Play therapy insights into everyday social pedagogical practice in residential child care

Psychotherapy and social pedagogical care, help and support in relation to children placed in out-of-home care are typically perceived as two separate forms of practice. In its typical form, psychotherapy is pictured as a meeting between therapist and client in a ‘therapeutic space’ separated out from daily life and activities, while social pedagogical care, help, and support is carried out in close proximity to everyday life in what is regarded as the person’s home. This article analyses an alternative relationship and way of collaborating between psychotherapy – more specifically play therapy – and everyday social pedagogical practice in residential care for children with severe emotional and behavioural problems. This is done by drawing on an empirical case study of the relationship between everyday practice and expertise of social pedagogical practice and play therapy in a children’s home in Denmark. Meeting the needs of children who have been severely neglected and/or abused is challenging in different ways, and it requires highly developed relational, emotional, and reflective skills. The authors argue that play therapy has a particular potential in foregrounding and developing core social pedagogical knowledge and skills. When designed and carried out as an integrated part of everyday social pedagogical practice, play therapy can support practitioners in integrating a reflective and conscious approach to understanding and meeting the children’s emotional and relational needs with the ability to create and enter into ‘playful encounters’ with the children that challenges one-sided and taken-for-granted power relationships, practices and norms

TIMP-1 and responsiveness to gemcitabine in advanced breast cancer:results from a randomized phase III trial from the Danish breast cancer cooperative group

BACKGROUND: Tissue inhibitor of metalloproteinases-1 (TIMP-1) has anti-apoptotic functions, which may protect TIMP-1 positive cancer cells from the effects of chemotherapy such as docetaxel and gemcitabine. The purpose of the present study was to evaluate TIMP-1 immunoreactivity as a prognostic and predictive marker in advanced breast cancer patients receiving docetaxel (D) or gemcitabine plus docetaxel (GD). METHODS: Patients with locally advanced or metastatic breast cancer who were assigned to D or GD by participation in a randomized phase III trial were included in the study. Assessment of TIMP-1 status was performed retrospectively on primary tumor whole-tissue sections by immunohistochemistry and tumor samples were considered positive if epithelial breast cancer cells were stained by the anti-TIMP-1 monoclonal antibody VT7. Time to progression (TTP) was the primary endpoint. Overall survival (OS) and response rate (RR) were secondary endpoints. Associations between TIMP-1 status and outcome after chemotherapy were analyzed by Kaplan-Meier estimates and Cox proportional hazards regression models. RESULTS: TIMP-1 status was available from 264 of 337 patients and 210 (80%) of the tumors were classified as cancer cell TIMP-1 positive. No significant difference for TTP between TIMP-1 positive versus TIMP-1 negative patients was observed in multivariate analysis, and RR did not differ according to TIMP-1 status. However, patients with TIMP-1 positive tumors had a significant reduction in OS events (hazard ratio = 0.71, 95% confidence interval (CI) = 0.52-0.98, P = 0.03). Additionally, a borderline significant interaction for OS was observed between TIMP-1 status and benefit from GD compared to D (P(interaction) = 0.06) such that median OS increased by nine months for TIMP-1 negative patients receiving GD. CONCLUSIONS: TIMP-1 status was an independent prognostic factor for OS but not TTP in patients with advanced breast cancer receiving either D or GD. There was no statistically significant interaction between TIMP-1 status and treatment, but a trend towards an incremental OS from the addition of gemcitabine to docetaxel in patients with TIMP-1 negative tumors suggests further investigation

Three decades of volume change of a small greenlandic glacier using ground penetrating radar, structure from motion, and aerial photogrammetry

Glaciers in the Arctic are losing mass at an increasing rate. Here we use surface topography derived from Structure from Motion (SfM) and ice volume from ground penetrating radar (GPR) to describe the 2014 state of Aqqutikitsoq glacier (2.85 km2) on Greenland's west coast. A photogrammetrically derived 1985 digital elevation model (DEM) was subtracted from a 2014 DEM obtained using land-based SfM to calculate geodetic glacier mass balance. Furthermore, a detailed 2014 ground penetrating radar survey was performed to assess ice volume. From 1985 to 2014, the glacier has lost 49.8 ± 9.4 106 m3 of ice, corresponding to roughly a quarter of its 1985 volume (148.6 ± 47.6 106 m3) and a thinning rate of 0.60 ± 0.11 m a-1. The computations are challenged by a relatively large fraction of the 1985 DEM (∼50% of the glacier surface) being deemed unreliable owing to low contrast (snow cover) in the 1985 aerial photography. To address this issue, surface elevation in low contrast areas was measured manually at point locations and interpolated using a universal kriging approach. We conclude that ground-based SfM is well suited to establish high-quality DEMs of smaller glaciers. Provided favorable topography, the approach constitutes a viable alternative where the use of drones is not possible. Our investigations constitute the first glacier on Greenland's west coast where ice volume was determined and volume change calculated. The glacier's thinning rate is comparable to, for example, the Swiss Alps and underlines that arctic glaciers are subject to fast changes

Effects of Renal Denervation on Insulin Sensitivity and Inflammatory Markers in Nondiabetic Patients with Treatment-Resistant Hypertension

Increased sympathetic activity is important in the pathogenesis of hypertension and insulin resistance. Afferent signaling from the kidneys elevates the central sympathetic drive. We investigated the effect of catheter-based renal sympathetic denervation (RDN) on glucose metabolism, inflammatory markers, and blood pressure in nondiabetic patients with treatment-resistant hypertension. Eight subjects were included in an open-labelled study. Each patient was studied before and 6 months after RDN. Endogenous glucose production was assessed by a 3-3H glucose tracer, insulin sensitivity was examined by hyperinsulinemic euglycemic clamp, hormones and inflammatory markers were analyzed, and blood pressure was measured by office blood pressure readings and 24-hour ambulatory blood pressure monitoring. Insulin sensitivity (M-value) increased nonsignificantly from 2.68 ± 0.28 to 3.07 ± 0.41 (p=0.12). A significant inverse correlation between the increase in M-value and BMI 6 months after RDN (p=0.03) was found, suggesting beneficial effects on leaner subjects. Blood pressure decreased significantly, but there were no changes in hormones, inflammatory markers, or endogenous glucose production. Our results indicate that RDN may improve insulin sensitivity in some patients with treatment-resistant hypertension, albeit confirmation of these indications of beneficial effects on leaner subjects awaits the outcome of larger randomized controlled studies

Sustainable bioethanol production combining biorefinery principles using combined raw materials from wheat undersown with clover-grass

To obtain the best possible net energy balance of the bioethanol production the biomass raw materials used need to be produced with limited use of non-renewable fossil fuels. Intercropping strategies are known to maximize growth and productivity by including more than one species in the crop stand, very often with legumes as one of the components. In the present study clover-grass is undersown in a traditional wheat crop. Thereby, it is possible to increase input of symbiotic fixation of atmospheric nitrogen into the cropping systems and reduce the need for fertilizer applications. Furthermore, when using such wheat and clover-grass mixtures as raw material, addition of urea and other fermentation nutrients produced from fossil fuels can be reduced in the whole ethanol manufacturing chain. Using second generation ethanol technology mixtures of relative proportions of wheat straw and clover-grass (15:85, 50:50, and 85:15) were pretreated by wet oxidation. The results showed that supplementing wheat straw with clover-grass had a positive effect on the ethanol yield in simultaneous saccharification and fermentation experiments, and the effect was more pronounced in inhibitory substrates. The highest ethanol yield (80% of theoretical) was obtained in the experiment with high fraction (85%) of clover-grass. In order to improve the sugar recovery of clover-grass, it should be separated into a green juice (containing free sugars, fructan, amino acids, vitamins and soluble minerals) for direct fermentation and a fibre pulp for pretreatment together with wheat straw. Based on the obtained results a decentralized biorefinery concept for production of biofuel is suggested emphasizing sustainability, localness, and recycling principle

Evaluation of serum ARGS neoepitope as an osteoarthritis biomarker using a standardized model for exercise-induced cartilage extra cellular matrix turnover

Summary: Objective: To propose a standardized model for exercise-induced cartilage turnover and investigate residual levels and dynamics of biomarker serum ARGS (sARGS) in primary osteoarthritis (OA) patients and a supportive group of young healthy subjects. Method: The trial is a randomized, cross-over, exploratory study with interventions of exercise and inactivity. 20 subjects with knee OA, as well as 20 young healthy subjects (mean age 25.7 years (range; 19–30), 50% male), underwent cycling, running and resting interventions on separate days one week apart. Blood samples were taken at baseline, immediately, 1, 2, 3 and 24 h after activity start. sARGS was measured by sandwich ELISA. Results: Intraclass correlation between visits were 0.97 and 0.77 for the OA and healthy group, respectively. An acute drop in sARGS in response to high-intensity exercise was observed in both groups. Minute acute sARGS increase was observed in OA subjects in response to moderate intensity running and cycling, which normalized within 24 h. In healthy subjects an acute drop in sARGS was seen immediately after running, but not cycling, and no other changes were observed. A negative correlation between baseline Kellgren-Lawrence (KL) grade and baseline sARGS (r = −0.69, p = 0.002) in OA was found. A negative correlation between age and sARGS was found in healthy subjects (r = −0.67, p = <0.002). Conclusion: sARGS sensitivity to physical activity is considered low and sARGS is a reproducible and stable marker. Minute acute increases in sARGS were observed in the hours following moderate intensity exercise

Pituitary apoplexy: re-evaluation of risk factors for bleeding into pituitary adenomas and impact on outcome

Objective: To assess frequency, symptoms and outcome of pituitary apoplexy (PA) among pituitary adenoma patients, to gain better insight into risk factors for bleeding into pituitary adenoma, and to estimate the sequelae of PA by means of a matched control group. Method: By reviewing charts of 574 patients with pituitary adenoma we analysed incidence, symptoms and outcome of PA, and potential risk factors for developing PA by means of a control group (patients with pituitary adenoma without PA). Results: 42 suffered from PA; all had macroadenomas. 30/217 male (14%) and 12/179 female (7%) macroadenoma patients, 32/194 patients with clinically non-functioning (16.5%) and 10/202 with clinically active (5.0%) macroadenoma were affected. Antithrombotic therapy predisposed patients to PA (p = 0.026), diabetes mellitus and hypertension did not (p = 1.00). Patients with PA and pituitary adenoma patients without PA had similar frequencies of hypopituitarism (45 vs. 48%, p > 0.05) and visual field defects (38 vs. 55%, p > 0.05), but ophthalmoplegia was significantly more common (76 vs. 5%, p < 0.001) in patients with PA. Nearly all patients were treated by surgery; most recovered from ophthalmoplegia whereas visual function improved only moderately. Endocrine outcome was worse in patients with PA compared to patients without PA. Conclusions: Male gender and characteristics of the adenoma itself (especially tumour size and tumour type) rather than patient's cardiovascular risk factors such as diabetes and hypertension seem to predispose to PA; antithrombotic therapy may also be important

Cross-linked amylose bio-plastic: A transgenic-based compostable plastic alternative

Bio-plastics and bio-materials are composed of natural or biomass derived polymers, offering solutions to solve immediate environmental issues. Polysaccharide-based bio-plastics represent important alternatives to conventional plastic because of their intrinsic biodegradable nature. Amylose-only (AO), an engineered barley starch with 99% amylose, was tested to produce cross-linked all-natural bioplastic using normal barley starch as a control. Glycerol was used as plasticizer and citrate cross-linking was used to improve the mechanical properties of cross-linked AO starch extrudates. Extrusion converted the control starch from A-type to Vh- and B-type crystals, showing a complete melting of the starch crystals in the raw starch granules. The cross-linked AO and control starch specimens displayed an additional wide-angle diffraction reflection. Phospholipids complexed with Vh-type single helices constituted an integrated part of the AO starch specimens. Gas permeability tests of selected starch-based prototypes demonstrated properties comparable to that of commercial Mater-Bi© plastic. The cross-linked AO prototypes had composting characteristics not different from the control, indicating that the modified starch behaves the same as normal starch. The data shows the feasibility of producing all-natural bioplastic using designer starch as raw material