Clients\u27 Experiences Giving Gifts to Therapists

Nine therapy clients were interviewed regarding their experiences of giving gifts to therapists. Data were analyzed using consensual qualitative research. In describing a specific event when they gave a gift that was accepted, participants described having a good relationship with the therapist and usually identified their therapy concerns as relationship or family struggles or both. Most bought a relatively inexpensive gift they thought their therapist would like and gave it during a nontermination session to express appreciation or mark an important life event. Most participants acknowledged mixed emotions when giving the gift and noted that any discussion of the gift was brief and did not explore its deeper meaning. Nevertheless, most participants perceived that gift events positively affected them and their therapists

Effect of partially-screened nuclei on fast-electron dynamics

We analyze the dynamics of fast electrons in plasmas containing partially ionized impurity atoms, where the screening effect of bound electrons must be included. We derive analytical expressions for the deflection and slowing-down frequencies, and show that they are increased significantly compared to the results obtained with complete screening, already at sub-relativistic electron energies. Furthermore, we show that the modifications to the deflection and slowing down frequencies are of equal importance in describing the runaway current evolution. Our results greatly affect fast-electron dynamics and have important implications, e.g. for the efficacy of mitigation strategies for runaway electrons in tokamak devices, and energy loss during relativistic breakdown in atmospheric discharges.Comment: 6 pages, 3 figures, fixed minor typo

A Bayesian dose-finding design for drug combination clinical trials based on the logistic model

International audienceIn early phase dose-finding cancer studies, the objective is to determine the maximum tolerated dose, defined as the highest dose with an acceptable dose-limiting toxicity rate. Finding this dose for drug-combination trials is complicated because of drug–drug interactions, and many trial designs have been proposed to address this issue. These designs rely on complicated statistical models that typically are not familiar to clinicians, and are rarely used in practice. The aim of this paper is to propose a Bayesian dose-finding design for drug combination trials based on standard logistic regression. Under the proposed design, we continuously update the posterior estimates of the model parameters to make the decisions of dose assignment and early stopping. Simulation studies show that the proposed design is competitive and outperforms some existing designs. We also extend our design to handle delayed toxicities. Copyright © 2014 John Wiley & Sons, Ltd

Maintaining Quality in Online Learning Environments: Issues and Challenges

The online classroom continues to play an ever increasing role in higher education. There are proven, research-based pedagogical techniques available to instructors who want to create online courses that are both dynamic and engaging. With careful planning, online learning can provide students with a positive learning experience without sacrificing the academic quality of learning. Addressing security issues and challenges is vital to maintaining the desired academic rigor and quality. This paper discusses these important security issues and offers a variety of solutions for facilitating a secure learning environment

Comment les syndicats locaux agissent-ils de manière significative sur les conditions de travail et d'emploi qui influencent la santé et la sécurité du travail? : le point de vue d'élus nationaux et sectoriels et de conseillers d'une centrale syndicale québécoise

Les quelques études québécoises portant sur l'action syndicale en prévention en santé et sécurité du travail (SST) et sur le contenu de la section dédiée à la SST des conventions collectives traitent essentiellement des comités paritaires SST, de l'action des représentants à la prévention et de la fourniture d'équipements de protection individuelle. Ainsi, elles ne permettent pas de bien connaître les autres moyens utilisés par les syndicats pour agir en prévention, et les leviers et obstacles qui y sont associés. Or il s'agit de questions liées directement au débat sur la revitalisation syndicale. Ce mémoire s'intéresse donc à la manière dont les syndicats locaux agissent pour influer sur les conditions de travail et d'emploi affectant la SST. La recherche vise à comprendre la place de la prévention en SST et ce qui l'influence, à identifier les leviers et les obstacles à l'action syndicale en prévention en SST, et à déterminer des pistes d'actions susceptibles de la renforcer. Le recueil des données s'est fait par le biais de 11 entrevues semi-dirigées avec des élus siégeant à des instances syndicales nationales ou sectorielles et avec des conseillers, provenant tous de syndicats affiliés à une grande centrale syndicale québécoise. Il s'agit de la première phase d'une étude plus vaste devant se poursuivre auprès de syndicats locaux particulièrement actifs. La présente étude, basée sur le point de vue d'élus nationaux et sectoriels et de conseillers en contact régulier avec un grand nombre de syndicats locaux, présente la variabilité de la place de la prévention en SST et les facteurs l'expliquant. Elle décrit un répertoire d'actions syndicales pour agir en prévention. On observe que celles-ci transcendent les moyens traditionnels identifiés dans la littérature scientifique et élargissent le périmètre des actions au-delà des CSS. On note la concurrence entre les tâches de défense des travailleurs accidentés et celles de prévention, étant donné les difficultés reliées au processus d'indemnisation. Enfin, l'étude documente les ressources de pouvoir utilisées par les syndicats locaux, ainsi que leurs leviers et obstacles, sur la base de l'expérience des répondants dans leurs contacts avec ceux-ci. Les souhaits formulés par les répondants permettent d'identifier des pistes d'action pour le développement de l'action préventive dans les milieux de travail et quant au soutien que la centrale et ses structures sectorielles peuvent y apporter

Promising New Treatments for Psoriasis

Psoriasis is a chronic, proliferative, and inflammatory skin disease affecting 2-3% of the population and is characterized by red plaques with white scales. Psoriasis is a disease that can affect many aspects of professional and social life. Currently, several treatments are available to help control psoriasis such as methotrexate, ciclosporin, and oral retinoids. However, the available treatments are only able to relieve the symptoms and lives of individuals. The discovery of new immunological factors and a better understanding of psoriasis have turned to the use of immunological pathways and could develop new biological drugs against specific immunological elements that cause psoriasis. Biological drugs are less toxic to the body and more effective than traditional therapies. Thus, they should improve the quality of life of patients with psoriasis. This review describes new psoriasis treatments, which are on the market or currently in clinical trials that are being used to treat moderate-to-severe plaque psoriasis. In addition, this paper describes the characteristics and mechanisms in detail. In general, biological drugs are well tolerated and appear to be an effective alternative to conventional therapies. However, their effectiveness and long-term side effects need to be further researched

Endogenous Plasma Peptide Detection and Identification in the Rat by a Combination of Fractionation Methods and Mass Spectrometry

Mass spectrometry-based analyses are essential tools in the field of biomarker research. However, detection and characterization of plasma low abundance and/or low molecular weight peptides is challenged by the presence of highly abundant proteins, salts and lipids. Numerous strategies have already been tested to reduce the complexity of plasma samples. The aim of this study was to enrich the low molecular weight fraction of rat plasma. To this end, we developed and compared simple protocols based on membrane filtration, solid phase extraction, and a combination of both. As assessed by UV absorbance, an albumin depletion >99% was obtained. The multistep fractionation strategy (including reverse phase HPLC) allowed detection, in a reproducible manner (CV < 30%–35%), of more than 450 peaks below 3000 Da by MALDI-TOF/MS. A MALDI-TOF/MS-determined LOD as low as 1 fmol/μL was obtained, thus allowing nanoLC-Chip/MS/MS identification of spiked peptides representing ~10−6% of total proteins, by weight. Signal peptide recovery ranged between 5%–100% according to the spiked peptide considered. Tens of peptide sequence tags from endogenous plasma peptides were also obtained and high confidence identifications of low abundance fibrinopeptide A and B are reported here to show the efficiency of the protocol. It is concluded that the fractionation protocol presented would be of particular interest for future differential (high throughput) analyses of the plasma low molecular weight fraction

A Raster-Based Neighborhood Model for Evaluating Complexity in Dynamic Maps

ABSTRACT: The cartographic community has taken a renewed interest in evaluating the effectiveness of automated map displays, given their increasing prevalence among general map users. The changing values of the mapped area from frame to frame in a dynamic thematic map constitute its main element of visual complexity, while many of the peripheral map components often change little (titles) or not at all (scale bars, color ramps). Building on recent research into visual complexity as it relates to dynamic thematic mapping, this study developed a raster-based GIS model for evaluating the graphical variability between sequences of choropleth maps as they would appear as scenes in a dynamic map. The evaluation of visual complexity is based on two previously established metrics, Basic Magnitude of Change (BMOC) and Magnitude of Rank Change (MORC), for describing the variability and average class &apos;jump&apos; for enumeration units across map scenes. The model presented in this paper uses a neighborhood focal operator that sequentially moves across the entire map, replicating the user&apos;s viewing perspective as it divides the scene to instantaneously focus only on the part of the map within the foveal viewing area, a zone of enhanced visual-cognitive acuity. This model accepts a single vector map, uses its class membership attribute data as inputs, computes the BMOC and MORC variability, and writes the value to the focus. The model output is two smoothed map images depicting relative visual complexity values for the sequence of maps. While the neighborhood paradigm can theoretically be used to quantify change on either a vector or raster map, the raster-based approach suggests several improvements over one based on vector polygons. These include a potentially higher degree of accuracy in modeling the user&apos;s perspective, especially if enumeration units vary widely in size within the foveal area and map itself, plus the ability to use (with minimal customization) existing image-processing software such as ERDAS Imagine, ArcGIS Spatial Analyst and ENVI to perform analysis of dynamic map complexity

T1w/FLAIR ratio standardization as a myelin marker in MS patients

Image calibration; Integrity; Multiple sclerosisCalibración de imagen; Integridad; Esclerosis múltipleCalibració d'imatge; Integritat; Esclerosi múltipleIntroduction Calculation of a T1w/T2w ratio was introduced as a proxy for myelin integrity in the brain of multiple sclerosis (MS) patients. Since nowadays 3D FLAIR is commonly used for lesion detection instead of T2w images, we introduce a T1w/FLAIR ratio as an alternative for the T1w/T2w ratio. Objectives Bias and intensity variation are widely present between different scanners, between subjects and within subjects over time in T1w, T2w and FLAIR images. We present a standardized method for calculating a histogram calibrated T1w/FLAIR ratio to reduce bias and intensity variation in MR sequences from different scanners and at different time-points. Material and methods 207 Relapsing Remitting MS patients were scanned on 4 different 3 T scanners with a protocol including 3D T1w, 2D T2w and 3D FLAIR images. After bias correction, T1w/FLAIR ratio maps and T1w/T2w ratio maps were calculated in 4 different ways: without calibration, with linear histogram calibration as described by Ganzetti et al. (2014), and by using 2 methods of non-linear histogram calibration. The first nonlinear calibration uses a template of extra-cerebral tissue and cerebrospinal fluid (CSF) brought from Montreal Neurological Institute (MNI) space to subject space; for the second nonlinear method we used an extra-cerebral tissue and CSF template of our own subjects. Additionally, we segmented several brain structures such as Normal Appearing White Matter (NAWM), Normal Appearing Grey Matter (NAGM), corpus callosum, thalami and MS lesions using Freesurfer and Samseg. Results The coefficient of variation of T1w/FLAIR ratio in NAWM for the no calibrated, linear, and 2 nonlinear calibration methods were respectively 24, 19.1, 9.5, 13.8. The nonlinear methods of calibration showed the best results for calculating the T1w/FLAIR ratio with a smaller dispersion of the data and a smaller overlap of T1w/FLAIR ratio in the different segmented brain structures. T1w/T2w and T1w/FLAIR ratios showed a wider range of values compared to MTR values. Conclusions Calibration of T1w/T2w and T1w/FLAIR ratio maps is imperative to account for the sources of variation described above. The nonlinear calibration methods showed the best reduction of between-subject and within-subject variability. The T1w/T2w and T1w/FLAIR ratio seem to be more sensitive to smaller changes in tissue integrity than MTR. Future work is needed to determine the exact substrate of T1w/FLAIR ratio and to obtain correlations with clinical outcome