The perception of code-switched speech in noise.

This study investigates heritage bilingual speakers' perception of naturalistic code-switched sentences (i.e., use of both languages in one sentence). Studies of single word perception suggest that code-switching is more difficult to perceive than single language speech. However, such difficulties may not extend to more naturalistic sentences, where predictability and other cues may serve to ameliorate such difficulties. Fifty-four Mexican-American Spanish heritage bilinguals transcribed sentences in noise in English, Spanish, and code-switched blocks. Participants were better at perceiving speech in single language blocks than code-switched blocks. The results indicate that increased language co-activation when perceiving code-switching results in significant processing costs.

Women's empowerment in Pakistan-definitions and enabling and disenabling factors: a secondary data analysis.

PURPOSE: The purpose of the study was to explore Pakistani women's definition of women's empowerment, including its enabling and disenabling factors. Through understanding empowerment, interventions may be developed for women to be empowered. DESIGN: Transcriptions of 35 interviews from a previous study were reanalyzed through secondary data analysis. FINDINGS/RESULTS: The themes of economic stability, social acceptability, educational achievement, and family harmony emerged for the concept of definition of empowerment. Themes for enabling factors were strength of personality and openness of mind. Disenabling factors had sociocultural influences, religious misinterpretations, and dominant ideology as themes. DISCUSSION/CONCLUSIONS: Pakistani women hold on to their customs, traditions, and religion tenaciously. The views of empowerment leading to the themes were expressed as true for their lives.

Violence against women in Pakistan: a framework for analysis.

Understanding violence against women is as complex as its process. As a perusal of literature shows that most of the explanations were contextually and culturally based, this review attempts to analyze the issue of violence against women using theories applicable within the Pakistani context. Literature examining the issue of violence against women and its various theories was reviewed. A framework using the determinants of violence against women as proposed, include intrinsic and extrinsic factors within the people, the socio-economic-political and cultural system of Pakistan and the influences of surrounding countries. The Pakistani scenario has been described and the theoretical bases were presented. Each determinant has been discussed with supporting literature. Further studies are needed to strengthen the framework; however, it provided a modest view of violence against women in Pakistan. The framework would help the policy and decision makers to understand the dynamics of violence against women and may move them to action to bring about improvements in women's' lives.

Management of side effects of novel therapies for multiple myeloma: consensus statements developed by the International Myeloma Foundation's Nurse Leadership Board.

Nurses play an essential role in managing the care of patients with multiple myeloma, who require education and support to receive and adhere to optimal therapy. The International Myeloma Foundation created a Nurse Leadership Board comprised of oncology nurses from leading cancer centers and community practices. An assessment survey identified the need for specific recommendations for managing key side effects of novel antimyeloma agents. Myelosuppression, thromboembolic events, peripheral neuropathy, steroid toxicities, and gastrointestinal side effects were selected for the first consensus statements. The board developed recommendations for healthcare providers in any medical setting, including grading of side-effect toxicity and strategies for managing the side effects in general, with specific recommendations pertaining to the novel agents.

Myelosuppression associated with novel therapies in patients with multiple myeloma: consensus statement of the IMF Nurse Leadership Board.

Novel therapies for multiple myeloma include the immunomodulatory drugs lenalidomide and thalidomide and the proteasome inhibitor bortezomib, which have increased response rates and survival times. However, the agents can cause myelosuppression, which, if not managed effectively, can be life threatening and interfere with optimal therapy and quality of life. The International Myeloma Foundation's Nurse Leadership Board developed a consensus statement that includes toxicity grading, strategies for monitoring and managing myelosuppression associated with novel therapies, and educational recommendations for patients and their caregivers. Although anemia, neutropenia, and thrombocytopenia are expected side effects of novel therapies for multiple myeloma, they are manageable with appropriate interventions and education.

Predictors of academic performance in the first year of basic nursing diploma programme in Sindh, Pakistan.

Identification of the students who are most likely to succeed in the nursing programmes has always remained an important goal of nursing schools and nurse educators. This study was conducted to identify predictors of academic performance of the students in the first year of basic nursing diploma programme in the province of Sindh, Pakistan. For this descriptive study, data was collected from Sindh Nurses Examination Board and all schools of nursing in province of Sindh. Multiple linear regression analysis method was used to develop regression model that identified predictor variable. Results indicated that academic factors including entry qualification, previous academic performance, and type of school are significantly related with the academic performance of the students. The study concluded that academic factors are better predictors of students' academic performance than the non-academic factors.

Composition of the black crusts from the Saint Denis Basilica, France, as revealed by gas chromatography-mass spectrometry.

The organic fraction of black crusts from Saint Denis Basilica, France, is composed of a complex mixture of aliphatic and aromatic compounds. These compounds were studied by two different analytical approaches: tetramethyl ammonium hydroxide (TMAH) thermochemolysis in combination with gas chromatography-mass spectrometry (GC-MS), and solvent extraction, fractionation by silica column, and identification of the fraction components by GC-MS. The first approach, feasible at the microscale level, is able to supply fairly general information on a wide range of compounds. Using the second approach, we were able to separate the complex mixture of compounds into four fractions, enabling a better identification of the extractable compounds. These compounds belong to different classes: aliphatic hydrocarbons (nalkanes, n-alkenes), aliphatic and aromatic carboxylic acids (n-fatty acids, alpha,omega-dicarboxylic acids, and benzenecarboxylic acids), polycyclic aromatic hydrocarbons (PAH), and molecular biomarkers (isoprenoid hydrocarbons, diterpenoids, and triterpenoids). With each approach, similar classes of compounds were identified, although TMAH thermochemolysis failed to identify compounds present at low concentrations in black crusts. The two proposed methodological approaches are complementary, particularly in the study of polar fractions.

2-Chlorodeoxyadenosine alone and in combination for previously untreated Waldenstrom's macroglobulinemia.

Treatment for Waldenstrom's macroglobulinemia (WM) has usually been reserved for symptomatic patients and has included alkylating agent-steroid combinations and, more recently, nucleoside analogues. We now describe our experience with 2-chlorodeoxyadenosine (2-CdA) alone and in combination at our center. We treated 90 consecutive, previously untreated patients with symptomatic WM using either 2-CdA alone or in combination with other agents including prednisone (pred), cyclophosphamide (Cy), and rituximab (Rit) as follows: January 1991 to December 1992- 2-CdA 0.1 mg/kg by continuous infusion (CI) over 24 hours for days (16 patients); December 1992 to December 1995-2-CdA 0.1 mg/kg CI over 24 hours for 7 days plus pred 60 mg/m(2) orally daily for 7 days (20 patients); July 1996 to March 1998-2-CdA 1.5 mg/m(2) by subcutaneous injection (SC) every 8 hours for 7 days plus Cy 40 mg/m(2) orally twice daily for 7 days (37 patients); August 1999 to December 2001-2-CdA 1.5 mg/m(2) SC every 8 hours for 7 days plus Cy 40 mg/m(2) orally twice daily for 7 days plus Rit 375 mg/m(2) by intravenous infusion (IV) weekly for 4 weeks (17 patients). For nearly all patients, a second course was repeated after at least 6 weeks. Responding patients were monitored without further treatment until relapse. Overall response (complete [CR] + partial response [PR]) was 94% for 2-CdA alone, 60% for 2-CdA/pred, 84% for 2-CdA/Cy, and 94% for 2-CdA/Cy/Rit. Median overall survival is 73 months for 2-CdA, 41 months for 2-CdA/pred, and has not been reached for 2-CdA/Cy or 2-CdA/Cy/Rit. Cause-specific survival for 2-CdA/pred is 78 months and has not been reached for all other programs. The only poor prognostic factor for cause-specific survival was hemoglobin < 9 g/dL. 2-CdA regimens provide excellent response rates and improve cause-specific survival, with minimal treatment and little toxicity. These observations support the potential role of 2-CdA regimens as the treatment of choice for previously untreated WM.

Thalidomide alone or with dexamethasone for previously untreated multiple myeloma.

PURPOSE: To evaluate the activity of thalidomide in patients with asymptomatic multiple myeloma and of thalidomide-dexamethasone in patients with previously untreated symptomatic myeloma. PATIENTS AND METHODS: Twenty-eight patients with previously untreated asymptomatic myeloma were treated with thalidomide 100 to 200 mg orally (PO) at bedtime (qhs) with serial increments of 50 to 100 mg at weekly intervals, as tolerated to a maximum of 600 mg PO qhs. Forty consecutive previously untreated patients with symptomatic myeloma were also treated as above (maximum dose 400 mg) and received dexamethasone 20 mg/m(2) for 4 days beginning on days 1, 9, and 17; the second and third cycles of repeated dexamethasone were begun on day 30. Both groups of patients were treated for at least 3 months. RESULTS: The response rate was 36% for patients treated with thalidomide alone and 72% for patients treated with thalidomide-dexamethasone, the latter including complete remission in 16% of patients. The median time to remission was 4.2 months with thalidomide alone and 0.7 months with thalidomide-dexamethasone. Grade 3 toxicity included infections (nine patients) and thrombotic/embolic events (seven patients). Five deaths have occurred as a result of multiple myeloma (two patients), infection (one patient), unknown cause (one patient), and a possible thromboembolic event (one patient). CONCLUSION: Thalidomide alone was effective in patients with newly diagnosed myeloma. The combination with dexamethasone induced a high frequency of response, rapid onset of remission, and low incidence of serious irreversible toxicity. These observations support further studies of this promising combination for patients with newly diagnosed multiple myeloma.