When do we dare to stop biological or immunomodulatory therapy for Crohn's disease? Results of a multidisciplinary European expert panel.

BACKGROUND: Safety and economic issues have increasingly raised concerns about the long term use of immunomodulators or biologics as maintenance therapies for Crohn's disease (CD). Despite emerging evidence suggesting that stopping therapy might be an option for low risk patients, criteria identifying target groups for this strategy are missing, and there is a lack of recommendations regarding this question. METHODS: Multidisciplinary European expert panel (EPACT-II Update) rated the appropriateness of stopping therapy in CD patients in remission. We used the RAND/UCLA Appropriateness Method, and included the following variables: presence of clinical and/or endoscopic remission, CRP level, fecal calprotectin level, prior surgery for CD, and duration of remission (1, 2 or 4 years). RESULTS: Before considering withdrawing therapy, the prerequisites of a C-reactive protein (CRP) and fecal calprotectin measurement were rated as "appropriate" by the panellists, whereas a radiological evaluation was considered as being of "uncertain" appropriateness. Ileo-colonoscopy was considered appropriate 1 year after surgery or after 4 years in the absence of prior surgery. Stopping azathioprine, 6-mercaptopurine or methotrexate mono-therapy was judged appropriate after 4 years of clinical remission. Withdrawing anti-TNF mono-therapy was judged appropriate after 2 years in case of clinical and endoscopic remission, and after 4 years of clinical remission. In case of combined therapy, anti-TNF withdrawal, while continuing the immunomodulator, was considered appropriate after two years of clinical remission. CONCLUSION: A multidisciplinary European expert panel proposed for the first time treatment stopping rules for patients in clinical and/or endoscopic remission, with normal CRP and fecal calprotectin levels.

Dare to be different : a celebration of freedom in association with Amnesty International.

Los poemas y relatos de esta antología ponen de manifiesto que los principios justicia, libertad, igualdad, entre todas las personas, inspirándose en la labor de Amnistía Internacional, deben aplicarse en nuestra vida cotidiana y no sólo en la política, si queremos un mundo mejor.

Dare voce agli invisibili: Il teatro di Beppe Rosso

The article – which is co-authored with Irene Zagrebelsky – focuses on the work of the Italian playwright and actor Beppe Rosso, and it is the most detailed critical account on Rosso’s production so far. Based on original material and interviews, it not only analyses Rosso’s widely acclaimed “Trilogy of invisibility” in the light of recent political events in Italy, but it also – in its first two sections – introduces the so called “teatro di narrazione” to Italian scholars in the UK, and in its two last sections opens up new perspectives on the relationship between contemporary theatre, citizenship and political participation.

The theme that dare not speak its name: Geopolitik, geopolitics and German foreign policy since unification

The purpose of this chapter is to trace the emergence of a new security imaginary in the foreign policy discourse in Germany during the 1990s and to determine whether it constitutes a return of Geopolitik in German foreign policy making. Does the re- appearance of geopolitical terms and expressions in the official and the academic discourses in post-unification Germany indicate such a shift? The essay will argue that the claims about a return of Geopolitik cannot be sustained. To the extent that the rhetoric of German government officials changes during the 1990s, this does not produce a coherent geopolitical security imaginary that stands diametrically opposed to the definition of political and institutional spaces of the Bonner Republik.

"Dare to share!" : Bikt, moderskap och motstånd i Den stora mammabikten

”Dare to share!”: Confession, motherhood and resistance in The great mother confession This article explore the meaning of confession in a commercial, secular event – The great mother confession (TGM). The event is understood as imbedded in a therapeutic culture where emotional disclosure, in the form of confessions, is a highly valued practice. In a web-based confession-blog that constitutes part of the TGM-concept, confessions serve to free mothers from supressing norms. The blog becomes an arena for a volatile community where burdening and ”forbidden” thoughts and emotions becomes generalised and disarmed, releasing mothers from guilt. When this function of the blog is questioned from a competing sub-discourse of the therapeutic, emphasising the disclosure of happiness, a struggle emerges over the authority to define the meanings of confession. TGM can be understood as having potential for serving as an arena for challenging norms, but even as norms are implicitly addressed the practice makes a halt at that point. Norms that are seemingly dissolved in responses to confessions are not questioned, only recognised, normalised and de-politicised.

Marine resource facility, Dare County : environmental impact statement.

F available only in microfiche

Dare de seamă : aspura activității desfășurate de Comitetul Central de Acțiune în peroada dela 9 Decembrie 1916-31 Martie 1917 /

Mode of access: Internet.

Macleod of Dare /

Mode of access: Internet.

Dare ni mo wakaru koyomi no hanashi : tsuketari Saikin sanbyaku yonen kyūshinreki taishōhyō /

3rd printing.

Macleod of Dare.

Mode of access: Internet.