Inclusion of chemotherapy in addition to anthracycline in the treatment of acute promyelocytic leukaemia does not improve outcomes:results of the MRC AML15 trial

Two hundred eighty-five patients, median age 42, with PML-RARa-positive acute promyelocytic leukaemia were randomised to Ara-C-containing 'Medical Research Council (MRC) Chemotherapy'+ATRA (All-trans-retinoic acid) or anthracycline+ATRA (modified 'Spanish') therapy. MRC treatment comprised four courses with ATRA in courses 1-2. Spanish treatment comprised four anthracycline-based courses with ATRA in courses 1-3. In course 3 patients were randomised to gemtuzumab ozogamicin (GO) or not. The Spanish arm received 24-month maintenance. Patients were sequentially molecularly monitored. Quality of life was assessed at baseline, 3, 6, 9, 12, 24 months. Remission rates were similar in both arms (93%): cumulative incidence of haematological relapse (CIHR) was 6% at 5 years; 5 patients relapsed molecularly. Survival post relapse was 80%. There were more deaths in remission in the MRC arm (4% vs 10%: P=0.2). The overall 5-year relapse-free and overall survival was similar between arms (81% vs 82% and 84% vs 83%, respectively). More supportive care and hospitalisation (81.8 vs 63 days, P10 × 10(9)/l) was not prognostic overall, or within treatment arms. Both approaches deliver similar results with minor differences in quality of life. MRC treatment required more hospitalisation. This suggests that additional chemotherapy, Ara-C in particular, is not required.

New Perspectives on the Role of Cultural Intermediaries in Social Inclusion in the UK

Based on interviews with arts administrators responsible for addressing targeted groups labelled “socially excluded,” this paper highlights new understandings of the term “cultural intermediary” (Featherstone 1991; Bourdieu 2000) within art galleries and art centres. It considers the unique role of such figures in crossing the exclusion/inclusion boundary within the arts and developing more personal approaches to marketing activities in their institutions through relationship building. While it is acknowledged here that such workers find themselves in a privileged position in being able to shape questions of taste and particular consumerist dispositions to understanding the art world, little, if not no, effort has been made to understand this process. As such, there remains a void between the cultural policy‐oriented conception of social inclusion, which implies a version of repairing the “flawed consumer” (Bauman 2005), and the way in which such policy is played out on the ground.

A Case Study in Policy Delivery:Examining Social Inclusion through Interpretation and Practice

The current body of literature regarding social inclusion and the arts tends to focus
on two areas: the lack of clear or common understanding of the terminology involved
(GLLAM, 2000) and the difficulty in measuring impact (Newman 2001). Further, much
of the literature traces the historical evolution of social inclusion policy within the arts
from a political and social perspective (Belfiore & Bennett, 2007), whilst others
examine the situation in the context of the museum as an institution more generally
(Sandell, 2002b). Such studies are essential; however they only touch on the
importance of understanding the context of social inclusion programmes. As each
individual’s experience of exclusion (or inclusion) is argued to be different (Newman
et al., 2005) and any experience is also process-based (SEU 2001), there is a need
for more thorough examination of the processes underpinning project delivery
(Butterfoss, 2006), particularly within a field that has its own issues of exclusion, such
as the arts (Bourdieu & Darbel, 1991). This paper presents case study findings of a
programme of contemporary arts participation for adults with learning difficulties
based at an arts centre in Liverpool. By focusing on practice, the paper applies
Wenger’s (1998) social theory of learning in order to assert that rather than search
for measurable impacts, examining the delivery of programmes within their individual
contexts will provide the basis for a more reflective practice and thus more effective
policy making.

Optimized process for the inclusion of carbon nanotubes in elastomers with improved thermal and mechanical properties

The effects of addition of reinforcing carbon nanotubes (CNTs) into hydrogenated nitrile-butadiene rubber (HNBR) matrix on the mechanical, dynamic viscoelastic, and permeability properties were studied in this investigation. Different techniques of incorporating nanotubes in HNBR were investigated in this research. The techniques considered were more suitable for industrial preparation of rubber composites. The nanotubes were modified with different surfactants and dispersion agents to improve the compatibility and adhesion of nanotubes on the HNBR matrix. The effects of the surface modification of the nanotubes on various properties were examined in detail. The amount of CNTs was varied from 2.5 to 10 phr in different formulations prepared to identify the optimum CNT levels. A detailed analysis was made to investigate the morphological structure and mechanical behavior at room temperature. The viscoelastic behavior of the nanotube filler elastomer was studied by dynamic mechanical thermal analysis (DMTA). Morphological analysis indicated a very good dispersion of the CNTs for a low nanotube loading of 3.5 phr. A significant improvement in the mechanical properties was observed with the addition of nanotubes. DMTA studies revealed an increase in the storage modulus and a reduction in the glass-transition temperature after the incorporation of the nanotubes. Further, the HNBR/CNT nanocomposites were subjected to permeability studies. The studies showed a significant reduction in the permeability of nitrogen gas. Copyright © 2011 Wiley Periodicals, Inc.

Travelling without moving? Limits of European governance for Romani inclusion

The European Union's commitment to citizen participation in policymaking and implementation reflects a wider concern for securing Europe's ‘unity in diversity’. However, across its member-states, individuals belonging to the diverse linguistic, ethnic and social groups often referred to as ‘Roma’ find themselves excluded from political, social and economic participation in countries where they live. The past decade saw the appearance of a more concerted approach to improve the participation of individuals belonging to these groups in social and economic processes. This article examines what it refers to as the European Governance for Romani inclusion (EGRI), assessing policy steps undertaken at the European institutional level towards Romani inclusion and the tools for policy implementation. The paper concludes that the EGRI has offered only limited opportunities for the marginalised Roma to redress their exclusion.

European Recommendations for Primary Prevention of Congenital Anomalies: A Joined Effort of EUROCAT and EUROPLAN Projects to Facilitate Inclusion of This Topic in the National Rare Disease Plans

Congenital anomalies (CA) are the paradigm example of rare diseases liable to primary prevention actions due to the multifactorial etiology of many of them, involving a number of environmental factors together with genetic predispositions. Yet despite the preventive potential, lack of attention to an integrated preventive strategy has led to the prevalence of CA remaining relatively stable in recent decades. The 2 European projects, EUROCAT and EUROPLAN, have joined efforts to provide the first science-based and comprehensive set of recommendations for the primary prevention of CA in the European Union. The resulting EUROCAT-EUROPLAN 'Recommendations on Policies to Be Considered for the Primary Prevention of Congenital Anomalies in National Plans and Strategies on Rare Diseases' were issued in 2012 and endorsed by EUCERD (European Union Committee of Experts on Rare Diseases) in 2013. The recommendations exploit interdisciplinary expertise encompassing drugs, diet, lifestyles, maternal health status, and the environment. The recommendations include evidence-based actions aimed at reducing risk factors and at increasing protective factors and behaviors at both individual and population level. Moreover, consideration is given to topics specifically related to CA (e.g. folate status, teratogens) as well as of broad public health impact (e.g. obesity, smoking) which call for specific attention to their relevance in the pre- and periconceptional period. The recommendations, reported entirely in this paper, are a comprehensive tool to implement primary prevention into national policies on rare diseases in Europe.

The inclusion of open-ended questions on quantitative surveys of children: Dealing with unanticipated responses relating to child abuse and neglect

Web surveys have been shown to be a viable, and relatively inexpensive, method of data collection with children. For this reason, the Kids’ Life and Times (KLT) was developed as an annual online survey of 10 and 11 year old children. Each year, approximately 4,000 children participate in the survey. Throughout the six years that KLT has been running, a range of questions has been asked that are both policy-relevant and important to the lives of children. Given the method employed by the survey, no extremely sensitive questions that might cause the children distress are included. The majority of questions on KLT are closed yielding quantitative data that are analysed statistically; however, one regular open-ended question is included at the end of KLT each year so that the children can suggest questions that they think should be asked on the survey the following year. While most of the responses are innocuous, each year a small minority of children suggest questions on child abuse and neglect. This paper reports the responses to this question and reflects on how researchers can, and should, deal with this issue from both a methodological and an ethical perspective.

Revisiting Iris Marion Young on Normalisation, Inclusion and Democracy

Vieten's edited collection brings together papers that were given at the I M Young Memorial Symposium 'Inclusion and Democracy Revisited', held in Amsterdam in 2012. The different chapters presented explore in-depth, Young's models of a 'politics of cultural difference', and a 'politics of positional difference' read in combination with her critique of normalisation. Young regards the latter as decisive to any change for the better when reaching out politically to a fairer and more just democratic society.
With the current political, economic and socio-cultural crisis in mind, the contemporary world of global speed and transformed societies in and beyond Europe needs a refinement of what we understand 'normalisation' and 'difference' to be. How can we connect to each other, and in what ways can Young's 'structural inequality model' be applied to develop alternative outlooks on how to enhance inclusion and democracy in different nation states?

The inclusion and juridification of victims on the Island of Ireland

Concern for crime victims has been a growing political issue in improving the legitimacy and success of the criminal justice system through the rhetoric of rights. Since the 1970s there have been numerous reforms and policy documents produced to enhance victims’ satisfaction in the criminal justice system. Both the Republic of Ireland and Northern Ireland have seen a sea-change in more recent years from a focus on services for victims to a greater emphasis on procedural rights. The purpose of this chapter is to chart these reforms against the backdrop of wider political and regional changes emanating from the European Union and the European Court of Human Rights, and to critically examine whether the position of crime victims has actually ameliorated.

While separated into two legal jurisdictions, the Republic of Ireland and Northern Ireland as common law countries have both grappled with similar challenges in improving crime victim satisfaction in adversarial criminal proceedings. This chapter begins by discussing the historical and theoretical concern for crime victims in the criminal justice system, and how this has changed in recent years. The rest of the chapter is split into two parts focusing on the Republic of Ireland and Northern Ireland. Both parts examine the provisions of services to victims, and the move towards more procedural rights for victims in terms of information, participation, protection and compensation. The chapter concludes by finding that despite being different legal jurisdictions, the Republic of Ireland and Northern Ireland have introduced many similar reforms for crime victims in recent years.