Adjuvant breast cancer treatment and cognitive function: current knowledge and research directions

Evidence is mounting that potentially curative systemic adjuvant therapy for early-stage breast cancer may result in cognitive impairment. Five published studies have investigated cognitive function in this setting, and the consistent results of all five studies suggest an adverse effect of adjuvant chemotherapy. These studies are reviewed with particular attention to their methodologic limitations. For example, all five studies used cross-sectional designs, none controlled for possible confounding hormonal factors, and three examined patients who had not received a uniform chemotherapy regimen. The potential roles of chemotherapy-induced menopause and of adjuvant hormonal therapy in cognitive impairment are also discussed. Priorities for future research include confirmation of an effect of adjuvant chemotherapy in a study with a longitudinal design, closer examination of the potential contribution of hormonal factors, and similar studies on the effect of adjuvant therapy on cognitive function in other cancer types. If an effect of systemic adjuvant therapy on cognitive function is confirmed, such an effect will have implications for informed consent. It may also result in incorporation of objective measures of cognition in clinical trials of adjuvant therapy and in the investigation of preventive interventions that might minimize the impact of cognitive dysfunction after cancer treatment.

Learning Analytics: Challenges and Future Research Directions

In recent years, learning analytics (LA) has attracted a great deal of attention in technology-enhanced learning (TEL) research as practitioners, institutions, and researchers are increasingly seeing the potential that LA has to shape the future TEL landscape. Generally, LA deals with the development of methods that harness educational data sets to support the learning process. This paper provides a foundation for future research in LA. It provides a systematic overview on this emerging field and its key concepts through a reference model for LA based on four dimensions, namely data, environments, context (what?), stakeholders (who?), objectives (why?), and methods (how?). It further identifies various challenges and research opportunities in the area of LA in relation to each dimension.

It's about time: Current directions in prospective memory

Prospective memory is the ability to plan, to retain and to carry out an intention as planned. It is an important function for leading an autonomous life and only recently research has started to investigate developmental aspects in particular related to attention, executive functions and metacognition. In this symposium, this research is emphasized. In addition, new experimental research on the impact of implementation intentions and importance will be presented.

Family Preservation Services under Managed Care: Current Practices and Future Directions

Family preservation service agencies in the State of Kansas have undergone major changes since the implementation of a managed care model of service delivery in 1996. This qualitative study examines the successes and barriers experienced by agency directors in utilization of a managed care system. Outcome/ performance measures utilized by the State of Kansas are reviewed, and contributing factors to the successes and limitations of the program are discussed. Included in these reviews is an analysis and presentation of literature and research which has been used as support for the current program structure. Recommendations for further evolution of practice are proposed.

Nuclear power plants and childhood leukaemia: lessons from the past and future directions

In the 1980s, leukaemia clusters were discovered around nuclear fuel reprocessing plants in Sellafield and Dounreay in the United Kingdom. This raised public concern about the risk of childhood leukaemia near nuclear power plants (NPPs). Since then, the topic has been well-studied, but methodological limitations make results difficult to interpret. Our review aims to: (1.) summarise current evidence on the relationship between NPPs and risk of childhood leukaemia, with a focus on the Swiss CANUPIS (Childhood cancer and nuclear power plants in Switzerland) study; (2.) discuss the limitations of previous research; and (3.) suggest directions for future research. There are various reasons that previous studies produced inconclusive results. These include: inadequate study designs and limited statistical power due to the low prevalence of exposure (living near a NPP) and outcome (leukaemia); lack of accurate exposure estimates; limited knowledge of the aetiology of childhood leukaemia, particularly of vulnerable time windows and latent periods; use of residential location at time of diagnosis only and lack of data on address histories; and inability to adjust for potential confounders. We conclude that risk of childhood leukaemia around NPPs should continue to be monitored and that study designs should be improved and standardised. Data should be pooled internationally to increase the statistical power. More research needs to be done on other putative risk factors for childhood cancer such as low-dose ionizing radiation, exposure to certain chemicals and exposure to infections. Studies should be designed to allow examining multiple exposures.

Restenosis after infrapopliteal angioplasty - clinical importance, study update and further directions.

Patients with critical limb ischemia (CLI) represent the most severe form of peripheral arterial disease (PAD) and exhibit high mortality rates. Frequently, PAD in CLI patients involves the infrapopliteal arterial segment challenging endovascular revascularization strategies. Restenosis remains the major drawback of tibial angioplasty encountered in more than two thirds of CLI patients undergoing tibial revascularization. In contrast to earlier observations, tibial patency was recently shown to be essential to attain an optimal clinical outcome in CLI patients subsequent to tibial angioplasty. The exact pathopyhsiological mechanisms of tibial restenosis remains unclear. To date, most of our knowledge on tibial restenosis and its pathophysiology is derived from coronary arteries, based on the similarity of coronary arteries to tibial artery morphology. Nervertheless, multiple antirestenosis concepts are investigated within clinical trials to reduce tibial restenosis.Purpose of the present manuscript is to provide a current update on the pathophysiology of tibial restenosis and potential antirestenosis strategies.

Corrective experiences in psychotherapy: Definitions, processes, consequences, and research directions

After 5 years of conceptualizing, investigating, and writing about corrective experiences (CEs), we (the authors of this chapter) met to talk about what we learned. In this chapter, we summarize our joint understanding of (a) the definition of CEs; (b) the contexts in which CEs occur; (c) client, therapist, and external factors that facilitate CEs; (d) the consequences of CEs; and (e) ideas for future theoretical, clinical, empirical, and training directions. As will become evident, the authors of this chapter, who represent a range of theoretical orientations, reached consensus on some CE-related topics but encountered controversy and lively debate about other topics. (PsycINFO Database Record (c) 2013 APA, all rights reserved)

Diffusion-weighted imaging in musculoskeletal radiology-clinical applications and future directions

Diffusion-weighted imaging (DWI) is an established diagnostic tool with regards to the central nervous system (CNS) and research into its application in the musculoskeletal system has been growing. It has been shown that DWI has utility in differentiating vertebral compression fractures from malignant ones, assessing partial and complete tears of the anterior cruciate ligament (ACL), monitoring tumor response to therapy, and characterization of soft-tissue and bone tumors. DWI is however less useful in differentiating malignant vs. infectious processes. As of yet, no definitive qualitative or quantitative properties have been established due to reasons ranging from variability in acquisition protocols to overlapping imaging characteristics. Even with these limitations, DWI can still provide clinically useful information, increasing diagnostic accuracy and improving patient management when magnetic resonance imaging (MRI) findings are inconclusive. The purpose of this article is to summarize recent research into DWI applications in the musculoskeletal system.

Can IBEX detect interstellar neutral helium or oxygen from anti-ram directions?

To better constrain the parameters of the interstellar neutral flow, we searched the Interstellar Boundary EXplorer (IBEX)-Lo database for helium and oxygen from the interstellar medium in the anti-ram direction in the three years (2009-2011) with the lowest background rates. We found that IBEX-Lo cannot observe interstellar helium from the anti-ram direction because the helium energy is too low for indirect detection by sputtering off the IBEX-Lo conversion surface. Our results show that this sputtering process has a low energy threshold between 25 and 30 eV, whereas the energy of the incident helium is only 10 eV for these observations. Interstellar oxygen, on the other hand, could in principle be detected in the anti-ram hemisphere, but the expected magnitude of the signal is close to the detection limit imposed by counting statistics and by the magnetospheric foreground.

Harmonie-Fest-Messe in Es-Dur : für Sopran, Alt, Tenor ad lib., Bass, Flöte, 2 B-Clarinetten, 1 Flügelhorn in B, 1 Euphonion in B, 2 chrom. Trompeten in Es, 2 Hörner in Es, und Bombardon mit ausgesetzter Orgel als Directions-Stimme obligat ; ferner zur beliebigen Verstärkung bei Aufführungen im Freien 1 Piston in B, 2tes. Flügelhorn in B, Bombardino in B, Posaune und Pauken, nicht obligat ; op. 237

componirt von Johann Obersteiner