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When confessions are entered into evidence in criminal courts, issues of coercion and voluntariness are important and often contested matters. Occasionally, defense attorneys proffer expert witness...

The quality of the information provided in post-transplant follow-up is necessary to obtain a coherent and exploitable database. Since the beginning of 2017, three forms (Med-B-allograft) have been available: the first month (Day 0), Day 100 (second report) and an annual follow-up report. Recommendations for follow-up were addressed in the 2014 harmonization workshop, "Harmonization of Data Coding…". However, it is sometimes difficult to determine which data to specify in ProMISe for post-transplantation. The objective of this workshop was to clarify certain situations and/or items.

La finalidad de la presente investigación fue establecer, cómo la comunicación interna incide en la identidad corporativa de los funcionarios de la Municipalidad Distrital de Marcona, 2019. Fue una investigación de enfoque mixto, cuya muestra estuvo constituida por 116 funcionarios y servidores de la Municipalidad Distrital de Marcona, a esos se les aplicó una encuesta, y a los funcionarios responsables de la oficina de Identidad Corporativa, una entrevista no estructurada. Entre los resultados se tiene que el 21% de los funcionarios y servidores, están en desacuerdo con los flujos de comunicación interna que se vienen desarrollando en la Municipalidad. El 18% manifestó estar en desacuerdo con el manejo de los medios de comunicación interna. Para el 37% de los entrevistados, la cultura corporativa de creencias, se observa pocas veces en la Municipalidad. Para el 43% de los funcionarios y servidores la cultura corporativa de imagen se observa pocas veces. El 21% de los funcionarios y servidores entrevistados manifestaron que, la cultura corporativa de valores pocas veces se cumple. El personal del municipio, tienen escasos conocimientos de los valores institucionales. No existe amplia difusión de los objetivos institucionales. No se ha implementado un plan de comunicación interna, para conocer los objetivos que se tienen, y atender mejor a los ciudadanos. Existe una relación entre la Comunicación interna y la Identidad corporativa de los funcionarios de la Municipalidad Distrital de Marcona, por haberse encontrado una correlación de 0,691.

Interrogation has evolved over more than a century of policing into a discipline drawing on principles of law and psychology. This evolution has made necessary, and been facilitated by, increasingly sophisticated evaluations of police interviews and interrogations. Some research has been purely descriptive, some has been aimed at law enforcement training and assessment, and, more recently, some has evaluated the coercive pressures present in interrogations. Our chapter will begin with a discussion on the challenges of defining coercion in an interrogative context. A brief summary of methods of suspect questioning will also be provided. Individual differences in suspect vulnerability to the coercive pressures of interrogation will be considered, particularly with respect to youth and intellectual disability as risk factors. We will then review the differing perspectives of interrogation offered by laypeople, criminal justice officials, and social scientists. With that background in mind, we turn to observational studies and what commonly takes place during interrogations. Following these reviews, we propose a new psychometric framework for measuring and quantifying coercion in investigative interviews and interrogations, and review our nascent research on this instrument.

Police investigators, judges, and jurors are often very skeptical of alibi witness testimony. To investigate when and why individuals lie for one another, we conducted two studies in which witnesses' support of a false alibi was observed. We varied the level of social pressure exerted on witnesses and the level of affinity between suspect-witness pairs. During a study session purportedly intended to investigate dyadic problem-solving ability, a mock theft was staged. When questioned, participants were provided the opportunity to either corroborate or refute a confederate's false alibi that the latter was with them when the theft occurred. Participants were more likely to lie for the confederate when the latter explicitly asked participants to conceal his/her whereabouts during the time of the theft (Study 1). How much participants liked the suspect did not impact lying; however, participants lied for a confederate more often when the latter was a friend rather than a stranger (Study 2). Results show that alibi witnesses often lie and that investigators and jurors may not accurately estimate the likelihood that such witnesses will lie for one another. Witnesses who lied also reported doing so more often because they believed that the suspect was innocent rather than guilty. Copyright © 2016 John Wiley & Sons, Ltd.

Resume Les difficultes des etudes prospectives et retrospectives issues de la base des donnees europeenne (ProMISe), et des etudes propres a chaque centre sont dues a des donnees insuffisamment mises a jour, manquantes ou incoherentes. Si les donnees sont erronees, les resultats eux-memes seront errones. Lors des sixiemes ateliers d’harmonisation des pratiques, un groupe forme des data managers a travaille dans le but d’apporter une aide pour parvenir a une base de donnees « propre », avec un minimum d’erreurs a transmettre, et pour harmoniser la saisie des donnees. Le sujet de cet atelier etait le codage des diagnostics d’un certain nombre de maladies ainsi que l’etat hematologique a la greffe.

The quality of the information provided in post-transplant follow-up is necessary to obtain a coherent and exploitable database. Since the beginning of 2017, three forms (Med-B-allograft) have been available: the first month (Day 0), Day 100 (second report) and an annual follow-up report. Recommendations for follow-up were addressed in the 2014 harmonization workshop, "Harmonization of Data Coding…". However, it is sometimes difficult to determine which data to specify in ProMISe for post-transplantation. The objective of this workshop was to clarify certain situations and/or items.

Purpose To assess the efficacy and toxicity of bortezomib (Velcade; Milennium Pharmaceuticals Inc, Cambridge, MA; formerly PS-341) in patients with metastatic renal cell carcinoma (RCC). Patients and Methods Thirty-seven patients with metastatic RCC were treated with bortezomib. The first 25 patients enrolled onto the trial were treated with a dose of 1.5 mg/m2. The dose was decreased to 1.3 mg/m2 for the subsequent 12 patients, because more than 50% of the patients treated at the higher dose required dose reductions. Bortezomib was given by intravenous administration on a twice-weekly schedule for 2 weeks followed by 1 week without treatment until progression or unacceptable toxicity occurred. Twenty-three patients (62%) previously had undergone nephrectomy, and 19 patients (51%) had previously been treated with cytokine therapy. Results Of the 37 assessable patients, the best response was a partial response in four patients (11%; 95% CI, 3% to 25%) and stable disease in 14 patients (38%; 95% CI, 23% to 55%). The four patients with partial response experienced response durations of 8, 8+, 15+, and 20+ months. Grade 2 or 3 sensory neuropathy was present in 10 patients (53%) overall. One patient in the 1.5 mg/m2 group had grade 3 sensory neuropathy; no grade 3 sensory neuropathy was seen in the 1.3 mg/m2 group. Conclusion The results of this trial suggest that bortezomib has an antitumor effect in individual patients with metastatic RCC. The small proportion of patients who achieved a partial response does not support routine use in metastatic RCC. Efforts to identify the molecular profile associated with clinical response or combination therapy with interferon alfa or other novel agents, may be considered.

PurposeTo describe survival in previously treated patients with metastatic renal cell carcinoma (RCC) who are candidates for clinical trials of new agents as second-line therapy.Patients and MethodsThe relationship between pretreatment clinical features and survival was studied in 251 patients with advanced RCC treated during 29 consecutive clinical trials between 1975 and 2002. Clinical features were first examined in univariate analyses, and then a stepwise modeling approach based on Cox regression was used to form a multivariate model.ResultsMedian survival for the 251 patients was 10.2 months and differed according to year of treatment, with patients treated after 1990 showing longer survival. In this group, the median overall survival time was 12.7 months. Because the purpose of this analysis was to establish prognostic factors for present-day clinical trial design, prognostic factor analysis was performed on these patients. Pretreatment features associated with a shorter survival in the multivariate analysis were low Karnofsky performance status, low hemoglobin level, and high corrected serum calcium. These were used as risk factors to categorize patients into three different groups. The median time to death in patients with zero risk factors was 22 months. The median survival in patients with one of these prognostic factors was 11.9 months. Patients with two or three risk factors had a median survival of 5.4 months.ConclusionTreatment with novel agents during a clinical trial is indicated for patients with metastatic RCC after progression to cytokine treatment. Three prognostic factors for predicting survival were used to categorize patients into risk groups. These risk categories can be used in clinical trial design and interpretation.

BACKGROUND The objective of the current study was to evaluate the effect on response assessment classification in patients with metastatic renal cell carcinoma (RCC) using unidimensional (Response Evaluation Criteria in Solid Tumors) and bidimensional (World Health Organization) criteria, including or excluding measurements of the primary renal tumor and using a new index to compensate for the disproportionate effect of large renal tumors relative to their metastases. METHODS Fifty-three imaging studies involving a total of 44 patients with metastatic RCC who were treated on clinical trials of interferon-α analogue and/or thalidomide were reviewed retrospectively. The best overall response assessment and progression free survival were calculated with both unidimensional and bidimensional tumor measurements. Patients were then stratified into two groups: patients with primary renal tumors in situ and patients who underwent resection of their primary renal tumors. The best overall response and the time to disease progression were calculated based on the sum of measurements (conventional methodology), both including and excluding the primary tumor. A new method of response assessment, the ‘normalized lesion index’, which equalizes the differences in tumor size for an individual patient, was evaluated and compared with the conventional response assessment. RESULTS There was an 11% disagreement rate in the best overall response assessment between unidimensional and bidimensional measurements. The time to progression was 9.2 months measured unidimensionally, compared with 6.4 months assessed bidimensionally. In the group of patients who had primary renal tumors in situ, using the conventional sum of measurements method, the apparent time to progression was an average of 4.2 months longer compared with measurements that did not include the primary renal tumor. The use of the normalized lesion index method resulted in an improved concordance in best overall response assessments and similar time to progression assessments when the primary renal tumor was included compared with patients who did not have primary renal tumors in situ. CONCLUSIONS The use of unidimensional measurements in RCC therapy assessment results in significantly different time to progression classification compared with the use of bidimensional measurements. Response assessment classification in patients with RCC is affected by the exclusion or inclusion of measurements of the primary renal tumor. The normalized lesion index warrants further study in assessing response in patients with metastatic RCC and other solid tumor malignancies that often show substantial differences in sizes of measurable lesions. Cancer 2003. © 2003 American Cancer Society. DOI 10.1002/cncr.11712

Fourteen patients with cisplatin-refractory germ cell tumors (GCT) were treated with temozolomide on a phase II trial. Temozolomide was given orally at 150 mg/m2/day on days 1-5. The cycle length was 28 days. No patient experienced a grade 3 or 4 toxicity, and none of the 14 evaluable patients achieved a complete or partial response. Temozolomide is not efficacious in the treatment of cisplatin-refractory GCT patients.

Tesis Univ. Granada. Departamento de Psicología Experimental y Fisiología del Comportamiento. Leída el 21 de junio de 2011

Purpose To define the incidence, clinical features, and outcome to salvage chemotherapy in patients with late-relapse germ cell tumor (GCT) after a complete response to first-line chemotherapy. Patients and Methods Two patient populations were examined. First, retrospective analysis of 246 patients treated on a clinical trial with salvage chemotherapy was performed; 29 patients with late-relapse GCT were identified and evaluated for treatment outcome and survival. Salvage regimens included paclitaxel, ifosfamide, and cisplatin, single agents, or a high-dose chemotherapy program. Second, the incidence of late relapse was assessed by retrospective analysis of 551 patients after a complete response (CR) to first-line chemotherapy. Results Twenty-nine patients received salvage chemotherapy on a clinical trial for late relapse GCT. The median survival was 23.9 months. At a median follow-up of 50.6 months, there were nine survivors. The chemotherapy regimens varied, but the only CRs were observed in patients treated with paclitaxel, ifosfamide, and cisplatin. Seven (50%) of 14 patients treated with paclitaxel, ifosfamide, and cisplatin achieved a continuous CR. Among the second population of 551 patients who had previously achieved a CR to a first-line chemotherapy trial, 17 were identified as having a late relapse (3%). The median time to relapse for these 17 patients was 7.8 years. Conclusion Late-relapse GCT is uncommon and is associated with a poor prognosis resulting from a high degree of resistance to chemotherapy. Chemotherapy with paclitaxel, ifosfamide, and cisplatin followed by surgery may be effective in patients with late-relapse GCT who are not considered candidates for primary surgery.

Purpose The efficacy of paclitaxel was evaluated in combination with ifosfamide and cisplatin as second-line chemotherapy for patients with relapsed testicular germ cell tumors (GCTs). Patients and Methods Forty-six patients with progressive metastatic GCTs were treated with paclitaxel and ifosfamide plus cisplatin (TIP) as second-line therapy. Eligibility required that patients have both a testis primary tumor site and a prior complete response (CR) to a first-line chemotherapy program, which had been identified previously as favorable prognostic factors to conventional-dose salvage chemotherapy. Results Thirty-two (70%) of 46 patients achieved a CR to treatment. Three patients (7%) who achieved a CR relapsed after TIP chemotherapy. Twenty-nine patients are continuously disease free at a median follow-up time of 69 months, resulting in a 63% durable CR rate and a 2-year progression-free survival rate of 65% (95% CI, 51% to 79%). Conclusion Four cycles of TIP as second-line therapy achieved a durable CR rate in a high proportion of patients with relapsed testicular GCT. The high CR rate emphasizes the importance of patient selection according to prognostic factors to achieve a favorable outcome to conventional-dose salvage therapy.

4522 Background: Late relapse GCT occurs > 2 years after initial chemotherapy and is associated with a poor prognosis (JCO 13:1170). The MSKCC experience with late relapse GCT was examined from two...