Panorama del manejo cognitivo conductual de la disfunción de la memoria asociada a la quimioterapia

Objective: This article summarizes current empirical support for Memory and Attention Adaptation Training (MAAT), a cognitive-behavioral treatment program that uses a compensatory strategy approach for management of late cognitive effects of chemotherapy among cancer survivors. A description of MAAT, in addition to other treatment approaches, is presented. Results: Current methods of assessing treatment gains among cancer survivors with cognitive problems who have completed programs such as MAAT need to be expanded. As such, a table of patient reported outcome (PRO) measures that may be better suited for future outcome research is proposed. Conclusions: Identifying outcome measures that accurately assess the clinical targets of MAAT and other behavioral treatments is of prime importance, as certain variables (e.g., quality of life, role strain) are not detected by neuropsychological testing in isolation. The PRO table presented in this article is intended to aid future researchers in identifying measures that can reflect quality of life improvement in response to treatments such as MAAT.Objetivo: El presente artículo resume el apoyo empírico actual para el Entrenamiento de la Adaptación de la Memoria y la Atención (MAAT), un programa de tratamiento cognitivo-conductual que utiliza un enfoque de estrategia compensatoria para el manejo de los efectos cognitivos tardíos de la quimioterapia en los supervivientes del cáncer. Se presenta una descripción del MAAT, además de otros enfoques de tratamiento. Resultados: Es necesario ampliar los métodos actuales de evaluación de las mejorías del tratamiento en los supervivientes de cáncer con problemas cognitivos que han completado programas como el MAAT. En este sentido, se propone una tabla de medidas de resultado informadas (PRO) por el paciente que puede ser más adecuada para la investigación de resultados futuros. Conclusiones: Identificar medidas de de resultado que evalúen con precisión los objetivos clínicos del MAAT y otros tratamientos conductuales es de vital importancia, ya que algunas variables (ej., calidad de vida, estrés de rol), no son detectados por pruebas neuropsicológicas de modo aislado. La tabla de PRO presentada en este artículo tiene el propósito de ayudar a los futuros investigadores a identificar las medidas que pueden reflejar la mejoría en calidad de vida en respuesta a tratamientos como el MA

Using hormones to manage dairy cow fertility: the clinical and ethical beliefs of veterinary practitioners

In the face of a steady decline in dairy cow fertility over several decades, using hormones to assist reproduction has become common. In the European Union, hormones are prescription-only medicines, giving veterinary practitioners a central role in their deployment. This study explored the clinical and ethical beliefs of practitioners, and provides data on their current prescribing practices. During 2011, 93 practitioners working in England completed a questionnaire (95% response rate). Of the 714 non-organic farms they attended, only 4 farms (0.6%) never used hormones to assist the insemination of lactating dairy cows. Practitioners agreed (.80%) that hormones improve fertility and farm businesses profitability. They also agreed(.80%) that if farmers are able to tackle management issues contributing to poor oestrus expression, then over a five year period these outcomes would both improve, relative to using hormones instead. If management issues are addressed instead of prescribing hormones, practitioners envisaged a less favourable outcome for veterinary practices profitability (p,0.01), but an improvement in genetic selection for fertility (p,0.01) and overall cow welfare (p,0.01). On farms making no efforts to address underlying management problems, long-term routine use at the start of breeding for timing artificial insemination or inducing oestrus was judged ‘‘unacceptable’’ by 69% and 48% of practitioners, respectively. In contrast, practitioners agreed ($90%) that both these types of use are acceptable, provided a period of time has been allowed to elapse during which the cow is observed for natural oestrus. Issues discussed include: weighing quality versus length of cow life, fiscal factors, legal obligations, and balancing the interests of all stakeholders, including the increasing societal demand for food. This research fosters debate and critical appraisal, contributes to veterinary ethics, and encourages the pro-active development of professional codes of conduct

Rescinding Community Mitigation Strategies in an Influenza Pandemic

Thresholds for these strategies reduced the number of days strategies were needed without increasing illness rates

Organizing the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST): National Institutes of Health, Health Care Financing Administration, and industry funding

The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) is a prospective, randomized, multicenter clinical trial of carotid endarterectomy (CEA) versus carotid artery stenting (CAS) as prevention for stroke in patients with symptomatic stenosis greater than or equal to 50%. CREST is sponsored by the US National Institute of Neurological Disorders and Stroke (NINDS) of the US National Institutes of Health (NIH), with additional support by a device manufacturer, and will provide data to the US Food and Drug Administration (FDA) for evaluation of a stent device. Because of budget constraints for CREST, Health Care Financing Administration (HCFA) reimbursement for hospital costs incurred by CREST patients will be essential. The involvement of academic scientists, industry, and three separate government agencies (NIH, FDA, HCFA) has presented many challenges in conducting the trial. A review of the pathways followed to meet these challenges may be helpful to others seeking to facilitate sharing of the costs and burdens of conducting innovative clinical research

An overview of cognitive-behavioral management of memory dysfunction associated with chemotherapy

Objective: This article summarizes current empirical support for Memory and Attention Adaptation Training (MAAT), a cognitive-behavioral treatment program that uses a compensatory strategy approach for management of late cognitive effects of chemotherapy among cancer survivors. A description of MAAT, in addition to other treatment approaches, is presented. Results: Current methods of assessing treatment gains among cancer survivors with cognitive problems who have completed programs such as MAAT need to be expanded. As such, a table of patient reported outcome (PRO) measures that may be better suited for future outcome research is proposed. Conclusions: Identifying outcome measures that accurately assess the clinical targets of MAAT and other behavioral treatments is of prime importance, as certain variables (e.g., quality of life, role strain) are not detected by neuropsychological testing in isolation. The PRO table presented in this article is intended to aid future researchers in identifying measures that can reflect quality of life improvement in response to treatments such as MAAT

A hybrid double-dot in silicon

We report electrical measurements of a single arsenic dopant atom in the tunnel-barrier of a silicon SET. As well as performing electrical characterization of the individual dopant, we study series electrical transport through the dopant and SET. We measure the triple points of this hybrid double dot, using simulations to support our results, and show that we can tune the electrostatic coupling between the two sub-systems.Comment: 11 pages, 6 figure

The Relationship between Aerobic Test Performance and Injuries in Police Recruits

International Journal of Exercise Science 13(4): 1052-1062, 2020. Lower levels of fitness are associated with an increased risk of injury in police recruits. The aim of this study was to determine the relationships between initial aerobic performance assessments and injury risk during police recruit training. Retrospective data from 219 police recruits undergoing training program at a state police training academy, including 20-m Multistage Fitness Test (MSFT) and 30-15 Intermittent Fitness Test (IFT) scores and injury data, were collected. Spearman’s correlation analysis revealed a significant negative correlation between levels of fitness (MSFT rs = - 0.292, p \u3c 0.001: 30-15 IFT rs=- 0.315, p \u3c 0.001) and rates of injury. Furthermore, a Pearson’s correlation showed a strong correlation between MSFT and the 30-15 IFT scores (r = 0.877, p \u3c 0.001). Police recruits with lower fitness were at a higher risk of injury than those with higher fitness over the duration of a recruit training program. These findings indicate that aerobic performance assessments may be used by law enforcement agencies to estimate the relative risks of injury among cadets