Congress should reauthorize the Export-Import Bank to continue its crucial role in U.S. foreign policy

Recent weeks have seen debates in Congress over the future of the Export-Import Bank, a government agency that provides financing for exporters. While the Bank’s opponents accuse it of ‘corporate welfare’, Sarah Cleeland Knight argues that its benefits are not just economic. She writes that since its inception 80 years ago, the Export-Import Bank has kept firms engaged in countries where the U.S. would like to effect change, and that for the continuation of this important role, it should be reauthorized by Congress

How to use the International Classification of Functioning, Disability and Health as a reference system for comparative evaluation and standardized reporting of rehabilitation interventions

Rehabilitation aims to optimize functioning of persons experiencing functioning limitations. As such the comparative evaluation of rehabilitation interventions relies on the analysis of the differences between the change in patient functioning after a specific rehabilitation intervention versus the change following another intervention. A robust health information reference system that can facilitate the comparative evaluation of changes in functioning in rehabilitation studies and the standardized reporting of rehabilitation interventions is the International Classification of Functioning, Disability and Health (ICF). The objective of this paper is to present recommendations that Cochrane Rehabilitation could adopt for using the ICF in rehabilitation studies by: 1) defining the functioning categories to be included in a rehabilitation study; 2) specifying selected functioning categories and selecting suitable data collection instruments; 3) examining aspects of functioning that have been documented in a study; 4) reporting functioning data collected with various data collection instruments; and 5) communicating results in an accessible, meaningful and easily understandable way. The authors provide examples of concrete studies that underscore these recommendations, whereby also em-phasizing the need for future research on the implementation of specific recommendations, e.g. in meta-analysis in systematic literature reviews. Furthermore, the paper outlines how the ICF can complement or be integrated in established Cochrane and rehabilitation research structures and methods, e.g. use of standard mean difference to compare cross-study data collected using different measures, in developing core outcome sets for rehabilitation, and the use of the PICO model. © 2019 EDIZIONI MINERVA MEDICA

Pain and analgesic use associated with skeletal-related events in patients with advanced cancer and bone metastases

PURPOSE: Bone metastases secondary to solid tumors increase the risk of skeletal-related events (SREs), including the occurrence of pathological fracture (PF), radiation to bone (RB), surgery to bone (SB), and spinal cord compression (SCC). The aim of this study was to evaluate the impact of SREs on patients' pain, analgesic use, and pain interference with daily functioning. METHODS: Data were combined from patients with solid tumors and bone metastases who received denosumab or zoledronic acid across three identically designed phase 3 trials (N = 5543). Pain severity (worst pain) and pain interference were assessed using the Brief Pain Inventory at baseline and each monthly visit. Analgesic use was quantified using the Analgesic Quantification Algorithm. RESULTS: The proportion of patients with moderate/severe pain and strong opioid use generally increased in the 6 months preceding an SRE and remained elevated, while they remained relatively consistent over time in patients without an SRE. Regression analysis indicated that all SRE types were significantly associated with an increased risk of progression to moderate/severe pain and strong opioid use. PF, RB, and SCC were associated with significantly greater risk of pain interference overall. Results were similar for pain interference with emotional well-being. All SRE types were associated with significantly greater risk of pain interference with physical function. CONCLUSIONS: SREs are associated with increased pain and analgesic use in patients with bone metastases. Treatments that prevent SREs may decrease pain and the need for opioid analgesics and reduce the impact of pain on daily functioning

Pain and analgesic use associated with skeletal-related events in patients with advanced cancer and bone metastases

PURPOSE: Bone metastases secondary to solid tumors increase the risk of skeletal-related events (SREs), including the occurrence of pathological fracture (PF), radiation to bone (RB), surgery to bone (SB), and spinal cord compression (SCC). The aim of this study was to evaluate the impact of SREs on patients' pain, analgesic use, and pain interference with daily functioning. METHODS: Data were combined from patients with solid tumors and bone metastases who received denosumab or zoledronic acid across three identically designed phase 3 trials (N = 5543). Pain severity (worst pain) and pain interference were assessed using the Brief Pain Inventory at baseline and each monthly visit. Analgesic use was quantified using the Analgesic Quantification Algorithm. RESULTS: The proportion of patients with moderate/severe pain and strong opioid use generally increased in the 6 months preceding an SRE and remained elevated, while they remained relatively consistent over time in patients without an SRE. Regression analysis indicated that all SRE types were significantly associated with an increased risk of progression to moderate/severe pain and strong opioid use. PF, RB, and SCC were associated with significantly greater risk of pain interference overall. Results were similar for pain interference with emotional well-being. All SRE types were associated with significantly greater risk of pain interference with physical function. CONCLUSIONS: SREs are associated with increased pain and analgesic use in patients with bone metastases. Treatments that prevent SREs may decrease pain and the need for opioid analgesics and reduce the impact of pain on daily functioning

The Establishment of the GENEQOL Consortium to Investigate the Genetic Disposition of Patient-Reported Quality-of-Life Outcomes

To our knowledge, no comprehensive, interdisciplinary initiatives have been taken to examine the role of genetic variants on patient-reported quality-of-life outcomes. The overall objective of this paper is to describe the establishment of an international and interdisciplinary consortium, the GENEQOL Consortium, which intends to investigate the genetic disposition of patient-reported quality-of-life outcomes. We have identified five primary patient-reported quality-of-life outcomes as initial targets: negative psychological affect, positive psychological affect, self-rated physical health, pain, and fatigue. The first tangible objective of the GENEQOL Consortium is to develop a list of potential biological pathways, genes and genetic variants involved in these quality-of-life outcomes, by reviewing current genetic knowledge. The second objective is to design a research agenda to investigate and validate those genes and genetic variants of patient-reported quality-of-life outcomes, by creating large datasets. During its first meeting, the Consortium has discussed draft summary documents addressing these questions for each patient-reported quality-of-life outcome. A summary of the primary pathways and robust findings of the genetic variants involved is presented here. The research agenda outlines possible research objectives and approaches to examine these and new quality-of-life domains. Intriguing questions arising from this endeavor are discussed. Insight into the genetic versus environmental components of patient-reported quality-of-life outcomes will ultimately allow us to explore new pathways for improving patient care. If we can identify patients who are susceptible to poor quality of life, we will be able to better target specific clinical interventions to enhance their quality of life and treatment outcomes.quality of life, self-rated health, pain, fatigue, genetic disposition, Patient-Reported Quality-of-Life Outcomes

Digging Deeper: Enhancing Archaeoparasitology By Combining Molecular Methods With Traditional Morphological Approaches

Coprolite science, human parasitism and ancient DNA methodology, converge most appropriately in the sub-specialty of archaeoparasitology – the study of prehistoric parasitism. In this study, we have applied targeted PCR to an archaeological sample from La Cueva de los Muertos Chiquitos, El Zape, Durango, Mexico, ~ AD 600. The addition of molecular analysis, resulted in the identification of a rare human parasite, previously unidentified, and a clarification of ambiguous morphological parasite remains. Discovery of an unexpected parasite has implications for the interpretation of human health in this prehistoric site. An additional analysis of previously generated Whole Genome Shotgun (WGS) Next-Generation Sequencing (NGS) data, resulted in the development of a series of filters to increase certainty of taxonomic identifications. The results of the NGS data manipulation failed to identify parasites in the dataset, but provides a foundation for a discussion of future research and current deficiencies in the reference databases. It is recommended that a combined morphological and molecular approach is the most robust methodology for archaeoparasitological research. It is also recommended that resources be routed into the development of NGS targeted approaches. A final recommendation that increased systematic effort be applied to adding parasite reference sequences to publicly available reference databases. Given that human parasitism impacts one third of the world population, any technology that increases the information retrieved, while creating a cost effective and robust methodology, will benefit both modern clinical researchers and prehistoric researchers. Therefore, work from prehistoric studies is directly applicable to the issue of parasitism in the modern world

OncoLog Volume 45, Number 03, March 2000

Dental Oncologists Prepare Patients with Head and Neck Cancer for Radiation Therapy DiaLog: Nurses Bring Personal Touch to Clinical Research, by Charles S. Cleeland, PhD, Professor, Pain Research Group, Division of Anesthesiology and Critical Care House Call: Coping with Chemotherapy Radiofrequency Ablation Surpasses Cryoablation as the Treatment of Choice for Localized, Unresectable Liver Malignancieshttps://openworks.mdanderson.org/oncolog/1083/thumbnail.jp

Attitudes, perceptions, and experiences of casual relief teachers and permanent teachers in Victorian schools

Four hundred and eight casual relief teachers (CRTs) and 670 permanent teachers from government, independent, and Catholic primary schools and secondary schools in and around metropolitan Melbourne were surveyed using the researcher-developed Issues in Teaching Questionnaire (ITQ) in order to assess their attitudes, perceptions, and experiences in relation to 10 areas of concern including: job security, provisions and facilities, information and communication, lesson management, status, relationships with the school community, relationships with students, student management, job satisfaction, and job stress. These 10 areas of concern were derived from the literature regarding casual relief teaching, which comprised of various anecdotal, published, and unpublished sources. Classical test theory methods (e.g., Cronbach¡¦s ƒÑ and exploratory factor analysis) were used to determine the psychometric properties of the survey instrument, which indicated that the ITQ possessed excellent internal reliability and construct validity, and confirmed the existence of an ¡§in-class¡¨ factor and an ¡§out-of-class¡¨ factor. Using descriptive and multivariate inferential statistics, the responses of the CRTs and the permanent teachers were analysed. By comparison with the other group characteristics, employment status (i.e., CRT or permanent teacher) was the best predictor of scores on the ITQ. The CRTs reported significantly more positive attitudes, perceptions, and experiences regarding job stress (i.e., less job stress) compared with the permanent teachers, whereas the permanent teachers reported significantly more positive attitudes, perceptions, and experiences across all other areas of concern compared with the CRTs. When the responses of the CRTs and the permanent teachers were compared on a scale of magnitude (i.e., effect size), much larger effects were observed for the ¡§out-of-class¡¨ con cerns (e.g., Information and Communication, Provisions and Facilities, Lesson Management, Relationships with the School Community, Status, Job Security, and Job Satisfaction subscales) compared with the ¡§in-class¡¨ concerns (e.g., Relationships with Students, Student Management, and Job Stress subscales). Although many parallels were found between the CRTs and the permanent teachers in terms of their general classroom concerns, substantial differences existed between the two groups in relation to their concerns in the wider school context. Of particular importance were the considerable differences between the CRTs and the permanent teachers in terms of their employment conditions, and how they are currently being accommodated in schools and integrated into school communities. In these regards, CRTs are not receiving professional parity with their permanent counterparts. Overall, the results of this study (a) provide evidence of a psychometrically sound instrument for assessing the attitudes, perceptions, an d experiences of CRTs and permanent teachers across a range of school settings, (b) highlight the importance of employment status (i.e., CRT or permanent teacher) as a predictor of the ITQ subscales compared with the other group characteristics, and (c) present comprehensive and convincing evidence on the similarities and differences between the teaching experiences of CRTs and permanent teachers