Improving acute promyelocytic leukemia (APL) outcome in developing countries through networking, results of the International Consortium on APL

Thanks to modern treatment with all-trans retinoic acid and chemotherapy, acute promyelocytic leukemia (APL) is now the most curable type of leukemia. However, this progress has not yielded equivalent benefit in developing countries. the International Consortium on Acute Promyelocytic Leukemia (IC-APL) was established to create a network of institutions in developing countries that would exchange experience and data and receive support from well-established US and European cooperative groups. the IC-APL formulated expeditious diagnostic, treatment, and supportive guidelines that were adapted to local circumstances. APL was chosen as a model disease because of the potential impact on improved diagnosis and treatment. the project included 4 national coordinators and reference laboratories, common clinical record forms, 5 subcommittees, and laboratory and data management training programs. in addition, participating institutions held regular virtual and face-to-face meetings. Complete hematological remission was achieved in 153/180 (85%) patients and 27 (15%) died during induction. After a median follow-up of 28 months, the 2-year cumulative incidence of relapse, overall survival (OS), and disease-free survival (DFS) were 4.5%, 80%, and 91%, respectively. the establishment of the IC-APL network resulted in a decrease of almost 50% in early mortality and an improvement in OS of almost 30% compared with historical controls, resulting in OS and DFS similar to those reported in developed countries.American Society of HematologyFondazione Umberto VeronesiRoche Saudi ArabiaFundacao de Apoio a Pesquisa do Estado de São PauloFundacion Mexicana para la SaludSt. Jude Children's Research HospitalCephalon EuropeUniv São Paulo, Hematol Oncol Div, Dept Internal Med, Med Sch Ribeirao Preto, BR-14048900 Ribeirao Preto, BrazilUniv São Paulo, Ctr Cell Based Therapy, BR-14048900 Ribeirao Preto, BrazilDana Farber Canc Inst, Dept Biostat & Computat Biol, Boston, MA 02115 USAClin Ruiz Puebla, Puebla, MexicoHosp Salvador, Dept Hematol, Santiago, ChileAsociac Espanola Primera Socorros Mutuos, Montevideo, UruguayHosp Univ Dr Jose E Gonzalez, Div Hematol, Monterrey, MexicoFundacao HEMOPE, Recife, PE, BrazilUniv Fed Rio Grande do Sul, Div Hematol, Porto Alegre, RS, BrazilUniv Fed Parana, Div Hematol, BR-80060000 Curitiba, Parana, BrazilUniv Campinas UNICAMP, Hematol & Hemotherapy Ctr, Campinas, BrazilUniv Fed Minas Gerais, Div Hematol, Belo Horizonte, MG, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilSanta Casa Med Sch, Div Hematol, São Paulo, BrazilCtr Med Nacl Siglo XXI, Mexico City, DF, MexicoNorthwestern Univ, Feinberg Sch Med, Hematol Oncol Div, Chicago, IL 60611 USAAlbert Einstein Canc Ctr, New York, NY USAUniv Med Ctr, Dept Pediat & Adolescent Med, Freiburg, GermanyStanford Univ, Dept Med, Stanford, CA 94305 USAMem Sloan Kettering Canc Ctr, Dept Med, Leukemia Serv, Weill Cornell Med Coll, New York, NY 10021 USAKings Coll London Sch Med, Dept Med & Mol Genet, London, EnglandHannover Med Sch, Dept Hematol Hemostasis Oncol & Stem Cell Transpl, Hannover, GermanyHarvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med, Boston, MA 02115 USASt Jude Childrens Res Hosp, Dept Oncol, Memphis, TN 38105 USAUniv Roma Tor Vergata, Dept Biopathol, Rome, ItalySanta Lucia Fdn, Rome, ItalyErasmus MC, Dept Hematol, Rotterdam, NetherlandsValencia Univ Med Sch, Hosp Univ La Fe, Dept Hematol, Valencia, SpainUniversidade Federal de São Paulo, São Paulo, BrazilFundacao de Apoio a Pesquisa do Estado de São Paulo: 1998/14247-6Web of Scienc

Why Symbolic Representation Frames Parliamentary Public Engagement

The UK Parliament’s activity in public engagement has recently expanded considerably. Faced with declining levels of trust, it has invested considerable time and resources to new activities focusing specifically on engagement: educational resources and cultural events among many others. This embodies a new role for parliament of increasing importance particularly in the context of the twenty-first century parliament. This article analyses the aims of public engagement and its consequences for representation. We explore the potential representative role of public engagement, identifying key changes that have affected the relationship between public and parliament. We utilise evidence from documentary analysis and elite in-depth interviews with parliamentary officials to show that public engagement planning aims to develop amongst the public a sense of connectivity that relies on more collective and symbolic forms of representation, which seek to present the institution detached from its actors and politics. We utilise constructivist representation theories to support our analysis

The multiplicity of malaria transmission: a review of entomological inoculation rate measurements and methods across sub-Saharan Africa

Plasmodium falciparum malaria is a serious tropical disease that causes more than one million deaths each year, most of them in Africa. It is transmitted by a range of Anopheles mosquitoes and the risk of disease varies greatly across the continent. The "entomological inoculation rate" is the commonly-used measure of the intensity of malaria transmission, yet the methods used are currently not standardized, nor do they take the ecological, demographic, and socioeconomic differences across populations into account. To better understand the multiplicity of malaria transmission, this study examines the distribution of transmission intensity across sub-Saharan Africa, reviews the range of methods used, and explores ecological parameters in selected locations. It builds on an extensive geo-referenced database and uses geographical information systems to highlight transmission patterns, knowledge gaps, trends and changes in methodologies over time, and key differences between land use, population density, climate, and the main mosquito species. The aim is to improve the methods of measuring malaria transmission, to help develop the way forward so that we can better assess the impact of the large-scale intervention programmes, and rapid demographic and environmental change taking place across Africa