Arbutus

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Exploring the Role of Emotions in Clinical Legal Education: Inquiry and Results from an International Workshop for Legal Educators

Clinical legal education provides a unique opportunity to engage with emotions. This article describes and reflects on an interactive workshop that examined the nature, meaning and significance of emotions in clinical legal education. Through a variety of incorporated staged activities, employing the teaching methods of scaffolding as well as backward design, participants explored aspects of the emotional dimensions of the relationships between clinical teachers/supervisors and their students, along with the relationship between students and their clients. Participants extracted ideas for how educators should approach emotions when they surface in legal clinics. This article provides a detailed overview regarding the rationale for the workshop, followed by a summary of the workshop plans and steps, before detailing key observations and lessons from the workshop

Effectiveness of Group Behavioural Activation for Depression: A Pilot Study.

BACKGROUND: The evidence base for behavioural activation (BA) is mainly grounded in the individual delivery method, with much less known about the impact of group delivery. AIMS: To conduct a pilot study of behavioural activation in groups (BAG) for depression delivered in a routine service setting, in order to explore acceptability, effectiveness and predictors of outcome. METHODS: The manualized group treatment format was delivered in a Primary Care mental health setting, at step three of an Improving Access to Psychological Therapies (IAPT) service. BAG was facilitated by cognitive behavioural psychotherapists, and outcome measures (depression, anxiety and functional impairment) were taken at each session. Seventy-three participants were referred and treated within nine groups. RESULTS: BAG was an acceptable treatment generating a low drop-out rate (7%). Significant pre-post differences were found across all measures. There was a moderate to large depression effect size (d + = 0.74), and 20% met the criteria for a reliable recovery in depression. Greater severity of initial depression and attendance of at least four BAG sessions predicted better outcomes. CONCLUSIONS: BAG appears to be an effective depression treatment option that shows some clinical promise. Further larger and more controlled studies are nevertheless required

Curcuma longa extract improves serum electrolytes and hormone profile of dihydrotestosterone - Estradiol valerate induced benign prostatic hyperplasia male rats

The usefulness of methanol extract of Curcuma longa in management of benign prostatic hyperplasia (BPH) in rats was studied. Twenty  male Wistar rats were divided into five groups of 4 rats each. BPH was induced by subcutaneous injection of dihydrotestosterone (DHT) and estradiol valerate (10:1) daily for 28 days. The normal control (NC) received subcutaneous olive oil (as vehicle) for the same duration. The disease control (HC) and drug control groups (DC) were given subcutaneous olive oil and oral finasteride (standard drug: 5 mg/kg bw) respectively after induction of BPH. Rats in the test groups (T1 and T2) were given 100 and 200 mg/kg.bw of C. longa methanol extracts orally for 28 days respectively, following disease induction. Phytochemical constituents of plant extracts, selected biomarkers of BPH,  serum electrolyte and hormonal profile were determined using standard methods. Results revealed that C. longa have higher content of flavonoid (4.03 ± 0.01 mg/100 g) with lower concentration of terpene (0.40 ± 0.07 mg/100 g). There was significant decrease (p<0.05) in relative prostate weight and prostate specific antigen (PSA) in T1 and T2 compared to the HC group. Calcium and sodium showed  significant (p<0.05) decreased following administration of plant extract while chlorine and bicarbonate recorded no (p>0.05) difference. There was a (p<0.05) decrease in serum total testosterone and increase in FSH level, but no difference (p>0.05) was seen in serum estradiol levels within all experimental groups. This study reveals that C. longa may be useful in the treatment and/or management of BPH and itscomplications

Fluorescent amplified fragment length polymorphism analysis of Bacillus anthracis, Bacillus cereus, and Bacillus thuringiensis isolates

DNA from over 300 Bacillus thuringiensis, Bacillus cereus, and Bacillus anthracis isolates was analyzed by fluorescent amplified fragment length polymorphism (AFLP). B. thuringiensis and B. cereus isolates were from diverse sources and locations, including soil, clinical isolates and food products causing diarrheal and emetic outbreaks, and type strains from the American Type Culture Collection, and over 200 B. thuringiensis isolates representing 36 serovars or subspecies were from the U.S. Department of Agriculture collection. Twenty-four diverse B. anthracis isolates were also included. Phylogenetic analysis of AFLP data revealed extensive diversity within B. thuringiensis and B. cereus compared to the monomorphic nature of B. anthracis. All of the B. anthracis strains were more closely related to each other than to any other Bacillus isolate, while B. cereus and B. thuringiensis strains populated the entire tree. Ten distinct branches were defined, with many branches containing both B. cereus and B. thuringiensis isolates. A single branch contained all the B. anthracis isolates plus an unusual B. thuringiensis isolate that is pathogenic in mice. In contrast, B. thuringiensis subsp. kurstaki (ATCC 33679) and other isolates used to prepare insecticides mapped distal to the B. anthracis isolates. The interspersion of B. cereus and B. thuringiensis isolates within the phylogenetic tree suggests that phenotypic traits used to distinguish between these two species do not reflect the genomic content of the different isolates and that horizontal gene transfer plays an important role in establishing the phenotype of each of these microbes. B. thuringiensis isolates of a particular subspecies tended to cluster together

Exile Vol. XLIII No. 1

41st Year Title Page 1 Epigraph by Ezra Pound 2 Table of Contents 3 Shame(d) by alex e. blazer 4 enter play by alex e. blazer 5 sunday\u27s sex ed fundamentals by alex e. blazer 6 Dancing, Dedicated to Shannon by Paul Genesius Durica 7-8 On the Rocks by Katie Keller 9-10 In Heritage Station, Huntington, WV by Trish Klei 11 Untitled by Tyler Smith 12-14 Untitled by Camille Gammon-Hittelman 15 Untitled by erika laine hansen 16 Androgynous Implications by Elizabeth Nutting 17 Patterns of the Clouds by Angela Rae Bliss 18 Sister, Sister, Aspirations by Elizabeth Nutting 19 Sick Girl by Helena Jasna Oroz 20-21 The Television Era by Trish Klei 22 I\u27m Mistaken; He\u27s Alive by Bekah Taylor 23 Crucifixion on the Corner of State and Bruening by Paul Genesius Durica 24-25 reLiAnce: CorKscrews by Bekah Taylor 26 Colors of the Beast by Helena Jasna Oroz 27 Development by Brian P. Voroselo 28-31 Untitled by Peter Rees 32 Public Bathhouse by Paul Genesius Durica 33 The Sound of Silence Upon the Onyx Wall of Memories by Angela Rae Bliss 34 Untitled by Peter Rees 35 Empress by Paul Genesius Durica 36-37 Life is what you make it by Cathy Graham 38-42 Untitled by Peter Rees 43 Competition by Bekah Taylor 44 changeling by Casey McArdle 45 A Kiss is Just a Kiss, A Lick is Just a Lick by Helena Jasna Oroz 46 the-r-apist by alex e. blazer 47 Gone by Latisha Newton 48 Sonnet by Touch by Trish Klei 49 Contributors\u27 Notes 49-51 Staff Page & Editorial Policy 52 Editorial decisions are shared equally among the editorial board. Submissions are judged on a name-blind basis. Members of boards whose own work is under consideration must abstain from discussion regarding that work. -5

Accelerated versus standard epirubicin followed by cyclophosphamide, methotrexate, and fluorouracil or capecitabine as adjuvant therapy for breast cancer (UK TACT2; CRUK/05/19): quality of life results from a multicentre, phase 3, open-label, randomised, controlled trial

BACKGROUND: Adjuvant chemotherapy for patients with early breast cancer improves outcomes but its toxicity affects patients' quality of life (QOL). The UK TACT2 trial investigated whether accelerated epirubicin improves time to recurrence and if oral capecitabine is non-inferior to cyclophosphamide, methotrexate, and fluorouracil (CMF) for efficacy with less toxicity. Results showed no benefit for accelerated epirubicin and capecitabine was non-inferior. As part of the QOL substudy, we aimed to assess the effect of chemotherapies on psychological distress, physical symptoms, and functional domains. METHODS: TACT2 was a multicentre, phase 3, open-label, parallel-group, randomised, controlled trial done in 129 UK centres. Participants were aged 18 years or older with histologically confirmed node-positive or high-risk node-negative invasive primary breast cancer, who had undergone complete excision, and due to receive adjuvant chemotherapy. Patients were randomly assigned (1:1:1:1) to four cycles of 100 mg/m2 epirubicin either every 3 weeks (standard epirubicin) or every 2 weeks with 6 mg pegfilgrastim on day 2 of each cycle (accelerated epirubicin), followed by four 4-week cycles of either CMF (600 mg/m2 cyclophosphamide intravenously on days 1 and 8 or 100 mg/m2 orally on days 1–14; 40 mg/m2 methotrexate intravenously on days 1 and 8; and 600 mg/m2 fluorouracil intravenously on days 1 and 8 of each cycle) or four 3-week cycles of 2500 mg/m2 capecitabine (1250 mg/m2 given twice daily on days 1–14 of each cycle). The randomisation schedule was computer generated in random permuted blocks, stratified by centre, number of nodes involved (none vs 1–3 vs ≥4), age (≤50 years vs >50 years), and planned endocrine treatment (yes vs no). QOL was one of the secondary outcomes and is reported here. All patients from a subset of 44 centres were invited to complete QOL questionnaires (Hospital Anxiety and Depression Scale [HADS] and European Organisation for Research and Treatment of Cancer [EORTC] Quality of Life Questionnaire 30-item core module [QLQ-C30] and Quality of Life Questionnaire breast module [QLQ-BR23]) at baseline, end of standard or accelerated epirubicin, end of CMF or capecitabine, and at 12 and 24 months after randomisation. The QOL substudy prespecified two coprimary QOL outcomes assessed in the intention-to-treat population: overall QOL (reported elsewhere) and HADS total score. Prespecified secondary QOL outcomes were EORTC QLQ-C30 subscales of physical function, role function, and fatigue and EORTC QLQ-BR23 subscales of sexual function and systemic therapy side-effects. This trial is registered with ISRCTN, ISRCTN68068041, and ClinicalTrials.gov, NCT00301925. FINDINGS: From Dec 16, 2005, to Dec 5, 2008, 4391 patients (20 [0·5%] of whom were male) were enrolled in TACT2; 1281 (85·8%) of 1493 eligible patients were included in the QOL substudy. Eight (0·6%) participants in the QOL substudy were male and 1273 (99·4%) were female. Median follow-up was 85·6 months (IQR 80·6–95·9). Analysis was performed on the complete QOL dataset (as of Sept 15, 2011) when all participants had passed the 24-month timepoint. Prerandomisation questionnaires were completed by 1172 (91·5%) patients and 1179 (92·0%) completed at least one postrandomisation questionnaire. End-of-treatment HADS depression score (p=0·0048) and HADS total change score (p=0·0093) were worse for CMF versus capecitabine. Accelerated epirubicin led to worse physical function (p=0·0065), role function (p<0·0001), fatigue (p=0·0002), and systemic side-effects (p=0·0001), but not sexual function (p=0·36), compared with standard epirubicin during treatment, but the effect did not persist. Worse physical function (p=0·0048), sexual function (p=0·0053), fatigue (p<0·0001), and systemic side-effects (p<0·0001), but not role functioning (p=0·013), were seen for CMF versus capecitabine at end of treatment; these differences persisted at 12 months and 24 months. INTERPRETATION: Accelerated epirubicin was associated with worse QOL than was standard epirubicin but only during treatment. These findings will help patients and clinicians make an informed choice about accelerated chemotherapy. CMF had worse QOL effects than did capecitabine, which were persistent for 24 months. The favourable capecitabine QOL compared with CMF supports its use as an adjuvant option after neoadjuvant chemotherapy in patients with triple-negative breast cancer