Adopting Children with Down Syndrome: A qualitative study of family experiences

The purpose of this study is to qualitatively investigate and compare the family beliefs, values, and perceptions of parenting of families who have adopted children with Down syndrome (DS) to parents who have biological children with DS. Participants in the study included 27 parents of biological children with DS and six parents of adopted children with DS. Participants were interviewed through a digital survey that was distributed through Qualtrics Online Survey Software. Quantitative analysis placed the participants into groups and qualitative analysis was used to identify beliefs, values, and perceptions. Results showed that while both adoptive and biological parents indicated that support services have played an important role in raising their child with DS, 100% of adoptive parents indicated a desire for the creation of additional services/programs to better serve their child with DS and only 63% of biological parents indicated the same desire. There were no significant differences in level of stress seen between the two groups, joys and benefits added to family life, or challenges faced by families. While participants from both groups reported similar values and beliefs that have contributed to their parenting decisions, themes found in motivation differed between biological and adoptive parents

Effect of weight loss on urinary incontinence in women.

BackgroundThe purpose of this research was review the epidemiology of the association of obesity and urinary incontinence, and to summarize the published data on the effect of weight loss on urinary incontinence.MethodsA literature review of the association between urinary incontinence and overweight/obesity in women was performed. Case series and clinical trials reporting the effect of surgical, behavioral, and/or pharmacological weight loss on urinary incontinence are summarized.ResultsEpidemiological studies demonstrate that obesity is a strong and independent risk factor for prevalent and incident urinary incontinence. There is a clear dose-response effect of weight on urinary incontinence, with each 5-unit increase in body mass index associated with a 20%-70% increase in risk of urinary incontinence. The maximum effect of weight on urinary incontinence has an odds ratio of 4-5. The odds of incident urinary incontinence over 5-10 years increase by approximately 30%-60% for each 5-unit increase in body mass index. There appears to be a stronger association between increasing weight and prevalent and incident stress incontinence (including mixed incontinence) than for urge incontinence. Weight loss studies indicate that both surgical and nonsurgical weight loss leads to significant improvements in prevalence, frequency, and/or symptoms of urinary incontinence.ConclusionEpidemiological studies document overweight and obesity as important risk factors for urinary incontinence. Weight loss by both surgical and more conservative approaches is effective in reducing urinary incontinence symptoms and should be strongly considered as a first line treatment for overweight and obese women with urinary incontinence

Ray optical light trapping in silicon microwires: exceeding the 2n^2 intensity limit

We develop a ray optics model of a silicon wire array geometry in an attempt to understand the very strong absorption previously observed experimentally in these arrays. Our model successfully reproduces the n^2 ergodic limit for wire arrays in free space. Applying this model to a wire array on a Lambertian back reflector, we find an asymptotic increase in light trapping for low filling fractions. In this case, the Lambertian back reflector is acting as a wide acceptance angle concentrator, allowing the array to exceed the ergodic limit in the ray optics regime. While this leads to increased power per volume of silicon, it gives reduced power per unit area of wire array, owing to reduced silicon volume at low filling fractions. Upon comparison with silicon microwire experimental data, our ray optics model gives reasonable agreement with large wire arrays (4 μm radius), but poor agreement with small wire arrays (1 μm radius). This suggests that the very strong absorption observed in small wire arrays, which is not observed in large wire arrays, may be significantly due to wave optical effects

Manufacturing Dendritic Cells for Immunotherapy: Monocyte Enrichment

Dendritic cells play a key role in activation of the immune system as potent antigen-presenting cells. This pivotal position, along with the ability to generate dendritic cells from monocytes and ready uptake of antigen, makes them an intriguing vehicle for immunotherapy for a variety of indications. Since the first reported trial using dendritic cells in 1995, they have been used in trials all over the world for a plethora of indications. Monocyte-derived dendritic cells are generated from whole blood or apheresis products by culturing enriched monocytes in the presence of interleukin (IL)-4 and granulocyte-macrophage colony-stimulating factor (GM-CSF). A variety of methods can be used for enrichment of monocytes for generation of clinical-grade dendritic cells and are summarized herein

The Administrative Law of Regulatory Slop and Strategy

Judicial review of agency behavior is often criticized as either interfering too much with agencies’ domains or doing too little to ensure fidelity to statutory directives and the rule of law. But the Trump administration has produced an unprecedented volume of agency actions that blatantly flout settled administrative-law doctrine. This phenomenon, which we term “regulatory slop,” requires courts to reinforce the norms of administrative law by adhering to established doctrine and paying careful attention to remedial options. In this Article, we document numerous examples of regulatory slop and canvass how the Trump agencies have fared in court thus far. We contend that traditional critiques of judicial review carry little force in such circumstances. Further, regulatory slop should be of concern regardless of one’s political leanings because it threatens the rule of law. Rather than argue for a change to substantive administrative-law doctrine, therefore, we take a close look at courts’ remedial options in such circumstances. We conclude that a strong approach to remedies can send corrective signals to agencies that reinforce both administrative-law values and the rule of law

The Mass of Dwarf Planet Eris

The discovery of dwarf planet Eris was followed shortly by the discovery of its satellite, Dysnomia, but the satellite orbit, and thus the system mass, was not known. New observations with the Keck Observatory and the Hubble Space Telescopes show that Dysnomia has a circular orbit with a radius of 37,350 ± 140 (1-σ) kilometers and a 15.774 ± 0.002 day orbital period around Eris. These orbital parameters agree with expectations for a satellite formed out of the orbiting debris left from a giant impact. The mass of Eris from these orbital parameters is 1.67 × 10^(22) ± 0.02 × 10^(22) kilograms, or 1.27 ± 0.02 that of Pluto

Systematic review of therapeutic leave in inpatient mental health services

AimTo identify, critically evaluate, and synthesise the empirical evidence about therapeutic leave from mental health inpatient settings.Background“Leave” occurs when a mental health inpatient exits the hospital ward with the appropriate authorisation alone, or accompanied by staff, family, or friends. Limited research has previously addressed therapeutic as opposed to unauthorised leave, and the evidence-base has not been systematically evaluated.DesignSystematic review methodology following relevant Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidance.Data SourcesMultiple electronic databases (CINAHL; Criminal Justice database; PsycARTICLES; Scopus; OpenGrey; Cochrane; GoogleScholar) for papers published from January 1967 to July 2017.Review MethodsInformation was extracted under the following headings: study, purpose/aims, sample, country, setting, design and data collection method(s), data collection instrument, and results. Papers were assessed, as per the hierarchy of scientific evidence, and where there was sufficient data, we calculated a range of standardised rates of leave incidence.ResultsStandardised leave rates in forensic settings reflect security level. There was little meaningful information on which to base calculation of rates for civil settings. The strongest evidence supports leave used for supervised discharge; other forms of leave lack an evidence base and decisions appear to be made on the basis of heuristic rules and unsupported assumptions. Clinical decision making about therapeutic leave cannot claim to be evidence-based.ConclusionResearch is urgently needed to provide information about how leave is managed, the best ways to support leave, and what happens on leave

Therapeutic leave from secure mental health inpatient services::a review

I am delighted to have been invited to contribute a paper to this liber amicorum for Prof. dr. Frans Koenraadt in honour of his lifetime’s contribution to clinical and theoretical advances in forensic psychology, law, mental health, and education. I first had the pleasure of meeting Frans in Toronto when both he, I, and Lydia Dalhuisen, Frans’ then PhD student, were all presenting work on firesetters and firesetting. Our mutual interest led to further contact and an invitation was extended to me to join the examination panel for Dr Dalhuisen’s PhD thesis defence in Utrecht, a fascinating experience for me since it is not our tradition in the UK to conduct such a public defence. Since then, I have read with great interest and admiration the outputs of the PhD. It was my impression that Prof. Koenraadt provided a highly constructive and flexible educational experience which allowed the PhD room to breathe and grow. My acquaintance with Frans has been short, but I can say with sincerity that his natural curiosity, intellectual openness, and willingness to share his vast accumulated knowledge should serve as a model for us all. In this spirit of sharing, my colleague, EmilyMay Barlow, and I have chosen to address an issue which we feel passionate about. It is also an issue that lies firmly in those intersections between law, criminality, psychology, risk, and clinical practice in which Prof. Koenraadt excels. That issue is the use of therapeutic leave by patients in secure, forensic mental health care