Closing The Circle: Comprehensive Study Abroad Reentry Programming in a Small Liberal Arts College

In an increasingly globalized world, study abroad is growing in popularity. As a rising number of students study, work, research or simply move abroad, research by experts and practitioners has been focused on finding ways to maximize learning. An effective and wildly popular strategy adopted by most institutions is pre-departure orientation. However its counterpart, study abroad reentry, while also potentially transformative, isn’t equally widespread. This paper describes an effort to fill this gap through the creation of a reentry program for Marlboro College, a small, liberal arts college in Marlboro, Vermont. In order to tailor the program to Marlboro students’ specific learning objectives and styles, preliminary research was conducted among students, faculty and staff members. The results highlighted the need for a reflection and discussion-based program offering ample opportunities for students to share their experiences and learn from each other. Consequently, the semester-long “Back On The Hill” program was created. The experiential learning model was chosen as a foundational framework to guide the design of Back On The Hill as an interdisciplinary, collaborative curriculum based on three main components: reflection on one’s own learning, contextualization of that learning and application of it. To effectively deliver these components, program sessions were chosen to be weekly and centered around activities ranging from open discussions to guest panels, student-led workshops and community-wide events. To ensure accessibility and feasibility, the program was designed to fit smoothly into Marlboro’s everyday activities. The practicality of the logistics, together with the curriculum chosen, were intentional and aimed at situating this program as a potential model for other small, liberal arts colleges to develop similar efforts towards implementing reentry programs

Perspectives on hypertension treatment in older persons

No abstract available

Factors Affecting Blood Pressure Variability: Lessons Learned from Two Systematic Reviews of Randomized Controlled Trials

Systematic reviews can often reveal much more than the original objective of the work. The objectives of this retrospective analysis were to answer three basic questions about blood pressure variability: 1) Does blood pressure entry criterion have an effect on baseline blood pressure variability? 2) Do thiazide diuretics have a significant effect on blood pressure variability? and 3) Does systolic blood pressure vary to the same degree as diastolic blood pressure? This analysis of blood pressure variability is based on resting standardized research setting BP readings from two systematic reviews evaluating blood pressure lowering efficacy of thiazide diuretics from double blind randomized controlled trials in 33,611 patients with primary hypertension. The standard deviation reported in trials was the focus of the research and the unit of analysis. When a threshold systolic or diastolic blood pressure value is used to determine entry into a trial, baseline variability is significantly decreased, systolic from 14.0 to 9.3 mmHg and diastolic from 8.4 to 5.3 mmHg. Thiazides do not change BP variability as the standard deviation and coefficient of variation of systolic blood pressure and diastolic blood pressure did not differ between thiazide and placebo groups at end of treatment. The coefficient of variation of systolic blood pressure was significantly greater than the coefficient of variation of diastolic blood pressure. Entry criterion decreases the baseline blood pressure variability. Treatment with a thiazide diuretic does not affect blood pressure variability. Systolic blood pressure varies to a greater degree than diastolic blood pressure

Reducing the cardiovascular disease burden for people of all ages in the Americas region: Analysis of mortality data, 2000–15

Background: In accordance with the age parameters specified in Sustainable Development Goal target 3.4, current policy and monitoring of non-communicable disease (NCD) mortality trends focus on people aged 30–69 years. This approach excludes the majority of NCD deaths, which occur at older ages. We aimed to compare cardiovascular mortality for different age groups in the WHO Region of the Americas. Methods: We extracted mortality data from the Pan American Health Organization regional mortality database for 36 countries for the period 2000 to 2015. We calculated age-standardised mortality rates (ASMRs) from cardiovascular diseases for different age groups for these countries. Joinpoint regression models were used to estimate mortality trends, providing estimates of the average annual percentage change for the period 2000–15. Findings: Individuals aged 70 years or older accounted for the majority of cardiovascular disease deaths in all countries (range 52–82%). Considerable variation in cardiovascular deaths was observed between countries for all age categories. Between 2000 and 2015, in most countries, the largest reductions in ASMR were observed in the older age groups (aged ≥70 years). The total number of regional cardiovascular disease deaths that hypothetically could have been averted in 2015 for people aged 30–79 years was 440 777, of which 211 365 (48%) occurred among people aged 70–79 years. Interpretation: Data for the WHO Region of the Americas are sufficiently robust to permit comparative analysis of cardiovascular disease mortality trends for people aged 70 years and older over time and across countries. Although the reduction of cardiovascular disease mortality in individuals aged 30–69 years is a valid policy goal for the Americas region, this objective should be expanded to include people at older ages. Funding: None

Phase II, Open-label, Single-arm, Multicenter Study to Assess the Activity and Safety of Alectinib as Neoadjuvant Treatment in Surgically Resectable Stage III ALK-positive NSCLC: ALNEO Trial

Background: Alectinib is a potent anaplastic lymphoma kinase (ALK)-tyrosine kinase inhibitor (TKI) which is currently used in the first-line setting of advanced ALK+ non-small cell lung cancer (NSCLC). Despite favorable results in the metastatic setting, the activity of alectinib in locally-advanced ALK+ NSCLC as a neoadjuvant treatment remains to be assessed. We report the case of a patient with stage IIIA ALK+ NSCLC (cT2aN2) who received alectinib as neoadjuvant treatment, achieving major pathological response (MPR) at pathologic examination. Hence we present the treatment rationale and study design of a phase II, open-label, single-arm, multicenter clinical trial (ALNEO study, EUDRACT number 2020-003432-25). Materials and Methods: Patients with potentially resectable stage III ALK+ NSCLC (any T with N2, T4N0-1) will be registered to receive oral alectinib 600 mg twice daily for 2 cycles of 4 weeks each (8 weeks totally) during the neoadjuvant phase. After definitive surgery, patients will enter in the adjuvant setting, during which they will receive alectinib 600 mg twice daily for 24 cycles (96 weeks). The primary endpoint is MPR, defined as ≤10% residual viable tumor cells histologically detected in the resected primary tumor and all resected lymph nodes after surgery. Secondary endpoints include pathological complete response, objective response, event-free survival, disease-free survival, overall survival, adverse events. Conclusions: Our case report supports the feasibility of alectinib as neoadjuvant treatment. ALNEO study will further explore the activity and safety of this novel treatment strategy

Phytochemical investigations and antibacterial activity of Salacia oblonga Wall ethanolic extract

Abstract Salacia oblonga Wall, a medicinally important plant, belonging to the family Celastraceae, is a large woody climber distributed in southern India and Sri Lanka. In the present investigation, ethanol extracts of S. oblonga were prepared from aerial and root parts of the plant in the presence and absence of HCl and antibacterial activity was tested. Both aerial and root extracts exhibited pronounced activity against human pathogens. The MIC and MBC values ranged from 0.078-1.25 mg/ml and 0.156 -2.50 mg/ml, respectively. GC-MS profile of aerial and root extracts displayed the presence of 11 and 6 compounds. The present investigation demonstrated that ethanolic extracts of S. oblonga have potential antibacterial activity against human pathogens and could serve as a source for the development of new age antimicrobials

Authors' reply to Lee and colleagues

Non peer reviewe

Antihypertensive treatment in people with dementia

Introduction The range and magnitude of potential benefits and harms of antihypertensive treatment in people with dementia has not been previously established. Method A scoping review to identify potential domains of benefits and harms of antihypertensive therapy in people with dementia was undertaken. Systematic reviews of these domains were undertaken to examine the magnitude of the benefits or harms. Results Potential outcome domains identified in the 155 papers in the scoping review were cardio-vascular events, falls, fractures and syncope, depression, orthostatic hypotension, behavioural disturbances, polypharmacy risks, kidney problems, sleep problems, interactions with cholinesterase inhibitors and pain. The systematic reviews across these domains identified relatively few studies done in people with dementia, and no convincing evidence of safety, benefit or harm across any of them. Discussion There is no justification for materially different guidance for the treatment of hypertension in people with dementia, but sufficient evidence to warrant particular caution and further research into treatment in this group of patients