Table of Contents and Introduction

Kathy Miller, the first Chair of Symphony in the Flint Hills, Inc. provides an introductory message. This section also includes the 2010 table of contents, information about the major sponsor, UMB Financial Corporation, and In the Beginning… , a description of the origins of the Symphony in the Flint Hills

A Matter of Life and Death: Situating Death in Education

Abstract Death holds a significant place in our social and cultural worlds despite it not being a direct or first-hand experience for many of us. Informal education about death occurs regularly throughout our daily lives in the context of “teachable moments, the unplanned life events from which important lessons can be drawn” (Kastenbaum, 2007, p. 483). Building upon a meaningful clinical encounter with a woman who was dying, this literature review explores the need to situate death as a topic and as a curriculum within the broad context of education and across the lifespan. By exploring some of the relevant discourses on death relating to education, I identify ways in which we receive death education informally through media, religion, culture, and the arts, presenting an argument for more formalized death education within all systems and levels of education

Recent translational research: antiangiogenic therapy for breast cancer – where do we stand?

The central importance of angiogenesis and our understanding of how new blood vessels are formed have led to the development of novel antiangiogenic therapies. Although the number of agents in development has grown exponentially, only one phase III trial in breast cancer has been completed. In that study the addition of bevacizumab to capecitabine did not extend the progression-free survival of patients with refractory disease as compared with capecitabine monotherapy. Early enthusiasm for antiangiogenic therapy must give way to clinical reality. Our challenge now is to exploit better the activity of antiangiogenic agents seen in the early clinical studies

Triple Negative Breast Cancer - Review of Current and Emerging Therapeutic Strategies

Triple negative breast cancer (TNBC) is associated with a poor prognosis compared to other types of breast cancer. The classification of 'triple negative' is not one homogenous tumor type, but rather is made up of multiple molecularly and biologically diverse tumor subtypes. At present, no approved targeted therapy exists and the standard remains cytotoxic chemotherapy. The identification of TNBC subtypes has provided a basis for identifying possible targeted therapeutic options. In addition, the recognition that some TNBCs share characteristics similar to tumors arising in patients with germline BRCA mutations has led to consideration of DNA damaging agents as a potential treatment option. Multiple investigational approaches are also underway, including immune checkpoint inhibition, poly (ADP-ribose) polymerase inhibition, and androgen receptor blockage. The limited options available for systemic treatment of TNBC will hopefully expand as more is learned about the complex biology and molecular targets of this group of breast cancers. This review will discuss the biology of TNBC, current treatment options, and promising experimental strategies

Pain Relief in Older Adults Following Static Contractions is not Task-Dependent

Pain complaints increase with age. Exercise is frequently utilized for pain relief but the optimal exercise prescription to relieve pain is not clear. Following static contractions, young adults experience the greatest pain relief with low intensity, long duration contractions. The pain response to static contractions in older adults however is unknown. PURPOSE : To compare pain reports in healthy older adults before and after static contractions of varying intensity and duration. METHODS: Pain perception was assessed in 23 healthy older adults (11 men, 12 women; 72.0 ± 6.3 yrs) using a pressure pain device consisting of a 10 N force applied to the right index finger through a Lucite edge (8 x 1.5mm) for two minutes. Subjects pushed a timing device when they first felt pain (i.e., pain threshold) and rated their pain intensity every 20 seconds using a 0-10 numerical rating scale. Pain threshold and pain ratings were measured before and immediately after static contractions of the left elbow flexors at the following three doses: 1) three brief maximal voluntary contractions (MVC); 2) 25% MVC sustained for 2 minutes; and 3) 25% MVC sustained until task failure. Experimental sessions were randomized and separated by one week. RESULTS : Time to task failure for the 25% MVC contraction was 11.8 ± 5.1 minutes. A reduction in pain was found following all three tasks with no difference between tasks (trial x task effect: p \u3e 0.05), despite the duration of the 2 minute low-intensity contraction being ~17% of the contraction held to task failure. Pain thresholds for all doses increased 20% from 51 ± 33 to 61 ± 37 seconds and pain ratings averaged over the six time points decreased 20% from 3.3 ± 2.8 to 2.6 ± 2.5 following static contractions (trial effect: p \u3c 0.001 and p \u3c 0.001, respectively). CONCLUSION : Low and high intensity static contractions of both long and short duration produce similar levels of pain reduction in older adults. These preliminary data suggest that several different types of static contractions can induce significant pain relief in older adults. Age-related changes in the pain response to static contractions must be taken into account when prescribing static exercise for the management of pain

Pain Relief in Older Adults Following Static Contractions is not Task-Dependent

Pain complaints increase with age. Exercise is frequently utilized for pain relief but the optimal exercise prescription to relieve pain is not clear. Following static contractions, young adults experience the greatest pain relief with low intensity, long duration contractions. The pain response to static contractions in older adults however is unknown. PURPOSE : To compare pain reports in healthy older adults before and after static contractions of varying intensity and duration. METHODS: Pain perception was assessed in 23 healthy older adults (11 men, 12 women; 72.0 ± 6.3 yrs) using a pressure pain device consisting of a 10 N force applied to the right index finger through a Lucite edge (8 x 1.5mm) for two minutes. Subjects pushed a timing device when they first felt pain (i.e., pain threshold) and rated their pain intensity every 20 seconds using a 0-10 numerical rating scale. Pain threshold and pain ratings were measured before and immediately after static contractions of the left elbow flexors at the following three doses: 1) three brief maximal voluntary contractions (MVC); 2) 25% MVC sustained for 2 minutes; and 3) 25% MVC sustained until task failure. Experimental sessions were randomized and separated by one week. RESULTS : Time to task failure for the 25% MVC contraction was 11.8 ± 5.1 minutes. A reduction in pain was found following all three tasks with no difference between tasks (trial x task effect: p \u3e 0.05), despite the duration of the 2 minute low-intensity contraction being ~17% of the contraction held to task failure. Pain thresholds for all doses increased 20% from 51 ± 33 to 61 ± 37 seconds and pain ratings averaged over the six time points decreased 20% from 3.3 ± 2.8 to 2.6 ± 2.5 following static contractions (trial effect: p \u3c 0.001 and p \u3c 0.001, respectively). CONCLUSION : Low and high intensity static contractions of both long and short duration produce similar levels of pain reduction in older adults. These preliminary data suggest that several different types of static contractions can induce significant pain relief in older adults. Age-related changes in the pain response to static contractions must be taken into account when prescribing static exercise for the management of pain

ERC Recertification

Topics covered in this course include understanding contracts, how to negotiate, invoicing, and project delivery. This course will satisfy ERC requirements for one year following completion. Pre-registration for this course is required. To register, please send an e-mail to [email protected] with the subject line “Road School ERC Recertification.” Please include your name, agency, and telephone number. There will be an LPA Program update prior to the training

The Implications of Insurance Status on Presentation, Surgical Management and Mortality among Non-Metastatic Breast Cancer Patients in Indiana

Background The National Breast and Cervical Cancer Early Detection Program seeks to reduce health care disparities by providing uninsured and underinsured women access to screening mammograms. The objective of this study is to identify the differences in presentation, surgical management, and mortality among nonmetastatic uninsured patients diagnosed through Indiana's Breast and Cervical Cancer Program compared with patients with private and government (Medicare or Medicaid) insurance. Methods Study data were obtained using the Indiana state cancer registry and Indiana's Breast and Cervical Cancer Program. Women aged 50 to 64 with an index diagnosis of stage 0 to III breast cancer from January 1, 2006 to December 31, 2013, were included in the study. Bivariate intergroup analysis was conducted. Kaplan-Meier estimates between insurance types were compared using the log rank test. All-cause mortality was evaluated using a mixed effects model. Results The groups differed significantly for sociodemographic and clinical variables. Uninsured Indiana Breast and Cervical Cancer Program patients presented with later disease stage (P < .001) and had the highest overall mortality (hazard ratio 2.2, P = .003). Surgical management only differed among stage III patients (P = .012). Conclusion To improve insurance-based disparities in Indiana, implementation of the Breast and Cervical Cancer Program in conjunction with expansion of insurance coverage to vulnerable low-income populations need to be optimized

CURVE SPRINTING KINEMATICS EXHIBITED BY ATHLETES USING A SINGLE, TRANS-TIBIAL PROSTHESIS

The purpose of our study was to determine whether kinematics exhibited during the curve section of a 200 m sprint are influenced by ‘limb type’ (prosthetic vs nonprosthetic limb) or ‘prosthetic limb side’ (‘inside’ compared to the ‘outside’ of the curve). Two video cameras (60 Hz) were used to capture 13 male athletes using a single, trans-tibial prosthesis during an international, 200 m T-44 competition. From mixed-model ANOVA (p < .05), prosthetic and nonprosthetic limb kinematics were different, but differences were dependent on the prosthetic limb side. The inside versus outside prosthetic limb may be affected more due to the rotational influences that affect the inside and outside foot differently. Therefore, athletes whose prosthetic limb was on the inside may be at a disadvantage compared to those with an outside prosthetic limb