Is Topical 1% Pimecrolimus Cream an Effective Treatment for Rosacea?

OBJECTIVE: The objective of this systematic review is to determine whether or not topical 1% pimecrolimus cream is an effective treatment for rosacea

Women and military sexual trauma, a resilience study

Women have served in the military for decades, playing integral roles in both war and peacetime operations. However, at no time in history have women service members sacrificed more than in the past decade, when the many counterinsurgency operations that the nation has fought have forced women to participate directly in combat. With the population of women veterans continuing to rapidly grow, it has become crucial to examine these women’s mental health needs. One of these needs includes addressing the epidemic of military sexual trauma. This Ed.S. research paper examines the nuances of military sexual trauma, including the implications that surviving a sexual assault may have within the military system. The purpose of the research is to familiarize mental health clinicians with, not only the military environment, but with what it means to be a woman serving in today’s armed forces. By examining a few therapeutic interventions, including “bottom-up” sensorimotor approaches, which utilize the body as an entry point to unlocking emotions, as well as complementary interventions like yoga, therapists should be able to gain a better understanding of the general practices associated with treating women veterans

Derelect Churchbells Ring in New Technology

In order to accommodate this, we should first test algae facades on pre-existing building shells. I have a specific interest in derelect churches in because they are plenitful and although not on historic lists, they can still be preserved through the revitalization process. All buildings cannot be saved for preservation sake, so these buildings can accomodate new programs for specific city and site needs. Injecting these new technologies into the buildings will produce a contradiction that emphasizes both the new and old architecture. The deeper meaning of this thesis embodies what the visual chroma effects of algae are on the built enviornment. This includes their presence at night as a sustainable broadcaster through the RGB colors of algae and their daylit interiors encompassing a mixture of reflected colored light

Tearing up the nun : Charlotte Brontë's gothic self-fashioning

textThis report explores the ideological motivations behind Charlotte Brontë's inclusion of and alterations to gothic conventions in Villette (1853). By building on an account of the recent critical conversation concerning the conservative Enlightenment force of the gothic, this report seeks to explain the political significance of a specific, nineteenth-century mutation in the genre: Lucy Snowe as an experiment in the bourgeois paradigm. Lucy Snowe's sophisticated consciousness of genre manifests in her minute attention to dress, but the persistence of her personal gothic history means that Villette enacts political tension between individualistic "self-fashioning" and historical determinism as clashing models for the origin of identity.Englis

Improving the Outcomes of Transition Age Youth with Psychiatric Disabilities through the Adoption and Use of Best Practice Transition Planning [English and Spanish versions]

A Spanish translation of this publication is available to download under Additional Files below. The goal of the newly funded Translating Evidence to Support Transitions (TEST) grant is to increase the use and adoption of research-based best practices in transition planning services for high school students with emotional and behavioral disturbances (EBD) receiving special education services

Interrater reliability of directly-observed stepping and reclining in lower limb amputees in a laboratory setting

Introduction: Accurate measurement of physical behaviours in adults with lower limb absence is essential to report true patterns of physical behaviour and the effectiveness of interventions. Observation methods are often used for criterion-related validation. Establishing interrater reliability within direct observation methods is an important and necessary precursor to criterion-related validitystudies. Purpose: To assess the interrater reliability for quantifying steps and reclining time in simulated lifestyle activities in adults with unilateral lower limb absence. Methods: 15 adults completed three trials of a simulated set of lifestyle activities including kitchen work, sitting and lying and purposefulwalking. Trials were video recorded and subsequently analysed independently by three trained raters for three types of behavioural event (incidental stepping, purposeful stepping and reclining). Data were analysed using oneway intraclass correlation coefficients (ICC) and oneway repeated measures ANOVAand effect sizes (Cohen's d). Results: Reliability was high for the reliability of three raters (ICCs ranged from .98-1.00 for the three types of physical behaviours), and also when adjusted for a single rater (ICCsranged from .93-.99). Although there were significant (p < .05) mean differences among raters for incidental steps, total steps, and reclining time, these corresponded to small effect sizes (d = 0.08-0.29).Conclusions: Trained raters are able to consistently judge brief, incidental stepping and more prolonged stepping events as well as sitting and lying events performed by adults with unilateral lower limb absence in controlled laboratory simulations. Multiple raters are not needed in order to obtain reliable data. These data can be used to obtain a reliable record of physical behaviours for criterion-related validation of other measures such as accelerometers

Reliability and validity of the activPAL for measuring stepping and reclining in unilateral lower limb amputees

Introduction: Valid, reliable measurement of physical behaviours in adults with limb absence is essential to accurately describe physical behaviour patterns and intervention effects. Purpose: To assess parallel forms reliability and criterion-related validity of the activPAL for measuring steps and reclining time in simulated lifestyle activities in adults with unilateral lower limb absence. Methods: 15 adults completed three circuits of simulated kitchen work, sitting, lying and purposeful walking on level ground and stairs. Three trained raters independently analysed video recorded trials for incidental stepping, purposeful stepping and reclining. Simultaneous data were obtained from two activPAL monitors placed on the sound and prosthetic side. Data were analysed using oneway intraclass correlation coefficients (ICC; parallel forms reliability), and with Pearson correlations, oneway repeated ANOVAs, and Cohen's d (criterion-related validity). Results: Parallel forms reliability (prosthetic side vs. sound side) was poor for incidental steps (ICC = .05, d = 0.41) but acceptable for all other measures (ICC = .69-.98; d = 0.02-0.17). Correlations between direct observation and activPAL ranged from r = .65-.98 (activPAL on sound side) and from r = .30-.99 (activPAL on prosthetic side). Mean differences between observed measures and activPAL measures were generally large for all stepping variables (d = 0.56-4.22); observed mean scores were systematically higher than from the activPAL. Correlations were higher for reclining time (r = .98- .99), and differences were smaller (d = 0.25-0.28), although the pattern was similar (observed scores were higher). Conclusions: activPAL data from the sound side and prosthetic side are similar for adults with unilateral lower limb absence. Validity of the activPAL in this population seems poor in simulated lifestyle activities. These results may be at least partly due to the brief sampling period or the simulated activity protocol

Evaluation of different recall periods for the US National Cancer Institute’s Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)

Aims—The U.S. National Cancer Institute recently developed the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). PRO-CTCAE is a library of questions for clinical trial participants to self-report symptomatic adverse events (e.g., nausea). The objective of this study is to inform evidence-based selection of a recall period when PRO-CTCAE is included in a trial. We evaluated differences between 1-week, 2-week, 3-week, and 4-week recall periods, using daily reporting as the reference. Methods—English-speaking patients with cancer receiving chemotherapy and/or radiotherapy were enrolled at four U.S. cancer centers and affiliated community clinics. Participants completed 27 PRO-CTCAE items electronically daily for 28 days, and then weekly over 4 weeks, using 1-week, 2-week, 3-week, and 4-week recall periods. For each recall period, mean differences, effect sizes, and intraclass correlation coefficients were calculated to evaluate agreement between the maximum of daily ratings and the corresponding ratings obtained using longer recall periods (e.g., maximum of daily scores over 7 days vs. 1-week recall). Analyses were repeated using the average of daily scores within each recall period rather than the maximum of daily scores. Results—127 subjects completed questionnaires (57% male; median age 57). The median of the 27 mean differences in scores on the PRO-CTCAE 5-point response scale comparing the maximum daily versus the longer recall period (and corresponding effect size), was −0.20 (−0.20) for 1-week recall; −0.36 (−0.31) for 2-week recall; −0.45 (−0.39) for 3-week recall; and −0.47 (−0.40) for 4-week recall. The median intraclass correlation across 27 items between the maximum of daily ratings and the corresponding longer recall ratings for 1-week recall was 0.70 (range: 0.54–0.82); 2-week recall: 0.74 (range: 0.58–0.83); 3-week recall: 0.72 (range: 0.61–0.84); and 4-week recall: 0.72 (range: 0.64–0.86). Similar results were observed for all analyses using the average of daily scores rather than the maximum of daily scores. Conclusions—1-week recall corresponds best to daily reporting. Although intraclass correlations remain stable over time, there are small but progressively larger differences between daily and longer recall periods at 2, 3, and 4 weeks, respectively. The preferred recall period for the PRO-CTCAE is the past 7 days, although investigators may opt for recall periods of 2, 3, or 4 weeks with an understanding that there may be some information loss

Symptom Monitoring With Patient-Reported Outcomes During Routine Cancer Treatment: A Randomized Controlled Trial

There is growing interest to enhance symptom monitoring during routine cancer care using patient-reported outcomes, but evidence of impact on clinical outcomes is limited

Gene content evolution in the arthropods

Arthropods comprise the largest and most diverse phylum on Earth and play vital roles in nearly every ecosystem. Their diversity stems in part from variations on a conserved body plan, resulting from and recorded in adaptive changes in the genome. Dissection of the genomic record of sequence change enables broad questions regarding genome evolution to be addressed, even across hyper-diverse taxa within arthropods. Using 76 whole genome sequences representing 21 orders spanning more than 500 million years of arthropod evolution, we document changes in gene and protein domain content and provide temporal and phylogenetic context for interpreting these innovations. We identify many novel gene families that arose early in the evolution of arthropods and during the diversification of insects into modern orders. We reveal unexpected variation in patterns of DNA methylation across arthropods and examples of gene family and protein domain evolution coincident with the appearance of notable phenotypic and physiological adaptations such as flight, metamorphosis, sociality, and chemoperception. These analyses demonstrate how large-scale comparative genomics can provide broad new insights into the genotype to phenotype map and generate testable hypotheses about the evolution of animal diversity