Honeymoon Period Research Articles

Could New Generations of Sensors Reshape the Management of Parkinson’s Disease?

Parkinson's disease (PD) is a chronic neurologic disease that has a great impact on the patient’s quality of life. The natural course of the disease is characterized by an insidious onset of symptoms, such as rest tremor, shuffling gait, bradykinesia, followed by improvement with the initiation of dopaminergic therapy. However, this “honeymoon period” gradually comes to an end with the emergence of motor fluctuations and dyskinesia. PD patients need long-term treatments and monitoring throughout the day; however, clinical examinations in hospitals are often not sufficient for optimal management of the disease. Technology-based devices are a new comprehensive assessment method of PD patient’s symptoms that are easy to use and give unbiased measurements. This review article provides an exhaustive overview of motor complications of advanced PD and new approaches to the management of the disease using sensors.

Honeymoon Period in Newborn Rats With CDH Is Associated With Changes in the VEGF Signaling Pathway.

Background: Patients with congenital diaphragmatic hernia (CDH) have a short postnatal period of ventilatory stability called the honeymoon period, after which changes in pulmonary vascular reactivity result in pulmonary hypertension. However, the mechanisms involved are still unknown. The aim of this study was to evaluate mechanical ventilation's effect in the honeymoon period on VEGF, VEGFR-1/2 and eNOS expression on experimental CDH in rats.Materials and Methods: Neonates whose mothers were not exposed to nitrofen formed the control groups (C) and neonates with left-sided defects formed the CDH groups (CDH). Both were subdivided into non-ventilated and ventilated for 30, 60, and 90 min (n = 7 each). The left lungs (n = 4) were evaluated by immunohistochemistry of the pulmonary vasculature (media wall thickness), VEGF, VEGFR-1/2 and eNOS. Western blotting (n = 3) was performed to quantify the expression of VEGF, VEGFR-1/2 and eNOS.Results: CDH had lower biometric parameters than C. Regarding the pulmonary vasculature, C showed a reduction in media wall thickness with ventilation, while CDH presented reduction with 30 min and an increase with the progression of the ventilatory time (honeymoon period). CDH and C groups showed different patterns of VEGF, VEGFR-1/2 and eNOS expressions. The receptors and eNOS findings were significant by immunohistochemistry but not by western blotting, while VEGF was significant by western blotting but not by immunohistochemistry.Conclusion: VEGF, its receptors and eNOS were altered in CDH after mechanical ventilation. These results suggest that the VEGF-NO pathway plays an important role in the honeymoon period of experimental CDH.

The continuous but rocky developments of Sino-South Korean relations: examined by the four factor model

ABSTRACT Since the establishment of “friendly and cooperative relations’ in 1992, relations between South Korea and China have been continuously elevated almost every 5 years. The two countries have achieved great advancements in expanding civil exchanges, bringing economic relations closer, finding common ground in foreign policy and security and elevation of political relations. Despite the honeymoon period that the two countries experienced after they established diplomatic relations, however, conflict is now arising due to differences in opinion and interests in various fields such politics, economy, society, culture, diplomacy, and security. This paper will examine Sino-South Korean relations using the four factor model, which is based on four approaches, starting with economic relations, followed by perception and emotions, diplomacy and security and lastly, these factors” influence on domestic politics. Following this analysis, this paper will argue that despite their continuous but rocky developments, Sino-South Korean relations will sustainably maintain their development. Considering the synergy effect of bilateral relations, two countries are standing on the opportunity to build a New Type of Sino-South Korean relations which would allow for resolution of conflicts and misunderstandings through dialogue and communication.

Experiences of Western Australian rural nursing graduates: A mixed method analysis.

To determine whether the current rural graduate programmes in Western Australia adequately support new graduate nurses transitioning into practice. Graduate nurse's transition to employment is a time of significant change and challenge, often resulting in periods of transition shock. These challenges are magnified in rural areas where graduates have to relocate to commence their career with limited rural nursing experience. Graduate programmes were developed to smooth the transition for university trained bachelor's degree registered nurses into the workforce. Supportive graduate nursing programmes are essential for enabling transition to practice and reduce attrition rates. Longitudinal convergent mixed method parallel design was informed by Duchscher's transition stage model. Thematic analysis was applied to all interviews. COREQ checklist was completed. Descriptive statistics and content analysis were used to analyse the survey responses. New graduates cycled through both transition shock and honeymoon periods on commencement of employment, reporting high levels of satisfaction in simultaneity with signs of transition shock. Satisfaction dropped within 7months indicating a transition crisis before an adjustment period occurred at the end of their graduate year. Limited resources were highlighted as obstacles to providing adequate support to rural graduate nurses. The honeymoon stage of transition co-existed with transition shock at the commencement of graduate programmes, which may obscure the need for continuing adequate support. Inadequate and/or a lack of preceptorship was evident throughout the Western Australian rural graduate programmes. Graduate programmes need to be structured but flexible to allow for individual differences in graduates' and clinical contexts. Structured but flexible graduate programmes allow for individual differences in graduates and clinical situations. New graduate nurses would benefit from a break midway through their graduate year to assist and overcome the transition crisis stage. Education of nurses undertaking the preceptor role is required to deliver adequate support to graduate nurses and decrease transition shock.

Prolonged Honeymoon Period in a Thai Patient With Adult-Onset Type 1 Diabetes Mellitus - Metabolic Flexibility in Autoimmune Diabetes?

Abstract Background: ‘Honeymoon’ period among people with type 1 diabetes mellitus (T1DM) refers to the period of time (mostly less than 1 year) which beta-cell is still able to produce insulin to maintain good glycemic control shortly following the development of diabetes. This phenomenon remained incompletely understood but previous studies showed that absence of diabetic ketoacidosis (DKA) at initial presentation, short duration of symptoms, older age at presentation, and strenuous exercise could be potential factors. Herein, we report a 24-year old Thai patient with T1DM who has been in sustained complete remission for more than 5 years while he is maintaining low carbohydrate intake and regular exercise. Clinical Case: A 24-year-old male presented with a 6-month history of polyuria, polydipsia and weight loss of 15 kilograms (baseline BMI at 27.8 kg/m2). His initial laboratory data showed plasma glucose 398 mg/dL and A1C 9.3%. No ketonemia was found. He was diagnosed with stage 3 of Type 1 DM based on clinical presentation and positive pancreatic auto-antibodies (anti-GAD and anti-IA2). Euthyroid Hashimoto’s thyroiditis was also diagnosed based on his enlarged thyroid gland and positive thyroid auto-antibodies. He was started on basal-bolus insulin regimen for only 2 month and then A1C reversed to 5.9% within 2 months. Insulin was gradually withdrawn and completely stopped. Mixed meal stimulation test (MMST) was firstly evaluated at the second year of his diagnosis. The result revealed stimulated C-peptide at 5.5 ng/dL. Next-generation sequencing panel for monogenic diabetes revealed negative results. The patient maintains healthy lifestyle habit with low carbohydrate intake and regular exercise 5–6 times per week. His body weight was maintained at 60–63 kilograms during the past 4 years. His A1C was maintained between 5.0 to 6.0% without any anti-diabetic medication for more than 5 years. Repeated MMST in every 6–12 months still revealed preserved beta-cell functions and normal stimulated plasma glucose. Interestingly, repeated pancreatic auto-antibodies at 3 years after diagnosis showed negative anti-GAD and anti-IA2, but positive anti-ZnT8. The patient was advised to maintain his bodyweight and healthy behavior together with closely regular OPD follow-up. Conclusion: Restored beta-cell function with completely insulin withdrawal in new-onset T1DM has been reported in very few cases which have some common factors as in our patient (low carbohydrate intake with regular exercise). Delaying autoimmune activity by reducing metabolic load in newly diagnosed T1DM might play a role in maintaining a honeymoon period and could lead to an innovative therapeutic option in new-onset T1DM.

The relationship between voluntary employer change and work ability among older workers: investigating the honeymoon-hangover effect

The aim of the study was to investigate the effect of voluntary employer changes on self-reported work ability among older workers in Germany and whether a honeymoon-hangover effect (HHE) exists here. In research on job satisfaction, three typical periods around a voluntary employer change characterize a HHE: a deterioration in the old job (deterioration), an initial increase in the new job (honeymoon) and a subsequent decline over time (hangover). Whether a HHE exists in respect to work ability following a voluntary employer change remained open. The analyses are based on data from the first three waves of the lidA study (2011, 2014, 2018), a representative cohort study of older employees in Germany born in 1959 or 1965. Data from 2502 workers who participated in all three study waves was analyzed. Fixed-effects regression analyses including lag and lead variables were conducted. A deterioration, honeymoon and hangover period were found. Work ability increased substantially following the voluntary employer change. Our study shows that voluntary employer changes have the potential to maintain work ability at higher working age, but not to increase the work ability in the long-term perspective. However, despite the existence of a hangover period, the positive overall effect of the voluntary change should not be underestimated.

Bangladesh-India relations: Honeymoon period returned?

This article aims to provide a better understanding how deeply Bangladesh and India are maintaining good relations between them in recent time. Furthermore, this study has investigated and identified the factors that motivated both India and Bangladesh to revive their sound relations. In the South Asian region, India is the dominant power in terms of population, economy, military strengths, geographical size, location, etc. Bangladesh shares 78.86% of its total border with India. Both countries’ history, languages, culture, and economic nature is a more or less similar manner. During the liberation war of Bangladesh in 1971, it got a lot of support from India. After getting independence, both countries experience a sound relationship until 1975, which we can call the ‘Honey-moon’ period. After that, Bangladesh faces some difficulties in maintaining its relationship with India due to border killings, a sense of distrust, security concern, trade defficits, transit issues, and water sharing issues, etc. Recently, through Modi and Hasina's government's diplomatic efforts, both countries' relations have reached a new height, which I label as ‘Honeymoon period’ has returned. This study is basically based on the review of the secondary data and content analysis in nature. This paper finds that strategic geographical location of Bangladesh and China’s strategic engagement with Dhaka motivates India to maintain more close relationship with Dhaka to get it into its grip. In addition, this study suggested that if India wants to be a regional power, and Bangladesh wants to maintain its development; to fulfill its ambitions, both countries need to maintain a good relationship.

Understanding the Role of Duration of Vaccine Protection with MenAfriVac: Simulating Alternative Vaccination Strategies.

We previously developed a transmission dynamic model of Neisseria meningitidis serogroup A (NmA) with the aim of forecasting the relative benefits of different immunisation strategies with MenAfriVac. Our findings suggested that the most effective strategy in maintaining disease control was the introduction of MenAfriVac into the Expanded Programme on Immunisation (EPI). This strategy is currently being followed by the countries of the meningitis belt. Since then, the persistence of vaccine-induced antibodies has been further studied and new data suggest that immune response is influenced by the age at vaccination. Here, we aim to investigate the influence of both the duration and age-specificity of vaccine-induced protection on our model predictions and explore how the optimal vaccination strategy may change in the long-term. We adapted our previous model and considered plausible alternative immunization strategies, including the addition of a booster dose to the current schedule, as well as the routine vaccination of school-aged children for a range of different assumptions regarding the duration of protection. To allow for a comparison between the different strategies, we use several metrics, including the median age of infection, the number of people needed to vaccinate (NNV) to prevent one case, the age distribution of cases for each strategy, as well as the time it takes for the number of cases to start increasing after the honeymoon period (resurgence). None of the strategies explored in this work is superior in all respects. This is especially true when vaccine-induced protection is the same regardless of the age at vaccination. Uncertainty in the duration of protection is important. For duration of protection lasting for an average of 18 years or longer, the model predicts elimination of NmA cases. Assuming that vaccine protection is more durable for individuals vaccinated after the age of 5 years, routine immunization of older children would be more efficient in reducing disease incidence and would also result in a fewer number of doses necessary to prevent one case. Assuming that elimination does not occur, adding a booster dose is likely to prevent most cases but the caveat will be a more costly intervention. These results can be used to understand important sources of uncertainty around MenAfriVac and support decisions by policymakers.

From "Honeymoon Period" to "Stable Marriage": The Rise of Management Consultants in British Health Policymaking.

Since the creation of the National Health Service in 1948, different groups of experts have competed to inform the development of British health policy. This article analyzes the long-term rise of one of these groups-management consultants. The scale and regularity of their engagement has increased considerably over time, strikingly in recent years, and the functions fulfilled by consultants have become ever more diverse. At important moments they were often seen by policymakers-particularly when there was understood to be a lack of internal expertise-as possessors and imparters of important knowledge. Firms and individuals worked consciously to integrate themselves into emerging health policy networks. But there has often been relatively little consideration of their real suitability for work in the health field. Many debates around the use of external consultants today-accountability, value for money, dependency-were foreshadowed during earlier periods, with implications for current policymakers.

The honeymoon period after mass vaccination.

Vaccination is an effective method to prevent individuals from contracting diseases like measles and the flu. Its success is clearly demonstrated by the large declines in the incidence of many diseases (e.g., childhood diseases like measles) after the start of mass vaccination programs. However, what happens after this drop in incidence can be complicated. It is known that some diseases exhibit "honeymoon periods" (long periods of temporary low disease incidence after start of mass vaccination). These periods end with a natural resurgence of the disease, which is not due to any change in the system. To study honeymoon periods, we used the compartmental model analyzed in [1] that can exhibit different types of vaccine failures: failure in degree (leakiness), in take (all-or-nothing) and in duration (waning of vaccine-derived immunity). We showed that traditional measures of transient dynamics in ecology may not distinguish between models with different honeymoon periods. We also provide a proof of global stability of the endemic equilibrium when the reproduction number (accounting for vaccination) is greater than one, and introduce a technical definition of the honeymoon period.

Ventilatory management in extremely low birth weight infants

The improvement in survival in premature infants associated with the evolution of mechanical ventilation has been accompanied by an increase in ventilator induced lung injury. High frequency ventilation has been shown to reduce the incidence of ventilator induced lung injury and hence chronic lung disease in the very low birth weight infant. The evolution in understanding how to best use high frequency ventilation in this population has prompted us to ask whether similar strategies to optimize lung volumes on conventional mechanical ventilation can minimize chronic lung disease in the neonate. We retrospectively reviewed the medical charts of 51 extremely low birth weight infants born in Kingston, Ontario in two epochs, 1990 to 1991 and 1999 to 2000, for ventilatory strategy and outcome. From our review, it is clear that surfactant therapy rapidly changes lung mechanics by improving pulmonary compliance and that lung damage may result if there are not changes in the ventilatory management to reflect the altered compliance. Early ventilation strategies during the apparently stable "honeymoon period" in a patient with respiratory distress syndrome (RDS) has significant implications on long term morbidity. In the era prior to the use of surfactant, 30% of infants died and 40% developed chronic lung disease (CLD). Immediately following the use of surfactant , mortality was reduced to 18%, however, the incidence of CLD increased to 78%. In the most recent era, following 10 years of experience with surfactant and mechanical ventilation, morbidity was 17% and CLD 21%. This study demonstrates that a particularly crucial time is in the immediate period following surfactant administration. The use of lower peak inspiratory pressure (PIP) and mean airway pressure (MAP) over the first 24 hours and an increase in the use of synchronous intermittent mandatory ventilation (SIMV) was associated with an improved outcome. The challenge remaining is to determine how to best utilize a conventional mode of ventilation to best optimize lung volume and protect the immature lung.

Adoption workers’ perspectives on adoption adjustment and the honeymoon period

Abstract The process of adopting a child holds specific challenges for a new adoptive family. When a child joins an adoptive family, the adjustment necessary for each family member plays a significant role in the outcome of the placement. Yet, despite the importance that adjustment plays in the success of an adoption, very few studies have focused on the adjustment process or the “honeymoon period” for children and families. This study offers valuable insight into various aspects of healthy adoption adjustment and the honeymoon period and provides a foundation for a model of adoption adjustment with specific time frames and insight into when the most challenges to healthy adjustment arise. Implications for practice include tools and strategies for adoption workers in child welfare to monitor adoption adjustment more closely.

“Race” and “racism” in contemporary Africa-China relations research: approaches, controversies and reflections

ABSTRACT Over the last five years, as Africa-China relations have moved beyond the honeymoon period and into a more complex stage, a number of incidents have exploded into global controversies about “race,” “racism” and racial hierarchies. Given this context, research on “race” and “racism” in Africa-China relations has been scarce and fraught with methodological issues and challenges. In this article, I first provide a critical analysis of the ways in which the existing body of Africa-China relations knowledge engages with the analytical categories of “race” and “racism.” After that, following Monson and Lan, who have both argued for the need of a “triangulation” to better understand “racialisation processes” in the relationship, I introduce the notion of “multiple triangulations” to both analyse these processes and to distance the discussion from Euro-American binaries and dichotomies around “race” and “racism.” This is followed by a brief discussion on one of the most recent controversies relating to “race” and “racism” in Afro-Chinese mediascapes. Towards the end of the article, I reflect on the most common methodological issues and challenges in the research on Afro-Chinese encounters. Finally, I discuss the need to develop a global (post-imperial) vocabulary of “race” and “racism,” and indicate what may be the early steps towards doing so.

INITIAL ADJUSTMENT AND MENTAL ISOLATION ANALYSIS IN THE MOVIE “ANNA AND THE KING”

This study will be focused on the parts of the cultural adjustment process of the main character’s experience in the movie “Anna and The King”. The cultural adjument process consists of some stages, those are: honeymoon period, culture shock, initial adjustment, mental isolation, and acceptance and integration, but in this research the writer only focuses on the initial adjustment and mental isolation stage. The objective of the study is to analyze how the main character’s experiences cultural adjustment process relating to the initial adjustment and mental isolation based on Levine and Adelman theory known as the stage of the “W” pattern of cultural adjustment process. The writer used the descriptive qualitative method to analyze the main character’s experience in the movie. Initial Adjustment is stage relating to some difficulties and problems in culture shock but it will be solved by the main character. Furthermore, Mental isolation is the newcomer’s feeling that lost of self confident because the resulf of anxiety, depresion and loneliness.

Bangladesh-India relations: Honeymoon period returned?

This article aims to provide a better understanding how deeply Bangladesh and India are maintaining good relations between them in recent time. Furthermore, this study has investigated and identified the factors that motivated both India and Bangladesh to revive their sound relations. In the South Asian region, India is the dominant power in terms of population, economy, military strengths, geographical size, location, etc. Bangladesh shares 78.86% of its total border with India. Both countries’ history, languages, culture, and economic nature is a more or less similar manner. During the liberation war of Bangladesh in 1971, it got a lot of support from India. After getting independence, both countries experience a sound relationship until 1975, which we can call the ‘Honey-moon’ period. After that, Bangladesh faces some difficulties in maintaining its relationship with India due to border killings, a sense of distrust, security concern, trade defficits, transit issues, and water sharing issues, etc. Recently, through Modi and Hasina's government's diplomatic efforts, both countries' relations have reached a new height, which I label as ‘Honeymoon period’ has returned. This study is basically based on the review of the secondary data and content analysis in nature. This paper finds that strategic geographical location of Bangladesh and China’s strategic engagement with Dhaka motivates India to maintain more close relationship with Dhaka to get it into its grip. In addition, this study suggested that if India wants to be a regional power, and Bangladesh wants to maintain its development; to fulfill its ambitions, both countries need to maintain a good relationship.

Human Papillomavirus Genotype Replacement: Still Too Early to Tell?

BackgroundAlthough human papillomavirus (HPV) vaccines are highly efficacious in protecting against HPV infections and related diseases, vaccination may trigger replacement by nontargeted genotypes if these compete with the vaccine-targeted types. HPV genotype replacement has been deemed unlikely, based on the lack of systematic increases in the prevalence of nonvaccine-type (NVT) infection in the first decade after vaccination, and on the presence of cross-protection for some NVTs.MethodsTo investigate whether type replacement can be inferred from early postvaccination surveillance, we constructed a transmission model in which a vaccine type and an NVT compete through infection-induced cross-immunity. We simulated scenarios of different levels of cross-immunity and vaccine-induced cross-protection to the NVT. We validated whether commonly used measures correctly indicate type replacement in the long run.ResultsType replacement is a trade-off between cross-immunity and cross-protection; cross-immunity leads to type replacement unless cross-protection is strong enough. With weak cross-protection, NVT prevalence may initially decrease before rebounding into type replacement, exhibiting a honeymoon period. Importantly, vaccine effectiveness for NVTs is inadequate for indicating type replacement.ConclusionsAlthough postvaccination surveillance thus far is reassuring, it is still too early to preclude type replacement. Monitoring of NVTs remains pivotal in gauging population-level impacts of HPV vaccination.

The Association of Autoimmune Diseases with Type 1 Diabetes Mellitus in Children Depends Also by the Length of Partial Clinical Remission Phase (Honeymoon).

Type 1 diabetes mellitus (DM) is characterized by irreversible, autoimmune, pancreatic β-cell destruction. During the disease, some patients experience a phase of Partial Clinical Remission (PCR) known as “honeymoon.” This is a transitory period that is characterized by insulin production by residual β cells following DM diagnosis and initiating the insulin therapy. In this study, we aimed to evaluate the influence of insulin production on immune system after the onset of diabetes, and we showed that the duration of honeymoon period could be related to the onset of other autoimmune conditions. For this retrospective study, 159 children aged between 11 and 18 years with type 1 DM were eligible. They have been diagnosed diabetes at least 10 years ago and use exogenous insulin. Our results showed that younger age at the onset of Type 1 DM in children, predicts Celiac Disease. Female sex and low HCO3 levels at the onset of DM had a high predictive value on patients who did not experience longer Partial Clinical Remission phase. Patients with higher BMI at the diagnosis of DM experienced shorter honeymoon period than the average. Smaller of our patients who diagnosed just DM have more than 297 days honeymoon period with respect to patients with one associated autoimmune disease. This may be due to a continuous and prolonged stimulation of immune system during the period of honeymoon that predispose the patient to develop other TH1 diseases. The patients who experienced more than 297 days Partial Clinical Remission seem under risk of developing one other autoimmune disease more than the patients who experienced less than 297 days Partial Clinical Remission. We have to consider that this observation is very intriguing because many protocols spring-up to try prolonging the honeymoon period in patients with autoimmune DM. If this aim is important from a metabolic point of view, long follow-ups are needed to be sure that the risk of other autoimmune diseases does not increase.

Prolonged type 1 diabetes honeymoon period: Case report and review of the literature

The clinical and biochemical variables of a patient with unusual and relatively long? type 1 diabetes (T1DM) remission are reported. The case is followed by literature review of interventions with a positive impact on T1DM remission. The patient has clinical and biochemical phenotype consistent with T1DM. He refused to take treatment for diabetes. He has been using Trigonella foenum-graecum as the only treatment for diabetes. The patient has not developed diabetic ketoacidosis until the time of this report (34 months after his initial diagnosis), which is unusual for patients with T1DM. The positive effect of Trigonella foenum-graecum on T1DM remission in this patient is not ascertained but possible. Relevant literature of studies and case reports of similar prolonged T1DM remission reviewed and summarized. There is a clear need to continue exploring interventions in prospective studies to induce and prolong T1DM remission.

The Remission Phase in Type 1 Diabetes: Role of Hyperglycemia Rectification in Immune Modulation.

The remission phase (or honeymoon period) is a spontaneous “temporary cure stage” in type 1 diabetes course, which provides a good human model for studying β-cell protection. The exact mechanisms are still uncertain, but one of the generally recognized mechanisms is that correction of “glucotoxicity” by exogenous insulin therapy leads to “β-cell rest” and β-cell recovery. Beyond this, the remission phase is accompanied by changes in various immune cells and immune molecules, indicating downregulation of immune response, and induction of immune tolerance. The role of hyperglycemia rectification in the regulation of immune response should be emphasized because glucose metabolism is critical to maintain the normal function of immune system. Here, recent evidence of immune modulation based on the rectification of hyperglycemia from multiple aspects such as immune cells, inflammatory cytokines, biomolecules, and cell antigenicity was reviewed. It should be noteworthy that the interaction between glucose metabolism and immune plays an important role in the pathogenesis of the remission phase. The best intervention strategy may be the combination of strict glycemic control and immune modulation to protect β-cell function as early as possible.

Elections in Cape Verde, 1991-2016: Testing the second-order election model in a consolidated semi-presidential African democracy1

In this article, we analyse patterns of turnout and electoral choices of Cape Verde’s citizens in different types of elections, looking at all legislative, presidential and local elections held between 1991 and 2016, and testing four hypotheses derived from the second-order election model about differences in terms of turnout, number of spoiled/blank papers, results for the incumbent party and the electoral success of smaller parties. Our results show that, in what regards turnout and electoral behaviour, local elections present the features of second-order elections much more clearly than the presidential elections in this semi-presidential regime. However, this pattern does not necessarily mean that voters look at the latter as less second-order, but since they often took place in the honeymoon period of the legislative electoral cycle, it may only mean that there were lower incentives to punish the incumbent and/or disengage from political participation.