bluuebunny/crossref_metadata_2025 huggingface dataset:
„Queer podniky“ v Brně
Authors: Šerý Ondřej , Pitoňák Michal
Published: October 2019

Brno, Czech Republic is amongst the most liberal of cities and yet, but few know that in Brno as early as during the interwar period there were unique spaces dedicated to sexual diversity, various gay and lesbian initiatives came into existence, and that the first post-war semi-official / semilegal Czech gay business was opened here. Also, Brno hosted the first big Czech “queer march”, and the most significant Czech queer film festival was born there. This article aims to examine whether and, if so how, this diversity is mirrored in Brno’s “queer venues”, which we have contextualized within the broader perspective of geographies of sexualities, using semi-structured interviews. Our goal was to understand the locally-specific forms of socio-spatial organization and how they influence local non-heterosexual people, including their effects on sexual orientation and/or sexual identities in everyday negotiations. Our main findings include the identification of the characteristic features of Brno “queer enterprises”, the elucidation of their relative spatial concentration, and the physical and visual unobtrusiveness associated with the degree of use of “queer symbolism”. Our findings clarify the specific homonormative, and to a certain extent heteronormative, settings of local queer venues, which in the context of gay commodification significantly influence not only the form and degree of acceptance of non-heterosexual people in Brno, but also their mutual relationships, the possibilities of self-realization and new forms of exclusion. Even though we cannot find a “gay neighbourhood” in Brno, we can speak of a “queer-friendly city”.
Reliabilita a konstruktová validita metody Relationship Assessment Scale
Authors: Kvardová Nikol , Radimecká Monika , Drápalová Marie , Širůček Jan
Published: October 2019

Předkládaná studie se zabývala ověřením vybraných psychometrických charakteristik metody Relationship Assessment Scale (RAS), která zjišťuje partnerskou spokojenost. V rámci ověření byla zjišťována reliabilita metody v podobě vnitřní konzistence a konstruktová validita prostřednictvím souvislosti metody RAS s dimenzemi partnerské spokojenosti, partnerské shody a partnerské soudržnosti metody Revised Dyadic Adjustment Scale (RDAS), která zjišťuje partnerské přizpůsobení. Za účelem ověření těchto vlastností metody byla sesbírána data od 232 respondentů, data byla sesbírána po internetu. Reliabilita metody byla v rámci současné studie zjištěna jako uspokojivá pro výzkumné účely.  Souvislosti mezi faktorem partnerské spokojenosti metody RAS a faktory partnerské spokojenosti a soudržnosti metody RDAS podpořily hypotézu o konstruktové validitě metody RAS. Silný pozitivní vztah mezi faktorem partnerské spokojenosti metody RAS a faktorem partnerské shody metody RDAS nepodpořil hypotézu o konstruktové validitě, tento výsledek poukazoval na možnou shodu těchto dvou konstruktů. Výsledek však mohl být způsoben škálou partnerské shody metody RDAS, která na výzkumném vzorku současné studie nemusela fungovat jako spolehlivý ukazatel shody mezi partnery. Na základě výsledků byla navržena revize modelu.
Editorial 12. čísla
Authors: Cígler Hynek
Published: October 2019

Vážené čtenářky, vážení čtenáři, fanoušci psychologické diagnostiky a kvalitních testů.Myslím, že nepříjemně dlouhou odmlku od posledního vydání našeho časopisu se nám (a zejména tedy autorům příspěvků) podařilo více než vynahradit rozsáhlým a dle mého názoru velmi kvalitním obsahem aktuálního čísla. Mám dobrý pocit, že vám můžeme přinést na 59 stranách (nepočítaje v to přílohy, které – zejména u recenzí – tvoří značnou část obsahu) nejen recenze testů a jedné knihy, ale i dva empirické články.
Test pro identifikaci nadaných žáků v matematice – recenze metody
Authors: Krejčová Lenka
Published: October 2019

Celý proces vývoje testu pokládám za ukázkovou diagnostickou a psychometrickou práci. Autoři metodu koncipovali velmi systematicky, veškerá data velmi komplexně zpracovávali, všechny výsledky v manuálu detailně prezentují a současně interpretují, k čemu a proč dospěli. S daty pracují velmi zodpovědně, přesně specifikují, za jakých okolností je vhodné diagnostický nástroj užít a kdy je naopak jeho administrace nevhodná. Rozhodně se domnívám, že je vhodné test dále šířit mezi odborníky v praxi. Oceňuji, že autoři uvažují i o variantě, že metodu budou administrovat proškolení učitelé, nejen psychologové či speciální pedagogové. Toto bezpochyby zajistí mnohem širší využití testu. Na druhou stranu v této souvislosti pokládám za důležité připravit skutečně velmi podrobné školení, na němž si potenciální uživatelé ze školní praxe osvojí postupy zpracování a interpretace výsledků. Metoda je po psychometrické stránce velmi důkladně zpracovaná, což se promítá i do výstupů získaných její administrací. Pro „nepsychology“ může být náročné se orientovat ve způsobu práce s takovým typem informací, což by mohlo vést k dezinterpretaci, či dokonce poškození probandů. Toto pokládám za nutné pečlivě ošetřit způsobem školení uživatelů testu.Jedná se diagnostický nástroj s unikátním zaměřením. Doposud v České republice obdobná metoda nebyla k dispozici. Je proto nanejvýš žádoucí, aby byl šířen a v maximální možné míře využíván v poradenské, školní i výzkumné praxi.
The Nag Hammadi Reception of 1 Enoch
Authors: Berno Francesco ,   Instituto Patristico Augustinianum
Published: October 2019

The present article aims at providing a preliminary analysis of the literary and doctrinal relationship between the Nag Hammadi corpus and the Greek translation of 1 Enoch. The first section is devoted to examining the manuscript evidence for the Coptic reception of the Enochic dictate. The second part offers a more specific survey of this debated issue of the Valentinian Exposition (NHC XI, 2) and the so-called Liturgical Fragments (NHC XI, 2a-e).
La «ricchezza»: Gr. Nyss., Eccl. 7, 4 (SCh 416, 358)
Authors: Barbàra Maria Antonietta ,   Instituto Patristico Augustinianum
Published: October 2019

Gregory of Nyssa’s bearing in Qohelet 3:5b to wealth, rather than to the matrimonial “embrace”, is unusual by comparison withother ancient exegeses; it seems to be motivated not only by the acoluthia which characterizes his spiritual interpretation of the passage Qo. 3:2-8 (Sandro Leanza), but also by the crucial importance he gives to catharsis, as one the qualities he considered necessary for the exegete.
The Life of the Jura Fathers and the Monastic Clergy
Authors: Szafranowski Jerzy ,   Instituto Patristico Augustinianum
Published: October 2019

This article challenges the belief – popular in modern scholarship – in the predominantly lay character of monastic communities before the 7th century. A closer look at the early 6th century Life of the Jura Fathers shows monasteries rich in monks who were at the same time presbyters and deacons. The paper investigates the reasons behind the clerical ordinations of monks and examines the various roles of presbyters and deacons in their monasteries. Finally, it considers the ways in which the ordained monks could have destabilized the community and the measures employed to counter their negative influence.
Braulio of Zaragoza’s Letters on Mourning
Authors: Ferreiro Alberto ,   Instituto Patristico Augustinianum
Published: October 2019

Braulio of Zaragoza (c. 585/595-651) was one of the most prolific writers of seventh century Visigothic Spain. The collection of 44 letters that he wrote are a unique and rich depository of information for that era and region of western Christendom. He was a personal adviser to three Visigothic kings, Chinthila and Chindasvinth and Reccesvinth, and he correspondended with his renowned contemporary Isidore of Seville. This study focuses on the letters that he directed at people who had lost a loved one and who needed consolation in their moment of mourning. The letters do not reveal anything about funerary burial practices, but they do yield a rare personal glimpse of what the Church taught about mourning the dead. Personal letters by their very nature are a literary means where peopleexpress their intimate feelings, in this case both those who were the recipients and Braulio who wrote to them. We see the Bishop of Zaragoza at his pastoral best in the letters of consolation written to family and friends who were mourning.
A review of the cleptoparasitic bee genus Epeolus Latreille, 1802 (Hymenoptera: Apidae) in the Caribbean, Central America and Mexico
Authors: Onuferko Thomas M.
Published: October 2019

The cleptoparasitic bee genus Epeolus Latreille, 1802 is for the first time reviewed for species occurring in the Caribbean, Central America and Mexico, and a single dichotomous identification key to the females and males of species present or likely to be present in these regions is presented. A total of 25 species have been confirmed as present across the region, although another 10 likely occur south of the Mexico–United States border. Three species are newly described—E. hanusiae sp. nov., E. nomadiformis sp. nov. and E. odyneroides sp. nov.—and redescriptions are provided for species occurring exclusively south of the United States of America (species occurring north of Mexico were recently revised elsewhere) except E. danieli (Genaro, 2014) comb. nov., which was recently described. One subspecies is elevated to species level (E. obscuripes Cockerell, 1917 stat. nov.). The following five names are newly synonymized under those of four valid species: Trophocleptria schraderi Michener, 1954 syn. nov. under E. boliviensis Friese, 1908, Tro. odontothorax Michener, 1954 syn. nov. under E. claripennis Friese, 1908, E. rugosus Cockerell, 1949 syn. nov. and E. xanthurus Cockerell, 1917 syn. nov. under E. luteipennis Friese, 1916, and E. schmidti Friese, 1925 syn. nov. under E. obscuripes. A diagnosis is provided for the presumably monophyletic and almost entirely Neotropical species group originally regarded as a separate genus, Trophocleptria Holmberg, 1886. Differential diagnoses accompany the descriptions / redescriptions of Neotropical species of Epeolus, and known collection records and information about their ecology are presented.
Evaluating the Use of Octreotide for Acquired Chylothorax in Pediatric Critically Ill Patients Following Cardiac Surgery
Authors: Bui Annie , Long Courtney J. , Breitzka Robin L. , Wolovits Joshua S.
Published: October 2019

OBJECTIVES To evaluate the impact of octreotide on time to resolution of chylothorax compared with conventional therapy. Secondary outcomes include the following: time to reduction of chest tube output by 20%, additional surgeries for chylothorax, hospital length of stay, in-hospital mortality, and adverse drug reactions.

METHODS We retrospectively evaluated the efficacy of octreotide vs conventional therapy for treatment postoperative chylothorax in pediatric patients in the cardiac ICU following surgery for congenital heart disease between October 2008 and June 2017.

RESULTS Final analysis included 32 patients with chylothorax who met inclusion criteria. Patients who received octreotide had a longer duration of chest tube drainage than those who received conventional therapy (24 vs 9 days, p < 0.001). Resolution of chylothorax was achieved in 13 of 16 (81.3%) octreotide patients and 16 of 16 (100%) conventional patients (p = 0.178). There was a comparable time to reduction by 20% in drainage (6 vs 8 days, p = 0.337). There was no significant correlation between time after starting conventional management and reduction chylous output in either the octreotide or conventional therapy group (p = 0.809, p = 0.107, respectively). However, there was a significant and moderate correlation between octreotide and reduction in a chylous output following initiation of octreotide (R2 = 0.464, p = 0.021).

CONCLUSIONS Octreotide is potentially a safe and effective therapy for treatment in pediatric patients with refractory chylothorax following surgery for congenital heart disease.
Antibiotic-Induced Neutropenia During Treatment of Hematogenous Osteoarticular Infections in Otherwise Healthy Children
Authors: Solis Krystian , Dehority Walter
Published: October 2019

OBJECTIVES We studied the frequency and characteristics of antibiotic-induced neutropenia in otherwise healthy children receiving antibiotic therapy for hematogenous osteoarticular infections (OAIs).

METHODS We retrospectively enrolled otherwise healthy children between 1 month and 18 years of age discharged with an OAI from our institution over an 11-year period. An absolute neutrophil count (ANC) ≤1500 cells/μL was defined as neutropenia. We recorded demographic and clinical information, as well as the value and timing of each ANC in relation to changes in antibiotic therapy. A multivariable regression model assessed the contributions of various risk factors.

RESULTS A total of 186 children were enrolled (mean age, 7.6 years; 67.2% boys). β-Lactams represented 61.2% of all prescriptions. During treatment, 61 subjects (32.8%) developed neutropenia (median time to onset, 24 days). An ANC < 500 cells/μL occurred in 7 subjects (3.8%). Neutropenic subjects (mean age, 6.0 years) were significantly younger than those without neutropenia (mean age, 8.5 years) (OR = 0.86; 95% CI: 0.79–0.93; p < 0.001) and received significantly longer courses of total (89.3 vs. 55.8 days) and parenteral (24.6 vs. 19.9 days) antibiotic therapy (OR = 1.01; 95% CI: 1.01–1.02; p = 0.004 and OR = 1.02; 95% CI: 1.01–1.04; p = 0.041, respectively). Recurrent neutropenia occurred in 23.0% of all neutropenic subjects and was significantly more common in those with a longer mean duration of parenteral therapy (OR = 1.05; 95% CI: 1.02–1.09; p = 0.004.). No complications from neutropenia occurred.

CONCLUSIONS Neutropenia was common in our cohort of children receiving prolonged antibiotic therapy for OAIs. Younger age and longer courses of therapy were associated with an increased risk of neutropenia.
Pediatric Pharmacy Services: Current Models and Justification for Expansion
Authors: Webster Stephen , Kane Christine , Brown Carly , Warhurst Heather , Sedgley Sandy , Slaughter Wendi
Published: October 2019

Despite recommendations from numerous health care bodies, some hospitals that care for children have struggled to establish or expand pediatric pharmacy services. The current state of dedicated pediatric operational and clinical pharmacy services was characterized by results from a survey of hospitals that provide care to pediatric patients. The discussion of quality of care, safety, and financial impact is meant to provide concepts for justification of pediatric pharmacy service expansion.
Disulfiram-like Reaction With Metronidazole: An Unsuspected Culprit
Authors: Alonzo Morgan M. , Lewis Teresa V. , Miller Jamie L.
Published: October 2019

The association of disulfiram-like reaction with concomitant use of metronidazole and alcohol has been reported in the literature; however, alcohol containing oral liquids may not always be identified as a culprit. A case of a 14-year-old patient who experienced a possible disulfiram-like interaction while receiving metronidazole and Prednisone Intensol solution is reported. Metronidazole oral suspension was initiated for treatment of Clostridium difficile-associated diarrhea. Later, a 5-day course of oral Prednisone Intensol solution was initiated. On day 2 of concomitant metronidazole and steroid therapy, the patient experienced severe discomfort and abdominal distention accompanied by new onset tachycardia. A disulfiram-like reaction between the steroid solution and metronidazole was suspected; therefore, the Prednisone Intensol was discontinued. The patient's mother reported that, following discontinuation, the patient slept well for the first time in 2 days. Use of the Naranjo Adverse Drug Reaction Probability Scale indicated a possible relationship (score of 4) between the concomitant medication use and the gastrointestinal discomfort and tachycardia. If this interaction between metronidazole and alcohol containing medications occurs, it may be initially unrecognized, potentially resulting in patient discomfort or harm. It is important for healthcare professionals to identify these potential drug-drug interactions so that alternative medications may be utilized and offending agents can be avoided or replaced.
Intravenous Enoxaparin in Pediatric Burn Patients: A Case Series
Authors: Streetz Vonya N. , Patatanian Leslie K.
Published: October 2019

Patients with acute burns experience a hypercoagulable state that may necessitate the use of anticoagulants to prevent the complications of venous thromboembolism (VTE). Enoxaparin is a low molecular weight heparin that is commonly used for this purpose; however, the traditional SC route of administration poses potential limitations in the pediatric burn population. These include pain upon injection, increased anxiety, erroneous absorption and distribution, and difficulty in finding an administration site when burns encompass a large percentage of body surface area. As a result, the IV route of administration may be preferable in these patients. To date, a limited number of studies in critically ill pediatric patients have been performed. In this report, we present a case series of 3 pediatric burn patients who initially received SC enoxaparin and were transitioned to IV enoxaparin for VTE prophylaxis. The patients were 2, 8, and 10 years old. Burn involvement ranged from 8% to 75% total body surface area, and all patients had central line access. Adequate prophylactic low molecular weight heparin anti-Xa peak concentrations (0.1–0.3 international units/mL) were achieved with IV doses ranging from 0.35 to 0.5 mg/kg administered every 12 hours. No adverse effects, major bleeding events, or treatment failures occurred.
OBJETOS MEDIADOS: PINTURAS MESTIÇAS
Authors:   Unochapecó, Pellegrin Ricardo
Published: October 2019

Este artigo apresenta os resultados da pesquisa Objetos mediados: pinturas mestiças, desenvolvida entre 2011 e 2013, investigação que se estabeleceu na conjugação da prática artística a uma reflexão teórica, abordando as estratégias poéticas adotadas na concepção e realização desses trabalhos. A proposta instaurou-se nas problemáticas contemporâneas da representação de objetos na pintura (natureza-morta) através do emprego da imagem técnica, processo pictórico relacionado ao conceito de mestiçagem. Identificadas nas estratégias poéticas as questões deslocaram-se dos objetos para o ruído gerado pela mediação técnica (óptica) do modelo.
Início / Arquivos / v. 2 n. 1 (2016): Processo Criativo / Artigos Seção temática SEM TÍTULO, MESMO: DEZEMBRO DE 2015
Authors:   UDESC, Oliveira Silfarlem J. de
Published: October 2019

Em suas atribuições um resumo de um artigo se assemelha a uma sinopse de um filme. Ambos lemos antes da peça principal. Para alguns a leitura do resumo/sinopse é indispensável, para outros não tanto. Em termos pragmáticos um resumo ou uma sinopse auxiliam na escolha da “refeição”. No entanto, um resumo é um resumo e um artigo é um artigo. Quando o texto do resumo se confundi com o texto do artigo, das duas uma: leia apenas o resumo ou leia apenas o artigo. Abreviando, este texto, incluindo o resumo, é um artigo. Também é uma carta. Carta dirigida, primeiramente, aos colegas da disciplina “Sobre ser artista professor” e que tem como escopo comunicar algumas ideias sobre o mesmo: sobre arte, ensino e algo mais.
O PENSAR CRIATIVO - O PROCESSO CRIATIVO E O ENSINAMENTO DAS CORES
Authors:   CEART/DMO, Maciel Dulce Maria Holanda , Santos Fabiana Ludwig dos ,   CEART/DMO, San Romãn Schirlei Martins O. ,   Bolsista PIBIC/Cnpq
Published: October 2019

Este texto relata uma experiência no aprendizado sobre cores realizada na disciplina intitulada Fundamentos da Cor do curso de Design de Moda do CEART/UDESC no ano de 2012. O grande desafio estabelecido na disciplina foi ensinar os conceitos básicos relativos a cores, suas características, usos, círculo cromático e esquemas harmônicos. No começo da disciplina foram estabelecidas as tarefas e o aporte teórico o qual envolveu o processo criativo e o ensinamento das cores através de exercícios desenvolvidos em sala de aula. Este texto demonstra uma breve apresentação do trabalho desenvolvido no semestre.
THINKING IN THE MAKING: 3D DESIGNING AND PRINTING WITH YOUNG CHILDREN AND THE CREATION OF THRESHOLDS FOR LEARNING
Authors:   Columbia University Teachers College - UNITED STATES, Cabral Marta , Sean Justice ,   Columbia University Teachers College - UNITED STATES
Published: October 2019

THINKING IN THE MAKING: 3D DESIGNING AND PRINTING WITH YOUNG CHILDREN AND THE CREATION OF THRESHOLDS FOR LEARNING
Para chegar ao mictório deve-se descer a escada em dois lances de 8 ou 80
Authors:   UFRJ, Machado Milton
Published: October 2019

Partindo da consideração de que a tradição da pintura e a tradição do readymade são tradições concorrentes – portanto igualmente formativas e constituintes, no território da arte, de seus julgamentos e vigências – reflete-se sobre a condição de ambas as práticas no contexto da arte contemporânea. Com atenção a determinadas posturas assumidas por artistas, críticos e historiadores no trato com a produção pictórica brasileira dos anos 80, sugere-se que uma revisão crítica de seus postulados esteja ainda por fazer.
A Way to Know, A Way to Go
Authors:   UDESC, Ellmann Barbara
Published: October 2019

Barbara Ellmann, a New York painter and freelance teaching artist, describes an innovative concept that combines her work as a fine artist and as an aesthetic educator into an exhibition's unusual design. She discusses the experiences that led to her exhibition and the ideas that have developed over thirty-five years of painting and teaching. As an educator at The Museum of Modern Art and The Whitney Museum and having observed the distance between curatorial decisions and the location of educational experiences she questions how else art could be presented to the general public and to student groups. AN OPEN BOOK, work by Barbara Ellmann is an attempt to break the wall-text conventions of explanatory and didactic language by providing instead visual support materials for visitors to explore in the exhibition itself. On reflection both obvious and a surprise to her was the discovery that a lifetime of work as an artist had led to the innovations visible in this exhibition.
Conversa com Milton Machado
Authors:   UDESC, Cruz José Maria Dias da
Published: October 2019

Artigo de José Maria Dias da Cruz
Seminar Abstract Expressionism: the language of emotions
Authors:   USP, Giannotti Marco
Published: October 2019

Palestra de Marco Giannotti
A Sala de Aula como Estúdio
Authors: Daichendt James , Oliveira Vinícius de ,   UDESC
Published: October 2019

The Classroom as Studio G. James Daichendt (BU / PLNU) / A Sala de Aula como Estúdio Tradução do artista Vinícius de Oliveira Santos
Inventário de procedimentos e metodologias para habitar o mundo
Authors:   UDESC, Uriarte Sarah
Published: October 2019

Revista realizada na disciplina "Sobre ser artista professor" da Profª Drª Jociele Lampert
[ENTRE] Ação Educativa e a Arte Como Experiência
Authors:   UDESC, Kirst Adriane , Wosniak Fábio ,   UDESC, Siqueira Juliano ,   UDESC
Published: October 2019

Neste texto, são apresentadas reflexões sobre a concepção de Ação Educativa a partir da perspectiva cartográfica de Gilles Deleuze e Félix Guattari (1987) e do pressuposto de um pensamento através da arte como experiência, baseado em John Dewey (2010). O material educativo serve como dispositivo de diálogo, uma interface entre a exposição Deambulações Sobre Pintura, a Ação Educativa e a Experiência Estética; nele, o visitante do espaço da galeria contribui ativamente na produção de sentido (Rancière, 2014). Os autores concebem que não há uma maneira única de pensar a Ação Educativa e, muito menos, um modo específico de fazer/pensar uma ação educativa, havendo três espaços híbridos: âmbitos das corporalidades, das espacialidades, reunidos com riqueza em ambientações, situações e paisagens a serem usufruídas e recriadas pelos espectadores. Neste sentido, a atitude cartográfica acolhe as concepções do espectador e recria novas maneiras de pensar as obras, propiciando experiências estéticas e um conhecimento autônomo sobre as produções artísticas.
Projeto Albers: Estudos de um objeto/processo
Authors:   UDESC, Kirst Adriane
Published: October 2019

Projeto desenvolvido no Estúdio de Pintura Apotheke
Distress Management, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology
Authors: Riba Michelle B. , Donovan Kristine A. , Andersen Barbara , Braun IIana , Breitbart William S. , Brewer Benjamin W. , Buchmann Luke O. , Clark Matthew M. , Collins Molly , Corbett Cheyenne , Fleishman Stewart , Garcia Sofia , Greenberg Donna B. , Handzo Rev. George F. , Hoofring Laura , Huang Chao-Hui , Lally Robin , Martin Sara , McGuffey Lisa , Mitchell William , Morrison Laura J. , Pailler Megan , Palesh Oxana , Parnes Francine , Pazar Janice P. , Ralston Laurel , Salman Jaroslava , Shannon-Dudley Moreen M. , Valentine Alan D. , McMillian Nicole R. , Darlow Susan D.
Published: October 2019

Distress is defined in the NCCN Guidelines for Distress Management as a multifactorial, unpleasant experience of a psychologic (ie, cognitive, behavioral, emotional), social, spiritual, and/or physical nature that may interfere with the ability to cope effectively with cancer, its physical symptoms, and its treatment. Early evaluation and screening for distress leads to early and timely management of psychologic distress, which in turn improves medical management. The panel for the Distress Management Guidelines recently added a new principles section including guidance on implementation of standards of psychosocial care for patients with cancer.
NCCN Guidelines Insights: Multiple Myeloma, Version 1.2020
Authors: Kumar Shaji K. , Callander Natalie S. , Hillengass Jens , Liedtke Michaela , Baljevic Muhamed , Campagnaro Erica , Castillo Jorge J. , Chandler Jason C. , Cornell Robert F. , Costello Caitlin , Efebera Yvonne , Faiman Matthew , Garfall Alfred , Godby Kelly , Holmberg Leona , Htut Myo , Huff Carol Ann , Kang Yubin , Landgren Ola , Malek Ehsan , Martin Thomas , Omel James , Raje Noopur , Sborov Douglas , Singhal Seema , Stockerl-Goldstein Keith , Tan Carlyn , Weber Donna , Johnson-Chilla Alyse , Keller Jennifer , Kumar Rashmi
Published: October 2019

The NCCN Guidelines for Multiple Myeloma provide recommendations for diagnosis, workup, treatment, follow-up, and supportive care for patients with monoclonal gammopathy of renal significance, solitary plasmacytoma, smoldering myeloma, and multiple myeloma. These NCCN Guidelines Insights highlight some of the important updates and changes in the 1.2020 version of the NCCN Guidelines for Multiple Myeloma.
Long-Term Patterns of Oral Anticancer Agent Adoption, Duration, and Switching in Patients With CML
Authors: Banegas Matthew P. , Rivera Donna R. , O’Keeffe-Rosetti Maureen C. , Carroll Nikki M. , Pawloski Pamala A. , Tabano David C. , Epstein Mara M. , Yeung Kai , Hornbrook Mark C. , Lu Christine , Ritzwoller Debra P.
Published: October 2019

Background: Oral tyrosine kinase inhibitors (TKIs) have been the standard of care for chronic myeloid leukemia (CML) since 2001. However, few studies have evaluated changes in the treatment landscape of CML over time. This study assessed the long-term treatment patterns of oral anticancer therapies among patients with CML. Methods: This retrospective cohort study included patients newly diagnosed with CML between January 1, 2000, and December 31, 2016, from 10 integrated healthcare systems. The proportion of patients treated with 5 FDA-approved oral TKI agents—bosutinib, dasatinib, imatinib, nilotinib, and ponatinib—in the 12 months after diagnosis were measured, overall and by year, between 2000 and 2017. We assessed the use of each oral agent through the fourth-line setting. Multivariable logistic regression estimated the odds of receiving any oral agent, adjusting for sociodemographic and clinical characteristics. Results: Among 853 patients with CML, 81% received an oral agent between 2000 and 2017. Use of non-oral therapies decreased from 100% in 2000 to 5% in 2005, coinciding with imatinib uptake from 65% in 2001 to 98% in 2005. Approximately 28% of patients switched to a second-line agent, 9% switched to a third-line agent, and 2% switched to a fourth-line agent. Adjusted analysis showed that age at diagnosis, year of diagnosis, and comorbidity burden were statistically significantly associated with odds of receiving an oral agent. Conclusions: A dramatic shift was seen in CML treatments away from traditional, nonoral chemotherapy toward use of novel oral TKIs between 2000 and 2017. As the costs of oral anticancer agents reach new highs, studies assessing the long-term health and financial outcomes among patients with CML are warranted.
Physician Experience and Risk of Rituximab Discontinuation in Older Adults With Non-Hodgkin’s Lymphoma
Authors: Huntington Scott F. , Hoag Jessica R. , Wang Rong , Zeidan Amer M. , Giri Smith , Gore Steven D. , Ma Xiaomei , Gross Cary P. , Davidoff Amy J.
Published: October 2019

Background: Provider experience, or clinical volume, is associated with improved outcomes in many complex healthcare settings. Despite increased complexity of anticancer therapies, studies evaluating physician-level experience and cancer treatment outcomes are lacking. Methods: A population-based study was conducted of older adults (aged ≥66 years) diagnosed with B-cell non-Hodgkin’s lymphoma in 2004 through 2011 using SEER-Medicare data. Analysis focused on outcomes in patients receiving rituximab, the first approved monoclonal anticancer immunotherapy. We hypothesized that lower physician experience using rituximab and managing its infusion-related reactions would be associated with early treatment discontinuation. A 12-month look-back from each initiation of rituximab was used to categorize physician volume (0, 1–2, or ≥3 initiations per year). Modified Poisson regression was used to account for provider-level correlation and estimated relative risk (RR) of early rituximab discontinuation (<3 cycles within 180 days of rituximab initiation). Cox proportional hazards were used to measure the impact of rituximab discontinuation on survival. Results: Among 15,110 patients who initiated rituximab with 2,684 physicians, 7.6% experienced early rituximab discontinuation. Approximately one-fourth of patients (26.1%) initiated rituximab with a physician who had no rituximab initiations during the preceding 12 months. Compared with patients treated by physicians who had ≥3 rituximab initiations in the prior year, those treated by physicians without initiations were 57% more likely to experience early discontinuation (adjusted RR [aRR], 1.57; 95% CI, 1.35–1.82; P<.001 for 0 vs ≥3, and aRR, 1.19; 95% CI, 1.03–1.37; P=.02 for 1–2 vs ≥3). Additionally, rituximab discontinuation was associated with higher risk of death (adjusted hazard ratio, 1.39; 95% CI, 1.28–1.52; P<.001). Conclusions: Lower oncologist experience with rituximab was associated with increased risk of early rituximab discontinuation in Medicare beneficiaries with non-Hodgkin’s lymphoma. Physician-level volume may be an important factor in providing high-quality cancer care in the modern era.
Guideline Discordance and Patient Cost Responsibility in Medicare Beneficiaries With Metastatic Breast Cancer
Authors: Williams Courtney P. , Azuero Andres , Kenzik Kelly M. , Pisu Maria , Nipp Ryan D. , Bhatia Smita , Rocque Gabrielle B.
Published: October 2019

Background: Treatment for metastatic breast cancer (MBC) that is not concordant with the NCCN Guidelines for Breast Cancer has been associated with higher healthcare utilization and payer costs. However, a significant knowledge gap exists regarding the impact of guideline-discordant care on patient cost responsibility. This study examined this question among patients with MBC in the year postdiagnosis. Methods: This retrospective cohort study used data from the SEER-Medicare linked database from 2000 through 2013. Guideline discordance, defined by year-specific NCCN Guidelines, was assessed for first-line antineoplastic treatment and grouped into discrete categories. Patient cost responsibility (deductibles, coinsurance, copayments) in women with MBC were summed for all medical care received in the year postdiagnosis. The difference in patient cost responsibility by guideline discordance status was estimated using linear mixed-effect models. Results: Of 3,709 patients with MBC surviving at least 1 year postdiagnosis, 17.6% (n=651) received guideline-discordant treatment. Median cost responsibility in the year postdiagnosis for patients receiving guideline-discordant treatment was $7,421 (interquartile range [IQR], $4,359–$12,983) versus $5,171 (IQR, $3,006–$8,483) for those receiving guideline-concordant care. In adjusted models, guideline-discordant treatment was significantly associated with $1,841 higher patient costs in the first year from index diagnosis date (95% CI, $1,280–$2,401) compared with guideline-concordant care. Patient cost responsibility differed by category of guideline discordance, with those receiving nonapproved bevacizumab having the highest cost responsibility (β=$3,330; 95% CI, $1,711–$4,948). Conclusions: Deviations from current treatment guidelines may have implications on patient healthcare cost responsibility. Additional research is needed to fully understand the mechanisms underlying how guideline deviation leads to greater costs for patients with MBC.
The Evolution of Spiritual Care in the NCCN Distress Management Guidelines
Authors: Handzo George , Bowden Jill M. , King Stephen
Published: October 2019

Spiritual care and chaplaincy have been part of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Distress Management since the first meeting of the panel in 1997, possibly the first time this degree of spiritual care and chaplaincy care integration occurred in cancer care. Since that time, the chaplaincy care section of the guidelines, especially chaplain assessment categories derived from a spiritual care assessment, have provided a major resource for healthcare chaplaincy and have served as a model for integrating chaplaincy into the overall team practice of healthcare. However, this section of the NCCN Guidelines has not been substantially updated since it was originally written. During those 20 years, the practice of healthcare chaplaincy and the research that supports it have grown substantially. In the last year, at the request of the panel, we have updated the chaplaincy care section to fully integrate recently published evidence in spiritual care in healthcare, adding more value to this important set of guidelines. Those updates appear in the 2019 version of the NCCN Guidelines. This article discusses the history of chaplaincy involvement in the NCCN Guidelines for Distress Management and the precedent it set for the integration of chaplaincy in other efforts that followed. Integration of this section of the Guidelines into the spiritual care practice at Memorial Sloan Kettering Cancer Center is presented as an example of how these guidelines can be put into practice to improve patient care. Finally, a summary of the recent research by Drs. Kenneth Pargament and Julie Exline is presented as the foundation for the revised chaplain assessment categories and interventions.
Update on the Implementation of NCCN Guidelines for Distress Management by NCCN Member Institutions
Authors: Donovan Kristine A. , Deshields Teresa L. , Corbett Cheyenne , Riba Michelle B.
Published: October 2019

The first NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Distress Management were published in 1999. Since then, a number of other organizations have advocated for distress screening. Previous surveys of distress screening showed modest progress in implementation of the NCCN Guidelines for Distress Management by NCCN Member Institutions (MIs); this review examined whether further progress has been made. Representatives appointed to the NCCN Distress Management Panel or their designee were asked to complete an online survey in the summer of 2018. The survey was developed based on similar surveys performed in 2005 and 2012 and a survey of psychosocial staffing conducted in NCCN MIs in 2012. New items solicited details about triaging, rescreening, formal screening protocols, and tracking of distressed patients. The survey was completed by representatives from 23 of 27 NCCN MIs (85%). Among the responding institutions, 20 (87%) currently conduct routine screening for distress and 3 are piloting routine screening. All respondents reported use of a self-report measure to screen for distress, with the Distress Thermometer most often used. A total of 70% of respondents rescreen patients for distress and 83% reported having a formal distress screening protocol in place. Once triaged, 65% of institutions who routinely screen for distress track clinical contacts and referrals; 70% track rates of adherence to screening protocols. Findings suggest wide acceptance and implementation of the NCCN Guidelines. Most respondents reported the existence of a formal distress screening protocol, with routine tracking of clinical contacts and referrals and rates of protocol adherence. Clinical experience and the American College of Surgeons Commission on Cancer accreditation standard for cancer centers appear to have resulted in greater adoption and implementation of the guidelines, but considerable opportunities for improvement remain.
Zatična artrodeza interfalangealnih sklepov prstov na stopalih
Authors: Prlja Andrej
Published: October 2019

Izhodišče: Deformacije prstov nog, zlasti pri bolnicah, niso redka težava. Operiramo jih lahko v sklopu obsežnejših korekcij stopala ali kot samostojni poseg. Poznamo vrsto tehnik za zatrditev interfalangealnih sklepov. V prispevku opisujemo zatično (angl. peg-in-socket) tehniko in svoje izkušnje z njo.Metode: Primerjali smo zaplete med skupino 20 bolnikov (26 prstov), operiranih s tehniko zatrditve s Kirschnerjevo iglo (skupina KI), s skupino 50 bolnikov (61 prstov), operiranih s tehniko zatiča (skupina PEG). Razlike v pogostosti zapletov med skupinama KI in PEG smo primerjali s testom deleža (hi-kvadrat).Znotraj same skupine PEG smo izboljšave glede bolečine in omejitev aktivnosti ocenili s testom razlike dveh aritmetičnih sredin (Z-test). Opisali smo tudi težave z obutvijo, uspešnost zatrditve, morebitne ponovitve bolečih otiščancev na operiranih prstih ter obliko in položaj prstov pred in po posegu.Rezultati: Zgodnji zapleti so bili pogostejši v skupini KI kot v skupini PEG (p < 0,05).V sami skupini PEG se je bolečina po posegu izboljšala s 15,6 na 31,2 (p < 0,01), omejitve aktivnosti s 3,7 na 5,9, (p < 0,01). Tudi po zdravljenju so vsi bolniki še naprej uporabljali udobno ali ortopedsko obutev. Pri 5 od 50 bolnikov smo zatrditve ocenili kot neuspešne: 1 psevdoartroza, 2 rentgenski nezraščanji (angl. non union), 2 nepravilni zraščanji (angl. malunion). Pred operacijo so imeli vsi bolniki deformirane prste z bolečimi otiščanci. Po posegu je bilo 9 bolnikov brez otiščancev in bolečin, ostali pa so še navajali občasne manjše bolečine. Položaj in obliko prstov po posegu smo 9-krat ocenili kot odlične, 50-krat kot dobre in 2-krat kot slabe.Zaključek: Zatična zatrditev malih sklepov prstov stopal je nekoliko zahtevnejša tehnika, ki pa omogoča predvidljive in ponovljive rezultate z uporabo bolnikovih tkiv in brez tujkov. Izvaja se lahko ambulantno in ni draga.
A Reflexive View of Refugee Integration and Inclusion: A Case Study of the Mennonite Central Committee and the Private Sponsorship of Refugees Program
Authors: Good Gingrich Luann , Enns Thea
Published: October 2019

Through a qualitative case study with Mennonite Central Committee (MCC) sponsorship groups and former refugee newcomers, we adopt a reflexive, relational, and systemic lens (Bourdieu) to analyze the institutional and interpersonal relationships in the Private Sponsorship of Refugees (PSR) Program, and more specifically, the ways in which MCC Ontario’s sponsorship program invigorates or frustrates dynamics of social inclusion. We situate the institutional relations of the PSR Program as nested social fields and sub-fields, revealing complementary and competing systems of capital that direct explicit and implicit visions for “success” in MCC sponsorships. A peculiar Mennonite/MCC social field and structure of capital generates institutional and social tensions, yet an ambivalent disposition or divided habitus presents possibilities for seeing, understanding, and challenging dynamics of social exclusion.
“We Feel Like We’re Home”: The Resettlement and Integration of Syrian Refugees in Smaller and Rural Canadian Communities
Authors: Haugen Stacey
Published: October 2019

Despite the media attention to Syrian refugee families being welcomed, finding work, and feeling at home in small towns across Canada, little is known about resettlement and integration in smaller and rural communities. Addressing this knowledge gap, this study visited four rural communities across four provinces in an effort to highlight the experiences of smaller and rural communities and the refugees living there. Based on interviews and conversations with rural refugee sponsors and community members, Syrian refugees, and service providers, the findings tell a story of refugees being welcomed into rural and smaller communities and of communities coming together to support the newcomers and find solutions to rural challenges. The article concludes that rural places can have a lot to offer refugees, some of whom settle permanently in these areas, and their experiences should be included as part of the larger narrative of refugee resettlement in Canada.
Fostering Better Integration Through Youth-Led Refugee Sponsorship
Authors: McKee Carolyn , Lavell Lee-Anne , Manks Michelle , Korn Ashley
Published: October 2019

World University Service of Canada (WUSC) participates in private sponsorship as a sponsorship agreement holder through its Student Refugee Program. More than ninety campus-based constituent groups known as WUSC Local Committees resettle approximately 130 refugee students to Canadian post-secondary institutions each year. This article seeks to assess the effectiveness of the Student Refugee Program’s youth-to-youth sponsorship model in integrating former refugees into their receiving communities. We outline the impact of the Student Refugee Program upon its beneficiaries, the important role youth volunteers play in supporting their integration and building more welcoming communities for newcomers in Canada, and the effect of the program on receiving societies. We conclude with recommendations for scaling up the program in Canada and sharing the model internationally.
Australia’s Private Refugee Sponsorship Program: Creating Complementary Pathways Or Privatising Humanitarianism?
Authors: Hirsch Asher Lazarus , Hoang Khanh , Vogl Anthea
Published: October 2019

This article provides the first history and critique of Australia’s private refugee sponsorship program, the Community Support Program (CSP). As more countries turn to community sponsorship of refugees as a means to fill the “resettlement gap,” Australia’s model provides a cautionary tale. The CSP, introduced in 2017, does not expand Australia’s overall resettlement commitment but instead takes places from within the existing humanitarian resettlement program. The Australian program charges sponsors exorbitant application fees, while simultaneously prioritizing refugees who are “job ready,” with English-language skills and ability to integrate quickly, undermining the principle of resettling the most vulnerable. As such, we argue that the CSP hijacks places from within Australia’s humanitarian program and represents a market-driven outsourcing and privatization of Australia’s refugee resettlement priorities and commitments.
DIFFERENCE IN THE CARCASS QUALITY AND MEAT CHEMICAL COMPOSITION IN TWO LINES OF SLOWGROWING CHICKENS WITH OR WITHOUT ACCESS TO PASTURE
Authors: POPOVA Teodora , PETKOV Evgeni , IGNATOVA Maya
Published: October 2019

The study was carried out to compare the carcass quality and the chemicalcomposition of breast and thigh meat in two lines of slow-growing male chickens -La Belle (LB) and Bresse Gauloise (BB) reared conventionally or outdoors, havingaccess to pasture. The birds were slaughtered at 12 weeks of age. Two-wayANOVA was used to assess the effect of the rearing strategies as well as the line onthe carcass quality and meat chemical composition. Rearing system affectedsignificantly the carcass traits of the birds. The lines reared on pasture had lowerlive and carcass weight as well as lower dressing percentage (P<0.001). On theother hand they had higher percent (P<0.001) of the edible by-products (neck andgiblets). The percentage of the breast meat was significantly reduced in the birdsthat had access to pasture (P<0.001), while thigh remained unaffected. Thepastured chickens displayed higher part of the wings (P<0.01). Outdoors rearinginfluenced the chemical composition in the breast and thigh meat of the lines.Chickens reared on pasture were characterised by lower lipid content (P<0.01) inbreast and reduced protein in thigh (P<0.05), as well as increased moisture in bothkinds of meat, however depending on the line (P<0.05). Furthermore, pastureaccess resulted in reduced ash content of the breast meat (P<0.001), which waslower in the LB chickens (P<0.01), while in thigh this parameter was stronglydetermined by the interaction of the rearing system and line of the birds (P<0.01).
Bone morphogenetic protein 15 induces differentiation of mesenchymal stem cell derived from human follicular fluid to oocyte like cell
Authors: Taheri Moghadam Mahin , Eftekhari Moghadam Ali Reza , Saki Ghasem , Nikbakht Roshan
Published: October 2019

Background. To study the effect of Bone morphogenetic protein 15 on differentiation potential of mesenchymal stem cell derived from human follicular fluid to oocyte like cell. Methods. Human FF derived cells were collected from 78 women in assisted fertilization program, and cultured in differentiation medium containing human recombinant BMP15 for 21 days. Mesenchymal stem cells and OLCs were characterized by real-time PCR and immunocytochemistry (ICC) staining. Results. MSCs expressed germ line stem cell markers, such as OCT4 and NANOG. After 15 days, OLCs formed and expressed zona pellucida markers (ZP2, ZP3), and reached 20 – 30 µm in diameters. Ten days after induction with BMP15, round cells remarkably developed, and the maximum size of OLCs reached 115 µm. Finally, a decrease ranging from 0.04 to 4.5 in the expression of pluripotency and oocyte specific markers was observed in the cells cultured in BMP15 supplemented medium. Our work demonstrates, FF derived MSCs have an innate potency to differentiate into OLCs, and BMP15 is effective in stimulating the differentiation of these cells, which may give an in vitro model to examine human germ cell development.