Aggressive Targets Research Articles

Assessing the health impacts attributable to PM2.5 and ozone pollution in 338 Chinese cities from 2015 to 2020

China has effectively reduced the fine particulate (PM2.5) pollution from 2015 to 2020. Ozone pollution and related health impacts have become severe contemporaneously. The coordinated control of PM2.5 and ozone is becoming a new issue for China's air pollution control. This study quantitatively assessed the health impacts attributed to PM2.5 and ozone pollution in 338 Chinese cities from 2015 to 2020 and estimated the possible health benefits from achieving dual concentration targets during 2021–2025. Results show PM2.5 caused a total health impact of 2.45 × 107 disability-adjusted life years (DALYs) in 2020. All-cause and respiratory ozone-related health impact in 2020 was 1.04 × 107 DALYs and 1.56 × 106 DALYs. Between 2015 and 2020, the PM2.5-related health impacts decreased by 14.97%, while those ozone-related increased by 94.61% and 96.54% for all-cause and respiratory. Cities in the North China Plain have suffered higher health impacts attributable to PM2.5 and ozone pollution, indicating that the two-pollutant coordinated control is primarily needed. By achieving aggressive concentration target (decreasing 10%) between 2020 and 2025, China will reduce the PM2.5-related health impacts in 338 cities by 1.56 × 106 DALYs (improving 6.37%). By achieving general target (decreasing 10% or within the Interim target-1 of World Health Organization), the PM2.5-related health benefit will be 7.98 × 105 DALYs (improving 3.25%). The deteriorating ozone health risks will also be improved. Controlling air pollution in large cities and regional center cities can achieve remarkable health benefits. Due to the inter-region, inter-province, and inter-city difference of health impacts, targeted and differentiated pollution prevention and control need to be implemented.

A Randomized Controlled Trial of Computerized Interpretation Bias Training for Disruptive Mood Dysregulation Disorder: A Fast-Fail Study

To examine targeted, mechanism-based interventions is the next generation of treatment innovation. Biased threat labeling of ambiguous face emotions (interpretation bias) is a potential behavioral treatment target for anger, aggression, and irritability. Changing biases in face-emotion labeling may improve irritability-related outcomes. Here, we report the first randomized, double-blind, placebo-controlled targeted trial of interpretation bias training (IBT) in youths with chronic, severe irritability. Patients with current disruptive mood dysregulation disorder (DMDD; N= 44) were randomly assigned to complete 4 sessions of active(n= 22) or sham (n= 22) computerized IBT training within a 1-week period. The first and last trainings were completed onsite, and 2 trainings were completed at home. We examined the effects of active IBT on labeling bias, primary outcome measures of irritability, and secondary outcome measures of anxiety, depression, and functional impairment. Follow-up assessments were completed immediately after the intervention as well as 1 and 2 weeks later. We found that active IBT engaged the behavioral target in the active relative to the sham condition, as shown by a significant shift toward labeling ambiguous faces as happy. However, there was no consistent clinical improvement in active IBT relative to the sham condition either immediately after or 2 weeks after training in either the primary or secondary outcome measures. Although this randomized controlled trial of IBT in youths with DMDD engaged the proposed behavioral target, there was no statistically significant improvement on clinical outcome. Identifying and changing behavioral targets is a first step in novel treatment development; these results have broader implications for target-based intervention development. Psychological Treatments for Youth With Severe Irritability; https://clinicaltrials.gov/; NCT02531893.

Evidence for large microbial-mediated losses of soil carbon under anthropogenic warming

Anthropogenic warming is expected to accelerate global soil organic carbon (SOC) losses via microbial decomposition, yet, there is still no consensus on the loss magnitude. In this Perspective, we argue that, despite the mechanistic uncertainty underlying these losses, there is confidence that a strong, positive land carbon–climate feedback can be expected. Two major lines of evidence support net global SOC losses with warming via increases in soil microbial metabolic activity: the increase in soil respiration with temperature and the accumulation of SOC in low mean annual temperature regions. Warming-induced SOC losses are likely to be of a magnitude relevant for emission negotiations and necessitate more aggressive emission reduction targets to limit climate change to 1.5 °C by 2100. We suggest that microbial community–temperature interactions, and how they are influenced by substrate availability, are promising research areas to improve the accuracy and precision of the magnitude estimates of projected SOC losses.

From Pathways to Practice: Impact of Implementing Mobilization Recommendations in Head and Neck Cancer Surgery with Free Flap Reconstruction

Simple SummaryTreatment for head and neck cancer (HNC) often involves complex surgery to remove the tumour followed by a reconstructive procedure to restore function and appearance. Getting out of bed and moving after surgery (early mobilization) is key to a good recovery. Clinical guidelines (called Enhanced Recovery after Surgery or ERAS guidelines) recommend getting out of bed and moving in the first 24 h after HNC surgery. This study looks at compliance to mobilization recommendations in 445 patients within an ERAS care pathway for HNC surgery. Implementing a new mobilization recommendation resulted in a 10% increase in recommendation compliance, despite a more aggressive target for (from 48 to 24 h). Patients who had surgery after the new guideline were more likely to leave the hospital on time (within ten days after surgery). Engaging the healthcare team and changing the care instructions improved mobilization and adherence to guideline-recommended care after HNC surgery with free flap reconstruction.One of the foundational elements of enhanced recovery after surgery (ERAS) guidelines is early postoperative mobilization. For patients undergoing head and neck cancer (HNC) surgery with free flap reconstruction, the ERAS guideline recommends patients be mobilized within 24 h postoperatively. The objective of this study was to evaluate compliance with the ERAS recommendation for early postoperative mobilization in 445 consecutive patients who underwent HNC surgery in the Calgary Head and Neck Enhanced Recovery Program. This retrospective analysis found that recommendation compliance increased by 10% despite a more aggressive target for mobilization (from 48 to 24 h). This resulted in a decrease in postoperative mobilization time and a stark increase in the proportion of patients mobilized within 24 h (from 10% to 64%). There was a significant relationship between compliance with recommended care and time to postoperative mobilization (Spearman’s rho = −0.80; p < 0.001). Hospital length of stay was reduced by a median of 2 days, from 12 (1QR = 9–16) to 10 (1QR = 8–14) days (z = 3.82; p < 0.001) in patients who received guideline-concordant care. Engaging the clinical team and changing the order set to support clinical decision-making resulted in increased adherence to guideline-recommended care for patients undergoing major HNC surgery with free flap reconstruction.

Medicare bundles for arthroplasty : a journey back to fee for service?

There is concern that aggressive target pricing in the new Bundled Payment for Care Improvement Advanced (BPCI-A) penalizes high-performing groups that had achieved low costs through prior experience in bundled payments. We hypothesize that this methodology incorporates unsustainable downward trends on Target Prices and will lead to groups opting out of BPCI Advanced in favour of a traditional fee for service. Using the Centers for Medicare and Medicaid Services (CMS) data, we compared the Target Price factors for hospitals and physician groups that participated in both BPCI Classic and BPCI Advanced (legacy groups), with groups that only participated in BPCI Advanced (non-legacy). With rebasing of Target Prices in 2020 and opportunity for participants to drop out, we compared retention rates of hospitals and physician groups enrolled at the onset of BPCI Advanced with current enrolment in 2020. At its peak in July 2015, 342 acute care hospitals and physician groups participated in Lower Extremity Joint Replacement (LEJR) in BPCI Classic. At its peak in March 2019, 534 acute care hospitals and physician groups participated in LEJR in BPCI Advanced. In January 2020, only 14.5% of legacy hospitals and physician groups opted to stay in BPCI Advanced for LEJR. Analysis of Target Price factors by legacy hospitals during both programmes demonstrates that participants in BPCI Classic received larger negative adjustments on the Target Price than non-legacy hospitals. BPCI Advanced provides little opportunity for a reduction in cost to offset a reduced Target Price for efficient providers, as made evident by the 85.5% withdrawal rate for BPCI Advanced. Efficient providers in BPCI Advanced are challenged by the programme's application of trend and efficiency factors that presumes their cost reduction can continue to decline at the same rate as non-efficient providers. It remains to be seen if reverting back to Medicare fee for service will support the same level of care and quality achieved in historical bundled payment programmes. Cite this article: Bone Joint J2021;103-B(6 Supple A):119-125.

Utility of non-HDL-C and apoB targets in the context of new more aggressive lipid guidelines

ObjectiveMajor guidelines recommend the use of secondary targets, such as non-HDL-C and apoB, to further reduce cardiovascular risk. We aimed to evaluate the proportion at which newer, more aggressive secondary lipid targets are exceeded in patients with LDL-C < 70 mg/dL estimated by Friedewald (LDLf-C) and Martin/Hopkins equations (LDLm-C). MethodsWe analyzed patients from the Very Large Database of Lipids with fasting lipids and estimated LDL-C <70 mg/dL by the Friedewald equation and Martin/Hopkins algorithm. Patients were categorized into three groups: LDL-C <40, 40–54 and 55–69 mg/dL. We calculated the proportion of patients with non-HDL-C and apoB above high-risk targets (non-HDL-C ≥ 100 and apoB ≥ 80mg/dL) for those with LDL-C 55-69 mg/dL and very high-risk targets (non-HDL-C ≥ 85 and apoB ≥ 65mg/dL) for those with LDL-C < 40 mg/dL and 40-54 mg/dL. ResultsIn patients with LDLf-C < 40 mg/dL, ~8 and ~4% did not meet high-risk secondary targets and ~21 and 25% did not meet very high-risk secondary targets for non-HDL-C and apoB, respectively. However, in patients with LDLm-C < 40 mg/dL <1% did not meet high-risk targets, while only 3% did not meet the very-high risk secondary target for apoB and none exceeded the very-high risk secondary target for non-HDL-C. Among individuals with LDL-C< 40 mg/dL, there were increasing proportions of individuals not meeting the very high-risk secondary apoB target at greater triglyceride levels, reaching up to ~19% using LDLm-C compared to ~60% using LDLf-C when triglyceride levels were 200–399 mg/dL. There were higher proportions of individuals not meeting high and very-high risk targets as triglyceride levels increased among those with LDL-C 40–54 and 55–69 mg/dL. ConclusionIn a large, US cross-sectional sample of individuals with LDL-C < 70 mg/dL, secondary non-HDL-C and apoB targets overall provide modest utility. However, attainment of very high-risk cutpoints for non-HDL-C and apoB is not achieved in a significant fraction of patients with triglycerides 200–399 mg/dL, even when using a more accurate calculation of LDL-C.

Maximizing the probability of realizing profit targets versus maximizing expected profits: A reconciliation to resolve an agency problem

It is generally accepted in the operations literature that a firm should strive to maximize its expected profit. However, in practice it is not uncommon for a firm to offer a bonus to managers for achieving some pre-established target profit, possibly yielding managerial actions that differ from the profit-maximizing approach (given a profit target, we assume managers will maximize the probability of reaching that target). We use the Newsvendor framework to illustrate how the firm's shareholders (e.g., through its board of directors) can align these two seemingly different decision approaches: maximizing expected profit versus maximizing the probability of reaching a target profit. Alignment is achieved by setting what we call an “aligned profit target” (APT) – a target profit that yields the same managerial action namely, the same stocking quantity, across both decision approaches. We find that the APT should typically be an aggressive profit target, one that is significantly higher than the maximum expected profit, with a corresponding low probability of achievement – this result is consistent across demand distributions with light tails (uniform), moderate tails (normal) and heavy tails (lognormal). Notably, the aggressive APT target should be distinguished from any target that the firm might set to signal future profit expectations to financial analysts.

Optimizing the diagnosis and management of ductal prostate cancer.

Ductal adenocarcinoma (DAC) is the most common variant histological subtype of prostate carcinoma and has an aggressive clinical course. DAC is usually characterized and treated as high-risk prostatic acinar adenocarcinoma (PAC). However, DAC has a different biology to that of acinar disease, which often poses a challenge for both diagnosis and management. DAC can be difficult to identify using conventional diagnostic modalities such as serum PSA levels and multiparametric MRI, and the optimal management for localized DAC is unknown owing to the rarity of the disease. Following definitive therapy for localized disease with radical prostatectomy or radiotherapy, the majority of DACs recur with visceral metastases at low PSA levels. Various systemic therapies that have been shown to be effective in high-risk PAC have limited use in treating DAC. Although current understanding of the biology of DAC is limited, genomic analyses have provided insights into the pathology behind its aggressive behaviour and potential future therapeutic targets.

POS-289 A LONG-TERM STUDY TO EVALUATE TENAPANOR'S ABILITY, ALONE OR IN COMBINATION WITH SEVELAMER, TO ACHIEVE NORMAL SERUM PHOSPHORUS IN PATIENTS WITH CKD ON DIALYSIS (NORMALIZE)

Tenapanor is an investigational, first-in-class, non-binder therapy that targets the primary pathway of phosphate absorption, a novel approach to treating hyperphosphatemia. Tenapanor blocks the paracellular absorption of phosphate in the gastrointestinal tract by local inhibition of the sodium-hydrogen exchanger (NHE3) and is dosed as one small pill twice daily. Two monotherapy and one combination therapy pivotal trials of tenapanor met their primary efficacy endpoint. The objective of this study is to evaluate the ability of tenapanor alone or in combination with sevelamer to enable patient's to achieve normal serum phosphorus levels (<4.6 mg/dL), in line with the 2017 KDIGO guideline, a more aggressive target than is typically studied.

Violence in Psychiatric Settings: Demographic and Clinical Characteristics of Patients Who Were Targets of Aggression.

Violence is a serious concern in the psychiatric inpatient and emergency setting. Much of the research on victims of inpatient violence has focused on identifying and supporting staff who are at risk of being victimized when working in psychiatric settings. This article presents an analysis of 72 patients who were targeted during incidents of patient-on-patient physical aggression in hospital-based psychiatric settings (both inpatient and emergency) from 2014 to 2018. Results suggest that patients who are at risk of being targeted by another patient while in the hospital tend to be younger, are more likely to be male, and present with manic symptoms and recent cannabis use. These variables have all been identified as risk factors for perpetration of violence by patients with mental illness. This study adds to a literature demonstrating a consistent overlap between individuals with mental illness who are victimized and those who initiate violence.

On the reduction of electric energy consumption in electrolysis: A thermodynamic study

Electricity is the major component in the cost of hydrogen production via electrolysis. This study aims to reduce electric energy consumption in electrolysis and replace it with lower cost thermal energy. An idealized thermodynamic analysis of hydrogen production by electrolysis at higher temperatures is presented, with particular emphasis on isolating the work and thermal components of the required energy. There is significant advantage in using thermal energy from another complementary process to overheat the inlet steam to meet this need. The electricity demand for electrolysis, under reasonable conditions, can thus be reduced to 26.63 kWh kg−1. Introducing multiple stages can further reduce this to 25.22 kWh kg−1 and more significantly, greatly reduce the temperature of the thermal energy needed. At lower utilizations, it is possible to reduce the electrical requirement to below 20 kWh kg−1, which is less than half the most aggressive targets for electrolyzer improvements.

Least-cost targets and avoided fossil fuel capacity in India’s pursuit of renewable energy

India has set aggressive targets to install more than 400 GW of wind and solar electricity generation by 2030, with more than two-thirds of that capacity coming from solar. This paper examines the electricity and carbon mitigation costs to reliably operate India's grid in 2030 for a variety of wind and solar targets (200 GW to 600 GW) and the most promising options for reducing these costs. We find that systems where solar photovoltaic comprises only 25 to 50% of the total renewable target have the lowest carbon mitigation costs in most scenarios. This result invites a reexamination of India's proposed solar-majority targets. We also find that, compared to other regions and contrary to prevailing assumptions, meeting high renewable targets will avoid building very few new fossil fuel (coal and natural gas) power plants because of India's specific weather patterns and need to meet peak electricity demand. However, building 600 GW of renewable capacity, with the majority being wind plants, reduces how often fossil fuel power plants run, and this amount of capacity can hold India's 2030 emissions below 2018 levels for less than the social cost of carbon. With likely wind and solar cost declines and increases in coal energy costs, balanced or wind-majority high renewable energy systems (600 GW or ≈ 45% share by energy) could result in electricity costs similar to a fossil fuel-dominated system. As an alternative strategy for meeting peak electricity demand, battery storage can avert the need for new fossil fuel capacity but is cost effective only at low capital costs (≈ USD 150 per kWh).

A Canadian perspective on the revised 2020 ASHP-IDSA-PIDS-SIDP guidelines for vancomycin AUC-based therapeutic drug monitoring for serious MRSA infections.

A revised consensus guideline on therapeutic drug monitoring (TDM) of vancomycin for serious methicillin-resistant Staphylococcus aureus (MRSA) infections was recently published with endorsement of numerous American pharmacy and medical societies. Changing practice from trough TDM to area-under-the-curve-(AUC)-guided dosing was suggested. Recent literature was critically appraised to determine whether AUC TDM is appropriate for Canadian hospital practice. Previous 2009 vancomycin consensus guidelines recommended trough levels of 15-20mg/L for serious MRSA infections, based on relatively poor evidence for efficacy or safety. In the past decade, aggressive trough targets have led to unnecessary toxicity. Adoption of a TDM strategy using an alternative parameter (AUC) has been suggested, although the evidence for any outcome benefits is low quality. In addition, implementation would require greater resources at health care institutions in the forms of more frequent serum levels or acquisition of costly Bayesian software programs. Most studies on this subject have been observational and retrospective; therefore, relationships between TDM parameters and outcomes have not been convincingly and consistently demonstrated to be causal in nature. Despite claims to the contrary, based on few in silico experiments, available clinical data suggest correlation of trough levels and AUC is high. TDM with lower target trough levels is a simpler solution to reduce risk of toxicity. There are serious concerns with adoption of AUC TDM of vancomycin into routine practice in Canada. Trough-based monitoring with modest reduction in target levels remains the most evidence-informed practice at this time.

Challenges and Opportunities in Expanding Home Hemodialysis for 2025.

The Advancing American Kidney Health Initiative has set an aggressive target for home dialysis growth in the United States, and expanding both peritoneal dialysis and home hemodialysis (HHD) will be required. While there has been a growth in HHD across the United States in the last decade, its value in controlling specific risk factors has been underappreciated and as such its appropriate utilization has lagged. Repositioning how nephrologists incorporate HHD as a critical renal replacement therapy will require overcoming a number of barriers. Advancing education of both nephrology trainees and nephrologists in practice, along with increasing patient and family education on the benefits and requirements for HHD, is essential. Implementation of a transitional care unit design coupled with an intensive patient curriculum will increase patient awareness and comfort for HHD; patients on peritoneal dialysis reaching a modality transition point will benefit from Experience the Difference programs acclimating them to HHD. In addition, the potential link between HHD program size and patient outcomes will necessitate an increase in the size of the average HHD program to more consistently deliver quality dialysis results. Addressing the implications of the nursing shortage and need for designing in scope staffing models are necessary to safeguard HHD growth. Seemingly, certain government payment policy changes and physician documentation requirements deserve further examination. Future HHD innovations must result in decreasing the burden of care for HHD patients, optimize the level of device and biometric data flow, facilitate a more functional centralized patient management care approach, and leverage computerized clinical decision support for modality assignment.

Mechanisms of development of medicine stability &lt;i&gt;Mycobacterium tuberculosis&lt;/i&gt;: is there a chance to win?

The scientific review provides current information on the current epidemiological status of tuberculosis in our country and the world, genetic adaptability and the evolution of Mycobacterium tuberculosis. The well-known and recently discovered molecular targets of aggression of this microorganism are described, and possible methods of circumventing the resistance of the Office to existing and developed drugs are presented. Objective: to create a scientific analytical review, which allows you to form an idea of the basic principles of development of the mechanisms of drug resistance of M. tuberculosis, as well as ways to overcome them with the possibility of further development of the chosen direction with the involvement of reputable scientific groups and practical implementation. Methods. scientific analysis of international reports, highly indexed scientific articles and clinical protocols. Results. Ihanks to the conducted analytical work, critical biological markers of M. tuberculosis immunity to anti-tuberculosis therapy were identified, which protect it from pharmacological intervention by the person and do not adequately sanitize the centers of inflammation in the patient's body. Methods have been proposed for disintegrating the mechanisms of drug resistance, which will bring the algorithms for treating tuberculosis infection to a new level. Conclusion. The analyzed information will contribute to deepening and expanding the knowledge of specialists involved in the fight against tuberculosis about the importance of implementing a personalized approach in the provision of medical care to TB patients, taking into account the studied molecular indicators of resistance to standardized and developed drugs.

Low levels of low-density lipoprotein cholesterol and cognitive decline

The relationship between low levels of serum low-density lipoprotein cholesterol (LDL-C) and subsequent cognitive decline remains unclear. The present study aimed to evaluate the longitudinal association between low LDL-C levels and cognition decline in the context of the current aggressive guideline-recommended targets (LDL-C levels less than 55 mg/dL for individuals at very high risk of cardiovascular events, and less than 70 mg/dL for high risk individuals). Data from wave 13 (2016) to wave 14 (2018) of the Health and Retirement Study (HRS) were utilized. LDL-C concentrations measured at wave 13 were categorized into 5 levels, reflecting currently recommended values for lipid lowering treatment. Of 7129 included participants (mean age: 69.0 ± 9.9 years, 60.3% female), we found that compared to participants with LDL-C levels of 70.0–99.9 mg/dL, those with LDL-C levels of <55 mg/dL had significantly slower 2-year decline rates in global cognitive function (0.244 point/year; 95% confidence interval (CI): 0.065−0.422; P = 0.008), working memory (0.068 point/year; 95% CI: 0.004−0.133; P = 0.038), and borderline significantly in episodic memory (0.155 point/year; 95% CI: −0.004−0.315; P = 0.057). Similarly, significantly slower decline rates were observed in those with LDL-C levels of 55.0–69.9 mg/dL. The present study demonstrated that compared with LDL-C levels 70.0–99.9 mg/dL, low LDL-C levels (<70 mg/dL, especially <55 mg/dL) were associated with significantly slower cognitive decline in population-based setting. Future randomized controlled trials are warranted to ascertain the safety and benefit of current aggressive guideline-recommended targets on cognitive function.

Behavioral and physiological responses to instability in group membership in wild male woolly monkeys (Lagothrix lagotricha poeppigii).

In group-living species, integrating into a new social group after dispersal is an important life history milestone associated with physical and social challenges. Generally, this process seems to be accompanied by heightened glucocorticoid (GC) concentrations; however, most studies of physiological responses to group transfer have been conducted on species with despotic social relationships, where integrating individuals are often targets of frequent aggression. Here we present data on fecal glucocorticoid (fGC) concentrations during periods of unstable group membership for male woolly monkeys (Lagothrix lagotricha poeppigii), a species with extremely low rates of male-male aggression and generally tolerant male-male associations. We collected data on males in four study groups at the Tiputini Biodiversity Station, Ecuador, and observed three attempted transfer events, involving a total of four adult males, in one study group. We observed only three instances of overt aggression (chases) between males across the entire study period, though male display behaviors were more frequent. We tested whether rates of displays were higher during periods of unstable group membership using a generalized linear mixed model (LMM). We also examined whether male status, group stability, and the occurrence of intergroup encounters affected fGC concentrations using LMMs. Contrary to our predictions, rates of display behaviors were not higher during periods of unstable group membership. However, both transient/integrating males and those who were already group members showed elevated fGC concentrations during these unstable periods. Our results suggest that even in species with tolerant male-male relationships, the integration of unfamiliar individuals can provoke an increase in GCs.

Treatment of Hypertension in Patients with Diabetes Mellitus: a Contemporary Approach.

Blood pressure guidelines worldwide have changed their recommended blood pressure goals multiple times over the past decade due to an evolving understanding of the treatment of hypertension in patients with diabetes mellitus. While it is evident through randomized trials that treatment of hypertension in diabetes mellitus prevents complications, the optimal blood pressure goal is not clear. Post hoc analyses of the Action to Control Cardiovascular Risk in Diabetes-Blood Pressure (ACCORD-BP) trial, its long-term follow along study ACCORDION, and Systolic Blood Pressure Intervention Trial (SPRINT) suggest that patients with diabetes have a reduced risk of adverse cardiovascular events when aiming for more intensive blood pressure targets. High-quality data support guideline recommendations for more aggressive blood pressure targets in patients with diabetes mellitus. Reasoning for a return to more aggressive blood pressure goals in this at-risk population is discussed, and treatment strategies encompassing contemporary therapeutic options are recommended.

PENGARUH ANGER MANAGEMENT TRAINING TERHADAP PENURUNAN PERILAKU AGRESI PADA SISWA BERMASALAH DI SMP X BANDUNG

Aggression is all form of behavior which meant, to hurt other individual physically and mentally or harm the others which their behavior is undesireable (Berkowitz 1995). Aggressive behavior is a form of negative behaviors that arise mainlydue to the stimulation of environmental stimuli often lead to greater impact. Aggression can be physical or verbal, and may occur on other people or objects that become targets of aggression. Aggressive behavior shown junior high school students 'X' Bandung include fights either alone or in groups, pushing, hitting, and kicking her or inventory such asschool desks, chairs and doors (Displacement) due to a simple problem. Students also like to taunt and threaten her friends who do not follow their will (bullying), students also often yell and say rude to her if what she wants is not obeyed. The purpose of the research was to obtain empirical data on the effect of Anger Management Training (AMT) to decrease agression behavior at junior high school “x” Bandung. This AMT is focusing to changing of behavior through increase knowledge, helping student to be able to control their temper positively and able to express anger in a healthy way. In this study there were fifteen participants taken as a subject by using purposive techniques based on established criteria.Todetermine whether there is the effect of the AMT in reducing aggressive behavior of students, the data processing is doneby using the Wilcoxon Signed Ranks test statistic test. Statistical hypothesis proposed in this study is : there is the effect of interventions such as anger management training to decrease aggressive behavior in the study subjects. : there is the effect of interventions such as anger management training to decrease aggressive behavior in the study subjects. From theresults of statistical tests using the Wilcoxon Signed Ranks Test results obtained Z value of -3.410 with probability p for atwo-tailed test (asymp. Sig. 2 tailed) of 0.001. Given the value of p = 0.001 &lt;a = 0.05, then is rejected and is accepted. Thus, it can be said that there is the effect of interventions such as anger management training to decreaseaggressive behavior in students.&#x0D; &#x0D; &#x0D; Keywords: aggression, anger management training,

Foreign Threats to Ukraine’s Independence and the Challenge Posed to Polish National Security

The purpose of the article is to examine the Russian threat to Ukraine’s state sovereignty and its impact on Poland’s national security; to underline that Russia intends to take revenge for its defeat in the Cold War, to regain control over the former Soviet Union republics, to defeat the USA and EU, and to establish control in the territory of the Eurasian continent. The research hypothesis is that the main purpose of Russia’s foreign policy is the reconstruction of a neo-imperial state, Ukraine’s reintegration into the post-Soviet space, and ensuring Russia’s domination in the region. The research task was completed using the research methods of a detailed study of sources and literature and a critical analysis of the information available to the author. Conclusions: Russia is trying to take revenge for its defeat in the Cold War, to regain control over the former Soviet Union republics, to defeat the West, and to establish control over the Eurasian continent. Russia considers Ukraine and Poland as dangerous agents of Atlanticism. That is why the Russian Eurasian geopolitical project aims for the Ukrainian and Polish states to be neutralized in a radical way. To this end, Russia has started a “hybrid war” against Ukraine. Poland and the Baltic countries will be the next targets of Russian aggression. It is profitable for Russian neo-imperialism to destroy trust and the strategic partnership between Poland and Ukraine, and to act in accordance with the divide-and-conquer algorithm. In such circumstances, Ukraine and Poland need to work out a new “Doctrine of restraining Russia’s aggression,” to pursue gradual and coordinated policy for the sake of the victory over Russian neo-imperialism and the dismantlement of the Russian imperial social system. The article describes the peculiarities of the modernization of the Russian imperial system at the present stage, analyzes the content of the Russian neo-imperialistic policy against Ukraine, Poland and the West, the reasons for the failure of Ukraine to neutralize Russian expansion, and also shows possible geopolitical consequences for the national security of Poland in the event of the successful implementation of Russia’s geopolitical strategy.