Alliance Of Groups Research Articles

Patient Blood Management – from local initiatives to European collaborations

Patient blood management (PBM), as defined by the WHO, is a patient‐focused, evidence‐based and systematic approach to optimize the management of patient and transfusion of blood products for quality and effective patient care. It is designed to improve patient outcomes through the safe and rational use of blood and blood products and by minimizing unnecessary exposure to blood products. Important elements of PBM are optimizing haemoglobin concentrations without blood transfusion, minimizing blood loss and managing anaemia, especially by use of evidence‐based transfusion guidelines and pharmacological agents. Local PBM initiatives differ substantially. In one region of Denmark, the majority of PBM initiatives over the last 10 years have been based on provider education and enforcement of national guidelines. Evaluation of the effect of these initiatives indicated that education alone can be an effective and durable method of reducing unnecessary transfusions. To improve implementation and knowledge of PBM, benchmarking of experiences between hospitals and countries seems rational, and several initiatives regarding PBM are being undertaken in Europe. Patient Blood Management in Europe (PaBloE) is a working group of the European Blood Alliance. Its objectives are to derive good practices in PBM and to develop ways to implement these practices. Within this group, several surveys have been performed relating to blood product consumption, implementation of PBM, and knowledge of PBM principles and practices among clinicians. These surveys have shown variation in transfusion rates between the participating hospitals, and variable implementation of PBM activities and monitoring of transfusion practice.

Effectiveness of the addition of therapeutic alliance with minimal intervention in the treatment of patients with chronic, nonspecific low back pain and low risk of involvement of psychosocial factors: a study protocol for a randomized controlled trial (TalkBack trial)

BackgroundThe stratified model of care has been an effective approach for the treatment of low back pain. However, the treatment of patients with low risk of psychosocial-factor involvement is unclear. The addition of the therapeutic alliance to a minimal intervention may be an option for the treatment of low back pain. This paper reports on the rationale, design and protocol for a randomized controlled trial with blind assessor to assess the effectiveness of the addition of therapeutic alliance with minimal intervention on pain and disability in patients with chronic, nonspecific low back pain.MethodsTwo hundred and twenty-two patients with chronic, nonspecific low back pain and low risk of involvement of psychosocial factors will be assessed and randomly allocated into three groups (n = 74 patients per group). The Positive Therapeutic Alliance group will receive counseling and guidance with an emphasis on therapeutic alliance and empathy. The Usual Treatment group will receive the same information and counseling with limited interaction with the therapist. The Control group will not receive any intervention. The treatment will be composed by two intervention sessions with a 1-week interval. A blinded assessor will collect the following outcomes at baseline, 1 month, 6 months and 12 months after randomization: pain intensity (Pain Numerical Rating Scale), specific disability (Patient-specific Functional Scale), general disability (Oswestry Disability Index), global perceived effect (Global Perceived Effect Scale), empathy (Consultation and Relational Empathy Measure), credibility and expectations related to treatment. The analysis will be performed using linear mixed models.DiscussionThis will be the first study to understand the effect of combining enhanced therapeutic alliance to a treatment based on counseling, information and advice (minimal intervention). The addition of the therapeutic alliance to minimal intervention may improve the treatment of chronic, nonspecific low back pain.Trial registrationClinicalTrials.gov, NCT 02497625. Registered on 10 July 2015.

Patient Blood Management in Europe: surveys on top indications for red blood cell use and Patient Blood Management organization and activities in seven European university hospitals

Patient Blood Management (PBM) in Europe is a working group of the European Blood Alliance with the initial objective to identify the starting position of the participating hospitals regarding PBM for benchmarking purposes, and to derive good practices in PBM from the experience and expertise in the participating teams with the further aim of implementing and strengthening these practices in the participating hospitals. We conducted two surveys in seven university hospitals in Europe: Survey on top indications for red blood cell use regarding usage of red blood cells during 1 week and Survey on PBM organization and activities. A total of 3320 units of red blood cells were transfused in 1 week at the seven hospitals. Overall, 61% of red cell units were transfused to medical patients and 36% to surgical patients, although there was much variation between hospitals. The organization and activities of PBM in the seven hospitals were variable, but there was a common focus on optimizing the treatment of bleeding patients, monitoring the use of blood components and treatment of preoperative anaemia. Although the seven hospitals provide a similar range of clinical services, there was variation in transfusion rates between them. Further, there was variable implementation of PBM activities and monitoring of transfusion practice. These findings provide a baseline to develop joint action plans to further implement and strengthen PBM across a number of hospitals in Europe.

Congestion spill effects of Heathrow and Frankfurt airports on connection traffic in European and Gulf hub airports

We develop two stage fixed-effects single-spill and double-spill models for congestion connection spills of London Heathrow and Frankfurt airports on 9 hub airports in Europe and the Gulf. Our panel data covers connection traffic from 1997 to 2013 for Heathrow and 1997 to 2011 for Frankfurt. The single-spill results support strongly that the connection spills from Heathrow’s capacity limitations do strengthen competing hub airports of major alliance groups and to a lesser degree one Gulf hub. The double-spill model for Heathrow and Frankfurt shows nearly asymmetric overall spill characteristics between the two airports. Our results underline the influence of airline network strategies on congestion spills as European airline networks are shaped by alliances and umbrella mergers. Thus, the airline network perspective in airport capacity expansion decisions needs to play a greater role, as indicated by our asymmetric results for overall spill effects between Heathrow and Frankfurt airports.

The effects of the airline strategic alliance group on member airlines' productivity during pre-mature stage

Airline strategic alliance groups have become an important part of the airline industry and tend to have dominance in many markets. Airlines want to join a strategic alliance group in order to expand their business and reduce their costs. However, the true benefits of a strategic alliance group still remain unclear. This study adopted panel regression model to analyse and reveal the effects of joining a strategic alliance group on airline performance. Our results suggest that alliance group effects are limited in terms of improving airline productivity during the global airline alliance group's pre-mature stage. Airlines joining the alliance group may not necessarily achieve significant productivity gains. Additionally, the study also did not find any significant effect of the size of alliance groups and membership duration on airline productivity change. However, the results suggest that as the number of members in the airline alliance group increases, member airlines' productivity will increase accordingly until a certain point but will then fall thereafter. Furthermore, the study indicates that an airline's productivity level may drop as its alliance membership duration increases initially until it reaches a certain point; after which, performance will start to increase over time.

Competitive Devaluations in Commodity-Based Economies: Colombia and the Pacific Alliance Group

This paper investigates whether there is an S-Curve in Colombia using bilateral and disaggregated quarterly data for the period 1991-2014. More precisely, the short-run effects of a depreciation on the TB are analysed in 27 industries covered by the PAG Free Trade Agreement. The S-Curve found in sectors representing 30% of total industrial production suggests that in these cases competitive devaluations have a positive effect on the TB in the short run. However, the regression analysis using both OLS and FE methods shows that sizable ones are needed to produce the desired effects on trade flows. Our findings have important policy implications: since only large competitive devaluations can restore TB equilibrium, industrial restructuring would appear to be a more sensible strategy, though this cannot be achieved in the short run and is instead a medium/long-term goal.

Competitive Devaluations in Commodity-Based Economies: Colombia and the Pacific Alliance Group

This paper investigates whether there is an S-Curve in Colombia using bilateral and disaggregated quarterly data for the period 1991-2014. More precisely, the short-run effects of a depreciation on the TB are analysed in 27 industries covered by the PAG Free Trade Agreement. The S-Curve found in sectors representing 30% of total industrial production suggests that in these cases competitive devaluations have a positive effect on the TB in the short run. However, the regression analysis using both OLS and FE methods shows that sizable ones are needed to produce the desired effects on trade flows. Our findings have important policy implications: since only large competitive devaluations can restore TB equilibrium, industrial restructuring would appear to be a more sensible strategy, though this cannot be achieved in the short run and is instead a medium/long-term goal.

Calling Patterns for Major Alliance Groups in East Asia

Calling Patterns for Major Alliance Groups in East Asia

The GSA Difference: LGBTQ and Ally Experiences in High Schools with and without Gay-Straight Alliances

We examine the lived experiences of high-school students who participated in lesbian, gay, bisexual, transgender, and queer (LGBTQ)-centered activism of some kind, highlighting the promise of gay-straight alliance groups by comparing the experiences of students at schools with gay-straight alliances (GSA schools) with the experiences of students at schools that did not have an LGBTQ-specific group (no-GSA schools). We compare students at GSA and no-GSA schools based on their experiences of harassment, experiences of support from authority figures, and patterns of friendships. We find that students at both types of schools experienced harassment and heard negative comments about lesbian and gay people. However, students at GSA schools reported more support from teachers and administrators than students at no-GSA schools, who have stories of teachers and administrators actively opposing equality for LGBTQ people. Students at GSA schools reported a wide variety of friendships across sexual identities, while students at no-GSA schools felt more isolated and withdrawn. This much-needed qualitative comparative analysis of students’ experiences brings a human face to the improved quality of life that schools with gay-straight alliances can bring to young people.

How Gay–Straight Alliance Groups Mitigate the Relationship Between Gay-Bias Victimization and Adolescent Suicide Attempts

We examined the relationships between victimization from being bullied, suicide, hopelessness, and the presence of a Gay-Straight Alliance (GSA) on a school campus. We analyzed data from the California Healthy Kids Survey from 2005 to 2007 using hierarchical modeling. We found that gay-bias (versus non-gay-bias) victimization is meaningfully connected with the inwardly destructive behavior of attempted suicide among adolescents. We also found that hopelessness helps explain associations between gay-bias victimization and suicide attempts and that the presence of a GSA club on a school's campus attenuates significant connections between gay-bias victimization and suicide attempts by reducing hopelessness. Gay-bias victims are more likely than other victims to attempt suicide while also feeling more hopeless. The presence of a GSA on campus may help to reduce the attempted suicide and hopelessness associated with gay-bias victimization.

International code of conduct for genomic and health-related data sharing.

The draft to date has been developed under the auspices of the Regulatory and Ethics Working Group of the Global Alliance for Genomics and Health, in collaboration with many individuals, organizations and committees around the world.

Observation on clinical therapeutic efficacy of moxibustion combined with mecobalamin on diabetic perineuropathy and effects on patients' blood homocysteine

ObjectiveTo observe the therapeutic efficacy of moxibustion combined with mecobalamin on diabetic perineuropathy and the effects on blood homocysteine in patients with diabetic perineuropathy. MethodsOne hundred and fifty patients with diabetic perineuropathy meeting with the inclusive criteria were randomized into a moxibustion group, a mecobalamin group and a therapeutic alliance group by using random digits table. Moxibustion was carried out on Tàixī (▪ KI 3), Sānyīnjiāo (▪ SP 6), Zúsānl▪ (▪ ST 36), Hégŭ (▪ LI 4) and Qūchí (▪ LI 11) for the patients in the moxibustion group, the treatments were carried out once every other day, treatments for ten times were considered as a treatment course, and totally three treatment courses were carried out. The patients in the mecobalamin group were orally administered with mecobalamin tablet 500 μg once, three times a day, 20 days were considered as a treatment course, and totally three treatment courses were carried out. Moxibustion was carried out on the basis of oral administration with mecobalamin tablet in the therapeutic alliance group. The clinical symptoms, nerve conductive velocities and changes in blood homocysteine were observed before and after the treatments in the three groups. ResultsThe total effective rate in the moxibustion group was 74.0% (37/50), 82.0% (41/50) in the mecobalamin group, 94.0% (47/50) in the therapeutic alliance group, and the total effective rate in the therapeutic alliance group was significantly better than the other two groups (P<0.01). The nerve conductive velocities in the mecobalamin group and the therapeutic alliance group after the treatments were significantly increased and the blood homocysteine level decreased in comparison to those before the treatments (P<0.01), while the nerve conductive velocity increased and the blood homocysteine level decreased in the therapeutic alliance group after the treatments in comparison to those in the other two groups (P<0.01). ConclusionTreatments on diabetic perineuropathy by therapeutic alliance of moxibustion and mecobalamin can not only improve symptoms of patients, increase nerve conductive velocity in affected limbs, but also decrease blood homocysteine level. The method is simple, economical and safe, and it deserves being generalized in clinical practices.

Editorial on "Heat Shock Protein Peptide Complex-96 (HSPPC-96) Vaccination for Recurrent Glioblastoma: A Phase II, Single Arm Trial"

In this issue of Neuro-oncology, Bloch et al, report the results of an exciting, multi-center, open label, Phase II trial in adult patients with surgically resectable GBM who are given a heat shock protein peptide complex – 96 vaccine after gross total resection. Forty-one patients were treated in this single-arm trial. A median of 6 doses of the vaccine were given. Greater than 90% of the patients were alive at 6 months, and almost 30% were alive at 12 months. The median overall survival was 42.6 weeks. Only minimal toxicities were observed, unlike the toxicity that can be observed in some less specific immunotherapy approaches.1–4 These results will now be validated in a randomized Phase II trial sponsored by the NCI (Figure 1). A number of additional findings of interest are also reported in the trial. For example, they report that patients with lymphocyte counts below the cohort median demonstrated decreased overall survival. Perhaps this is expected based on previous results showing that in some patients the lymphocyte counts, particularly in the CD4 compartment, are extremely low – similar to patients with AIDs, in fact.5,6 Conversely, others have demonstrated the value of lymphopenia, which can be induced by therapeutic temozolomide, if followed by lymphocyte homeostatic proliferation. It is important to differentiate these two phenomena. A decreased lymphocyte count at baseline probably relates to the level of immunosuppression in these patients. However, cyclic induction of lymphopenia can, in fact, boost immune responses based on the well-known phenomena of homeostatic proliferation.7–10 During this recovery phase, lymphocytes that recognize their cognate antigen and are stimulated by cytokines, such as interleukin (IL)-7 and IL-15 which are produced in response to lymphopenia, will preferentially expand. In this context, the presence of a vaccinating antigen can preferentially enhance vaccine-induced immune responses. This has been shown for both vaccines targeting T cells and B cells. A number of other caveats must also be remembered in interpreting this study. First of all, one should not conclude much from the observation that patients receiving more vaccines lived longer. This will always be true as some patients will progress or die before receiving the full complement of vaccine. Similar caveats exist when patients are not started on therapy at equivalent time points. Patients who are much further from their time of initial diagnosis are a selected population who will always have longer overall survival times from diagnosis. Secondly, imaging criteria for tumor progression in post-surgical trials needs to be carefully considered. It is very difficult to assess progression when small rims of enhancement may persist after surgical resection. This has been highlighted previously in the literature.11 Finally, and specific to this trial, one must consider that of the 68 patients screened, only 41 were enrolled, which may limit the applicability of this approach. However it is likely that as familiarity with the technology increases, screening will become more efficient, and patient selection will be optimized. Still, even at this rate, this therapy will be applicable to many more patients than some other promising therapies.9,12 Despite these caveats the results presented here are indeed impressive and form the basis for a randomized Phase II study sponsored by the NCI and presently open for enrollment through the ALLIANCE and RTOG cooperative groups (Fig. 1). In this study patients with recurrent GBM will undergo surgical resection, and their resected tumor will be sent for vaccine purification. Once vaccine has been manufactured, patients will be randomized to one of three arms, including two experimental arms that combine vaccine with bevacizumab (either concurrently or in sequence), and a third arm that represents present day standard of care treatment with bevacizumab as a single agent. This study will also offer opportunities for validation of biomarkers based on immune monitoring and improved imaging criteria for progression – both are badly needed in the field. The authors of this manuscript should be congratulated on their collaborative efforts to move this complex therapy forward and potentially deliver a very promising therapy to patients in desperate need of new approaches.

Privacy Protection for Personal Health Device Communication and Healthcare Building Applications

This paper proposes a new method for protecting patient privacy when communicating with a gateway which collects bioinformation through using personal health devices, a type of biosensor for telemedicine, at home and in other buildings. As the suggested method is designed to conform with ISO/IEEE 11073-20601, which is the international standard, interoperability with various health devices was considered. We believe it will be a highly valuable resource for dealing with basic data because it suggests an additional standard for security with the Continua Health Alliance or related international groups in the future.

DOES PERTAINING TO A GLOBAL STRATEGIC ALLIANCE IMPROVE THE BOTTOM LINE?

This study researched whether pertaining to a global strategic alliance brought significant benefits to the ‘bottom line’ of allied airlines. The study used two groups: a group of airlines which had joined one of three global alliances against a control group of airlines which had not joined any alliances. The research compared the net return of those two groups before and after airlines joined their alliances (or equivalent measure), as well as their relative net performance both in the short-term and in a longer term. Results showed a sensible deterioration in net profitability for the alliance group and a perceptible improvement in net profitability for the nonalliance group. The latter also differed from the former in having a positive relative net performance in the short-term.

“They Were Only Joking”: Efforts to Decrease LGBTQ Bullying and Harassment in Seattle Public Schools

Seattle Public Schools has implemented policies and programs to increase safety, family involvement, and student achievement for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth. This case study examines students' perceptions of bullying and harassment in the school environment, and teacher intervention when these problems arise in the presence of strong district policies and programs aimed at reducing LGBTQ bullying and harassment in schools. We surveyed students in Gay-Straight Alliance (GSA) groups at 13 secondary schools (N = 107). We also conducted focus groups with GSA students and students not involved in the GSAs in 7 of 13 schools (N = 16 groups, including 154 students). GSA students who were lesbian, gay, bisexual, or questioning (LGBQ) were significantly more likely than straight students to experience several types of harassment. On the basis of student report, the 2 most common intervention strategies by teachers for verbal harassment included stopping the harassment and explaining why it is wrong; teachers intervened in physical harassment by trying to stop the harassment. Students provided input on how to strengthen teacher interventions, including the need for more consistency in responding and following up. Students also noted a need for more focus on educating those who harass, rather than just asking them to stop. Seattle Public Schools has made great strides in creating safe and welcoming schools for LGBTQ students, but still have to work further toward reaching this goal. Data from students on how they experience their school environment can help identify areas for improvement.

What Base Text to Use for the Do Not Track Compliance Specification, with Explanatory Memorandum

This document contains the decision of the Tracking Protection Working Group of the World Wide Web Consortium, as issued in July, 2013 by the co-chairs, Peter Swire and Matthias Schunter, as well as a detailed Explanatory Memorandum for that decision. In response to 27 comments and a large previous public record, the decision addresses the question of what base text to use for the Do Not Track Compliance Specification, and concludes that the draft put before the group in June (“June Draft”) will be the base text rather than the proposal submitted by the Digital Advertising Alliance and other group members (“DAA Proposal”). Part I of the Explanatory Memorandum provides history and background of the process to date, with emphasis on the issues that differ between the two texts. Part II is called “Do Not Target,” and discussing the definition of “tracking,” the means of user choice concerning targeted online advertising, and related topics. Part III is called “Do Not Collect,” and addresses issues including minimization of data collection and the use of unique identifiers. Part IV is called “Data Hygiene.” It examines a range of controls that a company may apply to de-identify data and reduce the risk that data is revealed without authorization. Parts II to IV include discussion of many of the comments submitted under the July 12, 2013 deadline concerning which base text to adopt. Part V addresses additional comments submitted, responding especially to comments that supported the DAA Proposal to become the base text.

Applying Models to National Surveys of Undergraduate Science Students: What Affects Ratings of Satisfaction?

Many countries use national-level surveys to capture student opinions about their university experiences. It is necessary to interpret survey results in an appropriate context to inform decision-making at many levels. To provide context to national survey outcomes, we describe patterns in the ratings of science and engineering subjects from the UK’s National Student Survey (NSS). New, robust statistical models describe relationships between the Overall Satisfaction’ rating and the preceding 21 core survey questions. Subjects exhibited consistent differences and ratings of “Teaching”, “Organisation” and “Support” were thematic predictors of “Overall Satisfaction” and the best single predictor was “The course was well designed and running smoothly”. General levels of satisfaction with feedback were low, but questions about feedback were ultimately the weakest predictors of “Overall Satisfaction”. The UK’s universities affiliated groupings revealed that more traditional “1994” and “Russell” groups over-performed in a model using the core 21 survey questions to predict “Overall Satisfaction”, in contrast to the under-performing newer universities in the Million+ and Alliance groups. Findings contribute to the debate about “level playing fields” for the interpretation of survey outcomes worldwide in terms of differences between subjects, institutional types and the questionnaire items.

Antisense MMP-9 RNA inhibits malignant glioma cell growth in vitro and in vivo

The matrix-degrading metalloproteinases (MMPs), particularly MMP-9, play important roles in the pathogenesis and development of malignant gliomas. In the present study, the oncogenic role of MMP-9 in malignant glioma cells was investigated via antisense RNA blockade in vitro and in vivo. TJ905 malignant glioma cells were transfected with pcDNA3.0 vector expressing antisense MMP-9 RNA (pcDNA-ASMMP9), which significantly decreased MMP-9 expression, and cell proliferation was assessed. For in vivo studies, U251 cells, a human malignant glioma cell line, were implanted subcutaneously into 4- to 6-week-old BALB/c nude mice. The mice bearing well-established U251 gliomas were treated with intratumoral pcDNA-AS-MMP9-Lipofectamine complex (AS-MMP-9-treated group), subcutaneous injection of endostatin (endostatin-treated group), or both (combined therapy group). Mice treated with pcDNA (empty vector)-Lipofectamine served as the control group. Four or eight weeks later, the volume and weight of tumor, MMP-9 expression, microvessel density and proliferative activity were assayed. We demonstrate that pcDNA-AS-MMP9 significantly decreased MMP-9 expression and inhibited glioma cell proliferation. Volume and weight of tumor, MMP-9 expression, microvessel density and proliferative activity in the antisense-MMP-9-treated and therapeutic alliance groups were significantly lower than those in the control group. The results suggest that MMP-9 not only promotes malignant glioma cell invasiveness, but also affects tumor cell proliferation. Blocking the expression of MMP-9 with antisense RNA substantially suppresses the malignant phenotype of glioma cells, and thus can be used as an effective therapeutic strategy for malignant gliomas.

A Hierarchical Feature Set optimization for effective code change based Defect Forecasting

The automatic detection of defective modules comprised by software systems may result in added dependable applications and decreased development expenses. In this attempt improvement and style metrics is utilized as attributes to predict defects in specified software component using SVM classifier. A development of preprocessing steps were utilized to the data preceding to categorization, for instance, contrasting of in alliance groups (defective or otherwise) as well as the removal of the sizable numeral of duplicating examples. The Support Vector Machine in this test yields that miles to a typical correctness ahead over present defect prediction models on previously unseen data.