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““Why shouldn’t I expect things from life?” – what people with lived experience from psychosis highlight as important to their personally defined long-term recovery process”
- G. Åsbø, H. Haavind, S. Hembre Kruse, K. Fjelnseth Wold, W. Ten Velden Hegelstad, K. Lie Romm, T. Ueland, I. Melle, C. Simonsen
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S117
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Introduction
Many people with lived experience from psychosis recover and thrive, contrary to the common stigmatizing belief that they will be chronic “patients”. But there are several ways to understand recovery, one is as a subjective process best explored through qualitative interviews with people who have recovered from psychosis. However, there is a need for more qualitative interview studies exploring what has been important for long-term subjective recovery for people with lived experience from psychosis outside of treatment. Exploring themes that are novel than previous research will have important clinical implications.
ObjectivesThis study aims to qualitatively explore what people with lived experience from psychosis believe has been the most important to attain and sustain their long-term personally defined recovery.
MethodsQualitative interviews with 20 individuals participating in two follow-up-studies (TOP and TIPS-study) 10 and years 20 years after first treatment for a psychotic disorder (schizophrenia- or bipolar spectrum), respectively. All participants were in either clinical recovery (symptom remission and adequate functioning) or personal recovery (self-rated questionnaire) or both. Interviews were analyzed with thematic analysis in group meetings between the PhD-candidate, the main supervisor, a professor emerita in qualitative method and a co-researcher with lived experience from bipolar disorder.
ResultsParticipants defined recovery differently, but: “understanding myself”, “stable symptoms” and “finding the life that is right for you” were of the most common definitions. Tentatively, five main themes appear to be the most salient contributions to recovery: 1. Balance stress management with taking risks and following personal goals. 2. Accepting experience/”owning your story” in order to strategically disclose and manage stigma. 3. Taking agency over own recovery and mastery of everyday life. 4. Social support is crucial, but should change over time depending on need. 5. Feeling a sense of belonging to society does not need to entail “normality”.
ConclusionsRecovery was defined differently by each participant, but common themes across participants highlight that appropriate risk-taking, accepting your experience/owning your story, sense of agency, social support and inclusion are important to long-term recovery in psychosis.
Disclosure of InterestNone Declared
Identifying early signs of Treatment Resistance in First Episode Psychosis to revise and aid further treatment
- K. F. Wold, C. B. Flaaten, G. Åsbø, L. Widing, I. Melle
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S444-S445
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Introduction
Approximately 1/3 of patients with first episode psychosis (FEP) will not benefit from antipsychotic medications and are considered treatment resistant (TR). TR is currently defined as sustained lack of remission with functional loss in the context of two adequate trials of different antipsychotics. Studies suggest that early initiation of clozapine treatment support a better course of illness in TR. Most treatment guidelines recommend clozapine after two antipsychotic failures. In practice, increased dosages of other antipsychotics or polypharmacy are tried out first. Identifying early signs of TR and revising treatment is thus important. Since the TR definition requires adequate lengths of treatment attempts, they are difficult to apply in FEP.
ObjectivesThe aim of the current study is to 1) investigate if a shorter observation period can be used to identify subgroups of FEP patients with early signs of TR (no indication of early clinical recovery - NoECR) and 2) investigate differences in antipsychotic treatments over the first year compared to patients in full or partial early recovery (ECR/ partial ECR).
MethodsParticipants 18 to 65 years in their first year of treatment were recruited from major hospitals in Oslo. The participants met the DSM-IV criteria for schizophrenia, schizophreniform disorder, schizoaffective disorder, and psychotic disorder NOS. A total of 387 completed baseline clinical assessments and 207 one-year follow-up. The SCID-I for DSM-IV was used for diagnosis, symptoms were measured with the SCI-PANSS. Treatment history was gathered through interviews and medical charts. No-ECR was defined as a) Not meeting remission criteria for at least 12 weeks at follow-up, and b) Not regained functioning, i.e., a GFS score < 60. ECR was defined as a) Meeting the criteria for remission and b) Regained functioning, i.e., a GFS score >=61. Partial ECR did not meet these criteria.
ResultsAt one year follow-up, 47% met the criteria for no-ECR, 29% the criteria for ECR and 24% the criteria for partial ECR. Baseline predictors of the no-ECR group corresponded to previously identified predictors of long-term TR. Only 35 (17%) participants met the full criteria for TR at this point. Of the 97 in the no-ECR group, 18 (19%) were in an ongoing trial (p<0.001 vs ECR/partial ECR) and 21 (22%) were using the same medication over the whole follow-up year (p =.008 vs ECR /partial ECR) despite lack of significant clinical effect.
ConclusionsWe show that the mostly used consensus definition of TR identifies only a proportion of FEP patients without sufficient clinical and functional improvement at one year follow-up. The main reason for not meeting the criteria is a lack of two adequate antipsychotic trials at this point of time. However, only half of these were in an ongoing trial despite recommendations in clinical guidelines.
Disclosure of InterestNone Declared
The relationship between visual hallucinations, functioning and suicidality over the course of illness: a 10-year follow-up study in first-episode psychosis
- I. Kreis, K. Fjelnseth Wold, G. Åsbø, C. Simonsen, I. Melle
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S441
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Introduction
Visual hallucinations are a common symptom across psychotic disorders and have been linked to illness severity, impaired functioning, and increased suicide risk. However, little is known about the stability of this relationship over the long-term course of illness.
ObjectivesThis study aims to assess whether the presence of visual hallucinations is associated with illness severity, functioning and suicidality, early and late in the course of illness. It further explores the potential role of childhood trauma in this context, which has been linked to both visual hallucinations and suicidality.
MethodsA sample of 185 individuals with first-episode psychosis was assessed with structured clinical interviews and self-report questionnaires at time of study inclusion and at 10-year follow-up. Those with lifetime experience of visual hallucinations at inclusion (VH+/+) as well as those where visual hallucinations first developed during the follow-up period (VH-/+) were compared to a group without such experiences (VH-/-). To this end, multinomial logistic regression models were applied, with a range of clinical and demographic variables as predictors.
ResultsAt time of inclusion, the VH+/+ group had significantly higher symptom severity scores, lower functioning scores, and were more likely to have a history of multiple suicide attempts. There were no such differences between the VH-/+ and the VH-/- group. At follow-up, this pattern of findings partially reversed. Here, only the VH-/+ group differed from the VH-/- group in terms of higher symptom severity scores and lower functioning scores. However, the VH+/+ group was still more likely to report multiple suicide attempts during the follow-up period, whereas VH-/+ did not differ from VH-/-. Notably, childhood trauma scores did not differ between groups.
ConclusionsIn line with previous studies, these findings point to an association between visual hallucinations and illness severity, functioning and suicidality. However, this association seems to change over the course of illness. Together, this highlights the relevance of assessing visual hallucinations in the clinical setting and monitoring their development over time.
Disclosure of InterestNone Declared
P.104 Grade 3 meningioma survival, recurrence and functional outcomes in an international multicenter cohort
- AD Rebchuk, K Tosefsky, JZ Wang, Y Ellenbogen, R Drexler, FL Ricklefs, T Sauvigny, U Schüller, C Cutler, B Lucke-Wold, Y Mehkri, S Lama, G Sutherland, M Karsy, BL Hoh, M Westphal, G Zadeh, S Yip, S Makarenko
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- Canadian Journal of Neurological Sciences / Volume 50 / Issue s2 / June 2023
- Published online by Cambridge University Press:
- 05 June 2023, p. S85
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Background: Meningiomas are the most common intracranial tumor, graded from 1 (benign) to 3 (malignant). The aim of this study was to identify clinical features associated with overall survival (OS), progression-free survival (PFS) and functional status for malignant meningiomas. Methods: Demographic, clinical and histopathological data from grade 3 intracranial meningioma cases were identified in the clinical databases from seven sites in North America and Europe from 1991-2022. Summary statistics and Kaplan-Meier OS and PFS curves were generated. Results: We identified 108 patients, with a median age 65 years (IQR: 52, 72) and 53.7% were female. Median OS was 109 months (95% CIs: 88, 227), and 5-year OS rate was 65% (95% CIs: 56, 76). Median PFS was 38 months (95% CIs: 24, 56) and 5-year PFS rate was 37% (95% CIs: 28, 49). OS and PFS were significantly lower in patients aged ≥65 years. Median preoperative KPS score was 80 (IQR: 70, 90), postoperatively KPS was 90 (IQR: 70, 98) and 1-year follow-up KPS was 70 (IQR: 50, 80). Conclusions: This study provides robust survival, recurrence and functional data for grade 3 meningiomas in North America and Europe over a 30-year period.
Subglacial Constructions and Investigations At Bondhusbreen, Norway
- B. Wold, G. Østrem
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- Journal of Glaciology / Volume 23 / Issue 89 / 1979
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- 30 January 2017, pp. 363-379
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For the construction of a hydro-electric power station in western Norway, a diversion tunnel was made to collect subglacial melt water under an outlet glacier from the Folgefonni ice cap. Many investigations were carried out by glaciologists and engineers before the project could begin, and several unexpected problems arose during the completion of the project. This paper deals with some of the problems and how they were solved.
To avoid coarse glacier-carried material from being flushed into the water-collecting tunnel system, a large sedimentation chamber was constructed in the bedrock under the glacier. The dimensions of this huge chamber were decided from sediment-transport studies in the glacier stream and from studies of old bottom deposits in a lake close to the glacier front.
Ice-velocity measurements were made on the glacier surface and similar studies were attempted in sub-glacial ice caves made by spraying hot water near the glacier bed, where the ice is 170 m thick.
The subglacial water-drainage system was studied from a horizontal tunnel constructed in the bedrock under the glacier. Some preliminary conclusions are drawn from these studies.
In future, it will still be possible to undertake subglacial studies because inspection tunnels have been left in the bedrock, and the accessibility is relatively good.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. Douglas Meeks, Monica Jyotsna Melanchthon, Ilie Melniciuc-Puica, Everett Mendoza, Raymond A. Mentzer, William W. Menzies, Ina Merdjanova, Franziska Metzger, Constant J. Mews, Marvin Meyer, Carol Meyers, Vasile Mihoc, Gunner Bjerg Mikkelsen, Maria Inêz de Castro Millen, Clyde Lee Miller, Bonnie J. Miller-McLemore, Alexander Mirkovic, Paul Misner, Nozomu Miyahira, R. W. L. Moberly, Gerald Moede, Aloo Osotsi Mojola, Sunanda Mongia, Rebeca Montemayor, James Moore, Roger E. Moore, Craig E. Morrison O.Carm, Jeffry H. Morrison, Keith Morrison, Wilson J. Moses, Tefetso Henry Mothibe, Mokgethi Motlhabi, Fulata Moyo, Henry Mugabe, Jesse Ndwiga Kanyua Mugambi, Peggy Mulambya-Kabonde, Robert Bruce Mullin, Pamela Mullins Reaves, Saskia Murk Jansen, Heleen L. Murre-Van den Berg, Augustine Musopole, Isaac M. T. Mwase, Philomena Mwaura, Cecilia Nahnfeldt, Anne Nasimiyu Wasike, Carmiña Navia Velasco, Thulani Ndlazi, Alexander Negrov, James B. Nelson, David G. Newcombe, Carol Newsom, Helen J. Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. Stewart, Cynthia Stokes Brown, Ken Stone, Anne Stott, Elizabeth Stuart, Monya Stubbs, Marjorie Hewitt Suchocki, David Kwang-sun Suh, Scott W. Sunquist, Keith Suter, Douglas Sweeney, Charles H. Talbert, Shawqi N. Talia, Elsa Tamez, Joseph B. Tamney, Jonathan Y. Tan, Yak-Hwee Tan, Kathryn Tanner, Feiya Tao, Elizabeth S. Tapia, Aquiline Tarimo, Claire Taylor, Mark Lewis Taylor, Bishop Abba Samuel Wolde Tekestebirhan, Eugene TeSelle, M. Thomas Thangaraj, David R. Thomas, Andrew Thornley, Scott Thumma, Marcelo Timotheo da Costa, George E. “Tink” Tinker, Ola Tjørhom, Karen Jo Torjesen, Iain R. Torrance, Fernando Torres-Londoño, Archbishop Demetrios [Trakatellis], Marit Trelstad, Christine Trevett, Phyllis Trible, Johannes Tromp, Paul Turner, Robert G. Tuttle, Archbishop Desmond Tutu, Peter Tyler, Anders Tyrberg, Justin Ukpong, Javier Ulloa, Camillus Umoh, Kristi Upson-Saia, Martina Urban, Monica Uribe, Elochukwu Eugene Uzukwu, Richard Vaggione, Gabriel Vahanian, Paul Valliere, T. J. Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- Book:
- The Cambridge Dictionary of Christianity
- Published online:
- 05 August 2012
- Print publication:
- 20 September 2010, pp xi-xliv
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Innovation in Basic Science: Stem Cells and their role in the treatment of Paediatric Cardiac Failure – Opportunities and Challenges
- Sunjay Kaushal, Jeffrey Phillip Jacobs, Jeffrey G. Gossett, Ann Steele, Peter Steele, Craig R. Davis, Elfriede Pahl, Kalpana Vijayan, Alfred Asante-Korang, Robert J. Boucek, Carl L. Backer, Loren E. Wold
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- Journal:
- Cardiology in the Young / Volume 19 / Issue S2 / November 2009
- Published online by Cambridge University Press:
- 01 November 2009, pp. 74-84
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Heart failure is a leading cause of death worldwide. Current therapies only delay progression of the cardiac disease or replace the diseased heart with cardiac transplantation. Stem cells represent a recently discovered novel approach to the treatment of cardiac failure that may facilitate the replacement of diseased cardiac tissue and subsequently lead to improved cardiac function and cardiac regeneration.
A stem cell is defined as a cell with the properties of being clonogenic, self-renewing, and multipotent. In response to intercellular signalling or environmental stimuli, stem cells differentiate into cells derived from any of the three primary germ layers: ectoderm, endoderm, and mesoderm, a powerful advantage for regenerative therapies. Meanwhile, a cardiac progenitor cell is a multipotent cell that can differentiate into cells of any of the cardiac lineages, including endothelial cells and cardiomyocytes.
Stem cells can be classified into three categories: (1) adult stem cells, (2) embryonic stem cells, and (3) induced pluripotential cells. Adult stem cells have been identified in numerous organs and tissues in adults, including bone-marrow, skeletal muscle, adipose tissue, and, as was recently discovered, the heart. Embryonic stem cells are derived from the inner cell mass of the blastocyst stage of the developing embryo. Finally through transcriptional reprogramming, somatic cells, such as fibroblasts, can be converted into induced pluripotential cells that resemble embryonic stem cells.
Four classes of stem cells that may lead to cardiac regeneration are: (1) Embryonic stem cells, (2) Bone Marrow derived stem cells, (3) Skeletal myoblasts, and (4) Cardiac stem cells and cardiac progenitor cells. Embryonic stem cells are problematic because of several reasons: (1) the formation of teratomas, (2) potential immunologic cellular rejection, (3) low efficiency of their differentiation into cardiomyocytes, typically 1% in culture, and (4) ethical and political issues. As of now, bone marrow derived stem cells have not been proven to differentiate reproducibly and reliably into cardiomyocytes. Skeletal myoblasts have created in vivo myotubes but have not electrically integrated with the myocardium. Cardiac stem cells and cardiac progenitor cells represent one of the most promising types of cellular therapy for children with cardiac failure.
Effect of draught force and diet on dry-matter intake, milk production and live-weight change in non-pregnant and pregnant cows
- E. Zerbini, A. G. Wold, D. Demissie
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- Journal:
- Animal Science / Volume 62 / Issue 2 / April 1996
- Published online by Cambridge University Press:
- 02 September 2010, pp. 225-231
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- April 1996
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Eighteen F1 crossbred dairy cows (Friesian × Boran and Simmental × Boran) were allocated to one of three diet groups (H: natural pasture hay; H+3: natural pasture hay + 3 kg concentrate; and H+5: natural pasture hay + 5 kg concentrate) using a stratified random sampling procedure, with parity, milk production genotype, body weight and body condition score as blocking variables. Cows on each diet were then allocated to three draught forces (7, 11 and 15 kg draught force per 100 kg live weight) in a cross-over design to investigate relationships between work output, live-weight changes, dry-matter intake (DMI) and milk yield. Each cow worked for 36 days in early lactation (from calving to 90 days) and for a further 36 days in late lactation (from 250 to 340 days post partum). Work output was similar for cows on each of the three diets. Cows on the H diet consumed more hay than cows on H+3 and H−5 diets. Hay and total DMI, milk yield and milk fat were similar across draught forces and during working and resting days when the cows were not pregnant. Similar results were obtained when cows were from 82 to 172 days pregnant. Pregnancy did not affect the ability of cows to perform work at different intensities. During working days cows lost live weight both when pregnant and when non-pregnant. During rest days, non-pregnant cows on diets H, H+3 and H+5 compensated proportionately 0·12, 0·59 and 0·59, respectively, of the live weight lost during working days. Pregnant cows on diet H+3 and H+5 compensated proportionately 0·95 and 1·77 live weight, respectively. Lower total live-weight losses during the pregnant period could be attributed partly to relatively greater DMIs and lower milk production, but also to gestation. Prediction of live-weight change from total DMI above maintenance, milk yield and work output during periods of 6 working days was poor (R2 = 0·18). However, the same parameters explained adequately changes in live weight for supplemented and non-supplemented working cows (R2 = 0·38 and 0·79, respectively) during a period of 90 days.
Effect of dietary repletion on reproductive activity in cows after a long anoestrous period
- E. Zerbini, A. G. Wold, T. Gemeda
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- Journal:
- Animal Science / Volume 62 / Issue 2 / April 1996
- Published online by Cambridge University Press:
- 02 September 2010, pp. 217-223
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- April 1996
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This study examined whether a prolonged anoestrus had any long-term effect on subsequent fertility of cows and estimated the relationship between repletion and resumption of reproductive activity. Twelve low body-condition, non-milking, non-cycling (depletion state) F1 crossbred dairy cows (Friesian × Boron and Simmental × Boran) were stratified to two diets (H: natural grass hay offered ad libitum and mineral lick +3 kg concentrate, and H + P: H + 7 h/day natural pasture grazing) according to parity, body weight, body condition score and calving intervals. Daily dry-matter intake was similar between cows on the two diets, but total intake of nitrogen was proportionately about 0·10 greater for cows with access to pasture. The calculated metabolizable energy intake was more than twice the estimated maintenance requirement for cows on both diets. Live weights increased from depletion to ovulation, to oestrus and to conception, but were not significantly different between cows on both diets. Body condition score increased from depletion time to first oestrus and to repletion and was greater for H + P than for H cows at first oestrus and at conception. After an average of 45 days of repletion, cows were already ovulating with no significant differences between cows on either diet. Days to onset of oestrus were 83 and 44 days for diet H and H + P, respectively. Time to conception was similar between coivs on both diets. Conception occurred when cows on H and H + P diets had recovered proportionately 0·51 and 0·58 of their live-weight and 0·84 and 1·27 of their body condition loss, respectively. Interval to repletion weight was 178 and 139 days for cows on the H and H + P diet, respectively. Cows subjected to an exceptionally long depletion period were able to resume ovarian cyclic activity and to conceive in less than 3 months when given twice maintenance requirements. These results have important management implication for on-farm situations in the tropics where fluctuations of food availability and quality occur.
Effect of draught work on performance and metabolism of crossbred cows 1. Effect of work and diet on body-weight change, body condition, lactation and productivity
- T. Gemeda, E. Zerbini, A. G. Wold, D. Demissie
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- Journal:
- Animal Science / Volume 60 / Issue 3 / June 1995
- Published online by Cambridge University Press:
- 02 September 2010, pp. 361-367
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- June 1995
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Forty pregnant F1 crossbred dairy cows (20 Friesian × Boran and 20 Simmental × Boran) were stratified in a 2 × 2 diet × work factorial experiment (not working-not supplemented, NWNS; not working-supplemented, NWS; working-not supplemented, WNS; and working-supplemented, WS). Working cows pulled sledges 100 days/year (pull = 350 to 450 N, 4 h/day, 4 days/week). Work output of supplemented and non-supplemented cows was similar over 1 and 2 years. Over all 3 years, dry-matter intake relative to metabolic body size (g/kg M0.75 was greater for working, compared with non-working cows. Body-weight changes and body condition score were similar for working and non-working cows. Non-supplemented cows lost weight throughout the first 2-year period, while supplemented cows tended to maintain or gain body weight over 1 and 3 years. Over 2 years, supplementation of working cows proportionately reduced live-weight loss by 0.73 and doubled the number of conceptions and parturitions. Days in milk, milk, milk fat and protein yields were similar for working and non-working cows, but were greater for supplemented, compared with non-supplemented, cows. Total conceptions and calves born in all 3 years tended to be greater for supplemented and non-working compared with non-supplemented and working cows. A productivity index (PI) that took into account food intake was calculated. The PI for supplemented cows over 2 years was greater than that for non-supplemented cows. Meanwhile the PI was similar for working and non-working cows over all periods considered. A similar PI for working and non-working cows under supplementation indicates potential of on-farm adoption of a cow traction technology that includes improved food production and ng strategies.
Effect of draught work on performance and metabolism of crossbred cows 2. Effect of work on roughage intake, digestion, digesta kinetics and plasma metabolites
- E. Zerbini, T. Gemeda, A. G. Wold, S. Nokoe, D. Demissie
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- Journal:
- Animal Science / Volume 60 / Issue 3 / June 1995
- Published online by Cambridge University Press:
- 02 September 2010, pp. 369-378
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- June 1995
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Forty pregnant F1 crossbred dairy cows (20 Friesian × Boran and 20 Simmental × Boran) were stratified in a 2 × 2 diet × work factorial arrangement (not working-not supplemented, NWNS; not working-supplemented, NWS; working-not supplemented, WNS; and working-supplemented, WS) were used to study the effect of work and diet supplementation on roughage intake, apparent digestibility of nutrients, digesta kinetics and plasma metabolites. Dry matter (DM) and organic matter (OM) intakes were greater for working than for non-working cows. Work and supplementation increased DM and OM in vivo apparent digestibility. This effect was particularly significant when comparing working cows at rest and at work. Passage rate and rumen mean retention of Cr-mordanted hay were similar for working and for nonworking cows. Liquid turn-over rate of Co-ethylene diamine tetra acetic acid (EDTA) was lower and rumen mean retention time of Co-EDTA was greater in working than in non-working cows whether supplemented or not. Working coios had lower plasma glucose during and immediately after working than non-working cows. Plasma non-esterified fatty acid (NEFA) was higher in working cows at the end of the working period and after rest between working hours. This effect was greater in non-supplemented than in supplemented cows. In working cows, β-hydroxybutyrate was lower at the end of working hours than in non-working cows. Lactate was greater in working than in non-working cows after the 3rd and 4th hours of work. Digesta kinetics could explain only partially the possible mechanisms responsible for greater roughage intake and apparent digestibility in working cows. The decrease of plasma glucose and the increase in NEFA during work indicates an increasing utilization of NEFA by muscle during consecutive working hours.
Reproductive performance of F1 crossbred dairy cows used for draught: effect of work and diet supplementation
- E. Zerbini, T. Gemeda, R. Franceschini, J. Sherington, A. G. Wold
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- Journal:
- Animal Production / Volume 57 / Issue 3 / December 1993
- Published online by Cambridge University Press:
- 25 May 2016, pp. 361-368
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- December 1993
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Forty pregnant F1 crossbred cows (20 Holstein-Friesian × Boran and 20 Simmental × Boran) were assigned to a 2 × 2 (work × diet) factorial experiment as follows: supplemented-non-working (SNW), supplemented-working (SW), non-supplemented-non-working (NSNW) and non-supplemented-working (NSW). Working cows pulled sledges 100 days/year (pull = 350 to 450 N, 4 h/day, 4 days/week). Conception and oestrus at fixed times (200 and 365 days post partum) were analysed using linear logistic models. Proportional hazard models were used for analysing ‘failure’ time data such as time to first oestrus or time to conception. Diet supplementation significantly decreased days to first oestrus and days to conception in non-working and working cows. SW cows had similar reproductive performance to NSNW cows. In supplemented cows, work significantly delayed days to conception. However, by 365 days post partum, conception rate was similar for SNW and SW cows. Body condition at calving significantly affected post-partum reproductive ability of non-working and working cows. Natural grass hay alone could not support potential reproductive ability of crossbred cows. Work output of supplemented cows may be associated with longer calving intervals. The economic trade-offs between longer calving intervals and work output should be examined in detail.
Interrelationship between vitamin A, iodine and iron status in schoolchildren in Shoa Region, Central Ethiopia
- Zewdie Wolde-Gebriel, Clive E. West, Haile Gebru, Amha-Selassie Tadesse, Tezera Fisseha, Petros Gabre, Chernet Aboye, Gonfa Ayana, Joseph G. A. J. Hautvast
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- Journal:
- British Journal of Nutrition / Volume 70 / Issue 2 / September 1993
- Published online by Cambridge University Press:
- 09 March 2007, pp. 593-607
- Print publication:
- September 1993
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A total of 14740 schoolchildren in seven provinces of Shoa Administrative Region in Central Ethiopia were surveyed for the prevalence of goitre, xerophthalmia and anaemia. Haemoglobin and packed cell volume were assessed in 966 children in one province while an in-depth study was conducted on 344 children in the same province and two others. Goitre, xerophthalmia (Bitot's spots) and clinical anaemia were observed in 34·2, 0·91 and 18·6% respectively of the children. Most biochemical variables were within the normal range while those of haemoglobin (Hb), mean corpuscular Hb concentration (MCHC) and urinary I excretion were lower, and mean corpuscular volume, mean corpuscular Hb (MCH), and immunoglobulins G and M were higher. Hb was strongly correlated with retinol. ferritin, MCHC, MCH, packed cell volume and erythrocyte count while retinol formed a triad with transthyretin (TTR) and retinol-binding protein (RBP) which were all correlated with one another. Total and free thyroxin and total and free triiodothyronine were positively correlated as were the concentrations of the total and free hormones. Thyrotropin (TSH) was negatively correlated with total and free thyroxin and positively correlated with free triiodothyronine. Thyroxin and triiodothyronine in both free and combined forms were all correlated with thyroxin-binding globulin which in turn was negatively correlated with the triad retinol, RBP and TTR. The triad was also negatively correlated with C-reactive protein. Urinary I excretion was positively associated with total thyroxin and negatively associated with TSH. The anaemia found was not nutritional in origin but due to the effect of infestation with intestinal parasites and malaria.