A Study on the Reproduction of Life in Agriculture

markdownabstractThe past two decades saw a rapid proliferation of sustainability standards created by multi-stakeholder partnerships of multinationals and international NGOs. This paper argues that the transformative capacity of these global partnerships to bring about sustainable change largely depends on how well the institutional features of global sustainability standards fit local organizational fields. This paper therefore aims to unravel the dynamics of global-local interactions. To this end, the concept of institutional fit is operationalized to assess whether and how the technical, cultural and political characteristics intrinsic to global sustainability standards are able to connect to local projects, strategies and practices. The introduction of the Aquaculture Stewardship Council’s standard into the Indonesian shrimp sector is used as a case to investigate these interactions. This paper shows that a process of fitting occurs when provisional institutions generated within a global partnership can be modified. We argue that global sustainability standards can benefit from steering more explicitly on dovetailing regulative and normative structures of global and local organizational fields. Local NGOs can play important mediating roles in this regard, which can potentially increase the transformative capacity of global standards in terms of generating and accelerating sustainable change

Persuasive Gaming in Context

The rapid developments in new communication technologies have facilitated the popularization of digital games, which has translated into an exponential growth of the game industry in recent decades. The ubiquitous presence of digital games has resulted in an expansion of the applications of these games from mere entertainment purposes to a great variety of serious purposes. In this edited volume, we narrow the scope of attention by focusing on what game theorist Ian Bogost has called 'persuasive games', that is, gaming practices that combine the dissemination of information with attempts to engage players in particular attitudes and behaviors.This volume offers a multifaceted reflection on persuasive gaming, that is, on the process of these particular games being played by players. The purpose is to better understand when and how digital games can be used for persuasion by further exploring persuasive games and some other kinds of persuasive playful interaction as well. The book critically integrates what has been accomplished in separate research traditions to offer a multidisciplinary approach to understanding persuasive gaming that is closely linked to developments in the industry by including the exploration of relevant case studies

Systematic screening and assessment of psychosocial well-being and care needs of people with cancer

Background : Receiving a diagnosis of cancer and the subsequent related treatments can have a significant impact on an individual's physical and psychosocial well-being. To ensure that cancer care addresses all aspects of well-being, systematic screening for distress and supportive care needs is recommended. Appropriate screening could help support the integration of psychosocial approaches in daily routines in order to achieve holistic cancer care and ensure that the specific care needs of people with cancer are met and that the organisation of such care is optimised. Objectives : To examine the effectiveness and safety of screening of psychosocial well-being and care needs of people with cancer. To explore the intervention characteristics that contribute to the effectiveness of these screening interventions. Search methods : We searched five electronic databases in January 2018: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO, and CINAHL. We also searched five trial registers and screened the contents of relevant journals, citations, and references to find published and unpublished trials. Selection criteria : We included randomised controlled trials (RCTs) and non-randomised controlled trials (NRCTs) that studied the effect of screening interventions addressing the psychosocial well-being and care needs of people with cancer compared to usual care. These screening interventions could involve self-reporting of people with a patient-reported outcome measures (PROMs) or a semi-structured interview with a screening interventionist, and comprise a solitary screening intervention or screening with guided actions. We excluded studies that evaluated screening integrated as an element in more complex interventions (e.g. therapy, coaching, full care pathways, or care programmes). Data collection and analysis : Two review authors independently extracted the data and assessed methodological quality for each included study using the Cochrane tool for RCTs and the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool for NRCTs. Due to the high level of heterogeneity in the included studies, only three were included in meta-analysis. Results of the remaining 23 studies were analysed narratively. Main results : We included 26 studies (18 RCTs and 8 NRCTs) with sample sizes of 41 to 1012 participants, involving a total of 7654 adults with cancer. Two studies included only men or women; all other studies included both sexes. For most studies people with breast, lung, head and neck, colorectal, prostate cancer, or several of these diagnoses were included; some studies included people with a broader range of cancer diagnosis. Ten studies focused on a solitary screening intervention, while the remaining 16 studies evaluated a screening intervention combined with guided actions. A broad range of intervention instruments was used, and were described by study authors as a screening of health-related quality of life (HRQoL), distress screening, needs assessment, or assessment of biopsychosocial symptoms or overall well-being. In 13 studies, the screening was a self-reported questionnaire, while in the remaining 13 studies an interventionist conducted the screening by interview or paper-pencil assessment. The interventional screenings in the studies were applied 1 to 12 times, without follow-up or from 4 weeks to 18 months after the first interventional screening. We assessed risk of bias as high for eight RCTs, low for five RCTs, and unclear for the five remaining RCTs. There were further concerns about the NRCTs (1 = critical risk study; 6 = serious risk studies; 1 = risk unclear). Due to considerable heterogeneity in several intervention and study characteristics, we have reported the results narratively for the majority of the evidence. In the narrative synthesis of all included studies, we found very low-certainty evidence for the effect of screening on HRQoL (20 studies). Of these studies, eight found beneficial effects of screening for several subdomains of HRQoL, and 10 found no effects of screening. One study found adverse effects, and the last study did not report quantitative results. We found very low-certainty evidence for the effect of screening on distress (16 studies). Of these studies, two found beneficial effects of screening, and 14 found no effects of screening. We judged the overall certainty of the evidence for the effect of screening on HRQoL to be very low. We found very low-certainty evidence for the effect of screening on care needs (seven studies). Of these studies, three found beneficial effects of screening for several subdomains of care needs, and two found no effects of screening. One study found adverse effects, and the last study did not report quantitative results. We judged the overall level of evidence for the effect of screening on HRQoL to be very low. None of the studies specifically evaluated or reported adverse effects of screening. However, three studies reported unfavourable effects of screening, including lower QoL, more unmet needs, and lower satisfaction. Three studies could be included in a meta-analysis. The meta-analysis revealed no beneficial effect of the screening intervention on people with cancer HRQoL (mean difference (MD) 1.65, 95% confidence interval (CI) -4.83 to 8.12, 2 RCTs, 6 months follow-up); distress (MD 0.0, 95% CI -0.36 to 0.36, 1 RCT, 3 months follow-up); or care needs (MD 2.32, 95% CI -7.49 to 12.14, 2 RCTs, 3 months follow-up). However, these studies all evaluated one specific screening intervention (CONNECT) in people with colorectal cancer. In the studies where some effects could be identified, no recurring relationships were found between intervention characteristics and the effectiveness of screening interventions. Authors' conclusions : We found low-certainty evidence that does not support the effectiveness of screening of psychosocial well-being and care needs in people with cancer. Studies were heterogeneous in population, intervention, and outcome assessment. The results of this review suggest a need for more uniformity in outcomes and reporting; for the use of intervention description guidelines; for further improvement of methodological certainty in studies and for combining subjective patient-reported outcomes with objective outcomes

Synthesis and characterization of surface-grafted polyacrylamide brushes and their inhibition of microbial adhesion

A method is presented to prevent microbial adhesion to solid surfaces exploiting the unique properties of polymer brushes. Polyacrylamide (PAAm) brushes were grown from silicon wafers by atom transfer radical polymerization (ATRP) using a three-step reaction procedure consisting of immobilization of a coupling agent gamma-aminopropyltriethoxysilane, anchoring of an ATRP initiator 4-(chloromethyl)benzoyl chloride, and controlled radical polymerization of acrylamide. The surfaces were characterized by X-ray photoelectron spectroscopy, Fourier transform infrared spectroscopy, ellipsometry, and contact-angle measurements. The calculated grafting density pointed to the presence of a dense and homogeneous polymer brush. Initial deposition rates, adhesion after 4 h, and detachment of two bacterial strains (Staphylococcus aureus ATCC 12600 and Streptococcus salivarius GB 24/9) and one yeast strain (Candida albicans GB 1/2) to both PAAm-coated and untreated silicon surfaces were investigated in a parallel plate flow chamber. A high reduction (70-92%) in microbial adhesion to the surface-grafted PAAm brush was observed, as compared with untreated silicon surfaces. Application of the proposed grafting method to silicone rubbers may offer great potential to prevent biomaterials-centered infection of implants.</p

TOp TEn resistant Microorganisms at intensive care unit: a 2018 global expert survey (TOTEM study protocol)

Background: This global survey will provide global expert ranking of the most urgent multidrug bacteria present at the intensive care units (ICU) that have become a threat in daily clinical practice. We believe efforts on education, investigation, funding and development of new antimicrobials or new antimicrobial approach should be directed in near future. The 2018 study protocol is reported here in. Methods: A global survey will be performed using an electronic platform (SurveyMonkey®). The survey will compile data on key aspects of the actual threat of antimicrobial-resistant bacteria globally in the ICU

Defining tumor growth in vestibular schwannomas:a volumetric inter-observer variability study in contrast-enhanced T1-weighted MRI

Introduction:For patients with vestibular schwannomas (VS), the need for reliable volumetric tumor monitoring is important. Currently, a volumetric cutoff of 20% increase in tumor volume is widely used to define tumor growth in VS. This study investigates the volumetric limits of agreement (LoA) of VS by an inter-observer study.Methods:This retrospective study included 100 VS patients who underwent contrast-enhanced T1-weighted MRI. Five observers volumetrically annotated the images. Observer agreement and reliability was measured using the LoA, estimated using the limits of agreement with the mean (LOAM) method, and the intraclass correlation coefficient (ICC). Influence of imaging parameters and tumor characteristics were assessed using univariable and multivariable linear regression analysis.Results:The 100 patients had an average median tumor volume of 903 mm3 (IQR: 193-3101). Peritumoral cysts were found in 6 patients. Patients were divided into four volumetric size categories based on tumor volume quartile. The smallest tumor volume quartile showed a LOAM relative to the mean of 26.8%, whereas for the largest tumor volume quartile this figure was found to be 7.3% and when excluding peritumoral cysts: 4.8%. Of all imagingparameters and tumor characteristics, only tumor volume was associated with the LoA (adjusted B=-0.001 [P=0.003]).Conclusion:Agreement limits within volumetric annotation of VS are affected by tumor volume, since the LoA improves with increasing tumor volume. As a result, for tumors larger than 200 mm3, growth can reliably be detected at an earlier stage, compared to the currently widely used cutoff of 20%.

Wait-and-Scan management in sporadic Koos grade 4 vestibular schwannomas:A longitudinal volumetric study

BackgroundVolumetric natural history studies specifically on large vestibular schwannomas (VSs), commonly classified as Koos grade 4, are lacking. The aim of the current study is to present the volumetric tumor evolution in sporadic Koos grade 4 VSs and possible predictors for tumor growth.MethodsVolumetric tumor measurements and tumor evolution patterns from serial MRI studies were analyzed from selected consecutive patients with Koos grade 4 VS undergoing initial wait-and-scan management between January 2001 and July 2020. The significant volumetric threshold was defined as a change in volume of ≥10%.ResultsAmong 215 tumors with a median size (IQR) of 2.7cm3 (1.8-4.2), 147 tumors (68%) demonstrated growth and 75 tumors (35%) demonstrated shrinkage during follow-up. Growth-free survival rates (95% CI) at 1, 2, 5, and 10 years were 55% (48-61), 36% (29-42), 29% (23-36), and 28% (21-34), respectively and did not significantly differ in tumors &gt;20 mm (Chi-square=.40; P-value=.53). Four tumor evolution patterns (% of total) were observed: continued growth (60); initial growth then shrinkage (7); continued shrinkage (27); and stability (5). Good hearing (adjusted HR 2.21, 95% CI 1.48-3.30; P&lt;.001) and peritumoral edema (adjusted HR 2.22, 95% CI 1.18-4.13; P.01) at diagnosis were significantly associated with an increased likelihood of growth.ConclusionsKoos grade 4 VSs show a wide variety in size and growth. Due to variable growth patterns, an initial wait-and-scan strategy with short scan intervals may be an acceptable option in selected tumors, if no significant clinical symptoms of mass effect that warrant treatment are present