927 resultados para Geography|Health Sciences, Public Health|Health Sciences, Epidemiology|Health Sciences, Oncology
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Seit Jahren werden Diskussionen über Erfolgskontrolle in der kommunalen Wirtschaftsförderung geführt. Im Vordergrund steht dabei die Suche nach Indikatoren und Verfahren, die es den kommunalen Wirtschaftsförderungen ermöglichen sollen, Erfolge zu messen. rnDa die Wirtschaftsförderung zu den freiwilligen Leistungen einer Gemeinde zählt, erhöht sich der Druck der Rechtfertigung gegenüber der Öffentlichkeit oder der Politik, das gilt insbesondere in Zeiten knapper öffentlicher Haushalte. Firmenansiedlungen, eine positive wirtschaftliche Entwicklung oder eine geringe Arbeitslosenquote sind sowohl im öffentlichen Bewusstsein als auch in der Politik wesentliche Kriterien einer erfolgreichen Wirtschaftsförderung. Sich ständig ändernde Rahmenbedingungen im wirtschaftsstrukturellen Gefüge haben dazu geführt, dass diese klassischen Nachweise von Erfolg immer seltener als solche präsentiert werden können. Erfolge sollten dennoch gemessen werden, um Maßnahmen und Instrumente einer kommunalen Wirtschaftsförderung zu überprüfen und gegebenenfalls an die geänderten Bedingungen anzupassen. rnEs ist schon mehr als 30 Jahre her, als in den 1970er Jahren die Suche nach Methoden und Verfahren der Erfolgskontrolle in der öffentlichen Verwaltung begann. Erfolge von kommunaler Wirtschaftsförderung können nicht einfach und ausschließlich an den markantesten wirtschaftlichen Ziffern der Kommune gemessen werden, z. B. der Zahl der sozialversicherungspflichtigen Arbeitsplätze. Seit Jahren wird um einen Lösungsweg bei der Durchführung von Erfolgskontrolle in der kommunalen Wirtschaftsförderung gerungen, abschließend wurde jedoch noch kein vollends befriedigend praktikabler Weg gefunden. Zu hinterfragen ist vor dem Hintergrund, inwiefern die vier Elemente einer Erfolgskontrolle, nämlich die Zielerreichungs-, Vollzugs-, Bedingungs- und Wirkungskontrolle, tatsächlich und hinreichend zum Einsatz kommen können.rnDie vorliegenden empirischen Untersuchungen beleuchten nun das Thema aus Sicht der kommunalen Wirtschaftsförderer und liefern Ergebnisse, die zu einem veränderten Bewusstsein gegenüber der Durchführung von Erfolgskontrolle in der kommunalen Wirtschaftsförderung führen müssten. Unabhängig von der Organisationsform und der Größe einer kommunalen Wirtschaftsförderung lässt sich empirisch nachweisen, dass der Anspruch, den der Begriff der Erfolgskontrolle in seiner gängigen Beschreibung erhebt, nicht hinreichend von einer kommunalen Wirtschaftsförderung erfüllt werden kann. rnMit Hilfe des neu entwickelten Prozesses einer modifizierten Erfolgskontrolle wird in vorliegender Arbeit ein idealtypischer Ablauf für eine kommunale Wirtschaftsförderung dargestellt. Der neue Ansatz einer modifizierten Erfolgskontrolle ist eine konsequente Reduzierung der Anforderungen auf das Praktikable und führt dazu, dass Erfolge der kommunalen Wirtschaftsförderung dargestellt werden können, ohne dass das Verfahren mehr Fragen offen lässt, als es beantwortet. Durch die modifizierte Erfolgskontrolle können die spezifischen Erfolge einer kommunalen Wirtschaftsförderung dargestellt und dokumentiert werden. rnEine modifizierte Erfolgskontrolle kann zweierlei: Sie ist eine Hilfestellung für die politisch Verantwortlichen bei der Erkenntnis, dass eine Notwendigkeit nach konkreten und der Ist-Situation sowie den Randbedingungen angepassten Zielformulierungen besteht. Sie bietet aber auch eine Möglichkeit, dass die kommunalen Wirtschaftsförderungseinrichtungen dem in der öffentlichen Diskussion formulierten Anspruch nach Erfolgskontrolle mit einem hohen Grad an Praktikabilität gerecht werden können. rnBevor also viele kommunale Wirtschaftsförderungen durch die fragwürdige Forderung an eine Erfolgskontrolle aufgrund der zu hohen Anforderungen an Methodik, Zeit und Personal aufgeben, sollte ihnen die Konzentration auf das Praktikable wieder Anreiz sein, eine modifizierte Erfolgskontrolle nach dem neuen Prozessschema in Angriff zu nehmen. rnrn
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This article explores the “unpopular” archived life of Charles P. Daly, thirty-five-year president (1864–1899) of the New York–based American Geographical Society. This one-time highly prominent judge and civic leader popularized geography among professionals and the public alike. Daly’s popular geography, along with his subsequent containment within the archives, suggests explanations for his dismissal among geographical audiences of today. It is a useful and necessary exercise to trace the neglect of Daly within histories of geography and recapture him for today’s audiences, not only because of his influence on post–Civil War American geography but also because his story can shed light on how “disciplinary remembering” functions in geography.
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"New impression"--T.p.
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Background Cancer can be a distressing experience for cancer patients and carers, impacting on psychological, social, physical and spiritual functioning. However, health professionals often fail to detect distress in their patients due to time constraints and a lack of experience. Also, with the focus on the patient, carer needs are often overlooked. This study investigated the acceptability of brief distress screening with the Distress Thermometer (DT) and Problem List (PL) to operators of a community-based telephone helpline, as well as to cancer patients and carers calling the service. Methods Operators (n = 18) monitored usage of the DT and PL with callers (cancer patients/carers, >18 years, and English-speaking) from September-December 2006 (n = 666). The DT is a single item, 11-point scale to rate level of distress. The associated PL identifies the cause of distress. Results The DT and PL were used on 90% of eligible callers, most providing valid responses. Benefits included having an objective, structured and consistent means for distress screening and triage to supportive care services. Reported challenges included apparent inappropriateness of the tools due to the nature of the call or level of caller distress, the DT numeric scale, and the level of operator training. Conclusions We observed positive outcomes to using the DT and PL, although operators reported some challenges. Overcoming these challenges may improve distress screening particularly by less experienced clinicians, and further development of the PL items and DT scale may assist with administration. The DT and PL allow clinicians to direct/prioritise interventions or referrals, although ongoing training and support is critical in distress screening.
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Purpose: The recognition of breast cancer as a spectrum tumor in Lynch syndrome remains controversial. The aim of this study was to explore features of breast cancers arising in Lynch syndrome families. Experimental Design: This observational study involved 107 cases of breast cancer identified from the Colorectal Cancer Family Registry (Colon CFR) from 90 families in which (a) both breast and colon cancer co-occurred, (b) families met either modified Amsterdam criteria, or had at least one early-onset (<50 years) colorectal cancer, and (c) breast tissue was available within the biospecimen repository for mismatch repair (MMR) testing. Eligibility criteria for enrollment in the Colon CFR are available online. Breast cancers were reviewed by one pathologist. Tumor sections were stained for MLH1, PMS2, MSH2, and MSH6, and underwent microsatellite instability testing. Results: Breast cancer arose in 35 mutation carriers, and of these, 18 (51%) showed immunohistochemical absence of MMR protein corresponding to the MMR gene mutation segregating the family. MMR-deficient breast cancers were more likely to be poorly differentiated (P = 0.005) with a high mitotic index (P = 0.002), steroid hormone receptor–negative (estrogen receptor, P = 0.031; progesterone receptor, P = 0.022), and to have peritumoral lymphocytes (P = 0.015), confluent necrosis (P = 0.002), and growth in solid sheets (P < 0.001) similar to their colorectal counterparts. No difference in age of onset was noted between the MMR-deficient and MMR-intact groups. Conclusions: MMR deficiency was identified in 51% of breast cancers arising in known mutation carriers. Breast cancer therefore may represent a valid tissue option for the detection of MMR deficiency in which spectrum tumors are lacking
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Double-strand breaks represent an extremely cytolethal form of DNA damage and thus pose a serious threat to the preservation of genetic and epigenetic information. Though it is well-known that double-strand breaks such as those generated by ionising radiation are among the principal causative factors behind mutations, chromosomal aberrations, genetic instability and carcino-genesis, significantly less is known about the epigenetic consequences of double-strand break formation and repair for carcinogenesis. Double-strand break repair is a highly coordinated process that requires the unravelling of the compacted chromatin structure to facilitate repair machinery access and then restoration of the original undamaged chromatin state. Recent experimental findings have pointed to a potential mechanism for double-strand break-induced epigenetic silencing. This review will discuss some of the key epigenetic regulatory processes involved in double-strand break (DSB) repair and how incomplete or incorrect restoration of chromatin structure can leave a DSB-induced epigenetic memory of damage with potentially pathological repercussions
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Purpose: The therapeutic ratio for ionising radiation treatment of tumour is a trade-off between normal tissue side-effects and tumour control. Application of a radioprotector to normal tissue can reduce side-effects. Here we study the effects of a new radioprotector on the cellular response to radiation. Methylproamine is a DNA-binding radioprotector which, on the basis of published pulse radiolysis studies, acts by repair of transient radiation-induced oxidative species on DNA. To substantiate this hypothesis, we studied protection by methylproamine at both clonogenic survival and radiation-induced DNA damage, assessed by γH2AX (histone 2AX phosphorylation at serine 139) focus formation endpoints. Materials and methods: The human keratinocyte cell line FEP1811 was used to study clonogenic survival and yield of γH2AX foci following irradiation (137Cs γ-rays) of cells exposed to various concentrations of methylproamine. Uptake of methylproamine into cell nuclei was measured in parallel. Results: The extent of radioprotection at the clonogenic survival endpoint increased with methylproamine concentration up to a maximum dose modification factor (DMF) of 2.0 at 10 μM. At least 0.1 fmole/nucleus of methylproamine is required to achieve a substantial level of radioprotection (DMF of 1.3) with maximum protection (DMF of 2.0) achieved at 0.23 fmole/nucleus. The γH2AX focus yield per cell nucleus 45 min after irradiation decreased with drug concentration with a DMF of 2.5 at 10 μM. Conclusions: These results are consistent with the hypothesis that radioprotection by methylproamine is mediated by attenuation of the extent of initial DNA damage.
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DNA double-strand breaks (DSBs), which are induced by either endogenous metabolic processes or by exogenous sources, are one of the most critical DNA lesions with respect to survival and preservation of genomic integrity. An early response to the induction of DSBs is phosphorylation of the H2A histone variant, H2AX, at the serine-139 residue, in the highly conserved C-terminal SQEY motif, forming gammaH2AX(1). Following induction of DSBs, H2AX is rapidly phosphorylated by the phosphatidyl-inosito 3-kinase (PIKK) family of proteins, ataxia telangiectasia mutated (ATM), DNA-protein kinase catalytic subunit and ATM and RAD3-related (ATR)(2). Typically, only a few base-pairs (bp) are implicated in a DSB, however, there is significant signal amplification, given the importance of chromatin modifications in DNA damage signalling and repair. Phosphorylation of H2AX mediated predominantly by ATM spreads to adjacent areas of chromatin, affecting approximately 0.03% of total cellular H2AX per DSB(2,3). This corresponds to phosphorylation of approximately 2000 H2AX molecules spanning approximately 2 Mbp regions of chromatin surrounding the site of the DSB and results in the formation of discrete gammaH2AX foci which can be easily visualized and quantitated by immunofluorescence microscopy(2). The loss of gammaH2AX at DSB reflects repair, however, there is some controversy as to what defines complete repair of DSBs; it has been proposed that rejoining of both strands of DNA is adequate however, it has also been suggested that re-instatement of the original chromatin state of compaction is necessary(4-8). The disappearence of gammaH2AX involves at least in part, dephosphorylation by phosphatases, phosphatase 2A and phosphatase 4C(5,6). Further, removal of gammaH2AX by redistribution involving histone exchange with H2A.Z has been implicated(7,8). Importantly, the quantitative analysis of gammaH2AX foci has led to a wide range of applications in medical and nuclear research. Here, we demonstrate the most commonly used immunofluorescence method for evaluation of initial DNA damage by detection and quantitation of gammaH2AX foci in gamma-irradiated adherent human keratinocytes(9)
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An early molecular response to DNA double-strand breaks (DSBs) is phosphorylation of the Ser-139 residue within the terminal SQEY motif of the histone H2AX1,2. This phosphorylation of H2AX is mediated by the phosphatidyl-inosito 3-kinase (PI3K) family of proteins, ataxia telangiectasia mutated (ATM), DNA-protein kinase catalytic subunit and ATM and RAD3-related (ATR)3. The phosphorylated form of H2AX, referred to as γH2AX, spreads to adjacent regions of chromatin from the site of the DSB, forming discrete foci, which are easily visualized by immunofluorecence microscopy3. Analysis and quantitation of γH2AX foci has been widely used to evaluate DSB formation and repair, particularly in response to ionizing radiation and for evaluating the efficacy of various radiation modifying compounds and cytotoxic compounds Given the exquisite specificity and sensitivity of this de novo marker of DSBs, it has provided new insights into the processes of DNA damage and repair in the context of chromatin. For example, in radiation biology the central paradigm is that the nuclear DNA is the critical target with respect to radiation sensitivity. Indeed, the general consensus in the field has largely been to view chromatin as a homogeneous template for DNA damage and repair. However, with the use of γH2AX as molecular marker of DSBs, a disparity in γ-irradiation-induced γH2AX foci formation in euchromatin and heterochromatin has been observed5-7. Recently, we used a panel of antibodies to either mono-, di- or tri- methylated histone H3 at lysine 9 (H3K9me1, H3K9me2, H3K9me3) which are epigenetic imprints of constitutive heterochromatin and transcriptional silencing and lysine 4 (H3K4me1, H3K4me2, H3K4me3), which are tightly correlated actively transcribing euchromatic regions, to investigate the spatial distribution of γH2AX following ionizing radiation8. In accordance with the prevailing ideas regarding chromatin biology, our findings indicated a close correlation between γH2AX formation and active transcription9. Here we demonstrate our immunofluorescence method for detection and quantitation of γH2AX foci in non-adherent cells, with a particular focus on co-localization with other epigenetic markers, image analysis and 3Dmodeling.
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Purpose The majority of cancer patients will receive radiotherapy (RT), therefore, investigations into advances of this modality are important. Conventional RT dose intensities are limited by adverse responses in normal tissues and a primary goal is to ameliorate adverse normal tissue effects. The aim of these experiments is to further our understanding regarding the mechanism of radioprotection by the DNA minor groove binder, methylproamine, in a cellular context at the DNA level. Materials and methods We used immunocytochemical methods to measure the accumulation of phosphorylated H2AX (γH2AX) foci following ionizing radiation (IR) in patient-derived lymphoblastoid cells exposed to methylproamine. Furthermore, we performed pulsed field gel electrophoresis DNA damage and repair assays to directly interrogate the action of methylproamine on DNA in irradiated cells. Results We found that methylproamine-treated cells had fewer γH2AX foci after IR compared to untreated cells. Also, the presence of methylproamine decreased the amount of lower molecular weight DNA entering the gel as shown by the pulsed field gel electrophoresis assay. Conclusions These results suggest that methylproamine acts by preventing the formation of DNA double-strand breaks (dsbs) and support the hypothesis that radioprotection by methylproamine is mediated, at least in part, by decreasing initial DNA damage.