Characteristics and experiences of past participants in the Texas Peer Assistance Program for Nurses

There are nearly 200,000 licensed practicing nurses in the state of Texas, representing one-tenth of the nations' workforce. The prevalence of substance abuse among nurses is estimated to range between six and 20 percent in this professional group.^ Since March 1987, the Texas Peer Assistance Program for Nurses (TPAPN) has offered intervention, education, support and monitoring to nurses in Texas whose practice has become impaired due to substance abuse and/or mental illness. Since then approximately 44 percent of nurses who voluntarily signed participation agreements successfully completed the program; fifty-six percent have not. One determinant of completion for those nurses identified as chemically dependent is abstinence from mood altering substances. Other helping professions report higher rates of abstinence two years following treatment.^ The purpose of this study was to investigate the relationship between relapse, demographics, treatment variables, work setting, "stress" indicators and support factors for nurses who participated in TPAPN. A questionnaire was mailed to 1000 randomly selected nurses who had signed agreements since 1987 and were no longer active in the program. More than 41% of the questionnaires were returned undeliverable.^ Recipients of the questionnaire were known only to TPAPN, never to the investigator. All information was received anonymously except when the participant chose to sign the questionnaire. A cover letter explaining the study and inviting participation was enclosed. Completion and return of the questionnaire was considered consent to participate.^ Findings demonstrated a significant relationship between relapse and opiates as the drug of choice for past participants in the Texas Peer Assistance Program for Nurses. Significant associations were found among factors such as control at work, support, physical complaints, job security, self-esteem and employment in this sample. Respondents shared copious written comments about their experiences in TPAPN. These data were analyzed using qualitative methods and compared with similar studies of recovering nurses. Further research with nurses whose practice has been affected by abuse of chemical and mental illness is warranted. ^

The Protection and Promotion of Cultural Diversity at the International Level

The Convention on the Protection and Promotion of the Diversity of Cultural Expressions, adopted under the auspices of the United Nations Educational, Cultural and Scientific Organization (UNESCO) in 2005, entered into force on 18 March 2007 after an incredibly swift ratification process. The Convention is the culmination of multiple-track efforts that spread over many years with the objective of providing a binding instrument for the protection and promotion of cultural diversity at the international level. These efforts, admirable as they may be, are not however isolated undertakings of goodwill, but a reaction to economic globalisation, whose advancement has been significantly furthered by the emergence of enforceable multilateral trade rules. These very rules, whose bearer is the World Trade Organization (WTO), have been perceived as the antipode to "culture" and have commanded the formulation of counteracting norms that may sufficiently "protect" and "promote" it. Against this backdrop of institutional tension and fragmentation, the present chapter explicates the emergence of the concept of cultural diversity on the international policy- and law-making scene and its legal dimensions given by the new UNESCO Convention. It critically analyses the Convention's provisions, in particular the rights and obligations of the State Parties, and asks whether indeed the UNESCO Convention provides a sufficient and appropriate basis for the protection and promotion of a thriving and diverse cultural environment.

Practices of pediatric oncology and hematology providers regarding fertility issues: A European survey.

BACKGROUND Fertility is impaired in many survivors of childhood cancer following treatment. Preservation of fertility after cancer has become a central survivorship concern. Nevertheless, several doctors, patients, and families do not discuss fertility and recommendations for fertility preservation in pediatrics are still lacking. Recommendations based on scientific evidence are needed and before their development we wanted to assess the practice patterns of fertility preservation in Europe. PROCEDURES On behalf of the PanCare network, we sent a questionnaire to pediatric onco-hematology institutions across Europe. The survey consisted of 21 questions assessing their usual practices around fertility preservation. RESULTS One hundred ninety-eight institutional representatives across Europe received the survey and 68 (response rate 34.3%) responded. Pre-treatment fertility counseling was offered by 64 institutions. Counseling was done by a pediatric onco-hematologist in 52% (33/64) and in 32% (20/64) by a team. The majority of institutions (53%) lacked recommendations for fertility preservation. All 64 centers offered sperm banking; eight offered testicular tissue cryopreservation for pre-pubertal males. For females, the possibility of preserving ovarian tissue was offered by 40 institutions. CONCLUSIONS There is a high level of interest in fertility preservation among European centers responding to our survey. However, while most recommended sperm cryopreservation, many also recommended technologies whose efficacy has not been shown. There is an urgent need for evidence-based European recommendations for fertility preservation to help survivors deal with the stressful topic of fertility. Pediatr Blood Cancer 2014;9999:1-5. © 2014 Wiley Periodicals, Inc.

Novel Prodrug-Like Fusion Toxin with Protease-Sensitive Bioorthogonal PEGylation for Tumor Targeting

Highly potent biotoxins like Pseudomonas exotoxin A (ETA) are attractive payloads for tumor targeting. However, despite replacement of the natural cell-binding domain of ETA by tumor-selective antibodies or alternative binding proteins like designed ankyrin repeat proteins (DARPins) the therapeutic window of such fusion toxins is still limited by target-independent cellular uptake, resulting in toxicity in normal tissues. Furthermore, the strong immunogenicity of the bacterial toxin precludes repeated administration in most patients. Site-specific modification to convert ETA into a prodrug-like toxin which is reactivated specifically in the tumor, and at the same time has a longer circulation half-life and is less immunogenic, is therefore appealing. To engineer a prodrug-like fusion toxin consisting of the anti-EpCAM DARPin Ec1 and a domain I-deleted variant of ETA (ETA″), we used strain-promoted azide alkyne cycloaddition for bioorthogonal conjugation of linear or branched polyethylene glycol (PEG) polymers at defined positions within the toxin moiety. Reversibility of the shielding was provided by a designed peptide linker containing the cleavage site for the rhinovirus 3C model protease. We identified two distinct sites, one within the catalytic domain and one close to the C-terminal KDEL sequence of Ec1-ETA″, simultaneous PEGylation of which resulted in up to 1000-fold lower cytotoxicity in EpCAM-positive tumor cells. Importantly, the potency of the fusion toxin was fully restored by proteolytic unveiling. Upon systemic administration in mice, PEGylated Ec1-ETA″ was much better tolerated than Ec1-ETA″; it showed a longer circulation half-life and an almost 10-fold increased area under the curve (AUC). Our strategy of engineering prodrug-like fusion toxins by bioorthogonal veiling opens new possibilities for targeting tumors with more specificity and efficacy.

Proper paraffin slide storage is crucial for translational research projects involving immunohistochemistry stains.

The use of paraffin slides and tissue microarrays (TMA) is indispensable for translational research. However, storage of paraffin slides over time has a substantial detrimental effect on the quality and reliability of immunohistochemistry stains. Particularly affected by this issue may be any collaborative efforts where paraffin slides or TMAs are shipped to central laboratories and then 'biobanked' for some time until use. This article summarizes some of the key issues affecting loss of antigenicity on paraffin slides and some simple storage solutions to help maintain high quality immunohistochemistry results when paraffin slides must be stored for a certain time prior to use.

A comparative review of water disinfection methods appropriate for developing countries and their efficacy, cost-efficiency, and usability

Developing countries are heavily burdened by limited access to safe drinking water and subsequent water-related diseases. Numerous water treatment interventions combat this public health crisis, encompassing both traditional and less-common methods. Of these, water disinfection serves as an important means to provide safe drinking water. Existing literature discusses a wide range of traditional treatment options and encourages the use of multi-barrier approaches including coagulation-flocculation, filtration, and disinfection. Most sources do not delve into approaches specifically appropriate for developing countries, nor do they exclusively examine water disinfection methods.^ The objective of this review is to focus on an extensive range of chemical, physio-chemical, and physical water disinfection techniques to provide a compilation, description and evaluation of options available. Such an objective provides further understanding and knowledge to better inform water treatment interventions and explores alternate means of water disinfection appropriate for developing countries. Appropriateness for developing countries corresponds to the effectiveness of an available, easy to use disinfection technique at providing safe drinking water at a low cost.^ Among chemical disinfectants, SWS sodium hypochlorite solution is preferred over sodium hypochlorite bleach due to consistent concentrations. Tablet forms are highly recommended chemical disinfectants because they are effective and very easy to use, but also because they are stable. Examples include sodium dichloroisocyanurate, calcium hypochlorite, and chlorine dioxide, which vary in cost depending on location and availability. Among physio-chemical disinfection options, electrolysis which produces mixed oxidants (MIOX) provides a highly effective disinfection option with a higher upfront cost but very low cost over the long term. Among physical disinfection options, solar disinfection (SODIS) applications are effective, but they treat only a fixed volume of water at a time. They come with higher initial costs but very low on-going costs. Additional effective disinfection techniques may be suitable depending on the location, availability and cost.^

Análisis de conceptos básicos de memoria y aprendizaje : ¿Hasta qué punto los "dogmas" cognitivos son realmente "dogmas"?

El aprendizaje como proceso se puede considerar un avance evolutivo importante para todos los sistemas vivientes que lo adquirieron en las tempranas épocas del desarrollo de la vida. La percepción de un entorno que tiene “pasado" y “presente" permitió a los animales primitivos adquirir una visión más completa del mundo que los rodeaba. El uso cognitivo de la información que está disponible en un sistema viviente se le reconoce ahora como “aprendizaje". A pesar que han pasado muchos años y muchos investigadores han estado muy comprometidos en el estudio de la memoria y el aprendizaje, su intrincada naturaleza todavía no se comprende bien. En este trabajo se amplían muchos términos comunes en la investigación de este tema, como memoria, aprendizaje y ensayo redefiniéndose en un contexto más acotado con la intención de uniformar su comprensión. Se vuelve a discutir el modelo de aprendizaje en términos de un “circuito de aprendizaje". También se amplía el concepto unificador de “engrama de la unidad vectorial de la memoria" para el proceso de aprendizaje y el almacenamiento de la información, descrito con anterioridad. Finalmente, las implicaciones del modelo propuesto se consideran en el contexto de patologías que producen déficit de memoria, evaluándose las predicciones del modelo con la evidencia comportamental de pacientes con lesiones localizadas en ciertas partes del cerebro.

El desplazamiento en la teoría de la propiedad de John Locke : del criterio de necesidad a la teoría del valor para justificar la colonización inglesa en América

La teoría de la propiedad de Locke tiene como escenario el estado de naturaleza, cuyo correlato empírico es la colonización inglesa de América. Este es el supuesto que permite articular la apelación a la teología para fundar la propiedad privada de modo unilateral y en cualquier lugar del mundo; el desplazamiento del criterio de necesidad a la teoría del valor para justificarla; así como el supuesto de abundancia que la hace posible sin requerir pacto político ni consenso social. En este sentido, si su teoría de la propiedad resultó esencial para legitimar el liberalismo que moldeó América desde la colonización inglesa y la Constitución norteamericana, el hecho de que América sea el ejemplo para su teórico más temprano y destacado, permite comprender mejor el carácter esencial de la relación entre liberalismo y colonialismo.

Factors that influence the decision to produce exportables in the Chilean agricultural sector

This study analyzes there lative importance of the factors that influence the decision to produce for foreign markets in the Chilean agricultural sector. Using data obtained from personal interviews with 368 farmers, the market/production decision was estimated using a multinomial logit model. Three market/production alternatives were analyzed: production aimed for the external market, production for the internal market but with expectations of being exported, and production targeted only for the internal market. Marginal effects, odds ratios and predicted probabilities were used to identify the relevance of each variable. The results showed that a producer that is male, with a higher educational level, that does not own the land, but rents it, whose farm has irrigation and is located in an area that has a high concentration of exporting producers, will have a high probability of producing exportables. However, the factor that has the highest impact on producing for the external market is the geographic concentration of exporting producers, that is, an export spillover effect. Indeed, when the concentration change from 0 to its maximum (0.26), the odds of producing exportables rather than producing traditional products increases by a factor of 70 (against a factor of 10 in the case of irrigation).

Geochemistry, clay mineralogy and grain size distribution in various sediment cores drilled during ODP Leg 119 on the Antarctic continental shelf off Prydz Bay

Drilling was undertaken at five sites (739-743) on ODP Leg 119 on a transect across the continental shelf of Prydz Bay, East Antarctica, to elucidate the long-term glacial history of the area and to examine the importance of the area with respect to the development of the East Antarctic ice sheet as a whole. In addition to providing a record of glaciation spanning 36 m.y. or more, Leg 119 has provided information concerning the development of a continental margin under the prolonged influence of a major ice sheet. This has allowed the development of a sedimentary model that may be applicable not only to other parts of the Antarctic continental margin, but also to northern high-latitude continental shelves. The cored glacial sedimentary record in Prydz Bay consists of three major sequences, dominated by diamictite: 1. An upper flat-lying sequence that ranges in thickness from a few meters in inner and western Prydz Bay to nearly 250 m in the outer or eastern parts of the bay. The uppermost few meters consist of Holocene diatom ooze and diatomaceous mud with a minor ice-rafted component overlying diamicton and diamictite of late Miocene to Quaternary age. The diamictite is mainly massive, but stratified varieties and minor mudstone and diatomite also occur. 2. An upper prograding sequence cored at Sites 739 and 743, unconformly below the flat-lying sequence. This consists of a relatively steep (4° inclination) prograding wedge with a number of discrete sedimentary packages. At Sites 739 and 743 the sequence is dominated by massive and stratified diamictite, some of which shows evidence of slumping and minor debris flowage. 3. A lower, more gently inclined, prograding sequence lies unconformably below the flat-lying sequence at Site 742 and the upper prograding sequence at Site 739. This extends to the base of both sites, to 316 and 487 mbsf, respectively. It is dominated by massive, relatively clast-poor diamictite which is kaolinite-rich, light in color, and contains sporadic carbonate-cemented layers. The lower part of Site 742 includes well-stratified diamictites and very poorly sorted mudstones. The base of this site has indications of large-scale soft-sediment deformation and probably represents proximity to the base of the glacial sequence. Facies analysis of the Prydz Bay glacial sequence indicates a range of depositional environments. Massive diamictite is interpreted largely as waterlain till, deposited close to the grounding line of a floating glacier margin, although basal till and debris flow facies are also present. Weakly stratified diamictite is interpreted as having formed close to or under the floating ice margin and influenced by the input of marine diatomaceous sediment (proximal glaciomarine setting). Well-stratified diamictite has a stronger marine input, being more diatom-rich, and probably represents a proximal-distal glaciomarine sediment with the glaciogenic component being supplied by icebergs. Other facies include a variety of mudstones and diatom-rich sediments of marine origin, in which an ice-rafted component is still significant. None of the recovered sediments are devoid of a glacial influence. The overall depositional setting of the prograding sequence is one in which the grounded ice margin is situated close to the shelf edge. Progradation was achieved primarily by deposition of waterlain till. The flat-lying sequence illustrates a complex sequence of advances and retreats across the outer part of the shelf, with intermittent phases of ice loading and erosion. The glacial chronology is based largely on diatom stratigraphy, which has limited resolution. It appears that ice reached the paleoshelf break by earliest Oligocene, suggesting full-scale development of the East Antarctic ice sheet by that time. The ice sheet probably dominated the continental margin for much of Oligocene to middle Miocene time. Retreat, but not total withdrawal of the ice sheet, took place in late Miocene to mid-Pliocene time. The late Pliocene to Pleistocene was characterized by further advances across, and progradation of, the continental shelf. Holocene time has been characterized by reduced glacial conditions and a limited influence of glacial processes on sedimentation.

Calcareous nannofossils of ODP Hole 123-765C and DSDP Hole 27-261

Sediments from the Argo Abyssal Plain (AAP), northwest of Australia, are the oldest known from the Indian Ocean and were recovered from ODP Site 765 and DSDP Site 261. New biostratigraphic and sedimentologic data from these sites, as well as reinterpretations of earlier findings, indicate that basal sediments at both localities are of Late Jurassic age and delineate a history of starved sedimentation punctuated by periodic influx of calcareous pelagic turbidites. Biostratigraphy and correlation of Upper Jurassic-Lower Cretaceous sediments is based largely on calcareous nannofossils. Both sites yielded variably preserved nannofossil successions ranging from Tithonian to Hauterivian at Site 765 and Kimmeridgian to Hauterivian at Site 261. The nannofloras are comparable to those present in the European and Atlantic Boreal and Tethyan areas, but display important differences that reflect biogeographic differentiation. The Argo region is thought to have occupied a position at the southern limit of the Tethyan nannofloral realm, thus yielding both Tethyan and Austral biogeographic features. Sedimentary successions at the two sites are grossly similar, and differences largely reflect Site 765's greater proximity to the continental margin. Jurassic sediments were deposited at rates of about 2 m/m.y. near the carbonate compensation depth (CCD) and contain winnowed concentrations of inoceramid prisms and nannofossils, redeposited layers rich in calcispheres and calcisphere debris, manganese nodules, and volcanic detritus. Lower Cretaceous and all younger sediments accumulated below the CCD at rates that were highest (about 20 m/m.y.) during mid-Cretaceous and Neogene time. Background sediment in this interval is noncalcareous claystone; turbidites dominate the sequence and are thicker and coarser grained at Site 765. AAP turbidites consist mostly of calcareous and siliceous biogenic components and volcanogenic smectite clay; they were derived from relatively deep parts of the continental margin that lay below the photic zone, but above the CCD. The Jurassic-Lower Cretaceous section is about the same thickness across the AAP; turbidites in this interval appear to have had multiple sources along the Australian margin. The Upper Cretaceous-Cenozoic section, however, is three times thicker at Site 765 than at Site 261; turbidites in this interval were derived predominantly from the south. Patterns of sedimentation across the AAP have been influenced by shifts in sea level, the CCD, and configuration of the continental margin. Major pulses of calcareous turbidite deposition occurred during Valanginian, Aptian, and Neogene time-all periods of eustatic lowstands and depressed CCD levels. Sediment redeposited on the AAP has come largely from the Australian outer shelf, continental slope, or rise, rather than the continent itself. Most terrigenous detritus was trapped in epicontinental basins that have flanked northwestern Australia since the early Mesozoic.

Teoría política posfundacional en La guerra del fin del mundo de Mario Vargas Llosa : ¿Canudos postestructuralista?

La relación entre teoría política y literatura quizás no pueda contarse entre las más fecundas si se la compara con el vínculo que han establecido disciplinas como la filosofía, la historia y la psicología. Si bien la política ha ocupado un lugar central en la literatura es difícil sostener que la teoría política haya obtenido un sitio destacado. Una notable excepción encontramos en la novela La guerra del fin del mundo de Mario Vargas Llosa, no porque el autor se dedique a la teoría política, sino por la complicidad de la trama de la novela con ciertas perspectivas teóricas contemporáneas. En este horizonte, el artículo tiene como objetivo realizar una lectura de La guerra del fin del mundo y sugerir su relación con categorías centrales de la teoría política de inspiración posfundacional como Heterogeneidad, Antagonismo, exterior constitutivo, significante vacío, discurso y hegemonía. El trabajo que presentamos, de este modo, pretende aportar a la discusión de ciertas categorías teórico políticas que muchas veces por su grado de abstracción han suscitado dificultades pero también ofrecer claves de lectura de esta novela desde la teoría política actual

Concentración económica en la región pampeana : El caso de los fideicomisos financieros

Durante la última década del siglo XX, la producción agropecuaria de la región pampeana ve reforzada su tendencia a la concentración económica, reduciéndose de forma muy significativa el número de EAPs. Si bien no existen relevamientos censales que den cuenta de lo ocurrido tras la crisis de 2001-2002, numerosos indicios señalan que este proceso continúa en la actualidad. Aparecen como protagonistas del mismo grandes capitales arrendatarios que logran, al tomar superficies lo suficientemente amplias, obtener economías de escala que les permiten desplazar a rivales menores merced a su posibilidad de ofrecer arriendos superiores. En este artículo se ofrecen los resultados de una investigación sobre una de las formas jurídicas que adopta este proceso: la constitución de Fideicomisos Financieros. Esta ha sido una herramienta financiera de muy alto crecimiento desde 2004, y parcialmente se ha volcado al sector agrario. Luego de compilar la información sobre la totalidad de FF colocados en el período 2004-2008, se procedió a tipificarlos, con especial atención en aquellos que financiaron al agro. Se estimó así el peso que han tenido en su capitalización, y se analizan las estrategias y características productivas de aquellos que tienen por objeto la siembra en campos de terceros, lo que permite aportar cifras concretas sobre la base microeconómica de la concentración económica en este sector

Eros y cultura

Es un lugar común la casi inexistente contribución de España a Ia literatura de corte erótico. Esta cuestión se relaciona, al mismo tiempo, con Ia consideración acerca de qué se considera "pornográfico". Aquí es necesario tener en cuenta, empero, en qué medida lo pornográfico implica la mirada del sujeto que lo percibe como tal. La arqueología, por su parte, ha venido dando pruebas de los cambios en la recepción de Ia iconografía antigua; y de este modo ha venido a echar cierta luz sobre la consideración de lo erótico en la misma España, donde la tabuización de Ia sexualidad por el poder eclesiástico ha acorralado lo erótico a un consumo masivo y trivial.

Producción y rentabilidad en la ganadería argentina. 1980-2006

El presente trabajo tiene como objetivo principal estudiar y analizar la producción y rentabilidad de la ganadería argentina. El trabajo intentará explorar si los vaivenes de la actividad se encuentran atados a la evolución de la economía en su conjunto, y del sector agropecuario en particular; o si por el contrario, se trata de un sector cuya senda ha logrado independizarse del resto de las actividades. En arreglo a lo dicho, se buscará dar cuenta del impacto de las políticas económicas y los cambios tecnológicos sobre la producción y rentabilidad del sector, prestando especial atención a cuestiones estructurales de la actividad como son la productividad, cantidad, localización y concentración del stock vacuno. Asimismo, y en relación a esta última variable, estudiaremos su incidencia sobre los pequeños, medianos y grandes productores. Para llevar a cabo dicho estudio, se analizará con especial atención lo acontecido a partir de 2002, intentando rescatar las rupturas y continuidades que supuso el abandono de la convertibilidad.