tiered learning system. CME should be more targeted to specific audiences (i.e., residents, fellows, and attendees) to provide training that is tailored to individual CME needs. On-demand courses can help balance work and family obligations. Finally, peer-reviewed, up-to-date information platforms should be expanded

Dietary omega-3 polyunsaturated fatty acid and alpha-linolenic acid are associated with physical capacity measure but not muscle mass in older women 65–72 years

Abstract Purpose The aim was to investigate the cross-sectional association of dietary omega-3 polyunsaturated fatty acids PUFA (alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA)) intake with multiple physical functions, muscle mass and fat mass in older women. Method Study subjects were 554 women from the Osteoporosis Risk Factor and Prevention Fracture Prevention Study, with dietary intake assessed with 3-day food record. Body composition was measured by dual-energy X-ray absorptiometry. Physical function measures included walking speed 10 m, chair rises, one leg stance, knee extension, handgrip strength and squat. Short physical performance battery (SPPB) score was defined based on the European working group on sarcopenia criteria. Results The multivariable adjusted models showed statistically significant associations for dietary ALA with higher SPPB (β = 0.118, P = 0.024), knee extension force at baseline (β = 0.075, P = 0.037) and lower fat mass (β = − 0.081, P = 0.034), as well as longer one-leg stance (β = 0.119, P = 0.010), higher walking speed (β = 0.113, P = 0.047), and ability to squat to the ground (β = 0.110, P = 0.027) at baseline. Total dietary omega-3 PUFA was associated with better SPPB (β = 0.108, P = 0.039), one-leg stance (β = 0.102, P = 0.041) and ability to squat (β = 0.110, P = 0.028), and with walking speed (β = 0.110, P = 0.028). However, associations for dietary EPA and DHA with physical function and body composition were not significant. Conclusion Dietary omega-3 and ALA, but not EPA and DHA, were positively associated with muscle strength and function in older women. The intake of omega-3 and its subtypes was not associated with muscle mass. Longitudinal studies are needed to show whether omega-3 intake may be important for muscle function in older women. </jats:sec

Medical treatment of juvenile idiopathic arthritis

Peer reviewe

Additional cytogenetic features determine outcome in patients allografted for TP53 mutant acute myeloid leukemia

BACKGROUND: The presence of TP53 mutations is associated with an unfavorable outcome in patients allografted for acute myeloid leukemia (AML), leading some to question the benefit of an allogeneic stem cell transplantation (allo-SCT) for this patient group, although this has not been studied in a large cohort. METHODS: A total of 780 patients with AML in first complete remission, with either intermediate- or adverse-risk cytogenetics, whose TP53 mutation status was reported, were included in this study from the European Society for Blood and Marrow Transplantation. RESULTS: Two-year overall survival (OS) was impaired in patients (n = 179) with evidence of a TP53 mutation at diagnosis (35.1%; 95% confidence interval [CI], 26.7–43.7) as compared to the cohort without (n = 601) (64%; 95% CI, 59.1–68.4; P =.001). In patients with mutant TP53 AML with no evidence of either chromosome 17p loss (17p–) and/or complex karyotype (CK) (n = 53, 29.6%), 2-year OS was 65.2% (95% CI, 48.4–77.6). This was not significantly different to patients without TP53 mutations. In patients with mutant TP53 AML with either 17p– and/or CK (n = 126, 70.4%), the OS was lower (24.6%; 95% CI, 16.2–34; P =.001). CONCLUSIONS: In summary, the adverse prognostic effect of TP53 mutations in AML following an allo-SCT is not evident in patients with neither co-occurring 17p– and/or CK, and these data inform decisions regarding allo-SCT in patients with TP53 mutant AML.</p

Mobile Air Quality Studies (MAQS) - an international project

Due to an increasing awareness of the potential hazardousness of air pollutants, new laws, rules and guidelines have recently been implemented globally. In this respect, numerous studies have addressed traffic-related exposure to particulate matter using stationary technology so far. By contrast, only few studies used the advanced technology of mobile exposure analysis. The Mobile Air Quality Study (MAQS) addresses the issue of air pollutant exposure by combining advanced high-granularity spatial-temporal analysis with vehicle-mounted, person-mounted and roadside sensors. The MAQS-platform will be used by international collaborators in order 1) to assess air pollutant exposure in relation to road structure, 2) to assess air pollutant exposure in relation to traffic density, 3) to assess air pollutant exposure in relation to weather conditions, 4) to compare exposure within vehicles between front and back seat (children) positions, and 5) to evaluate "traffic zone"- exposure in relation to non-"traffic zone"-exposure. Primarily, the MAQS-platform will focus on particulate matter. With the establishment of advanced mobile analysis tools, it is planed to extend the analysis to other pollutants including including NO2, SO2, nanoparticles, and ozone

Spotlights on Contemporary Family Life

Spotlights on Contemporary Family Life covers four issues of cross-cutting importance to families Structures and forms of families: issues relating to a diversification of families away from the ‘traditional nuclear family form’ are relatively uncontroversial from an academic perspective, but much more so for policy makers and family associations. Chapter 1 provides a thorough overview of the state of contemporary European families. Solidarities in families: too often the issue of an ‘ageing society’ is simply reduced to the problem of over-burdening social care systems, but longevity also represents opportunities for new kinds of solidarities inside families and family networks, and new relations between family members – not to mention the satisfaction felt by people who can continue to live fulfilling and rewarding lives long after they’re considered ‘elderly’. Chapter 2 gives voice to authors who identify these new opportunities and challenges. Demographic change: women are having fewer children and having them later in life. Having children is now a conscious decision and fertility rates have declined below the level required to sustain our current populations. At the same time we witness the ‘greying’ of Europe, which brings with it a whole host of opportunities and challenges. Chapter 3 raises important issues for policy makers today. Volunteering: inspired by family associations who could not survive without the support of volunteers, this chapter gives an overview of what’s known - and what isn’t - about volunteering. Coinciding with the European Year of Volunteering 2011, this chapter takes a timely look at the efforts that families put into volunteering across Europe and the important benefits that Europe gains from all of this combined voluntary effort. Linden Farrer and William Lay work for the Confederation of Family Organisations in the European Union (COFACE). This publication was produced by FAMILYPLATFORM, a project funded by the European Commission

Spotlights on Contemporary Family Life

Spotlights on Contemporary Family Life covers four issues of cross-cutting importance to families Structures and forms of families: issues relating to a diversification of families away from the ‘traditional nuclear family form’ are relatively uncontroversial from an academic perspective, but much more so for policy makers and family associations. Chapter 1 provides a thorough overview of the state of contemporary European families. Solidarities in families: too often the issue of an ‘ageing society’ is simply reduced to the problem of over-burdening social care systems, but longevity also represents opportunities for new kinds of solidarities inside families and family networks, and new relations between family members – not to mention the satisfaction felt by people who can continue to live fulfilling and rewarding lives long after they’re considered ‘elderly’. Chapter 2 gives voice to authors who identify these new opportunities and challenges. Demographic change: women are having fewer children and having them later in life. Having children is now a conscious decision and fertility rates have declined below the level required to sustain our current populations. At the same time we witness the ‘greying’ of Europe, which brings with it a whole host of opportunities and challenges. Chapter 3 raises important issues for policy makers today. Volunteering: inspired by family associations who could not survive without the support of volunteers, this chapter gives an overview of what’s known - and what isn’t - about volunteering. Coinciding with the European Year of Volunteering 2011, this chapter takes a timely look at the efforts that families put into volunteering across Europe and the important benefits that Europe gains from all of this combined voluntary effort. Linden Farrer and William Lay work for the Confederation of Family Organisations in the European Union (COFACE). This publication was produced by FAMILYPLATFORM, a project funded by the European Commission