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Associations between Sleep Disorders and Comfort at End-of-Life: Opportunities for Improvement
Karen J Klingman,Suzanne Sullivan 대한수면학회 2018 sleep medicine research Vol.9 No.2
Comfort and quality of life (QoL) at the end-of-life (EOL) comprise physical and psychosocial do- mains. e e ects of sleep disorders such as insomnia on comfort-related factors have been wide- ly reported for cancer patients, yet the e ect of sleep disorders on comfort may be less well-docu- mented for non-cancer conditions. Quantifying these e ects may inform improvements in EOL comfort by treating sleep disorders. e objective of this literature review is to quantify associations between sleep disorders and comfort in non-cancer patients at EOL. A systematic review of the lit- erature identi ed three articles comprising a total of 239 participants, 88% males, 83% with cancer. Comfort-related factors included QoL, dyspnea, rumination, depression, delirium, anxiety, cognitive impairment, and suicidal ideation. e e ect of sleep disorders on comfort related factors was sub- stantial. ere is a gap in the literature indicating a need for future studies in this area.
RISK REDUCTION STRATEGIES FOR USING CELEBRITIES IN LUXURY BRAND COMMUNICATIONS
Karen W. Miller,Jane Summers 글로벌지식마케팅경영학회 2016 Global Marketing Conference Vol.2016 No.7
Currently, the luxury retail market exceeds one trillion dollars in sales (Aroche, 2015) and is proliferated by the use of celebrities as endorsers and luxury brand ambassadors (Buckley, 2015; Okonkwo 2010). The practice of linking celebrities in luxury brand communications dates back to at least the 1800s and while the successful usage of celebrities is widely documented (e.g., Agrawal & Kamakura, 1995), so too are the stories of catastrophes as a result of celebrity transgression, overshadowing or just poor fit. Even without negative publicity or inappropriate behaviours, the use of a celebrity can still present risks to the luxury brand. For example, where unintended meanings associated with the celebrities are transferred to the luxury brand (Walker & Langmeyer, 1992; Till, 1998) or when the popularity of the celebrity (e.g. Angelina Jolie) overshadows the brand (e.g. St John) (Buckley, 2015; Horwell, 2011; Rossiter & Percy, 1987; Till & Busler, 2000). Overshadowing isn’t the only risk luxury brand managers may encounter when utilising a celebrity to endorse their brand. If, for example, consumers don’t see a match between the brand and the celebrity, or if consumers perceive the celebrity as being irrelevant to the brand, or if the celebrity has lost their appeal and connection with consumers then the celebrity presents a risk for the brand image (Choi & Rifon, 2012; Fleck, Korchia & Le Roy, 2012; Till & Busler, 2000). The choice of the ‘wrong’ celebrity can be an extremely costly mistake, with loss of sales and/or damage to the brand equity and image of the luxury brand being the potential outcome (Carrillat, D’Astous & Lasure, 2013; Folse, Burton & Netemeyer, 2013; Halonen-Knight & Hurmerinta, 2010; Thwaites, Lowe, Monkhouse & Barmes, 2012). Risk reducing strategies and due diligence during the selection process is a lengthy, complicated and complex process (Erdogan, Baker & Tagg, 2001). Luxury brand managers have long called for a more systematic and objective criteria by which to evaluate the potential celebrity risk factors (Okonkwo, 2010; Toncar, Reid, & Anderson, 2007); and this paper takes up that call with three contributions to both the literature and to practice. The first contribution concerns risk reduction strategies and extensions to the current thinking on the celebrity construct (for a thorough discussion on the celebrity construct see Gabler, 2001; Goldman, 2011; Rojek, 2001; Turner, 2004). There is a small stream of research that discusses the non-human celebrity as both a risk reducer for celebrity endorsement and also as an extension of the concept of ‘celebrity’ (e.g., Blewitt, 2013; Callcott & Lee, 1995; Folse et al., 2013; Giles, 2013; Rindova, Pollock & Hayward, 2006). This stream of research is novel and emergent and our work adds to this literature by defending our claim that like firms, animals, mythical beings and fictitious humans, events can also be celebrities. Broadening the conceptualisation of celebrity to apply to more than just real people, allows luxury brand managers to reduce costs, and regain some degree of control over the important image and reputational management of the celebrities with whom they wish to be associated The second contribution is the Celebrity Criterion Checklist, which provides luxury brand managers with a simple, systematic and quick way to determine whether someone or something (an entity) is a celebrity or not (given at least 15 years of debate about the contest term of “celebrity”). The Celebrity Criterion Checklist contains five criterion. If a luxury brand manager finds the entity they are considering fulfils all five criteria, then the brand manager be confident that they are a celebrity. The third contribution is the Celebrity Risk Evaluation Matrix (CREM). The Celebrity Risk Evaluation Matrix (CREM), facilitates higher-ordered assessments of the risk/benefit ratio associated with using different types of celebrities in luxury brand communications in a simple visual representation. Since celebrities are dynamic and have an ongoing narrative, celebrities can and do move between these quadrants and movement will depend on their life-cycle, their behavioural choices, their media presence, their authenticity and their relevance to consumers.
The Role of Axonopathy in Parkinson's Disease
Karen L. O'Malley 한국뇌신경과학회 2010 Experimental Neurobiology Vol.19 No.3
New genetic and environmental studies of Parkinson's disease have revealed early problems in synaptic function and connectivity indicating that axonal impairment may be an important hallmark in this disorder. Since many studies suggest that axonal dysfunction precedes cell body loss, it is critical to target axons with treatments aimed at preserving "connectivity" as well as to develop and verify "biomarkers" with which to assess disease progression and drug efficacy.
Karen S. Ballard,Howard D. Homesley,Charles Hodson,Cary A. Presant,James Rutledge,Allan Hallquist,Mathieu Perree 대한부인종양학회 2010 Journal of Gynecologic Oncology Vol.21 No.1
Objective: The in vitro microculture kinetic (MiCK) apoptosis assay has been used to predict single or combination chemotherapy response in leukemia patients. This feasibility study addressed MiCK in endometrial cancer specimens. Methods: Endometrial cancer specimens from total abdominal hysterectomies were processed at a central laboratory. Single cell suspensions of viable endometrial cancer cells were plated in individual wells. Single and combination regimens were tested: combinations of doxorubicin, cisplatin, and paclitaxel and carboplatin and paclitaxel (Gynecologic Oncology Group [GOG] 209 endometrial cancer phase III trial arms) as well as single agent testing with paclitaxel,carboplatin, doxorubicin, cisplatin, ifosfamide, and vincristine (active agents in GOG trials). Apoptosis was measured continuously over 48 hours. Results: Fifteen of nineteen patients had successful assays. The highest mean chemo sensitivity was noted in the combination of cisplatin, doxorubicin, and paclitaxel with lower mean chemosensitivity for carboplatin and paclitaxel. Combination chemotherapy had higher chemosensitivity than single drug chemotherapy. However, in 25% of patients a single drug had higher chemosensitivity than combination chemotherapy. As single agents, ifosfamide, cisplatin, and paclitaxel had the highest kinetic unit values. Conclusion: Using a panel of agents simulating clinical dose regimens, the MiCK assay was feasible in evaluating in vitro chemosensitivity of endometrial cancer. MiCK assay results correlated with GOG clinical trial results. However,25% of patients might be best treated with single agent chemotherapy selected by MiCK. Ifosfamide, cisplatin, and paclitaxel appear to have high activity as single agents. MiCK may be useful in future new drug testing and individualizing endometrial cancer patient’s chemotherapy management.
Viewpoints on Acid-Induced Inflammatory Mediators in Esophageal Mucosa
( Karen M Harnett ),( Florian Rieder ),( Jose Behar ),( Piero Biancani ) 대한소화관운동학회 2010 Journal of Neurogastroenterology and Motility (JNM Vol.16 No.4
We have focused on understanding the onset of gastroesophageal reflux disease by examining the mucosal response to the presence of acid in the esophageal lumen. Upon exposure to HCl, inflammation of the esophagus begins with activation of the transient receptor potential channel vanilloid subfamily member-1 (TRPV1) in the mucosa, and production of IL-8, substance P (SP), calcitonin gene related peptide (CGRP) and platelet activating factor (PAF). Production of SP and CGRP, but not PAF, is abolished by the neural blocker tetrodotoxin suggesting that SP and CGRP are neurally released and that PAF arises from non neural pathways. Epithelial cells contain TRPV1 receptor mRNA and protein and respond to HCl and to the TRPV1agonist capsaicin with production of PAF. PAF, SP and IL-8 act as chemokines, inducing migration of peripheral blood leukocytes. PAF and SP activate peripheral blood leukocytes inducing the production of H2O2. In circular muscle, PAF causes production of IL-6, and IL-6 causes production of additional H2O2, through activation of reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidases. Among these, NADPH oxidase 5 cDNA is significantly up-regulated by exposure to PAF; H2O2 content of esophageal and lower esophageal sphincter circular muscle is elevated in human esophagitis, causing dysfunction of esophageal circular muscle contraction and reduction in esophageal sphincter tone. Thus esophageal keratinocytes, that constitute the first barrier to the refluxate, may also serve as the initiating cell type in esophageal inflammation, secreting inflammatory mediators and pro-inflammatory cytokines and affecting leukocyte recruitment and activity.
Outcomes and strategies in the ‘New Great Game’: China and the Caspian states emerge as winners
Karen Smith Stegen,Julia Kusznir 한양대학교 아태지역연구센터 2015 Journal of Eurasian Studies Vol.6 No.2
The decades-long struggle for control over oil and natural gas resources, infrastructure and influence in the Caspian region has been referred to as the ‘New Great Game’, with Europe, China, the US and Russia typically cited as the main combatants. We explore recent developments and aver that, if present trends continue, Europe will have access to Azerbaijan's resources, China to those of the East Caspian states, the US will stay commercially and strategically engaged, and Russia's influence will (continue to) diminish. How did this unexpected turn of events arise? We examine China's dominance and argue that the foreign policies of the US and Russia - within the region and even further abroad - have inadvertently driven the East Caspian states and China towards each other. Wary of potential maritime chokepoints in the Pacific, China feels strongly compelled to shore up resources and influence in the Caspian region. In part because of Russia's intransigence regarding the Caspian Sea's status, the East Caspian states - faced with constrained access to the West - have turned to China as an alternative market and counterbalance to Russia. Copyright © 2015, Asia-Pacific Research Center, Hanyang University. Production and hosting by Elsevier Ltd. All rights reserved.
Karen Hui-Jung Chen,Angela Yung-Chi Hou 서울대학교 교육연구소 2016 Asia Pacific Education Review Vol.17 No.1
In 2012, Taiwan implemented a dual-track quality assurance system comprising accreditation and self-accreditation in higher education institutions. Self-accrediting institutions can accredit their programs without requiring approval from external quality assurance agencies. In contrast to other countries, the Ministry of Education of Taiwan authorized self-accrediting institutions to develop their own evaluation standards. This study investigated the institution-based accreditation standards and their implications on institutional internal quality assurance. Content analysis revealed that 37 % of the indicators of self-accreditation were new and not used as review indicators in the original accreditation track. Two frequently added indicators were featured indicators and levels of internationalization. The results also indicated that institutions tend to structure their internal quality assurance systems uniquely. Three types of approaches for developing institution-based standards were identified: bottom-up, hybrid, and innovative approaches. Self-accreditation has benefited institutions committed to educational quality and pursuing excellence by enabling them to employ a fitness-for-purpose approach. The diversity of higher education and educational policy changes constitute new challenges to higher education. Balancing between accountability and autonomy is critical for all stakeholders of higher education.