Churg-Strauss syndrome presenting with conjunctival and eyelid masses: a case report.

PubMed

Ameli, F; Phang, K S; Masir, N

2011-12-01

Churg-Strauss syndrome, a small and medium vessel vasculitis, was first described by Churg and Strauss in 1951. It is characterised by the presence of asthma, prominent tissue and blood eosinophilia, systemic vasculitis, and pulmonary and systemic necrotising allergic granulomas. Involvement of the skin, heart and gastrointestinal tract is well documented, but ocular presentation is unusual. We describe a 40-year-old lady who presented with recurrent upper eyelid swelling due to conjunctival lesions. Although she has chronic asthma, Churg-Strauss syndrome was never suspected. The diagnosis of Churg-Strauss syndrome was only made following histological examination of the conjunctival lesions.

[Mastitis revealing Churg-Strauss syndrome].

PubMed

Dannepond, C; Le Fourn, E; de Muret, A; Ouldamer, L; Carmier, D; Machet, L

2014-01-01

Churg-Strauss syndrome often involves the skin, and this may sometimes reveal the disease. A 25-year-old woman was referred to a gynaecologist for inflammation of the right breast with breast discharge. Cytological analysis of the liquid showed numerous inflammatory cells, particularly polymorphonuclear eosinophils and neutrophils. Ultrasound examination of the breast was consistent with galactophoritis. CRP was normal, and hypereosinophilia was seen. The patient was subsequently referred to a dermatology unit. Skin examination revealed inflammation of the entire breast, which was painful, warm and erythematous; the border was oedematous with blisters. Necrotic lesions were also present on the thumbs and knees. Skin biopsy of the breast showed a dermal infiltrate with abundant infiltrate of polymorphonuclear eosinophils, including patchy necrosis and intraepidermal vesicles. Histological examination of a biopsy sample from a thumb revealed eosinophilic granuloma and leukocytoclastic vasculitis. The patient was also presenting asthma, pulmonary infiltrates and mononeuropathy at L3, consistent with Churg-Strauss syndrome. Breast involvement in Churg-Strauss syndrome is very rare (only one other case has been reported). This is the first case in which the breast condition revealed the disease. Cutaneous involvement of the breast is, however, also compatible with Wells' cellulitis. The lesions quickly disappeared with 1mg/kg/d oral prednisolone. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

[Parotid involvement in Churg-Strauss syndrome].

PubMed

Bonnet, R; Bertin, H; Delemazure, A S; Clairand, R; Mercier, J; Corre, P

2014-06-01

Churg-Strauss syndrome is a rare systemic vascularitis. This disease causes eosinophilic tissue infiltration. The most frequent manifestations are cortico-dependent asthma, mono- or polyneuropathy, paranasal sinus polyposis, and digestive and renal dysfunction. Salivary glands are very rarely involved. We describe a case of CSS in a patient presenting with bilateral parotid swelling. The morphological study of salivary glands revealed an unusual thickening of the salivary duct walls. Salivary gland involvement in Churg and Strauss syndrome can be difficult to demonstrate histologically; it does not usually present in the clinical foreground of the disease, and can be a source of misdiagnosis. The biopsy should be performed in the symptomatic gland, away from any previous corticoid treatment. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Neoconservatism and Leo Strauss: The Place of a Liberal Education

ERIC Educational Resources Information Center

York, J. G.

2008-01-01

This paper is concerned with the work of Leo Strauss, specifically his two essays on liberal education. Strauss is often claimed to be a founding thinker of neoconservatism and while much scholarship has been produced analyzing his work, very little discusses his essays on liberal education and how these fit within his larger project. This essay…

Phytochemicals and nutritional composition in accessions of Kei-apple (Dovyalis caffra): Southern African indigenous fruit.

PubMed

Mpai, Semkaleng; du Preez, Rosemary; Sultanbawa, Yasmina; Sivakumar, Dharini

2018-07-01

Current study was initiated to identify the phytochemicals and the nutritional profile of eleven Kei-apple fruit accessions. Accession FH29 showed the highest level (492.45 mg 100 g -1 fresh weight) of total phenolic content, higher than the referral fruit, blueberry. Pyrogallol was identified as the predominant phenolic compound in all accessions. Accession FH 29 showed the highest (49.75 µmol TEAC g -1 fresh weight) antioxidant capacity. Catechin content was higher in accessions; FH151, FH15, FH14, FH29, FH243, FH 239 and FH 231. Accessions, FH14 and FH232 exhibited higher levels of β-carotene than the referral fruit apples (cv. Top red) and peaches (cv. Excellence). The total sugar (glucose and fructose) was highest (50 mg g -1 fresh weight) in accession FH240. Asparagine (3122.18 mg L -1 ) and gamma-aminobutyric (1688.87 mg L -1 ) were higher in accessions FH239 and FH243 respectively. Overall, the accession Kei-apple FH236 can be regarded as a good source of essential amino acids. Copyright © 2018 Elsevier Ltd. All rights reserved.

Churg-Strauss syndrome from an orthopaedic perspective.

PubMed

Kung, K L; Yee, P K

2015-12-01

Churg-Strauss syndrome, which has been frequently described by physicians in the literature, is a small and medium-sized vessel systemic vasculitis typically associated with asthma, lung infiltrates, and hypereosinophilia. We report a case of Churg-Strauss syndrome with presenting symptoms of bilateral lower limb weakness and numbness only. The patient was admitted to an orthopaedic ward for management and a final diagnosis was reached following sural nerve biopsy. The patient's symptoms responded promptly to steroid treatment and she was able to walk with a stick 3 weeks following admission. This report emphasises the need to be aware of this syndrome when managing patients with neurological deficit in order to achieve prompt diagnosis and treatment.

Churg Strauss syndrome associated with montelukast--case report.

PubMed

Man, Milena Adina; Alexandrescu, Dana; Pop, Monica; Trofor, Antigona

2012-01-01

Churg-Strauss Syndrome (allergic granulomatous angiitis) is a rare systemic and pulmonary vasculitis. We report the case of a 62 years old female, non-smoker, with a 20 years history of moderate persistent asthma treated with Salmeterol/Fluticasone 50/500 microg bid for 5 years and supplemental Montelukast in the past 5 months. The patient was admitted in our hospital with fever, malaise, sensory deficits in the lower extremities, diffuse musculoskeletal and thoracic pain. Blood eosinophil was 38% of her total WBC, thoracic computed tomography evidenced ill-defined groundglass attenuation predominantly involving the lateral segment of the middle lobe. Pulmonary infiltrates with eosinophilia can be used to define eosinophilic lung diseases. We made the differential diagnosis of eosinophilic lung disease: acute or chronic eosinophilic pneumonias, allergic bronchopulmonary aspergillosis, Loffler syndrome, Churg-Strauss syndrome, bronchocentric granulomatousis, idiopathic hypereosinophilic syndromes. Bronchoalveolar lavage showed 14.6% eosinophils. Few days after hospital admission patient experienced nausea, vomiting and diarrhea. She underwent a digestive endoscopy, which showed eosinophilic enteritis according to colon biopsy. Nasal mucosa biopsy found granulomas. Anti-neutrophil cytoplasmatic antibody (ANCA) was positive at 1:20. She displayed more than four American College of Rheumatology (ACR) criteria for Churg-Strauss Syndrome (developed while she was receiving montelukast therapy). Discontinuation of Montelukast and association of oral prednisone (1 mg/kgc) induced rapid improvement of symptoms and rapid decrease of peripheric eosinophils (72 hours). This case report illustrates the importance of early diagnosis of Churg-Strauss syndrome and the possible pathogenic link between leukotriene receptor antagonist use and CSS development.

Central retinal artery occlusion in a patient with ANCA-negative Churg-Strauss syndrome

PubMed Central

Kumano, Yuji; Yoshida, Noriko; Fukuyama, Satoru; Miyazaki, Masanori; Enaida, Hiroshi; Matsui, Takaaki

2012-01-01

Ocular involvement in Churg-Strauss syndrome is infrequent. We describe the case of a 54-year-old woman with eosinophilia and involvement of the respiratory tract, skin, and peripheral nervous system, fulfilling the American College of Rheumatology criteria for Churg-Strauss syndrome. The patient presented with acute, painless vision loss in her right eye. Central retinal artery occlusion (CRAO) without accompanying retinal vasculitis was diagnosed by angiographic findings and funduscopic findings of retinal whitening with a cherry-red spot. Although her antineutrophil cytoplasmic antibody (ANCA) status was negative, CRAO was thought to be an ocular manifestation of Churg-Strauss syndrome, and appropriate treatment was planned. She was treated with high-dose corticosteroids and anticoagulant therapy. Her macular edema improved, but visual recovery was poor. Specific therapy to alter inflammation, blood coagulation, and rheology reportedly plays an important role in ANCA-positive patients with Churg-Strauss syndrome who develop CRAO. Regardless of ANCA status, high-dose corticosteroids should be considered for CRAO in patients with Churg-Strauss syndrome, as discussed in this case. PMID:22927731

Churg-Strauss syndrome concomitant with chronic symmetrical dacryoadenitis suggesting Mikulicz's disease.

PubMed

Hanioka, Yusuke; Yamagami, Keiko; Yoshioka, Katsunobu; Nakamura, Tomomi; Kishida, Masatsugu; Nakamura, Tomoyuki; Yamaguchi, Toshimasa; Koshimo, Naomi; Inoue, Takeshi; Imanishi, Masahito

2012-01-01

A case of Churg-Strauss syndrome complicated by chronic symmetrical dacryoadenitis suggestive of Mikulicz's disease is herein presented. A 72-year-old Japanese man, who had been previously diagnosed with asthma, presented with weakness of the left leg and purpura on the lower extremities. A neurological examination showed multiple mononeuropathies and a laboratory examination revealed elevated eosinophil counts, IgE levels and the presence of Myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCAs). Churg-Strauss syndrome was diagnosed, although the patient also exhibited bilateral swelling of the lachrymal glands. Furthermore, elevated serum IgG4 levels, an infiltration of a relatively large number of IgG4-positive plasmacytes in the nasal mucosa and hypocomplementemia were also observed. These findings were consistent with a diagnosis of Mikulicz's disease (MD). Oral prednisolone (30 mg) was administered and the swelling of the lachrymal glands resolved. Churg-Strauss syndrome may be accompanied by Mikulicz's disease (an IgG4-related disease), and common pathogeneses between Churg-Strauss syndrome and IgG4-related disease may exist.

Central retinal artery occlusion in an ANCA negative Churg-Strauss syndrome patient.

PubMed

Türkçüoğlu, Peykan; Isik, Ahmet; Deniz, Nurettin; Turgut, Burak; Kan, Elif Kiliç

2007-12-01

To describe a central retinal artery occlusion in a patient with antineutrophil cytoplasmic antibody (ANCA) negative Churg-Strauss syndrome. Review of clinical and laboratory findings of a 44-year-old woman with ANCA negative Churg-Strauss syndrome that developed sudden vision loss in left eye. Left central retinal artery occlusion was diagnosed by retinal whitening, a cherry-red spot, and delayed arterial filling on fluorescein angiography. Perinuclear ANCA and cytoplasmic ANCA were negative. Central retinal artery occlusion can occur in ANCA negative Churg-Strauss syndrome. Patients with this diagnosis should be considered for prophylactic high dose corticosteroid, regardless of their ANCA status.

Anosmia and hypogeusia in Churg-Strauss syndrome.

PubMed

Tallab, Hussam F; Doty, Richard L

2014-05-13

Churg-Strauss syndrome is a rare disorder that is often misdiagnosed. In this report we describe a 57-year-old man with Churg-Strauss syndrome who presented with symptoms of lessened smell and taste function that occurred approximately 3 months before the onset of his neurological symptoms. Psychophysical testing using a battery of well-validated smell and taste tests revealed that the patient had total anosmia and marked hypogeusia. While one anecdotal report exists in the Spanish literature that alludes to the presence of anosmia in a single case of this syndrome, no further confirmation of such dysfunction has appeared in the literature. These findings support the concept that smell and taste loss may be an early sign of this disorder. 2014 BMJ Publishing Group Ltd.

Anosmia and hypogeusia in Churg-Strauss syndrome

PubMed Central

Tallab, Hussam F; Doty, Richard L

2014-01-01

Churg-Strauss syndrome is a rare disorder that is often misdiagnosed. In this report we describe a 57-year-old man with Churg-Strauss syndrome who presented with symptoms of lessened smell and taste function that occurred approximately 3 months before the onset of his neurological symptoms. Psychophysical testing using a battery of well-validated smell and taste tests revealed that the patient had total anosmia and marked hypogeusia. While one anecdotal report exists in the Spanish literature that alludes to the presence of anosmia in a single case of this syndrome, no further confirmation of such dysfunction has appeared in the literature. These findings support the concept that smell and taste loss may be an early sign of this disorder. PMID:24825557

A Case of Loeffler's Endocarditis Associated with Churg-Strauss Syndrome

PubMed Central

Seo, Jeong-Sook; Kim, Dae-Hee; Kang, Duk-Hyun; Song, Jae-Kwan

2010-01-01

Loeffler's endocarditis is generally caused by hypereosinophilic syndrome. It is a restrictive cardiomyopathy characterized with eosinophilia and eosionophilic penetration leading to the fibrous thickening of endocardium of both ventricles, apical obliteration and heart failure. We report a case of a 23-year-old male with Loeffler's endocarditis caused by Churg-Strauss syndrome. The echocardiogram showed that biventricular failure with large thrombus in left ventricle. His symptoms and typical echocardiographic findings markedly improved within 2 months after treatment for Churg-Strauss syndrome. PMID:20661332

Churg-strauss syndrome: a case report.

PubMed

Zhdan, Vyacheslav М; Kitura, Yevdokiia М; Kitura, Oksana Ye; Babanina, Maryna Yu; Tkachenko, Maksym V; Lebid, Volodymyr G

A clinical case of Churg-Strauss syndrome has been reported on the 53-year-old female patient Ts. with bronchial asthma and allergic rhinitis. The main clinical signs and syndromes depending on the stage of the disease are presented, as well as therapeutic treatment of patients with this disease.

An Abdominal Presentation of Churg-Strauss Syndrome

PubMed Central

Rees, J. R. E.; Burgess, P.

2010-01-01

Churg-Strauss syndrome is a small and medium vessel vasculitis that is also known as allergic granulomatous angiitis. It most commonly presents with an asthma like symptoms. It was first described in Mount Siani Hospital, New York in 1951 by Jacob Churg and Lotte Stauss and was recognised after the study of a series of 13 patients who had asthma, eosinophilia, granulomatous inflammation necrotising systemic vasculitis and necrotising glomerulonephritis. We describe a case of Churg-Strauss syndrome presenting with abdominal pain and later during the hospital admission a mono-neuritis multiplex syndrome affecting the lower limbs. The patient presented in such an atypical fashion with abdominal signs and symptoms that they required laparotomy and the diagnosis was made after histological examination of tissue taken at the time of surgery. Treatment with immunosuppression and aggressive rehabilitation achieved a progressive recovery which continued on discharge from hospital. PMID:20814555

Complete remission of coronary vasculitis in Churg-Strauss Syndrome by prednisone and cyclophosphamide.

PubMed

Riksen, Niels P; Gehlmann, Helmut; Brouwer, Annemarie E; van Deuren, Marcel

2013-03-01

The heart is involved in up to 50% of all patients with Churg-Strauss syndrome, but vasculitis of the coronary arteries has only been rarely documented. We present a young patient with severe coronary aneurysms and stenotic lesions due to a Churg-Strauss vasculitis. Prompt therapy with prednisone and cyclophosphamide resulted in the complete resolution of all lesions.

Congestive cardiomyopathy and endobronchial granulomas as manifestations of Churg-Strauss syndrome.

PubMed Central

Alvarez-Sala, R.; Prados, C.; Armada, E.; Del Arco, A.; Villamor, J.

1995-01-01

Churg-Strauss syndrome is a systemic vasculitis. Its most frequent complications are heart diseases and asthma. Usually, cardiological manifestations are pericarditis, cardiac failure and myocardial infarction. Endobronchial granulomas identified by bronchoscopy are unusual. We present the case of a man with congestive cardiomyopathy and endobronchial granulomas macroscopically visible at bronchoscopy. After a review of medical literature, we found one case of congestive cardiomyopathy and no cases of endobronchial granulomas observed by bronchoscopy associated with Churg-Strauss syndrome. Images Figure PMID:7644400

Churg-Strauss syndrome: a case report*

PubMed Central

Fernandes, Gabriel Lacerda; Teixeira, Arivaldo Araújo; Antón, Ana Graziela Santana; Reis, Alan Timóteo Rodrigues; de Freitas, Ana Carolina Rezende; Basílio, Dunya Bachour

2014-01-01

Churg-Strauss syndrome is a rare systemic disease primarily characterized by hypereosinophilia, asthma and vasculitis. The lung is the organ most frequently involved. In the present report, the authors describe a relatively rare finding in this disease - the presence of a pulmonary nodule -, while recalling the main radiological findings and the most relevant differential diagnoses. PMID:25741095

Eosinophilic leukocytoclastic vasculitis - a spectrum ranging from Wells' syndrome to Churg-Strauss syndrome?

PubMed

Ratzinger, Gudrun; Zankl, Julia; Eisendle, Klaus; Zelger, Bernhard

2014-01-01

Wells' syndrome is defined as an inflammatory disorder with the histopathological presence of eosinophilic infiltrates and flame figures in the absence of vasculitis. Eosinophilic leukocytoclastic vasculitis shows eosinophilic infiltrates in combination with vasculitic changes. And Churg Strauss Syndrome comprises all three characteristics - eosinophilic infiltrates, vasculitis and flame figures. To determine whether these three diseases are distinct entities or different manifestations of a similar clinicopathologic process. Histopathological samples and clinical courses of 17 patients with eosinophilic infiltrates, flame figures and clinical features of Wells' syndrome were re-evaluated. Histopathologically, we focused on the presence or absence of vasculitic features. Clinically, we included only patients who were diagnosed with Wells' syndrome at least once in the course of their disease. 4 patients were finally diagnosed with Wells' syndrome, 5 with eosinophilic leukocytoclastic vasculitis and 6 with Churg Strauss syndrome. Further, we had one case of an overlap between Wells' syndrome and eosinophilic vasculitis and one case of Wegener granulomatosis. Vasculitic features were found in the samples of all patients. Histologically, we find vasculitic features in typical presentations of Wells' syndrome. Clinically, we find typical features of Wells' syndrome in patients finally diagnosed with eosinophilic leukocytoclastic vasculitis or Churg Strauss syndrome. Furthermore, we have observed and formerly reported 3 patients with progression from Wells' syndrome to Churg Strauss syndrome. Thus, we assume that eosinophilic leukocytoclastic vasculitis might form a bridge between Wells' syndrome and Churg Strauss syndrome.

Churg-Strauss syndrome.

PubMed

Greco, Antonio; Rizzo, Maria Ida; De Virgilio, Armando; Gallo, Andrea; Fusconi, Massimo; Ruoppolo, Giovanni; Altissimi, Giancarlo; De Vincentiis, Marco

2015-04-01

Churg-Strauss syndrome (CSS), alternatively known as eosinophilic granulomatosis with polyangiitis (EGPA), was first described in 1951 by Churg and Strauss as a rare disease characterized by disseminated necrotizing vasculitis with extravascular granulomas occurring exclusively among patients with asthma and tissue eosinophilia. EGPA is classified as a small-vessel vasculitis associated with antineutrophil cytoplasmic antibodies (ANCAs) and the hypereosinophilic syndromes (HESs) in which vessel inflammation and eosinophilic proliferation are thought to contribute to organ damage. Although still considered an idiopathic condition, EGPA is classically considered a Th2-mediated disease. Emerging clinical observations provide compelling evidence that ANCAs are primarily and directly involved in the pathogenesis of AASVs, although recent evidence implicates B cells and the humoral response as further contributors to EGPA pathogenesis. EGPA has traditionally been described as evolving through a prodromic phase characterized by asthma and rhino-sinusitis, an eosinophilic phase marked by peripheral eosinophilia and organ involvement, and a vasculitic phase with clinical manifestations due to small-vessel vasculitis. The American College of Rheumatology defined the classification criteria to distinguish the different types of vasculitides and identified six criteria for EGPA. When four or more of these criteria are met, vasculitis can be classified as EGPA. The French Vasculitis Study Group has identified five prognostic factors that make up the so-called five-factor score (FFS). Patients without poor prognosis factors (FFS=0) have better survival rates than patients with poor prognosis factors (FFS≥1). The treatment of patients with CSS must be tailored to individual patients according to the presence of poor prognostic factors. A combination of high-dose corticosteroids and cyclophosphamide is still the gold standard for the treatment of severe cases, but the use of

Levi-Strauss's "Bricolage" and Theorizing Teachers' Work.

ERIC Educational Resources Information Center

Hatton, Elizabeth

1989-01-01

A teacher's work is compared to Claude Levi-Strauss's concept of "bricolage." A "bricoleur" is a professional do-it-yourself person, falling somewhere between an odd-job person and a craftsperson. The concept helps to explain pedagogical inadequacy by linking inherent limiting features of teachers' work and some causal…

Chronic calcific constrictive pericarditis complicating Churg-Strauss syndrome: first reported case.

PubMed

Aboukhoudir, Falah; Pansieri, Michel; Rekik, Sofiene

2014-10-01

Churg-Strauss syndrome is a necrotizing systemic vasculitis characterized by extravascular granulomas and eosinophilic infiltrates of small vessels. Although cardiac complications are considered to be relatively common, no case of constrictive calcified pericarditis has ever been previously described in this setting. In this report, we present the case of a 46-year-old man with Churg-Strauss syndrome, in whom we were able to document the development of symptomatic calcific constrictive pericarditis during a 10-year period despite long-term corticosteroid therapy. Georg Thieme Verlag KG Stuttgart · New York.

Churg-Strauss syndrome associated with AA amyloidosis: a case report.

PubMed

Maamar, Mouna; Tazi-Mezalek, Zoubida; Harmouche, Hicham; El Hamany, Zitouna; Adnaoui, Mohammed; Aouni, Mohammed

2012-01-01

Churg Strauss syndrome is a rare systemic and pulmonary vasculitis exceptionally associated with AA amyloidosis. We report the case of a 65-year old woman with past medical history of asthma. She developed polyarthralgia, headache and purpura. A laboratory workout found hypereosinophilia (1150/µL), positive p-ANCA, microscopic haematuria and proteinuria at 2g/day. A diagnosis of Churg-Strauss syndrome was established based on five criteria of the American College of Rheumatology (ACR). Renal biopsy showed an important type AA amyloid deposit. The patient was treated with steroids with a good response of the vasculitis and amyloidosis with disappearance of the proteinuria.

Churg-Strauss syndrome associated with AA amyloidosis: a case report

PubMed Central

Maamar, Mouna; Tazi-Mezalek, Zoubida; Harmouche, Hicham; El Hamany, Zitouna; Adnaoui, Mohammed; Aouni, Mohammed

2012-01-01

Churg Strauss syndrome is a rare systemic and pulmonary vasculitis exceptionally associated with AA amyloidosis. We report the case of a 65-year old woman with past medical history of asthma. She developed polyarthralgia, headache and purpura. A laboratory workout found hypereosinophilia (1150/µL), positive p-ANCA, microscopic haematuria and proteinuria at 2g/day. A diagnosis of Churg-Strauss syndrome was established based on five criteria of the American College of Rheumatology (ACR). Renal biopsy showed an important type AA amyloid deposit. The patient was treated with steroids with a good response of the vasculitis and amyloidosis with disappearance of the proteinuria. PMID:22891088

A case of undeclared debt? Claude Lévi-Strauss' ambiguities and paradoxes toward analytical psychology.

PubMed

Serina, Florent

2018-06-09

If his relationship to Sigmund Freud's psychoanalysis has been widely acknowledged, Claude Lévi-Strauss' rapport with C.G. Jung's analytical psychology remains quite obscure. While secondary commentary has been abundant, its approach has above all been intertextual, to the detriment of a rigorously historical reading. Even if certain arguments put forward by supporters of so-called "influence" deserve to be taken into account, especially because they highlight Lévi-Strauss ambiguities and paradoxes toward Jung, this paper provides proof that a precise reading of the texts, with the help of recent studies on the intellectual genesis of Lévi-Strauss, lead to reject the thesis of an unstated debt owed by the French anthropologist to the Zurich psychologist. © 2018 Wiley Periodicals, Inc.

[A case of hemorrhagic cholecystitis associated with Churg-Strauss syndrome].

PubMed

Koizumi, Satomi; Kamisawa, Terumi; Kuruma, Sawako; Chiba, Kazuro; Tabata, Taku; Koizumi, Koichi; Kurata, Masanao; Horiguchi, Shinichiro; Hishima, Tsunekazu

2016-01-01

A woman in her 70s with Churg-Strauss syndrome presented with epigastric pain. She was being treated with steroids at the time of admission. Computed tomography showed swelling of the gallbladder, and percutaneous transhepatic cholangiography revealed bloody secretion. On duodenoscopy, bleeding was observed from the orifice of the major duodenal papilla. Emergency cholecystectomy was performed under a diagnosis of hemorrhagic cholecystitis;intraoperatively, extensive hematoma was detected in the thickened wall of the gallbladder. Subsequent histopathological examination revealed mucosal ulceration with infiltration of inflammatory cells, torn small vessels, and extensive transmural bleeding and abscess formation in the thickened wall of the gallbladder. We considered that the hemorrhagic cholecystitis was induced by either vasculitis or corticosteroid therapy. To the best of our knowledge, this is the first report of hemorrhagic cholecystitis associated with Churg-Strauss syndrome.

Churg-Strauss Syndrome as an Unusual Cause of Dysphagia: Case Report.

PubMed

Park, Jihye; Im, Sun; Moon, Su-Jin; Park, Geun-Young; Jang, Yongjun; Kim, Yeonjin

2015-06-01

Systemic vasculitis is a rare disease, and the diagnosis is very difficult when patient shows atypical symptoms. We experienced an unusual case of dysphagia caused by Churg-Strauss syndrome with lower cranial nerve involvement. A 74-year-old man, with a past history of sinusitis, asthma, and hearing deficiency, was admitted to our department for evaluation of dysphagia. He also complained of recurrent bleeding of nasal cavities and esophagus. Brain magnetic resonance imaging did not show definite abnormality, and electrophysiologic findings were suggestive of mononeuritis multiplex. Dysphagia had not improved after conventional therapy. Biopsy of the nasal cavity showed extravascular eosinophilic infiltration. All these findings suggested a rare form of Churg-Strauss syndrome involving multiple lower cranial nerves. Dysphagia improved after steroid therapy.

From Leo Strauss to Collapse Theory: Considering the Neoconservative Attack on Modernity and the Work of Education

ERIC Educational Resources Information Center

Smith, David Geoffrey

2008-01-01

This paper locates the work of Leo Strauss within the broader conservative assault on modernity and especially its roots in liberalism. Four themes from Strauss's work are identified, then hermeneutically engaged for their relevance to educational practice in global times. The four themes are: (1) the liberal/modern concept of an open society is…

A case of Churg-Strauss syndrome: tissue diagnosis established by sigmoidoscopic rectal biopsy.

PubMed Central

Leen, E J; Rees, P J; Sanderson, J D; Wilkinson, M L; Filipe, M I

1996-01-01

A case is presented of Churg-Strauss syndrome in a young man in whom the definitive diagnostic procedure was a full thickness sigmoidoscopic rectal biopsy, with submucosal sampling. Gastrointestinal changes in Churg-Strauss syndrome, a rare systemic illness characterised by asthma, blood and tissue eosinophilia, vasculitis, and granulomatous inflammation are common but poorly reported. The endoscopic and histopathological features of a case are described and emphasise the potential value of a limited sigmoidoscopy in establishing the diagnosis, when lower gastrointestinal symptoms are present. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 PMID:8801216

Long term effectiveness of intravenous immunoglobulin in Churg-Strauss syndrome

PubMed Central

Danieli, M; Cappelli, M; Malcangi, G; Logullo, F; Salvi, A; Danieli, G

2004-01-01

Objective: To study the long term effectiveness of intravenous immunoglobulin and plasmapheresis associated with prednisone and cyclophosphamide in Churg-Strauss syndrome. Subjects and methods: We studied 18 subjects with new onset Churg-Strauss syndrome. All received the "standard" treatment based on prednisone (1 mg/kg/day for 1 month and then slowly tapered) and cyclophosphamide (2 mg/kg/day for 6 months in severe cases). In nine patients, synchronised cycles with plasmapheresis and intravenous immunoglobulin (2 g/kg) were repeated monthly for 6 months and every other month for a further three cycles. Clinical (disease activity monitored by Birmingham vasculitis activity score (BVAS) and damage index (modified Rankin score)) and functional (C reactive protein, blood eosinophil count, and electromyogram-electoneurogram) parameters were collected during treatment and the 3 year follow up period. Results: After 12 months, all patients in the treatment group and four (44%) in the control group were in remission. At the end of the 3 year follow up period, we documented significant differences in BVAS (p<0.01), global damage (p<0.02), modified Rankin score (p<0.04), and the daily maintenance prednisone dose (p<0.002) between the two groups. We found a tendency towards lower frequency of relapse and incidence of osteoporosis in the treatment group. Conclusion: Complete clinical and functional recovery with a long term stable remission and a low incidence of side effects can be achieved by intravenous immunoglobulin associated with plasmapheresis in patients with Churg-Strauss syndrome. PMID:15547090

CHURG–STRAUSS SYNDROME

PubMed Central

Ghosh, Subhasish; Bhattacharya, Maitreyee; Dhar, Sandipan

2011-01-01

Churg–Strauss syndrome (CSS) is a rare granulomatous necrotizing small vessel vasculitis characterized by the presence of asthma, sinusitis, and hypereosinophilia. The cause of this allergic angiitis and granulomatosis is unknown. Other common manifestations are pulmonary infiltrates, skin, gastrointestinal, and cardiovascular involvement. No data have been reported regarding the role of immune complexes or cell mediated mechanisms in this disease, although autoimmunity is evident with the presence hypergammaglobulinemia, increased levels of IgE and Antineutrophil cytoplasmic antibody (positive in 40%). We report the case of a 27-year-old lady presenting with painful swelling of predominantly lower limbs with extensive vesicles and ecchymotic patches and fever shortly after stopping systemic steroids taken for a prolonged duration (2002--2010). The aim of this case report is to point to the possibility of CSS in patients presenting with extensive skin lesions masquerading as Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Syndrome (SJS/TENS). PMID:22345778

Anterior ischemic optic neuropathy in a patient with Churg-Strauss syndrome.

PubMed

Lee, Ji Eun; Lee, Seung Uk; Kim, Soo Young; Jang, Tae Won; Lee, Sang Joon

2012-12-01

We describe a patient with Churg-Strauss syndrome who developed unilateral anterior ischemic optic neuropathy. A 54-year-old man with a history of bronchial asthma, allergic rhinitis, and sinusitis presented with sudden decreased visual acuity in his right eye that had begun 2 weeks previously. The visual acuity of his right eye was 20 / 50. Ophthalmoscopic examination revealed a diffusely swollen right optic disc and splinter hemorrhages at its margin. Goldmann perimetry showed central scotomas in the right eye and fluorescein angiography showed remarkable hyperfluorescence of the right optic nerve head. Marked peripheral eosinphilia, extravascular eosinophils in a bronchial biopsy specimen, and an increased sedimentation rate supported the diagnosis of Churg-Strauss syndrome. Therapy with methylprednisolone corrected the laboratory abnormalities, improved clinical features, and preserved vision, except for the right central visual field defect. Early recognition of this systemic disease by ophthalmologists may help in preventing severe ocular complications.

[Update Churg-Strauss syndrome].

PubMed

Moosig, F; Hellmich, B

2012-11-01

The Churg-Strauss syndrome (CSS) is the rarest subtype of the so-called anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) and has the lowest frequency of ANCA-positivity (around 30%). In addition to asthma and blood eosinophilia, CSS is characterized by end-organ damage, which can be caused by either vasculitis and/or tissue infiltration of eosinophilic granulocytes. The CSS shares many etiological and clinical features of other hypereosinophilic syndromes. Recently, a distinct genetic background could be demonstrated for both the ANCA-positive and ANCA-negative subtypes of CSS as compared to the other two forms of AAV. Among other cytokines, interleukin-5 (IL-5) could be identified as a key mediator of eosinophilia. Therefore, recent clinical trials in CSS aimed to target IL-5. Outside of clinical trials, treatment of CSS is adapted to disease stage and activity, as recommended for other types of AAV.

Churg-Strauss syndrome masquerading as an acute coronary syndrome.

PubMed

Triantafyllis, Andreas S; Sakadakis, Eleftherios A; Papafilippaki, Argyro; Katsimbri, Pelagia; Panou, Fotios; Anastasiou-Nana, Maria; Lekakis, Ioannis

2015-02-01

Churg-Strauss Syndrome (CSS) is a rare vasculitis with multiorgan involvement. Cardiac manifestations are common causing serious complications. We report a case of CSS masquerading as a non-ST elevation myocardial infarction with heart failure. CSS should be considered in the differential diagnosis of an acute coronary syndrome(ACS)with normal coronary arteries when history of asthma, peripheral eosinophilia and multisystemic involvement is present.

Anterior Ischemic Optic Neuropathy in a Patient with Churg-Strauss Syndrome

PubMed Central

Lee, Ji Eun; Lee, Seung Uk; Kim, Soo Young; Jang, Tae Won

2012-01-01

We describe a patient with Churg-Strauss syndrome who developed unilateral anterior ischemic optic neuropathy. A 54-year-old man with a history of bronchial asthma, allergic rhinitis, and sinusitis presented with sudden decreased visual acuity in his right eye that had begun 2 weeks previously. The visual acuity of his right eye was 20 / 50. Ophthalmoscopic examination revealed a diffusely swollen right optic disc and splinter hemorrhages at its margin. Goldmann perimetry showed central scotomas in the right eye and fluorescein angiography showed remarkable hyperfluorescence of the right optic nerve head. Marked peripheral eosinphilia, extravascular eosinophils in a bronchial biopsy specimen, and an increased sedimentation rate supported the diagnosis of Churg-Strauss syndrome. Therapy with methylprednisolone corrected the laboratory abnormalities, improved clinical features, and preserved vision, except for the right central visual field defect. Early recognition of this systemic disease by ophthalmologists may help in preventing severe ocular complications. PMID:23204805

[Acute coronary syndrome as a first manifestation of Churg-Strauss syndrome].

PubMed

Asdonk, T; Pabst, S; Clauberg, R; Schaefer, C; Skowasch, D; Nickenig, G; Tiyerili, V

2012-03-01

A 53-year-old woman was admitted to our chest pain unit because of an acute coronary syndrome (non ST-elevation myocardial infarction). She complained of asthma, chronic sinusitis and involuntary weight loss, occasional fever and night sweats over the past six months. Coronary angiography did not show any signs of macroscopic coronary artery disease, while echocardiography demonstrated a hemodynamically not significant pericardial effusion. Magnetic resonance imaging of the heart revealed a subendocardial scar, extension and localization pointing to a vascular genesis. Thoracic computed tomography revealed pulmonary opacities and blood tests showed an eosinophilia, leading to the clinical diagnosis of Churg-Strauss syndome. The patient responded quickly to oral steroids, and blood parameters returned to normal. Acute coronary syndrome in youngish patients without classical cardiovascular risk factors is suggestive for myocarditis but also for vasculitis. Churg-Strauss syndrome usually responds quickly to immunosuppressive therapy, associated with a rather good prognosis without high mortality. © Georg Thieme Verlag KG Stuttgart · New York.

Usefulness of cardiac resonance imaging in Churg-Strauss syndrome.

PubMed

Nadeau, Pierre L; Kumar, Andreas; O'Connor, Kim; Couture, Christian Y; Bourgault, Christine; Dubois, Michelle; Sénéchal, Mario

2016-12-01

: Churg-Strauss syndrome (CSS) is a rare entity that is characterized by widespread vasculitis, which affects both small and medium-sized blood vessels of nearly all organs. More than 50% of these cases have cardiac involvement, which is the major cause of morbidity and mortality. We describe a case of a patient with cardiac biopsy proven CSS, and we discuss the usefulness of cardiovascular MRI for its diagnosis.

Seaweed Fortification on Crispy Enbal as Local Food of Kei Islands

NASA Astrophysics Data System (ADS)

Marasabessy, Ismael; Sudirjo, Fien

2017-10-01

One of health problems phenomenon in Indonesian and the world is increasing the degenerative disease because human’s bad habits of eating that having less fiber. Source of fiber which is relatively abundant in eastern Indonesia is seaweed that is very precise to fortified on local food that aims to be more nutritious and economically valuable. The purpose of this study is to got appropriate seaweed fortification technique to produce Seaweed Crispy Enbal (SCE) as typical food from Kei islands that rich in fiber and preferred by consumers. The research was done in two stages. The first stage is to analyze quality of fiber and HCN content of seaweed and enbal flour as SCE raw material, and the two-stage is fortified fiber to enbal lempeng using two types of raw materials, namely pulp seaweed and flour seaweed. The results showed that the fiber content of seaweed Eucheuma cottonii and flour enbal respectively 7.01% and 4%, while HCN content less than 3 mg/kg. Fortification techniques using pulp seaweed better than others. It is because pulp seaweed produces seaweed crispy enbal with high value of sensory (really like) with having fiber content is 7.48%.

Cutaneous manifestations of Churg-Strauss syndrome: key to diagnosis*

PubMed Central

Marques, Camila Carneiro; Fernandes, Elizabeth Leocadia; Miquelin, Gabriela Momente; Colferai, Mariana Morais Tavares

2017-01-01

Churg-Strauss syndrome is a rare systemic vasculitis characterized by asthma and other allergy symptoms as well as eosinophilia and necrotizing vasculitis involving small and medium-sized vessels. Its prevalence in the general population ranges from 1-3 cases per million a year, varying according to the population studied. The authors describe a case of a female patient affected by the disease with important systemic manifestations and not very florid skin lesions. PMID:29267447

Cutaneous manifestations of Churg-Strauss syndrome: key to diagnosis.

PubMed

Marques, Camila Carneiro; Fernandes, Elizabeth Leocadia; Miquelin, Gabriela Momente; Colferai, Mariana Morais Tavares

2017-01-01

Churg-Strauss syndrome is a rare systemic vasculitis characterized by asthma and other allergy symptoms as well as eosinophilia and necrotizing vasculitis involving small and medium-sized vessels. Its prevalence in the general population ranges from 1-3 cases per million a year, varying according to the population studied. The authors describe a case of a female patient affected by the disease with important systemic manifestations and not very florid skin lesions.

Marked improvement of Churg–Strauss syndrome neuropathy by intravenous immunoglobulin and cyclophosphamide

PubMed Central

Umeda, Akira; Yamane, Tateki; Takeuchi, Jin; Imai, Yasuo; Suzuki, Keisuke; Yumura, Wako

2014-01-01

A 42-year-old Japanese man developed Churg–Strauss syndrome 7 years after being diagnosed with chronic eosinophilic pneumonia. Prominent eosinophilia, subcutaneous nodules, and neuropathy in the left leg were seen. A pathological diagnosis of necrotizing vasculitis was determined by a biopsy of a subcutaneous nodule. The leg pain was severe and there was prominent atrophy of the thigh and calf, but the muscle weakness was mild. Serum anti-myeloperoxidase anti-neutrophil cytoplasmic antibody was positive. Because the initial treatment with an intravenous methylprednisolone pulse at 1 g/day for 3 days was not sufficient, a onetime treatment with intravenous cyclophosphamide at 15 mg/kg and intravenous immunoglobulin therapy (IVIG) at 400 mg/kg/day for 5 days were administered. Peripheral eosinophilia improved and the leg pain significantly improved. IVIG was repeated 1 month later and symptoms gradually improved further. The early diagnosis of Churg–Strauss syndrome and the early initiation of IVIG with cyclophosphamide were thought to be important. PMID:25473575

Eosinophilic myocarditis due to Churg-Strauss syndrome with markedly elevated eosinophil cationic protein.

PubMed

Hara, Tomoya; Yamaguchi, Koji; Iwase, Takashi; Kadota, Muneyuki; Bando, Mika; Ogasawara, Kozue; Bando, Sachiko; Ise, Takayuki; Niki, Toshiyuki; Ueda, Yuka; Tomita, Noriko; Taketani, Yoshio; Yamada, Hirotsugu; Soeki, Takeshi; Wakatsuki, Tetsuzo; Sata, Masataka

2013-01-01

A 67-year-old woman with asthma visited our hospital with increasing dyspnea and new-onset paresthesia and purpura in her legs. Physical examination showed a wheeze, pretibial edema, and surrounding purpura. Chest X-rays showed cardiac decompensation and an electrocardiogram revealed a new ST-T change. Laboratory data showed leukocytosis, hypereosinophilia (10,450/μL), troponin T(+), elevated BNP, and markedly elevated eosinophil cationic protein (ECP) (> 150 ng/mL). Echocardiography revealed diffuse left ventricular hypokinesis (ejection fraction 30%) with increased wall thickness. Coronary angiography was normal. Cardiac magnetic resonance imaging implied diffuse myocardial edema and subendocardial late gadolinium enhancement. Skin biopsy of purpura showed superfi cial perivascular dermatitis with remarkable eosinophilic infiltrations. No evidence of drug allergies, parasitic infection, or myeloproliferative disorder was detected. Based on these findings, a diagnosis of eosinophilic myocarditis due to Churg-Strauss syndrome was considered. She was administered prednisolone at a dose of 1 mg/kg, cyclophosphamide, and diuretics. Several markers of eosinophilic myocarditis and heart failure gradually improved, including ECP. She was discharged 30 days later with no cardiac event. Eosinophilic myocarditis is characterized by predominantly eosinophilic infi ltration. Eosinophilic granule proteins, such as ECP and major basic protein, play important roles in the pathogenesis of eosinophilic myocarditis. We experienced a rare case of eosinophilic myocarditis due to Churg-Strauss syndrome. Markedly elevated ECP played an important role in the early diagnosis and subsequent reduction in ECP served as a marker of monitoring. In an asthmatic patient with dyspnea, hypereosinophilia, and vasculitis, Churg-Strauss syndrome with eosinophilic myocarditis should be considered.

[Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)].

PubMed

Guillevin, Loïc

2012-10-01

Eosinophilic granulomatosis with polyangiitis (EGPA) (Churg-Strauss), is a rare necrotizing vasculitis of small-sized vessels, associated to antimyeloperoxydase ANCA in 40% of patients. EGPA occurs in patients with asthma. Asthma is sever, associated with eosinophilia and extrapulmonary symptoms. Among them, mononeuritis multiplex is the most frequent symptom. When cardiac involvement is present, prognosis is poor. Despite a good overall prognosis, deaths are caused by vasculitis activity, gastrointestinal and cardiac involvement. Treatment is well codified based on steroids, which are quickly effective. Immunosuppressants combined with corticosteroids are compulsory to treat the most sever forms, mainly when cardiac and gastrointestinal or renal symptoms are present. Copyright © 2012. Published by Elsevier Masson SAS.

Familial Churg-Strauss Syndrome in a Sister and Brother.

PubMed

Alyasin, Soheyla; Khoshkhui, Maryam; Amin, Reza

2015-06-01

Churg-Strauss syndrome (CSS) is a granulomatous small vessel vasculitis. It is characterized by asthma, allergic granulomatosis and vasculitis. This syndrome is rare in children. A 5 years old boy was admitted with cough, fever and dyspnea for 2 weeks. On the basis of laboratory data (peripheral eosinophilia), associated with skin biopsy, and history of CSS in his sister, this disease was eventually diagnosed. The patient had good response to corticosteroid. In every asthmatic patient with prolonged fever, eosinophilia and multisystemic involvment, CSS should be considered.

Crescentic glomerulonephritis in non-asthmatic Churg-Strauss syndrome.

PubMed

Kaul, Anupma; Sharma, Raj Kumar; Jaisuresh, Krishna Swamy; Agrawal, Vinita

2014-03-01

A 58-year-old male presented with sensory motor polyneuropathy and rapidly progressive renal failure. Investigations revealed marked peripheral eosinophilia and elevated perinuclear antineutrophil cytoplasmic antibody titers. Renal biopsy showed pauci-immune cre-scentic glomerulonephritis with interstitial eosinophil infiltrates. He had no history of asthma. Computed tomography of the chest and X-ray of the paranasal sinuses were normal. On Day 1, the patient developed ileal perforation. Resected ileal segments showed small vessel vasculitis with extravascular eosinophils. A diagnosis of non-asthmatic variant of Churg-Strauss syndrome was made. Renal recovery was achieved in 12 weeks with a combination therapy of corticosteroid and cyclophosphamide. The patient has been relapse-free for 12 months on oral prednisolone therapy.

Co-brand strategy of evaluation of visual images in furniture design: Jimmy S.P.A. and STRAUSS as examples

NASA Astrophysics Data System (ADS)

Chen, Tien-Li; Pan, Fang-Ming; Tsai, Jen-Hui

2013-03-01

This study aimed to investigate the correlation of the image associated by the design Co-Brand (Jimmy S.P.A. and STRAUSS) and the impression perceived by subject of viewers. Visual images were used to examine the merit of the evaluation. The best result is provided using an object as an appropriate evaluation method. There are a lot of factors which influence to evaluation of a design. This study is limited to distinguish the appearance from Jimmy's picture books transform furniture and so on. Co-Brand of Jimmy S.P.A. and STRAUSS is not easy because there are not from the same cultural, and industry background and applying different marketing strategy, it is a way to combine the two brands by designing, used questionnaire of SD (Semantic differential evaluation) evaluation method to test out the perception of viewers, the objective of this study is to investigate and appraised the Co-Brands use by of the image in furniture from patrons. SD evaluation result showed, if design cannot understand the perception image of Jimmy S.P.A and STRAUSS with viewers mind, furniture design also can't transmit feeling with design.

Churg-Strauss syndrome presenting with acute kidney injury in a case of primary focal segmental glomerulosclerosis.

PubMed

Patil, Sachin B; Vanikar, Aruna V; Gumber, Manoj R; Kute, Vivek B; Shah, Pankaj R; Patel, Himanshu V; Trivedi, Hargovind L

2014-01-01

Churg-Strauss syndrome (CSS) also called allergic granulomatosis and angiitis is a multisystem disorder. Churg-Strauss syndrome is defined as an eosinophil-rich, granulomatous inflammation involving the respiratory tract, along with necrotizing vasculitis affecting small- to medium-sized vessels, and is associated with asthma and eosinophilia. Renal involvement in CSS varies from 26 to 88 % but is usually of mild to moderate stage, and advanced renal failure is uncommon. We encountered an unusual case of 27-year-old man with asthma and primary focal segmental glomerulosclerosis diagnosed as CSS showing myeloperoxidase anti-neutrophil cytoplasmic antibody-associated acute kidney injury with crescentic glomerulonephritis. Patient responded to steroid and cyclophosphamide. Over a follow-up of 2 months, he has no hematuria/eosinophilia and serum creatinine of 2.3 mg/dL has decreased to 1.7 mg/dL.

Churg-Strauss syndrome and hemorrhagic vasculitis

PubMed Central

Marques, Rui Moreira; Cabral, Ana Rita; Monteiro, Antonio; Henriques, Pedro

2011-01-01

Churg-Strauss syndrome (CSS) is a rare syndrome characterized by sinusitis, asthma and peripheral eosinophilia. This vasculitic syndrome affects medium and small-sized vessels, the lung being the most commonly affected organ, followed by the skin. The authors report a case of a 59-year-old male with a past history of asthma and allergic rhinitis. He presented necrohemorragic lesions in the distal phalanx of the 2nd, 3rd and 4th fingers of the left-hand and petechial lesions in the plant of both feet, accompanied by asthenia, anorexia and weight loss. The analytical study revealed leukocytosis with eosinophilia, elevated inflammatory parameters and p-ANCA positive antibodies. The diagnosis of CSS was established based on clinical and histopathological data. Cutaneous manifestations of hemorragic vasculitis are rare in CSS syndrome but can be the first manifestation of the disease. The recognition of this presentation is important for the early diagnosis and treatment of this syndrome. PMID:25386301

A fatal case of Churg-Strauss syndrome presenting with acute polyneuropathy mimicking Guillain-Barré syndrome.

PubMed

De Toni Franceschini, Luisa; Amadio, Stefano; Scarlato, Marina; Fazio, Raffaella; Quattrini, Angelo; Dell'antonio, Giacomo; Comi, Giancarlo; Del Carro, Ubaldo

2011-10-01

A 64-year-old woman, with asthma and sinusal polyposis in her history, suddenly developed a painful polyneuropathy with diplopia. Nerve conduction studies, performed at the very onset of the neuropathy, could not definitely rule out a Guillain-Barré syndrome (GBS) and high-dose i.v. immunoglobulins were administered. Clinical and laboratory findings subsequently supported the diagnosis of Churg-Strauss syndrome; corticosteroid therapy was started and clinical stabilisation of neuropathy was apparently achieved. No indicators of unfavourable outcome were present at that time. Nevertheless, 30 days after the onset the patient acutely worsened with severe polyneuropathy relapse and fatal systemic diffusion to heart, kidney and mesenteric district, which a single cyclophosphamide pulse failed to control. This case highlights the possibility that a GBS-like onset of Churg-Strauss syndrome neuropathy should be regarded as a part of multiorgan, severe or even life-threatening vasculitic involvement, requiring the most aggressive treatments, regardless of the presence of recognised factors of poor outcome.

Cutting edge issues in the Churg-Strauss syndrome.

PubMed

Szczeklik, Wojciech; Jakieła, Bogdan; Adamek, Dariusz; Musiał, Jacek

2013-02-01

Churg-Strauss syndrome (CSS) is a rare systemic small-vessel vasculitis that develops in the background of bronchial asthma, which is characterized by eosinophilia and eosinophilic infiltration of various tissues. It belongs to the group of antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitides. The triggering factors and pathogenesis of CSS are still unknown. The possible role of eotaxin-3 and CCR4-related chemokines in selective recruitment of eosinophils to the target tissues in CSS has been recently suggested, but the role of eosinophilic inflammation in the development of vasculitic lesions is not completely understood. From the clinical view, two distinct phenotypes of the disease are slowly emerging depending on the ANCA-positivity status. Glucocorticoids are still the mainstay of treatment; however, data are accumulating regarding the beneficial role of novel immunosuppressants and biologic compounds, especially in patients with poorer prognosis.

Heart transplantation in patients with eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome).

PubMed

Groh, Matthieu; Masciocco, Gabriella; Kirchner, Elizabeth; Kristen, Arnt; Pellegrini, Carlo; Varnous, Shaïda; Bortman, Guillermo; Rosenberg, Mark; Brucato, Antonio; Waterworth, Paul; Bonacina, Edgardo; Facchetti, Fabio; Calabrese, Leonard; Gregorini, Gina; Scali, Juan Jose; Starling, Randall; Frigerio, Maria; D'Armini, Andrea Maria; Guillevin, Loïc

2014-08-01

Heart involvement is the leading cause of death of patients with eosinophilic granulomatosis with polyangiitis (EGPA; formerly Churg-Strauss syndrome) and is more frequent in anti-neutrophil cytoplasm antibody (ANCA)-negative patients. Post-transplant outcome has only been reported once. We conducted a retrospective international multicenter study. Patients satisfying the criteria of the American College of Rheumatology and/or revised Chapel Hill Consensus Conference Nomenclature were identified by collaborating vasculitis and transplant specialists, and the help of the Churg-Strauss Syndrome Association. Nine ANCA(-) patients who received transplants between October 1987 and December 2009 were identified. The vasculitis and cardiomyopathy diagnoses were concomitant for 5 patients and separated by 12 to 288 months for the remaining 4 patients. Despite ongoing immunosuppression, histologic examination of 7 (78%) patients' explanted hearts showed histologic patterns suggestive of active vasculitis. The overall 5-year survival rate was low (57%), but rose to 80% when considering only the 6 patients transplanted during the last decade. After survival lasting 3 to 60 months, 4 (44%) patients died sudden deaths. The search for EGPA-related cardiomyopathy is mandatory early in the course of this type of vasculitis. Indeed, prompt treatment with corticosteroids and cyclophosphamide may achieve restore cardiac function. Most patients in this series were undertreated. For patients with refractory EGPA, heart transplantation should be performed, which carries a fair prognosis. No optimal immunosuppressive strategy has yet been identified. Copyright © 2014 International Society for Heart and Lung Transplantation. All rights reserved.

Churg-Strauss syndrome: a case report.

PubMed

Dinić, Miroslav Z; Sekulović, Lidija Kandolf; Zolotarevski, Lidija; Zecević, Rados D

2013-07-01

Churg-Strauss syndrome (CSS) is an allergic granulomatous angiitis, a rare disease of small and medium arteries and veins, associated with the presence of perinuclear antineutrophil cytoplasmic antibodies (p-ANCA). According to the American College of Rheumatology (ACR), there are four or more criteria out of six for the diagnosis: asthma, eosinophilia (> 10% in peripheral blood), paranasal sinusitis, pulmonary infiltrates, histological evidence of vasculitis with extravascular eosinophils, and mononeuritis multiplex or polyneuropathy. We reported a female patient, aged 80 years, with asthma for many decades and repeatedly verified eosinophilia in peripheral blood, in which CSS was suspected only after the occurrence of skin changes in the form of vesicles, vesiculopustule, purpuric macula, papule and petechiae. Further tests verified pulmonary infiltrates, paranasal sinusitis, extravascular eosinophils on histopathologic sample of skin tissue, and polyneuropathy. The treatment started with methylprednisolone (60 mg/d, with decreasing doses), and continued with pulse doses of cyclophosphamide (800 mg once monthly), also corticosteroid ointment for skin lesions. Despite long-standing pulmonary symptoms and laboratory findings of eosinophilia, the appearance of skin changes raised suspicion of possible CSS. Skin changes resolved and the patient was reffered to rheumatologist.

Coronary involvement in Churg-Strauss syndrome.

PubMed

Dendramis, Gregory; Paleologo, Claudia; Piraino, Davide; Arrotti, Salvatore; Assennato, Pasquale

2015-01-01

Systemic autoimmune diseases are themselves a relevant and independent risk factor for atherosclerosis and coronary ectasia. We describe a case of a 58-year-old Caucasian man who was admitted to our department for unstable angina. History of asthma, paranasal sinus abnormality, and peripheral eosinophilia given a high suspicion of Churg-Strauss syndrome (CSS). Diagnosis was performed with 5 of the 6 American College of Rheumatology criteria. The knowledge that CSS is often associated with significant coronary artery involvement and the persistence of chest pain led us to performing immediately a coronary angiography. Coronary angiography showed diffuse ectasic lesions, chronic occlusion of left anterior descending artery with homocoronary collateral circulation from left circumflex artery and subocclusive stenosis in the proximal tract of posterior descending artery. The early recognition of CSS, an aggressive invasive diagnostic approach, and an early appropriate therapy are important to prevent the progressive and permanent cardiac damage in these patients. In the setting of a multidisciplinary approach, careful cardiac assessment is an essential step in CSS, even in mildly symptomatic patients. Copyright © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

Echocardiographic Changes in Eosinophilic Endocarditis Induced by Churg-Strauss Syndrome.

PubMed

Masaki, Nobuyuki; Issiki, Ami; Kirimura, Masato; Kamiyama, Tetsuo; Sasaki, Osamu; Ito, Hiroyuki; Maruyama, Yoshiaki; Nishioka, Toshihiko

Eosinophilic myocarditis may be accompanied by Churg-Strauss syndrome (CSS). We report a case of CSS that was accompanied by myocardial changes in the early stage. A 71-year-old woman complained of mild chest pain at rest, but routine echocardiography did not reveal any endocardial abnormalities. Four months later, the patient was hospitalized due to congestive heart failure with neuropathy of both upper extremities. A diagnosis of eosinophilic myocarditis was made based on the patient's laboratory results and the presence of mural thrombus. This case illustrates that, although early eosinophilic myocarditis is an important differential diagnosis in patients with chest pain, it may be difficult to identify in without an apparent mural thrombus.

Churg-Strauss syndrome presenting with eosinophilic myocarditis: a diagnostic challenge.

PubMed

Correia, Ana Sofia; Gonçalves, Alexandra; Araújo, Vítor; Almeida e Silva, João; Pereira, José Manuel; Rodrigues Pereira, Pedro; Pizarro, Manuel; Silva, João Carlos; Maciel, Maria Júlia

2013-09-01

Churg-Strauss syndrome (CSS) is an unusual disease that presents as systemic vasculitis and peripheral eosinophilia in patients with an atopic constitution. Cardiac involvement is unusual and often not prominent on initial presentation, but is an important cause of morbidity and mortality in patients with CSS. We report the case of a young woman with severe acute myocarditis. Coronary arteriography demonstrated extensive focal vasculopathy, consistent with coronary vasculitis, and myocardial biopsy showed eosinophilic myocarditis. This presentation led to an initial diagnosis of CSS in this patient and appropriate therapy resulted in a spectacular remission of disease activity. Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Echocardiographic Changes in Eosinophilic Endocarditis Induced by Churg-Strauss Syndrome

PubMed Central

Masaki, Nobuyuki; Issiki, Ami; Kirimura, Masato; Kamiyama, Tetsuo; Sasaki, Osamu; Ito, Hiroyuki; Maruyama, Yoshiaki; Nishioka, Toshihiko

2016-01-01

Eosinophilic myocarditis may be accompanied by Churg-Strauss syndrome (CSS). We report a case of CSS that was accompanied by myocardial changes in the early stage. A 71-year-old woman complained of mild chest pain at rest, but routine echocardiography did not reveal any endocardial abnormalities. Four months later, the patient was hospitalized due to congestive heart failure with neuropathy of both upper extremities. A diagnosis of eosinophilic myocarditis was made based on the patient's laboratory results and the presence of mural thrombus. This case illustrates that, although early eosinophilic myocarditis is an important differential diagnosis in patients with chest pain, it may be difficult to identify in without an apparent mural thrombus. PMID:27725542

Initial neuro-ophthalmological manifestations in Churg–Strauss syndrome

PubMed Central

Vallet, Anne-Evelyne; Didelot, Adrien; Guebre-Egziabher, Fitsum; Bernard, Martine; Mauguière, François

2010-01-01

Churg–Strauss syndrome (CSS) is a systemic vasculitis with frequent respiratory tract involvement. It can also affect the nervous system, notably the optic tract. The present work reports the case of a 65-year-old man diagnosed as having CSS in the context of several acute onset neurological symptoms including muscle weakness and signs of temporal arteritis, including bilateral anterior ischaemic optic neuropathy (ON). Electroretinograms (ERGs) and visual evoked potentials (VEPs) were performed. Flash ERGs were normal whereas VEPs were highly abnormal, showing a dramatic voltage reduction, thus confirming the ON. The vision outcome was poor. Ophthalmological presentations of CSS have rarely been reported, but no previous case of sudden blindness documented by combined ERG and VEP investigations were found in the literature. The present case strongly suggests that the occurrence of visual loss in the context of systemic inflammation with hypereosinophilia should lead to considering the diagnosis of CSS. PMID:22789694

[Otolaryngologic manifestations of Churg-Strauss sindrome. Report of a case and review of the literature].

PubMed

Pino Rivero, V; González Palomino, A; Pantoja Hernández, C G; Trinidad Ruíz, G; Pardo Romero, G; Montero García, C; Blasco Huelva, A

2006-01-01

Churg-Strauss Sindrome or allergic granulomatosis is a small vessel systemic vasculitis characterized by asthma, hypereosinophilia and necrotizing vasculitis with extravascular eosinophil granulomas. We describe a case assisted in our hospital who presented pulmonary infiltrates, fever, peripherical neuropathy, weight loss, myalgia, rhinosinusitis, with antecedents of nasal polyposis, and facial edema. Our aim is to review the main otolaryngologic manifestations of this rare illness that is treated with oral corticosteroids, immunosupresor drugs like ciclofosfamide and plasmapheresis.

Subarachnoid and Intracerebral Hemorrhage in Patients with Churg-Strauss Syndrome: Two Case Reports

PubMed Central

Go, Myeong Hoon; Park, Jeong Un; Kang, Jae Gyu

2012-01-01

Churg-Strauss syndrome (CSS) is a systemic necrotizing vasculitis of the small and medium vessels, associated with extravascular eosinophilic granulomas, peripheral eosinophilia, and asthma. The exact etiology of CSS is unknown. This syndrome commonly affects the lungs, peripheral nerves, skin, heart, and gastrointestinal tract, but rarely the central nervous system. Subarachnoid and intracerebral hemorrhage in CSS patients is extremely rare; however, clinicians should consider that CSS may be a cause of intracranial hemorrhage and its high rate of mortality and morbidity. The authors report on two cases of subarachnoid and intracerebral hemorrhage with CSS and discuss a brief review of CSS. PMID:23210058

Churg-Strauss syndrome associated with antiphospholipid antibodies in a patient with retinal vasculitis.

PubMed

Sánchez-Vicente, J L; Gálvez-Carvajal, S; Medina-Tapia, A; Rueda, T; González-García, L; Szewc, M; Muñoz-Morales, A

2016-11-01

We present the case of a 69-year-old woman with unilateral retinal vasculitis. Investigations showed asthma, rhinosinusitis, nasal polyposis, peripheral blood eosinophilia, increased sedimentation rate, proteinuria, and antiphospholipid antibodies. Anti-neutrophil cytoplasmic antibodies (ANCA) were negative. Although her anti-neutrophil cytoplasmatic antibody (ANCA) status was negative, taking into account the other clinical and laboratory features, retinal vasculitis was thought to be an ocular manifestation of Churg-Strauss syndrome. Treatment was started with high-dose corticosteroids and anticoagulant therapy. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

Multiple cerebral and cerebellar infarcts as the first clinical manifestation in a patient with Churg-Strauss syndrome: case report and literature review.

PubMed

Cheng, Meng-Ju; Huang, Pai-Hao; Liao, Pin-Wen; Chen, Jen-Tse; Chiang, Tsuey-Ru

2012-12-01

Churg-Strauss syndrome (CSS) is a rare autoimmune disease with small-vessel vasculitis. Neurological manifestation of CSS is common. Central nervous system is less frequently involved than that of peripheral nervous system. We report a case of 60-year-old man who presented with acute onset of right hemiparesis and impaired cognition. The presence of hypereosinophilia, asthma, sinusitis and extravascular eosinophil accumulation led to the diagnosis of Churg-Strauss syndrome. Brain magnetic resonance imaging (MRI) revealed multiple infarcts in bilateral cerebral and cerebellar hemispheres. The neurophysiology study did not reveal peripheral neuropathy. The patient was effectively treated with methylprednisolone, cyclophosphamide and warfarin. Symptoms and signs of central nervous system can be the initial neurological manifestation of CSS patients. CSS should be considered while patients have stroke and hypereosinophilia. In our patient, there is a good response to timely steroid, immunosuppressant and anticoagulant therapies.

Eosinophilic myocarditis due to Churg-Strauss syndrome mimicking reversible dilated cardiomyopathy.

PubMed

Chen, Ming-xian; Yu, Bi-lian; Peng, Dao-quan; Zhou, Sheng-hua

2014-01-01

A 41-year-old woman with a history of asthma arrived at the emergency room of our hospital with dyspnea. The electrocardiogram showed no specific results. Echocardiography defects revealed an obvious decrease in the left ventricular systolic function and enlargement of the left chamber. We initially considered her condition to be dilated cardiomyopathy. However, she had eosinophilia in the peripheral blood and elevated cardiac enzymes. The coronary angiography showed normal coronary arteries. Single photon emission computed tomography (SPECT) showed infiltrative myocardial disease. She was then diagnosed with eosinophil infiltrations. Combined with peripheral nerve injury and lung involvement, she was diagnosed as having Churg-Strauss syndrome. After initiating prednisone treatment, her eosinophilia and rising cardiac enzymes recovered to normal, and both her echocardiographic abnormalities and symptoms noticeably improved. Copyright © 2014 Elsevier Inc. All rights reserved.

Distribution of the near-inertial kinetic energy inside mesoscale eddies: Observations in the Gulf of Mexico

NASA Astrophysics Data System (ADS)

Ixetl Garcia Gomez, Beatriz; Pallas Sanz, Enric; Candela Perez, Julio

2017-04-01

The near-inertial oscillations (NIOs), generated by the wind stress on the surface mixed layer, are the inertia gravity waves with the lowest frequency and the highest kinetic energy. NIOs are important because they drive vertical mixing in the interior ocean during wave breaking events. Although the interaction between NIOs and mesoscale eddies has been reported by several authors, these studies are mostly analytical and numerical, and only few observational studies have attempted to show the differences in near-inertial kinetic energy (KEi) between anticyclonic and cyclonic eddies. In this work the spatial structure of the KEi inside the mesoscale eddies is computed using daily satellite altimetry and observations of horizontal velocity from 23 moorings equipped with acoustic Doppler current profilers in the western Gulf of Mexico. Consistent to theory, the obtained four-year KEi-composites show two times more KEi inside the anticyclonic eddies than inside the cyclonic ones. The vertical and horizontal cross-sections of the KEi-composites show that the KEi is mainly located near to the surface of the cyclonic eddies (positive vorticity), whereas the KEi in anticyclonic eddies (negative vorticity) is maximum in the eddy's center near to the base of the eddy where the NIOs become more inertial, are trapped, and amplified. The mean vertical profiles show that the cyclonic eddies present a maximum of KEi near to the surface at 50, while the maximum of KEi in the anticyclonic eddies occurs between 900 and 1100 m. Inside anticyclonic eddies another two relative maximums are observed, one in the mixed layer and the second at 300 m. In contrast, the mean profile of KEi outside the mesoscale eddies has the maximum value at the surface ( 50 m), with high values of KEi in the first 200 m and negligible energy beneath that depth. A different mean distribution of the KEi is observed depending on the type of wind generator: tropical storms or unidirectional wind.

The Historical Foundation of Learning Disabilities: A Quantitative Synthesis Assessing the Validity of Strauss and Werner's Exogenous versus Endogenous Distinction of Mental Retardation.

ERIC Educational Resources Information Center

Kavale, Kenneth A.; Forness, Steven R.

1985-01-01

The paper reviews research of A. Strauss and H. Werner on behavioral differences between exogeneous (brain injured) and endogeneous (familial-cultural) mental retardation using quantitative methods of research synthesis. Findings offer little empirical support for the presumed behavioral differences and reveal considerable overlap among the…

Coronary involvement in Churg-Strauss syndrome: a case report with CT findings.

PubMed

Doo, Kyung Won; Yong, Hwan Seok; Kang, Eun-Young

2013-12-01

We report a case of Churg-Strauss syndrome (CSS) associated with coronary artery involvement, as demonstrated on coronary CT angiography (CCTA), without specific cardiac symptoms. A 69-year-old male had an 8-year history of bronchial asthma and chronic sinusitis with hypereosinophilia (35 %), polyneuropathy, and a positive antineutrophil cytoplasmic antibody titer, so he was diagnosed with CSS. The patient had no specific cardiac symptoms, but CCTA showed vasculitis and a saccular aneurysm involving the proximal coronary arteries. The 3-year follow-up CCTA demonstrated an increase in the extent of soft-tissue wall thickening and infiltration involving the coronary arteries. Although vasculitis of the major coronary arteries is not a prominent feature of CSS, our case suggests that the coronary arteries may also be targeted in this syndrome.

Churg–Strauss syndrome in a patient previously diagnosed with multiple sclerosis

PubMed Central

Sarkar, Pamela; Ibitoye, Richard Tolulope; Promnitz, Douglas Anthony

2011-01-01

A lady in her 70s with a background of multiple sclerosis (MS) and late-onset asthma was admitted with a 2-week history of cough and shortness of breath, progressive right-sided weakness and functional decline. Investigation revealed eosinophilia, elevated myeloperoxidase antineutrophil cytoplasmic antibody, CT sinuses showed long-standing inflammatory changes consistent with sinonasal polyposis and MRI head showed lesions consistent with vasculitis. She then developed left-sided weakness and increased wheeze. Review of her case notes demonstrated that, the eosinophilia was long-standing, her asthma was severe and steroid-dependent, and her neurologic syndrome was atypical for MS. Intravenous methylprednisolone then cyclophosphamide were administered. She demonstrated remarkable improvement, becoming more alert, with improvement in left-sided weakness. A diagnosis of Churg–Strauss syndrome was established. She was discharged to a nursing home with outpatient rheumatology follow-up. The diagnosis of MS was revisited. PMID:22679315

Churg-Strauss syndrome presenting as scar reactivation: histopathologic features and an illustration of 'locus minoris resistentiae'.

PubMed

Gee, Sarah N; Harris, Anna C; Zimarowski, Mary Jane

2013-05-01

We report a 33-year-old female with cutaneous involvement by Churg-Strauss syndrome confined to surgical scars that were obtained 13 years before. She presented to the emergency department with 2-day history of fever, night sweats, right-sided weakness, hoarseness and worsening asthma symptoms. She was found to have an eosinophilia and two sub-5-mm pulmonary nodules. The patient also reported that the scars on her right thumb, inner wrist and back had been swollen, red and painful for 2 days. Examination revealed tender, erythematous, well-healed edematous scars studded with small skin colored papules. She had no clinical findings that were classic for cutaneous vasculitis. A skin biopsy of a scar revealed perivascular and palisading granulomatous inflammation consisting of histiocytes and neutrophils with leukocytoclasia. Focal vascular injury was identified. Scattered tissue eosinophils were seen. Special stains were negative for infection. Thereafter, she was started on intravenous steroids, at which point the fever, pulmonary and cutaneous symptoms subsided. Although scar sarcoidosis is a well-described phenomenon, granulomatous inflammation and vasculitis seen in Churg-Strauss syndrome exclusively manifesting in well-healed surgical scars highlights the unique features seen in this case and draws attention to the concept of locus minoris resistentiae. This case also highlights how a skin biopsy in the setting of suspected systemic vasculitis can confirm the presence of vasculitis and/or granulomatous inflammation and obviate the need for more invasive, higher risk procedures such as lung biopsy. Copyright © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

A case of Churg-Strauss syndrome and central retinal artery occlusion with good visual recovery.

PubMed

Kamata, Yuki; Hashizume, Kouhei; Kaneko, Muneyoshi; Kurosaka, Daijiro

2013-04-01

Here we report a case of Churg-Strauss syndrome (CSS) and central retinal artery occlusion (CRAO), with good visual recovery. A 58-year-old Japanese man with CSS experienced acute painless loss of vision in his right eye. CRAO was diagnosed by fundoscopic findings (retinal whitening with a cherry-red spot). Steroid pulse therapy (methylprednisolone at 1 g daily for 3 days) followed by combined treatment with prednisolone (30 mg/day) and cyclophosphamide (150 mg/day) was administered; his visual acuity recovered to 20/30 in 1 month, and no recurrence has occurred for 1 year. Steroid pulse therapy may be effective for CRAO in CSS patients.

Leukocytoclastic Vasculitis: A Window to Systemic Churg Strauss Syndrome

PubMed Central

Medhekar, Sudhir V; Vasani, Resham J; Kamath, Ratnakar R

2012-01-01

A twenty year old male presented with purpuric lesions with chronic painful ulcers over the lower extremities and a recurrent pruritic rash on the trunk for 10 years. He was diagnosed as idiopathic leukocytoclastic vasculitis (LCV) after investigations failed to reveal a systemic association. He was treated with immunosuppressants at each visit with partial remission. In 2004, he was diagnosed with bronchial asthma and allergic rhinitis. In his recent admission, he showed necrotic ulcers on legs and extensive shiny, truncal micropapules. Examination revealed maxillary sinus tenderness and loss of sensation on the medial aspect of the left lower limb. Biopsy of ulcer and the micropapules showed the presence of extravascular eosinophils, while hematological investigations showed peripheral eosinophilia of 18%, raised serum Immunoglobulin E (IgE), Anti nuclear antibody (ANA) positivity and negative antineutrophil cytoplasmic antibody (ANCA). Radiography confirmed maxillary sinusitis, nerve conduction studies revealed mononeuritis of the anterior tibial nerve and pulmonary function tests (PFT) were normal. Clinical examination and investigations pointed towards the diagnosis of Churg-Strauss syndrome (CSS). This report highlights the development of full-blown CSS over a period of 12 years in a patient initially diagnosed as idiopathic LCV, emphasizing the need for regular follow-up of resistant and recurrent cases of LCV. PMID:22707776

[The relationship between the structuralism of Levi-Strauss and linguistic methods. An attempt at applying structuralist phonologic models to the study of pathologic language].

PubMed

Lhote, E

1975-01-01

The structuralism which is generally accepted as a 'good French' school of thinking, presents in some of its applications the short-time character of fashion in such a way that one often forgets what this philosophy implicates. In this essay, the author intends to show that even though a structural method really exists, one cannot say who exactly is 'the father' of structuralism. But during the long maturity period of thought that resulted in structuralism, one important step has been made in France by Lévi-Strauss who has been using a great number of linguistic concepts, and at the same time has contributed to the consequent progress realized in that discipline. In the light of linguistics and of the works made by Lévi-Strauss some notions are redefined: those of structure, those of oppositions in the systems, those of relations inside one system, and the interactions between 'significant' and 'signifié'. Born from recent research in mathematics and cybernetics, the notion of Model, very fertile in linguistics, is an important element in the Lévi-Strauss structural methodology. With the help of examples taken from phonetics and phonology, the author intends to show how to elaborate a model, of what nature are the links between the observed object and the model, and what can be the applications of that method in the study of pathological languages; the author also intends to show that the main interest in a model of structural type is its explicative and previsional quality. A critical study of the structural analysis makes it possible to show the real contribution of structuralism: the author presents new ways that have been revealed by structuralism and some developments later on favorized by this discipline, mainly in linguistics. Remark. In this study of structuralism, the author places herself on the level with 'method' and not with 'philosophy'.

Acute coronary syndrome caused by coronary vasospasms associated with Churg-Strauss syndrome: effects of betamethasone therapy.

PubMed

Suzuki, Yuji; Nishiyama, Osamu; Sakai, Toshiaki; Niiyama, Masanobu; Itoh, Tomonori; Nakamura, Motoyuki

2014-01-01

A 42-year-old woman with a history of aspirin-induced asthma was admitted with severe chest pain. Emergency coronary angiography revealed coronary artery spasms. The administration of vasodilators did not suppress the anginal symptoms, and the differential white blood cell count continued to show eosinophilia. The patient's symptoms of aspirin-induced asthma, eosinophilia and other allergic states led to the diagnosis of Churg-Strauss syndrome (CSS). After starting betamethasone therapy, the eosinophilia and cardiac symptoms rapidly disappeared. Although coronary vasospasms related to CSS are rare, the present case suggests that a differential white blood cell count should be obtained in patients with refractory coronary vasospasms.

The linkage between Churg-Strauss syndrome and leukotriene receptor antagonists: fact or fiction?

PubMed Central

McDanel, Deanna L; Muller, Barbara A

2005-01-01

Epidemiologic evidence has shown that the worldwide prevalence of asthma is increasing. The leukotriene receptor antagonists (LTRAs) represent a new class of therapy for asthma. They have been developed in the last decade and play a pivotal steroid-sparing role in treating the inflammatory component of asthma. Consequently, reports of Churg-Strauss syndrome (CSS), a rare form of systemic vasculitis, have been recognized as a potential side effect in individuals with moderate to severe asthma on LTRA therapy. The serious nature of this disorder is worthy of prompt recognition by clinicians and aggressive therapy to avoid the subsequent longstanding effects of vasculitis. To validate the postulated linkage between the LTRAs and CSS, this review comprehensively evaluates reported cases in the literature and supports a pathophysiological relationship between the LTRAs and the development of CSS. PMID:18360552

Hospital Morbidity Database for Epidemiological Studies on Churg-Strauss Syndrome.

PubMed

Kanecki, Krzysztof; Nitsch-Osuch, Aneta; Gorynski, Paweł; Tarka, Patryk; Tyszko, Piotr

2017-01-01

Churg-Strauss syndrome or more accurately eosinophilic granulomatosis with polyangiitis (EGPA) is a small-vessel necrotizing vasculitis with a characteristic late-onset allergic rhinitis and asthma. The use of hospital morbidity database is an important element of the epidemiological analysis of this rare disease. The present study was undertaken to assess the incidence of EGPA and factors related to its epidemiology in Poland; the first analysis of the kind in Poland, enabling a comparison in the European context. This is a retrospective, population-based study using hospital discharge records with EGPA diagnosis, collected for a National Institute of Public Health survey covering the period from 2008 to 2013. The group consisted of 344 patients (206 females and 138 males) with the first-time hospitalization for EGPA. The major findings are that the annual incidence of EGPA in Poland was 1.5 per million (95% confidence intervals: 1.2-1.8), with the point prevalence of 8.8 per million at the end of 2013. A greater incidence of EGPA was observed in the regions with urban predominance. We conclude that discharge records may be a useful element of epidemiological studies on EGPA.

Diagnosis of Churg-Strauss Syndrome Presented With Neuroendocrine Carcinoma: A Case Report.

PubMed

Park, Dayun; Lee, Ho Jun; Lee, Kwang Hoon; Kwon, Bum Sun; Park, Jin-Woo; Nam, Ki Yeun; Lee, Kyoung Hwan

2017-06-01

Churg-Strauss syndrome (CSS) is a rare systemic vasculitis that affect small and medium-sized blood vessels and is accompanied by asthma, eosinophilia, and peripheral neuropathy. This report describes a case of a 52-year-old man who had a history of sinusitis, asthma, and thymus cancer and who had complained of bilateral lower extremity paresthesia and weakness for a month. Peripheral neuropathy was detected by electrodiagnostic studies. Resection of a mediastinal mass, which was diagnosed as thymic neuroendocrine carcinoma, was performed five months before his visit. After thymectomy, peripheral blood tests revealed a gradual increase in eosinophils. Two months after surgery, he was admitted to the hospital for dyspnea, and nodules of focal consolidation were found in his chest X-ray. One month later, pyoderma occurred in the right shin, and the skin biopsy showed extravascular eosinophilic infiltration. He was diagnosed with CSS after thymectomy, and we report a very rare case of CSS presented with thymic neuroendocrine carcinoma.

Low Median Nerve Palsy as Initial Manifestation of Churg-Strauss Syndrome.

PubMed

Roh, Young Hak; Koh, Young Do; Noh, Jung Ho; Gong, Hyun Sik; Baek, Goo Hyun

2017-06-01

Anterior interosseous nerve (AIN) syndrome is typically characterized by forearm pain and partial or complete dysfunction of the AIN-innervated muscles. Although the exact etiology and pathophysiology of the disorder remain unclear, AIN syndrome is increasingly thought to be an inflammatory condition of the nerve rather than a compressive neuropathy because the symptoms often resolve spontaneously following prolonged observation. However, peripheral neuropathy can be 1 of the first symptoms of systemic vasculitis that needs early systemic immunotherapy to prevent extensive nerve damage. Churg-Strauss syndrome (CSS; eosinophilic granulomatosis with polyangiitis) is 1 type of primary systemic vasculitis that frequently damages the peripheral nervous system. CSS-associated neuropathy usually involves nerves of the lower limb, and few studies have reported on the involvement of the upper limb alone. We report on a rare case of low median nerve palsy as the initial manifestation of CSS. The patient recovered well with early steroid treatment for primary systemic vasculitis. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Development of a compact ECR ion source for various ion production.

PubMed

Muramatsu, M; Hojo, S; Iwata, Y; Katagiri, K; Sakamoto, Y; Takahashi, N; Sasaki, N; Fukushima, K; Takahashi, K; Suzuki, T; Sasano, T; Uchida, T; Yoshida, Y; Hagino, S; Nishiokada, T; Kato, Y; Kitagawa, A

2016-02-01

There is a desire that a carbon-ion radiotherapy facility will produce various ion species for fundamental research. Although the present Kei2-type ion sources are dedicated for the carbon-ion production, a future ion source is expected that could provide: (1) carbon-ion production for medical use, (2) various ions with a charge-to-mass ratio of 1/3 for the existing Linac injector, and (3) low cost for modification. A prototype compact electron cyclotron resonance (ECR) ion source, named Kei3, based on the Kei series has been developed to correspond to the Kei2 type and to produce these various ions at the National Institute of Radiological Sciences (NIRS). The Kei3 has an outer diameter of 280 mm and a length of 1120 mm. The magnetic field is formed by the same permanent magnet as Kei2. The movable extraction electrode has been installed in order to optimize the beam extraction with various current densities. The gas-injection side of the vacuum chamber has enough space for an oven system. We measured dependence of microwave frequency, extraction voltage, and puller position. Charge state distributions of helium, carbon, nitrogen, oxygen, and neon were also measured.

Churg-Strauss syndrome associated with rapid deterioration of left ventricular diastolic dysfunction and conduction disturbance.

PubMed

Chin, Jung Yeon; Yi, Jeong Eun; Youn, Ho-Joong

2013-10-01

Cardiac involvement in Churg-Strauss syndrome (CSS) is a major cause of mortality. Here we report a case of a 75-year-old woman with eosinophilic endomyocarditis due to CSS. An electrocardiogram showed intraventricular conduction delay, and echocardiography showed an impaired relaxation pattern and biventricular apical thickening. Magnetic resonance imaging revealed subendocardial delayed enhancement with biventricular apical thrombi. Endomyocardial biopsy showed perivascular eosinophilic infiltration. Despite resolution of the hypereosinophilia after steroid therapy, her left ventricular (LV) diastolic function worsened into a restrictive pattern and she died with a ventricular escape rhythm on her 14th day in the hospital. This case is unusual in that there was rapid progression of the LV diastolic dysfunction and conduction disturbance due to CSS. © 2013, Wiley Periodicals, Inc.

[Cardiac involvement in Churg-Strauss syndrome].

PubMed

Brucato, Antonio; Maestroni, Silvia; Masciocco, Gabriella; Ammirati, Enrico; Bonacina, Edgardo; Pedrotti, Patrizia

2015-09-01

Churg-Strauss syndrome, recently renamed eosinophilic granulomatosis with polyangiitis (EGPA), is a rare form of systemic vasculitis, characterized by disseminated necrotizing vasculitis with extravascular granulomas occurring among patients with asthma and tissue eosinophilia. EGPA is classified as a small and medium-sized vessel vasculitis associated with antineutrophil cytoplasmic antibodies (ANCA) and the hypereosinophilic syndrome. Typical clinical features include asthma, sinusitis, transient pulmonary infiltrates and neuropathy. Blood eosinophils are often >1500/µl or more than 10% on the differential leukocyte count. Blood eosinophils should always be tested in unexplained cardiac disorders, and may normalize even after low doses of corticosteroids. ANCA are positive in 40-60% of cases, mainly anti-myeloperoxidase. Heart involvement occurs in approximately 15-60% of EGPA patients, especially those who are ANCA negative. Any cardiac structure can be involved, and patients present with myocarditis, heart failure, pericarditis, arrhythmia, coronary arteritis, valvulopathy, intracavitary cardiac thrombosis. Although cardiovascular involvement is usually an early manifestation, it can also occur later in the course of the disease. A significant proportion of patients with cardiac involvement is asymptomatic. In the absence of symptoms and major ECG abnormalities, cardiac involvement may be detected in nearly 40% of the patients. All patients with EGPA should be studied not only with a detailed history of cardiac symptoms and ECG, but also with echocardiography; if abnormalities are detected, a cardiac magnetic resonance study should be performed. Coronary angiography and endomyocardial biopsy should be reserved to selected cases. Heart involvement carries a poor prognosis and causes 50% of the deaths of these patients. It is often insidious and underestimated. Optimal therapy is therefore important and based on high-dose corticosteroids plus immunosuppressive

ANCA-Negative Churg-Strauss Syndrome Presenting as Acute Multiple Cerebral Infarcts: A Case Report.

PubMed

Psychogios, Klearchos; Evmorfiadis, Ilias; Dragomanovits, Spyros; Stavridis, Athanasios; Takis, Konstantinos; Kaklamanis, Loukas; Stathis, Pantelis

2017-03-01

Eosinophilic granulomatosis with polyangiitis (EGPA, previously named Churg-Strauss syndrome) is a form of necrotizing vasculitis occurring in patients with asthma and eosinophilia. Ischemic stroke is a relatively rare complication of the disease. We report a case of a 63-year-old woman with multiple embolic infarcts, hypereosinophilia (for >7 years), and skin rash. Elevated cardiac enzymes and cardiac magnetic resonance imaging were consistent with endomyocarditis. The simultaneous presence of history of asthma, sinusitis, hypereosinophilia, and vasculitis led to the diagnosis of EGPA. This case contributes to the recent debate of the 2 possible presentations of the disease according to the ANCA (antineutrophil cytoplasmic antibodies) status. We furthermore underscore the need for careful differential diagnosis of the "ANCA negative" cases with persistent hypereosinophilia from the idiopathic hypereosinophilic syndrome. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Development of a compact ECR ion source for various ion production

DOE Office of Scientific and Technical Information (OSTI.GOV)

Muramatsu, M., E-mail: m-mura@nirs.go.jp; Hojo, S.; Iwata, Y.

2016-02-15

There is a desire that a carbon-ion radiotherapy facility will produce various ion species for fundamental research. Although the present Kei2-type ion sources are dedicated for the carbon-ion production, a future ion source is expected that could provide: (1) carbon-ion production for medical use, (2) various ions with a charge-to-mass ratio of 1/3 for the existing Linac injector, and (3) low cost for modification. A prototype compact electron cyclotron resonance (ECR) ion source, named Kei3, based on the Kei series has been developed to correspond to the Kei2 type and to produce these various ions at the National Institute ofmore » Radiological Sciences (NIRS). The Kei3 has an outer diameter of 280 mm and a length of 1120 mm. The magnetic field is formed by the same permanent magnet as Kei2. The movable extraction electrode has been installed in order to optimize the beam extraction with various current densities. The gas-injection side of the vacuum chamber has enough space for an oven system. We measured dependence of microwave frequency, extraction voltage, and puller position. Charge state distributions of helium, carbon, nitrogen, oxygen, and neon were also measured.« less

Combined Churg-Strauss syndrome and allergic bronchopulmonary aspergillosis - case report and review of the literature.

PubMed

Ren, Shaohua

2013-01-01

A rare case of combined Churg-Strauss syndrome (CSS) and allergic bronchopulmonary aspergillosis (ABPA) was presented. A 41-year-old woman was diagnosed with CSS based upon asthma, eosinophilia (23%), chest radiographic findings, paranasal sinusitis, peripheral neuropathy and positive p- anti-neutrophil cytoplasmic antibodies (pANCA). The diagnosis of ABPA was established on the pathological findings of allegic mucin impaction and fungal hyphae on lung biopsy. It was further proved by positive serum IgE and IgG antibodies specific to afumigatus. The clinical investigation features were reviewed in the patients with combined CSS and ABPA. All patients had the time sequence of the development of CSS after ABPA uniformly, suggesting immunopathogenesis involving the emergence of CSS. The role of lung biopsy in the diagnosis of the condition was emphasized. © 2012 Blackwell Publishing Ltd.

Clinical features and prognostic factors of Churg-Strauss syndrome

PubMed Central

Kim, Mi-Yeong; Sohn, Kyoung-Hee; Song, Woo-Jung; Park, Heung-Woo; Cho, Sang-Heon; Min, Kyung-Up

2014-01-01

Background/Aims Churg-Strauss syndrome (CSS) is a rare systemic necrotizing small-vessel vasculitis, with accompanying bronchial asthma, eosinophilia, and eosinophilic infiltration of various tissues. The purposes of our study were to characterize the clinical features of CSS and to identify factors associated with CSS prognosis in Koreans. Methods Medical records were reviewed retrospectively for all physician-diagnosed CSS patients in the Seoul National University Hospital between January 1990 and March 2011. Results Data from 52 CSS patients were analyzed. The respiratory tract was the most commonly involved organ (90.4%). Renal involvement was less frequent in antineutrophilic cytoplasmic antibody (ANCA)(-) patients than in ANCA(+) patients (p = 0.048). Clinical remission occurred in 95.3% of patients, but 16.3% of them relapsed. Patients who maintained remission for more than 6 months were relatively older (median, 51 years) at diagnosis (p = 0.004), had been diagnosed in earlier stages (p = 0.027), showed more frequent respiratory involvement (p = 0.024) and generalized symptoms (p = 0.039), and showed less frequent cutaneous involvement (p = 0.030) than those who did not achieve persistent (> 6 months) remission. Patients who achieved persistent remission also showed higher C-reactive protein (CRP) levels (p = 0.031) than those who did not. Conclusions ANCA(-) CSS patients showed less frequent renal involvement. Characteristics of good responders were older age, diagnosis at earlier stages, less cutaneous involvement, more respiratory involvement, high CRP values, and more generalized symptoms. PMID:24574837

Clinical features and prognostic factors of Churg-Strauss syndrome.

PubMed

Kim, Mi-Yeong; Sohn, Kyoung-Hee; Song, Woo-Jung; Park, Heung-Woo; Cho, Sang-Heon; Min, Kyung-Up; Kang, Hye-Ryun

2014-01-01

Churg-Strauss syndrome (CSS) is a rare systemic necrotizing small-vessel vasculitis, with accompanying bronchial asthma, eosinophilia, and eosinophilic infiltration of various tissues. The purposes of our study were to characterize the clinical features of CSS and to identify factors associated with CSS prognosis in Koreans. Medical records were reviewed retrospectively for all physician-diagnosed CSS patients in the Seoul National University Hospital between January 1990 and March 2011. Data from 52 CSS patients were analyzed. The respiratory tract was the most commonly involved organ (90.4%). Renal involvement was less frequent in antineutrophilic cytoplasmic antibody (ANCA)(-) patients than in ANCA(+) patients (p = 0.048). Clinical remission occurred in 95.3% of patients, but 16.3% of them relapsed. Patients who maintained remission for more than 6 months were relatively older (median, 51 years) at diagnosis (p = 0.004), had been diagnosed in earlier stages (p = 0.027), showed more frequent respiratory involvement (p = 0.024) and generalized symptoms (p = 0.039), and showed less frequent cutaneous involvement (p = 0.030) than those who did not achieve persistent (> 6 months) remission. Patients who achieved persistent remission also showed higher C-reactive protein (CRP) levels (p = 0.031) than those who did not. ANCA(-) CSS patients showed less frequent renal involvement. Characteristics of good responders were older age, diagnosis at earlier stages, less cutaneous involvement, more respiratory involvement, high CRP values, and more generalized symptoms.

Churg-Strauss Syndrome as an Unusual Aetiology of Stroke with Haemorrhagic Transformation in a Patient with No Cardiovascular Risk Factors

PubMed Central

Sairanen, Tiina; Kanerva, Mari; Valanne, Leena; Lyytinen, Jukka; Pekkonen, Eero

2011-01-01

Background We present here a case of haemorrhagic brain infarction in a middle-aged and physically active male, who had never smoked. This case report aims to remind the internist and neurologist to bear in mind unusual aetiologies of brain infarcts in patients without classical cardiovascular risk factors. Case Description A 49-year-old male with pulmonary asthma and a prior history of nasal polyps had a wake-up stroke with left-sided symptoms and speech disturbance. A head MRI and MR angiography revealed a recent haemorrhagic infarct in the right putamen and corona radiata. The left hemiparesis progressed to sensory-motor hemiplegia on the 4th day. In the head CT, it was shown that the haemorrhagic infarct had progressed to a large haematoma. A pansinusitis was also diagnosed. The aetiological investigations revealed a minor atrial septal defect (ASD) with shunting and a heterozygotic clotting factor V R506Q mutation. A remarkable blood eosinophilia of 9.80 E9/l (42%) together with fever, sinusitis, wide-spread bilateral nodular pulmonary infiltrates that did not respond to wide-spectrum antimicrobial treatment, positive anti-neutrophilic cytoplasmic antibodies, a high myeloperoxidase antibody level and slightly positive anti-proteinase 3 antibodies suggested the diagnosis of Churg-Strauss syndrome. These inflammatory symptoms and findings promptly responded to treatment with corticosteroids and cyclophosphamide. Conclusions Even after the concomitant findings of the low risk factors, i.e. small ASD and heterozygotic clotting factor mutation, continued search for the final aetiology of stroke revealed Churg-Strauss syndrome, which was the key to the treatment. PMID:21468361

Polyangiitis overlap syndrome of granulomatosis with polyangiitis (Wegener's granulomatosis) and eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome).

PubMed

Uematsu, Hironori; Takata, Shohei; Sueishi, Katsuo; Inoue, Hiromasa

2014-02-27

Polyangiitis overlap syndrome is defined as systemic vasculitis that cannot be classified into one of the well-defined vasculitic syndromes. In this report, a female patient who presented with vasculitis-like and asthmatic symptoms was diagnosed as having polyangiitis overlap syndrome of granulomatosis with polyangiitis (GPA; formerly known as Wegener's granulomatosis) and eosinophilic granulomatosis with polyangiitis (EGPA; formerly known as Churg-Strauss syndrome). The patient fulfilled the American College of Rheumatology diagnostic criteria for GPA and EGPA. She was successfully treated with immunosuppressants and steroids and has been in remission for 20 months. It is important to establish a proper diagnosis and introduce an appropriate treatment modality in patients with this rare and serious pathology to prevent irreversible organ damage.

Churg-Strauss syndrome and persistent heart failure: active disease or damage?

PubMed

Lin, Yih Chang; Oliveira, Guilherme H M; Villa-Forte, Alexandra

2013-10-01

Churg-Strauss syndrome (CSS) is a rare small-vessel vasculitis typically associated with adult-onset asthma, peripheral and tissue hypereosinophilia, migratory pulmonary infiltrates, upper respiratory tract symptoms, and clinical evidence of systemic vasculitis. Cardiac involvement is a well-recognized complication with an estimated prevalence of 60%. Heart disease is associated with poor prognosis, accounting for almost 50% mortality in CSS. We present a case of a 48-year-old woman with CSS complicated by congestive heart failure with left ventricular ejection fraction of 25%, who was initially treated with long course of high-dose steroids without any clinical or echocardiographic improvement. She was referred to our hospital 1 year later and was initiated with cyclophosphamide 2 mg/kg per day and prednisone 60 mg/d followed by slow taper. Subsequently, the patient had remarkable improvement. Patient was then transitioned to azathioprine for 1.5 years with sustained disease remission. It may be difficult to determine myocardial disease activity status versus tissue damage in CSS with prolonged duration of heart failure symptoms. This is the first case report demonstrating that CSS cardiac disease may remain active despite 1 year of corticosteroid therapy, and significant improvement or remission can still be achieved by administering more aggressive cytotoxic immunosuppressive therapy.

A case report for fatal Churg-Strauss syndrome complications: first reported death due to rapid progression of prominently huge hepatic capsular hematoma and multi-system organ hemorrhage

PubMed Central

Qian, Jiejing; Tong, Hongyan; Chen, Feifei; Mai, Wenyuan; Lou, Yinjun; Jin, Jie

2014-01-01

Churg-Strauss syndrome (CSS) is a rare disease that has an extremely low incidence rate. CSS prognosis is good, in general; and there are no reports of multiple-organ hemorrhage in CSS. We report a unique case of CSS, wherein, an elderly man experienced multiple organ hemorrhage -- a particularly huge hematoma under the capsule of the liver and poor prognosis. PMID:25419420

[A case of Churg-Strauss syndrome with subarachnoid hemorrhage].

PubMed

Ito, Miiko; Kato, Naoki; Su, Ching-Chan; Kayama, Takamasa

2014-03-01

Churg-Strauss syndrome (CSS) is a vasculitis syndromes and is only rarely complicated by subarachnoid hemorrhage. In the current report, we describe a case of CSS with subarachnoid hemorrhage, which showed a favorable outcome following conservative treatment. A 68-year-old man with CSS on maintenance steroid therapy underwent MRI/A during tinnitus aggravation, and showed dilation of the left middle cerebral artery and stenosis of the peripheral area of the right vertebral artery. After 2 months, he presented sudden pain in the occipitocervical area, and CT revealed subarachnoid hemorrhage. Intracranial 3D CT-A and MRI/A showed the development of a protrusion at the base of the left anterior cerebral artery. Although both findings suggested cerebral artery dissection, the source of hemorrhage could not be identified. The 2009 Japanese Guidelines for the Management of Stroke recommends early diagnosis and treatment of hemorrhagic cerebral artery dissection because of the high risk of re-bleeding. However, considering the risks of vasculitis aggravation, development of systemic complications, and recurrence, conservative treatment was selected. In addition, owing to the risk of complications associated with the frequent use of iodinated contrast agents and angiography procedures, patient was followed up using MRI. His course was favorable, and he was discharged despite mild right abducens paralysis. When patients with hemorrhagic cerebral artery dissection have a history of allergic diseases, CCS should be considered; conservative treatment consisting of rest, strict blood pressure control, and steroid therapy may be the most appropriate option for certain patients.

Fasting plasma zeaxanthin response to Fructus barbarum L. (wolfberry; Kei Tze) in a food-based human supplementation trial.

PubMed

Cheng, Chung Yuen; Chung, Wai Yuen; Szeto, Yim Tong; Benzie, Iris F F

2005-01-01

Age-related macular degeneration (AMD) is a common disorder that causes irreversible loss of central vision. Increased intake of foods containing zeaxanthin may be effective in preventing AMD because the macula accumulates zeaxanthin and lutein, oxygenated carotenoids with antioxidant and blue light-absorbing properties. Lycium barbarum L. is a small red berry known as Fructus lycii and wolfberry in the West, and Kei Tze and Gou Qi Zi in Asia. Wolfberry is rich in zeaxanthin dipalmitate, and is valued in Chinese culture for being good for vision. The aim of this study, which was a single-blinded, placebo-controlled, human intervention trial of parallel design, was to provide data on how fasting plasma zeaxanthin concentration changes as a result of dietary supplementation with whole wolfberries. Fasting blood was collected from healthy, consenting subjects; fourteen subjects took 15 g/d wolfberry (estimated to contain almost 3 mg zeaxanthin) for 28 d. Repeat fasting blood was collected on day 29. Age- and sex-matched controls (n 13) took no wolfberry. Responses in the two groups were compared using the Mann-Whitney test. After supplementation, plasma zeaxanthin increased 2.5-fold: mean values on day 1 and 29 were 0.038 (sem 0.003) and 0.096 (sem 0.009) micromol/l (P<0.01), respectively, for the supplementation group; and 0.038 (sem 0.003) and 0.043 (sem 0.003) micromol/l (P>0.05), respectively, for the control group. This human supplementation trial shows that zeaxanthin in whole wolfberries is bioavailable and that intake of a modest daily amount markedly increases fasting plasma zeaxanthin levels. These new data will support further study of dietary strategies to maintain macular pigment density.

Acute painless monocular visual loss due to central retinal artery occlusion in a patient with Churg-Strauss vasculitis.

PubMed

Skrapari, Ioanna; Kagkelari, Eleftheria; Charitatos, Evangelos; Pantelidaki, Catherine; Gounaris, Theodoros; Sioula, Evagelia

2008-01-01

Ocular involvement in Churg-Strauss syndrome (CSS) is infrequent. We describe a case of a 50-year-old woman, with blood eosinophilia, involvement of the respiratory tract, skin, and peripheral nervous system, fulfilling the American College of Rheumatology criteria for CSS, who presented with left foot drop followed by left acute painless visual loss. Central retinal artery occlusion was diagnosed by fundoscopic findings (retinal whitening with a cherry-red spot). CSS was confirmed by sural nerve biopsy. Despite treatment with high-dose corticosteroids, cyclophosphamide, and anticoagulant therapy, visual acuity was not substantially improved. Acute blindness in CSS has been rarely described. Even more rarely, central retinal artery occlusion has been found to be the underlying cause of this infrequent clinical manifestation in CSS.

Sequential rituximab and omalizumab for the treatment of eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome).

PubMed

Aguirre-Valencia, David; Posso-Osorio, Iván; Bravo, Juan-Carlos; Bonilla-Abadía, Fabio; Tobón, Gabriel J; Cañas, Carlos A

2017-09-01

Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome (CSS), is a small vessel vasculitis associated with eosinophilia and asthma. Clinical manifestations commonly seen in patients presenting with EGPA range from upper airway and lung involvement to neurological, cardiac, cutaneous, and renal manifestations. Treatment for severe presentations includes steroids, cyclophosphamide, plasmapheresis, and recently, rituximab. Rituximab is associated with a good response in the treatment of vasculitis, but a variable response for the control of allergic symptoms. Here, we report a 16-year-old female patient with severe EGPA (gastrointestinal and cutaneous vasculitis, rhinitis and asthma) refractory to conventional treatment. She was treated with rituximab, which enabled rapid control of the vasculitis component of the disease, but there was no response to rhinitis and asthma. Additionally, she developed severe bronchospasm during rituximab infusion. Sequential rituximab and omalizumab were initiated, leading to remission of all manifestations of vasculitis, rhinitis, and asthma, in addition to bronchospasm related to rituximab infusion.

A Case Report of Churg–Strauss Syndrome Presenting With Cardiogenic Shock Treated With Extracorporeal Membrane Oxygenation

PubMed Central

Cui, Na; Su, Longxiang; Wang, Hao; Long, Yun; Pang, Cheng; Yang, Fei; Liu, Dawei

2015-01-01

Abstract Churg–Strauss Syndrome (CSS) complicated with cardiogenic shock is rare. Few case reports have described successful treatment of this rare disease. However, no one has reported on the application of mechanical life support with extracorporeal membrane oxygenation (ECMO) to treat this life-threatening disease. A 36-year-old female with limb numbness for >10 days, chest tightness for 2 days, and worsening dyspnea for 5 h presented in the emergency room. Vital signs showed a low blood pressure (104/60 mm Hg), increased heart rate (158 bpm), and respiration rate (28 bpm). Laboratory tests revealed that eosinophil was significantly increased (WBC: 34.46 × 109/L, neutrophil: 7.56 × 109/L[21.9%], eosinophil: 23.84 × 109/L[69.2%]), and serum myocardial enzymes was abnormal (CK 1049U/L, CKMB-mass 145.1 μg/L, cTnI 16.24 μg/L). Myocardial injury (tachycardia with ST elevation) and poor heart function (LVEF 31%) were found by electrocardiogram and transthoracic echocardiography. On the next day, cardiogenic shock had been developed as demonstrated by deteriorating the perfusion index. Churg–Strauss Syndrome with cardiogenic shock. A series of conservative therapy with drugs such as corticosteroids, anticoagulant, antiplatelet, nitrates, calcium antagonists, inotrope, and vasopressors were initiated on the day of admission. The treatment was ineffective and a cardiogenic shock developed on the next day. Thus, ECMO was initiated immediately to stabilize circulation and perfusion. At the same time, high-dose corticosteroids combined with immunosuppressive therapy were continuously used. Symptoms of cardiogenic shock were gradually improved after ECMO treatment. Elevated values of cardiac enzymes were decreased and the dose of vasoactive drugs was reduced. Extracorporeal membrane oxygenation was discontinued after 8 days, and the patient was eventually weaned off the ventilator. The patient was discharged after 40 days treatment. Once a CSS

A Case Report of Churg-Strauss Syndrome Presenting With Cardiogenic Shock Treated With Extracorporeal Membrane Oxygenation.

PubMed

Cui, Na; Su, Longxiang; Wang, Hao; Long, Yun; Pang, Cheng; Yang, Fei; Liu, Dawei

2015-10-01

Churg-Strauss Syndrome (CSS) complicated with cardiogenic shock is rare. Few case reports have described successful treatment of this rare disease. However, no one has reported on the application of mechanical life support with extracorporeal membrane oxygenation (ECMO) to treat this life-threatening disease.A 36-year-old female with limb numbness for >10 days, chest tightness for 2 days, and worsening dyspnea for 5 h presented in the emergency room. Vital signs showed a low blood pressure (104/60 mm Hg), increased heart rate (158 bpm), and respiration rate (28 bpm). Laboratory tests revealed that eosinophil was significantly increased (WBC: 34.46 × 10/L, neutrophil: 7.56 × 10/L[21.9%], eosinophil: 23.84 × 10/L[69.2%]), and serum myocardial enzymes was abnormal (CK 1049U/L, CKMB-mass 145.1 μg/L, cTnI 16.24 μg/L). Myocardial injury (tachycardia with ST elevation) and poor heart function (LVEF 31%) were found by electrocardiogram and transthoracic echocardiography. On the next day, cardiogenic shock had been developed as demonstrated by deteriorating the perfusion index.Churg-Strauss Syndrome with cardiogenic shock.A series of conservative therapy with drugs such as corticosteroids, anticoagulant, antiplatelet, nitrates, calcium antagonists, inotrope, and vasopressors were initiated on the day of admission. The treatment was ineffective and a cardiogenic shock developed on the next day. Thus, ECMO was initiated immediately to stabilize circulation and perfusion. At the same time, high-dose corticosteroids combined with immunosuppressive therapy were continuously used.Symptoms of cardiogenic shock were gradually improved after ECMO treatment. Elevated values of cardiac enzymes were decreased and the dose of vasoactive drugs was reduced. Extracorporeal membrane oxygenation was discontinued after 8 days, and the patient was eventually weaned off the ventilator. The patient was discharged after 40 days treatment.Once a CSS develops into a

Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome) Complicated by Perforation of the Small Intestine and Cholecystitis.

PubMed

Ohnuki, Yoichi; Moriya, Yusuke; Yutani, Sachiko; Mizuma, Atsushi; Nakayama, Taira; Ohnuki, Yuko; Uda, Shuji; Inomoto, Chie; Yamamoto, Soichiro; Nakamura, Naoya; Takizawa, Shunya

2018-03-01

We report a case of eosinophilic granulomatosis with polyangiitis (EGPA; formerly known as Churg-Strauss syndrome) complicated by perforation of the small intestine and necrotizing cholecystitis. A 69-year-old man with a history of bronchial asthma was admitted with mononeuritis multiplex. The laboratory findings included remarkable eosinophilia. He was treated with corticosteroids and his laboratory indices showed improvement; however, his functional deficits remained. His neuropathy gradually improved after the addition of intravenous immunoglobulin (IVIG). He was subsequently treated with oral prednisolone (40 mg/day) as maintenance therapy. Within a month after finishing IVIG, he developed perforation of the small intestine and necrotizing cholecystitis. Intestinal perforation has often been reported as a gastrointestinal complication of EGPA. In contrast, cholecystitis is a rare complication. We report this case because the manifestation of more than one complication is extremely rare. Gastrointestinal symptoms may be a complication of EGPA itself and/or immunosuppressive treatment.

A case report and literature review of Churg-Strauss syndrome presenting with myocarditis.

PubMed

Qiao, Lu; Gao, Dengfeng

2016-12-01

Churg-Strauss syndrome (CSS) is a multisystem disorder characterized by asthma, prominent peripheral blood eosinophilia, and vasculitis signs. Here we report a case of CSS presenting with acute myocarditis and heart failure and review the literature on CSS with cardiac involvement. A 59-year-old man with general fatigue, numbness of limbs, and a 2-year history of asthma was admitted to the department of orthopedics. Eosinophilia, history of asthma, lung infiltrates, peripheral neurological damage, and myocarditis suggested the diagnosis of CSS. Transthoracic echocardiography revealed a dilated hypokinetic left ventricle (left ventricular ejection fraction ∼40%) with mild segmental abnormalities in the septal and apical segments. By reviewing the present case reports, we concluded that (1) the younger age of CSS, the greater occurrence rate of complicating myocarditis and the poorer prognosis; (2) female CSS patients are older than male patients; (3) patients with cardiac involvement usually have a history of severe asthma; (4) markedly increased eosinophil count suggests a potential diagnosis of CSS (when the count increases to 20% of white blood cell counts or 8.1 × 109/L, eosinophils start to infiltrate into myocardium); and (5) negative ANCA status is associated with heart disease in CSS.

Cardiac tamponade leading to the diagnosis of eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome): a case report and review of the literature.

PubMed

Yano, Toshiyuki; Ishimura, Shutaro; Furukawa, Tetsuaki; Koyama, Masayuki; Tanaka, Marenao; Shimoshige, Shinya; Hashimoto, Akiyoshi; Miura, Tetsuji

2015-11-01

Eosinophilic granulomatosis with polyangiitis (EGPA), which was previously called Churg-Strauss syndrome, is a necrotizing systemic vasculitis of unknown cause accompanied by prominent eosinophilia. Cardiovascular complications, including eosinophilic myocarditis, are a major cause of mortality in this disorder. Acute pericarditis with slight pericardial effusion is a typical manifestation in EGPA, though hemodynamically significant pericardial effusion has been reported in a few cases. We report a case that initially presented with isolated cardiac tamponade, which was followed by systemic manifestations of EGPA over 3 weeks. Including the present case, previous EGPA cases with cardiac tamponade are reviewed to delineate its clinical characteristics.

A pseudoleukemic blood differentiation in a 13-year-old child: an extraordinary presentation of Churg-Strauss syndrome.

PubMed

Mutsaers, E R; Witteveen, R; van den Bosch-Ruis, W; Kuijpers, T W; van Houten, M A; van den Berg, J M

2013-03-01

Churg-Strauss syndrome (CSS) is a rare systemic vasculitis of the small- and medium-size vessels. It is mostly seen in elderly patients presenting as de novo asthma, eosinophilia, and vasculitic organ involvement. In childhood, CSS is extremely rare. The course of pediatric CSS is usually severe and often lethal. We present a case of a 13-year-old girl with a short history of asthma, marked eosinophilia, and multiorgan involvement. The extremely high level of blood eosinophilic granulocytes (51.6 × 10(9)/L) prompted a workup for eosinophilic leukemia before the diagnosis CSS could be made. Subsequently, the disease was successfully treated. This case report shows a classical case of childhood CSS, remarkable because of the presence of extreme hypereosinophilia. It underlines the importance of CSS as a life-threatening cause of hypereosinophilia in children.

Juvenile Churg-Strauss Syndrome as an Etiology of Myocarditis and Ischemic Stroke in Adolescents; a Case Report

PubMed Central

Moradinejad, Mohammad-Hassan; Rezaei, Amir; Ziaee, Vahid

2011-01-01

Background Churg-Strauss syndrome (CSS), a systemic vasculitis accompanied by asthma and eosinophilia, almost invariably affects the lung and is frequently associated with cutaneous involvement. It rarely has cardiac involvement. We report an unusual case of CSS with myocardial involvement and stroke. Case Presentation A 16-year old female suffered of allergic asthma for 4 years. She was under treatment with oral prednisolone and seretide inhalation. After CSS diagnosis, she developed paroxysmal atrial tachycardia. Serum levels of Troponin I and Troponin T were increased indicating massive myocardial damage probably due to myocarditis. After 5 months she developed acute hemiparesis without any evidence of ischemic or hemorrhagic event. She was treated with IVIg, intravenous pulses of methylprednisone and cyclophosphamide for each complication. Conclusion Myocarditis and stroke may also complicate CSS which should be taken in consideration for better management. PMID:23056844

Impact of tidal phenomenon “Met Ef” on the exploitation of benthos at inshore shoals in Kei islands, Indonesia

NASA Astrophysics Data System (ADS)

Renjaan, Eugenius Alfred; Makailipessy, Marvin Mario

2017-10-01

A study on benthos exploitation at five shoals located in Rosenberg and Nerong Straits, the kei islands had been conducted during period of the lowest ebb tide phenomenon which locally termed Met Ef on 2016. The purpose of the study is to know the impact of the Met Ef on benthos exploitation at the shoals by local communities during the Met Ef. Data of tidal amplitudes were obtained from the Tide Charts Mobile Applications which confirmed the observations on tide pole during October, November, and December 2013 until 2016. Data of benthos exploited during periods of Met Ef at the shoals was obtained through direct observation on benthos exploited by the local communities, also by interviewing them using questionnaires. The results showed that the lowest ebb tide of the Met Ef occurred in November, i.e., at 2 to 5 days after the full moon and/or new moon, with an average tidal range of 2.66 m and even have ever one reached 2.80 m. The most exploited benthos at the shoals is Giant clam (Tridacna sp.), Spider conch (Lambis sp.), Hammer oyster (Malleus sp.), Octopus (Octopus spp.). The intensity of benthos exploited at the shoals increased during the period of Met Ef especially in October because at that time the sea was very calm and clear due to relatively lower wind speed and the rain fall was relatively lower. This has promoted an easier accessibility of the communities to exploit benthos at shoals and, therefore October is considered by the local communities as the peak of Met Ef, instead of November. During November and, December the availability of benthos in shoals has been reduced due to it has been exploited intensely in October.

[A case of Churg-Strauss syndrome with short duration from the onset of asthma to diagnosis of vasculitis].

PubMed

Fuse, Yoshikazu

2013-01-01

A 68-year-old woman was hospitalized because of bronchial asthma and a high myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) level. She had suffered from rhinitis from one year before hospitalization, body weight loss from three months before, and asthma from one month before. On admission, she complained of dyspnea and body weight loss of over 6 kg. On laboratory tests, high MPO-ANCA and urinary abnormalities were found. On the next day, a renal biopsy was performed and histology showed necrotizing vasculitis with cellular crescents. Churg-Strauss syndrome (CSS) was diagnosed on the basis of the clinical course and histological findings. Prednisolone therapy induced rapid symptom remission, which was achieved within one month from the onset of asthma to the diagnosis of CSS. Early diagnosis and early care led to a good prognosis.

Multiple Thromboembolic Cerebral Infarctions from the Aorta in a Patient with Churg-Strauss Syndrome.

PubMed

Okada, Hideo

2017-02-01

Ischemic stroke is a rare complication of Churg-Strauss syndrome (CSS) and its pathogenesis has not been well clarified yet. We report a case of cerebral infarction in a patient with CSS due to embolism from a thrombus on the wall of the aorta. A 39-year-old man had multiple cerebral infarctions with symptoms of mild left hemiparesis and reduced vision. He was clinically diagnosed to have CSS based on remarkable eosinophilia, history of asthma, sinusitis, pulmonary infiltrates, and histologically proven extravascular eosinophilic infiltrates in the specimen of gastric mucosa. Cerebral angiography did not show any stenotic lesions in cerebral arteries. A thrombus was detected on the wall of the aorta by transesophageal echocardiography, which was considered as the source of embolism. The thrombus resolved on follow-up examination 3 months after the onset of the stroke. This is the first case report on cerebral infarction caused by aortogenic thromboembolism in a CSS patient. Other than cerebral vasculitis, embolism from cardiovascular system, including the wall of the aorta, is a possible cause of cerebral infarctions in a CSS patient. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

A case report and literature review of Churg–Strauss syndrome presenting with myocarditis

PubMed Central

Qiao, Lu; Gao, Dengfeng

2016-01-01

Abstract Background: Churg–Strauss syndrome (CSS) is a multisystem disorder characterized by asthma, prominent peripheral blood eosinophilia, and vasculitis signs. Case summary: Here we report a case of CSS presenting with acute myocarditis and heart failure and review the literature on CSS with cardiac involvement. A 59-year-old man with general fatigue, numbness of limbs, and a 2-year history of asthma was admitted to the department of orthopedics. Eosinophilia, history of asthma, lung infiltrates, peripheral neurological damage, and myocarditis suggested the diagnosis of CSS. Transthoracic echocardiography revealed a dilated hypokinetic left ventricle (left ventricular ejection fraction ∼40%) with mild segmental abnormalities in the septal and apical segments. Conclusion: By reviewing the present case reports, we concluded that (1) the younger age of CSS, the greater occurrence rate of complicating myocarditis and the poorer prognosis; (2) female CSS patients are older than male patients; (3) patients with cardiac involvement usually have a history of severe asthma; (4) markedly increased eosinophil count suggests a potential diagnosis of CSS (when the count increases to 20% of white blood cell counts or 8.1 × 109/L, eosinophils start to infiltrate into myocardium); and (5) negative ANCA status is associated with heart disease in CSS. PMID:28002315

[Anesthetic management for surgery of giant coronary aneurysms complicated with Churg-Strauss syndrome].

PubMed

Kido, Koji; Tokuda, Rui; Suzuki, Tomofumi; Hanashiro, Ako; Kobashigawa, Teruyo; Mayama, Takashi; Kamikawa, Michie

2014-04-01

Few cases of Churg-Strauss syndrome (CSS) complicated by giant coronary aneurysms (CAs)have been reported thus far. We report a case of CSS in a 60-year-old man who underwent surgery for giant CAs, and was managed with anesthetics. The patient developed acute myocardial infarction, and was diagnosed with giant CAs in the right coronary artery (RCA, 11 cm) and circumflex artery (3 cm). The CA in RCA was communicating with the right ventricle. He had a history of pericardiectomy for pericarditis caused by the CSS and developed thrombocytopenia due to consumptive coagulopathy within the CAs. An operation, including ligation and excision of the CAs, and coronary artery bypass grafting was performed under general anesthesia and cardiopulmonary bypass. There was massive hemorrhage followed by hemodynamic instability while detaching the tight pericardial adhesion and fragile surface of the CAs. Massive transfusion was required along with inotropes administration and intraaortic balloon support. In this case, determination of the appropriate surgical timing was difficult because symptoms of the CSS became worse followed by rapid enlargement of the CAs, myocardial infarction, and thrombocytopenia. Steroids were administered for treating CSS, and the blood transfusion was sufficient. However, it was difficult to control the hemorrhage and maintain hemodynamic stability.

Serum biomarkers are similar in Churg-Strauss syndrome and hypereosinophilic syndrome.

PubMed

Khoury, P; Zagallo, P; Talar-Williams, C; Santos, C S; Dinerman, E; Holland, N C; Klion, A D

2012-09-01

Churg-Strauss syndrome (CSS) and hypereosinophilic syndrome (HES) overlap considerably in clinical presentation. A reliable means of distinguishing between these groups of patients is needed, especially in the setting of glucocorticoid therapy. A retrospective chart review of 276 adult subjects referred for evaluation of eosinophilia > 1500/μl was performed, and subjects with a documented secondary cause of eosinophilia or a PDGFR -positive myeloproliferative neoplasm were excluded. The remaining subjects were assessed for the presence of American College of Rheumatology (ACR) criteria. Laboratory and clinical parameters were compared between subjects with biopsy-proven vasculitis (CSS; n = 8), ≥4 ACR criteria (probable CSS; n = 21), HES with asthma and/or sinusitis without other CSS-defining criteria (HESwAS; n = 20), HES without asthma or sinusitis (HES; n = 18), and normal controls (n = 8). Serum biomarkers reported to be associated with CSS were measured using standard techniques. There were no differences between the subjects with definite or probable CSS or HES with respect to age, gender, or maintenance steroid dose. Serum CCL17, IL-8, and eotaxin levels were significantly increased in eosinophilic subjects as compared to normal controls, but were similar between the eosinophilic groups. Serum CCL17 correlated with eosinophil count (P < 0.0001, r = 0.73), but not with prednisone dose. In patients with a history of asthma and sinusitis, distinguishing between ANCA-negative CSS and PDGFR-negative HES is difficult because of significant overlap in clinical presentation and biomarker profiles. Published 2012. This article is a U.S. Government work and is in the public domain in the USA.

Serum biomarkers are similar in Churg-Strauss syndrome and hypereosinophilic syndrome

PubMed Central

Khoury, Paneez; Zagallo, Patricia; Talar-Williams, Cheryl; Santos, Carlo S.; Dinerman, Ellen; Holland, Nicole C.; Klion, Amy D.

2012-01-01

Rationale Churg-Strauss syndrome (CSS) and hypereosinophilic syndrome (HES) overlap considerably in clinical presentation. A reliable means of distinguishing between these groups of patients is needed, especially in the setting of glucocorticoid therapy. Methods A retrospective chart review of 276 adult subjects referred for evaluation of eosinophilia >1500/μl was performed, and subjects with a documented secondary cause of eosinophilia or a PDGFR-positive myeloproliferative neoplasm were excluded. The remaining subjects were assessed for the presence of American College of Rheumatology (ACR) criteria. Laboratory and clinical parameters were compared between subjects with biopsy-proven vasculitis (CSS; n=8), ≥4 ACR criteria (probable CSS; n=21), HES with asthma and/or sinusitis without other CSS-defining criteria (HESwAS; n=20), HES without asthma or sinusitis (HES; n=18), and normal controls (n=8). Serum biomarkers reported to be associated with CSS were measured using standard techniques. Results There were no differences between the subjects with definite or probable CSS or HES with respect to age, gender, or maintenance steroid dose. Serum CCL17, IL-8 and eotaxin levels were significantly increased in eosinophilic subjects as compared to normal controls, but were similar between the eosinophilic groups. Serum CCL17 correlated with eosinophil count (p<0.0001, r=0.73), but not with prednisone dose. Conclusions In patients with a history of asthma and sinusitis, distinguishing between ANCA-negative CSS and PDGFR-negative HES is difficult due to significant overlap in clinical presentation and biomarker profiles. PMID:22775568

Not All Coughs Are Asthma or Allergies: Churg-Strauss Syndrome.

PubMed

Bodoutchian, Ani A; Jain, Hitender; Velez, Tania

2016-09-01

Cardiomyopathy in patients with Churg-Strauss syndrome (CSS) carries a poor prognosis, with a high 5-year mortality rate, and requires treatment with immunosuppressive therapy. There is no single pathognomonic test or clinical finding for diagnosing CSS; instead, it is based upon meeting four of six criteria. A 47-year-old woman with a 6-month medical history of "asthma" presented to our hospital with a 1-month history or dyspnea on exertion. She denied any chest pain, cough, fever, orthopnea, or leg swelling. She was afebrile and normotensive, and her physical examination was unremarkable. Her white blood cell count was 23,000/mm(3) with 23% eosinophils, and her troponin T level was 1.08 ​Ng/ml. Extensive work-up revealed CSS. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be aware of unusual cases because not every patient that walks into an emergency department has a simple case of "asthma" or "allergies." Our patient had been diagnosed with asthma for 6 months before her symptoms had progressed to a point that prompted her to seek medical attention in a hospital. Emergency physicians are in a unique position to identify patients who present with recurrent complaints of asthma-especially late-onset asthma, which gradually worsens and is refractory to usual treatment. A complete blood cell count with a differential will prove valuable. Assessments of a patient's C-reactive protein level and erythrocyte sedimentation rate are inexpensive and check for signs of inflammation, although they are nonspecific. A chest radiograph or computed tomography scan of the chest or sinuses in some patients can also prove to be of value. Prompt recognition and treatment with steroids is imperative to ablate vasculitis tissue damage because this can improve the outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

Optimal therapy and prospects for new medicines in eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome).

PubMed

Pagnoux, Christian; Groh, Matthieu

2016-10-01

The prevalence of eosinophilic granulomatosis with polyangiitis (EGPA; previously known as Churg-Strauss syndrome) is lower than that of other antineutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAV's), and only a few randomized controlled trials have been conducted for this rare disease. However, recent international efforts have helped delineate the best treatment approach. At present, EGPA conventional therapy is by default similar to that of other AAVs. Limited, non-severe EGPA can initially be treated with glucocorticoids (GCs) alone. Patients with life-threatening manifestations and/or major organ involvement must receive a combination of GCs and an immunosuppressant, mainly cyclophosphamide. Remission can be achieved in >85% of patients with these first-line treatments, but vasculitis relapses occur in more than one-third of patients, and about 85% cannot stop GC treatment because of GC-dependent asthma and/or ENT manifestations. A few biologic agents, including rituximab or mepolizumab, are now under investigation after interesting preliminary results. Expert commentary: Treatment for EGPA still has several unmet needs. Several biologic agents are now under investigation in randomized controlled trials, but a few others should be considered soon. Their benefit should be demonstrated for devising more EGPA-tailored therapeutic strategies (ideally GC-free).

Churg-Strauss Syndrome: The Clinical Features and Long-term Follow-up of 17 Patients

PubMed Central

Oh, Mi-Jung; Lee, Jin-Young; Kwon, Nam-Hee

2006-01-01

Churg-Strauss syndrome (CSS) is a rare multi-system vasculitis; some cases have been reported in Korea. The aim of this study is to describe the clinical features, treatment outcome, and long-term follow-up of CSS from a single Korean medical center. Between 1995 and 2004, seventeen patients were diagnosed with CSS at the Department of Medicine of the Samsung Medical Center, Sungkyunkwan University School of Medicine. The diagnosis of CSS is based on the classification criteria of the American Collage of Rheumatology. All patients had asthma. As in other case series, the lung, peripheral nervous system, and skin were the most commonly involved organs. During the active stage of the disease, most of the patients exhibited peripheral blood eosinophilia and an elevated serum eosinophil cationic protein level. Ten patients were treated with pulses of methylprednisolone followed by tapering and cyclophosphamide, and the others were treated with corticosteroids alone. The outcomes after long-term follow-up were generally good. One patient who was refractory to initial treatment died of heart failure during the follow-up period. CSS was highly variable in its presentation and course. The manifestations may range from mild symptoms to life-threatening conditions. The outcome after long-term follow-up was as good as that of previous studies. PMID:16614512

Control of Growth Within Drosophila Peripheral Nerves by Ras and Protein Kinase A

DTIC Science & Technology

2008-02-01

assistance and Kei Ito, Vanessa Auld, Marc Tatar, Hideyuki Okano, Sally Leevers, Ernst Hafen, Exelixis Corporation, and the Bloomington Drosophila Stock...and Auld, 1999) and were provided by Van - essa Auld (University of British Columbia, Vancouver, British Columbia, Canada) and Kei Ito (National...nerve barrier (Auld et al., 1995) and an outer, meso- dermally derived perineurial glia ( Edwards et al., 1993). A trans- mission electron micrograph

Control of Growth Within Drosophila Peripheral Nerves by Ras and Protein Kinase A

DTIC Science & Technology

2007-02-01

Grant W81XWH-04- 1-0272 (M.S.). We are grateful to Angela Lynn, Vanathi Sundaresan, and Gia Fazio for technical assistance and Kei Ito, Vanessa Auld, Marc...by Van - essa Auld (University of British Columbia, Vancouver, British Columbia, Canada) and Kei Ito (National Institute for Basic Biology, Okazaki, Ja...and an outer, meso- dermally derived perineurial glia ( Edwards et al., 1993). A trans- mission electron micrograph (TEM) of a peripheral nerve cross

Churg-Strauss syndrome with concomitant occurrence of ischemic stroke and relapsing purpura.

PubMed

Tanaka, Koji; Koga, Masatoshi; Ishibashi-Ueda, Hatsue; Matsumoto, Chiho; Toyoda, Kazunori

2012-11-01

A 77-year-old woman suffering from chronic bronchial asthma and chronic atrial fibrillation who had had a previous ischemic stroke presented to our emergency unit with gait disturbance. She had new-onset truncal ataxia, right hemiparesis, and right sensory disturbance related to the previous stroke. Her lower legs were slightly swollen and had a reddened appearance. Her medical history included mitral valve replacement because of severe mitral valve regurgitation. Her white blood cell count was 8600/μL, mainly consisting of eosinophils (4480/μL; 52.1%). Serum nonspecific immunoglobulin E was elevated to 1600 IU/mL (normal range <170 IU/mL). She was taking warfarin for secondary stroke prevention, and on admission her prothrombin time international normalized ratio was 3.06. Diffusion-weighted magnetic resonance imaging revealed a fresh infarct in the right cerebellum. No stenosis or occlusion was shown in the cervicocephalic arteries on magnetic resonance angiography or carotid ultrasound. No emboligenic diseases, except for atrial fibrillation, were identified. On day 3, an extensive itchy, purpuric rash appeared on her lower limbs. The rash remitted and recurred spontaneously for several weeks. A skin biopsy specimen of the purpuric lesions revealed massive eosinophilic infiltration of the dermis and eosinophilic vasculitis involving small vessels. We diagnosed the patient with Churg-Strauss syndrome (CSS). Skin lesions and eosinophilia disappeared after oral corticosteroid therapy. In this case, cerebellar infarction occurred with purpuric rash despite well-controlled anticoagulation. Patients with CSS may suffer from ischemic stroke when the condition of CSS deteriorates. Copyright © 2012 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Interleukin-25: a cytokine linking eosinophils and adaptive immunity in Churg-Strauss syndrome.

PubMed

Terrier, Benjamin; Bièche, Ivan; Maisonobe, Thierry; Laurendeau, Ingrid; Rosenzwajg, Michèlle; Kahn, Jean-Emmanuel; Diemert, Marie-Claude; Musset, Lucile; Vidaud, Michel; Sène, Damien; Costedoat-Chalumeau, Nathalie; Le Thi-Huong, Du; Amoura, Zahir; Klatzmann, David; Cacoub, Patrice; Saadoun, David

2010-11-25

Churg-Strauss syndrome (CSS) is characterized by systemic vasculitis and blood and tissue eosinophilia. Blood eosinophilia correlates with disease activity, and activated T cells from CSS patients are predominantly T helper 2 (Th2). Interleukin (IL)-25 has been shown to link innate and adaptive immunity by enhancing Th2 cytokine production. We sought to determine the involvement of IL-25 and its receptor IL-17RB in the pathogenesis of CSS. We found increased levels of IL-25 in the serum of active CSS patients (952 ± 697 vs 75 ± 49 pg/mL in inactive patients and 47 ± 6 pg/mL in healthy donors). IL-25 was correlated with disease activity and eosinophil level. Eosinophils were the main source of IL-25, whereas activated CD4(+) memory T cells were the IL-17RB-expressing cells in CSS. IL-25 enhanced the production of IL-4, IL-5, and IL-13 by activated peripheral blood mononuclear cells. IL-25 and IL-17RB were observed within the vasculitic lesions of patients with CSS, and IL-17RB colocalized with T cells. Increased expression of IL-17RB, tumor necrosis factor receptor-associated factor 6, and JunB in vasculitic lesions of CSS underscored the IL-25-mediated activation, whereas up-regulation of GATA3 and IL-10 supported Th2 differentiation. Our findings suggest that eosinophils, through the production of IL-25, exert a critical role in promoting Th2 responses in target tissues of CSS.

Diagnosis and classification of eosinophilic granulomatosis with polyangiitis (formerly named Churg-Strauss syndrome).

PubMed

Mouthon, Luc; Dunogue, Bertrand; Guillevin, Loïc

2014-01-01

Recently, a group of experts in the field suggested to rename Churg-Strauss syndrome as eosinophilic granulomatosis with polyangiitis (EGPA). This condition, first described in 1951, is a rare small- and medium-sized-vessel vasculitis characterized by an almost constant association with asthma and eosinophilia, and, by the presence of anti-myeloperoxidase (MPO) antineutrophil cytoplasm antibodies (ANCA) in 30-38% of the patients. Vasculitis typically develops in a previously asthmatic and eosinophilic middle-aged patient. Asthma is severe, associated with eosinophilia and extrapulmonary symptoms. Most frequently EGPA involves the peripheral nerves and skin. Other organs, however, may be affected and must be screened for vasculitis, especially those associated with a poorer prognosis, such as the heart, kidney and gastrointestinal tract, as assessed by the recently revised Five-Factor Score (FFS). Recent insights, particularly concerning clinical differences associated with ANCA status, showed that EGPA patients might constitute a heterogeneous group. Thus, EGPA patients with anti-MPO ANCA suffered more, albeit not exclusively, from vasculitis symptoms, such as glomerulonephritis, mononeuritis multiplex and alveolar hemorrhage, whereas ANCA-negative patients more frequently develop heart involvement. This observation led to the hypothesis that EGPA might be divided into different clinical and pathophysiological subtypes, which could be managed better with more specifically adapted therapies. For now, EGPA treatment still relies mainly on corticosteroids and, when necessary for patients with poorer prognoses, combined immunosuppressant drugs, especially cyclophosphamide. Overall survival of EGPA patients is good, despite not uncommon relapses. Copyright © 2014 Elsevier Ltd. All rights reserved.

Churg-Strauss Syndrome Following Vaccination Against 2010 Influenza A (H1N1): A Case Report.

PubMed

Fu, Mu-Hui; Tsai, Wan-Chen; Lan, Jui; Lu, Cheng-Hsien; Lee, Lian-Hui; Huang, Chih-Cheng

2014-09-01

Churg-Strauss syndrome (CSS) is a systemic inflammatory disorder characterized by asthma, transient pulmonary infiltration, hyper-eosinophilia, and systemic vasculitis. Reported triggering factors include infections, drugs, allergic desensitization, and vaccinations, although cases involving the latter two are extremely rare. Herein, we describe a patient who developed CSS after receiving an H1N1 vaccination. A 55-year-old woman presented with fever, skin eruptions, and sensory impairment of her feet within one week after an H1N1 vaccine injection. A chest X-ray showed pulmonary infiltrations in both lower lung fields. Eosinophilia was noted in a hematological test, and an electrophysiological study revealed a pattern of mononeuritis multiplex. A skin biopsy was performed which revealed palisading necrotizing granuloma around a degenerated dermis and eosinophilic infiltration of the blood vessel walls. These findings combined with the hematological and electrophysiological findings met the criteria of CSS according to the American College of Rheumatology. The patient recovered well after steroid treatment. This case highlights the possibility that the H1N1 vaccination can trigger CSS. Due to the rarity of reported autoimmune events after vaccine administration and the obscure causal association between autoimmunity and a vaccine, further post-marketing surveillance and research are necessary to clarify the relationship and identify risk factors.

Successful management of Churg-Strauss syndrome using omalizumab as adjuvant immunomodulatory therapy: first documented pediatric case.

PubMed

Iglesias, E; Camacho Lovillo, M; Delgado Pecellín, I; Lirola Cruz, M J; Falcón Neyra, M D; Salazar Quero, J C; Bernabeu-Wittel, J; González Valencia, J P; Neth, O

2014-03-01

Churg-Strauss syndrome (CSS) is an anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis; it is extremely rare in childhood and defined according to the Chapel-Hill Consensus as an eosinophil-rich and granulomatous inflammation involving the respiratory tract and necrotizing vasculitis affecting small to medium-sized vessels. Children commonly have a history of asthma and sinusitis whilst clinical presentation typically involves pulmonary tract and less frequently skin, heart, gastrointestinal tract, and peripheral nerves. Cardiopulmonary disease is higher in children and prognosis is worse. It is associated with significant eosinophilia and raised serum IgE-levels. ANCA are only found in 25% of childhood cases. Here we report the case of a 10-year-old girl who presented to us with vomiting, abdominal pain, and weight loss, paresthesias of lower extremities and breathlessness as well as a history of asthma, sinusitis and allergic rhinitis. She was treated with corticosteroids, cyclophosphamide, intravenous immunoglobulin, mycophenolate mofetil (MMF), and rituximab. However, remission was only achieved after initiation of omalizumab therapy, a recombinant humanized anti-IgE antibody. To the best of our knowledge this is the first pediatric patient suffering from CSS successfully managed with adjuvant anti-IgE therapy resulting in the control of respiratory as well as gastrointestinal symptoms. © 2013 Wiley Periodicals, Inc.

Branch retinal vein occlusion followed by central retinal artery occlusion in Churg-Strauss syndrome: unusual ocular manifestations in allergic granulomatous angiitis.

PubMed

De Salvo, Gabriella; Li Calzi, Concetta; Anastasi, Mario; Lodato, Gaetano

2009-01-01

To describe a rare branch retinal vein occlusion (BRVO) followed by central retinal artery occlusion (CRAO) in a patient with Churg-Strauss syndrome (CSS). A 55-year-old man with a not yet diagnosed CSS developed a BRVO in the left eye and 1 year later a CRAO with painless and acute vision loss in the same eye. Medical history included bronchial asthma, history of allergy, eosinophilic pneumonia, bilateral pleuric and pericardial effusion, hypereosinophilia, and purpuric vasculitis. CRAO in the left eye was diagnosed by retinal whitening and a cherry red spot with coexisting old BRVO evidenced by previous laser photocoagulation. Corticosteroids and cyclophosphamide therapy improved his general condition but no visual recovery occurred. BRVO and CRAO can occur in the same eye in CSS. In the presence of systemic signs or symptoms, it is important to rule out systemic vasculitis in order to start appropriate immune-modulatory treatment thereby avoiding unnecessary mortality.

Antineutrophil cytoplasmic autoantibodies and myeloperoxidase autoantibodies in clinical expression of Churg-Strauss syndrome.

PubMed

Healy, Bridget; Bibby, Susan; Steele, Richard; Weatherall, Mark; Nelson, Harold; Beasley, Richard

2013-02-01

The clinical significance of antineutrophil cytoplasmic antibodies (ANCAs) in the phenotypic expression of Churg-Strauss syndrome (CSS) is uncertain. We sought to investigate the relationship between ANCA status and the clinical expression of CSS in a case series derived from the US Food and Drug Administration's adverse events database. All cases of CSS reported to the US Food and Drug Administration from 1997 to April 2003 were reviewed. Information about basic demographics, suspect medication use, clinical manifestations, histologic findings, ANCA staining patterns, and the presence of antibodies to myeloperoxidase (anti-MPO) or proteinase 3 (anti-PR3) was recorded when available. There were 93 case reports of CSS with sufficient documentation, including ANCA status. There were 38 (40.9%) of 93 cases with positive ANCA results, of which 15 cases reported a positive ELISA, all of which were positive for anti-MPO. ANCA negativity was associated with an increased proportion of cardiac involvement (risk difference [RD], 38.2%; 95% CI, 25.3% to 51.0%), gastrointestinal involvement (RD, 25.5%; 95% CI, 13.9% to 37.0%), pulmonary infiltrates (odds ratio, 4.9; 95% CI, 1.5-16.2), and the outcome of a life-threatening event or death (RD, 30.9%; 95% CI, 18.7% to 43.1%) when compared with anti-MPO-positive cases. ANCA negativity was associated with a decreased proportion of peripheral neuropathy (odds ratio, 0.3; 95% CI, 0.07-0.9). These findings support the hypothesis that the presence or absence of autoantibodies influences the clinical expression and severity of CSS. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Churg-Strauss syndrome with coexistence of eosinophilic vasculitis, granulomatous phlebitis and granulomatous dermatitis in bullous pemphigoid-like blisters.

PubMed

Ishibashi, Masafumi; Kudo, Saori; Yamamoto, Kyoko; Shimai, Nobuko; Chen, Ko-Ron

2011-03-01

The main histopathological features in the cutaneous lesions of Churg-Strauss syndrome (CSS) are dermal leukocytoclastic vasculitis with a variable eosinophilic infiltrate and non-vasculitic tissue eosinophilia with granuloma formation. This wide histopathological spectrum may account for the various skin manifestations of CSS. However, the unique histopathological combination of dermal eosinophilic vasculitis and subcutaneous granulomatous phlebitis accompanied by bulla formation has not been previously described. We report an unusual CSS case showing dermal necrotizing eosinophilic vasculitis and granulomatous phlebitis in purpuric lesions coupled with subepidermal blistering. The blisters showed dermal granulomatous dermatitis and eosinophilia without evidence of vasculitis. Dermal necrotizing eosinophilic vasculitis was characterized by fibrinoid alteration of the vessel wall, a prominent perivascular eosinophilic infiltrate, a few infiltrating histiocytes along the affected vessel wall, and the absence of neutrophilic infiltration. The underlying subcutaneous granulomatous phlebitis was characterized by an angiocentric histiocytic infiltrate surrounded by marked eosinophilic infiltrate. Deposition of cytotoxic proteins and radicals derived from eosinophils in the vessel walls and papillary dermis followed by a secondary granulomatous response may account for the unique clinical and histopathological features in this case. Copyright © 2010 John Wiley & Sons A/S.

Churg-Strauss syndrome: a new endotype of severe asthma? Results of 14 Turkish patients.

PubMed

Yılmaz, İnsu; Çelik, Gülfem; Aydın, Ömür; Özdemir, Seçil Kepil; Soyyiğit, Şadan; Sözener, Zeynep; Özgüçlü, Selcan; Atasoy, Çetin; Düzgün, Nurşen; Mungan, Dilşad; Sin, Betül; Demirel, Yavuz Selim; Mısırlıgil, Zeynep

2015-07-01

Churg-Strauss syndrome (CSS) is a rare multisystem vasculitis. Considering the variation of autoimmune diseases in different races, it is of interest to determine whether any outstanding features exist for Turkish patients with CSS. The aim of this study was to evaluate the clinical and serological features of the disease, the treatment, and long-term follow-up details, and to investigate possible etiological factors of Turkish CSS patients. The study included 14 patients who were diagnosed with CSS, and followed by our department between 2004 and 2012. Possible etiological factors, initial symptoms, clinical presentations, treatment, as well as outcomes were documented. The study was approved by the local ethics. All patients fulfilled the American College of Rheumatology criteria. Initial symptoms were worsening asthma (n = 14; 100%) and skin lesions (n = 6; 43%). All patients had a diagnosis of asthma and nasal polyps, whereas 57.1% had aspirin hypersensitivity at the time of diagnosis. The lungs (100%) and skin (43%) were most commonly involved. Peripheral eosinophilia dominated on initial presentations of all patients. Initial treatments included oral methyl prednisolone in all cases, whereas cyclophosphamide and azathioprine were used in three cases. Relapses were detected in five cases. None of the cases were able to stop the oral corticosteroid treatment. No fatalities were observed. We herein describe a new severe asthma endotype in connection with CSS. We suggest that physicians who deal with uncontrolled severe asthma cases should consider CSS in the presence of nasal polyps, aspirin hypersensitivity, and especially peripheral blood eosinophilia over 10%. © 2014 John Wiley & Sons Ltd.

Development of eosinophilic granulomatosis with poliangiitis (Churg-Strauss syndrome) and brain tumor in a patient after more than 7 years of omalizumab use: A case report.

PubMed

Borekci, S; Aydin, O; Hatemi, G; Gemicioglu, B

2015-03-01

Omalizumab is a monoclonal anti-immunoglobulin E antibody used for the treatment of severe perennial allergic asthma. Previous reports have suggested that omalizumab treatment can be associated with the development of eosinophilic granulomatosis with poliangiitis (EGPA) (formerly known as Churg-Strauss syndrome) and an increased risk of malignancy. Long-term risks of omalizumab treatment are not very well defined. Here, we report the case of a 75-year-old woman with concurrent occurrence of EGPA and brain tumor after more than 7 years of omalizumab treatment. The possibility of EGPA should be borne in mind during long-term treatment with omalizumab. Despite the absence of definitive data, an association may also exist between the development of malignancy and omalizumab use. © The Author(s) 2015.

Childhood-onset eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome): a contemporary single-center cohort.

PubMed

Gendelman, Samantha; Zeft, Andrew; Spalding, Steven J

2013-06-01

To date only 38 cases of childhood-onset eosinophilic granulomatosis with polyangiitis (cEGPA; formerly Churg-Strauss syndrome) have been reported. Additional patients with cEGPA could enhance the understanding of this rare and life-threatening condition. Our objectives were (1) to determine the frequency of specific organ system involvement; (2) to examine initial therapeutic regimen; and (3) to document disease and therapy-related morbidity in a contemporary cohort of patients with cEGPA. Retrospective review of patients evaluated at the Cleveland Clinic between 2003 and 2011 who met either American College of Rheumatology or Lanham criteria for EGPA and whose age was < 18 years at symptom onset. Nine patients (8 female; 7 white) were identified. Median age at onset of rhinitis/asthma symptom was 13 years and median age at diagnosis of cEGPA was 15 years. All patients demonstrated eosinophilia, upper airway disease (allergic rhinitis, chronic sinusitis, and/or nasal polyps), and pulmonary involvement. Other frequently involved organ systems included musculoskeletal (67%), gastrointestinal (67%), cutaneous (67%), neurologic (56%), and cardiac (44%). Antineutrophil cytoplasmic antibody (ANCA) serologies were negative in all patients. The medications used most frequently for initial therapy included oral (44%) or intravenous corticosteroids (56%) and azathioprine (67%). Disease or therapeutic complications occurred in half of the cohort and included heart failure, stroke, and sequela from longterm, high-dose steroids. Eosinophilia, in combination with upper airway, pulmonary, musculoskeletal, neurologic, and cardiac manifestations, is frequently observed in cEGPA. ANCA titers are often negative. Steroids are the mainstay of initial therapy but steroid-related side effects occur regularly.

Minding experience: An exploration of the concept of "experience" in the early French anthropology of Durkheim, Lévy-Bruhl, and Lévi-Strauss.

PubMed

Throop, C Jason

2003-01-01

In line with the growing concern with the unexamined reliance upon the concept of "experience" in anthropology, this article explores in some detail the various usages and definitions of the concept in the work of three of early French anthropology's most influential theorists: Emile Durkheim (1858-1918), Lucien Lévy-Bruhl (1857-1939), and Claude Lévi-Strauss (1908-). With its important influence on both British and American anthropology, the early French anthropological tradition, as epitomized in the writings of these three thinkers, has indeed played a pivotal role in shaping many current taken-for-granted understandings of the concept of experience in the discipline of anthropology as a whole. In the process of exploring how experience is viewed by these three scholars, this paper will thus take some initial steps toward the historical contextualization of many of the unquestioned assumptions underpinning current understandings of experience in the discipline of anthropology and the social sciences more generally. Copyright 2003 Wiley Periodicals, Inc.

Cardiac involvement in ANCA (+) and ANCA (-) Churg-Strauss syndrome evaluated by cardiovascular magnetic resonance.

PubMed

Mavrogeni, Sophie; Karabela, Georgia; Gialafos, Elias; Stavropoulos, Efthymios; Spiliotis, George; Katsifis, Gikas; Kolovou, Genovefa

2013-10-01

The cardiovascular magnetic resonance (CMR) pattern of Churg-Strauss syndrome (CSS) includes myopericarditis, diffuse subendocardial vasculitis or myocardial infarction with or without cardiac symptoms and is usually associated with lack of antineutrophil cytoplasmic antibodies (ANCA). To correlate the CMR pattern with ANCA in CSS, compare it with healthy controls and systemic lupus erythematosus (SLE) patients and re-evaluate 2 yrs after the first CMR. 28 consecutive CSS, aged 42±7 yrs, were referred for CMR and 2 yrs re-evaluation. The CMR included left ventricular ejection fraction (LVEF), T2-weighted (T2-W), early (EGE) and late gadolinium enhanced (LGE) imaging. Their results were compared with 28 systemic lupus erythematosus (SLE) under remission and 28 controls with normal myocardial perfusion, assessed by scintigraphy. CMR revealed acute cardiac lesions in all ANCA (-) CSS with active disease and acute cardiac symptoms and only in one asymptomatic ANCA (+) CSS, with active disease. Diffuse subendocardial fibrosis (DSF) or past myocarditis was identified in both ANCA(+) and ANCA (-) CSS, but with higher incidence and fibrosis amount in ANCA (-) CSS (p<0.05). In comparison to SLE, both ANCA (+) and ANCA (-) CSS had higher incidence of DSF, lower incidence of myocarditis and no evidence of myocardial infarction, due to coronary artery disease (p<0.05). In 2 yrs CMR follow up, 1/3 of CSS with DSF presented LV function deterioration and one died, although immunosuppressive treatment was given early after CSS diagnosis. Cardiac involvement either as DSF or myocarditis, can be detected in both ANCA (+) and ANCA (-) CSS, although more clinically overt in ANCA (-). DSF carries an ominous prognosis for LV function. CMR, due to its capability to detect disease severity, before cardiac dysfunction takes place, is an excellent tool for CSS risk stratification and treatment individualization.

Sodium uptake in different life stages of crustaceans: the water flea Daphnia magna Strauss.

PubMed

Bianchini, Adalto; Wood, Chris M

2008-02-01

The concentration-dependent kinetics and main mechanisms of whole-body Na+ uptake were assessed in neonate and adult water flea Daphnia magna Strauss acclimated to moderately hard water (0.6 mmol l(-1) NaCl, 1.0 mmol l(-1) CaCO3 and 0.15 mmol l(-1) MgSO4.7H2O; pH 8.2). Whole-body Na+ uptake is independent of the presence of Cl(-) in the external medium and kinetic parameters are dependent on the life stage. Adults have a lower maximum capacity of Na+ transport on a mass-specific basis but a higher affinity for Na+ when compared to neonates. Based on pharmacological analyses, mechanisms involved in whole-body Na+ uptake differ according to the life stage considered. In neonates, a proton pump-coupled Na+ channel appears to play an important role in the whole-body Na+ uptake at the apical membrane. However, they do not appear to contribute to whole-body Na+ uptake in adults, where only the Na+ channel seems to be present, associated with the Na+/H+ exchanger. In both cases, carbonic anhydrase contributes by providing H+ for the transporters. At the basolateral membrane of the salt-transporting epithelia of neonates, Na+ is pumped from the cells to the extracellular fluid by a Na+, K+-ATPase and a Na+/Cl(-) exchanger whereas K+ and Cl(-) move through specific channels. In adults, a Na+/K+/2Cl(-) cotransporter replaces the Na+/Cl(-) exchanger. Differential sensitivity of neonates and adults to iono- and osmoregulatory toxicants, such as metals, are discussed with respect to differences in whole-body Na+ uptake kinetics, as well as in the mechanisms of Na+ transport involved in the whole-body Na+ uptake in the two life stages.

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A nationwide survey on the epidemiology and clinical features of eosinophilic granulomatosis with polyangiitis (Churg-Strauss) in Japan.

PubMed

Sada, Ken-Ei; Amano, Koichi; Uehara, Ritei; Yamamura, Masahiro; Arimura, Yoshihiro; Nakamura, Yoshikazu; Makino, Hirofumi

2014-07-01

We conducted a cross-sectional nationwide survey to determine eosinophilic granulomatosis with polyangiitis (Churg-Strauss) (EGPA) prevalence and clinical features in Japan. Data for EGPA patients in 2008 were collected from 1,564 hospitals. In total, 965 patients were reported from 365 departments. In a second survey, clinical data for 473 patients were obtained. We estimated that 1,866 (95% CI: 1,640-2,092) patients have EGPA in Japan (prevalence, 17.8/1,000,000). Of the 473 patients in the second survey, 315 fulfilled American College of Rheumatology (ACR) criteria or Lanham's criteria for EGPA. The mean age (± SD) of the 315 at onset was 55 ± 14 years, male to female ratio 1:2. 93% of patients had neurological manifestations, which were the organ system most frequently involved. Among 277 patients tested for myeloperoxidase (MPO)-/p anti-neutrophil cytoplasmic antibody (ANCA), 139 (50%) were positive, while only 6 of 238 were positive for proteinase3 (PR3)-/cANCA. MPO-ANCA-positive patients had renal involvement, mucous membrane or ophthalmological symptoms, and ENT symptoms more frequently, whereas cutaneous lesions and cardiovascular involvement were less common. The prevalence of EGPA and the frequency of MPO-/p-ANCA-positivity in Japanese EGPA patients were mostly similar to those of Western countries. However, female predominance and a high frequency of neurological manifestations characterized Japanese patients.

Development of a compact electron-cyclotron-resonance ion source for high-energy carbon-ion therapy

NASA Astrophysics Data System (ADS)

Muramatsu, M.; Kitagawa, A.; Sakamoto, Y.; Sato, S.; Sato, Y.; Ogawa, Hirotsugu; Yamada, S.; Ogawa, Hiroyuki; Yoshida, Y.; Drentje, A. G.

2005-11-01

Ion sources for medical facilities should have characteristics of easy maintenance, low electric power consumption, good stability, and long operation time without problems (one year or longer). For this, a 10GHz compact electron-cyclotron-resonance ion source with all-permanent magnets (Kei2 source) was developed. The maximum mirror magnetic fields on the beam axis are 0.59T at the extraction side and 0.87T at the gas-injection side, while the minimum B strength is 0.25T. These parameters have been optimized for the production of C4+ based on the experience at the 10GHz NIRS-ECR ion source and a previous prototype compact source (Kei source). The Kei2 source has a diameter of 320mm and a length of 295mm. The beam intensity of C4+ was obtained to be 530μA under an extraction voltage of 40kV. The beam stability was better than 6% at C4+ of 280μA during 90h with no adjustment of the operation parameters. The details of the design and beam tests of the source are described in this paper.

Analysis of semantic search within the domains of uncertainty: using Keyword Effectiveness Indexing as an evaluation tool.

PubMed

Lorence, Daniel; Abraham, Joanna

2006-01-01

Medical and health-related searches pose a special case of risk when using the web as an information resource. Uninsured consumers, lacking access to a trained provider, will often rely on information from the internet for self-diagnosis and treatment. In areas where treatments are uncertain or controversial, most consumers lack the knowledge to make an informed decision. This exploratory technology assessment examines the use of Keyword Effectiveness Indexing (KEI) analysis as a potential tool for profiling information search and keyword retrieval patterns. Results demonstrate that the KEI methodology can be useful in identifying e-health search patterns, but is limited by semantic or text-based web environments.

Intravenous immunoglobulin for chronic residual peripheral neuropathy in eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome): a multicenter, double-blind trial.

PubMed

Koike, Haruki; Akiyama, Kazuo; Saito, Toyokazu; Sobue, Gen

2015-03-01

Eosinophilic granulomatosis with polyangiitis (EGPA), previously called Churg-Strauss syndrome, frequently affects the peripheral nervous system. We conducted a multicenter, double-blind, three-arm treatment period, randomized, pre-post trial to assess the efficacy of intravenous immunoglobulin (IVIg) administration for residual peripheral neuropathy in patients with EGPA that is in remission, indicated by laboratory indices. Twenty-three patients were randomly assigned into three groups, in which the timing of IVIg and placebo administration was different. Each group received one course of intervention and two courses of placebo at 2-week intervals. Treatment effects were assessed every 2 weeks for 8 weeks. The primary outcome measure, the amount of change in the manual muscle testing sum score 2 weeks after IVIg administration, significantly increased (p = 0.002). The results over time suggested that this effect continued until the last assessment was done 8 weeks later. The number of muscles with manual muscle testing scores of three or less (p = 0.004) and the neuropathic pain scores represented by the visual analogue scale (p = 0.005) also improved significantly 2 weeks after IVIg administration. This study indicates that IVIg treatment for EGPA patients with residual peripheral neuropathy should be considered even when laboratory indices suggest remission of the disease.

Effect of delayed diagnosis on disease course and management of Churg-Strauss syndrome: a retrospective study.

PubMed

Sokołowska, Barbara; Szczeklik, Wojciech; Mastalerz, Lucyna; Kuczia, Paweł; Wodkowski, Michał; Stodółkiewicz, Edyta; Macioł, Karolina; Musiał, Jacek

2013-03-01

Delayed diagnosis in patients with Churg-Strauss syndrome (CSS) is largely attributed to the variable and nonspecific presentation of the disease's initial symptoms. The aim of the study was to evaluate the effect of delayed diagnosis on the course of CSS. We conducted a retrospective study of 30 CSS patients followed up in our department. In each patient, we assessed the delay in CSS diagnosis (the time when patients already fulfilled four out of six of the American College of Rheumatology criteria and the diagnosis was not yet established), the disease activity at the time of diagnosis, and organ involvement during CSS course. A median value of 2 weeks was chosen as the cutoff point after which the diagnosis was considered as delayed. Sixteen patients were diagnosed before (group 1) and 14 patients after this cutoff point (group 2). In group 2, we found a higher Birmingham Vasculitis Activity Score at the moment of diagnosis (20.4 vs 25.1, p < 0.05) and a more severe disease course, resulting in more frequent hospitalization rates (0.64 vs 2.26/year, p < 0.00001), higher corticosteroids dose requirements (5.87 vs 11.57 mg/day converted to methylprednisolone, p < 0.0001), and additional immunosuppressive therapy administration (56.2 vs 92.8 %, p < 0.05) to maintain disease remission. All six perinuclear pattern of antineutrophil cytoplasmic antibobodies (pANCA)-positive patients (20 %) were found in group 1. Concluding, the delay in diagnosis of CSS of more than 2 weeks was found to be associated with a disease course that was more severe. The presence of the pANCA antibodies may occasionally facilitate establishment of the diagnosis.

Clinical and laboratory characteristics of 19 patients with Churg-Strauss syndrome from a single South Australian centre.

PubMed

Whyte, A F; Smith, W B; Sinkar, S N; Kette, F E; Hissaria, P

2013-07-01

Churg-Strauss syndrome (CSS) is a rare, idiopathic systemic vasculitis. There is emerging evidence of an association between the presence or absence of antineutrophil cytoplasmic antibodies (ANCA) and clinical phenotype. Thromboembolism is an increasingly recognised complication of the disease. Given the paucity of Australian data, the aim of this study was to examine the clinical and laboratory features of CSS in a single Australian centre. We performed a retrospective review of all patients who fulfilled the American College of Rheumatology classification criteria for CSS managed at the Department of Immunology, Royal Adelaide Hospital between 2002 and 2008. Nineteen patients were included. All patients had asthma and most had upper airway involvement. Peripheral nerve, musculoskeletal, gastrointestinal and cutaneous involvement was common. Renal and cardiac involvement was uncommon in this series. Histological confirmation was obtained in 15 patients (78.9%). Ten patients (52.6%) were ANCA+, and these were more likely to have musculoskeletal involvement, such as arthralgia or myalgia (odds ratio 57, P = 0.005). Thrombosis was a feature at diagnosis in six patients (31.6%); two of these recurred with relapse. Sixteen patients (84.2%) were followed up; five died, and mean survival was 8.9 years. This is the first Australian study to focus on CSS. Our results demonstrate similar presentation and prognosis of CSS to previous descriptions; however, we noted that musculoskeletal involvement was more common in ANCA+ patients. In our series, thrombosis was a significant complication and we suggest that thromboprophylaxis may be warranted. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

Increase Economic Valuation of Marine Ecotourism Spots In Small Islands

NASA Astrophysics Data System (ADS)

Rahakbauw, Siska D.; Teniwut, Wellem A.; Renjaan, Meiskyana R.; Hungan, Marselus

2017-10-01

Ecotourism is one of the fast-growing sectors especially in the developing country as a source of revenue. To get a sustainable development of ecotourism, it needs broad and comprehensive effort from central government and local government, perfect example in that regards in Indonesia is Bali and Lombok. For another area in Indonesia like Kei Islands which located in two administrative governments have a major problem to build a sustainable nature-based tourism because of the location of this area to the major cities in the country makes the travel cost is high. This situation makes the role of local community as the backbone of the growth and development of nature-based tourism is critical. By using structural equation modeling (SEM), we constructed a model to enhance local community perception on economic valuation of ecotourism spots in the area. Results showed that perceived quality as the mediation driven by the intensity of appearance on national television and the internet could increase community attachment to increase willingness to pay from the local community on ecotourism in Kei islands. Also, the result also indicated that WTP value for the local community on ecotourism in Kei Islands was 10.81 per trip, with average trip per month was 1 to 4 times.

OSL age and stratigraphy of the Strauss sand sheet in New Mexico, USA

NASA Astrophysics Data System (ADS)

Hall, Stephen A.; Goble, Ronald J.

2015-07-01

The Strauss sand sheet occurs in south-central New Mexico, USA, and northern Chihuahua, Mexico, covering an area of about 4740 km2. Its chronology is determined by 19 OSL ages. The sand sheet formed primarily during three phases of eolian deflation and deposition, each phase with a separate sand source and under different climatic and environmental circumstances. The first phase of eolian sedimentation occurred 45 to 15 ka with the deposition of unit 1. The sand source for the first phase was beach-related features along the eastern shoreline of pluvial Lake Palomas in Mexico. The glacial-age climate was cool, wet, and windy because of the southern path of the jet stream at that time. After 15 ka, with the onset of warmer conditions of the Bølling-Allerød, the shutting down of the Palomas sand source, and wet conditions of the Younger Dryas, the sand sheet stabilized with weak soil development in unit 1. By 11 ka, the climate shifted to Holocene drying conditions and the second phase of sand accumulation began, forming unit 2; the sand source was the local deflation of the previously deposited unit 1 sand. The sand sheet stabilized again by 1.9 ka with slightly wetter late Holocene climate; a weak soil formed in unit 2 sand. About A.D. 1500 and extending to about A.D. 1850 or later, an A horizon formed on the sand sheet, probably in response to a desert grassland vegetation during the period of wet climate of the Little Ice Age. In an anthropogenic third phase of eolian activity, after A.D. 1850, the vegetation was likely disturbed by overgrazing; and the unit 2 and A horizon (unit 3) sands were deflated, resulting in the deposition of a thin layer of massive eolian sand (unit 4) across the sand sheet. By about A.D. 1900 mesquite shrubs had increased in abundance; and deflated sand, largely from unit 2, began to accumulate around the shrubs, forming coppice dunes (unit 5). Mesquite coppice dunes continued to increase in number and volume during the twentieth

Anterior ischaemic optic neuropathy in eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome): a case report and review of the literature.

PubMed

Padovano, Ilaria; Pazzola, Giulia; Pipitone, Nicolò; Cimino, Luca; Salvarani, Carlo

2014-01-01

We report a 62-year-old man with mild fever, headache and acute visual loss in his right eye due to anterior ischaemic optic neuropathy (AION), followed a few days later by pain in the legs and left arm associated with numbness and weakness. Giant cell arteritis complicated by AION was suspected at the beginning and high-dose oral glucocorticoids were started. However, on the basis of the past medical history of nasal polyposis, asthma, and hypereosynophilia as well as of further investigations (biopsy of the nasal mucosa showing granulomatous inflammation with a rich eosinophilic infiltrate, electromyography demonstrating, mononeuritis multiplex and positive p-ANCA), eosinophilic granulomatosis with polyangiitis (EGPA), previously known as Churg-Strauss syndrome, was diagnosed. Because visual acuity in the right eye deteriorated despite glucocorticoid therapy, pulse intravenous cyclophosphamide was started, subsequently replaced by oral azathioprine, while prednisone was slowly tapered. This treatment led to gradual improvement of the neurological symptoms, whereas the right visual impairment remained unchanged. EGPA-related AION is an uncommon lesion that is probably due to vasculitic involvement of posterior ciliary and/or chorioretinal arteries. The prognosis of established AION is poor for the affected eye, even when glucocorticoid treatment is started immediately. However, early recognition of AION and prompt aggressive treatment with high-dose glucocorticoids plus cyclophosphamide can prevent visual loss in the unaffected eye.

Modulation of MMP-2 and MMP-9 in Churg-Strauss syndrome respiratory mucosa: potential monitoring parameters.

PubMed

Leone, A; Uzzo, M L; Gerbino, A; Tortorici, S; Tralongo, P; Cappello, F; Incandela, S; Spatola, G F; Jurjus, A R

2014-01-01

Churg-Strauss (CSS) syndrome is rare and of unknown etiology. It is associated with vasculitis, blood eosinophilia and granulomatosis, and affects multiple organs and systems at various stages of the disease. Specific diagnostic and monitoring tests are not yet available. This study aims to assess the changes in MMP-2 and MMP-9 along with the histopathological alterations in two cases of CSS, as possible potential diagnostic and monitoring criteria. Two adult male patients were diagnosed with CSS in the otorhinolaryngology clinic in the University of Palermo, based on multiple clinical and histopathologic criteria. Biopsies of respiratory mucosa were taken after the consent of the patients, processed for routine histopathology and immunohistochemistry as well as quantitative polymerase chain reaction (qPCR). Similar biopsies were also taken from a non- CSS patient. The Assessment of MMP-2 and MMP-9 was performed using both immunohistochemistry and qPCR techniques. Histopathological alterations in the respiratory mucosa were consistent with vasculitis and granulomatous tissue formation, in addition to inflammatory cell infiltration with abundance of eosinophils. Immunohistochemistry assay performed on the samples derived from the two CSS patients showed a relative and remarkable increase of both MMP-2 and MMP-9 compared to controls. Such an increase was consistent with the qPCR results which depicted a significant increase between 20 and 30% for both MMP-2 and MMP-9, respectively. Since the secretion of MMPs is an essential step in angiogenesis, could these enzymatic factors be used as parameters to diagnose or monitor the evolution of CSS? The small number of samples analyzed in this study does not allow us to suggest a general statement correlating the increase in expression of MMP-2 and MMP-9 to the appearance or evolution of vasculitis; it is only speculative.

Flexible Conformable Clamps for a Machining Cell with Applications to Turbine Blade Machining.

DTIC Science & Technology

1983-05-01

PERIOD COVERED * FLEXIBLE CONFORMABLE CLAMPS FOR A MACHINING CELL Interim WITH APPLICATIONS TO TURBINE BLADE MACHINING 6. PERFORMING ORG. REPORT NUMBER...7. AuTmbR(s) 6. CONTRACT OR GRANT NUMBER(a) Eiki Kurokawa 3. PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELE%4NTPROJECT. TASK Carnegie-Mellon...University AREA a WORK UhIT NUMBERS The Robotics Institute Pittsburgh, PA. 15213 II. CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE May 1983. 13

A Pseudomonas aeruginosa strain isolated from a contact lens-induced acute red eye (CLARE) is protease-deficient.

PubMed

Estrellas, P S; Alionte, L G; Hobden, J A

2000-03-01

Pseudomonas aeruginosa proteases are thought to be important virulence factors in the pathogenesis of corneal disease. This study examined protease production from two strains of P. aeruginosa responsible for two very distinct clinical diseases: strain Paer1, isolated from a Contact Lens-induced Acute Red Eye (CLARE), and strain KEI 1025, isolated from a corneal ulcer. Strains were compared to a laboratory strain (ATCC 19660) known to produce severe keratitis in experimentally infected mice for protease production and for ocular virulence. Protease production was examined with colorimetric assays, gelatin zymography and western blots. Elastase A activity was quantitated with a staphylolytic assay. Ocular virulence was examined using a mouse scratch model of keratitis. In contrast to strains KEI 1025 or ATCC 19660, Paer1 was unable to produce enzymatically active elastase A, elastase, and protease IV. All three strains produced active alkaline protease. Strains KEI 1025 and ATCC 19660 produced a fulminant keratitis in mice whereas Paer1 produced a mild transient infection. Restoration of elastase activity in Paer1 via genetic complementation did not result in a virulent phenotype. Co-infection of mouse eyes with strains Paer1 and ATCC 19660 resulted in the eventual loss of Paer1 from corneal tissue. These studies suggest that P. aeruginosa elastase A and/or protease IV, but not alkaline protease or elastase, contribute to the ocular virulence of this organism.

Contrasting association of a non-synonymous leptin receptor gene polymorphism with Wegener's granulomatosis and Churg-Strauss syndrome.

PubMed

Wieczorek, Stefan; Holle, Julia U; Bremer, Jan P; Wibisono, David; Moosig, Frank; Fricke, Harald; Assmann, Gunter; Harper, Lorraine; Arning, Larissa; Gross, Wolfgang L; Epplen, Joerg T

2010-05-01

There is evidence that the leptin/ghrelin system is involved in T-cell regulation and plays a role in (auto)immune disorders such as SLE, RA and ANCA-associated vasculitides (AAVs). Here, we evaluate the genetic background of this system in WG. We screened variations in the genes encoding leptin, ghrelin and their receptors, the leptin receptor (LEPR) and the growth hormone secretagogue receptor (GHSR). Three single nucleotide polymorphisms (SNPs) in each gene region were analysed in 460 German WG cases and 878 ethnically matched healthy controls. A three-SNP haplotype of GHSR was significantly associated with WG [P = 0.0067; corrected P-value (P(c)) = 0.026; odds ratio (OR) = 1.30; 95% CI 1.08, 1.57], as was one non-synonymous SNP in LEPR (Lys656Asn, P = 0.0034; P(c) = 0.013; OR = 0.72; 95% CI 0.58, 0.90). These four SNPs were re-analysed in independent cohorts of 226 German WG cases and 519 controls. While the GHSR association was not confirmed, allele frequencies of the LEPR SNP were virtually identical to those from the initial cohorts. Analysis of this SNP in the combined WG and control panels revealed a significant association of the LEPR 656Lys allele with WG (P = 0.00032; P(c) = 0.0013; OR = 0.72; 95% CI 0.60, 0.86). Remarkably, the Lys656Asn SNP showed contrasting allele distribution in two cohorts of 108 and 88 German cases diagnosed with Churg-Strauss syndrome (CSS, combined P = 0.0067; OR = 1.41; 95% CI 1.10, 1.81), whereas identical allele frequencies were revealed when comparing British WG and microscopic polyangiitis cases. While GHSR has to be further evaluated, these data provide profound evidence for an association of the LEPR Lys656Asn SNP with AAV, resulting in opposing effects in WG and CSS.

Relationship among antineutrophil cytoplasmic antibody, blood urea nitrogen and complement in patients with eosinophilic granulomatosis polyangiitis (Churg-Strauss syndrome).

PubMed

Kawakami, Tamihiro; Kimura, Satoko; Takeuchi, Sora; Soma, Yoshinao

2013-07-01

Eosinophilic granulomatosis with polyangiitis (EGPA), also known as Churg-Strauss syndrome, is an antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis characterized by a history of asthma, hypereosinophilia. The prevalence of ANCA in EGPA is less common than in other ANCA-associated vasculitis. Increasing evidence of complement activation in the pathogenesis of ANCA-associated vasculitis has been provided by studies in animal models. We examined EGPA patients with cutaneous manifestations as an initial sign and investigated the correlations among clinical, serological and histopathological findings. We focused on differences among ANCA, blood urea nitrogen and complement levels such as complement 3 (C3), C4 and total complement hemolytic activity (CH50). We retrospectively investigated the records of 22 patients (11 male and 11 female) with EGPA admitted to our hospital from 1997-2012. Ten of the 22 patients (46%) were positive for serum myeloperoxidase (MPO)-ANCA. In contrast, all the patients were negative for serum proteinase 3 ANCA. There was a significantly positive correlation between serum CH50 and C4 levels in patients with EGPA. Serum blood urea nitrogen (BUN) levels differed significantly between MPO-ANCA-positive and -negative patients. Serum CH50 levels were higher in MPO-ANCA-positive patients compared to negative patients. Serum BUN levels were higher in elevated CH50 patients compared to normal and low CH50-negative patients. We propose that positive findings for MPO-ANCA with CH50 high activity may be a risk factor for developing renal insufficiency. Assuming there are correlations between the presence of ANCA and complements, earlier diagnosis based on initial efficacious treatment for EGPA. © 2013 Japanese Dermatological Association.

Cover Image, Volume 176A, Number 3, March 2018.

PubMed

Tamai, Kei; Tada, Katsuhiko; Takeuchi, Akihito; Nakamura, Makoto; Marunaka, Hidenori; Washio, Yosuke; Tanaka, Hiroyuki; Miya, Fuyuki; Okamoto, Nobuhiko; Kageyama, Misao

2018-03-01

The cover image, by Kei Tamai et al., is based on the Clinical Report Fetal ultrasonographic findings including cerebral hyperechogenicity in a patient with non-lethal form of Raine syndrome, DOI: 10.1002/ajmg.a.38598. © 2018 Wiley Periodicals, Inc.

The ANCA Vasculitis Questionnaire (AAV-PRO©)

ClinicalTrials.gov

2017-05-01

Eosinophilic Granulomatosis With Polyangiitis (Churg-Strauss) (EGPA); Churg-Strauss Syndrome (CSS); Granulomatosis With Polyangiitis (Wegener's) (GPA); Wegener Granulomatosis (WG); Microscopic Polyangiitis (MPA); ANCA-Associated Vasculitis (AAV); Vasculitis

A 92-Year-Old Male with Eosinophilic Asthma Presenting with Recurrent Palpable Purpuric Plaques

PubMed Central

Negbenebor, Nicole A.; Khalifian, Saami; Foreman, Ruth K.; Kroshinsky, Daniela

2018-01-01

Churg-Strauss syndrome or eosinophilic granulomatosis with polyangiitis is a systemic vasculitis affecting the small and medium-sized vasculature. It is commonly associated with asthma and eosinophilia. Most patients are diagnosed at around the age of 40. We report a case of biopsy-confirmed Churg-Strauss syndrome in a 92-year-old male with a history of eosinophilic asthma and peripheral eosinophilia who was later diagnosed with Churg-Strauss syndrome. PMID:29719830

Status of a compact electron cyclotron resonance ion source for National Institute of Radiological Sciences-930 cyclotron.

PubMed

Hojo, S; Katagiri, K; Nakao, M; Sugiura, A; Muramatsu, M; Noda, A; Okada, T; Takahashi, Y; Komiyama, A; Honma, T; Noda, K

2014-02-01

The Kei-source is a compact electron cyclotron resonance ion source using only permanent magnets and a frequency of 10 GHz. It was developed at the National Institute of Radiological Sciences (NIRS) for producing C(4+) ions oriented for high-energy carbon therapy. It has also been used as an ion source for the NIRS-930 cyclotron. Its microwave band region for the traveling-wave-tube amplifier and maximum output power are 8-10 GHz and 350 W, respectively. Since 2006, it has provided various ion beams such as proton, deuteron, carbon, oxygen, and neon with sufficient intensity (200 μA for proton and deuteron, 50 μA for C(4+), for example) and good stability for radioisotope production, tests of radiation damage, and basic research experiments. Its horizontal and vertical emittances were measured using a screen monitor and waist-scan. The present paper reports the current status of the Kei-source.

Anti-IgE Monoclonal Antibody (Omalizumab) in Refractory and Relapsing Eosinophilic Granulomatosis With Polyangiitis (Churg-Strauss): Data on Seventeen Patients.

PubMed

Jachiet, Marie; Samson, Maxime; Cottin, Vincent; Kahn, Jean-Emmanuel; Le Guenno, Guillaume; Bonniaud, Philippe; Devilliers, Hervé; Bouillet, Laurence; Gondouin, Anne; Makhlouf, Fatma; Meaux-Ruault, Nadine; Gil, Helder; Bienvenu, Boris; Coste, André; Groh, Matthieu; Giraud, Violaine; Dominique, Stéphane; Godeau, Bertrand; Puéchal, Xavier; Khouatra, Chahera; Ruivard, Marc; Le Jeunne, Claire; Mouthon, Luc; Guillevin, Loïc; Terrier, Benjamin

2016-09-01

To describe the efficacy and safety of omalizumab, an anti-IgE monoclonal antibody, in patients with refractory and/or relapsing eosinophilic granulomatosis with polyangiitis (Churg-Strauss) (EGPA). We conducted a nationwide retrospective study including EGPA patients who received omalizumab. Response was defined as the absence of asthma and/or sinonasal exacerbations with a prednisone dosage of ≤7.5 mg/day (complete response) or >7.5 mg/day (partial response). Seventeen patients (median age 45 years) received omalizumab for severe steroid-dependent asthma (88%) and/or sinonasal involvement (18%). After a median follow-up of 22 months, 6 patients (35%) achieved a complete response, 5 patients (30%) achieved a partial response, and 6 patients (35%) had no improvement. The median Birmingham Vasculitis Activity Score decreased from 2.5 at baseline to 0.5 at 12 months. The median number of exacerbations per month decreased from 1 at baseline to 0 at 12 months, and the median forced expiratory volume in 1 second increased from 63% of the percent predicted at baseline to 85% of the percent predicted at 12 months. The median prednisone dosage decreased from 16 mg/day at baseline to 11 mg/day at 6 months and 9 mg/day at 12 months. Omalizumab was discontinued in 8 patients (47%) during follow-up, because of remission (12.5%), adverse event despite disease remission (12.5%), refractory disease (25%), or relapse (50%). Relapses included retrobulbar optic neuritis attributable to EGPA in 2 patients and severe asthma flare in 2 others. The results of this study suggest that omalizumab may have a corticosteroid-sparing effect in EGPA patients with asthmatic and/or sinonasal manifestations, but reducing the corticosteroid dose may also increase the risk of severe EGPA flares, which raises the question of the safety of omalizumab in patients with EGPA. © 2016, American College of Rheumatology.

Unfavorably Altered Fibrin Clot Properties in Patients with Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome): Association with Thrombin Generation and Eosinophilia.

PubMed

Mastalerz, Lucyna; Celińska-Lӧwenhoff, Magdalena; Krawiec, Piotr; Batko, Bogdan; Tłustochowicz, Witold; Undas, Anetta

2015-01-01

Given reports on the increased prevalence of thromboembolic incidents in patients with eosinophilic granulomatosis with polyangiitis (EGPA; Churg-Strauss syndrome), we investigated whether fibrin clot properties are unfavorably altered in EGPA. Ex vivo plasma fibrin clot characteristics, including clot permeability, turbidimetry and efficiency of fibrinolysis using two assays, were investigated in 34 consecutive patients with remission in EGPA according to the Birmingham Vasculitis Activity Score version 3 (23 female, 11 male), aged 48 (range, 21-80) years. The control group comprised 34 age- and sex- matched volunteers. Compared with controls, patients with EGPA were characterized by denser fiber clots (estimated pore size, Ks, 7.30±0.93 vs 10.14±1.07 10-9 cm2), faster fibrin polymerization (lag phase in a turbidimetric curve, 41.8±3.6 vs 47.4±2.9 s), thicker fibrin fibers (maximum absorbance, ΔAbs, 0.87±0.09 vs 0.72±0.07), higher maximum levels of D-dimer released from clots (DDmax 4.10±0.46 vs 3.54±0.35 mg/L), and prolonged clot lysis time (t50%; 9.50±1.45 vs 7.56±0.87 min); all p<0.0001. Scanning electron microscopy images confirmed denser plasma fibrin networks composed of thinner fibers formed in EGPA. Antineutrophil cytoplasmic antibody status and C-reactive protein did not affect clot variables. Multivariate analysis adjusted for fibrinogen showed that Ks was predicted by eosinophil count, peak thrombin generation, factor VIII, and soluble CD40 ligand, whereas eosinophil count, peak thrombin generation and antiplasmin predicted t50%. This study is the first to show that EGPA is associated with prothrombotic plasma fibrin clot phenotype, which may contribute to thromboembolic manifestations reported in this disease.

Unfavorably Altered Fibrin Clot Properties in Patients with Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome): Association with Thrombin Generation and Eosinophilia

PubMed Central

Mastalerz, Lucyna; Celińska-Lӧwenhoff, Magdalena; Krawiec, Piotr; Batko, Bogdan; Tłustochowicz, Witold; Undas, Anetta

2015-01-01

Objectives Given reports on the increased prevalence of thromboembolic incidents in patients with eosinophilic granulomatosis with polyangiitis (EGPA; Churg-Strauss syndrome), we investigated whether fibrin clot properties are unfavorably altered in EGPA. Methods Ex vivo plasma fibrin clot characteristics, including clot permeability, turbidimetry and efficiency of fibrinolysis using two assays, were investigated in 34 consecutive patients with remission in EGPA according to the Birmingham Vasculitis Activity Score version 3 (23 female, 11 male), aged 48 (range, 21–80) years. The control group comprised 34 age- and sex- matched volunteers. Results Compared with controls, patients with EGPA were characterized by denser fiber clots (estimated pore size, Ks, 7.30±0.93 vs 10.14±1.07 10−9 cm2), faster fibrin polymerization (lag phase in a turbidimetric curve, 41.8±3.6 vs 47.4±2.9 s), thicker fibrin fibers (maximum absorbance, ΔAbs, 0.87±0.09 vs 0.72±0.07), higher maximum levels of D-dimer released from clots (DDmax 4.10±0.46 vs 3.54±0.35 mg/L), and prolonged clot lysis time (t50%; 9.50±1.45 vs 7.56±0.87 min); all p<0.0001. Scanning electron microscopy images confirmed denser plasma fibrin networks composed of thinner fibers formed in EGPA. Antineutrophil cytoplasmic antibody status and C-reactive protein did not affect clot variables. Multivariate analysis adjusted for fibrinogen showed that Ks was predicted by eosinophil count, peak thrombin generation, factor VIII, and soluble CD40 ligand, whereas eosinophil count, peak thrombin generation and antiplasmin predicted t50%. Conclusion This study is the first to show that EGPA is associated with prothrombotic plasma fibrin clot phenotype, which may contribute to thromboembolic manifestations reported in this disease. PMID:26540111

Mapping Marine Resources Utilization Based on Seascapes Area: A Study on Gender Comparison

NASA Astrophysics Data System (ADS)

Picaulima, Simon; Teniwut, Wellem A.; Kahfi, Syahibul; M. K Teniwut, Roberto; Dewa Ayu Raka Susanti, Ida I.; Hungan, Marselus; Rahantoknam, Meyske; Hasyim, Cawalinya; Rahakbauw, Siska D.; Renjaan, M. R.; Ngabalin, Anna M.; Ngangun, Tati A.; Pentury, Frischila; Betaubun, K. D.; Ngamel, A. K.; Ohoiwutun, E. C.

2017-10-01

Each section of coastal area from village area to deep sea has particular fisheries and marine activities. Therefore requirements for knowledge, skill, and risk are distinct between each scape. Based on this notion we divided seascapes based on three different area, first is village area to mangrove and coconut trees before coast area, second is area from beach to shallow water and the third is deep sea. We conducted our data collection in Kei Islands, Indonesia, with purposive sampling to target fishermen and aquaculture farmers in the coastal area. Purposes of this research are to analyze the role and the contribution of male and female on each area to formulate the best way to improve and maintain the sustainability of microenterprises and coastal community welfare; we used logistic regression to analyze the data. The result demonstrated each fisheries activity in each seascape with based on gender on each area and activity. Recommendation of this study especially for the government as empirical guidance to improve the economic welfare of the coastal community in Kei Islands and small islands area in general.

Planning an Anti-Racism Initiative. Project Change.

ERIC Educational Resources Information Center

Batten Susan T.; Leiderman, Sally A.

Project Change was launched by the Levi Strauss Foundation in 1991 as an initiative to address racial prejudice and institutional racism in communities in which Levi Strauss & Co. had facilities. Working with multiracial coalitions in Albuquerque (New Mexico), El Paso (Texas), Valdosta (Georgia), and Knoxville (Tennessee), the Foundation and…

How Exemplar Counselor Advocates Develop Social Justice Interest: A Qualitative Investigation

ERIC Educational Resources Information Center

Swartz, Melissa Robinson; Limberg, Dodie; Gold, Joshua

2018-01-01

The authors examined the experiences of 10 peer-nominated exemplar counselor advocates using grounded theory methodology (Strauss & Corbin, [Strauss, A., 1998]). Analysis by the authors yielded a model of how exemplar counselor advocates develop a social justice interest and provided key insights on how counselor educators can enhance social…

Libert-E Motor

ERIC Educational Resources Information Center

Sieloff, Susan F.; Kinnunen, Raymond; Chevarley, Joseph

2011-01-01

Kei Yun Wong has big dreams. She has been entrusted with the United States launch of Libert-E Motor, a new line of Chinese-manufactured electric scooters. With only $750,000 of her original budget of $3 million left, she needs to make sure that the launch succeeds, as it represents the initial step in her desire to create the first Chinese global…

Solar Energy Investigation Activities for Primary Pupils: Experience Sharing from a Teacher of a Solar Energy School in Hong Kong

ERIC Educational Resources Information Center

Cho, Kit Fan

2005-01-01

CCC Kei Wai Primary School (Ma Wan) is a 30-classroom 7-story primary school located at Ma Wan Island. The campus was completed in 2003. There are three arrays of photovoltaic modules installed on the roof with an expected annual yield of 5600 kWh a.c. electricity. This system is supported by a research project called "Building Integrated…

Treatment of good-prognosis polyarteritis nodosa and Churg-Strauss syndrome: comparison of steroids and oral or pulse cyclophosphamide in 25 patients. French Cooperative Study Group for Vasculitides.

PubMed

Gayraud, M; Guillevin, L; Cohen, P; Lhote, F; Cacoub, P; Deblois, P; Godeau, B; Ruel, M; Vidal, E; Piontud, M; Ducroix, J P; Lassoued, S; Christoforov, B; Babinet, P

1997-12-01

Twenty-five patients with good-prognosis polyarteritis nodosa or Churg-Strauss syndrome entered a prospective, randomized, multicentre study comparing two treatments: either oral corticosteroids and oral cyclophosphamide (CY; 2 mg/kg/day) for 1 yr (group A), or oral corticosteroids and monthly i.v. CY pulses (0.6 g/m2) (group B) for 1 yr. The objective was to determine the optimal CY regimen. Judgement criteria were the efficacy of the treatment in controlling the disease and the development of side-effects. Among the 25 patients who could be analysed, complete recovery was achieved with the experimental treatment in 9/12 patients in group A and 10/13 patients in group B. Two patients in each group relapsed after the end of therapy and were well controlled by corticosteroids or other drugs. One failure occurred in each group. The mean follow-up was 60.8 +/- 14.5 months after the beginning of the treatment. Side-effects associated with the administration of CY and steroids were noted 27 times in group A vs 14 times in group B (not significant). The oldest patient in these series (group B) died of pneumonia. No superiority in terms of efficacy could be established between the two regimens; however, the number of patients included was too small to conclude definitively. Toxic side-effects were significantly more frequent in women (P < 0.02). The high number of adverse effects leads us to recommend pulse over oral CY and an overall lowering of the doses of immunosuppression.

Defense Acquisitions. Missile Defense Agency Fields Initial Capability but Falls Short of Original Goals

DTIC Science & Technology

2006-03-01

Implementation Plan MAP Missile Defense System Assurance Provisions MDA Missile Defense System NASA National Aeronautics and Space Administration NFIRE ...fourth element, KEI, also delayed some activities related to its Near Field Infrared Experiment ( NFIRE ), which is being conducted to gather data on the...to complete a number of tasks that would have enabled it to conduct the NFIRE experiment. The experiment places sensors aboard a satellite that

Churg-Strauss Syndrome

MedlinePlus

... Sinus pain and inflammation (sinusitis). You may experience facial pain and develop nasal polyps, which are soft, noncancerous ( ... go away, especially if it's accompanied by persistent facial pain. Also see your doctor if you have asthma ...

High-Speed Laser Imaging, Emission and Temperature Measurements of Explosions

DTIC Science & Technology

2006-09-01

of these optical fibers illuminated the entrance slit of a dedicated Ocean Optics model HR-2000 spectrograph. The seven spectrographs were modified...Hewlett-Packard). The spectral response of the system was calibrated using an ARC Model XS432 Xenon lamp. Time resolution is approximately 12...F FOROHAR 101 STRAUSS AVE INDIAN HEAD MD 20640-5035 1 NAVAL SURFACE WARFARE CTR CODE 920J R GUIRGUIS 101 STRAUSS AVE INDIAN

Interleukin-12 Induces a Th1-like Response to Burkholderia mallei and Limited Protection in BALB/c Mice

DTIC Science & Technology

2005-09-02

protection from a lethal challenge. 15. SUBJECT TERMS Burkholderia mallei , glanders , cytokines, immune response, humoral, cellular, laboratory animals...model of sublethal and lethal intraperitoneal glanders ( Burkholderia mallei ). Vet Pathol 2000;37:626–36. [34] Jankovic D, Caspar P, Zweig M, Garcia...Vaccine 24 (2006) 1413–1420 Interleukin-12 induces a Th1-like response to Burkholderia mallei and limited protection in BALB/c mice Kei Amemiya

Stability and instability of periodic travelling wave solutions for the critical Korteweg-de Vries and nonlinear Schrödinger equations

NASA Astrophysics Data System (ADS)

Angulo Pava, Jaime; Natali, Fábio M. Amorin

2009-04-01

In this paper we establish new results about the existence, stability, and instability of periodic travelling wave solutions related to the critical Korteweg-de Vries equation ut+5u4ux+u=0, and the critical nonlinear Schrödinger equation ivt+v+|v=0. The periodic travelling wave solutions obtained in our study tend to the classical solitary wave solutions in the infinite wavelength scenario. The stability approach is based on the theory developed by Angulo & Natali in [J. Angulo, F. Natali, Positivity properties of the Fourier transform and the stability of periodic travelling wave solutions, SIAM J. Math. Anal. 40 (2008) 1123-1151] for positive periodic travelling wave solutions associated to dispersive evolution equations of Korteweg-de Vries type. The instability approach is based on an extension to the periodic setting of arguments found in Bona & Souganidis & Strauss [J.L. Bona, P.E. Souganidis, W.A. Strauss, Stability and instability of solitary waves of Korteweg-de Vries type, Proc. Roy. Soc. London Ser. A 411 (1987) 395-412]. Regarding the critical Schrödinger equation stability/instability theories similar to the critical Korteweg-de Vries equation are obtained by using the classical Grillakis & Shatah & Strauss theory in [M. Grillakis, J. Shatah, W. Strauss, Stability theory of solitary waves in the presence of symmetry II, J. Funct. Anal. 94 (1990) 308-348; M. Grillakis, J. Shatah, W. Strauss, Stability theory of solitary waves in the presence of symmetry I, J. Funct. Anal. 74 (1987) 160-197]. The arguments presented in this investigation have prospects for the study of the stability of periodic travelling wave solutions of other nonlinear evolution equations.

Development of optical sciences in Poland

NASA Astrophysics Data System (ADS)

Romaniuk, Ryszard S.

2013-10-01

Research and technical communities for optics, photonics and optoelectronics is grouped in this country in several organizations and institutions. These are: Photonics Society of Poland (PSP), Polish Committee of Optoelectronics of SEP, Photonics Section of KEiT PAN, Laser Club at WAT, and Optics Section of PTF. Each of these communities keeps slightly different specificity. PSP publishes a quarterly journal Photonics Letters of Poland, stimulates international cooperation, and organizes conferences during Industrial Fairs on Innovativeness. PKOpto SEP organizes didactic diploma competitions in optoelectronics. KEiT PAN takes patronage over national conferences in laser technology, optical fiber technology and communications, and photonics applications. SO-PTF has recently taken a decision to organize a cyclic event "Polish Optical Conference". The third edition of this conference PKO'2013 was held in Sandomierz on 30.06-04.07.2013. The conference scientific and technical topics include: quantum and nonlinear optics, photon physics, optic and technology of lasers and other sources of coherent radiation, optoelectronics, optical integrated circuits, optical fibers, medical optics, instrumental optics, optical spectroscopy, optical metrology, new optical materials, applications of optics, teaching in optics. This paper reviews chosen works presented during the III Polish Optical Conference (PKO'2013), representing the research efforts at different national institutions.

X-Ray Laser

DTIC Science & Technology

1991-01-31

Reflection in Relativistic Electron Beam Channel Radiation Systems, IEEE Trans. on Plasma Science 16(5), 548 (1988). 3. M. Strauss, P. Amendt, N...Reduced Radiation Losses in a Channeled-Beam X-Ray Laser by Bragg Reflection Coupling, Phys. Rev. A 39(11), 5791 (1989). 6. M. Strauss and N. Rostoker... Radiation Guiding in Channeling Beam X-Ray Laser by Bragg Reflection Coupling, Phys. Rev. A 40(12), 7097 (1989). 91-00870111 llllltl

Development of a Low cost Ultra tiny Line Laser Range Sensor

DTIC Science & Technology

2016-12-01

Development of a Low-cost Ultra-tiny Line Laser Range Sensor Xiangyu Chen∗, Moju Zhao∗, Lingzhu Xiang†, Fumihito Sugai∗, Hiroaki Yaguchi∗, Kei Okada...and Masayuki Inaba∗ Abstract— To enable robotic sensing for tasks with require- ments on weight, size, and cost, we develop an ultra-tiny line laser ...view customizable using different laser lenses. The optimal measurement range of the sensor is 0.05[m] ∼ 2[m]. Higher sampling rates can be achieved

Defense Acquisitions. Assessments of Selected Weapon Programs

DTIC Science & Technology

2007-03-01

Selected Weapon Programs March 2007 GAO-07-406SP Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for...unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 What GAO Found United States Government Accountability Office Why GAO Did This...Joint Tactical Radio System Ground Mobile Radio (JTRS GMR) 93 JTRS Handheld, Manpack, Small Form Fit (JTRS HMS) 95 Kinetic Energy Interceptors (KEI) 97

Pairing Heterocyclic Cations with closo-dodecafluorododecaborate(2-). Synthesis of Binary Heterocyclium(1+) Salts and a AG4(heterocycle)8(4+) Salt of B12F12(2-) (Preprint)

DTIC Science & Technology

2011-04-04

10989). 13. SUPPLEMENTARY NOTES For publication in the AIAA Journal of Fluorine Chemistry. 14. ABSTRACT Eight binary salts that pair triazolium...4]. This characteristic permitted the synthesis of the B12F122– dianion by electrophilic attack of supercritical HF in 1992 (it was isolated as Cs2...B. A. Wight, H. L. Ammon, D. V. Peryshkov, S. H. Strauss, Org. Lett. 12 (2010) 2714–2717. [9] D. V. Peryshkov, S. H. Strauss J. Fluorine Chem. 131

Animal Models of Ionizing Radiation Damage

DTIC Science & Technology

1992-01-01

Phagocytosis, Bacterio/. Proc., p. 92-98, 1967. 27. Mukherjee, A.K., B. Paul, R. Strauss , and A.J. Sbarra, The Role of the Phagncyte in Host-parasite...29. Paul, B., R. Strauss , and A.J. Sbarra, The Role of the Phagocyte in Host-parasite Interactions. XVI. Effect of X-irradiation on H202 Production in...1960. 156. Madrazo, A., J. Churg , and Y. Suzuki, Radiation Nephritis. Acute Changes Following High Doses of Radiation, Am. J. Path., 54:507-527, 1969

Interleukin-12 Induces a Th1-Like Response to Burkholderia mallei and Limited Protection in BALB/c Mice

DTIC Science & Technology

2006-01-01

sublethal and lethal intraperitoneal glanders ( Burkholderia mallei ). Vet Pathol 2000;37:626–36. [34] Jankovic D, Caspar P, Zweig M, Garcia-Moll M...Vaccine 24 (2006) 1413–1420 Interleukin-12 induces a Th1-like response to Burkholderia mallei and limited protection in BALB/c mice Kei Amemiya...IL)-12 on the immune response to Burkholderia mallei in BALB/c mice. Mice were vaccinated with non-viable B. mallei cells with or without IL-12

Development of gas pulsing system for electron cyclotron resonance ion source.

PubMed

Hojo, S; Honma, T; Muramatsu, M; Sakamoto, Y; Sugiura, A

2008-02-01

A gas-pulsing system for an electron cyclotron resonance ion source with all permanent magnets (Kei2 source) at NIRS has been developed and tested. The system consists of a small vessel (30 ml) to reserve CH(4) gas and two fast solenoid valves that are installed at both sides of the vessel. They are connected to each other and to the Kei2 source by using a stainless-steel pipe (4 mm inner diameter), where the length of the pipe from the valve to the source is 60 cm and the conductance is 1.2 l/s. From the results of the test, almost 300 e microA for a pulsed (12)C(4+) beam was obtained at a Faraday cup in an extraction-beam channel with a pressure range of 4000 Pa in the vessel. At this time, the valve has an open time of 10 ms and the delay time between the valve open time and the application of microwave power is 100 ms. In experiments, the conversion efficiency for input CH(4) molecules to the quantity of extracted (12)C(4+) ions in one beam pulse was found to be around 3% and the ratio of the total amount of the gas requirement was only 10% compared with the case of continuous gas provided in 3.3 s of repetition in HIMAC.

Analysis of seaweed marketing in warbal village, Southeast Maluku Regency, Indonesia

NASA Astrophysics Data System (ADS)

Tumiwa, Bruri B.; Renjaan, Meiskyana R.; B. A Somnaikubun, Glen; Betauubun, Kamilius D.; Hungan, Marselus

2017-10-01

Seaweed in Warbal Village, West Kei Kecil Subdistrict, Southeast Maluku Regency has prospects and business opportunities are adequate to give hope to farmers in improving welfare. The fact that seaweed farming has not yet provided better and maximum results as desired by the farmers. This study aims to evaluation the marketing channels, marketing margins and profit share of marketing agencies. The research is located in Warbal Village, West Kei Kecil Subdistrict, Southeast Maluku Regency which is determined purposively. The number of sample is 30 farmers taken by simple random sampling, 2 wholesaler traders and 2 collector traders taken by using snowball method. The data collection methods is interview and questionnaire directly to farmers and marketing agencies, literary method or data collector from institutions related to the research’s aims. The research results show that there is two marketing channel, as follows: Channel I: farmers, wholesaler traders, collector traders, PAP; Channel II: farmers, collector traders, PAP. The magnitude of marketing margins is different between the marketing channels, and so it is with profit share of a marketing agency. On channel I, magnitude margin is IDR 3,250 and profit share is 71.11% on farmers, 17.76% on wholesaler traders and 11.09% on collector traders. On channel II, the magnitude of marketing margin is IDR 1,250 and profit share is 88.88% on farmers and 11.09% to collector traders.

Transition Delay in Hypervelocity Boundary Layers by Means of Vibrational Relaxation and Acoustic Instability Interactions

DTIC Science & Technology

2014-01-04

Ca, 93536 Stuart Laurence2, Amy War-Kei Beierholm3, Hans G. Hornung4 Caltech, Pasadena, Ca, 91125 and Ross Wagnild5, Graham Candler6 University...The shots refer to particular conditions tested in the T5 facility for a 45-degree swept cylinder. Taken from [10]. The theory of how relaxation...0. 25 14 /6 .2 00 9- 12 87 27 American Institute of Aeronautics and Astronautics 15 3 Mack, L.M., “Boundary-layer stability theory ,” In

Proceedings of the International Conference on Parallel Architectures and Compilation Techniques Held 24-26 August 1994 in Montreal, Canada

DTIC Science & Technology

1994-08-26

an Itegrated Circuit Global Router. In Proc. of PPEARS 88, pages 138-145, 1988. [7] S. Sakai, Y. Yamaguchi, K. Hiraki , Y. Kodama, and T. Yuba. An...Computer Architecture, 1992. [5] S. Sakai, Y. Yamaguchi, K. Hiraki , Y. Kodama, and T. Yuba. An architecture of a data-flow single chip processor. In Int...EM-4 and sparing time for tech- nical discussions. We also thank Prof. Kei Hiraki at the Univ. of Tokyo for his helpful comments. Hidehiko Masuhara’s

Mediastinal emphysema after head-banging in a rock artist: pseudo shaken-baby syndrome in adulthood.

PubMed

Matsuzaki, Saeko; Tsunoda, Koichi; Chong, Tonghyo; Hamaguchi, Reo

2012-12-01

A 34-year-old man was seen because of severe right neck pain. He was a guitarist in a special type of heavy metal rock (so-called visual-kei, a subgenre related to glam-rock) band and habitually shook his head violently throughout concert performances. He regularly experienced neck and chest pain after a concert, which persisted for some time. Computed tomography scanning of the neck showed mediastinal emphysema. We surmise that head-banging resemble those of shaken-baby syndrome. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Low Dose Naltrexone to Improve Physical Health in Patients With Vasculitis

ClinicalTrials.gov

2018-06-08

Eosinophilic Granulomatosis With Polyangiitis (EGPA); Churg-Strauss Syndrome (CSS); Giant Cell Arteritis; Granulomatosis With Polyangiitis; Microscopic Polyangiitis; Polyarteritis Nodosa; Takayasu Arteritis

Educational Needs of Patients With Systemic Vasculitis

ClinicalTrials.gov

2014-07-11

Behcet's Disease; Churg-Strauss Syndrome; Vasculitis, Central Nervous System; Giant Cell Arteritis; Wegener Granulomatosis; Henoch-Schoenlein Purpura; Microscopic Polyangiitis; Polyarteritis Nodosa; Takayasu's Arteritis

Pediatric Vasculitis Initiative

ClinicalTrials.gov

2018-05-03

Wegeners Granulomatosis (Granulomatosis With Polyangiitis); Microscopic Polyangiitis; Churg Strauss Syndrome (Eosinophilic Granulomatosis With Polyangiitis); Polyarteritis Nodosa; Takayasu Arteritis; Primary CNS Vasculitis; Unclassified Vasculitis

Induced polarization research at Kennecott, 1965-1977

USGS Publications Warehouse

Nelson, Philip H.

1997-01-01

Geophysics research and development (R&D) was a small research group at Kennecott Inc. (KEI), a subsidiary of Kennecott Copper Corporation. The research group served Geophysics-Operations, which in turn worked for another subsidiary, Bear Creek Mining Company (BCMC). BCMC did Kennecott's exploration work such as reconnaissance mapping, staking and proving up claims, and assessment drilling. The working environment at Geophysics R&D included emphasis on instrument development and being strongly field oriented; having entrepreneurial leaders engaged in technical work; interaction between R&D and its `customer', the Operations group and; emphasis on lowering costs and increasing production.

Reproductive Health in Men and Women With Vasculitis

ClinicalTrials.gov

2014-06-25

Giant Cell Arteritis; Takayasu's Arteritis; Polyarteritis Nodosa; Wegener's Granulomatosis; Microscopic Polyangiitis; Churg-Strauss Syndrome; Behcet's Disease; Kawasaki Disease; Henoch-schoenlein Purpura; Vasculitis, Central Nervous System; Drug-induced Necrotizing Vasculitis

VCRC Tissue Repository

ClinicalTrials.gov

2018-04-23

Aortitis; Cutaneous Vasculitis; Eosinophilic Granulomatosis With Polyangiitis; Giant Cell Arteritis; Granulomatosis With Polyangiitis (Wegener's); Henoch-Schonlein Purpura; IgA Vasculitis; Microscopic Polyangiitis; Polyarteritis Nodosa; Takayasu Arteritis; Churg-Strauss Syndrome

Formation of Structure in the Universe

NASA Technical Reports Server (NTRS)

Bahcall, John; Fisher, Karl; Miralda-Escude, Jordi; Strauss, Michael; Weinberg, David

1997-01-01

This grant supported research by the investigators through summer salary support for Strauss and Weinberg, support for graduate students at Princeton University and Ohio State University, and travel, visitor, and publication support for the investigators. The grant originally had a duration of 1 year, and it was extended (without additional funding) for an additional year. The impact of the grant was considerable given its relatively modest duration and funding level, in part because it provided 'seed' funding to get Strauss and Weinberg started at new institutions, and in part because it was combined with support from subsequent grants. Here we summarize progress in the three general areas described in the grant proposal: Lyman alpha absorbers and the intergalactic medium, galaxy formation; and large scale structure.

Technology: Making the Connections. Innovations in the Apparel Industry. Resources in Technology.

ERIC Educational Resources Information Center

Threlfall, K. Denise

1996-01-01

Describes the partnership between Levi Strauss & Co., the largest brand-name apparel manufacturer in the world, and Custom Clothing Technology, the developer of software to customize jeans for female customers. (JOW)

Creative Inspiration in Composers

ERIC Educational Resources Information Center

Gowan, John Curtis

1977-01-01

Discussed are sources of creative inspiration noted by composers such as Wagner, Strauss, and Puccini; and charted are discrete steps in creativity common to composers seen as producing works of genius. (IM)

Generational forecasting in academic medicine: a unique method of planning for success in the next two decades.

PubMed

Howell, Lydia Pleotis; Joad, Jesse P; Callahan, Edward; Servis, Gregg; Bonham, Ann C

2009-08-01

Multigenerational teams are essential to the missions of academic health centers (AHCs). Generational forecasting using Strauss and Howe's predictive model, "the generational diagonal," can be useful for anticipating and addressing issues so that each generation is effective. Forecasts are based on the observation that cyclical historical events are experienced by all generations, but the response of each generation differs according to its phase of life and previous defining experiences. This article relates Strauss and Howe's generational forecasts to AHCs. Predicted issues such as work-life balance, indebtedness, and succession planning have existed previously, but they now have different causes or consequences because of the unique experiences and life stages of current generations. Efforts to address these issues at the authors' AHC include a work-life balance workgroup, expanded leave, and intramural grants.

Genetics Home Reference: dystonia 6

MedlinePlus

... neck, causing problems with speaking (dysarthria) and eating (dysphagia). Eyelid twitching (blepharospasm) may also occur. Involvement of ... dystonia, DYT6 type The Bachmann-Strauss Dystonia and Parkinson Foundation: What Is Dystonia? Patient Support and Advocacy ...

Deciding about an IUD

MedlinePlus

... Groot LJ, de Krester DM, et al, eds. Endocrinology: Adult and Pediatric . 7th ed. Philadelphia, PA: Elsevier ... Strauss JF, Barbieri RL, eds. Yen & Jaffe's Reproductive Endocrinology . 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap ...

Endometrial polyps

MedlinePlus

... Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology . 13th ed. Philadelphia, PA: Elsevier; 2016:chap 17. ... Strauss JF, Barbieri RL, eds. Yen & Jaffe's Reproductive Endocrinology . 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap ...

Intrauterine devices (IUD)

MedlinePlus

... Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric . 7th ed. Philadelphia, PA: Elsevier ... Strauss JF, Barbieri RL, eds. Yen & Jaffe's Reproductive Endocrinology . 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap ...

Proceedings of the Annual Midwest Research-to-Practice Conference in Adult, Continuing and Community Education (15th, Lincoln, Nebraska, October 17-19, 1996).

ERIC Educational Resources Information Center

Dirkx, John M., Ed.

These proceedings comprise 33 presentations. They are "Glaser or Strauss?"(Babchuk); "Reframing Participation in Adult Education Programs" (Babchuk); "Multicultural Adult Education as Discourse in the Social Construction of Reality" (Baptiste); "Political Construction of Adult Education" (Baptiste, Heaney);…

Development of Compact Electron Cyclotron Resonance Ion Source with Permanent Magnets for High-Energy Carbon-Ion Therapy

NASA Astrophysics Data System (ADS)

Muramatsu, M.; Kitagawa, A.; Iwata, Y.; Hojo, S.; Sakamoto, Y.; Sato, S.; Ogawa, Hirotsugu; Yamada, S.; Ogawa, Hiroyuki; Yoshida, Y.; Ueda, T.; Miyazaki, H.; Drentje, A. G.

2008-11-01

Heavy-ion cancer treatment is being carried out at the Heavy Ion Medical Accelerator in Chiba (HIMAC) with 140 to 400 MeV/n carbon ions at National Institute of Radiological Sciences (NIRS) since 1994. At NIRS, more than 4,000 patients have been treated, and the clinical efficiency of carbon ion radiotherapy has been demonstrated for many diseases. A more compact accelerator facility for cancer therapy is now being constricted at the Gunma University. In order to reduce the size of the injector (consists of ion source, low-energy beam transport and post-accelerator Linac include these power supply and cooling system), an ion source requires production of highly charged carbon ions, lower electric power for easy installation of the source on a high-voltage platform, long lifetime and easy operation. A compact Electron Cyclotron Resonance Ion Source (ECRIS) with all permanent magnets is one of the best types for this purpose. An ECRIS has advantage for production of highly charged ions. A permanent magnet is suitable for reduce the electric power and cooling system. For this, a 10 GHz compact ECRIS with all permanent magnets (Kei2-source) was developed. The maximum mirror magnetic fields on the beam axis are 0.59 T at the extraction side and 0.87 T at the gas-injection side, while the minimum B strength is 0.25 T. These parameters have been optimized for the production of C4+ based on experience at the 10 GHz NIRS-ECR ion source. The Kei2-source has a diameter of 320 mm and a length of 295 mm. The beam intensity of C4+ was obtained to be 618 eμA under an extraction voltage of 30 kV. Outline of the heavy ion therapy and development of the compact ion source for new facility are described in this paper.

Autologous Peripheral Blood Stem Cell Transplantation in Patients With Life Threatening Autoimmune Diseases

ClinicalTrials.gov

2005-06-23

Purpura, Schoenlein-Henoch; Graft Versus Host Disease; Anemia, Hemolytic, Autoimmune; Rheumatoid Arthritis; Churg-Strauss Syndrome; Hypersensitivity Vasculitis; Wegener's Granulomatosis; Systemic Lupus Erythematosus; Giant Cell Arteritis; Pure Red Cell Aplasia; Juvenile Rheumatoid Arthritis; Polyarteritis Nodosa; Autoimmune Thrombocytopenic Purpura; Takayasu Arteritis

Germany and the Future of Nuclear Deterrence in Europe

DTIC Science & Technology

1992-12-01

OF GERMANY PRIOR TO REUNIFICATION ........................................ 10 A. INTRODUCTION .................................... 10 B . 1945-1960...Strategic Thinking and the Role of Franz Josef Strauss ..................................... 19 b . Domestic and International Opposition ............ 23 c...63 B . UNITED KINGDOM .................................. 63 1. Background of Deterrence ........................... 64 2

A Structural View of American Educational History

ERIC Educational Resources Information Center

Maxcy, Spencer J.

1977-01-01

Displays the components of the structuralist views of Levi-Strauss, Michel Foucault, and Thomas S. Kuhn; constructs a model for doing structuralist studies in educational research; and tests the model on the pragmatic/progressive period in American educational history. (Author/IRT)

Military Education: Models from Antiquity

ERIC Educational Resources Information Center

Strauss, Barry

2008-01-01

Unlike Westerners today, the Greeks and Romans put military training at the heart of their educational system. Examining the ancients' preoccupation with the inculcation of soldierly skills and disciplines, Professor Strauss asks whether we can find profit in their example. (Contains 7 footnotes.)

Vasculitis Pregnancy Registry

ClinicalTrials.gov

2018-04-30

Vasculitis; Behcet's Disease; CNS Vasculitis; Cryoglobulinemic Vasculitis; Eosinophilic Granulomatosis With Polyangiitis (EGPA); Churg-Strauss Syndrome (CSS); Granulomatosis With Polyangiitis (GPA); Wegener's Granulomatosis; IgA Vasculitis; Henoch-Schoenlein Purpura (HSP); Microscopic Polyangiitis (MPA); Polyarteritis Nodosa (PAN); Takayasu Arteritis (TAK); Urticarial Vasculitis; Systemic Vasculitis

La Generacion Millennials en La Universidad: Nuevas Realidades Para El Consejero Profesional

ERIC Educational Resources Information Center

Dominguez-Davila, Nelissa

2013-01-01

College life strategies must be reassessed in light of the new generational culture taking hold with the arrival in college campuses of "Millennials" Generation students (Strauss & Howe 2000). This study explored college professional counselors' "Millennials" Generation knowledge, their techniques and strategies in…

Career Narratives of African American Female College Students: Insights for College Counselors

ERIC Educational Resources Information Center

Storlie, Cassandra A.; Hilton, Tracy Lara; Duenyas, Deborah; Archer, Robin; Glavin, Kevin

2018-01-01

The authors collected narrative data from 11 African American female college students at a predominantly White institution using the Career Construction Interview (Savickas & Hartung, 2012), the Future Career Autobiography (Rehfuss, 2009), and a qualitative career experiences questionnaire. Using the constant comparison method (Strauss &…

Music and Early Childhood in the Tristes Tropiques: The Brazilian Experience

ERIC Educational Resources Information Center

Ilari, Beatriz

2007-01-01

Inspired by ideas that Levi-Strauss (1955) presented in "Tristes Tropiques", the author discusses music and early childhood in Brazil from educational, historical, anthropological, and sociological perspectives. She begins with a short history of early childhood education in Brazil, including changes in educational policies, teacher…

Telling and Not-Telling: A Classic Grounded Theory of Sharing Life-Stories

ERIC Educational Resources Information Center

Powers, Trudy Lee

2013-01-01

This study of "Telling and Not-Telling" was conducted using the classic grounded theory methodology (Glaser 1978, 1992, 1998; Glaser & Strauss, 1967). This unique methodology systematically and inductively generates conceptual theories from data. The goal is to discover theory that explains, predicts, and provides practical…

34. VIEW SOUTHEAST, WEST ABUTMENT OF OPERATING MACHINERY LARGE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

34. VIEW SOUTHEAST, WEST ABUTMENT OF OPERATING MACHINERY - LARGE GEAR AT LEFT CENTER IS 'D' - REFER TO STRAUSS SHEETS #15 AND #18 FOR POWER TRAIN RELATIONSHIPS - Tomlinson Bridge, Spanning Quinnipiac River at Forbes Street (U.S. Route 1), New Haven, New Haven County, CT

What Influences Agents to Pursue a Career in Extension?

ERIC Educational Resources Information Center

Arnold, Shannon; Place, Nick

2010-01-01

The qualitative study reported here explored why agricultural agents pursue an Extension career. A purposive sample was used to select twelve Florida agricultural agents. Interviews investigated positive and negative influences that affected agents' employment decisions. Grounded theory was used as the primary data analysis method (Strauss &…

New Principal Coaching as a Safety Net

ERIC Educational Resources Information Center

Celoria, Davide; Roberson, Ingrid

2015-01-01

This study examines new principal coaching as an induction process and explores the emotional dimensions of educational leadership. Twelve principal coaches and new principals--six of each--participated in this qualitative study that employed emergent coding (Creswell, 2008; Denzin, 2005; Glaser & Strauss, 1998; Spradley, 1979). The major…

Glanders in donkeys (Equus Asinus) in the state of pernambuco, Brazil: A case report

PubMed Central

Mota, Rinaldo Aparecido; da Fonseca Oliveira, Andréa Alice; da Silva, Andréa Marques Vieira; Junior, José Wilton Pinheiro; da Silva, Leonildo Bento Galiza; de Farias Brito, Marilene; Rabelo, Silvana Suely Assis

2010-01-01

The clinical, anatomical and histopatological findings of glanders diagnosis in donkeys in the state of Pernambuco-Brazil are reported. The animals were euthanized and necropsied, and evaluated for lesions in respiratory and lymphatic systems, confirming the disease by isolation of Burkholderia mallei and Strauss test. PMID:24031474

Poststructuralism as Theory and Practice in the English Classroom. ERIC Digest.

ERIC Educational Resources Information Center

Bush, Harold K., Jr.

This digest provides a historical review of some current literary theories and practices which developed from contemporary philosophy. Structuralism, associated with Ferdinand de Saussure and Claude Levi-Strauss, with a seemingly scientific view of language and culture posited a systemic "center" that organized and sustained an entire…

Lived Experiences of Low Socioeconomic Millennial Generation College Students

ERIC Educational Resources Information Center

Thacker, Kelly L.

2012-01-01

The characteristics and needs of college students across the United States are ever-changing. As Millennial generation students, born between 1982 and 2003 (Howe & Strauss, 2000), attend college, unique characteristics are present. Commonalities within the Millennial generation have been identified; however, socioeconomic status can impact a…

77 FR 41191 - Proposed Collection; Comment Request: Effectiveness of the NIH Curriculum Supplements Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-12

... comment on proposed data collection projects, the Office of Science Education, the National Institutes of... collection of information, contact Lisa Strauss, Office of Science Education, National Institutes of Health... supplements in presenting science in a more engaging and interactive way. The supplements help K-12 educators...

33. EAST ABUTMENT, VIEW NORTHEAST OF OPERATING MACHINERY SMALL ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

33. EAST ABUTMENT, VIEW NORTHEAST OF OPERATING MACHINERY - SMALL GEAR IS IDENTIFIED AS 'C' - LARGE GEAR IS 'B' REFER TO GEARING DIAGRAMS - STRAUSS SHEET #15 FOR POWER TRAIN RELATIONSHIPS - Tomlinson Bridge, Spanning Quinnipiac River at Forbes Street (U.S. Route 1), New Haven, New Haven County, CT

35. VIEW SOUTHEAST, WEST ABUTMENT OF OPERATING MACHINERY BASCULE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

35. VIEW SOUTHEAST, WEST ABUTMENT OF OPERATING MACHINERY - BASCULE LEAF RAISED - LARGE GEAR AT LEFT CENTER IS 'D' - REFER TO STRAUSS SHEETS #15 AND #18 FOR POWER TRAIN RELATIONSHIPS - Tomlinson Bridge, Spanning Quinnipiac River at Forbes Street (U.S. Route 1), New Haven, New Haven County, CT

The Millennial Generation: Howe and Strauss Disputed

ERIC Educational Resources Information Center

Alexander Agati, Holly

2012-01-01

Researchers have attempted to untangle the complexity of a generation through four primary effects--time interval, cohort, period, and attitude--based on personal and societal attributes. The Millennial generation, born 1982-2000, has received considerable attention through the media, in educational institutions, and in the workplace. The seven…

Ganas of Showing the Way: A Grounded Theory Study of Hispanic Presidents in Higher Education

ERIC Educational Resources Information Center

Barrios Gutierrez, Eugenio

2010-01-01

In this dissertation, based on classical grounded theory (Glaser & Strauss, 1967, 1971; Glaser, 1978, 1992, 1993, 1994a, 1994b, 1996, 1998, 2001, 2003, 2004), second generation Hispanic presidents and chancellors in higher education were studied to discover how they continually try to resolve second culture-coping challenges, the…

X Chromosome Inactivation and Breast Cancer: Epigenetic Alteration in Tumor Initiation and Progression

DTIC Science & Technology

2007-09-01

Okada, Y., Sugihara, H., Hattori, T., Reeve, A.E., Ogawa, O., and Okamoto, K. (2004). Char- acterization of loss-of-inactive X in Klinefelter ... syndrome and female- derived cancer cells. Oncogene 23, 6163–6169. Marahrens, Y., Panning, B., Dausman, J., Strauss, W., and Jaenisch, R. (1997). Xist

Taking-On: A Grounded Theory of Addressing Barriers in Task Completion

ERIC Educational Resources Information Center

Austinson, Julie Ann

2011-01-01

This study of taking-on was conducted using classical grounded theory methodology (Glaser, 1978, 1992, 1998, 2001, 2005; Glaser & Strauss, 1967). Classical grounded theory is inductive, empirical, and naturalistic; it does not utilize manipulation or constrained time frames. Classical grounded theory is a systemic research method used to generate…

Discovering Implicit Networks from Point Process Data

DTIC Science & Technology

2013-08-03

Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 SOCIAL NETWORK ANALYSIS Szell et al, Nature 2012 Saturday, August 3, 13 (a) Adjacency...processes: ‣ Seismology ‣ Epidemiology ‣ Economics ‣ Modeling dependence is challenging - “beyond Poisson” ‣ Strauss and Gibbs Processes ‣ Determinantal

An Authorization Logic with Explicit Time

DTIC Science & Technology

2008-02-02

that η-logic can be used in specifying the behavior of systems with time-dependent authorization policies. In such cases, the logic can be used to...10(4):265– 310, November 1992. [26] Christopher Lesniewski-Laas, Bryan Ford, Jacob Strauss, M. Frans Kaashoek, and Robert Morris. Alpaca : extensible

Do-It-Yourselfers or Engineers? Bricolage as a Metaphor for Teacher Work and Learning.

ERIC Educational Resources Information Center

Scribner, Jay Paredes

This study explores the nature of teacher learning within the broader context of increasing state-level accountability, applying Levi-Strauss' bricolage metaphor to teachers' workplace learning. Based on the assumption that "problems of practice" serve as catalysts for learning, it addresses how teachers define and solve problems in…

Characteristics of Millennial Students at a Two-Year College

ERIC Educational Resources Information Center

Fenske, Susanne Kelly

2011-01-01

The purpose of this research is to describe the degree to which Millennial students who attend two-year colleges exhibit the characteristics of the seven Millennial generation characteristics. Howe and Strauss (2007) purport that the Millennials exhibit seven key characteristics in their behavior: Special, Sheltered, Confident, Team-oriented,…

Get the Federal Government out of Education? That Wasn't the Founding Fathers' Vision

ERIC Educational Resources Information Center

Jennings, Jack

2011-01-01

During the 2010 election campaign, Senator Rand Paul from Kentucky demanded the dismantling of the U.S. Department of Education. "I am against any federal funding or control of education," he said. "Historically, education was funded and controlled locally" (Strauss, 2010). Another new Republican senator, Mike Lee from…

Intergenerational Challenges in Australian Jewish School Education

ERIC Educational Resources Information Center

Gross, Zehavit; Rutland, Suzanne D.

2014-01-01

The aim of this research is to investigate the intergenerational changes that have occurred in Australian Jewish day schools and the challenges these pose for religious and Jewish education. Using a grounded theory approach according to the constant comparative method (Strauss 1987), data from three sources (interviews [296], observations [27],…

L'analyse structurale en traduction poetique (Structural Analysis in Poetic Translation)

ERIC Educational Resources Information Center

Larose, Robert; Slote, Daniel

1978-01-01

Mallarme's translation of the third stanza of Poe's "Israfel" is used to illustrate this method, based on that of Jacobsen and Levi-Strauss. The categories for analysis are divided into formal and semantic properties, each of which is subdivided into phonology, morphology, lexicology and syntax. (Text is in French.) (AMH)

The Problems of Practice: Bricolage as a Metaphor for Teachers' Work and Learning

ERIC Educational Resources Information Center

Scribner, Jay Paredes

2005-01-01

In this article the author uses Levi-Strauss' (1966) metaphor of Bricolage to examine how teachers, not policymakers, make sense of their "problems of practice" in three United States high schools. The article also examines how teachers address these problems of practice. It concludes by underscoring the disconnect between teachers' and…

Walking a Fine Balance: The Life History of a Woman Principal

ERIC Educational Resources Information Center

Fennell, Hope-Arlene

2008-01-01

This article describes the leadership journey of Kathryn, an educational leader, in relation to current research on women's experiences as educational leaders. This life history was developed as a grounded theory (Glaser & Strauss, 1967) study. Conducted over a two-year period, the semi-structured interviews used to conduct the study were…

The Cutting Edge: Workplace English. Project Handbook and Instructional Guide.

ERIC Educational Resources Information Center

Clymer-Spradling, Carol

A workplace literacy program for garment workers is described and evaluated. The program, a partnership between El Paso Community College (Texas) and Levi Strauss & Company, consisted of a three-level, job-specific, video-based curriculum for limited-English-speaking employees implemented at seven plants in El Paso. The 18-month model…

Puzzling the Picture Using Grounded Theory

ERIC Educational Resources Information Center

Bennett, Elisabeth E.

2016-01-01

Since the first publication by Glaser and Strauss in 1967, Grounded Theory has become a highly influential research approach in the social sciences. The approach provides techniques and coding strategies for building theory inductively from the "ground up" as concepts within the data earn relevance into an evolving substantive theory.…

Finding the Groove: A Grounded Theory Study on Leading Others to a Productive Path

ERIC Educational Resources Information Center

Williams, Roshann Reed

2011-01-01

Finding the groove was systematically discovered directly from data following the classical grounded theory methodology developed by Glaser and Strauss (1967) and further developed by Glaser (1965, 1978, 1992, 1998, 2001). This basic social process emerged from data as the pattern of behavior that leaders proceed through to increase performer…

Managing Information Overload for Senior Leaders in the 21st Century

ERIC Educational Resources Information Center

Jackson, Jason M.

2013-01-01

Information overload is a state where information input exceeds processing capability by an individual, and adverse effects of information overload, such as becoming less productive, making bad decisions, and becoming highly selective, are growing. Guided by Glaser and Strauss' work on grounded theory, this study examined adverse impact of…

Cope, Conform, or Resist? Functions of a Black American Identity at a Predominantly White University

ERIC Educational Resources Information Center

Payne, Yasser Arafat; Suddler, Carl

2014-01-01

This study organized five black American undergraduate students into a participatory action research (PAR) team to examine Cross and Strauss' (1998) and Cross, Smith, and Payne's (2002) functions of blackness theory (i.e., bonding, code switching, and individualism) within a sample of black American students, frontline staff (i.e., janitors), and…

Work and Family. Special Focus.

ERIC Educational Resources Information Center

Goetz, Kathy, Ed.

1992-01-01

This newsletter issue focuses on issues concerning families with both parents employed outside the home and describes several employer programs designed to help employees balance their work and family life. The newsletter includes the following articles: (1) "Work and Family: 1992"; (2) "Levi Strauss and Co.--A Work/Family Program…

Welcoming a New Generation to College: The Millennial Students

ERIC Educational Resources Information Center

Elam, Carol; Stratton, Terry; Gibson, Denise D.

2007-01-01

High on any required reading list for college-level student affairs officers and high school counselors is "Millennials Rising: The Next Great Generation" by Neil Howe and William Strauss (2000). Experts on generational change in the United States, the authors contend that the current generation of college-age and pre-college-age…

NREL Finds Nanotube Semiconductors Well-suited for PV Systems | News | NREL

Science.gov Websites

photoinduced electron transfer for emerging organic semiconductors such as single-walled carbon nanotubes (SWCNT) that can be used in organic PV devices. In organic PV devices, after a photon is absorbed Larson, and Steven Strauss from Colorado State University. Organic PV devices involve an interface

Language and Nutrition (Mis)Information: Food Labels, FDA Policies and Meaning

ERIC Educational Resources Information Center

Taylor, Christy Marie

2013-01-01

In this dissertation, I address the ways in which food manufacturers can exploit the often vague and ambiguous nature of FDA policies concerning language and images used on food labels. Employing qualitative analysis methods (Strauss, 1987; Denzin and Lincoln, 2003; Mackey and Gass, 2005) that drew upon critical discourse analysis (Fairclough,…

Piaget's Structural Developmental Psychology.

ERIC Educational Resources Information Center

Broughton, John M.

1981-01-01

Piaget's theory is identified as a branch of structuralism concerned with the concept of truth, in distinction from French structuralism, which is focused on meaning. The two branches are compared and contrasted, and relations between logic and language are explored. Similarities and differences in the theories of Piaget, Levi-Strauss, and Chomsky…

Hidden Myth: Structure & Symbolism in Advertising.

ERIC Educational Resources Information Center

Leymore, Varda Langholz

This discussion of advertising treats it as a communication system analyzable in structuralist terms. Building on the approaches of Levi-Strauss and others, the discussion begins with a general introduction to structuralism and goes on to outline the specific methodology adopted in this study. The approach is illustrated in two contexts: static…

Fostering Social and Emotional Competencies in Students Diagnosed with Dyslexia: Teachers' Perspectives

ERIC Educational Resources Information Center

Scott-Beale, Hope

2016-01-01

This research study is the result of an investigation into the lived experiences of ten teachers' commitment to working with students diagnosed with dyslexia. The methodology used to collect and analyze the data was Corbin and Strauss' (2008) grounded theory. The data was collected through face-to-face, semi-structured interviews that were…

Learning: What Do Primary Pupils Think about It?

ERIC Educational Resources Information Center

Sahin Taskin, Cigdem

2012-01-01

The author aimed to explore primary pupils' perceptions of learning and to what extent they perceive learning is important to them. Fifty-five primary school pupils in Istanbul and Canakkale (Turkey) were interviewed. To analyze the data, A. Strauss and J. Corbin's (1998) grounded theory methodology was followed. NVivo 7 (QSR, Australia) a…

Readying One's Self: A Grounded Theory Investigation of the LatinoJustice PRLDEF LawBound Program Participants

ERIC Educational Resources Information Center

Joseph, Angela Marie Banner

2011-01-01

This study was a grounded theory investigation of the LatinoJustice PRLDEF LawBound participants. The research was conducted using the grounded theory method developed by Glaser and Strauss (1967) and Glaser (1978, 1992, 1993, 1996, 1998, 2001, 2003, 2005) to discover an explanatory theory directly from the data. The discovery of the…

A Content Analysis of Themes That Emerge from School Principals' Web2.0 Conversations

ERIC Educational Resources Information Center

Manning, Rory

2011-01-01

The purpose of this qualitative study was to analyze the self initiated conversations held by school principals on web2.o platforms, such as blogs, through the lens of current leadership standards. The online writings of thirteen school principals were analyzed using grounded theory techniques (Strauss and Corbin, 1998) to elucidate emerging…

Recognizing Social Class in the Psychotherapy Relationship: A Grounded Theory Exploration of Low-Income Clients

ERIC Educational Resources Information Center

Thompson, Mindi N.; Cole, Odessa D.; Nitzarim, Rachel S.

2012-01-01

The process of psychotherapy among 16 low-income clients was explored using grounded theory (Charmaz, 2006; Glaser & Strauss, 1967) in order to understand and identify their unique experiences and needs. Semistructured interviews were conducted with 12 women and 4 men who had attended at least 6 sessions of psychotherapy within 6 months of the…

The Cutting Edge: Workplace English. Section I: Project Handbook.

ERIC Educational Resources Information Center

El Paso Community Coll., TX. Literacy Center.

A model workplace literacy program of El Paso Community College (Texas), in cooperation with Levi Strauss and Company, is described. The partnership designed a three-part, job-specific, video-based curriculum in English as a Second Language (ESL) for garment industry workers, implemented in seven local plants. The 18-month program had these goals:…

The Cutting Edge: Workplace English. Instructional Guide.

ERIC Educational Resources Information Center

El Paso Community Coll., TX. Literacy Center.

The instructional guide for the Cutting Edge workplace literacy program, a cooperative project of El Paso Community College (Texas) and Levi Strauss and Company, is an expanded version of one appendix the project handbook. It describes and provides an instructional model for the three-part, job-specific, video-based program of English as a Second…

Videotape Recording of Narcotic Addicts in Group Therapy: The Analysis of Communicational and Interactive Behavior.

ERIC Educational Resources Information Center

Soloway, Irv

An approach to the study of drug sub-culture groups and a model for predictive research in the identification and isolation of heroin addicts are developed in this thesis. The basic methodologies employed are the linguistic methods of Kenneth Pike and Claude Levi-Strauss for use in the analysis of social phenomena. Communicative mechanisms by…

Mirror Your Audience's Attitude: A Global Profile.

ERIC Educational Resources Information Center

Meussling, Vonne

Recent advertising research has suggested that to gain initial entry into and retain continual success with a targeted audience of consumers, it is wise to mirror the attitudes and desires of those consumers. This has proven effective in the United States, where companies such as Chevrolet, Levi Strauss, and Coca-Cola have successfully catered to…

4th International Symposium on Autophagy: exploiting the frontiers of autophagy research.

PubMed

Eskelinen, Eeva-Liisa; Deretic, Vojo; Neufeld, Thomas; Levine, Beth; Cuervo, Ana Maria

2007-01-01

The 4th International Symposium on Autophagy was held in Mishima, a small town between Tokyo and Kyoto, October 1-5, 2006 (http://isa4th.umin.jp/). The meeting was organized by the group of Eiki Kominami. Approximately 150 participants took part in this well-organized meeting in the spacious and comfortable Toray Conference Hall (Fig. 1). The social program offered opportunities for informal discussions, Japanese culture (from karaoke singing to traditional drumming; Fig. 2), history and nature (a visit to a steaming volcano; Fig. 3), as well as delicious Japanese food. The scientific program started with two plenary lectures on Sunday evening. Daniel Klionsky gave an overview of Atg9 cycling in yeast and Shigekazu Nagata talked about apoptosis and engulfment of dead cells by macrophages. The meeting consisted of five oral sessions and two poster sessions covering a wide range of autophagy-related topics. Exciting unpublished results were presented in all sessions, showing how quickly autophagy research is progressing. Two themes were discussed in many sessions during the symposium: the role of autophagy in the degradation of aggregate-prone proteins and protein aggregates, and the possible role of p62 in autophagy.

Pulmonary eosinophilia associated with montelukast

PubMed Central

Franco, J.; Artes, M. J.

1999-01-01

Antileukotriene drugs are new therapeutic agents that have recently been approved for the treatment of asthma. Several cases of eosinophilic conditions including Churg-Strauss syndrome have been reported to be associated with zafirlukast, a cysteinyl leukotriene type 1 receptor antagonist. So far no other leukotriene modifier has been associated with the syndrome. The case history is presented of a man with allergic rhinitis and asthma who had received intermittent pulse therapy with oral corticosteroids. Pulmonary eosinophilia developed while he was receiving treatment with montelukast, a chemically distinct cysteinyl leukotriene type 1 receptor antagonist. After discontinuation of montelukast therapy and administration of systemic corticosteroids the patient's symptoms reversed rapidly and there was prompt resolution of the pulmonary infiltrates. We believe that cysteinyl leukotriene type 1 receptor antagonists are safe and effective drugs for most patients with asthma but caution is needed for those with more severe disease who require systemic corticosteroids, especially if they show characteristics of the atypical allergic diathesis seen in the prodromal phase of Churg-Strauss syndrome.

 PMID:10335014

School Choice or the Politics of Desperation? Black and Latinx Parents of Students with Dis/Abilities Selecting Charter Schools in Chicago

ERIC Educational Resources Information Center

Waitoller, Federico R.; Super, Gia

2017-01-01

In this paper, we focus on the city of Chicago to examine how Black and Latinx parents of students with dis/abilities1 engage with school choice. Using analytical tools from grounded theory (Strauss & Corbin, 1990) and a theoretical lens informed by critical notions of space, race and dis/ability, we analyze interviews with parents of students…

Guardians of the Republic

DTIC Science & Technology

2007-04-01

said to be the implicit rejection of philosophy, does not know ’nature’: the Hebrew term for ’nature’ is unknown to the Hebrew Bible ." LEO STRAUSS...approximation to natural law, is -just as happened - the precursor to the tyranny of the majority. "The Social Contract (1762) was the ’ Bible ’ of the

Bryon W. Larson | NREL

Science.gov Websites

Avdoshenko, AA Popov, OV Boltalina, SH Strauss, N Kopidakis, G Rumbles. "Inter-Fullerene Electronic , EV Bukovsky, BW Larson, JB Whitaker, SHM Deng, N Kopidakis, G Rumbles, AA Popov, Y-S Chen, X-B Wang Science, 6, 1801-1815, 2015. BW Larson, JB Whitaker, AA Popov, N Kopidakis, G Rumbles, OV Boltalina, SH

Clinical trial tests first-in-class bifunctional immunotherapy drug in HPV-associated cancers | Center for Cancer Research

Cancer.gov

HPV-associated cancers that spread or do not respond to treatment are often incurable. Julius Strauss, M.D., of the Laboratory of Tumor Immunology and Biology is testing a first-in-class bifunctional immunotherapy to see if it can control the growth of HPV-associated tumors by restoring and improving the immune system’s ability to kill cancer cells.

Understanding Children's Drawings: The Path to Manhood. With "Notes on the Study of Man," By Wolfgang Schad.

ERIC Educational Resources Information Center

Strauss, Michaela

Based on the notes of Hanns Strauss and his collection of 6,000 drawings by 2- to 7-year-olds, this book describes the stages of development of children's drawings by using the framework of Rudolf Steiner's "anthroposophical" science. In the introduction, the early development of children's drawing is compared with works of art left by…

A Preliminary Inquiry into the Successful and Unsuccessful Listening Strategies of Beginning College Japanese Students.

DTIC Science & Technology

1984-01-01

Qualitative research for education: An introduction to theory and methods ...finally to present his findings in a particular way" (Ruby, 1980). 11. Grounded Theory : Describes a method by which social scientists can ground their... theory and research in the reality they are studying . According to Glaser and Strauss (1967), "our approach, allowing substantive concepts and

Culture and Identity: Critical Considerations for Successful State-building Endeavors

DTIC Science & Technology

2010-05-21

cultures. The literature consulted was largely based on anthropological and political science research both of which also included references to...ambiguity. 79 For the purposes of this research and analysis, the definitions of culture offered by the political science and anthropological ...is both a metaquestion, and 80 Claude Lévi-Strauss, “Social Structure” in Anthropology Today

Residents' Interaction with Their College Living-Learning Peer Mentor: A Grounded Theory

ERIC Educational Resources Information Center

Wylie, Jonathan Patrick

2012-01-01

This study used Strauss and Corbin's (1998) grounded theory model to describe and explain the stories of residents' interactions with their peer mentor, in a health, education, and human development living-learning community (LLC). The question answered in this study was: What is the impact of the interaction between a peer mentor and…

Taking a Closer Look at the "Grit" Narratives

ERIC Educational Resources Information Center

Socol, Ira

2014-01-01

In this article Ira Socol explores the pros and cons of Paul Tough's "How Children Succeed: Grit, Curiosity, and the Hidden Power of Character." As Tough told Valerie Strauss, "The book is about two things: first, an emerging body of research that shows the importance of so-called non-cognitive skills in children's…

The Levi Strauss Project: Development of a Curriculum.

ERIC Educational Resources Information Center

Bell, Jill

1982-01-01

A program initiated by a garment company and carried out in cooperation with a board of education focused on conversational skills and industry jargon as well as problem-solving language. The program's development is described, including an evaluation and suggestions by a company manager. (MSE)

31. VIEW NORTHEAST OF OPERATING MACHINERY. GEAR 'C5' IS AT ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

31. VIEW NORTHEAST OF OPERATING MACHINERY. GEAR 'C5' IS AT LOWER LEFT AND EMERGENCY BRAKE MECHANISM ON PEDESTAL AT CENTER. NOTE LOWER EQUALIZING LINKAGE FOR COUNTERWEIGHT AT LEFT CENTER OF PHOTOGRAPH - THIS WAS A KEY COMPONENT OF STRAUSS' PATENT PARALLOGRAM LINKAGE - Tomlinson Bridge, Spanning Quinnipiac River at Forbes Street (U.S. Route 1), New Haven, New Haven County, CT

Visions of Students Today: A Message from the Editors

ERIC Educational Resources Information Center

Wentzell, G. W.; Richlin, L.; Cox. M. D.

2012-01-01

In Michael Wesch's (2007) now widely seen video "A Vision of Students Today" (http://www.youtube.com/watch?v=dGCJ46vyR9o), a camera pans across a large, traditional classroom where college students hold up messages about themselves as members of the current generation of learners, who have been dubbed Millennials (Howe & Strauss, 2000). The video…

Estimating the Effects of Radio Frequency Identification (RFID) Tagging Technologies on the Army’s War-Time Logistics Network

DTIC Science & Technology

2004-07-01

five qualitative methods , each a potential candidate for conducting this study . Of the five methods listed, the grounded theory method fit this study ...Strauss and Corbin define the grounded theory approach as a qualitative research method that uses a systematic set of procedures to develop and... research question may also be used” (Leedy and Ormrod, 2001). The primary research method

Analytical Tools for the Application of Operational Culture: A Case Study in the Trans-Sahel

DTIC Science & Technology

2011-03-28

Study Team Working Paper 3: Research Methods Discussion for the Study Team Methods229 Generating Empirical Materials In grounded theory ... research I have conducted using these methods . UNCLASSIFIED Analytical Tools for the Application of Operational Culture: A Case Study in the...Survey and a Case Study ,‖ Kjeller, Norway: FFI Glaser, B. G. & Strauss, A. L. (1967). ―The discovery of grounded theory

Pulmonary eosinophilia.

PubMed

Campos, Luiz Eduardo Mendes; Pereira, Luiz Fernando Ferreira

2009-06-01

Pulmonary eosinophilia comprises a heterogeneous group of diseases defined by eosinophilia in pulmonary infiltrates (bronchoalveolar lavage fluid) or in tissue (lung biopsy specimens). Although the inflammatory infiltrate is composed of macrophages, lymphocytes, neutrophils and eosinophils, eosinophilia is an important marker for the diagnosis and treatment. Clinical and radiological presentations can include simple pulmonary eosinophilia, chronic eosinophilic pneumonia, acute eosinophilic pneumonia, allergic bronchopulmonary aspergillosis and pulmonary eosinophilia associated with a systemic disease, such as in Churg-Strauss syndrome and hypereosinophilic syndrome. Asthma is frequently concomitant and can be a prerequisite, as in allergic bronchopulmonary aspergillosis and Churg-Strauss syndrome. In diseases with systemic involvement, the skin, the heart and the nervous system are the most affected organs. The radiological presentation can be typical, or at least suggestive, of one of three types of pulmonary eosinophilia: chronic eosinophilic pneumonia, acute eosinophilic pneumonia and allergic bronchopulmonary aspergillosis. The etiology of pulmonary eosinophilia can be either primary (idiopathic) or secondary, due to known causes, such as drugs, parasites, fungal infection, mycobacterial infection, irradiation and toxins. Pulmonary eosinophilia can be also associated with diffuse lung diseases, connective tissue diseases and neoplasia.

Mechanisms of Decreased Plasma Volume During Acute Psychological Stress and Postural Change in Humans

DTIC Science & Technology

1993-09-14

follicular phase of their menstrual cycle as defined as 1 to 11 days post menses . Experimental Protocol Each subject was screened by telephone to...studies exist regarding possible gender differences in plasma volume changes during acute psychological stress. Menstrual cycle effects on physiologic...the different phases of the menstrual cycle (Strauss, Schultheiss, & Cohen, 1983; Carroll , ’I\\lrner I Lee I & Stephenson, 1984). Conflicting

Obadiah Reid | NREL

Science.gov Websites

.; Boltalina, O. V.; Strauss, S. H.; Kopidakis, N.; Rumbles, G. Inter-Fullerene Electronic Coupling Controls .; Noel, N. K.; Reid, O. G.; Rumbles, G.; Kukura, P.; et al. Mechanism for Rapid Growth of Organic Organic Framework. J. Phys. Chem. Lett. 2016, 7, 3660-3665. Reid, O. G.; Yang, M.; Kopidakis, N.; Zhu, K

Department of the Navy Explosives Safety Site Approval Process Improvement Initiative

DTIC Science & Technology

2010-07-01

All applicable existing land-use restrictions, such as explosives safety quantity distance (ESQD) arcs, Hazards of Electromagnetic Radiation to... Ordnance ( HERO ) zones, air field safety zones, and munitions response program sites are noted in the ESAR.  PWO will have in place a written...N547) Naval Ordnance Safety and Security Activity Farragut Hall, 3817 Strauss Ave, Suite 108 Indian Head, MD 20640-5151 (301) 744-6059

The Recruitment and Retention of the 180A: The Special Forces Warrant Officer

DTIC Science & Technology

2015-03-01

that are gained through unique institutions associated with the vocation itself. The professional individual is an expert who performs a service that...Warrant Officer. Research Report 1851. U.S. Army Research Institute . Glaser, B., & Strauss, A. (1967). The discovery of grounded theory : Strategies...the Special Forces Regiment. The watrant officer’s institutional knowledge--developed over years of operational experience-is essential to the success

Key Effectiveness Indicators (KEI Report): American River College Five-Year Profile, 1997-2002.

ERIC Educational Resources Information Center

Barr, Jim; Higgins, Jim; Grill, Cathie

This document addresses the key effectiveness indicators for American River College between 1997-2002. The figures are presented in table and graph format and some figures shown present detailed enrollment numbers for fall, spring, and summer while in other figures terms are collapsed into one full academic year. Dramatic enrollment gains were…

Effect of Various Conditions on Accumulation of Oxytetracycline in Escherichia coli

PubMed Central

Izaki, Kazuo; Arima, Kei

1965-01-01

Izaki, Kazuo (University of Tokyo, Tokyo, Japan), and Kei Arima. Effect of various conditions on accumulation of oxytetracycline in Escherichia coli. J. Bacteriol. 89:1335–1339. 1965.—Accumulation of large amounts of oxytetracycline occurred in Escherichia coli when the cells were incubated with high concentrations of oxytetracycline (100 to 400 μg/ml) in nutrient broth or in a medium containing glucose, K2HPO4, and MgSO4. In the absence of glucose or MgSO4, the accumulation was very small. The optimal pH for accumulation was about 6.5. Manganous ion could replace Mg++ in promoting the accumulation, though with decreased effectiveness. Malate and succinate were effective promoters of accumulation as well as glucose. Accumulation was inhibited at low temperatures or in the presence of metabolic inhibitors such as 2,4-dinitrophenol or sodium azide. Images PMID:14293007

Pickett angles and Cremer-Pople coordinates as collective variables for the enhanced sampling of six-membered ring conformations

NASA Astrophysics Data System (ADS)

Sega, M.; Autieri, E.; Pederiva, F.

2011-01-01

Although completely equivalent for the description of puckered ring conformers, the two popular coordinates sets of Strauss-Pickett dihedral angles and Cremer-Pople spherical coordinates are shown to have contrasting features when employed as collective variables in free-energy calculations with accelerated sampling techniques. Results from a 100 ns molecular dynamics simulation at conformational equilibrium and from combined metadynamics/umbrella sampling calculations of glucose are exploited to elucidate these differences.

Chaplain Training at a Crossroads: What Lies Ahead?

DTIC Science & Technology

1998-04-01

challenges in their lives. Their skills will include computer literacy , an understanding of diversity, and a global mind-set. They will thrive in a...learned to be critical and skeptical, especially of the media. Since they grew up in an environment of broken families, diminished financial expectations...generation born 1984 and after. He calls this group the Millennial Generation.5 According to Strauss, the Millennials will have more collective esteem as

Report of the Defense Science Board Task Force on Trends and Implications of Climate Change on National and International Security

DTIC Science & Technology

2011-10-01

Propulsion Laboratory Dr. Diane Evans Jet Propulsion Laboratory CAPT Tim Gallaudet US Navy Task Force on Climate Change Mr. David Goldwyn State...Ashley Moran Strauss Center, University of Texas, Austin DOD’s (Minerva) Climate Change and African Political Stability Project CAPT Timothy ... Gallaudet Office of the Oceanographer of the Navy Navy’s Climate Change Task Force Dr. Sherri Goodman, Dr. Ralph Espach and Mr. Peter MacKenzie CNA

Sideways Force Produced During Disruptions

NASA Astrophysics Data System (ADS)

Strauss, H. R.; Paccagnella, R.; Breslau, J.; Jardin, S.; Sugiyama, L.

2012-10-01

We extend previous studies [1] of vertical displacement events (VDE) which can produce disruptions. The emphasis is on the non axisymmetric ``sideways'' wall force Fx. Simulations are performed using the M3D [2] code. A VDE expels magnetic flux through the resistive wall until the last closed flux surface has q < 3. At this point the plasma is unstable to an (m,n) = (2,1) mode. A theory of sideways force produced by this mode in the presence of a VDE is presented. The wall force depends strongly on γτw, where γ is the mode growth rate and τw is the wall resistive penetration time. The force Fx is largest when γτw is a constant of order unity, which depends on the initial conditions. For large values of γτw, the wall force asymptotes to a relatively smaller value, well below the critical value ITER is designed to withstand. The principle of disruption mitigation by massive gas injection is to cause a disruption with large γτw. [4pt] [1] H. R. Strauss, R. Paccagnella, and J. Breslau,Phys. Plasmas 17, 082505 (2010) [2] W. Park, E.V. Belova, G.Y. Fu, X. Tang, H.R. Strauss, L.E. Sugiyama, Phys. Plasmas 6, 1796 (1999).

[Artificial Intelligence in Drug Discovery].

PubMed

Fujiwara, Takeshi; Kamada, Mayumi; Okuno, Yasushi

2018-04-01

According to the increase of data generated from analytical instruments, application of artificial intelligence(AI)technology in medical field is indispensable. In particular, practical application of AI technology is strongly required in "genomic medicine" and "genomic drug discovery" that conduct medical practice and novel drug development based on individual genomic information. In our laboratory, we have been developing a database to integrate genome data and clinical information obtained by clinical genome analysis and a computational support system for clinical interpretation of variants using AI. In addition, with the aim of creating new therapeutic targets in genomic drug discovery, we have been also working on the development of a binding affinity prediction system for mutated proteins and drugs by molecular dynamics simulation using supercomputer "Kei". We also have tackled for problems in a drug virtual screening. Our developed AI technology has successfully generated virtual compound library, and deep learning method has enabled us to predict interaction between compound and target protein.

Bridged Heterocyclium Di-Cationic closo-Icosahedral Perfluoroborane, Borane, and Carborane Salts via Aqueous, Open-Air Benchtop Synthesis (Preprint)

DTIC Science & Technology

2010-03-11

AFB CA 93524-7680 AFRL-RZ-ED-JA-2010-090 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) Air...Force Research Laboratory (AFMC) AFRL/RZS 11. SPONSOR/MONITOR’S 5 Pollux Drive NUMBER(S) Edwards AFB CA 93524-7048 AFRL-RZ-ED-JA-2010...Strauss § Air Force Research Laboratory, Propellants Branch (AFRL/RZSP), 10 East Saturn Blvd., Edwards AFB, CA 93524-7680, Department of Chemistry and

JPRS Report, West Europe.

DTIC Science & Technology

1988-06-21

ITALY PCI’s Napolitano Denies Rapprochement With CPSU 14 NORWAY Kristiansen Expains Reason for Leaving Storting 17 Dissatisfied With Party Policies...Strauss has now also cited. In July of last year , the finance experts along the Leine [river] declared that the federalist welfare and subsidy state...supple- mentary grants. The debate was conducted in a luke- warm manner, and Albrecht did not mind. At the turn of the year 1988, he began his

Computation of inverse magnetic cascades

NASA Technical Reports Server (NTRS)

Montgomery, D.

1981-01-01

Inverse cascades of magnetic quantities for turbulent incompressible magnetohydrodynamics are reviewed, for two and three dimensions. The theory is extended to the Strauss equations, a description intermediate between two and three dimensions appropriate to Tokamak magnetofluids. Consideration of the absolute equilibrium Gibbs ensemble for the system leads to a prediction of an inverse cascade of magnetic helicity, which may manifest itself as a major disruption. An agenda for computational investigation of this conjecture is proposed.

Evaluation of NF-B Signaling in T Cells

DTIC Science & Technology

2009-01-01

of cancer cells, ranging from myelomas (46) to breast cancer (47) to esophageal cancer (48), to name a few. NF-κB activation is also implicated in...Sonenshein. 1997. Aberrant nuclear factor-kappaB/Rel expression and the pathogenesis of breast cancer . J Clin Invest 100:2952-2960. 48. Abdel-Latif, M... Cancer Res 3:345-353. 43. Hinz, M., D. Krappmann, A. Eichten, A. Heder, C. Scheidereit, and M. Strauss. 1999. NF-kappaB function in growth control

Assessments and Viewpoints on the Biological and Human Health Effects of Extremely Low Frequency (ELF) Electromagnetic Fields. Compilation of Commissioned Papers for the ELF Literature Review Project.

DTIC Science & Technology

1985-05-01

Environ. Biophys. 20:53-65. 1983. Electric field effects on bacteria and yeast cells . Radiat. Environ. Biophys. 22 :149-162. Husing, J. 0., F. Strauss, and...Jr., Ph.D. 141 A Review of Cell Effects Induced by Exposure of Extremely Low 155 Frequency Electromagnetic Fields - Eugene M. Goodman, Ph.D. and Ben...and E. M. Goodman. 1983. Cell surface effects of 60 Hz electromagnetic fields. Radiat. Res. 94:217-220. artucci, G. I., P. C. Gailey, and R. A. Tell

The German Debate Over Military Peacekeeping Missions: The First Step Toward an Eventual Combat Role

DTIC Science & Technology

1993-12-01

3Clay Clemens , "Opportunity or Obligation? Redefining Germany’s Military Role Outside of NATO," in Armed Forces and Soci&L, vol. 19, No. 2, Winter 1993, p...ranged from 79 fuchs NBC detection vehi-les, an excess of 315,000 rounds of tank and artillery ammunition, 2,000 radio sets, 600 shower-bath vehicles...Tale," p. 96. ’ 59Ibid., p. 92. The three activists were Franz Josef Strauss (CSU) from 1956 to 1962, Helmut Schmidt (SPD) from 1969 to 1972 and Manfred

Causality and complexity: the myth of objectivity in science.

PubMed

Mikulecky, Donald C

2007-10-01

Two distinctly different worldviews dominate today's thinking in science and in the world of ideas outside of science. Using the approach advocated by Robert M. Hutchins, it is possible to see a pattern of interaction between ideas in science and in other spheres such as philosophy, religion, and politics. Instead of compartmentalizing these intellectual activities, it is worthwhile to look for common threads of mutual influence. Robert Rosen has created an approach to scientific epistemology that might seem radical to some. However, it has characteristics that resemble ideas in other fields, in particular in the writings of George Lakoff, Leo Strauss, and George Soros. Historically, the atmosphere at the University of Chicago during Hutchins' presidency gave rise to Rashevsky's relational biology, which Rosen carried forward. Strauss was writing his political philosophy there at the same time. One idea is paramount in all this, and it is Lakoff who gives us the most insight into how the worldviews differ using this idea. The central difference has to do with causality, the fundamental concept that we use to build a worldview. Causal entailment has two distinct forms in Lakoff 's analysis: direct causality and complex causality. Rosen's writings on complexity create a picture of complex causality that is extremely useful in its detail, grounding in the ideas of Aristotle. Strauss asks for a return to the ancients to put philosophy back on track. Lakoff sees the weaknesses in Western philosophy in a similar way, and Rosen provides tools for dealing with the problem. This introduction to the relationships between the thinking of these authors is meant to stimulate further discourse on the role of complex causal entailment in all areas of thought, and how it brings them together in a holistic worldview. The worldview built on complex causality is clearly distinct from that built around simple, direct causality. One important difference is that the impoverished causal

Discriminant function analysis as tool for subsurface geologist

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chesser, K.

1987-05-01

Sedimentary structures such as cross-bedding control porosity, permeability, and other petrophysical properties in sandstone reservoirs. Understanding the distribution of such structures in the subsurface not only aids in the prediction of reservoir properties but also provides information about depositional environments. Discriminant function analysis (DFA) is a simple yet powerful method incorporating petrophysical data from wireline logs, core analyses, or other sources into groups that have been previously defined through direct observation of sedimentary structures in cores. Once data have been classified into meaningful groups, the geologist can predict the distribution of specific sedimentary structures or important reservoir properties in areasmore » where cores are unavailable. DFA is efficient. Given several variables, DFA will choose the best combination to discriminate among groups. The initial classification function can be computed from relatively few observations, and additional data may be included as necessary. Furthermore, DFA provides quantitative goodness-of-fit estimates for each observation. Such estimates can be used as mapping parameters or to assess risk in petroleum ventures. Petrophysical data from the Skinner sandstone of Strauss field in southeastern Kansas tested the ability of DFA to discriminate between cross-bedded and ripple-bedded sandstones. Petroleum production in Strauss field is largely restricted to the more permeable cross-bedded sandstones. DFA based on permeability correctly placed 80% of samples into cross-bedded or ripple-bedded groups. Addition of formation factor to the discriminant function increased correct classifications to 83% - a small but statistically significant gain.« less

Role of CDK4 in Breast Development and Cancer

DTIC Science & Technology

2008-04-01

Steward, A. H. Parr, M. D. Thomas, J. A. Henry, B. Angus , T. W. Lennard, C. H. Horne, Oncogene 11, 885 (1995). 12. J. Bartkova, J. Likas, M. Strauss...Cdk6 and Cdk2 in all four of the genotypes studied here. The results presented in Fig. 4A show that in both Cdk4(neo/neo):MMTV-wnt and in Cdk4(neo/neo...contrast, the levels of Cdk6 and Cdk2 were approximately equal in all four genotypes . These results suggest that neither Cdk6 nor Cdk2 compensate for

Reentry trajectories of a space glider, taking acceleration and heating constraints into account

NASA Astrophysics Data System (ADS)

Strauss, Adi

1988-03-01

Three-dimensional trajectories for aerodynamically controlled reentry of an unpowered Space Shuttle-type vehicle from equatorial orbit are investigated analytically, summarizing the results obtained in the author's thesis (Strauss, 1987). Computer programs constructed on the basis of the governing equations of Chern and Yang (1982) and Chern and Vinh (1980) in modified dimensionless Chapman variables are used to optimize the roll angle and lift coefficient of the trajectories. Typical results are presented in graphs and maps and shown to be in good agreement with AVION SPATIAL predictions for the ESA Hermes spacecraft.

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) presenting as diffuse myositis.

PubMed

Parent, Marc-Etienne; Larue, Sandrine; Ellezam, Benjamin

2014-11-21

Eosinophilic granulomatosis with polyangiitis is a complex multisystemic syndrome with heterogeneous presentation. Most often, there is a clinical history of asthma or other atopic conditions, and current presentation generally includes signs of cutaneous or pulmonary involvement. Very few reports described myalgia or weakness as the chief complaint. Of these, only a few included muscle biopsy evaluation and none showed convincing evidence of primary myositis. We believe this report is the first to demonstrate true myositis in the setting of early eosinophilic granulomatosis with polyangiitis. This report describes a 74 year old Caucasian man, with no known allergies, presenting severe myalgia, muscle weakness, jaw claudication, and fever. Blood work showed marked eosinophilia and high creatine kinase levels. Biceps brachialis muscle biopsy revealed eosinophilic necrotizing vasculitis and true myositis with myophagocytosis of non-necrotic fibers and strong sarcolemmal MHC-1 overexpression by immunohistochemistry. This patient was successfully treated with prednisone and azathioprine. Our finding of true myositis in a case of eosinophilic granulomatosis with polyangiitis suggests that primary auto-immunity against muscle fibers, distinct from the secondary effects of vasculitis, can occur in this entity and may represent an overlap syndrome. Early recognition of eosinophilic granulomatosis with polyangiitis in patients presenting with myositis may provide an opportunity to treat the vasculitis before onset of severe multisystemic disease. We recommend the use of muscle biopsy with immunohistochemistry for MHC-1 to confirm the diagnosis of myositis in the setting of eosinophilic granulomatosis with polyangiitis.

Pulmonary vasculature and critical asthma syndromes: a comprehensive review.

PubMed

Avdalovic, Mark

2015-02-01

One of the important factors and consequences in persistent asthma is the change in the vasculature of the airways and lung parenchyma. These changes could contribute to worsening asthma control and predispose asthmatics to critical asthma syndromes. For many years, the contribution of vasculature to severe asthma was limited to discussion of small and medium vessel vasculitis commonly referred to as Churg-Strauss syndrome. This comprehensive review will explore the known mechanisms that are associated with remodeling of the vasculature in a variety of critical asthma presentations. Inflammation of pulmonary and bronchial small blood vessels may contribute significantly but silently to asthma pathobiology. Inflammation in the vasculature of the lung parenchyma can decrease lung capacity while inflammation in airway vasculature can decrease airflow. This review will provide a modern perspective on Churg-Strauss syndromes with a focus on phenotyping, mechanism, and ultimately modern therapeutic approaches. Vascular remodeling and airway remodeling are not mutually exclusive concepts in understanding the progression of asthma and frequency of acute exacerbations. Furthermore, the contribution of vascular leak, particularly in the parenchymal vasculature, has become an increasingly recognized component of certain presentations of poorly controlled, severe persistent asthmatic and during exacerbations. We highlight how these mechanisms can contribute to some the severe presentations of influenza infection in patients with a history of asthma. The ultimate aim of this review is to summarize the current literature concerning vasculitis and the contribution of airway and parenchymal vascular remodeling to presentation of persistent asthma and its consequences during acute exacerbations and critical asthma syndromes.

[Symptomatic sinus dysfunction. A new use of electrophysiology].

PubMed

Graux, P; Jacquemart, T; Carlioz, R; Lemaire, N; Dutoit, A; Croccel, L

1993-06-01

The authors undertook a prospective electrophysiological study of 950 patients: 53 subjects considered to be "controls" since they were free of any history of syncope or faintness were identified, as well as 39 symptomatic subjects with a strong suspicion of sinus dysfunction, since no other detectable cause of fainting episodes was found by extracardiac investigation, 24 hour ECG nor electrophysiology. Following the creation of a computerised tool enabling not only the entry of indirect tests, processing, averaging of results, printing and memorization, but also assistance in interpretation, several electrophysiological parameters were used: heart rate and existence of sinus arrhythmia, Strauss tests with adjusted data or not, effective nodal refractory period, Guize, Narula and Mandel tests, and an atropine (0.03 mg/kg) test which was performed only in the symptomatic group. These tests were studied by single-variate and correlative analysis to define their normal ranges, their critical values and their dependence or independence. The performance of each test (i.e. its efficiency, and the specificity and sensitivity of each critical value) was measured. Tests found to be most useful (specificity and efficiency > 90%) were as follows: Mandel test = CSRT > or = 534 ms, Narula test = TECASA > or = 339 ms, heart rate < or = 55/min, type II, IIa and chaotic Strauss curve associated with a pathological Guize test. The combination of these tests in this algorithm resulted in an increase in sensitivity to 84%, at the price of a very moderate fall in specificity to 87%.(ABSTRACT TRUNCATED AT 250 WORDS)

The role of community mental health nurses caring for people with schizophrenia in Taiwan: a substantive grounded theory.

PubMed

Huang, Xuan-Yi; Yen, Wen-Jiuan; Liu, Shwu-Jiuan; Lin, Chouh-Jiuan

2008-03-01

The aim was to develop a practice theory that can be used to guide the direction of community nursing practice to help clients with schizophrenia and those who care for them. Substantive grounded theory was developed through use of grounded theory method of Strauss and Corbin. Two groups of participants in Taiwan were selected using theoretical sampling: one group consisted of community mental health nurses and the other group was clients with schizophrenia and those who cared for them. The number of participants in each group was determined by theoretical saturation. Semi-structured one-to-one in-depth interviews and unstructured non-participant observation were utilized for data collection. Data analysis involved three stages: open, axial and selective coding. During the process of coding and analysis, both inductive and deductive thinking were utilized and the constant comparative analysis process continued until data saturation occurred. To establish trustworthiness, the four criteria of credibility, transferability, dependability and confirmability were followed along with field trial, audit trial, member check and peer debriefing for reliability and validity. A substantive grounded theory, the role of community mental health nurses caring for people with schizophrenia in Taiwan, was developed through utilization of grounded theory method of Strauss and Corbin. In this paper, results and discussion focus on causal conditions, context, intervening conditions, consequences and phenomenon. The theory is the first to contribute knowledge about the field of mental health home visiting services in Taiwan to provide guidance for the delivery of quality care to assist people in the community with schizophrenia and their carers.

["Kaitai-Shinsho": a change of languages and concepts].

PubMed

Okada, Masanobu

2003-07-01

The translation of "Outleedkundige Tafelen (Dutch) [Anatomische Tabellen (German)]" to "Kaitai-Shinsho" by Gempaku Sugita and others was not the mere substitution of Dutch for Japanese. They responded to the writing according to the situation of the change to modern medicine from the medicine of ancient-medieval times based on Galen's teachings, by using the Japanese culture of those days in a form of "bricolage" (a term used by Claude Levi-Strauss), in combination with Western medicine, leading to its establishment as Japanese medicine. That is, their work was not a mere translation, but an innovation of Japanese medical language system.

The changing 'shape' of the nursing station.

PubMed

Wakefield, Ann

2002-10-01

The Nursing Station is a puzzling structure fulfilling a variety of roles throughout the day. At times, it resembles a communal market place with staff standing around chatting. Yet, once a shift commences, regulatory characteristics emerge to control a person's entry and exit from the ward, by ensuring that they have an authentic reason for being there. This paper juxtaposes the role of the Nursing Station with Strauss et al.'s (1964) notion of shape. In this way, is intended to examine in detail how the Nursing Station can influence the normal and natural flow of work within a ward.

The 3D distribution of cordierite and biotite in hornfels from the Bugaboo contact aureole (British Columbia, Canada)

NASA Astrophysics Data System (ADS)

Gaidies, Fred; Petley-Ragan, Arianne; Pattison, David

2016-04-01

The size, abundance, shape and spatial distribution of metamorphic minerals bears important information on the rates and mechanisms of fundamental processes that take place during metamorphic crystallization. X-ray computed tomography (XR-CT) has become the method of choice to study the three-dimensional (3D) disposition of minerals in rocks as it allows investigation of relatively large sample volumes at sufficiently high resolution required for statistically meaningful analyses, and as its non-destructive fashion permits further studies such as mineral chemical, isotopic or crystallographic analyses of select grains identified through XR-CT. We present results obtained through the quantification of the 3D disposition of cordierite and biotite crystals in a hornfels from the contact aureole of the Bugaboo Batholith (British Columbia, Canada) using XR-CT and global as well as scale-dependent pattern statistics (Petley-Ragan et al., 2016). The results demonstrate a random distribution of cordierite and biotite crystal sizes for all scales across the entire rock volume studied indicative of interface-controlled prograde metamorphic reaction kinetics. We show that the common approach to approximate the shape of crystals as spherical underestimates the influence of the Strauss hard-core process on rock texture which may be misinterpreted to reflect ordering of crystal sizes by inhibition of nucleation and growth commonly associated with diffusion-controlled reaction kinetics. According to our findings, Strauss hard-core ordering develops at length scales equal to and less than the average major axis of the crystal population. This is significantly larger than what is obtained if a spherical crystal geometry would be assumed, and increases with deviation from sphericity. For the cordierite and biotite populations investigated in this research, Strauss hard-core ordering developed at length scales of up to ˜2.2 and 1.25 mm, respectively, which is almost 1 mm longer than

Response of the Kuroshio Extension path state to near-term global warming in CMIP5 experiments with MIROC4h

NASA Astrophysics Data System (ADS)

Li, Rui; Jing, Zhao; Chen, Zhaohui; Wu, Lixin

2017-04-01

In this study, responses of the Kuroshio Extension (KE) path state to near-term (2006-2035) global warming are investigated using a Kuroshio-resolving atmosphere-ocean coupled model. Under the representative concentration pathway 4.5 (RCP4.5) forcing, the KE system is intensified and its path state tends to move northward and becomes more stable. It is suggested that the local anticyclonic wind stress anomalies in the KE region favor the spin-up of the southern recirculation gyre, and the remote effect induced by the anticyclonic wind stress anomalies over the central and eastern midlatitude North Pacific also contributes to the stabilization of the KE system substantially. The dominant role of wind stress forcing on KE variability under near-term global warming is further confirmed by adopting a linear 1.5 layer reduced-gravity model forced by wind stress curl field from the present climate model. It is also found that the main contributing longitudinal band for KE index (KEI) moves westward in response to the warmed climate. This results from the northwestward expansion of the large-scale sea level pressure (SLP) field.

Promoter for Sindbis virus RNA-dependent subgenomic RNA transcription.

PubMed

Levis, R; Schlesinger, S; Huang, H V

1990-04-01

Sindbis virus is a positive-strand RNA enveloped virus, a member of the Alphavirus genus of the Togaviridae family. Two species of mRNA are synthesized in cells infected with Sindbis virus; one, the 49S RNA, is the genomic RNA; the other, the 26S RNA, is a subgenomic RNA that is identical in sequence to the 3' one-third of the genomic RNA. Ou et al. (J.-H. Ou, C. M. Rice, L. Dalgarno, E. G. Strauss, and J. H. Strauss, Proc. Natl. Acad. Sci. USA 79:5235-5239, 1982) identified a highly conserved region 19 nucleotides upstream and 2 nucleotides downstream from the start of the 26S RNA and proposed that in the negative-strand template, these nucleotides compose the promoter for directing the synthesis of the subgenomic RNA. Defective interfering (DI) RNAs of Sindbis virus were used to test this proposal. A 227-nucleotide sequence encompassing 98 nucleotides upstream and 117 nucleotides downstream from the start site of the Sindbis virus subgenomic RNA was inserted into a DI genome. The DI RNA containing the insert was replicated and packaged in the presence of helper virus, and cells infected with these DI particles produced a subgenomic RNA of the size and sequence expected if the promoter was functional. The initiating nucleotide was identical to that used for Sindbis virus subgenomic mRNA synthesis. Deletion analysis showed that the minimal region required to detect transcription of a subgenomic RNA from the negative-strand template of a DI RNA was 18 or 19 nucleotides upstream and 5 nucleotides downstream from the start of the subgenomic RNA.

Promoter for Sindbis virus RNA-dependent subgenomic RNA transcription.

PubMed Central

Levis, R; Schlesinger, S; Huang, H V

1990-01-01

Sindbis virus is a positive-strand RNA enveloped virus, a member of the Alphavirus genus of the Togaviridae family. Two species of mRNA are synthesized in cells infected with Sindbis virus; one, the 49S RNA, is the genomic RNA; the other, the 26S RNA, is a subgenomic RNA that is identical in sequence to the 3' one-third of the genomic RNA. Ou et al. (J.-H. Ou, C. M. Rice, L. Dalgarno, E. G. Strauss, and J. H. Strauss, Proc. Natl. Acad. Sci. USA 79:5235-5239, 1982) identified a highly conserved region 19 nucleotides upstream and 2 nucleotides downstream from the start of the 26S RNA and proposed that in the negative-strand template, these nucleotides compose the promoter for directing the synthesis of the subgenomic RNA. Defective interfering (DI) RNAs of Sindbis virus were used to test this proposal. A 227-nucleotide sequence encompassing 98 nucleotides upstream and 117 nucleotides downstream from the start site of the Sindbis virus subgenomic RNA was inserted into a DI genome. The DI RNA containing the insert was replicated and packaged in the presence of helper virus, and cells infected with these DI particles produced a subgenomic RNA of the size and sequence expected if the promoter was functional. The initiating nucleotide was identical to that used for Sindbis virus subgenomic mRNA synthesis. Deletion analysis showed that the minimal region required to detect transcription of a subgenomic RNA from the negative-strand template of a DI RNA was 18 or 19 nucleotides upstream and 5 nucleotides downstream from the start of the subgenomic RNA. Images PMID:2319651

Orbital stability of solitary waves for generalized Boussinesq equation with two nonlinear terms

NASA Astrophysics Data System (ADS)

Zhang, Weiguo; Li, Xiang; Li, Shaowei; Chen, Xu

2018-06-01

This paper investigates the orbital stability and instability of solitary waves for the generalized Boussinesq equation with two nonlinear terms. Firstly, according to the theory of Grillakis-Shatah-Strauss orbital stability, we present the general results to judge orbital stability of the solitary waves. Further, we deduce the explicit expression of discrimination d‧‧(c) to judge the stability of the two solitary waves, and give the stable wave speed interval. Moreover, we analyze the influence of the interaction between two nonlinear terms on the stable wave speed interval, and give the maximal stable range for the wave speed. Finally, some conclusions are given in this paper.

Editorial Commentary: Role of Synovial Biomarkers in Patient Outcomes After Knee Arthroscopy.

PubMed

Brand, Jefferson C

2016-03-01

Humans are notably poor at predicting event outcomes. In "Correlation of Synovial Fluid Biomarkers With Cartilage Pathology and Associated Outcomes in Knee Arthroscopy," Cuellar, Cuellar, Kirsch, and Strauss show that some synovial fluid biomarkers (20 were sampled for the investigation) may predict operative findings at the time of arthroscopy and patient-reported outcome measures at follow-up. Further research will clarify the role of synovial biomarkers in knee pathology and, hopefully, narrow the choices to one or two pertinent markers that can be used to improve our ability to predict outcomes from arthroscopic knee surgery. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Nonstructural proteins nsP3 and nsP4 of Ross River and O'Nyong-nyong viruses: sequence and comparison with those of other alphaviruses.

PubMed

Strauss, E G; Levinson, R; Rice, C M; Dalrymple, J; Strauss, J H

1988-05-01

We have sequenced the nsP3 and nsP4 region of two alphaviruses, Ross River virus and O'Nyong-nyong virus, in order to examine these viruses for the presence or absence of an opal termination codon present between nsP3 and nsP4 in many alphaviruses. We found that Ross River virus possesses an in-phase opal termination codon between nsP3 and nsP4, whereas in O'Nyong-nyong virus this termination codon is replaced by an arginine codon. Previous studies have shown that two other alphaviruses, Sindbis virus and Middelburg virus, possess an opal termination codon separating nsP3 and nsP4 [E.G. Strauss, C.M. Rice, and J.H. Strauss (1983), Proc. Natl. Acad. Sci. USA 80, 5271-5275], whereas Semliki Forest virus possesses an arginine codon in lieu of the opal codon [K. Takkinen (1986), Nucleic Acids Res. 14, 5667-5682]. Thus, of the five alphaviruses examined to date, three possess the opal codon and two do not. Production of nsP4 requires readthrough of the opal codon in those alphaviruses that possess this termination codon and the function of the termination codon may be to regulate the amount of nsP4 produced. It is an open question then as to whether alphaviruses with no termination codon use other mechanisms to regulate the activity of this gene. The nsP4s of these five alphaviruses are highly conserved, sharing 71-76% amino acid sequence similarity, and all five contain the Gly-Asp-Asp motif found in many RNA virus replicases. The nsP3s are somewhat less conserved, sharing 52-73% amino acid sequence similarity throughout most of the protein, but each possesses a nonconserved C-terminal domain of 134 to 246 amino acids of unknown function.

Generating or developing grounded theory: methods to understand health and illness.

PubMed

Woods, Phillip; Gapp, Rod; King, Michelle A

2016-06-01

Grounded theory is a qualitative research methodology that aims to explain social phenomena, e.g. why particular motivations or patterns of behaviour occur, at a conceptual level. Developed in the 1960s by Glaser and Strauss, the methodology has been reinterpreted by Strauss and Corbin in more recent times, resulting in different schools of thought. Differences arise from different philosophical perspectives concerning knowledge (epistemology) and the nature of reality (ontology), demanding that researchers make clear theoretical choices at the commencement of their research when choosing this methodology. Compared to other qualitative methods it has ability to achieve understanding of, rather than simply describing, a social phenomenon. Achieving understanding however, requires theoretical sampling to choose interviewees that can contribute most to the research and understanding of the phenomenon, and constant comparison of interviews to evaluate the same event or process in different settings or situations. Sampling continues until conceptual saturation is reached, i.e. when no new concepts emerge from the data. Data analysis focusses on categorising data (finding the main elements of what is occurring and why), and describing those categories in terms of properties (conceptual characteristics that define the category and give meaning) and dimensions (the variations within properties which produce specificity and range). Ultimately a core category which theoretically explains how all other categories are linked together is developed from the data. While achieving theoretical abstraction in the core category, it should be logical and capture all of the variation within the data. Theory development requires understanding of the methodology not just working through a set of procedures. This article provides a basic overview, set in the literature surrounding grounded theory, for those wanting to increase their understanding and quality of research output.

Investigating the purpose of trigonometry in the modern sciences

NASA Astrophysics Data System (ADS)

Hertel, Joshua T.

This dissertation reports the results of a qualitative research project that aimed to develop a research-based perspective on the purpose of trigonometry in the modern sciences. The investigation was guided by three objectives. First, the study sought to identify the purpose of trigonometry as described by educators and high school textbooks. Second, the research investigated the perspectives these sources held about definitions of the trigonometric functions. Third, the investigation examined the potential benefits and drawbacks of a line-segment definition of the trigonometric functions. The study followed a grounded theory methodology with data collection and analysis intertwined. Participants included faculty from two large Midwestern research universities, high school teachers, and authors of standards documents. Textbooks were drawn from introductory algebra, geometry, advanced algebra, precalculus, and calculus texts. Data collected included surveys, interviews, and textbook excerpts. Analysis used the constant comparative method (Corbin & Strauss, 2008; Glaser & Strauss, 2006/1967). Analysis resulted in the emergence of a grounded theory, the tensions of trigonometry, which described three interrelated themes within the data: definition, application, and role. Two ideas emerged that connected the tensions of trigonometry, the regions of interaction, which described the interplay between the three tensions, and the idealized dichotomy of trigonometry education, which outlined opposing perspectives on trigonometry: trigonometry for all and trigonometry for some. The grounded theory outlines a range of competing purposes for trigonometry in the modern sciences. It suggests that educators are engaged in a process of continual negotiation that results in the formation of a localized purpose of trigonometry. The benefits and drawbacks of different definitions are not based on mathematical sophistication, but are situational. Furthermore, the theory suggests that

The Individual and the Collective: Sociological Influences on Lacan's Concept of the Relation Subject-Other.

PubMed

Schrans, David

2018-01-01

In this conceptual analysis we discuss the sociological influences on Lacan's conceptualization of the relation between the subject and the other. In his writings predating World War II Lacan defines this relation in terms of identification. However, from 1953 onward he defines it in terms of the subject of speech and the Symbolic Other. It is a popular notion to characterize this change in terms of a radical breach, influenced by the reading of Lévi-Strauss. However, through a close reading of both Lacan's early writings and their Durkheimian influences we will demonstrate that what has changed, is Lacan's conceptualization of the relation between the individual and the collective. This change was gradual rather than sudden. Moreover, it can be situated within the theoretical evolution of the contiguous fields of sociology, anthropology and psychoanalysis. Thus we reject the idea of a breach within his own thought and with what came before him. We will establish our point through a summary of how the relation between the individual and the collective was theorized before Lacan. Durkheim conceptualized this relation as dual: the individual and the collective are radically separated. Mauss attempted to unify the field of anthropology through the holistic concept of the total man. In Lévi-Straus's formalization the individual becomes a function within a structured, Symbolic system. Finally, a reading of Lacan's publications concerning the notion of the logic of the collective will testify to his attempts at formulating a notion of the subject that asserts itself against this collective while at the same time retaining its nature of a logical function. This is the conundrum that Lacan will confront time and again throughout his teachings. Lévi-Strauss merely provided him with the methodological tools of structural anthropology that helped him refine the interrogations that he had already begun.

The Individual and the Collective: Sociological Influences on Lacan's Concept of the Relation Subject—Other

PubMed Central

Schrans, David

2018-01-01

In this conceptual analysis we discuss the sociological influences on Lacan's conceptualization of the relation between the subject and the other. In his writings predating World War II Lacan defines this relation in terms of identification. However, from 1953 onward he defines it in terms of the subject of speech and the Symbolic Other. It is a popular notion to characterize this change in terms of a radical breach, influenced by the reading of Lévi-Strauss. However, through a close reading of both Lacan's early writings and their Durkheimian influences we will demonstrate that what has changed, is Lacan's conceptualization of the relation between the individual and the collective. This change was gradual rather than sudden. Moreover, it can be situated within the theoretical evolution of the contiguous fields of sociology, anthropology and psychoanalysis. Thus we reject the idea of a breach within his own thought and with what came before him. We will establish our point through a summary of how the relation between the individual and the collective was theorized before Lacan. Durkheim conceptualized this relation as dual: the individual and the collective are radically separated. Mauss attempted to unify the field of anthropology through the holistic concept of the total man. In Lévi-Straus's formalization the individual becomes a function within a structured, Symbolic system. Finally, a reading of Lacan's publications concerning the notion of the logic of the collective will testify to his attempts at formulating a notion of the subject that asserts itself against this collective while at the same time retaining its nature of a logical function. This is the conundrum that Lacan will confront time and again throughout his teachings. Lévi-Strauss merely provided him with the methodological tools of structural anthropology that helped him refine the interrogations that he had already begun. PMID:29867625

Postponing Labor in Fisheries, Tourism and Agriculture Sectors: Rural Eastern Indonesian University Students in Java

NASA Astrophysics Data System (ADS)

Foertsch, Christopher

2017-10-01

This paper explores the migration of Eastern Indonesian university students who come to Java for education. Often from rural, economically disadvantaged regions such as the Kei Islands in Southeast Maluku, and Nusa Tenggara Timur (NTT), these young adults delay joining fisheries, agriculture, or tourism sectors. Instead, these relatively high-performing students travel to the “center of the country” seeking skills and experiences promised by higher education in Javanese urban centers. This qualitative, anthropological research complements other, more technical and economic approaches. Based on interview and observational data, a complicated portrait emerges of these bright young people from fishing and farming communities in Maluku and NTT. Many idealistically plan to return to their home communities, hoping to improve local fishing and farming methods or to work as teachers, civil servants, or tour guides. Others do not intend to return home, where they think jobs are scarce and traditional livelihoods unattractive. Analysis of this generation’s perspective has critical implications for educators and policymakers wishing to prevent a “brain drain” of their educated native sons and daughters, whose experience and skills could contribute importantly to the various socio-economic demands present in island regions, including fisheries and agriculture, conservation, tourism, and employment.

Macro- and meso-fabric structures of peritidal tufa stromatolites along the Eastern Cape coast of South Africa

NASA Astrophysics Data System (ADS)

Edwards, Mark Joseph Kalahari; Anderson, Callum Robert; Perissinotto, Renzo; Rishworth, Gavin Midgley

2017-08-01

Stromatolites are rare in modern ecosystems due to factors associated with seawater chemistry or biological competition that restrict their formation. Actively calcifying stromatolites, near the Kei Mouth in the Eastern Cape, South Africa, were discovered in the early 2000s. Similar deposits were later described along a 200 km stretch on the south coast of Port Elizabeth. This study aims to describe the environmental setting, the macro- and meso-structures, as well as the evolution of the deposits near Port Elizabeth compared to other similar formations. Results show that the general environmental setting is consistent amongst peritidal stromatolites, including those described in this study. In all instances stromatolite growth occurs on a wave-cut rocky platform in and around rock pools. Growth is maximal within the intertidal to supratidal zone, as a result of freshwater inflow via emerging mineral springs at the base of landward slopes, and the periodic intrusion of seawater via storm surges or wave splash. In comparison with other systems, the South African stromatolite formations exhibit an additional macro-structure (beachrock/conglomerate) and four previously undescribed meso-structures: wrinkled laminar, laminar flat, rhizoliths, and blistered types. The South African stromatolites are also larger and more concentrated than other peritidal stromatolites, which could be due to this area having more suitable growth conditions.

Photonics and web engineering in Poland, WILGA 2009

NASA Astrophysics Data System (ADS)

Romaniuk, Ryszard S.

2009-06-01

The paper is a digest of work presented during a cyclic Ph.D. student symposium on Photonics and Web Engineering WILGA 2009. Symposium is organized by ISE PW in cooperation with professional organizations IEEE, SPIE, PSP and KEiT PAN. There are presented mainly Ph.D. and M.Sc. theses as well as achievements of young researchers. These papers, presented in such a big number, more than 250 in some years, are in certain sense a good digest of the condition of academic research capabilities in this branch of science and technology. The undertaken research subjects for Ph.D. theses in electronics is determined by the interest and research capacity (financial, laboratory and intellectual) of the young researchers and their tutors. Basically, the condition of academic electronics research depends on financing coming from applications areas. During Wilga 2009 there were organized, and thus the paper debates, the following topical sessions concerning applications of advanced electronics and photonics systems: merging of electronic systems and photonics, Internet engineering, distributed measurement systems, security in information technology, astronomy and cosmic technology, HEP experiments, environment protection, image processing and biometry. The paper contains also more general remarks concerning the workshops organized by and for the Ph.D. students in advanced photonics and electronics systems.

Effects of compositional modifications on the sensitization behavior of FeCrMn steels

NASA Astrophysics Data System (ADS)

Edgemon, G. L.; Tortorelli, P. F.; Bell, G. E. C.

1992-09-01

FeCrMn may possibly be used in conjunction with aqueous blankets or cooants in a fusion device. Therefore, standard chemical immersion (modified Strauss) tests were conducted to characterize the effects of compositional modifications on the thermal sensitization behavior of these steels. A good correlation among weight losses, intergranular corrosion, and cracking was found. The most effective means of decreasing their susceptibility was through reduction of the carbon concentration of these steels to 0.1%, but the sensitization resistance of FeCrMn0.1 C compositions was still inferior to type 304L and other similar stainless steels. Alloying additions that form stable carbides did not have a very significant influence on the sensitization behavior.

Overview: The Impact of Microbial Genomics on Food Safety

NASA Astrophysics Data System (ADS)

Milillo, Sara R.; Wiedmann, Martin; Hoelzer, Karin

The first use of the term "genome" is attributed to Hans Winkler in his 1920 publication Verbeitung und Ursache der Parthenogenesis im Pflanzen und Tierreiche (Winkler, 1920). However, it was not until 1986 that the study of genomic concepts coalesced with the creation of a new journal by the same name (McKusick, 1997). The study of genomics was initially defined as the use or the application of "informatic tools" to study features of a sequenced genome (Strauss and Falkow, 1997). Today the field of genomics is typically considered to encompass efforts to determine the nucleic acid DNA sequence of an organism as well as the expression of genetic information using high-throughput, genome-wide methods, including transcriptomic, proteomic, and metabolomic analyses.

Transforming vulnerability.

PubMed

Jones, Patricia S; Zhang, Xinwei Esther; Meleis, Afaf I

2003-11-01

Asian American immigrant women engaged in filial caregiving are at special risk for health problems due to complex contextual factors related to immigration, cultural traditions, and role transition. This study examines the experience of two groups of immigrant Asian American women who are caring for older parents. A total of 41 women (22 Chinese American and 19 Filipino American) were interviewed in a study based on Strauss and Corbin's grounded theory methodology. The women were determined to be loyal to their traditional culture, which included strong filial values, while adapting to a new culture. Through the struggle of meeting role expectations and coping with paradox, the women mobilized personal and family resources to transform vulnerability into strength and well-being.

[Influence of HIV related stigma on health care access].

PubMed

Bermúdez-Román, Viviana; Bran-Piedrahita, Lemy; Palacios-Moya, Lucía; Posada-Zapata, Isabel Cristina

2015-01-01

To notice the influence of the stigma surrounding HIV on the access to health services among the seropositive population of Medellín, Colombia, in 2012. A qualitative approach using Strauss' and Corbin's grounded theory. Data was collected through 13 interviews at two different moments.These interviews were transcribed and analyzed, and the data found in them was processed via axial and open coding. The myths surrounding HIV become a barrier preventing access to healthcare;this hinders timely treatment of the virus. Government policies must aim to reduce the effect that the historical discrimination against HIV has generated so that it can guarantee that infected individuals have early access to treatments for this condition as well as health promotion services.

Preliminary greenhouse design for a Martian colony: Structural, solar collection, and light distribution systems

NASA Technical Reports Server (NTRS)

1990-01-01

The design of a greenhouse that will be a component of a long-term habitat on Mars is presented. The greenhouse will be the primary food source for people stationed on Mars. The food will be grown in three identical underground modules, pressurized at 1 atm to allow a shirt-sleeve environment within the greenhouse. The underground location will support the structure, moderate the large environmental variations on the surface, and protect the crops from cosmic radiation. The design effort is concentrated on the outer structure and the lighting system for the greenhouse. The structure is inflatable and made of a Kevlar 49/Epoxy composite and a pipe-arched system that is corrugated to increase stiffness. This composite is pliable in an uncured state, which allows it to be efficiently packaged for transport. The lighting system consists of several flat-plate fiber optic solar collectors with dual-axis tracking systems that will continually track the sun. This design is modeled after the Himawari collector, which was designed by Dr. Kei Mori and is currently in use in Japan. The light will pass through Fresnel lenses that filter out undesirable wavelengths and send the light into the greenhouses by way of fiber optic cables. When the light arrives at the greenhouse, it is dispersed to the plants via a waveguide and diffuser system.

High prevalence of small Babesia species in canines of Kerala, South India.

PubMed

Jain, Kollannur Jose; Lakshmanan, Bindu; Syamala, Karunakaran; Praveena, Jose E; Aravindakshan, Thazhathuveetil

2017-11-01

Canine babesiosis is an important vector-borne hemoparasitic disease caused by Babesia canis vogeli and Babesia gibsoni , in India. The communication places on record the salient findings of the study directed to detect and characterize the pathogenic B. gibsoni isolates of Kerala state. A total of 150 dogs were examined for the presence of hemoparasites by light microscopy as well as by PCR targeting the 18S rRNA gene of B. gibsoni . Hematological parameters were also analysed. Phylogenetic tree was constructed based on Tamura kei model adopting ML method. A sensitive and specific polymerase chain reaction assay was developed with newly designed primer pair BAGI-F/BAGI-R for the amplification of 488 bp fragment of 18S rRNA gene of B. gibsoni . Out of the 150 dogs examined, molecular evidence of B. gibsoni was recorded in 47.3% animals, while light microscopy detected the infection in 26.67% cases. The phylogenetic analyses revealed that B. gibsoni , Kerala, isolate was closest and occurred together with Bareilly isolate. Anemia and thrombocytopenia were the significant hematological alterations in chronic B. gibsoni infection. A high prevalence of natural infection of B. gibsoni was detected among the study population. The affected animals showed anaemia and thrombocytopenia. Phylogenetic analysis of this pathogenic isolate from south India revealed the closest similarity with Bareilly isolates.

High prevalence of small Babesia species in canines of Kerala, South India

PubMed Central

Jain, Kollannur Jose; Lakshmanan, Bindu; Syamala, Karunakaran; Praveena, Jose E; Aravindakshan, Thazhathuveetil

2017-01-01

Aim: Canine babesiosis is an important vector-borne hemoparasitic disease caused by Babesia canis vogeli and Babesia gibsoni, in India. The communication places on record the salient findings of the study directed to detect and characterize the pathogenic B. gibsoni isolates of Kerala state. Materials and Methods:: A total of 150 dogs were examined for the presence of hemoparasites by light microscopy as well as by PCR targeting the 18S rRNA gene of B. gibsoni. Hematological parameters were also analysed. Phylogenetic tree was constructed based on Tamura kei model adopting ML method. Results:: A sensitive and specific polymerase chain reaction assay was developed with newly designed primer pair BAGI-F/BAGI-R for the amplification of 488 bp fragment of 18S rRNA gene of B. gibsoni. Out of the 150 dogs examined, molecular evidence of B. gibsoni was recorded in 47.3% animals, while light microscopy detected the infection in 26.67% cases. The phylogenetic analyses revealed that B. gibsoni, Kerala, isolate was closest and occurred together with Bareilly isolate. Anemia and thrombocytopenia were the significant hematological alterations in chronic B. gibsoni infection. Conclusion:: A high prevalence of natural infection of B. gibsoni was detected among the study population. The affected animals showed anaemia and thrombocytopenia. Phylogenetic analysis of this pathogenic isolate from south India revealed the closest similarity with Bareilly isolates. PMID:29263592

Smooth Particle Hydrodynamics GPU-Acceleration Tool for Asteroid Fragmentation Simulation

NASA Astrophysics Data System (ADS)

Buruchenko, Sergey K.; Schäfer, Christoph M.; Maindl, Thomas I.

2017-10-01

The impact threat of near-Earth objects (NEOs) is a concern to the global community, as evidenced by the Chelyabinsk event (caused by a 17-m meteorite) in Russia on February 15, 2013 and a near miss by asteroid 2012 DA14 ( 30 m diameter), on the same day. The expected energy, from either a low-altitude air burst or direct impact, would have severe consequences, especially in populated regions. To mitigate this threat one of the methods is employment of large kinetic-energy impactors (KEIs). The simulation of asteroid target fragmentation is a challenging task which demands efficient and accurate numerical methods with large computational power. Modern graphics processing units (GPUs) lead to a major increase 10 times and more in the performance of the computation of astrophysical and high velocity impacts. The paper presents a new implementation of the numerical method smooth particle hydrodynamics (SPH) using NVIDIA-GPU and the first astrophysical and high velocity application of the new code. The code allows for a tremendous increase in speed of astrophysical simulations with SPH and self-gravity at low costs for new hardware. We have implemented the SPH equations to model gas, liquids and elastic, and plastic solid bodies and added a fragmentation model for brittle materials. Self-gravity may be optionally included in the simulations.

Aspergillus oryzae AoSO is a novel component of stress granules upon heat stress in filamentous fungi.

PubMed

Huang, Hsiang-Ting; Maruyama, Jun-ichi; Kitamoto, Katsuhiko

2013-01-01

Stress granules are a type of cytoplasmic messenger ribonucleoprotein (mRNP) granule formed in response to the inhibition of translation initiation, which typically occurs when cells are exposed to stress. Stress granules are conserved in eukaryotes; however, in filamentous fungi, including Aspergillus oryzae, stress granules have not yet been defined. For this reason, here we investigated the formation and localization of stress granules in A. oryzae cells exposed to various stresses using an EGFP fusion protein of AoPab1, a homolog of Saccharomyces cerevisiae Pab1p, as a stress granule marker. Localization analysis showed that AoPab1 was evenly distributed throughout the cytoplasm under normal growth conditions, and accumulated as cytoplasmic foci mainly at the hyphal tip in response to stress. AoSO, a homolog of Neurospora crassa SO, which is necessary for hyphal fusion, colocalized with stress granules in cells exposed to heat stress. The formation of cytoplasmic foci of AoSO was blocked by treatment with cycloheximide, a known inhibitor of stress granule formation. Deletion of the Aoso gene had effects on the formation and localization of stress granules in response to heat stress. Our results suggest that AoSO is a novel component of stress granules specific to filamentous fungi. The authors would specially like to thank Hiroyuki Nakano and Kei Saeki for generously providing experimental and insightful opinions.

[Acute myocardial infarction as Eosinophilic granulomatosis with polyangiitis (formerly Churg Strauss syndrome) initial presentation].

PubMed

Sulaiman, Wahinuddin; Seung, Ong Ping; Noor, Sabariah Mohd

2014-01-01

Eosinophilic granulomatosis with polyangiitis is a rare primary vasculitic disease characterized by hypereosinophilia, late onset asthma and extravascular eosinophil granulomas. We report a case presented initially with acute myocardial infarction which later only proceed with asthma, skin manifestations and peripheral neuropathy. Laboratory parameters showed hypereosinohpilia with negative perinuclear pattern of antineutrophil cytoplasmic autoantibodies (p-ANCA). Skin biopsy showed leucocytoclastic vasculitis with eosinophilic infiltration while coronary angiography was normal. The patient's symptoms improved with IV methylprednisolone, pulse cyclophosphamide and azathioprine. Copyright © 2014 Elsevier Editora Ltda. All rights reserved.

Israeli children's reactions to the assassination of the Prime Minister.

PubMed

Klingman, A

2001-01-01

The assassination of Israel's Prime Minister Yitzhak Rabin by a political opponent caused disbelief, shock, anxiety, and deep grief in the Israeli society. This study reports on 229 4th-grade children's responses to the traumatic event 2 days after it occurred. In the present study, a semi-projective measure, the Bar-Ilan Picture Test for Children (R. Itskovitz & H. Strauss, 1982, 1986), was adapted to the situation to assess their affective reactions, social support resources, and coping on the second day after the murder. Overall, the results reveal that their reactions reflect the general adult population affective response to the assassination and resemble the responses of children found in epidemiological studies following trauma and disaster. The role played by the school as social support system is also discussed.

Cultural narratives and the succession scenario: Slumdog Millionaire and other popular films and fictions.

PubMed

Paul, Robert A

2011-04-01

An approach to the analysis of cultural narratives is proposed drawing inspiration from Lévi-Strauss's analysis of myths as fantasied resolutions of conflicts and contradictions in culture and of typical dilemmas of human life. An example of such an analysis revolves around contradictions in the Western cultural construction of the succession of generations. The logic of the structural analysis of cultural representations is explicated, the schema of the succession scenario is laid out, and the conflicts that generate it are identified. The movie Slumdog Millionaire is examined in some detail as an illustration of the succession scenario at work, and a comparative analysis shows how the same underlying schema accounts for otherwise obscure aspects of comparable contemporary popular narratives including Harry Potter, The Lion King and Star Wars. Copyright © 2011 Institute of Psychoanalysis.

Kei hea te Ora? The Whereabouts of the Health of Children in the Early Childhood Curriculum of Aotearoa New Zealand

ERIC Educational Resources Information Center

Gibbons, Andrew

2015-01-01

The policies and practices of early childhood teaching in Aotearoa New Zealand have been an ongoing site of political, economic, social and cultural contestation. Competing values and beliefs regarding experiences of both the child and the teacher have been central to the contesting. Helen May (2001, 2009) tracks these tensions through the waxing…

Rituximab in the treatment of refractory or relapsing eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome).

PubMed

Thiel, Jens; Hässler, Fabian; Salzer, Ulrich; Voll, Reinhard E; Venhoff, Nils

2013-09-24

Eosinophilic granulomatosis with polyangiitis (EGPA) is part of antineutrophil cytoplasmic antibodies (ANCAs)-associated vasculitides. In EGPA small-vessel vasculitis is associated with eosinophilia and asthma. About 40% of EGPA patients are ANCA-positive, suggesting a role for B cells in the pathogenesis of EGPA. B cell-depleting therapy with rituximab (RTX) can be effective in ANCA-positive EGPA, but very few patients have been published to date. The role of RTX in the treatment of ANCA-negative EGPA is unclear. We report a single-center cohort of patients with eosinophilic granulomatosis with polyangiitis. Of these patients, nine (six ANCA-positive, three ANCA-negative) had been treated with RTX for relapsing or refractory disease on standard immunosuppressive treatment. In a retrospective analysis, data on treatment response, frequency of relapses, adverse events, and peripheral B-cell reconstitution were evaluated. Furthermore, serum immunoglobulin concentrations, ANCA status, and peripheral B cell subpopulations were assessed after RTX treatment. All patients had high disease activity before RTX treatment. At presentation 3 months after RTX therapy, all ANCA-positive and ANCA-negative patients had responded to RTX, with one patient being in complete remission, and eight patients being in partial remission. After a mean follow-up of 9 months, C-reactive protein concentrations had normalized, eosinophils had significantly decreased, and prednisone had been tapered in all patients. In all patients, RTX therapy was combined with a standard immunosuppressive therapy. Within the 9-month observation period, no relapse was recorded. Three patients were preemptively retreated with RTX, and during the median follow-up time of 3 years, no relapse occurred in these patients. During the follow-up of 13 patient-years, five minor but no major infections were recorded. In our analysis on nine patients with EGPA resistant to standard therapy, rituximab proved to be an efficient and safe treatment for ANCA-positive and ANCA-negative patients. Preemptive retreatment with RTX, combined with standard maintenance immunosuppressants, resulted in a sustained treatment response. Prospective, randomized trials evaluating the use of RTX in EGPA are warranted.

Opera in the Foreign Language Classroom: Learning German with Mozart, Wagner, Weber, and Johann Strauss

ERIC Educational Resources Information Center

Heinz, Solveig M.

2010-01-01

Content-based instruction (CBI) has been part of the foreign language curriculum for many years at US colleges, leading to courses that combine language instruction with specific content domains, such as film, literature, politics, sports and many others. This article presents a rather unusual choice of content domain for a second-year language…

'They have to show that they can make it': vitality as a criterion for the prognosis of premature infants.

PubMed

Brinchmann, B S

2000-03-01

In this article, the vitality of premature infants will be described and discussed. Vitality was one of the main factors in a grounded theory study in which the aim was to generate knowledge concerning the ethical decision-making processes with which nurses and physicians are faced in a neonatal unit. Which assessments underlie decisions about whether to start, continue or stop medical treatment of very sick premature babies? A descriptive study design, including 120 hours of field observations and 22 qualitative in-depth interviews with doctors and nurses, was chosen. Strauss and Glaser's comparative method was used to analyse the field observations and interviews. The findings indicate that life-and-death decisions are somewhat ambivalent; experience does not always make them easier. In situations of ambiguity, decisions also seem to be based upon the vitality of the babies concerned.

[Introduction to grounded theory].

PubMed

Wang, Shou-Yu; Windsor, Carol; Yates, Patsy

2012-02-01

Grounded theory, first developed by Glaser and Strauss in the 1960s, was introduced into nursing education as a distinct research methodology in the 1970s. The theory is grounded in a critique of the dominant contemporary approach to social inquiry, which imposed "enduring" theoretical propositions onto study data. Rather than starting from a set theoretical framework, grounded theory relies on researchers distinguishing meaningful constructs from generated data and then identifying an appropriate theory. Grounded theory is thus particularly useful in investigating complex issues and behaviours not previously addressed and concepts and relationships in particular populations or places that are still undeveloped or weakly connected. Grounded theory data analysis processes include open, axial and selective coding levels. The purpose of this article was to explore the grounded theory research process and provide an initial understanding of this methodology.

Vaccination learning experiences of nursing students: a grounded theory study.

PubMed

Ildarabadi, Eshagh; Karimi Moonaghi, Hossein; Heydari, Abbas; Taghipour, Ali; Abdollahimohammad, Abdolghani

2015-01-01

This study aimed to explore the experiences of nursing students being trained to perform vaccinations. The grounded theory method was applied to gather information through semi-structured interviews. The participants included 14 undergraduate nursing students in their fifth and eighth semesters of study in a nursing school in Iran. The information was analyzed according to Strauss and Corbin's method of grounded theory. A core category of experiential learning was identified, and the following eight subcategories were extracted: students' enthusiasm, vaccination sensitivity, stress, proper educational environment, absence of prerequisites, students' responsibility for learning, providing services, and learning outcomes. The vaccination training of nursing students was found to be in an acceptable state. However, some barriers to effective learning were identified. As such, the results of this study may provide empirical support for attempts to reform vaccination education by removing these barriers.

What it takes to get proactive: An integrative multilevel model of the antecedents of personal initiative.

PubMed

Hong, Ying; Liao, Hui; Raub, Steffen; Han, Joo Hun

2016-05-01

Building upon and extending Parker, Bindl, and Strauss's (2010) theory of proactive motivation, we develop an integrated, multilevel model to examine how contextual factors shape employees' proactive motivational states and, through these proactive motivational states, influence their personal initiative behavior. Using data from a sample of hotels collected from 3 sources and over 2 time periods, we show that establishment-level initiative-enhancing human resource management (HRM) systems were positively related to departmental initiative climate, which was positively related to employee personal initiative through employee role-breadth self-efficacy. Further, department-level empowering leadership was positively related to initiative climate only when initiative-enhancing HRM systems were low. These findings offer interesting implications for research on personal initiative and for the management of employee proactivity in organizations. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

[Vitality as a criterion of the prognosis in the treatment of premature children?].

PubMed

Brinchmann, B S

1999-08-30

The aim of this study was to generate knowledge about the ethical decision-making processes nurses and physicians are faced with in a neonatal unit. What are the ethical assessments underlying decisions about whether to start, continue or stop medical treatment of very sick premature babies? The theoretical framework was deontological ethics, utilitarianism, Aristotelian virtue ethics theory and an ethics of proximity. A descriptive study design with 120 hours of field observations and 22 qualitative in-depth interviews was chosen. Strauss & Glaser's comparative method, grounded theory, was used to analyze the field observations and interviews. The findings seem to indicate that ethical decisions are somewhat ambivalent. Experience does not always make these decisions easier. There are indications that nurses and physicians use elements from all the different ethical positions. In situations of ambiguity, decisions are also based upon the vitality of the babies.

Iranian undergraduate nursing student perceptions of informal learning: A qualitative research.

PubMed

Seylani, Khatereh; Negarandeh, Reza; Mohammadi, Easa

2012-11-01

Nursing education is both formal and informal. Formal education represents only a small part of all the learning involved; and many students learn more effectively through informal processes. There is little information about nursing student informal education and how it affects their character and practice. This qualitative study explores undergraduate nursing student perceptions of informal learning during nursing studies. Data were gathered through semi-structured interviews with a sample of undergraduate nursing students (n = 14). Strauss and Corbin's constant comparison analysis approach was used for data analysis. The categories that emerged included personal maturity and emotional development, social development, closeness to God, alterations in value systems, and ethical and professional commitment. Findings reveal that nursing education could take advantage of informal learning opportunities to develop students' nontechnical skills and produce more competent students. Implications for nursing education are discussed.

Catastrophe modelling in the biological sciences.

PubMed

Deakin, M A

1990-03-01

Catastrophe Theory was developed in an attempt to provide a form of Mathematics particularly apt for applications in the biological sciences. It was claimed that while it could be applied in the more conventional "physical" way, it could also be applied in a new "metaphysical" way, derived from the Structuralism of Saussure in Linguistics and Lévi-Strauss in Anthropology. Since those early beginnings there have been many attempts to apply Catastrophe Theory to Biology, but these hopes cannot be said to have been fully realised. This paper will document and classify the work that has been done. It will be argued that, like other applied Mathematics, applied Catastrophe Theory works best where the underlying laws are securely known and precisely quantified, requiring those same guarantees as does any other branch of Mathematics when it confronts a real-life situation.

Safety of the Japanese K-car in a real-world low-severity frontal collision.

PubMed

Hitosugi, Masahito; Matsui, Yasuhiro

2015-01-01

Kei-cars (K-cars), which are a tiny 660 cc mini-car class 3.4 m long or less, 1.48 m wide or less, and 2.00 m high or less, have become popular in Japan. To evaluate the safety of K-car drivers in frontal collisions, we retrospectively compared the severity of injuries suffered by drivers between K-cars and standard vehicles involved in frontal collisions in which at least one injury occurred. From in-depth data provided by the Institute for Traffic Accident Research and Data Analysis from 1993 to 2010, records for 1379 drivers aged 36.8 ± 15.6 years were collected for analysis. Of the 1379 drivers, 1115 subjects were in standard vehicles and 264 were in K-cars. The mean delta V of the struck vehicle was 28.6 ± 15.6 km/h. After classifying the subjects according to seat belt use and air bag deployment, the background of the drivers and delta V, the injury severity scores (ISSs) and Abbreviated Injury Scale (AIS) scores were compared for all body regions. Under similar conditions, no significant differences in severity of injuries of the drivers were found between K-cars and standard vehicles. Although we are generally concerned that drivers of small vehicles suffer more severe injuries, our results suggest that, for real-world accidents, K-cars provide similar safety for drivers involved in frontal collisions as standard vehicles in low delta V impact conditions.

Continuous country-wide rainfall observation using a large network of commercial microwave links: Challenges, solutions and applications

NASA Astrophysics Data System (ADS)

Chwala, Christian; Boose, Yvonne; Smiatek, Gerhard; Kunstmann, Harald

2017-04-01

Commercial microwave link (CML) networks have proven to be a valuable source for rainfall information over the last years. However, up to now, analysis of CML data was always limited to certain snapshots of data for historic periods due to limited data access. With the real-time availability of CML data in Germany (Chwala et al. 2016) this situation has improved significantly. We are continuously acquiring and processing data from 3000 CMLs in Germany in near real-time with one minute temporal resolution. Currently the data acquisition system is extended to 10000 CMLs so that the whole of Germany is covered and a continuous country-wide rainfall product can be provided. In this contribution we will elaborate on the challenges and solutions regarding data acquisition, data management and robust processing. We will present the details of our data acquisition system that we run operationally at the network of the CML operator Ericsson Germany to solve the problem of limited data availability. Furthermore we will explain the implementation of our data base, its web-frontend for easy data access and present our data processing algorithms. Finally we will showcase an application of our data in hydrological modeling and its potential usage to improve radar QPE. Bibliography: Chwala, C., Keis, F., and Kunstmann, H.: Real-time data acquisition of commercial microwave link networks for hydrometeorological applications, Atmos. Meas. Tech., 9, 991-999, doi:10.5194/amt-9-991-2016, 2016

The sampling characteristics of electivity indices.

PubMed

Lechowicz, Martin J

1982-01-01

Electivity indices measure the utilization of food types (r) in relation to their abundance or availability in the environment (p). Foods that constitute a larger proportion of the diet than of the available foods are considered preferred; conversely those proportionately underrepresented in the diet are avoided. A food is eaten at random if its proportion in the diet equals its proportion in the environment. A family of electivity indices stemming from Ivlev's (1961) classic monograph exist and differ only in the particular algorithm used to calculate electivity from r and p.For each available index I graphed the values of electivity as contours for all combinations of r and p. These graphs are compared to illustrate the strengths and weaknesses of each index on the basis of the following criteria: 1) the value of the index when r=p for a food, 2) the symmetry of the electivity value as feeding deviates from random, 3) the possible range of index values, 4) the linearity of changes in electivity over the full range of r and p, 5) the sensitivity of the index to sampling errors, 6) the statistical testability of the electivity, and 7) the stability of the electivity value for a food type that changes relative abundance or occurs in combination with different food types. No one index ideally satisfies all the criteria.The host preferences of gypsy moth, Lymantria dispar, feeding on tree foliage in an undisturbed deciduous forest in southwestern Quebec, Canada were used to compare the available indices: Ivlev's electivity, E; Ivlev's forage ratio, E'; Jacob's modified electivity, D; Jacob's modified forage ratio, log Q; Chesson's alpha; Strauss' linear index, L; and Vanderploeg and Scavia's relativized electivity, E * . The electivity values calculated by each index differ one from another; host trees shown as preferred by one index will frequently appear avoided according to an alternative index. The rank order electivities for the 19 available host trees, however

Scientists' conceptions of scientific inquiry: Revealing a private side of science

NASA Astrophysics Data System (ADS)

Reiff, Rebecca R.

Science educators, philosophers, and pre-service teachers have contributed to conceptualizing inquiry but missing from the inquiry forum is an in-depth research study concerning science faculty conceptions of scientific inquiry. The science education literature has tended to focus on certain aspects of doing, teaching, and understanding scientific inquiry without linking these concepts. As a result, conceptions of scientific inquiry have been disjointed and are seemingly unrelated. Furthermore, confusion surrounding the meaning of inquiry has been identified as a reason teachers are not using inquiry in instruction (Welch et al., 1981). Part of the confusion surrounding scientific inquiry is it has been defined differently depending on the context (Colburn, 2000; Lederman, 1998; Shymansky & Yore, 1980; Wilson & Koran, 1976). This lack of a common conception of scientific inquiry is the reason for the timely nature of this research. The result of scientific journeys is not to arrive at a stopping point or the final destination, but to refuel with questions to drive the pursuit of knowledge. A three-member research team conducted Interviews with science faculty members using a semi-structured interview protocol designed to probe the subject's conceptions of scientific inquiry. The participants represented a total of 52 science faculty members from nine science departments (anthropology, biology, chemistry, geology, geography, school of health, physical education and recreation (HPER), medical sciences, physics, and school of environmental science) at a large mid-western research university. The method of analysis used by the team was grounded theory (Strauss & Corbin, 1990; Glaser & Strauss, 1967), in which case the frequency of concepts, patterns, and themes were coded to categorize scientists' conceptions of scientific inquiry. The results from this study address the following components: understanding and doing scientific inquiry, attributes of scientists engaged

[Lack of insight in schizophrenia: a review].

PubMed

Raffard, S; Bayard, S; Capdevielle, D; Garcia, F; Boulenger, J-P; Gely-Nargeot, M-C

2008-10-01

Relative to other psychiatric disorders, patients with schizophrenia are often unaware of the consequences of their disease and their need for treatment. These deficits in awareness referred in general in the English literature as "poor insight", have been the focus of many clinical studies over recent years. This phenomenon, which is considered as fundamental in clinical evaluations of schizophrenia, should be understood as a multidimensional process rather than a dichotomic phenomenon, as is presently the case. The links between insight deficits and responses to vocational rehabilitation efforts represent a major interest in research, including those related to medication compliance and clinical outcome. To conduct such studies, various evaluation tools have been developed, enabling the assessment of insight, of its time-course and of its components in psychosis and schizophrenia spectrum disorders. The Scale to Assess Unawareness of illness in Mental Disorders (SUMD) developed by Amador and Strauss appears to be the most frequently used scale for the evaluation of awareness of the disorder in schizophrenia. Although the model proposed by Amador and Strauss is considered as the privileged model in the multidimensional approach of insight, it corresponds only to a phenomenological analysis of this concept. In the second part of this article, we thus review the current models attempting to explain the lack of insight in schizophrenia. Four current explanatory models of lack of insight will be described as follows: resulting either from adaptation or defence mechanisms to environmental stressors, resulting from cognitive bias of data processing, resulting from neuropsychological functional deficits and resulting from metacognitive deficits. Several hypotheses concerning these deficits arise from clinical studies. Although coping, and defence mechanisms to the consequences and stigmatization of the disease were hardly studied, the fact that poor insight does not

Teacher and student actions to construct biology literacy at a community college: A bounded case study

NASA Astrophysics Data System (ADS)

Griesel, Patricia

2000-10-01

Science content area literacy, particularly literacy development in college level biology, is the focus of this study. The study investigates the actions and activities of an instructor and six students over the course of 16 weeks. The study is in response to interest in the literate practices in science classes (NSES, 1996) and to the call for contextual studies that facilitate the learning of science (Borasi & Siegel, 1999; Moje, 1996; Nist & Holschuh, 1996; Prentiss, 1998). A collaborative study between the biology teacher and the researcher, this study investigates the practices believed to be effective for the development of biology literacy. Data sources, in the qualitative bounded case study (Bogdin & Biklin, 1982; Glaser & Strauss, 1967; Miles & Huberman, 1994), include: field notes of classroom observations, in-depth interviews (Seidman, 1992), class surveys, and literate artifacts. The data were coded and analyzed using a constant comparative method (Glaser & Strauss, 1967). The six students reveal similarities and differences regarding the actions, patterns, practices and use of materials and their beliefs about effective practice in the development of biology literacy. The results indicate that a variety of actions and activities are needed to facilitate the development of biology literacy. The common themes to develop from the students' data about effective teacher actions are the following: (a) involves and engages students in inquiry learning through group projects, hands-on, and group discussions; (b) relates examples, experiences, and stories; (c) exhibits expertise; (d) encourages a relaxed classroom atmosphere; (e) facilitates and coaches students; and (f) credits creativity. Further, students report their teacher to be an expert, in terms of science knowledge and literate practices, and that her expertise contributes to their understanding of biology literacy. The teachers' data reveals three themes embedded in her classroom actions: science as

Towards a history of operatic psychoanalysis.

PubMed

Carpenter, Alexander

2010-01-01

This paper examines the history of the trope of psychoanalytic therapy in musical dramas, from Richard Wagner to Kurt Weill, concluding that psychoanalysis and the musical drama are, in some ways, companions and take cues from each other, beginning in the mid-19th century. In Wagner's music dramas, psychoanalytic themes and situations - specifically concerning the meaning and analysis of dreams - are presaged. In early modernist music dramas by Richard Strauss and Arnold Schoenberg (contemporaries of Freud), tacit representations of the drama of hysteria, its aetiology and "treatment" comprise key elements of the plot and resonate with dissonant musical soundscapes. By the middle of the 20th century, Kurt Weill places the relationship between analyst and patient in the foreground of his musical "Lady in the Dark," thereby making manifest what is latent in a century-spanning chain of musical works whose meaning centres, in part, around representations of psychoanalysis.

[Cavitating lung lesions in the course of ANCA-associated vasculitis: differential diagnostic aspects].

PubMed

Kirchner, J; Raab, H P; Länger, F; Wigand, R; Mitrou, P; Jacobi, V

1998-05-01

Antineutrophil cytoplasmatic antibodies (ANCA)-associated vasculitides (Wegener's granulomatosis, microscopic polyangiitis, Churg-Strauss syndrome) show quite variable courses. Clinical features of the full blown generalized systemic vasculitis are usually found in the respiratory tract and the kidney. Pulmonary involvement of Wegener's granulomatosis shows commonly nodules and cavitations but also diffuse alveolar hemorrhage. We report the case of a 57 year-old man suffering from dyspnea, thoracal pain, arthralgia, purpura, scleritis and tinitus. Specimen of the kidney showed segmental glomerulosclerosis and tubulointerstitial nephritis. Because of the presence of cANCA Wegener's disease was assumed. Pulmonary infiltrates developed under immunosuppressive treatment with cyclophosphamid. As differential diagnosis of the pulmonary infiltrates, we considered invasive pulmonary aspergillosis as well as infiltrates due to Wegener's granulomatosis. In spite of maximal therapeutic management of patient died of respiratory and cardiovascular failure. The findings at autopsy showed distinct invasive pulmonary aspergillosis and perifocal hemorrhage.

Barriers to self-care in women of reproductive age with HIV/AIDS in Iran: a qualitative study.

PubMed

Oskouie, Fatemeh; Kashefi, Farzaneh; Rafii, Forough; Gouya, Mohammad Mehdi

2017-01-01

Although increasing attention is paid to HIV/AIDS, patients with HIV still experience several barriers to self-care. These barriers have been previously identified in small quantitative studies on women with HIV, but qualitative studies are required to clarify barriers to self-care. We conducted our study using the grounded theory methodological approach. A total of 28 women with HIV and their family members, were interviewed. The data were analyzed with the Corbin and Strauss method (1998). The key barriers to self-care in women with HIV/AIDS included social stigma, addiction, psychological problems, medication side-effects and financial problems. Women with HIV/AIDS face several barriers to self-care. Therefore, when designing self-care models for these women, social and financial barriers should be identified. Mental health treatment should also be incorporated into such models and patients' access to health care services should be facilitated.

The Attitudes of Indian Palliative-care Nurses and Physicians to Pain Control and Palliative Sedation.

PubMed

Gielen, Joris; Gupta, Harmala; Rajvanshi, Ambika; Bhatnagar, Sushma; Mishra, Seema; Chaturvedi, Arvind K; den Branden, Stef Van; Broeckaert, Bert

2011-01-01

We wanted to assess Indian palliative-care nurses and physicians' attitudes toward pain control and palliative sedation. From May to September 2008, we interviewed 14 physicians and 13 nurses working in different palliative-care programs in New Delhi, using a semi-structured questionnaire, and following grounded-theory methodology (Glaser and Strauss). The interviewees did not consider administration of painkillers in large doses an ethical problem, provided the pain killers are properly titrated. Mild palliative sedation was considered acceptable. The interviewees disagreed whether palliative sedation can also be deep and continuous. Arguments mentioned against deep continuous palliative sedation were the conviction that it may cause unacceptable side effects, and impedes basic daily activities and social contacts. A few interviewees said that palliative sedation may hasten death. Due to fears and doubts regarding deep continuous palliative sedation, it may sometimes be too easily discarded as a treatment option for refractory symptoms.

Caregiving between two cultures: an integrative experience.

PubMed

Jones, Patricia S; Zhang, Xinwei Esther; Jaceldo-Siegl, Karen; Meleis, Afaf I

2002-07-01

In 1995, more than half of elderly immigrants to the United States were born in Asia or the Pacific region. The purpose of this study was to describe the process of caring for elderly parents by Asian American women. Forty-one women (22 Chinese American and 19 Filipino American) caring for elderly parents were interviewed in a study based on Strauss and Corbin's grounded theory methodology (1990). Although the women were moderately acculturated, indications of being in transition were evident. Analysis of interview data led to development of a substantive theory of caregiving between two cultures, reflecting the paradox of living and caregiving by two sets of standards and worldviews. The primary strategies used to manage the caregiving challenges were connecting and calibrating. Through personal growth and finding meaning, the caregivers integrated the caregiver role into their lives and became more connected with their families and within themselves.

Large-scale disruptions in a current-carrying magnetofluid

NASA Technical Reports Server (NTRS)

Dahlburg, J. P.; Montgomery, D.; Doolen, G. D.; Matthaeus, W. H.

1986-01-01

Internal disruptions in a strongly magnetized electrically conducting fluid contained within a rigid conducting cylinder of square cross section are investigated theoretically, both with and without an externally applied axial electric field, by means of computer simulations using the pseudospectral three-dimensional Strauss-equations code of Dahlburg et al. (1985). Results from undriven inviscid, driven inviscid, and driven viscid simulations are presented graphically, and the significant effects of low-order truncations on the modeling accuracy are considered. A helical current filament about the cylinder axis is observed. The ratio of turbulent kinetic energy to total poloidal magnetic energy is found to undergo cyclic bounces in the undriven inviscid case, to exhibit one large bounce followed by decay to a quasi-steady state with poloidal fluid velocity flow in the driven inviscid case, and to show one large bounce followed by further sawtoothlike bounces in the driven viscid case.

A Redshift Survey of IRAS Galaxies. II. Methods for Determining Self-consistent Velocity and Density Fields: Erratum

NASA Astrophysics Data System (ADS)

Yahil, Amos; Strauss, Michael A.; Davis, Marc; Huchra, John P.

1991-11-01

In the paper, "A Redshift Survey of IRAS Galaxies. II. Methods for Determining Self-consistent Velocity and Density Fields" by Amos Yahil, Michael A. Strauss, Marc Davis, and John P. Huchra (ApJ, 372,380 [1991]), Figures 14 and 15 were presented out of order, with their legends reversed. Thus, the figure at the bottom of page 391 is Figure 15, and should have the legend: "Fig. 15.-As in Fig. 13, for the method 3 results." The figure at the top of page 392 is Figure 14, and should have the legend: "Fig. 14.-Plot in Galactic coordinates of the quantity V_diff_ for galaxies within 3000 km s^-1^ of the LG. The symbol size is proportional to V_diff_ - 400 km s^-1^, which measures the deviation of the redshift- distance relation along the line of sight to that galaxy from pure Hubble flow."

[Operating Room Nurses' Experiences of Securing for Patient Safety].

PubMed

Park, Kwang Ok; Kim, Jong Kyung; Kim, Myoung Sook

2015-10-01

This study was done to evaluate the experience of securing patient safety in hospital operating rooms. Experiential data were collected from 15 operating room nurses through in-depth interviews. The main question was "Could you describe your experience with patient safety in the operating room?". Qualitative data from the field and transcribed notes were analyzed using Strauss and Corbin's grounded theory methodology. The core category of experience with patient safety in the operating room was 'trying to maintain principles of patient safety during high-risk surgical procedures'. The participants used two interactional strategies: 'attempt continuous improvement', 'immersion in operation with sharing issues of patient safety'. The results indicate that the important factors for ensuring the safety of patients in the operating room are manpower, education, and a system for patient safety. Successful and safe surgery requires communication, teamwork and recognition of the importance of patient safety by the surgical team.

Bruner's Search for Meaning: A Conversation between Psychology and Anthropology

PubMed Central

Mattingly, Cheryl; Lutkehaus, Nancy C.; Throop, C. Jason

2010-01-01

We introduce a special issue of Ethos devoted to the work of Jerome Bruner and his careerlong attempts to seek innovative ways to foster a dialogue between psychology and anthropology. The articles in this special issue situate Bruner's meaning-centered approach to psychology and his groundbreaking work on narrative in the broader context of the developmental trajectory of both of fields of inquiry. Bruner's work has been enormously influential in the subfields of cultural psychology and psychological anthropology, especially because of his important contributions to our understanding of the intimate relationship between culture and mind. We examine Bruner's past and ongoing engagement with such luminary figures as Lev Vygotsky, Jean Piaget, Alfred Kroeber, Claude Lévi-Strauss, and Clifford Geertz to highlight points of convergence and tension between his version of cultural psychology and contemporary theorizing and practice in psychological anthropology. We also review his practical and theoretical contributions to the fields of medicine, law, and education. PMID:20706551

Family caregivers of palliative cancer patients at home: the puzzle of pain management.

PubMed

Mehta, Anita; Cohen, S Robin; Carnevale, Franco A; Ezer, Hélène; Ducharme, Francine

2010-01-01

The purpose of this grounded theory study was to understand the processes used by family caregivers to manage the pain of cancer patients at home. A total of 24 family caregivers participated. They were recruited using purposeful then theoretical sampling. The data sources were taped, transcribed (semi-structured) interviews and field notes. Data analysis was based on Strauss and Corbin's (1998) requirements for open, axial, and selective coding. The result was an explanatory model titled "the puzzle of pain management," which includes four main processes: "drawing on past experiences"; "strategizing a game plan"; "striving to respond to pain"; and "gauging the best fit," a decision-making process that joins the puzzle pieces. Understanding how family caregivers assemble their puzzle pieces can help health care professionals make decisions related to the care plans they create for pain control and help them to recognize the importance of providing information as part of resolving the puzzle of pain management.

Nursing students' time management, reducing stress and gaining satisfaction: a grounded theory study.

PubMed

Mirzaei, Tayebeh; Oskouie, Fatemeh; Rafii, Forough

2012-03-01

In the course of their studies, nursing students must learn many skills and acquire the knowledge required for their future profession. This study investigates how Iranian nursing students manage their time according to the circumstances and obstacles of their academic field. Research was conducted using the grounded theory method. Twenty-one nursing students were purposefully chosen as participants. Data was collected through semi-structured interviews and analyzed using the method suggested by Corbin and Strauss. One of the three processes that the nursing students used was "unidirectional time management." This pattern consists of accepting the nursing field, overcoming uncertainty, assessing conditions, feeling stress, and trying to reduce stress and create satisfaction. It was found that students allotted most of their time to academic tasks in an attempt to overcome their stress. The findings of this study indicate the need for these students to have time for the extra-curricular activities and responsibilities that are appropriate to their age. © 2012 Blackwell Publishing Asia Pty Ltd.

DOE Office of Scientific and Technical Information (OSTI.GOV)

McNamara, B.

Tandem and stellarator equilibria at high ..beta.. have proved hard to compute and the relaxation methods of Bauer et al., Chodura and Schluter, Hirshman, Strauss, and Pearlstein et al. have been slow to converge. This paper reports an extension of the low-..beta.. analytic method of Pearlstein, Kaiser, and Newcomb to arbitrary ..beta.. for tandem mirrors which converges in 10 to 20 iterations. Extensions of the method to stellarator equilibria are proposed and are very close to the analytic method of Johnson and Greene - the stellarator expansion. Most of the results of all these calculations can be adequately described bymore » low-..beta.. approximations since the MHD stability limits occur at low ..beta... The tandem mirror, having weak curvature and a long central cell, allows finite Larmor radius effects to eliminate most ballooning modes and offers the possibility of really high average ..beta... This is the interest in developing such three-dimensional numerical algorithms.« less

What community resources do older community-dwelling adults use to manage their osteoarthritis? A formative examination

PubMed Central

Martin, Kathryn Remmes; Schoster, Britta; Woodard, Janice

2011-01-01

Community resources can influence health outcomes, yet little research has examined how older individuals use community resources for osteoarthritis (OA) management. Six focus groups were conducted with 37 community-dwelling older adult African Americans and Caucasians who self-reported OA and resided in Johnston County, North Carolina. Descriptive analyses and qualitative constant comparison methodology revealed individuals use local recreational facilities, senior centers, shopping centers, religious organizations, medical providers, pharmacies and their social network for OA management. Participants also identified environmental characteristics (e.g., sidewalk conditions, curb-cuts, handicapped parking, automatic doors) that both facilitated and hindered use of community resources for OA management. Identified resources and environmental characteristics were organized around Corbin & Strauss framework tasks: medical/behavioral, role, and emotional management. As older Americans live with multiple chronic diseases, better understanding of what community resources are used for disease management may help improve the health of community-dwelling adults, both with and without OA. PMID:23049159

The Attitudes of Indian Palliative-care Nurses and Physicians to Pain Control and Palliative Sedation

PubMed Central

Gielen, Joris; Gupta, Harmala; Rajvanshi, Ambika; Bhatnagar, Sushma; Mishra, Seema; Chaturvedi, Arvind K; den Branden, Stef Van; Broeckaert, Bert

2011-01-01

Aim: We wanted to assess Indian palliative-care nurses and physicians’ attitudes toward pain control and palliative sedation. Materials and Methods: From May to September 2008, we interviewed 14 physicians and 13 nurses working in different palliative-care programs in New Delhi, using a semi-structured questionnaire, and following grounded-theory methodology (Glaser and Strauss). Results: The interviewees did not consider administration of painkillers in large doses an ethical problem, provided the pain killers are properly titrated. Mild palliative sedation was considered acceptable. The interviewees disagreed whether palliative sedation can also be deep and continuous. Arguments mentioned against deep continuous palliative sedation were the conviction that it may cause unacceptable side effects, and impedes basic daily activities and social contacts. A few interviewees said that palliative sedation may hasten death. Conclusion: Due to fears and doubts regarding deep continuous palliative sedation, it may sometimes be too easily discarded as a treatment option for refractory symptoms. PMID:21633619

["Grounded theory" develops medicine. Popular research method for exploring human behavior can discover new connections].

PubMed

Thulesius, Hans; Barfod, Toke; Ekström, Helene; Håkansson, Anders

2004-09-30

Grounded theory (GT) is a popular research method for exploring human behavior. GT was developed by the medical sociologists Glaser and Strauss while they studied dying in hospitals in the 1960s resulting in the book "Awareness of dying". The goal of a GT is to generate conceptual theories by using all types of data but without applying existing theories and hypotheses. GT procedures are mostly inductive as opposed to deductive research where hypotheses are tested. A good GT has a core variable that is a central concept connected to many other concepts explaining the main action in the studied area. A core variable answers the question "What's going on?". Examples of core variables are: "Cutting back after a heart attack"--how people adapt to life after a serious illness; and "Balancing in palliative cancer care"--a process of weighing, shifting, compensating and compromising when treating people with a progressive and incurable illness trajectory.

Necrotizing fasciitis and its mimics: what radiologists need to know.

PubMed

Chaudhry, Ammar A; Baker, Kevin S; Gould, Elaine S; Gupta, Rajarsi

2015-01-01

The purpose of this article is to review the imaging features of necrotizing fasciitis and its potential mimics. Key imaging features are emphasized to enable accurate and efficient interpretation of variables that are essential in appropriate management. Necrotizing fasciitis is a medical emergency with potential lethal outcome. Dissecting gas along fascial planes in the absence of penetrating trauma (including iatrogenic) is essentially pathognomonic. However, the lack of soft-tissue emphysema does not exclude the diagnosis. Mimics of necrotizing fasciitis include nonnecrotizing fasciitis (eosinophilic, paraneoplastic, inflammatory (lupus myofasciitis, Churg-Strauss, nodular, or proliferative), myositis, neoplasm, myonecrosis, inflammatory myopathy, and compartment syndrome. Necrotizing fasciitis is a clinical diagnosis, and imaging can reveal nonspecific or negative findings (particularly during the early course of disease). One should be familiar with salient clinical and imaging findings of necrotizing fasciitis to facilitate a more rapid and accurate diagnosis and be aware that its diagnosis necessitates immediate discussion with the referring physician.

Disaster Reintegration Model: A Qualitative Analysis on Developing Korean Disaster Mental Health Support Model

PubMed Central

O’Donnell, Meaghan

2018-01-01

This study sought to describe the mental health problems experienced by Korean disaster survivors, using a qualitative research method to provide empirical resources for effective disaster mental health support in Korea. Participants were 16 adults or elderly adults who experienced one or more disasters at least 12 months ago recruited via theoretical sampling. Participants underwent in-depth individual interviews on their disaster experiences, which were recorded and transcribed for qualitative analysis, which followed Strauss and Corbin’s (1998) Grounded theory. After open coding, participants’ experiences were categorized into 130 codes, 43 sub-categories and 17 categories. The categories were further analyzed in a paradigm model, conditional model and the Disaster Reintegration Model, which proposed potentially effective mental health recovery strategies for disaster survivors, health providers and administrators. To provide effective assistance for mental health recovery of disaster survivors, both personal and public resilience should be promoted while considering both cultural and spiritual elements. PMID:29463030

A qualitative analysis of the information needs of informal carers of terminally ill cancer patients.

PubMed

Rose, K E

1999-01-01

This article discusses issues relating to information arising from a qualitative study of the experiences of informal carers of terminally ill cancer patients. Qualitative data analysis, drawing on methods of literary criticism, revealed that information was a key area in carers' experience. The findings are presented in the context of needing to provide individualized care to every family and deal with information needs relating to the illness and prognosis. The question of who is in possession of what information is raised, and the effect that this can have on couples is discussed, together with the issue of false information which carers may receive. The discussion centres on the complexity of understanding carers' information needs and considers how these are affected by the context within which carers operate. The work of Glaser and Strauss on awareness contexts is discussed in this respect. Finally, the importance of the nurse's role as a sensitive mediator of information is considered.

Constructing a bricolage of nursing research, education and practice.

PubMed

Warne, T; McAndrew, S

2009-11-01

Drawing upon post doctoral reflections of a shared methodology, the authors explore the use of bricolage as a way of better understanding the inter-related connections between theory, nursing practice and the felt experiences of service users. The origins of bricolage can be traced back to the work of Levi-Strauss, and Denzin and Lincoln's contribution to qualitative methodologies. Bricolage is a multifaceted approach to the research process. Differing epistemological positions and mixed methods of data collection are utilised to bring a richer understanding of human beings and the complexities of their lived experiences. For the bricoleur the object of inquiry, cannot be separated from its context, that is the language used to describe it, its historical situatedness and the social and cultural interpretations of its meaning as an entity in the world. The paper discusses the importance of being able to move beyond the notion of the research method being merely a procedure, to one that respects the complexities of the lived world.

Children's affective reactions and coping under threat of missile attack: a semiprojective assessment procedure.

PubMed

Zeidner, M; Klingman, A; Itskowitz, R

1993-06-01

This study reports on 170 Israeli school children at risk for missile attack during the Persian Gulf War. The Bar-Ilan Picture Test for Children (Itskowitz & Strauss, 1982, 1986) was specially adapted to the war situation specifically to measure children's affective reactions and coping strategies. Children with a greater sense of control and social support, and more complex defenses, tended to demonstrate better coping strategies. Children who were less defensive showed higher levels of anxiety under stress. Children scoring higher in social support showed greater perceived control over their immediate environment and more verbal expressivity with respect to the crisis situation. Girls scored higher than boys on emotional and verbal expressiveness. These data, elicited through semiprojective procedures, are consistent with much of the prior research based mainly on objective scales or self-report questionnaires. Overall, the results lend additional validity to the nexus of relations (largely established through conventional objective scales) between resources, coping, and outcomes in a naturalistic stressor situation.

Resilience and work-life balance in first-line nurse manager.

PubMed

Kim, Miyoung; Windsor, Carol

2015-03-01

The aim of this study was to explore how first-line nurse managers constructed the meaning of resilience and its relationship to work-life balance for nurses in Korea. Participants were 20 first-line nurse managers working in six university hospitals. Data were collected through in-depth interviews from December 2011 to August 2012, and analyzed using Strauss and Corbin's grounded theory method. Analysis revealed that participants perceived work-life balance and resilience to be shaped by dynamic, reflective processes. The features consisting resilience included "positive thinking", "flexibility", "assuming responsibility", and "separating work and life". This perception of resilience has the potential to facilitate a shift in focus from negative to positive experiences, from rigidity to flexibility, from task-centered to person-centered thinking, and from the organization to life. Recognizing the importance of work-life balance in producing and sustaining resilience in first-line nurse managers could increase retention in the Korean nursing workforce. Copyright © 2015. Published by Elsevier B.V.

P3 event-related potentials and childhood maltreatment in successful and unsuccessful psychopaths

PubMed Central

Gao, Yu; Raine, Adrian; Schug, Robert A.

2011-01-01

Although P3 event-related potential abnormalities have been found in psychopathic individuals, it is unknown whether successful (uncaught) psychopaths and unsuccessful (caught) psychopaths show similar deficits. In this study, P3 amplitude and latency were assessed from a community sample of 121 male adults using an auditory three-stimulus oddball task. Psychopathy was assessed using the Psychopathy Checklist-Revised (Hare, 2003) while childhood physical maltreatment was assessed using the Conflict Tactic Scale (Strauss, 1979). Results revealed that compared to normal controls, unsuccessful psychopaths showed reduced parietal P3 amplitudes to target stimuli and reported experienced more physical abuse in childhood. In contrast, successful psychopaths exhibited larger parietal P3 amplitude and shorter frontal P3 latency to irrelevant nontarget stimuli than unsuccessful psychopaths. This is the first report of electrophysiological processing differences between successful and unsuccessful psychopaths, possibly indicating neurocognitive and psychosocial distinctions between these two subtypes of psychopathy. PMID:21820788

Conceptualization of competency based curricula in pre-service nursing and midwifery education: A grounded theory approach.

PubMed

Muraraneza, Claudine; Mtshali, Gloria Ntombifikile

2018-01-01

In health professional education, the competency-based curriculum concept has been an important driver of reform in the training of competent graduates for the 21st century. In African countries, although there has been implementing it in pre-service nursing and midwifery education and the literature reports a lack of understanding of what is it on the part of the implementers. This article explores the meaning of competency based curriculum in pre-service nursing and midwifery education in Rwanda. A grounded theory approach, following Corbin and Strauss, was used. Following ethical clearance by the university ethical committee, data was collected from 17 participants through in-depth individual interviews of staff. Four categories emerged: (a) transformation, (b) tool for primary health care philosophy, (c) technological approach to education, (d) and modular system. Competency-based curriculum is confirmed as an appropriate educational tool in producing competent graduates for today and the future. Copyright © 2017 Elsevier Ltd. All rights reserved.

Parents' perceptions of child-to-parent socialization in organized youth sport.

PubMed

Dorsch, Travis E; Smith, Alan L; McDonough, Meghan H

2009-08-01

The purpose of this study was to enhance understanding of how parents are socialized by their children's organized youth sport participation. Five semistructured focus groups were conducted with youth sport parents (N = 26) and analyzed using qualitative methods based on Strauss and Corbin (1998). Sixty-three underlying themes reflected parents' perceived socialization experiences resulting from their children's organized youth sport participation. Each theme represented 1 of 11 subcategories of parental change, which were subsumed within four broad categories of parent sport socialization (behavior, cognition, affect, relationships). Each category of parental change was interconnected with the other three categories. Moreover, six potential moderators of parent sport socialization were documented, namely, child age, parent past sport experience, parent and child gender, child temperament, community sport context, and type of sport setting (individual or team). Together, these findings enhance understanding of parent sport socialization processes and outcomes, thus opening avenues for future research on parents in the youth sport setting.

Cannabis use and dating violence among college students: A call for research.

PubMed

Shorey, Ryan C; Haynes, Ellen; Strauss, Catherine; Temple, Jeff R; Stuart, Gregory L

2017-01-01

Dating violence is a serious and prevalent problem on college campuses. Although there is a robust literature documenting that alcohol use is consistently associated with increased risk for perpetrating dating violence, little research has examined the role of cannabis in dating violence perpetration. With increasing legalisation of cannabis throughout the world, it is imperative to understand what role, if any, cannabis may play in the important public health problem of dating violence. In this commentary, we discuss the current state of the research on cannabis and dating violence and suggest avenues for additional research in this area. It is critical that we conduct methodologically sound research on the association between cannabis and dating violence so that we can understand what role, if any, cannabis exerts on this important problem. [Shorey RC, Haynes E, Strauss C, Temple JR, Stuart GL. Cannabis use and dating violence among college students: A call for research. Drug Alcohol Rev 2017;36:17-19]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

A Genealogy of Animal Diseases and Social Anthropology (1870-2000).

PubMed

Keck, Frédéric

2018-03-23

Culling, vaccinating, and monitoring animals are the three main techniques used in contemporary veterinary public health to manage animal diseases that can be transmitted to humans. Each technique is underpinned by different ontological understandings of how microbes figure in relations between humans and animals. Therefore, animal diseases are not only a question for an applied anthropology but also involve the theoretical core of the discipline: that is, understanding how social causality emerges out of physical causality. To defend this argument, the article describes what Herbert Spencer wrote about foot-and-mouth disease; what William Robertson Smith thought about sacrifice in the context of bovine tuberculosis; how Emile Durkheim took vaccination for smallpox as a metaphor for the pathologies of the social; and what Claude Lévi-Strauss wrote about mad cow disease. The conceptions of the social in the writing of these four authors are analyzed through their understanding of the risk of transmission of animal diseases to humans, moving from prevention to precaution to preparedness. © 2018 by the American Anthropological Association.

When cultures clash: a case study of the Texaco takeover of Getty Oil and the impact of acculturation on the acquired firm

DOE Office of Scientific and Technical Information (OSTI.GOV)

Altendorf, D.M.

1986-01-01

Historical surveys of merger and acquisition performance indicate that corporate combinations often do not result in the sought after financial success. An ethnographic case study of the Texaco takeover of Getty Oil was undertaken. Based on the in-depth open-ended interviews, field notes, historical accounts, corporate documents, and organizational symbols, data were analyzed using qualitative techniques explicated by Geertz and Glaser and Strauss. The analysis explored cross cultural contact, employee interpretations resulting in related behavioral and performance outcomes, and the factors influencing the type of acculturation observed. Theoretical properties emerged from descriptive accounts. An integrated theory was developed suggesting that themore » form of acculturation that occurs in the combination of two or more firms is a direct consequence of culture differences and the interpretations that the employees make of these differences. Different occurrences - events, strategies, and activities - contributed to corporate culture clash and organizational change. Results also indicated that how meaning is created and managed affects cross cultural contact, employee assessments, and acculturation. Related propositions were generated and implications for future research discussed.« less

Millennial children of immigrant parents: Transnationalism, disparities, policy, and potential.

PubMed

Yazykova, Ekaterina; McLeigh, Jill D

2015-09-01

At 11% of their generational cohort, second-generation millennials account for the larger number of children of immigrants than any other generation before them. Second-generation millennials belong to a cohort that comprises about 80 million people, the largest cohort of young people that the United States has ever seen. The "creators" of the millennial generation, Neil Howe and William Strauss, proposed seven core millennials' traits that are now overwhelmingly accepted as being factual: They are special, sheltered, confident, team-oriented, conventional, achieving, and pressured. In contemporary discourse, millennials have been described as tech savvy, open to change, compassionate, inclusive, and politically active, but also self-centered and lacking attachment or direction. Although it is true that many second-generation millennials fit these descriptions and are doing as well financially and educationally as their nonimmigrant peers, a significant proportion are struggling. The diverse outcomes raise questions about why some children of immigrant parents fare better than others. If these factors can be identified, efforts can be undertaken to promote the wellbeing of these young adults

[Public health stewardship and governance regarding the Colombian healthcare system, 2012-2013].

PubMed

Roth-Deubel, André N; Molina-Marín, Gloria

2013-01-01

Analysing decision-making concerning public health issues regarding the Colombian healthcare system from a market economy-based approach. This study involved applying Glaser and Strauss's grounded theory in six Colombian cities during 2012: Bogotá, Barranquilla, Bucaramanga, Leticia, Medellin and Pasto. 120 individual interviews were conducted with professionals involved in decision-making, running public healthcare programmes and making policy within public and private institutions. Fourteen focus groups were held with community organisation leaders. The findings suggested national and municipal health authorities' weak stewardship and ineffective governance regarding public healthcare policy and programmes, related to a lack of staff trained in public health management issues. In turn, this was related to political parties' interference and private insurers' particular interests and the structural fragmentation of functions and actors within the health system, thereby limiting public health development. A new axiology is necessary for achieving effective governance (I.e. cooperation between Colombian Healthcare Social Security System actors) to overcome current incompetence and financial self-interest predominating within the Colombian healthcare system.

The Flushtration Count Illusion: Attribute substitution tricks our interpretation of a simple visual event sequence.

PubMed

Thomas, Cyril; Didierjean, André; Kuhn, Gustav

2018-04-17

When faced with a difficult question, people sometimes work out an answer to a related, easier question without realizing that a substitution has taken place (e.g., Kahneman, 2011, Thinking, fast and slow. New York, Farrar, Strauss, Giroux). In two experiments, we investigated whether this attribute substitution effect can also affect the interpretation of a simple visual event sequence. We used a magic trick called the 'Flushtration Count Illusion', which involves a technique used by magicians to give the illusion of having seen multiple cards with identical backs, when in fact only the back of one card (the bottom card) is repeatedly shown. In Experiment 1, we demonstrated that most participants are susceptible to the illusion, even if they have the visual and analytical reasoning capacity to correctly process the sequence. In Experiment 2, we demonstrated that participants construct a biased and simplified representation of the Flushtration Count by substituting some attributes of the event sequence. We discussed of the psychological processes underlying this attribute substitution effect. © 2018 The British Psychological Society.

Preservice special education teachers' understandings, enactments, views, and plans for scientific inquiry: Issues and hopes

NASA Astrophysics Data System (ADS)

Ghosh, Rajlakshmi

This study examined the understandings, enactments, views, and plans for scientific inquiry held by preservice special education teachers enrolled in a K--8 general science methods course. Sixteen participants from four special education concentration areas---Mild to Moderate Educational Needs, Moderate to Intense Educational Needs, Mild to Moderate Educational Needs with Language Arts and Reading Emphasis, and Early Childhood Intervention---participated in this study. Qualitative data were collected from questionnaires, interviews, teaching videos, lesson plans, planning commentaries, and reflection papers. Data were analyzed using a grounded theory approach (Strauss & Corbin, 1990) and compared against the theoretical view of inquiry as conceptualized by the National Research Council (NRC, 2000). The participants held unique interpretations of inquiry that only partially matched with the theoretical insights provided by the NRC. The participants' previous science learning experiences and experiences in special education played an important role in shaping their conceptualizations of inquiry as learned in the science methods class. The impacts of such unique interpretations are discussed with reference to both science education and special education, and implications for teacher education are provided.

Myocardial late gadolinium enhancement in specific cardiomyopathies by cardiovascular magnetic resonance: a preliminary experience.

PubMed

Silva, Caterina; Moon, James C; Elkington, Andrew G; John, Anna S; Mohiaddin, Raad H; Pennell, Dudley J

2007-12-01

Late gadolinium enhancement cardiovascular magnetic resonance (CMR) can visualize myocardial interstitial abnormalities. The aim of this study was to assess whether regions of abnormal myocardium can also be visualized by late enhancement gadolinium CMR in the specific cardiomyopathies. A retrospective review of all referrals for gadolinium CMR with specific cardiomyopathy over 20 months. Nine patients with different specific cardiomyopathies were identified. Late enhancement was demonstrated in all patients, with a mean signal intensity of 390 +/- 220% compared with normal regions. The distribution pattern of late enhancement was unlike the subendocardial late enhancement related to coronary territories found in myocardial infarction. The affected areas included papillary muscles (sarcoid), the mid-myocardium (Anderson-Fabry disease, glycogen storage disease, myocarditis, Becker muscular dystrophy) and the global sub-endocardium (systemic sclerosis, Loeffler's endocarditis, amyloid, Churg-Strauss). Focal myocardial late gadolinium enhancement is found in the specific cardiomyopathies, and the pattern is distinct from that seen in infarction. Further systematic studies are warranted to assess whether the pattern and extent of late enhancement may aid diagnosis and prognostic assessment.

[Learning strategies of autonomous medical students].

PubMed

Márquez U, Carolina; Fasce H, Eduardo; Ortega B, Javiera; Bustamante D, Carolina; Pérez V, Cristhian; Ibáñez G, Pilar; Ortiz M, Liliana; Espinoza P, Camila; Bastías V, Nancy

2015-12-01

Understanding how autonomous students are capable of regulating their own learning process is essential to develop self-directed teaching methods. To understand how self-directed medical students approach learning in medical schools at University of Concepción, Chile. A qualitative and descriptive study, performed according to Grounded Theory guidelines, following Strauss & Corbin was performed. Twenty medical students were selected by the maximum variation sampling method. The data collection technique was carried out by a semi-structured thematic interview. Students were interviewed by researchers after an informed consent procedure. Data were analyzed by the open coding method using Atlas-ti 7.5.2 software. Self-directed learners were characterized by being good planners and managing their time correctly. Students performed a diligent selection of contents to study based on reliable literature sources, theoretical relevance and type of evaluation. They also emphasized the discussion of clinical cases, where theoretical contents can be applied. This modality allows them to gain a global view of theoretical contents, to verbalize knowledge and to obtain a learning feedback. The learning process of autonomous students is intentional and planned.

VizieR Online Data Catalog: Galaxy Zoo 2: new classification (Hart+, 2016)

NASA Astrophysics Data System (ADS)

Hart, R. E.; Bamford, S. P.; Willett, K. W.; Masters, K. L.; Cardamone, C.; Lintott, C. J.; Mackay, R. J.; Nichol, R. C.; Rosslowe, C. K.; Simmons, B. D.; Smethurst, R. J.

2017-11-01

We make use of morphological information from the public data release of Galaxy Zoo 2. The galaxies classified by GZ2 were taken from the SDSS Data Release 7 (DR7; Abazajian et al. 2009ApJS..182..543A). The SDSS main galaxy sample is an r-band selected sample of galaxies in the legacy imaging area targeted for spectroscopic follow-up (Strauss et al., 2002AJ....124.1810S) The GZ2 sample contains essentially all well-resolved galaxies in DR7 down to a limiting absolute magnitude of mr<=17, supplemented by additional sets of galaxies in Stripe 82 for which deeper, co-added imaging exists (see W13 (Willett et al., 2013MNRAS.435.2835W, Cat. J/MNRAS/435/2835) for details). In this paper, we only consider galaxies with mr<=17 that were classified in normal-depth SDSS imaging and which have DR7 spectroscopic redshifts. We refer to this as our full sample, containing 228201 galaxies, to which the debiasing procedure described in Section 3.3 is applied. (1 data file).

Why are you here? Needs analysis of an interprofessional health-education graduate degree program

PubMed Central

Cable, Christian; Knab, Mary; Tham, Kum Ying; Navedo, Deborah D; Armstrong, Elizabeth

2014-01-01

Little is known about the nature of faculty development that is needed to meet calls for a focus on quality and safety with particular attention to the power of interprofessional collaborative practice. Through grounded-theory methodology, the authors describe the motivation and needs of 20 educator/clinicians in multiple disciplines who chose to enroll in an explicitly interprofessional master’s program in health profession education. The results, derived from axial coding described by Strauss and Corbin, revealed that faculty pursue such postprofessional master’s degrees out of a desire to be better prepared for their roles as educators. A hybrid-delivery model on campus and online provided access to graduate degrees while protecting the ability of participants to remain in current positions. The added benefit of a community of practice related to evidence-based and innovative models of education was valued by participants. Authentic, project-based learning and assessment supported their advancement in home institutions and systems. The experience was described by participants as a disruptive innovation that helped them attain their goal of leadership in health profession education. PMID:24748830

Revisiting the systemic vasculitis in eosinophilic granulomatosis with polyangiitis (Churg-Strauss): A study of 157 patients by the Groupe d'Etudes et de Recherche sur les Maladies Orphelines Pulmonaires and the European Respiratory Society Taskforce on eosinophilic granulomatosis with polyangiitis (Churg-Strauss).

PubMed

Cottin, Vincent; Bel, Elisabeth; Bottero, Paolo; Dalhoff, Klaus; Humbert, Marc; Lazor, Romain; Sinico, Renato A; Sivasothy, Pasupathy; Wechsler, Michael E; Groh, Matthieu; Marchand-Adam, Sylvain; Khouatra, Chahéra; Wallaert, Benoit; Taillé, Camille; Delaval, Philippe; Cadranel, Jacques; Bonniaud, Philippe; Prévot, Grégoire; Hirschi, Sandrine; Gondouin, Anne; Dunogué, Bertrand; Chatté, Gérard; Briault, Christophe; Pagnoux, Christian; Jayne, David; Guillevin, Loïc; Cordier, Jean-François

2017-01-01

To guide nosology and classification of patients with eosinophilic granulomatosis with polyangiitis (EGPA) based on phenotype and presence or absence of ANCA. Organ manifestations and ANCA status were retrospectively analyzed based on the presence or not of predefined definite vasculitis features or surrogates of vasculitis in patients asthma, eosinophilia, and at least one systemic organ manifestation attributable to systemic disease. The study population included 157 patients (mean age 49.4±14.1), with a follow-up of 7.4±6.4years. Patients with ANCA (31%) more frequently had weight loss, myalgias, arthralgias, biopsy-proven vasculitis, glomerulonephritis on biopsy, hematuria, leukocytoclastic capillaritis and/or eosinophilic infiltration of arterial wall on biopsy, and other renal disease. A total of 41% of patients had definite vasculitis manifestations (37%) or strong surrogates of vasculitis (4%), of whom only 53% had ANCA. Mononeuritis multiplex was associated with systemic vasculitis (p=0.005) and with the presence of ANCA (p<0.001). Overall, 59% of patients had polyangiitis as defined by definite vasculitis, strong surrogate of vasculitis, mononeuritis multiplex, and/or ANCA with at least one systemic manifestation other than ENT or respiratory. Patients with polyangiitis had more systemic manifestations including arthralgias (p=0.02) and renal disease (p=0.024), had higher peripheral eosinophilia (p=0.027), and a trend towards less myocarditis (p=0.057). Using predefined criteria of vasculitis and surrogates of vasculitis, ANCA alone were found to be insufficient to categorise patients with vasculitis features. We suggest a revised nomenclature and definition for EGPA and a new proposed entity referred to as hypereosinophilic asthma with systemic (non vasculitic) manifestations. Copyright © 2016 Elsevier B.V. All rights reserved.

Photonics applications and web engineering: WILGA Winter 2016

NASA Astrophysics Data System (ADS)

Romaniuk, Ryszard S.

2016-09-01

Since twenty years, young researchers form the Institute of Electronic Systems, Warsaw University of Technology, organize two times a year, under only a marginal supervision of the senior faculty members, under the patronage of WEiTI PW, KEiT PAN, SPIE, IEEE, PKOpto SEP and PSF, the WILGA Symposium on advanced, integrated functional electronic, photonic and mechatronic systems [1-5]. All aspects are considered like: research and development, theory and design, technology - material and construction, software and hardware, commissioning and tests, as well as pilot and practical applications. The applications concern mostly, which turned after several years to be a proud specialization of the WILGA Symposium, Internet engineering, high energy physics experiments, new power industry including fusion, nuclear industry, space and satellite technologies, telecommunications, smart municipal environment, as well as biology and medicine [6-8]. XXXVIIth WILGA Symposium was held on 29-31 January 2016 and gathered a few tens of young researchers active in the mentioned research areas. There were presented a few tens of technical papers which will be published in Proc.SPIE together with the accepted articles from the Summer Edition of the WILGA Symposium scheduled for 29.05-06.06.2016. This article is a digest of chosen presentations from WILGA Symposium 2016 Winter Edition. The survey is narrowed to a few chosen and main topical tracks, like electronics and photonics design using industrial standards like ATCA/MTCA, also particular designs of functional systems using this series of industrial standards. The paper, summarizing traditionally since many years the accomplished WILGA Symposium organized by young researchers from Warsaw University of Technology, is also the following part of a cycle of papers concerning their participation in design of new generations of electronic systems used in discovery experiments in Poland and in leading research laboratories of the world.

Long-term outcomes of 118 patients with eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) enrolled in two prospective trials.

PubMed

Samson, Maxime; Puéchal, Xavier; Devilliers, Hervé; Ribi, Camillo; Cohen, Pascal; Stern, Marc; Pagnoux, Christian; Mouthon, Luc; Guillevin, Loïc

2013-06-01

The purpose of this study was to assess the outcomes of 118 patients with eosinophilic granulomatosis with polyangiitis (EGPA) enrolled in 2 prospective, randomized, open-label clinical trials (1994-2005), with or without Five-Factor Score (FFS)-defined poor-prognosis factors, focusing on survival, disease-free survival, relapses, clinical and laboratory findings, therapeutic responses, and factors predictive of relapse. Forty-four patients with FFS ≥ 1 were assigned to receive 6 or 12 cyclophosphamide pulses plus corticosteroids and the seventy-four with FFS = 0 received corticosteroids alone, with immunosuppressant adjunction when corticosteroids failed. Patients were followed (2005-2011) under routine clinical care in an extended study and data were recorded prospectively. Mean ± SD follow-up was 81.3 ± 39.6 months. Among the 118 patients studied, 29% achieved long-term remission and 10% died. Among the 115 patients achieving a first remission, 41% experienced ≥1 relapses, 26.1 ± 26.8 months after treatment onset, with 57% of relapses occurring when corticosteroid-tapering reached <10 mg/day. Treatment achieved new remissions in >90%, but relapses recurred in 38%. Overall survival was good, reaching 90% at 7 years, regardless of baseline severity. Age ≥65 years was the only factor associated with a higher risk of death during follow-up. The risk of relapse was higher for patients with anti-myeloperoxidase antibodies and lower for those with >3000 eosinophils/mm(3). Sequelae remained frequent, usually chronic asthma and peripheral neuropathy. In conclusion, EGPA patients' survival rate is very good when treatment is stratified according to the baseline FFS. Relapses are frequent, especially in patients with anti-myeloperoxidase antibodies and baseline eosinophilia <3000/mm(3). Copyright © 2013 Elsevier Ltd. All rights reserved.

A Grounded theory study of the intention of nurses to leave the profession.

PubMed

Alilu, Leyla; Zamanzadeh, Vahid; Valizadeh, Leila; Habibzadeh, Hosein; Gillespie, Mark

2017-06-05

this study explores the process of the development of an intention to leave bedside nursing. the process was studied from the perspective of 21 nurses using the grounded theory method. Data were collected using semi-structured interviews and the constant comparative method of Corbin and Strauss was used for data analysis. according to the participants, the two main categories, "social image of nursing", and "culture and structure of the bedside", were the contextual factors that influence why nurses are leaving bedside care provision. Disappointment with a perceived lack of progress or improvement in the clinical experience formed primary psychosocial concerns for the participants. Competence and a process of self-control were steps taken by the participants. These, associated with interventional conditions produced the outcomes of the loss of professional commitment and desire to leave bedside nursing. "Failure to integrate personal expectations with organizational expectations: in search of escape" was the central category of the study that linked the categories together. the findings of this study provide useful information about the needs of nurses for overcoming the intention to leave bedside care. The identification of this process can help in recognizing emerging problems and providing solutions for them. este estudo explora o processo de desenvolvimento da intenção de deixar a enfermagem de cabeceira. o processo foi estudado desde a perspectiva de 21 enfermeiras utilizando o método da Grounded Theory (Teoria Fundamentada). Os dados foram coletados utilizando entrevistas semi-estruturadas e o método comparativo constante de Corbin e Strauss se utilizou para analisar os dados. segundo os participantes, duas categorias principais, "imagem social da enfermagem" e "cultura e estrutura de cabeceira", foram os fatores contextuais que influenciam as razões para que as enfermeiras estejam deixando o cuidado de cabeceira. A decepção com a percepção de falta

[Motivation and self-directed learning among medical students].

PubMed

Fasce H, Eduardo; Ortega B, Javiera; Ibáñez G, Pilar; Márquez U, Carolina; Pérez V, Cristhian; Bustamante D, Carolina; Ortiz M, Liliana; Matus B, Olga; Bastías V, Nancy; Espinoza P, Camila

2016-05-01

Motivation is an essential aspect in the training process of medical students. The association that motivation can have with learning self-regulation is of utmost importance for the design of curriculum, teaching methods and evaluation. To describe the motivational aspects of self-directed learning among medical students from a traditional Chilean University. A qualitative, descriptive study based on grounded theory of Strauss and Corbin. Twenty 4th and 5th year medical students were selected using a maximum variation sampling technique. After obtaining an informed consent, semi-structured interviews and field notes were carried out. Data were analyzed to the level of open coding through Atlas-ti 7.5.2. From the student point of view, personal motivational aspects are linked to the search for information, constant updating, the perception of the physician-patient relationship and interest in subject matters. From the scope of teachers, a main issue is related to their ability to motivate students to develop independent study skills. Personal motivational aspects facilitate the development of independent study skills, specifically in the search of information. The role of teachers is crucial in promoting these skills and the perception of medical students from their learning process.

Body and Corporality in adolescents and young adults with spinal cord injury.

PubMed

Duarte Torres, Diana Milena; Torres Bolaños, Yuri Marcela; Moreno Fergusson, María Elisa

2016-04-01

To describe the meaning given by adolescents and young adults to the changes in their bodies and corporality after a spinal cord injury. Qualitative study based on symbolic interactionism in which 12 adolescents and young adults, who had suffered spinal cord injury 6 months or more before, participated. The information was recollected through a series of in-depth interviews and field journals. The guidelines proposed by Corbin and Strauss were followed for the process of codification and categorization of the data. Four categories were identified that describe the meanings given by participants to the changes in their bodies and corporality: Transformation of self-image, living with contradictions in the relationships with others, withstanding the burden of a disability and adapting to the new conditions. The results allow for the comprehension of the meanings that are given by the people who have suffered a spinal cord lesion to their situation. This will in turn open the possibility of offering these people a better individual nursing care that focuses more on the particular needs, so that both they and their families can be helped on their way to adaptation to the new situation.

An attempt for empowering education: A qualitative study of in-service training of nursing personnel

PubMed Central

Chaghari, Mahmood; Ebadi, Abbas; Ameryoun, Ahmad; Safari, Mohsen

2016-01-01

Background: In-service training of nursing personnel has a significant role in increasing the empowerment of nurses and promotion of the quality of health services. The objective of this study is to identify and explain the process of in-service training of nursing personnel in the hospitals affiliated with Baqiyatallah University of Medical Sciences in Tehran. Materials and Methods: The present study employed a qualitative approach using Corbin and Strauss method (2008) in 2015, and examined the viewpoints and experiences of 35 nurses, nurse managers, and educational managers with the in-service education of nursing staffs. According to this method, comparisons, asking questions, flip-flop technique, depicting personal experiences, and raising red flag were used for data analysis. Results: In this study, five major themes including unsuccessful mandatory education, empowering education, organizational challenges, weakness in the educational management, and educational-job resiliency were derived from the results. Unsuccessful mandatory education was the main concern of participants and empowering education was the core category derived from this study. Conclusions: Empowering education emphasizes the practice-oriented and self-directed training. It is an applied education, is participation-oriented, facilitates job functions, and is based on exploration. PMID:27904634

Empowering citizens in international governance of nanotechnologies.

PubMed

Malsch, Ineke; Subramanian, Vrishali; Semenzin, Elena; Hristozov, Danail; Marcomini, Antonio; Mullins, Martin; Hester, Karena; McAlea, Eamonn; Murphy, Finbarr; Tofail, Syed A M

The international dialogue on responsible governance of nanotechnologies engages a wide range of actors with conflicting as well as common interests. It is also characterised by a lack of evidence-based data on uncertain risks of in particular engineered nanomaterials. The present paper aims at deepening understanding of the collective decision making context at international level using the grounded theory approach as proposed by Glaser and Strauss in "The Discovery of Grounded Theory" (1967). This starts by discussing relevant concepts from different fields including sociological and political studies of international relations as well as political philosophy and ethics. This analysis of current trends in international law making is taken as starting point for exploring the role that a software decision support tool could play in multi-stakeholder global governance of nanotechnologies. These theoretical ideas are then compared with the current design of the SUN Decision Support System (SUNDS) under development in the European project on Sustainable Nanotechnologies (SUN, www.sun-fp7.eu). Through constant comparison, the ideas are also compared with requirements of different stakeholders as expressed during a user workshop. This allows for highlighting discussion points for further consideration.

Nonlinear Two Fluid and Kinetic ELM Simulations

NASA Astrophysics Data System (ADS)

Strauss, H. R.; Sugiyama, L.; Chang, C. S.; Ku, S.; Hientzsch, B.; Breslau, J.; Park, W.; Samtaney, R.; Adams, M.; Jardin, S.

2006-04-01

Simulations of ELMs using dissipative MHD, two fluid MHD, and neoclassical kinetic physics models are being carried out using the M3D code [1]. Resistive MHD simulations of nonlinear edge pressure and current driven instabilities have been performed, initialized with realistic DIIID equilibria. Simulations show the saturation of the modes and relaxation of equilbrium profiles. Linear simulations including two fluid effects show the stabilization of toroidal mode number n = 10 modes, when the Hall parameter H, the ratio of ion skin depth to major radius, exceeds a threshhold. Nonlinear simulations are being done including gyroviscous stabilization. Kinetic effects are incorporated by coupling with the XGC code [2], which is able to simulate the edge plasma density and pressure pedestal buildup. These profiles are being used to initialize M3D simulations of an ELM crash and pedestal relaxation. The goal is to simulate an ELM cycle. [1] Park, W., Belova, E.V., Fu, G.Y., Tang, X.Z., Strauss, H.R., Sugiyama, L.E., Phys. Plas. 6, 1796 (1999).[2] Chang, C.S., Ku, S., and Weitzner, H., Phys. Plas. 11, 2649 (2004)

[Threats to Identity: A Grounded Theory Approach on Student Nurses' Experience of Incivility during Clinical Placement].

PubMed

Kang, Jiyeon; Jeong, Yeon Jin; Kong, Kyoung Ran

2018-02-01

This qualitative study aimed to explore the experience of incivility among nursing students. Sixteen nursing students who had experienced incivility during their clinical placement were invited for one-on-one interviews until the point of theoretical saturation. The grounded theory approach of Corbin and Strauss was adopted to analyze transcribed interview contents. Incivility occurred in the context of a hierarchical organizational culture, due to nursing students' position as outsiders, non-systematic clinical education, and poor nursing work environment. The experience of incivility was identified as "being mistreated as a marginal person," and nursing students responded to this phenomenon in the following three steps: reality shock, passive action, and submissive acceptance. This process caused students to lose self-esteem and undergo role conflict. Furthermore, nursing students' experience of incivility could eventually lead to workplace bullying in nurses. The results of this study suggest that nursing students' experience of incivility can be a process that threatens their identity. It is necessary to develop educational programs and provide appropriate counseling services so that nursing students can actively cope with the incivility. In addition, institutional plans are needed to ensure safe and supportive clinical learning environments. © 2018 Korean Society of Nursing Science.

Mythical thinking, scientific discourses and research dissemination.

PubMed

Hroar Klempe, Sven

2011-06-01

This article focuses on some principles for understanding. By taking Anna Mikulak's article "Mismatches between 'scientific' and 'non-scientific' ways of knowing and their contributions to public understanding of science" (IPBS 2011) as a point of departure, the idea of demarcation criteria for scientific and non-scientific discourses is addressed. Yet this is juxtaposed with mythical thinking, which is supposed to be the most salient trait of non-scientific discourses. The author demonstrates how the most widespread demarcation criterion, the criterion of verification, is self-contradictory, not only when it comes to logic, but also in the achievement of isolating natural sciences from other forms of knowledge. According to Aristotle induction is a rhetorical device and as far as scientific statements are based on inductive inferences, they are relying on humanities, which rhetoric is a part of. Yet induction also has an empirical component by being based on sense-impressions, which is not a part of the rhetoric, but the psychology. Also the myths are understood in a rhetorical (Lévi-Strauss) and a psychological (Cassirer) perspective. Thus it is argued that both scientific and non-scientific discourses can be mythical.

[The role adaptation process of the executive director of nursing department].

PubMed

Kang, Sung-Ye; Park, Kwang-Ok; Kim, Jong-Kyung

2010-12-01

The purpose of this study was to identify the role adaptation process experienced by executive directors of nursing department of general hospitals. Data were collected from 9 executive nursing directors though in-depth interviews about their experiences. The main question was "How do you describe your experience of the process of role adaptation as an executive nursing director?" Qualitative data from field and transcribed notes were analyzed using Strauss & Corbin's grounded theory methodology. The core category of experience of the process of role adaptation as an executive nursing director was identified as "entering the center with pushing and pulling". The participants used five interactional strategies;'maintaining modest attitudes','inquiring about trends of popular feeling','making each person a faithful follower','collecting & displaying power','leading with initiative'. The consequences of role adaptation in executive nursing directors were'coexisting with others','immersing in one's new role with dedication', and'having capacity for high tolerance'. The types of role adaptations of executive directors in nursing department were friendly type, propulsive type, accommodating type. The results of this study produced useful information for executive nursing directors on designing a self-managerial program to enhance role adaptation based on interactional strategies.

Genetic Susceptibility to ANCA-Associated Vasculitis: State of the Art

PubMed Central

Bonatti, Francesco; Reina, Michele; Neri, Tauro Maria; Martorana, Davide

2014-01-01

ANCA-associated vasculitis (AAV) is a group of disorders that is caused by inflammation affecting small blood vessels. Both arteries and veins are affected. AAV includes microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA) renamed from Wegener’s granulomatosis, and eosinophilic granulomatosis with polyangiitis (EGPA), renamed from Churg–Strauss syndrome. AAV is primarily due to leukocyte migration and resultant damage. Despite decades of research, the mechanisms behind AAV disease etiology are still not fully understood, although it is clear that genetic and environmental factors are involved. To improve the understanding of the disease, the genetic component has been extensively studied by candidate association studies and two genome-wide association studies. The majority of the identified genetic AAV risk factors are common variants. These have uncovered information that still needs further investigation to clarify its importance. In this review, we summarize and discuss the results of the genetic studies in AAV. We also present the novel approaches to identifying the causal variants in complex susceptibility loci and disease mechanisms. Finally, we discuss the limitations of current methods and the challenges that we still have to face in order to incorporate genomic and epigenomic data into clinical practice. PMID:25452756

The goldfish syndrome. Human nature and the posthuman myth.

PubMed

Valera, Luca; Tambone, Vittoradolfo

2014-01-01

Posthumanism is a myth. This does not mean to say that it constitutes a narrative devoid of any foundation, inspired by mere fantasy, far from it. The myth, as shown by Ries, Eliade and Lévi Strauss on several occasions, is based on something real and true, and appeals to conceptual structures that keep it away from a mere scientific report: having had to do with the essence of things, it does not even have a purpose of classification in a given place or time. In this sense, the posthuman myth lives outside of time and out of the common space of existence, or perhaps, it lives in its own time and in its own space. Just like the myth, posthumanism lives in consciousness: to prove this assumption, we will discuss in greater depth the spatial and temporal coordinates of posthumanism, as well as its cosmological and anthropological point of view. Once demonstrated its mythical essence, it will therefore be easier to remember how the posthuman myth - despite intending to present itself as a radically innovative and progressive thought, makes no more than re-emerge some coordinates that have always been present in the history of philosophy.

Inattentional deafness in music.

PubMed

Koreimann, Sabrina; Gula, Bartosz; Vitouch, Oliver

2014-01-01

While inattentional blindness is a modern classic in attention and perception research, analogous phenomena of inattentional deafness have been widely neglected. We here present the first investigation of inattentional deafness in and with music under controlled experimental conditions. Inattentional deafness in music is defined as the inability to consciously perceive an unexpected musical stimulus when attention is focused on a certain facet of the piece. Participants listened to a modification of the first 1'50″ of Richard Strauss' Thus Spake Zarathustra; while the control group just listened, the experimental group had to count the number of timpani beats. An e-guitar solo served as the unexpected event. In Study 1, experimental data from n = 115 participants were analyzed. Non-musicians were compared with musicians to investigate the impact of expertise. In Study 2 (n = 47), the scope of the inattentional deafness effect was investigated with a more salient unexpected stimulus. Results demonstrate an inattentional deafness effect under dynamic musical conditions. Quite unexpectedly, the effect was structurally equivalent even for musicians. Our findings clearly show that sustained inattentional deafness exists in the musical realm, in close correspondence to inattentional blindness with dynamic visual stimuli.

The ambiguity of symbols in the structure of healing.

PubMed

Laderman, C

1987-01-01

In his article, 'The Effectiveness of Symbols,' Lévi-Strauss contends that the details of a Cuna birth incantation evoke specific physiological responses from parturient women, aiding them through difficult labors. His argument, which analyzes the incantation as a text divorced from its social setting, has drawn criticism from students of Cuna society on a number of substantive points, primarily centering around the difficulties that the special linguistic form of ritual language would present to a non-adept. If the patient lacks a thorough comprehension of the mythic details, how can the incantation change her physiological processes? In an attempt to evaluate the effect of myth upon a woman in labor, this article calls upon Cuna and Malay ethnographic data, and presents a Malay birth incantation as interpreted by the ritual practitioner who recited it. Following a discussion of the non-semantic aspects of the incantation and the extent to which the patient shares the interpretation of the healer in both the Malay and Cuna societies, recent biomedical studies are cited in support of hypotheses concerning the physiological and biochemical effects of myth in the management of childbirth.

An attempt for empowering education: A qualitative study of in-service training of nursing personnel.

PubMed

Chaghari, Mahmood; Ebadi, Abbas; Ameryoun, Ahmad; Safari, Mohsen

2016-01-01

In-service training of nursing personnel has a significant role in increasing the empowerment of nurses and promotion of the quality of health services. The objective of this study is to identify and explain the process of in-service training of nursing personnel in the hospitals affiliated with Baqiyatallah University of Medical Sciences in Tehran. The present study employed a qualitative approach using Corbin and Strauss method (2008) in 2015, and examined the viewpoints and experiences of 35 nurses, nurse managers, and educational managers with the in-service education of nursing staffs. According to this method, comparisons, asking questions, flip-flop technique, depicting personal experiences, and raising red flag were used for data analysis. In this study, five major themes including unsuccessful mandatory education, empowering education, organizational challenges, weakness in the educational management, and educational-job resiliency were derived from the results. Unsuccessful mandatory education was the main concern of participants and empowering education was the core category derived from this study. Empowering education emphasizes the practice-oriented and self-directed training. It is an applied education, is participation-oriented, facilitates job functions, and is based on exploration.

Empowering citizens in international governance of nanotechnologies

NASA Astrophysics Data System (ADS)

Malsch, Ineke; Subramanian, Vrishali; Semenzin, Elena; Hristozov, Danail; Marcomini, Antonio; Mullins, Martin; Hester, Karena; McAlea, Eamonn; Murphy, Finbarr; Tofail, Syed A. M.

2015-05-01

The international dialogue on responsible governance of nanotechnologies engages a wide range of actors with conflicting as well as common interests. It is also characterised by a lack of evidence-based data on uncertain risks of in particular engineered nanomaterials. The present paper aims at deepening understanding of the collective decision making context at international level using the grounded theory approach as proposed by Glaser and Strauss in "The Discovery of Grounded Theory" (1967). This starts by discussing relevant concepts from different fields including sociological and political studies of international relations as well as political philosophy and ethics. This analysis of current trends in international law making is taken as starting point for exploring the role that a software decision support tool could play in multi-stakeholder global governance of nanotechnologies. These theoretical ideas are then compared with the current design of the SUN Decision Support System (SUNDS) under development in the European project on Sustainable Nanotechnologies (SUN, www.sun-fp7.eu). Through constant comparison, the ideas are also compared with requirements of different stakeholders as expressed during a user workshop. This allows for highlighting discussion points for further consideration.

Implementing community-based education in basic nursing education programs in South Africa.

PubMed

Mtshali, N G

2009-03-01

Education of health professionals using principles of community-based education is the recommended national policy in South Africa. A paradigm shift to community-based education is reported in a number of nursing education institutions in South Africa. Reviewed literature however revealed that in some educational institutions planning, implementation and evaluation of Community-based Educational (CBE) programmes tended to be haphazard, uncoordinated and ineffective, resulting in poor student motivation. Therefore the purpose of this study was to analyse the implementation of community-based education in basic nursing education programmes in South Africa. Strauss and Corbin's (1990) grounded theory approach guided the research process. Data were collected by means of observation, interviews and document analysis. The findings revealed that collaborative decision-making involving all stakeholders was crucial especially during the curriculum planning phase. Furthermore, special criteria should be used when selecting community learning sites to ensure that the selected sites are able to facilitate the development of required graduate competencies. Collaborative effort, true partnership between academic institutions and communities, as well as government support and involvement emerged as necessary conditions for the successful implementation of community-based education programmes.

Challenges of Hospital Response to the Twin Earthquakes of August 21, 2012, in East Azerbaijan, Iran.

PubMed

Pouraghaei, Mahboub; Jannati, Ali; Moharamzadeh, Peyman; Ghaffarzad, Amir; Far, Moharram Heshmati; Babaie, Javad

2017-08-01

As the cornerstone of any health system, hospitals have a crucial role in response to disasters. Because hospital experiences in disaster response can be instructive, this study examined the challenges of hospital response to the twin earthquakes of 2012 in East Azerbaijan, Iran. In this qualitative study, the challenges of hospital response in the East Azerbaijan earthquakes were examined through focus group discussions. Participants were selected purposefully, and focus group discussions continued until data saturation. The data were manually analyzed by using Strauss and Corbin's recommended method. Hospitals were faced with 6 major challenges: lack of preparedness, lack of coordination, logistic deficiencies, patient/injured management, communication management, and other smaller challenges that were categorized in the "other challenges" category. The main theme was the lack of preparedness for disasters. Although hospital preparedness is emphasized in credible references, this study showed that lack of preparedness is a major challenge for hospitals during disasters. Thus, it seems that hospital officials' disaster risk perception and hospital preparedness should be improved. In addition, hospital preparedness assessment indexes should be included in the hospital accreditation process. (Disaster Med Public Health Preparedness. 2017;11:422-430).

[Turnover Experience of Male Nurses].

PubMed

Kim, Hyunsu; Lee, Jeongseop

2017-02-01

The aim of this study was to identify turnover experiences of men in nursing and to derive a substantive theory on the turnover experience of men who are nurses. Data were collected through in-depth interviews with 13 men who had worked as a nurse for 1 year or more, and had a turnover experience during that period. Collected data were analyzed on the basis of Strauss and Corbin's grounded theory. The core category in the turnover experiences of the respondents was 'seeking a stable place for me'. In the analysis of the core category, types of 'contentment', 'seeking', 'survival' and 'confusion' were identified. The sequential stages of these nurses' turnover experience were 'confrontation', 'incertitude', 'retrying' and 'realization'. However, when a problem arose in the process, they returned to the stage of confusion. Thus, these stages could occur in a circular fashion. These findings provide a deep understanding of the turnover experience of men in nursing and offers new information about how they adapt to nursing practice. The findings should be useful as foundational data for men who hope to become nurses and also for managers responsible for nurses who are men. © 2017 Korean Society of Nursing Science

Central nervous system involvement in eosinophilic granulomatosis with polyangiitis (Churg-Strauss): Report of 26 patients and review of the literature.

PubMed

André, Raphaël; Cottin, Vincent; Saraux, Jean-Luc; Blaison, Gilles; Bienvenu, Boris; Cathebras, Pascal; Dhote, Robin; Foucher, Aurélie; Gil, Helder; Lapoirie, Joëlle; Launay, David; Loustau, Valentine; Maurier, François; Pertuiset, Edouard; Zénone, Thierry; Seebach, Jörg; Costedoat-Chalumeau, Nathalie; Puéchal, Xavier; Mouthon, Luc; Guillevin, Loïc; Terrier, Benjamin

2017-09-01

Although peripheral nervous system involvement is common in eosinophilic granulomatosis with polyangiitis (EGPA), central nervous system (CNS) manifestations are poorly described. This study aimed to describe CNS involvement in EGPA. This retrospective, observational, multicenter study included patients with EGPA and CNS involvement affecting cranial nerves, brain and/or spinal cord. We also undertook a systematic literature review. We analyzed 26 personal cases and 62 previously reported cases. At EGPA diagnosis, asthma was noted in 97%, eosinophilia in 98%, peripheral neuropathy in 55% and cardiac involvement in 41%. 38/71 (54%) were ANCA-positive, with a perinuclear-labeling pattern and/or anti-MPO specificity. CNS was involved in 86% at EGPA diagnosis, preceded EGPA in 2%, and occurred during follow-up in 12% after a median of 24months. Main neurological manifestations were ischemic cerebrovascular lesions in 46 (52%), intracerebral hemorrhage and/or subarachnoid hemorrhage in 21 (24%), loss of visual acuity in 28 (33%) (15 with optic neuritis, 9 with central retinal artery occlusion, 4 with cortical blindness), and cranial nerves palsies in 18 (21%), with 25 patients having ≥1 of these clinical CNS manifestations. Among the 81 patients with assessable neurological responses, 43% had complete responses without sequelae, 43% had partial responses with long-term sequelae and 14% refractory disease. After a mean follow-up of 36months, 11 patients died including 5 from intracerebral hemorrhages. EGPA-related CNS manifestations form 4 distinct neurological pictures: ischemic lesions, intracerebral hemorrhages, cranial nerve palsies and loss of visual acuity. Such manifestation should prompt practitioners to consider EGPA in such conditions. Long-term neurological sequelae were common, and intracerebral hemorrhages had the worst prognostic impact. Copyright © 2017 Elsevier B.V. All rights reserved.

A Sparse-Sampled Redshift Survey of IRAS Galaxies - Part One - the Convergence of the IRAS Dipole and the Origin of Our Motion with Respect to the Microwave Background

NASA Astrophysics Data System (ADS)

Rowan-Robinson, M.; Lawrence, A.; Saunders, W.; Crawford, J.; Ellis, R.; Frenk, C. S.; Parry, I.; Xiaoyang, X.; Allington-Smith, J.; Efstathiou, G.; Kaiser, N.

1990-11-01

We have carried out a sparse-sampled redshift survey of IRAS Point Source Catalog 60-micron sources, at a sampling rate of one in six. For a sample of 2163 sources with S>=0.6 Jy at |b|>10^deg^, we have redshifts for 2093, or 97 per cent. Of the sources, which were selected from the IRAS 60-micron Galaxy Catalogue of Rowan-Robinson et al., 1.2 per cent turned out to be galactic and 0.4 per cent are blank fields. Our survey reaches significantly deeper than the all-sky IRAS galaxy redshift survey of Strauss & Davis, which is complete to 1.94 Jy. We have used these data to investigate the convergence of the IRAS dipole. We find that the peculiar acceleration acting on the Local Group, as measured with IRAS galaxies, is generated within 100h^-1^ Mpc. For d<50h^-1^ Mpc, our estimate of the acceleration generated agrees with that of Strauss & Davis. However, we find that a non-negligible acceleration is generated between 50 and 100h^-1^ Mpc. The direction of the acceleration is consistent, within the uncertainties, with that of the microwave background dipole. The amplitude implies a value for the cosmological density parameter {OMEGA}_0_ = 0.7 (+0.3,-0.2) if the IRAS galaxy distribution traces that of the total mass. If {OMEGA}_0_ = 1, a bias parameter b = 1.23+/-0.23 is inferred. The convergence properties of the dipole are similar to those obtained from random locations in N-body simulations of a cold dark matter universe. Assuming that the IRAS galaxies trace the mass distribution, we predict a peculiar velocity for each galaxy in the survey, by calculating the dipole at each galaxy position, initially assuming distances based on velocities. We then construct a simple analytical model for this flow field, involving 12 massive clusters (including the prominent superclusters within 150h^-1^Mpc) correcting galaxy distances and peculiar velocities in an iterative procedure. The model clusters have large haloes in which the density is proportional to r^-1.6^, extending

Overview of Classical Test Theory and Item Response Theory for Quantitative Assessment of Items in Developing Patient-Reported Outcome Measures

PubMed Central

Cappelleri, Joseph C.; Lundy, J. Jason; Hays, Ron D.

2014-01-01

Introduction The U.S. Food and Drug Administration’s patient-reported outcome (PRO) guidance document defines content validity as “the extent to which the instrument measures the concept of interest” (FDA, 2009, p. 12). “Construct validity is now generally viewed as a unifying form of validity for psychological measurements, subsuming both content and criterion validity” (Strauss & Smith, 2009, p. 7). Hence both qualitative and quantitative information are essential in evaluating the validity of measures. Methods We review classical test theory and item response theory approaches to evaluating PRO measures including frequency of responses to each category of the items in a multi-item scale, the distribution of scale scores, floor and ceiling effects, the relationship between item response options and the total score, and the extent to which hypothesized “difficulty” (severity) order of items is represented by observed responses. Conclusion Classical test theory and item response theory can be useful in providing a quantitative assessment of items and scales during the content validity phase of patient-reported outcome measures. Depending on the particular type of measure and the specific circumstances, either one or both approaches should be considered to help maximize the content validity of PRO measures. PMID:24811753

[The educational context to train health care professionals. A qualitative approach].

PubMed

Matus B, Olga; Ortega B, Javiera; Parra P, Paula; Ortiz M, Liliana; Márquez U, Carolina; Stotz R, Melita; Fasce H, Eduardo

2017-07-01

There are differences in the educational context in Health Sciences, between clinical and non-clinical teachers. Therefore, the didactic and reflexive peculiarities of both educational scenarios should be analyzed. To describe the conditions of the educational context in Health Sciences for the practice of the teaching role in a Chilean university. Qualitative study, performed according to Grounded Theory of Strauss and Corbin. Thirty one teachers from six health sciences programs were selected according to Patton's maximum variation criterion and contacted personally, after an informed consent process. Semi-structured interviews and focus group were performed, analyzed by open coding, using the constant comparison method, with the Atlas-ti 7.5.2 software. Six conditions of the educational context that can support the teaching role in these careers emerged. Namely, a clinical field suited for patient attention and teaching, classrooms designed for the new educational models, number of students in the classrooms and clinical settings, insertion programs for teachers' training, teachers' coordination and economic resources of the program. Health Sciences programs are developed in a complex educational context, having to articulate diverse elements to train professionals. Therefore, it is fundamental to understand the conditions of the educational context that can favor the practice of the teaching role, thus generating improvements in teaching-learning process.

VizieR Online Data Catalog: Galaxy properties in clusters. II. (Muriel+, 2014)

NASA Astrophysics Data System (ADS)

Muriel, H.; Coenda, V.

2014-06-01

In paper I (Coenda & Muriel, 2009A&A...504..347C, Cat. J/A+A/504/347), we selected an X-ray sample of 49 clusters of galaxies from Popesso et al. (2004A&A...423..449P, Cat. J/A+A/423/449, hereafter P04) in the redshift range 0.05Strauss et al. 2002AJ....124.1810S) of the Fifth Data Release (DR5; Adelman-McCarthy et al. 2007ApJS..172..634A, Cat. II/276) of SDSS, which includes spectroscopic redshifts down to a Petrosian magnitude r=17.77. In this paper, we expand the X-ray cluster sample using the cross-correlation between NORAS and SDSS. We identify a subsample from Bohringer et al. (2000ApJS..129..435B, Cat. J/ApJS/129/435, hereafter B00), which we labelled C-B00-I, using the MGS of the Seventh Data Release (DR7; Abazajian et al. 2009ApJS..182..543A) of SDSS. This subsample comprises 55 galaxy clusters in the redshift range 0.05

Balancing power: A grounded theory study on partnership of academic service institutes.

PubMed

Heshmati Nabavi, Fatemeh; Vanaki, Zohreh; Mohammadi, Eesa; Yazdani, Shahram

2017-07-01

Governments and professional organizations have called for new partnerships between health care providers and academics to improve clinical education for the benefit of both students and patients. To develop a substantive grounded theory on the process of forming academic-service partnerships in implementing clinical education, from the perspective of academic and clinical nursing staff members and managers working in Iranian settings. The participants included 15 hospital nurses, nurse managers, nurse educators, and educational managers from two central universities and clinical settings from 2009 to 2012. Data were collected through 30 in-depth, semi-structure interviews with the individual participants and then analyzed using the methodology of Strauss and Corbin's grounded theory. Utilizing "balancing power" as the core variable enabled us to integrate the concepts concerning the partnership processes between clinical and educational institutes. Three distinct and significant categories emerged to explain the process of partnership: 1) divergence, 2) conflict between educational and caring functions, and 3) creation of balance between educational and caring functions. In implementing clinical education, partnerships have been formed within a challenging context in Iran. Conflict between clinical and educational functions was the main concern of both sides of the partnership in forming a collaborative relationship, with our findings emphasizing the importance of nursing educators' role in the establishment of partnership programs.

An ethnographic investigation of junior doctors' capacities to practice interprofessionally in three teaching hospitals.

PubMed

Milne, Jacqueline; Greenfield, David; Braithwaite, Jeffrey

2015-01-01

Collaborative practice among early career staff is at the bedrock of interprofessional care. This study investigated factors influencing the enactment of interprofessional practice by using the day-to-day role of six junior doctors in three teaching hospitals as a gateway to understand the various professions' interactive behaviours. The contextual framework used for the study was Strauss' theory of negotiated order. Ethnographic techniques were applied to observe the actions and interactions of participants on typical working days in their hospital environments. Field notes were created and thematic analysis was applied to the data. Three themes explored were culture, communication, and collaboration. Issues identified highlight the bounded organisational and professional cultures within which junior doctors work, and systemic problems in interprofessional interaction and communication in the wards of hospitals. There are indications that early career doctors are interprofessional isolates. The constraints of short training terms and pressure from multi-faceted demands on junior doctors can interfere with the establishment of meaningful relationships with nurses and other health professionals. The realisation of sustained interprofessional practice is, therefore, practically and structurally difficult. Enabling factors supporting the sharing of expertise are outweighed by barriers associated with professional and hospital organisational cultures, poor interprofessional communication, and the pressure of competing individual task demands in the course of daily practice.

Adjustment process in Iranian men to their wives' breast cancer.

PubMed

Nasiri, A; Taleghani, F; Irajpour, A

2016-03-01

Women's breast cancer causes various problems in both spouses' family life as well as enormous stress for their husbands. This grounded theory study aimed to define ways in which men adjust to their wives' breast cancer and to present an appropriate model in this respect. Twenty-six individuals (22 husbands, 2 patients and 2 physicians) were selected through purposive and theoretical sampling. The data were collected through in-depth individual interviews. Strauss and Corbin's method was used for data analysis. Data analysis revealed that Iranian men's adjustment to their wives' breast cancer occurs during the following three stages: the first stage turbulence after confrontation with the disease that contains categories 'internal unrest', 'concerns about disease management' and 'sensing the beginning of disorganization in family life'; the second stage disorganisation of family life that contains 'disturbance of family life', 'attempt to get rid of tension' and 'resistance against family life disorganisation'; and the third stage struggle to reorder family life consisting of 'support to the wife', 'revision in communications with relatives' and 'seeking external support' categories. Iranian men struggled for constant organisation of family life after their wives' disease. Health providers should take measures to support the men by facilitating their adjustment to their wives' disease. © 2015 John Wiley & Sons Ltd.

Finding the New Normal: Accepting Changes After Combat-Related Mild Traumatic Brain Injury.

PubMed

Hyatt, Kyong S; Davis, Linda L; Barroso, Julie

2015-07-01

More than 300,000 soldiers have returned from Southwest Asia (i.e., Iraq and Afghanistan) with combat-related mild traumatic brain injuries (mTBIs). Despite less visible physical injuries, these soldiers demonstrate various physical and cognitive symptoms that impact their ability to reintegrate post-mTBI. This study explores family reintegration experiences, as described by married dyads, following a combat-related mTBI. Nine soldiers with mTBI and their spouses participated, and a total of 27 interviews, both joint and individual, were conducted. Strauss and Corbin's grounded theory methodology and semistructured interviews were used to collect participants' perceptions and analyze the data. The overarching theme of the reintegration experience is described as finding the "new normal." A new normal was defined by participants as the couple's new, post-mTBI expectation of the family unit or family routine. Some participants indicated that they had accepted the post-mTBI changes and were working toward this new normal, whereas others indicated these changes were unacceptable and continued their efforts to return to pre-injury functioning. Individuals with mTBI and their families may benefit from interventions that directly address mismatched expectations and promote the acceptance of a new normal. © 2015 Sigma Theta Tau International.

[The transformation process among a group of heart patients followed in ergotherapy with the aim of modifying the balance of occupation].

PubMed

Dubouloz, C J; Chevrier, J; Savoie-Zajc, L

2001-06-01

Transformative learning is a process of adaptation that allows for profound personal change in occupational therapy clients. This process is provoked by a triggering factor, such as illness, which results in a critical reflection on values, beliefs, feelings and personal knowledge associated with the object of change (Mezirow, 1991). As part of an objective aimed at modifying the balance of occupation, nine participants were interviewed over a 6 month period to explore their processes of change. Eight concepts related to the objective of change of the balance of occupation emerged from an inductive data analysis process (Glaser and Strauss, 1967). The perception of work was interpreted by the authors as having undergone the most significant sense of transformation amongst the participants. Two other perceptions, 1) the definition of self and 2) the concept of health emerged as new elements essential to the modification of the balance of occupation. The transformation process linked to these eight concepts revealed a specific structure and sequence. The results highlight the primary role of critical reflection amongst occupational therapy clients and underline the importance of deconstructing common values and beliefs which could slow down the process of change. Moreover, the development of new values and beliefs is a vehicle for change in occupational therapy.

Family problem solving interactions and 6-month symptomatic and functional outcomes in youth at ultra-high risk for psychosis and with recent onset psychotic symptoms: a longitudinal study.

PubMed

O'Brien, Mary P; Zinberg, Jamie L; Ho, Lorena; Rudd, Alexandra; Kopelowicz, Alex; Daley, Melita; Bearden, Carrie E; Cannon, Tyrone D

2009-02-01

This study prospectively examined the relationship between social problem solving behavior exhibited by youths at ultra-high risk for psychosis (UHR) and with recent onset psychotic symptoms and their parents during problem solving discussions, and youths' symptoms and social functioning six months later. Twenty-seven adolescents were administered the Structured Interview for Prodromal Syndromes and the Strauss-Carpenter Social Contact Scale at baseline and follow-up assessment. Primary caregivers participated with youth in a ten minute discussion that was videotaped, transcribed, and coded for how skillful participants were in defining problems, generating solutions, and reaching resolution, as well as how constructive and/or conflictual they were during the interaction. Controlling for social functioning at baseline, adolescents' skillful problem solving and constructive communication, and parents' constructive communication, were associated with youths' enhanced social functioning six months later. Controlling for symptom severity at baseline, we found that there was a positive association between adolescents' conflictual communications at baseline and an increase in positive symptoms six months later. Taken together, findings from this study provide support for further research into the possibility that specific family interventions, such as problem solving and communication skills training, may improve the functional prognosis of at-risk youth, especially in terms of their social functioning.

Caring and its role in effective life science teaching: A case study

NASA Astrophysics Data System (ADS)

Seals, Mark A.

The focus of this inquiry was to explore, analyze, and describe the reciprocity of caring as it is embedded in and shapes the culture of the high school life science classroom. The data collection and analysis was guided by the theoretical underpinnings of phenomenology and heuristics, while following a multiple case study design. The case study involved two life science teachers, one male (Mr. Gene Fischer) and one female (Mrs. Carrie Sanders), who are perceived to be effective and caring educators. They were selected purposely, along with two of their classes (an upper level genetic/molecular biology class and a lower level freshman biology course), which included 82 students. Data were collected in the form of field notes, videotapes and documents at each site. Grounded theory generated from the study was analyzed by following a case analysis (Merriam, 1988), and cross-case analysis (Merriam, 1988) approach, while also using the tenets of the constant comparative method by Glaser and Strauss (1967). By studying experienced, effective and caring teachers (and their students) over time, it was hoped to expand the extant theory about the ethic of care to better understanding the impact caring has in a variety of teaching and learning situations within the life science classroom.

Stress, Socializing, and Other Motivations for Smoking Among the Lesbian, Gay, Bisexual, Transgender, and Queer Community in New York City.

PubMed

Jannat-Khah, Deanna P; Dill, LeConté J; Reynolds, Simone A; Joseph, Michael A

2017-01-01

This study contributes to the emerging literature on lesbian, gay, bisexual, transgendered, and queer (LGBTQ) health disparities and tobacco use by examining the motivations for smoking among the New York City (NYC) LGBTQ population. We used grounded theory and blended methods from 3 grounded theorists-Strauss, Corbin, and Charmaz-for data collection, coding, and analysis. NYC has extensive legislation to prevent smoking; however, the current smoking prevalence of homosexuals is double that of heterosexuals. Study participants were leaders from 23 NYC LGBTQ organizations. Leaders were chosen to establish a relationship with community and to ensure cultural sensitivity. Eligibility criteria required holding a leadership position in an organization serving the NYC LGBTQ community. Interviews were transcribed verbatim and uploaded into Dedoose for analysis. An initial code list was developed from the interview guide. Key themes were identified as the themes with the most number of quotes. Three key themes emerged from our interviews: image, socializing, and stress. Smoking was reported to be a socialization aid and a maladaptive coping technique for stress arising from interactions of conflicting identities. Future smoking cessation interventions among the LGBTQ community should equip smokers with healthy coping mechanisms that address the stressors that arise from the intersections of smokers' many identities.

Transformation of dwelling culture based on riverine community in Musi River Palembang

NASA Astrophysics Data System (ADS)

Wicaksono, Bambang; Siswanto, Ari; Kusdiwanggo, Susilo; Anwar, Widya Fransiska Febriati

2017-11-01

Palembang City development since the Palembang Darussalam Sultanate era to the reformation era has impact on the living culture community, less of the raft houses, houses on stilts transformed into a terraced house, and the house became the dominant land. Dwelling Culture oriented on transformation of river become land-oriented. The development has leaving identity, character, and potential of the riverine architecture and dwelling life of river. The goals of study are to describe a case and revealing the meaning of dwelling cultural transformation in Musi River society from the process of cultural acculturation and investigate the architectural aspect from the form of house and modes of dwelling through the structuralism approach. The data collection is conducted qualitatively by using data collection techniques such as observation, interview, literature study, whereas the method of analysis, is a method that is done through Levi-Strauss structuralism approach that identifies all the elements of community thought in a systematic procedure. The results showed the structure behind the orientation, position, shape, and layout of dwelling revealed through the meanings in it. It means, the change and development from cultural acculturation process which oriented in the land dwelling, based on structure thinking of Palembang society.

Family problem solving interactions and 6-month symptomatic and functional outcomes in youth at ultra-high risk for psychosis and with recent onset psychotic symptoms: A longitudinal study

PubMed Central

O'Brien, Mary P.; Zinberg, Jamie L.; Ho, Lorena; Rudd, Alexandra; Kopelowicz, Alex; Daley, Melita; Bearden, Carrie E.; Cannon, Tyrone D.

2009-01-01

This study prospectively examined the relationship between social problem solving behavior exhibited by youths at ultra-high risk for psychosis (UHR) and with recent onset psychotic symptoms and their parents during problem solving discussions, and youths' symptoms and social functioning six months later. Twenty-seven adolescents were administered the Structured Interview for Prodromal Syndromes and the Strauss-Carpenter Social Contact Scale at baseline and follow-up assessment. Primary caregivers participated with youth in a ten minute discussion that was videotaped, transcribed, and coded for how skillful participants were in defining problems, generating solutions, and reaching resolution, as well as how constructive and/or conflictual they were during the interaction. Controlling for social functioning at baseline, adolescents' skillful problem solving and constructive communication, and parents' constructive communication, were associated with youths' enhanced social functioning six months later. Controlling for symptom severity at baseline, we found that there was a positive association between adolescents' conflictual communications at baseline and an increase in positive symptoms six months later. Taken together, findings from this study provide support for further research into the possibility that specificfamily interventions, such as problem solving and communication skills training, may improve the functional prognosis of at-risk youth, especially in terms of their social functioning. PMID:18996681

The phenomenon of hand holding as a coping strategy in adolescents experiencing treatment-related pain.

PubMed

Weekes, D P; Kagan, S H; James, K; Seboni, N

1993-01-01

The purpose of this study was to understand the phenomenon of hand holding as a coping strategy used by adolescents to deal with treatment-related pain. The convenience sample consisted of 20 adolescents whose ages were 11 to 19 years: 10 had cancer and 10 had renal disease (this served as the comparison group). Using a descriptive design, a semistructured interview was conducted with each adolescent. To supplement and support interview data, structured observations were conducted as adolescents underwent painful treatments (eg, blood draws, shunt placement, peripheral chemotherapy, lumbar punctures, and bone marrow aspirations). Data were analyzed using descriptive statistics and qualitative analytic techniques similar to those delineated by Strauss and Corbin. The results of this study indicated that subjects in both the cancer and the renal disease group perceived hand holding to be a very effective coping strategy in ameliorating treatment-related pain. Overwhelmingly the patients preferred to hold their mother's hand. When the mother was unavailable, they preferred to hold a specific nurse's hand. Hand holding functioned to reduce tension associated with impending treatments, as a source of distraction, and as a source of security. Accordingly, adolescents' subjective experience of treatment-related pain was reduced when they felt more secure, less tense, and were distracted.

[A Grounded Theory Approach on Nurses' Experience with Workplace Bullying].

PubMed

Kang, Jiyeon; Yun, Seonyoung

2016-04-01

The purpose of this qualitative study was to explore the workplace bullying experience of Korean nurses. Participants were twenty current or former hospital nurses who had experienced workplace bullying. Data were collected through focus group and individual in-depth interviews from February to May, 2015. Theoretical sampling method was applied to the point of theoretical saturation. Transcribed interview contents were analyzed using Corbin and Strauss's grounded theory method. A total of 110 concepts, 48 sub-categories, and 17 categories were identified through the open coding process. As a result of axial coding based on the paradigm model, the central phenomenon of nurses' workplace bullying experience was revealed as 'teaching that has become bullying', and the core category was extracted as 'surviving in love-hate teaching' consisting of a four-step process: confronting reality, trial and error, relationship formation, and settlement. The relationship formation was considered to be the key phase to proceed to the positive settlement phase, and the participants utilized various strategies such as having an open mind, developing human relationships, understanding each other in this phase. The in-depth understanding of the workplace bullying experience has highlighted the importance of effective communication for cultivating desirable human relationships between nurses.

[The experience of adult Korean children caring for parents institutionalized with dementia].

PubMed

Kwon, Suhye; Tae, Young Sook

2014-02-01

The purpose of the study was to explore and describe the experience of adult Korean children who are caregivers for parents institutionalized with dementia. Participants were fourteen adult children caregivers of elders institutionalized with dementia. Data were collected through in-depth unstructured interviews with individual participants from August to November, 2012. Theoretical sampling was used to the point of theoretical saturation. Data were analyzed using Strauss and Corbin's Grounded Theory Method. From open coding, 67 concepts, 29 sub-categories, and 14 categories were identified. Analysis revealed that the core category of the experience of adult children caring for their parents institutionalized with dementia was 'enduring the role of a prop' consisting of four phases: initial turmoil, exploration, role adjustment, and acclimation. To manage the role of a prop, participants utilized various action/interactional strategies such as overcoming the unfamiliarity, overseeing the nursing home care, and counterbalancing the caring roles. As a result, participants experienced ambivalence towards the existence of parents with dementia, changes in family relationships, altered viewpoint towards nursing homes, and restructuring of life. In-depth understanding of the experience will guide nurses to promote effective interventions in order to better support the Korean family caregivers of parents institutionalized with dementia.

A Grounded theory study of the intention of nurses to leave the profession 1

PubMed Central

Alilu, Leyla; Zamanzadeh, Vahid; Valizadeh, Leila; Habibzadeh, Hosein; Gillespie, Mark

2017-01-01

ABSTRACT Objective: this study explores the process of the development of an intention to leave bedside nursing. Method: the process was studied from the perspective of 21 nurses using the grounded theory method. Data were collected using semi-structured interviews and the constant comparative method of Corbin and Strauss was used for data analysis. Results: according to the participants, the two main categories, "social image of nursing", and "culture and structure of the bedside", were the contextual factors that influence why nurses are leaving bedside care provision. Disappointment with a perceived lack of progress or improvement in the clinical experience formed primary psychosocial concerns for the participants. Competence and a process of self-control were steps taken by the participants. These, associated with interventional conditions produced the outcomes of the loss of professional commitment and desire to leave bedside nursing. "Failure to integrate personal expectations with organizational expectations: in search of escape" was the central category of the study that linked the categories together. Conclusion: the findings of this study provide useful information about the needs of nurses for overcoming the intention to leave bedside care. The identification of this process can help in recognizing emerging problems and providing solutions for them. PMID:28591301

Knowledge Creation in Nursing Education

PubMed Central

Hassanian, Zahra Marzieh; Ahanchian, Mohammad Reza; Ahmadi, Suleiman; Gholizadeh, Rezvan Hossein; Karimi-Moonaghi, Hossein

2015-01-01

In today’s society, knowledge is recognized as a valuable social asset and the educational system is in search of a new strategy that allows them to construct their knowledge and experience. The purpose of this study was to explore the process of knowledge creation in nursing education. In the present study, the grounded theory approach was used. This method provides a comprehensive approach to collecting, organizing, and analyzing data. Data were obtained through 17 semi-structured interviews with nursing faculties and nursing students. Purposeful and theoretical sampling was conducted. Based on the method of Strauss and Corbin, the data were analyzed using fragmented, deep, and constant-comparative methods. The main categories included striving for growth and reduction of ambiguity, use of knowledge resources, dynamism of mind and social factors, converting knowledge, and creating knowledge. Knowledge was converted through mind processes, individual and group reflection, praxis and research, and resulted in the creation of nursing knowledge. Discrete nursing knowledge is gained through disconformity research in order to gain more individual advantages. The consequence of this analysis was gaining new knowledge. Knowledge management must be included in the mission and strategic planning of nursing education, and it should be planned through operational planning in order to create applicable knowledge. PMID:25716383

The vacuole model: new terms in the second order deflection of light

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bhattacharya, Amrita; Nandi, Kamal K.; Garipova, Guzel M.

2011-02-01

The present paper is an extension of a recent work (Bhattacharya et al. 2010) to the Einstein-Strauss vacuole model with a cosmological constant, where we work out the light deflection by considering perturbations up to order M{sup 3} and confirm the light bending obtained previously in their vacuole model by Ishak et al. (2008). We also obtain another local coupling term −5πM{sup 2}Λ/8 related to Λ, in addition to the one obtained by Sereno (2008, 2009). We argue that the vacuole method for light deflection is exclusively suited to cases where the cosmological constant Λ disappears from the path equation.more » However, the original Rindler-Ishak method (2007) still applies even if a certain parameter γ of Weyl gravity does not disappear. Here, using an alternative prescription, we obtain the known term −γR/2, as well as another new local term 3πγM/2 between M and γ. Physical implications are compared, where we argue that the repulsive term −γR/2 can be masked by the Schwarzschild term 2M/R in the halo regime supporting attractive property of the dark matter.« less

The origin of high frequency radiation in earthquakes and the geometry of faulting

NASA Astrophysics Data System (ADS)

Madariaga, R.

2004-12-01

In a seminal paper of 1967 Kei Aki discovered the scaling law of earthquake spectra and showed that, among other things, the high frequency decay was of type omega-squared. This implies that high frequency displacement amplitudes are proportional to a characteristic length of the fault, and radiated energy scales with the cube of the fault dimension, just like seismic moment. Later in the seventies, it was found out that a simple explanation for this frequency dependence of spectra was that high frequencies were generated by stopping phases, waves emitted by changes in speed of the rupture front as it propagates along the fault, but this did not explain the scaling of high frequency waves with fault length. Earthquake energy balance is such that, ignoring attenuation, radiated energy is the change in strain energy minus energy released for overcoming friction. Until recently the latter was considered to be a material property that did not scale with fault size. Yet, in another classical paper Aki and Das estimated in the late 70s that energy release rate also scaled with earthquake size, because earthquakes were often stopped by barriers or changed rupture speed at them. This observation was independently confirmed in the late 90s by Ide and Takeo and Olsen et al who found that energy release rates for Kobe and Landers were in the order of a MJ/m2, implying that Gc necessarily scales with earthquake size, because if this was a material property, small earthquakes would never occur. Using both simple analytical and numerical models developed by Addia-Bedia and Aochi and Madariaga, we examine the consequence of these observations for the scaling of high frequency waves with fault size. We demonstrate using some classical results by Kostrov, Husseiny and Freund that high frequency energy flow measures energy release rate and is generated when ruptures change velocity (both direction and speed) at fault kinks or jogs. Our results explain why super shear ruptures are

Conduits to care: call lights and patients' perceptions of communication.

PubMed

Montie, Mary; Shuman, Clayton; Galinato, Jose; Patak, Lance; Anderson, Christine A; Titler, Marita G

2017-01-01

Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients' perceptions concerning call light use and communication. The specific aim of this study was to solicit patients' perceptions regarding their call light use and communication with nursing staff. Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated). Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. Using qualitative descriptive methods, five major themes emerged from patients' perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants' perceptions of "nurse work"). Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. Findings from this study extend the knowledge of patients' understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery.

Conduits to care: call lights and patients’ perceptions of communication

PubMed Central

Montie, Mary; Shuman, Clayton; Galinato, Jose; Patak, Lance; Anderson, Christine A; Titler, Marita G

2017-01-01

Background Call light systems remain the primary means of hospitalized patients to initiate communication with their health care providers. Although there is vast amounts of literature discussing patient communication with their health care providers, few studies have explored patients’ perceptions concerning call light use and communication. The specific aim of this study was to solicit patients’ perceptions regarding their call light use and communication with nursing staff. Methods Patients invited to this study met the following inclusion criteria: proficient in English, been hospitalized for at least 24 hours, aged ≥21 years, and able to communicate verbally (eg, not intubated). Thirty participants provided written informed consent, were enrolled in the study, and completed interviews. Results Using qualitative descriptive methods, five major themes emerged from patients’ perceptions (namely; establishing connectivity, participant safety concerns, no separation: health care and the call light device, issues with the current call light, and participants’ perceptions of “nurse work”). Multiple minor themes supported these major themes. Data analysis utilized the constant comparative methods of Glaser and Strauss. Discussion Findings from this study extend the knowledge of patients’ understanding of not only why inconsistencies occur between the call light and their nurses, but also why the call light is more than merely a device to initiate communication; rather, it is a direct conduit to their health care and its delivery. PMID:29075125

Mentoring Nurse Practitioners in a Hospital Setting.

PubMed

Pop, Rodica S

2017-08-01

Nursing philosophy is the foundation of nurse practitioner (NP) training. However, NP practice is based on the medical care model. Thus, the necessity of mediating between these two approaches is often problematic for new NPs who are transitioning into their new roles. Mentoring has been used successfully to facilitate role transition and role understanding for nurses, NPs, and physicians. However, mentoring has been rarely studied in NPs. The purpose of this study was to develop a theory of mentoring for new NPs in a hospital setting. Grounded theory methodology was used. The sampling approach was initially purposive and was then shifted to theoretical to ensure the collection of meaningful data. Semistructuredinterviews were recorded and transcribed into Word documents for analysis. The three-phase analysis developed by Corbin and Strauss was initiated after the second interview. Sixteen participants (eight mentors and eight mentees) were interviewed between February and June 2011. The core category that emerged from the data was "defining self," and the main categories were forming the relationship, developing the relationship, and mentoring outcomes. A well-designed formal mentoring program may greatly improve the transition of NPs into a new role. The theory generated by the data from these study participants provides clearly defined categories that may be operationally defined and utilized to develop evaluation tools for mentoring programs.

Robotics as science (re)form: Exploring power, learning and gender(ed) identity formation in a "community of practice"

NASA Astrophysics Data System (ADS)

Hurner, Sheryl Marie

"Robotics as Science (re)Form" utilizes qualitative research methods to examine the career trajectories and gender identity formation of female youth participating as members of an all-girl, academic team within the male-dominated environment of the FIRST Robotics competition. Following the constant comparative approach (Glaser & Strauss, 1967), my project relies upon triangulating ethnographic data drawn from extensive field notes, semi-structured interviews, and digital and video imagery compiled over two years of participant observation. Drawing upon the sociolinguistic "community of practice" (CoP) framework (Eckert & McConnell-Ginet, 1992; Lave & Wenger, 1991; Wenger, 1998), this study maps the range of gendered "identities" available to girls involved in non-traditional academic and occupational pursuits within a local context, and reveals the nature, structure and impact of power operating within this CoP, a significantly underdeveloped construct within the language and gender literature. These research findings (1) contribute to refining theories of situated or problem based learning with a focus on female youth (Lave & Wenger, 1991; Wenger, 1998); (2) reveal affordances and barriers within the local program design that enable (and preclude) women and minority youth entering the engineering pipeline; and (3) enrich our understanding of intragroup language and gendered "practices" to counter largely essentializing generalizations based upon quantitative analysis. Keywords: Robotics, gender, identity formation, science, STEM, communities of practice

Universal happiness? Cross-cultural measurement invariance of scales assessing positive mental health.

PubMed

Bieda, Angela; Hirschfeld, Gerrit; Schönfeld, Pia; Brailovskaia, Julia; Zhang, Xiao Chi; Margraf, Jürgen

2017-04-01

Research into positive aspects of the psyche is growing as psychologists learn more about the protective role of positive processes in the development and course of mental disorders, and about their substantial role in promoting mental health. With increasing globalization, there is strong interest in studies examining positive constructs across cultures. To obtain valid cross-cultural comparisons, measurement invariance for the scales assessing positive constructs has to be established. The current study aims to assess the cross-cultural measurement invariance of questionnaires for 6 positive constructs: Social Support (Fydrich, Sommer, Tydecks, & Brähler, 2009), Happiness (Subjective Happiness Scale; Lyubomirsky & Lepper, 1999), Life Satisfaction (Diener, Emmons, Larsen, & Griffin, 1985), Positive Mental Health Scale (Lukat, Margraf, Lutz, van der Veld, & Becker, 2016), Optimism (revised Life Orientation Test [LOT-R]; Scheier, Carver, & Bridges, 1994) and Resilience (Schumacher, Leppert, Gunzelmann, Strauss, & Brähler, 2004). Participants included German (n = 4,453), Russian (n = 3,806), and Chinese (n = 12,524) university students. Confirmatory factor analyses and measurement invariance testing demonstrated at least partial strong measurement invariance for all scales except the LOT-R and Subjective Happiness Scale. The latent mean comparisons of the constructs indicated differences between national groups. Potential methodological and cultural explanations for the intergroup differences are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Balancing power: A grounded theory study on partnership of academic service institutes

PubMed Central

HESHMATI NABAVI, FATEMEH; VANAKI, ZOHREH; MOHAMMADI, EESA; YAZDANI, SHAHRAM

2017-01-01

Introduction: Governments and professional organizations have called for new partnerships between health care providers and academics to improve clinical education for the benefit of both students and patients. To develop a substantive grounded theory on the process of forming academic-service partnerships in implementing clinical education, from the perspective of academic and clinical nursing staff members and managers working in Iranian settings. Methods: The participants included 15 hospital nurses, nurse managers, nurse educators, and educational managers from two central universities and clinical settings from 2009 to 2012. Data were collected through 30 in-depth, semi-structure interviews with the individual participants and then analyzed using the methodology of Strauss and Corbin's grounded theory. Results: Utilizing “balancing power” as the core variable enabled us to integrate the concepts concerning the partnership processes between clinical and educational institutes. Three distinct and significant categories emerged to explain the process of partnership: 1) divergence, 2) conflict between educational and caring functions, and 3) creation of balance between educational and caring functions. Conclusions: In implementing clinical education, partnerships have been formed within a challenging context in Iran. Conflict between clinical and educational functions was the main concern of both sides of the partnership in forming a collaborative relationship, with our findings emphasizing the importance of nursing educators' role in the establishment of partnership programs. PMID:28761886

Polymorphisms in genes encoding leptin, ghrelin and their receptors in German multiple sclerosis patients.

PubMed

Rey, Linda K; Wieczorek, Stefan; Akkad, Denis A; Linker, Ralf A; Chan, Andrew; Hoffjan, Sabine

2011-01-01

Multiple sclerosis (MS) is a neuro-inflammatory, autoimmune disease influenced by environmental and polygenic components. There is growing evidence that the peptide hormone leptin, known to regulate energy homeostasis, as well as its antagonist ghrelin play an important role in inflammatory processes in autoimmune diseases, including MS. Recently, single nucleotide polymorphisms (SNPs) in the genes encoding leptin, ghrelin and their receptors were evaluated, amongst others, in Wegener's granulomatosis and Churg-Strauss syndrome. The Lys656Asn SNP in the LEPR gene showed a significant but contrasting association with these vasculitides. We therefore aimed at investigating these polymorphisms in a German MS case-control cohort. Twelve SNPs in the LEP, LEPR, GHRL and GHSR genes were genotyped in 776 MS patients and 878 control subjects. We found an association of a haplotype in the GHSR gene with MS that could not be replicated in a second cohort. Otherwise, no significant differences in allele or genotype frequencies were observed between patients and controls in this particular cohort. Thus, the present results do not support the hypothesis that genetic variation in the leptin/ghrelin system contributes substantially to the pathogenesis of MS. However, a modest effect of GHSR variation cannot be ruled out and needs to be further evaluated in future studies. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Effectiveness of institutional policies to prevent adolescent alcohol use: The view of experts and adolescents].

PubMed

Suárez, Cristian; del Moral, Gonzalo; Musitu, Gonzalo; Sánchez, Juan Carlos; John, Bev

2014-01-01

The objective of this study is to obtain the views of a sample of adolescents and experts on adolescence, family, school, local policies and media, regarding the effectiveness of institutional policies to prevent adolescent alcohol use. Four educational centers in the province of Seville. Head office of the Alcohol and Society Foundation in Madrid. Qualitative study using the method proposed by Grounded theory (Glaser and Strauss, 1967). Data were collected from 10 discussion groups guided by semistructured interviews. The data were analyzed using Atlas ti 5 software. A total of 32 national experts and 40 adolescents of both sexes aged 15 to 20 years living in the province of Seville, selected by theoretical intentional sampling. The experts believed that most of the evaluated preventive actions were effective, while adolescents disputed the preventive impact of most of them. Adolescents proposed actions focused on the reduction of supply of alcohol. Experts proposed a mixed model as the most effective strategy to prevent alcohol consumption in adolescents, combining supply and demand reduction policies, depending on specific short and long term objectives. We have obtained, not only an overview of what is working (or not) from the view of adolescents and experts, but also the key points that should be taken into account for designing effective prevention policies. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Etiology of cutaneous vasculitis: utility of a systemic approach

PubMed

Chanussot-Deprez, Caroline; Vega-Memije, María Elisa; Flores-Suárez, Luis; Ríos-Romero, Celia; Cabiedes-Contreras, Javier; Reyes, Edgardo; Rangel-Gamboa, Lucia

2018-01-01

Cutaneous vasculities (CV) represents a diagnostic challenge, occurs as primary cutaneous disorder or as a manifestation of other entities. To search the cause of CV. Methods: Patients with CV were prospectively evaluated. In all patients, skin biopsies were drawn, and direct immunofluorescence was done in most of the patients. American College of Rheumatology (ACR) and Chapel Hill Consensus Conference Criteria (CHCC) were used for classification. 32 patients were studied. There was female predominance (71.8%). Children presented drug-associated CV or Schönlein-Henoch púrpura (SHP). Adults presented more frequently SHP, systemic lupus erythematosus or paraneoplastic vasculitis, other diagnosis as polyarteritis nodosa, microscopic polyangiitis, thrombotic vasculitis (post-puerperal), antiphospholipid syndrome, Churg-Strauss syndrome, and drug-associated CV were presented. Using the ACR and CHCC criteria, 50% of cases were classified. In our institution, during this work the etiologic diagnostic of CV increased more than twice. However, in the case of HSV or LA and SHP none of the proposed criteria had high specificity; other parameters were used to discern between both. Six patients remained as not classified. In our view, cryoglobulins and hepatitis serology do not seem useful unless patient’s history supports they need to be done. Unclassified patients were followed-up closely for 2 years. Copyright: © 2018 SecretarÍa de Salud

The social practice of rescue: the safety implications of acute illness trajectories and patient categorisation in medical and maternity settings.

PubMed

Mackintosh, Nicola; Sandall, Jane

2016-02-01

The normative position in acute hospital care when a patient is seriously ill is to resuscitate and rescue. However, a number of UK and international reports have highlighted problems with the lack of timely recognition, treatment and referral of patients whose condition is deteriorating while being cared for on hospital wards. This article explores the social practice of rescue, and the structural and cultural influences that guide the categorisation and ordering of acutely ill patients in different hospital settings. We draw on Strauss et al.'s notion of the patient trajectory and link this with the impact of categorisation practices, thus extending insights beyond those gained from emergency department triage to care management processes further downstream on the hospital ward. Using ethnographic data collected from medical wards and maternity care settings in two UK inner city hospitals, we explore how differences in population, cultural norms, categorisation work and trajectories of clinical deterioration interlink and influence patient safety. An analysis of the variation in findings between care settings and patient groups enables us to consider socio-political influences and the specifics of how staff manage trade-offs linked to the enactment of core values such as safety and equity in practice. © 2015 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

Assessment of cultural competence in Texas nursing faculty.

PubMed

Marzilli, Collen

2016-10-01

Cultural competence [CC] is an essential component of nursing education and nursing practice yet there is a gap in the research evaluating CC in faculty and how to practically develop this skillset for faculty members. To explore CC in faculty as evaluated with the Nurses' Cultural Competence Scale [NCCS] and apply the findings to the Purnell Model of Cultural Competence [PMCC] to guide professional development opportunities for faculty members. This was a concurrent mixed-methods study. Faculty members teaching in Texas nursing programs were recruited for the study. Quantitative data was collected using an online survey tool and qualitative data was collected over the phone. 89 Texas faculty members completed the quantitative strand and a subset of 10 faculty members completed the qualitative strand. Descriptive statistics were used to examine the quantitative data and Strauss and Corbin's methodology guided the evaluation of the qualitative data. These two strands were used to support the results. Faculty in Texas are moderately culturally competent. The qualitative findings support the application of the PMCC to the areas identified by the NCCS. The PMCC may be applied to the application of culture and values in nursing professional education as supported by the NCCS. Recommendations are to include the PMCC as a structure for the creation of professional development opportunities for faculty. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Meaning of Disease and Spiritual Responses to Stressors in Adults With Acute Leukemia Undergoing Hematopoietic Stem Cell Transplantation.

PubMed

Farsi, Zahra

2015-12-01

Some studies have shown that patients with cancer may experience significant spiritual distress as well as spiritual growth, that there is a positive association between spirituality and coping, and that positive religious coping predicts enhanced health outcomes. This study was designed to help explain how the meaning of disease and spiritual responses to threatening stressors influence the final experiential outcomes of adults with leukemia undergoing hematopoietic stem cell transplantation in Iran. This grounded theory study conducted in-depth interviews between 2009 and 2011 on 10 adults in Iran with leukemia undergoing hematopoietic stem cell transplantation. Recorded audio interviews were transcribed verbatim in Persian and coded and analyzed using Corbin and Strauss (2008)'s approach. Main categories that emerged from data included "experiencing the meaning of cancer"; "changing perceptions of death, life and health"; and "moving toward perfection and sublimity." "Finding meaning" was the main concept that defined the final outcome of the experience of participants. Understanding the meaning to patients of disease and treatments may help healthcare providers better appreciate the patients' perspective and improve the physician-patient relationship. Nurses are well positioned to play a decisive role in helping patients cope effectively with their treatment process and in helping ensure positive outcomes for treatments through their helping patients find the unique meaning of their experience.

Self-perception in Iranian adolescents with diabetes: a qualitative study.

PubMed

Rostami, Shahnaz; Parsa-Yekta, Zahra; Najafi-Ghezeljeh, Tahereh; Vanaki, Zohreh; Zarea, Kourosh

2015-01-01

It is obvious that self-perception can play an important role in the development of self-management behaviours among adolescents with diabetes to promote their health and quality of life. This study seeks to explain self-perception in adolescents with diabetes. This qualitative study, which is of "grounded theory" type, was performed in 2013 in Ahvaz, Iran, through semi-structured interviews with ten adolescents with type 1 diabetes, two parents and a nurse, who were chosen objectively. Data analysis was performed using Strauss and Corbin 1998 method. Four main theme was obtained from the analysis of data, and the consequence theme was inferred as follows: getting insight (knowledge acquisition and belief management), perceiving similarities with others (not hiding the disease, showing the illness is normal, and accepting an active role in the family), and self-care management (independent control of food and treatment regimen and understanding of capabilities to manage the future of life and manage the daily activities of life), and life satisfaction (perception of being healthy and having a normal life). Getting insight into the disease is the most important part of perceiving similarities with others and offering self-care, which can provide a person's positive perception of himself/herself and the illness, as well as life satisfaction for their adolescent over time. These results are an operational guide for personnel providing health care services, especially diabetes specialist nurses.

Use of Traditional Birth Practices by Chinese Women in the United States.

PubMed

Saito, Maki; Lyndon, Audrey

The purpose of our study was to explore how foreign-born Chinese women living in California engage in various traditional and American birth practices. A descriptive qualitative study was conducted using a grounded theory approach. Chinese women from Mainland China, Hong Kong, and Taiwan who had childbirth experiences in the United States were purposively sampled. Semistructured interviews were conducted with 13 women, with follow-up interviews with 5 women. Interview data were analyzed using grounded theory according to the method of Strauss and Corbin. There are many traditional practices for pregnancy and childbirth. Women investigated the traditions through various means, and built their own perspective on each tradition by integrating an evaluation of the Chinese perspective and an evaluation of the American perspective. Women considered several factors in the process of evaluating the Chinese and American perspectives to reach their own integrated perspective on each tradition. These factors included whether or not the tradition made sense to them, how the traditional practice affected their comfort, nature of available options, attitudes of female elders, previous experiences of their peers and themselves, and outcomes of temporary trials of traditional or nontraditional practices. Healthcare providers should respect women's diverse perspectives on traditional practices and encourage flexible arrangements. Including the elder generation in health education may be useful in helping women manage conflicts and to support their decisions.

A comparison of temperature increases produced by "premium" and "standard" diamond burs: An in-vitro study.

PubMed

Segal, Pnina; Sap, Danny; Ben-Amar, Ariel; Levartovsky, Shifra; Matalon, Shlomo

2016-02-01

Vital tooth preparations may cause irreversible thermal damage to the pulp. The manufacturing techniques of dental burs may decrease heat production and minimize the risk of overheating and trauma to the dental pulp. Strauss (Raanana, Israel) has introduced "premium" diamond burs, claiming superior efficiency and longevity. We sought to determine the safest preparation methods by performing a comparison of intrapulpal temperature increases caused with "standard" and "premium" burs. Three types of diamond burs (F1R, F21R, and K2) were tested on extracted human teeth (n = 8 teeth per bur type). Premium and standard manufacturing techniques were compared for each bur type (n = 24 teeth per group; total 48 teeth). An intrapulpal thermocouple was used to measure the temperature during the procedure. Comparisons were analyzed with the t test and one-way ANOVA. P ≤ .05 was considered significant. All premium burs demonstrated lower temperature increases compared to the standard burs (P ≤ .001 for F21R and K2, P = .086 for F1R). The temperature increases with premium burs were similar for different bur shapes, but the temperature increases with standard burs depended on the bur shape (P < .001). Using premium diamond burs for tooth preparation may reduce the risk of pulp tissue damage, and thus reduce postoperative pulp-associated complications.

Applying a contemporary grounded theory methodology.

PubMed

Licqurish, Sharon; Seibold, Carmel

2011-01-01

The aim of this paper is to discuss the application of a contemporary grounded theory methodology to a research project exploring the experiences of students studying for a degree in midwifery. Grounded theory is a qualitative research approach developed by Glaser and Strauss in the 1950s but the methodology for this study was modelled on Clarke's (2005) approach and was underpinned by a symbolic interactionist theoretical perspective, post-structuralist theories of Michel Foucault and a constructionist epistemology. The study participants were 19 midwifery students completing their final placement. Data were collected through individual in-depth interviews and participant observation, and analysed using the grounded theory analysis techniques of coding, constant comparative analysis and theoretical sampling, as well as situational maps. The analysis focused on social action and interaction and the operation of power in the students' environment. The social process in which the students were involved, as well as the actors and discourses that affected the students' competency development, were highlighted. The methodology allowed a thorough exploration of the students' experiences of achieving competency. However, some difficulties were encountered. One of the major issues related to the understanding and application of complex sociological theories that challenged positivist notions of truth and power. Furthermore, the mapping processes were complex. Despite these minor challenges, the authors recommend applying this methodology to other similar research projects.

A collective unconscious reconsidered: Jung's archetypal imagination in the light of contemporary psychology and social science.

PubMed

Hunt, Harry T

2012-02-01

A needed rapprochement between Jung and the contemporary human sciences may rest less on the much debated relevance of a biologistic collective unconscious than on a re-inscribing of an archetypal imagination, as the phenomenological and empirical core of Jungian psychology. The most promising approaches in this regard in terms of theory and research in psychology come from combining the cognitive psychology of metaphor and synaesthesia, individual differences in imaginative absorption and openness to numinous experience and spirituality as a form of symbolic intelligence. On the socio-cultural side, this cognitive psychology of archetypal imagination is also congruent with Lévi-Strauss on the metaphoric roots of mythological thinking, and Durkheim on a sociology of collective consciousness. This conjoined perspective, while validating the cross cultural commonality of physical metaphor intuited by Jung and Hillman on alchemy, also shows Jung's Red Book, considered as the expressive source for his more formal psychology, to be far closer in spirit to a socio-cultural collective consciousness, based on metaphoric imagination, than to a phylogenetic or evolutionary unconscious. A mutual re-inscribing of Jung into congruent areas of contemporary psychology, anthropology, sociology, and vice versa, can help to further validate Jung's key observations and is fully consistent with Jung's own early efforts at synthesis within the human sciences. © 2012, The Society of Analytical Psychology.

Trainees' self-evaluation of their development as psychotherapists: An Italian contribution to an international collaborative study on psychotherapy training.

PubMed

Messina, Irene; Gelo, Omar C G; Sambin, Marco; Bianco, Francesca; Mosconi, Andrea; Fenelli, Antonio; Curto, Marcello; Gullo, Salvo; Orlinsky, David

2018-03-01

This study presents a pilot contribution to the new collaborative, multinational study of psychotherapy trainee development that was undertaken by the Society for Psychotherapy Research Interest Section on Therapist Training and Development (see Orlinsky, Strauss, Rønnestad, et al., ). Although the main project is longitudinal in design, this preliminary study investigated cross-sectional differences between trainees in different years of training and explored the influence of core training experiences-including supervision and personal therapy-on their perceived development as therapists. Using the trainee current-progress report that was designed for the Society for Psychotherapy Research Interest Section on Therapist Training and Development project, 90 trainees at 4 different 4-year training programs in Italy provided self-evaluations of their development and of their therapeutic work experiences. Perceived development included overall change, progress, deterioration, overcoming past limitations, and realization of potential as a therapist. Therapeutic work experiences were assessed using scales of healing and stressful involvement (Orlinsky & Rønnestad, ). Year in training and support in supervision predicted perceived development and healing involvement, whereas experiencing criticism in supervision was associated with stressful involvement. Having had personal therapy, and especially ratings of benefit from personal therapy, was also associated with perceived development and healing involvement. Results are discussed with regard of their implications for psychotherapy training. Copyright © 2017 John Wiley & Sons, Ltd.

Opium addiction in patients with coronary artery disease: a grounded theory study.

PubMed

Farahani, Mansoureh A; Ghaffari, Fatemeh; Seyed Fatemi, Naiemeh

2015-01-01

There are widespread misconceptions about the positive effects of opium on coronary artery disease (CAD). Thus, we performed a study to explore the opium addiction process contributing factors among CAD patients using a grounded theory approach. The sample comprised 30 addicted CAD patients and their family members, physicians, nurses and friends. Purposive and theoretical sampling was employed; semi-structured interviews were conducted. Coding and constant comparative analysis techniques were as proposed by Strauss and Corbin (1998). The core category was 'Fighting for Survival', comprising three main themes, namely, 'the gateway', 'blowing into the fire' and 'getting stuck in the mud'. Increasing knowledge about the adverse effects of opium on the cardiovascular system would reinforce prevention and rehabilitation measures. Involving patients' family-members in addiction prevention and rehabilitation programs and referring patients to specialized rehabilitation centres could help patients quit opium. Healthcare providers (HCPs) should notice to the effects of opium consumption among CAD patients; nursing care must be holistic in nature. Although opium is stigmatised in Iran, HCPs must treat addicted CAD patients similar to other patients. Nursing students' must be aware of the negative effects of illegal drugs on CAD patients and the misconceptions regarding the positive effects thereof. Any misconceptions must be probed and clarified. Rehabilitation centres must be supervised by cardiologists and HCPs.

Recruitment of older women: lessons learned from the Baltimore Hip Studies.

PubMed

Resnick, Barbara; Concha, Betty; Burgess, Judy Graham; Fine, Mary Louise; West, Linda; Baylor, Karen; Nahm, Eun Shim; Buie, Verita Custis; Werner, Michelle; Orwig, Denise; Magaziner, Jay

2003-01-01

This study used a qualitative approach in which participants were asked to write about their experiences in recruiting older women into either one of two exercise intervention studies that are part of the Baltimore Hip Studies. The sample included 8 researcher nurses all women, White, and 42-53 years of age. Older adults, particularly older women, are less likely to participate in research studies when compared to their younger counterparts. The purpose of this study was to explore the techniques successfully used by research nurses in the Baltimore Hip Studies to recruit older women after hip fracture into exercise intervention studies. Data analysis was performed using basic content analysis (Crabtree & Miller, 1992; Miles & Huberman, 1984) "in vivo" coding (Dowd, 1991), or "grounded" coding (Glaser & Strauss, 1967), which involves using the informants' own words to capture a particular idea. A total of 16 codes were identified and reduced to nine themes. Seven themes focused on techniques that facilitated recruitment: (a) caring for individuals; (b) emphasizing benefits; (c) eliciting support from others; (d) being an expert; (e) using role models; (f) using good timing; and (g) giving good first impressions. The remaining two themes identified barriers to recruitment: (a) time commitment and (b) lack of support. Based on these themes, specific recruitment techniques are recommended. Ongoing research, however, is needed to establish the most effective recruitment procedures with older women.

["A Little Bit of Switzerland, a Little Bit of Kosovo". Swiss Immigrants from Former Yugoslavia with Type 2 Diabetes. A Qualitative Study' in Analogy to Grounded Theory].

PubMed

Wenger, A; Mischke, C

2015-10-01

Type 2 diabetes is on the increase among the Swiss immigrants. The cultural background of patients presents new linguistic and sociocultural barriers and gains in importance for health care. In order to develop patient-centred care, it is necessary to focus on different sociocultural aspects in everyday life and experiences of immigrants from the former republics of Yugoslavia with diabetes who have rarely been studied in Switzerland. Based on these insights the needs for counselling can be identified and nursing interventions can be designed accordingly. Using the Grounded Theory approach, 5 interviews were analysed according to the Corbin and Strauss coding paradigm. The central phenomenon found is the experience to live in 2 different cultures. The complexity arises from the tension living in 2 cultural backgrounds at the same time. It turns out that in the country of origin the immigrants adjust their disease management. The changing daily rhythm and the more traditional role model affect aspects of their disease management such as diet and/or drug therapy. The different strategies impact the person's roles, emotions, their everyday lives and their families. It provides an insight into the perspective of Swiss immigrants from the former republics of Yugoslavia suffering from diabetes. Many questions are still unanswered and further research will be required. © Georg Thieme Verlag KG Stuttgart · New York.

Participation a Key Factor for Life Recovery After Disaster: A Grounded Theory Study in an Iranian Context

PubMed Central

Nakhaei, Maryam; Khankeh, Hamid Reza; Masoumi, Gholam Reza; Hosseini, Mohammad Ali; Parsa-Yekta, Zohreh

2016-01-01

Background Since life recovery after disasters is a subjective and multifaceted construct influenced by different factors, and survivors’ main concerns and experiences are not clear, the researchers intended to explore this process. Materials and Methods This study was conducted in 2011 - 2014 based on the grounded theory approach. Participants were selected by purposeful sampling followed by theoretical sampling to achieve conceptual and theoretical saturation. Data were collected through interviews, observation, focus group discussion, and document reviews. Data were analyzed by Strauss and Corbin’s (2008) recommended approach. Results Transcribed data from 26 interviews (managers, health care providers, and receivers), field notes, and other documents were analyzed, and 1,652 open codes were identified. The codes were categorized, using constant comparative analysis, into five main categories including reactive exposure, subsiding emotions, need for comprehensive health recovery, improvement of normalization (new normality achievement), and contextual factors. The process of life recovery after disaster was also explored. Conclusions The results clarified a deep perception of participants’ experiences after disaster. The path of life recovery after disasters involves participants’ striving to achieve a comprehensive health recovery, which starts with the need for all-inclusive health recovery as a main concern; this is the motivator for a responding strategy. This strategy is participatory, and the process is progressive; achievement of a new normality is the final goal, with new development and levels of empowerment. PMID:27703797

Teacher beliefs in contemporary science education goals and classroom practice: The case of Souhegan High School

NASA Astrophysics Data System (ADS)

Mueller, Jennifer Creed

The central research question for this study was: To what extent is a teacher's purported beliefs in contemporary science education goals embedded in his/her routine classroom practice? Two sub-research questions were necessary to investigate this central research question: (1) To what degree do Souhegan High School science teachers believe in the contemporary goals of science education? (2) What is a Souhegan High School science teacher's degree of conviction to his/her beliefs of particular goals? The goal of this study was to develop grounded hypotheses/research questions. Given the stated research questions, a case study design most appropriately met the intended purpose of this study. The study was initiated with the science teachers at Souhegan High School taking the survey of Contemporary Goals of Science Education (Zeidler & Duffy, 1994). Following analysis of the group's responses, two equal ranges of scores were established. In addition, a weighted mean provided data on a teacher's degree of conviction to his/her beliefs of particular goals. Three teachers were invited to continue with the study, each range represented. Classroom observations provided data in the next phase of inquiry. Samples of assessment tasks were also collected as data. Following classroom observations, interviews were conducted. These interviews were semi-structured, with the use of Newmann, Secada, and Wehlage (1995), Standards and Scoring Criteria for Classroom Instruction and Assessment Tasks as a vehicle for teacher reflection. Data collection and analyses occurred simultaneously as characterized by the constant comparative method in accordance with grounded theory (Glaser & Strauss, 1967). Spradley's Developmental Research Sequence (1980) provided a framework and process for implementing grounded theory which was modified to meet the goals of this study. Analysis of the data from the Survey of Contemporary Goals of Science Education showed strong preference for the contemporary

Advanced photonic, electronic, and web engineering systems: WILGA Symposium, January 2013

NASA Astrophysics Data System (ADS)

Romaniuk, Ryszard S.

2013-10-01

The cycle of WILGA Symposia [wilga.ise.pw.edu.pl] on Photonics and Web Engineering, Advanced Electronic Systems, under the auspices of SPIE, IEEE, KEiT PAN and WEiTI PW was initiated in 1998 by a Research Team PERG/ELHEP ISE PW. The WILGA conferences take place two times a year and the participants are young scientists from this country and abroad. This paper debates chosen topical tracks and some papers presented during the 31 WILGA Multi-Conference, which took place on 8-10 February 2013 at the Faculty of WEiTI PW. The January conference was attended by around 100 persons. Here we discuss closer the subjects of biomedical photonics, electronics and informatics, as well as chosen aspects of applications of advanced photonic, electronic circuits and systems. The 32 nd WILGA Symposium took place on 27 May - 02 June 2013 in WUT WILGA resort near Warsaw. These two editions of WILGA Conferences - January and May have generated more than 250 articles, from which around 100 were chosen by the Symposium and Conference Committees to be published in this volume of Proc.SPIE. WILGA Symposium papers are traditionally submitted via the WILGA web page [wilga.ise.pw.edu.pl] to the SPIE Proceedings publishing system [spie.org]. Email for the correspondence is: photonics@ise.pw.edu.pl. All Wilga papers are published in journals Elektronika, IJET-PAN and in Proc.SPIE. Topical tracks of the symposium usually embrace, among others, new technologies for photonics, sensory and nonlinear optical fibers, object oriented design of hardware, photonic metrology, optoelectronics and photonics applications, photonics-electronics co-design, optoelectronic and electronic systems for astronomy and high energy physics experiments, JET and pi-of-the sky experiments development. The symposium In its two editions a year is a summary of the development of numerable Ph.D. theses carried out in this country and this geographical region in the area of advanced electronic and photonic systems. It is also

Long-term impact of sewage irrigation on soil properties and assessing risk in relation to transfer of metals to human food chain.

PubMed

Meena, Ramu; Datta, S P; Golui, Debasis; Dwivedi, B S; Meena, M C

2016-07-01

A case study was undertaken to assess the risk of sewage-irrigated soils in relation to the transfer of trace elements to rice and wheat grain. For this purpose, peri-urban agricultural lands under the Keshopur Effluent Irrigation Scheme (KEIS) of Delhi were selected. These agricultural lands have been receiving irrigation through sewage effluents since 1979. Sewage effluent, groundwater, soil, and plant (rice and wheat grain) samples were collected with GPS coordinates from this peri-urban area. Under wheat crop, sewage irrigation for four decades resulted into a significant buildup of zinc (141 %), copper (219 %), iron (514 %), nickel (75.0 %), and lead (28.1 %) in sewage-irrigated soils over adjacent tube well water-irrigated ones. Under rice crop, there was also a significant buildup of phosphorus (339 %), sulfur (130 %), zinc (287 %), copper (352 %), iron (457 %), nickel (258 %), lead (136 %), and cadmium (147 %) in sewage-irrigated soils as compared to that of tube well water-irrigated soils. The values of hazard quotient (HQ) for intake of trace toxic elements by humans through consumption of rice and wheat grain grown on these sewage-irrigated soils were well within the safe permissible limit. The variation in Zn, Ni, and Cd content in wheat grain could be explained by solubility-free ion activity model (FIAM) to the extent of 50.1, 56.8, and 37.2 %, respectively. Corresponding values for rice grain were 49.9, 41.2, and 42.7 %, respectively. As high as 36.4 % variation in As content in rice grain could be explained by solubility-FIAM model. Toxic limit of extractable Cd and As in soil for rice in relation to soil properties and human health hazard associated with consumption of rice grain by humans was established. A similar exercise was also done in respect of Cd for wheat. The conceptual framework of fixing the toxic limit of extractable metals and metalloid in soils with respect to soil properties and human health hazard under the

Dynamics of a flexible splitter plate in the wake of a circular cylinder

NASA Astrophysics Data System (ADS)

Shukla, S.; Govardhan, R. N.; Arakeri, J. H.

2013-08-01

Rigid splitter plates in the wake of bluff bodies are known to suppress the primary vortex shedding. In the present work, we experimentally study the problem of a flexible splitter plate in the wake of a circular cylinder. In this case, the splitter plate is free to continuously deform along its length due to the fluid forces acting on it; the flexural rigidity (EI) of the plate being an important parameter. Direct visualizations of the splitter plate motions, for very low values of flexural rigidity (EI), indicate periodic traveling wave type deformations of the splitter plate with maximum tip amplitudes of the order of 1 cylinder diameter. As the Reynolds number based on cylinder diameter is varied, two regimes of periodic splitter plate motions are found that are referred to as mode I and mode II, with a regime of aperiodic motions between them. The frequency of plate motions in both periodic modes is found to be close to the plane cylinder Strouhal number of about 0.2, while the average frequencies in the non-periodic regime are substantially lower. The measured normalized phase speed of the traveling wave for both periodic modes is also close to the convection speed of vortices in the plane cylinder wake. As the flexural rigidity of the plate (EI) is increased, the response of the plate was found to shift to the right when plotted with flow speed or Re. To better capture the effect of varying EI, we define and use a non-dimensional bending stiffness, K*, similar to the ones used in the flag flutter problem, K=EI/(0.5ρUL), where U is the free-stream velocity and L is the splitter plate length. Amplitude data for different EI cases when plotted against this parameter appear to collapse on to a single curve for a given splitter plate length. Measurements of the splitter plate motions for varying splitter plate lengths indicate that plates that are substantially larger than the formation length of the plane cylinder wake have similar responses, while shorter

Identifying the Factors Leading to Success: How an Innovative Science Curriculum Cultivates Student Motivation

NASA Astrophysics Data System (ADS)

Scogin, Stephen C.

2016-06-01

PlantingScience is an award-winning program recognized for its innovation and use of computer-supported scientist mentoring. Science learners work on inquiry-based experiments in their classrooms and communicate asynchronously with practicing plant scientist-mentors about the projects. The purpose of this study was to identify specific factors contributing to the program's effectiveness in engaging students. Using multiple data sources, grounded theory (Strauss and Corbin in Basics of qualitative research. Sage, Newbury Park, 1990) was used to develop a conceptual model identifying the central phenomenon, causal conditions, intervening conditions, strategies, contexts, and student outcomes of the project. Student motivation was determined to be the central phenomenon explaining the success of the program, with student empowerment, online mentor interaction, and authenticity of the scientific experiences serving as causal conditions. Teachers contributed to student motivation by giving students more freedom, challenging students to take projects deeper, encouraging, and scaffolding. Scientists contributed to student motivation by providing explanations, asking questions, encouraging, and offering themselves as partners in the inquiry process. Several positive student outcomes of the program were uncovered and included increased positivity, greater willingness to take projects deeper, better understanding of scientific concepts, and greater commitments to collaboration. The findings of this study provide relevant information on how to develop curriculum, use technology, and train practitioners and mentors to utilize strategies and actions that improve learners' motivation to engage in authentic science in the classroom.

Design-based online teacher professional development to introduce integration of STEM in Pakistan

NASA Astrophysics Data System (ADS)

Anwar, Tasneem

In today's global society where innovations spread rapidly, the escalating focus on science, technology, engineering and mathematics (STEM) has quickly intensified in the United States, East Asia and much of Western Europe. Our ever-changing, increasingly global society faces many multidisciplinary problems, and many of the solutions require the integration of multiple science, technology, engineering, and mathematics (STEM) concepts. Thus, there is a critical need to explore the integration of STEM subjects in international education contexts. This dissertation study examined the exploration of integration of STEM in the unique context of Pakistan. This study used three-phase design-based methodological framework derived from McKenney and Reeves (2012) to explore the development of a STEM focused online teacher professional development (oTPD-STEM) and to identify the design features that facilitate teacher learning. The oTPD-STEM program was designed to facilitate eight Pakistani elementary school teachers' exploration of the new idea of STEM integration through both practical and theoretical considerations. This design-based study employed inductive analysis (Strauss and Corbin, 1998) to analyze multiple data sources of interviews, STEM perception responses, reflective learning team conversations, pre-post surveys and artifacts produced in oTPD-STEM. Findings of this study are presented as: (1) design-based decisions for oTPD-STEM, and (2) evolution in understanding of STEM by sharing participant teachers' STEM model for Pakistani context. This study advocates for the potential of school-wide oTPD for interdisciplinary collaboration through support for learner-centered practices.

[Everything is valid in chronic pain: Interventions by older adults for pain relief].

PubMed

Alvarado-García, Alejandra María; Salazar-Maya, Ángela María

To describe interventions used by older adults with benign chronic pain. Qualitative study with 25 older adults with benign chronic pain, inhabitants of the cities of Medellín and Bogotá. The technique used to collect information was in-depth interview. The analysis was made using the tools of the theory based on the guidelines of Strauss and Corbin. Using open, axial and selective coding, the constant comparison method allowed the identification of categories and subcategories and simultaneously memos and diagrams were made to reach theoretical saturation. A number of categories were found in this study, suggesting interventions used by the elderly to address chronic pain. They started looking at a number of options such as: taking medication, self-prescribing, feeling fear of taking pills, identifying the damage caused by drugs, using hot water, staying still, taking right postures, walking and exercising, using attachments that help them and making home remedies; all of them become alternatives that can cause pain relief. The study allowed describing interventions that older adults use to mitigate their pain. This ranged from pharmacological to non-pharmacological interventions, as simple as posture, cold, heat, massage or distractions among others, which play an important role in pain relief. Knowing these interventions helps healthcare professionals consider care options different to medication intake, proposing strategies that are easily accessible and can operate at the time to address a patient with chronic pain. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Microaggressions experienced by persons with mental illnesses: An exploratory study.

PubMed

Gonzales, Lauren; Davidoff, Kristin C; Nadal, Kevin L; Yanos, Philip T

2015-09-01

Microaggressions are subtle verbal or behavioral communications of disparaging messages to people based upon membership in a socially marginalized group. Their negative impact has been demonstrated for racial/ethnic groups, gender, sexual orientation, and physical disability, but currently no research exists on microaggressions as experienced by persons with mental illnesses. Qualitative data were gathered from 4 focus groups with 2 samples: adult mental health consumers in an assertive community treatment program and college students with mental illness diagnoses. Focus group transcripts were then analyzed using an open coding approach (Strauss & Corbin, 1990) to identify hierarchical themes and categories. Five major themes were identified, including invalidation, assumption of inferiority, fear of mental illness, shaming of mental illness, and second class citizen. Perpetrators of microaggressions were most commonly identified as being close friends, family members, and authority figures. Importantly, participants reported experiencing more overt discrimination experiences than subtle microaggression experiences. Reported negative outcomes related to microaggression experiences included isolation, negative emotions, and treatment nonadherence. Reported consequences of microaggressions have important implications for mental health treatment, especially as perpetrators were reported to include treatment providers and were usually unaware of such negative social exchanges. Loss of social support reported by participants and the frequent occurrence of microaggressions within close relationships implies these experiences could contribute to internalization of stigmatizing attitudes toward mental illness. Directions for future research include an investigation of motivation and reasoning behind perpetration of microaggressions against persons with mental illnesses. (c) 2015 APA, all rights reserved).

The Perceived Threat in Adults with Leukemia Undergoing Hematopoietic Stem Cell Transplantation

PubMed Central

Farsi, Zahra; Dehghan Nayeri, Nahid; Negarandeh, Reza

2013-01-01

Background: Leukemia and hematopoietic stem cell transplantation (HSCT) create physical, psychological, social, and spiritual distresses in patients. Understanding this threatening situation in adults with leukemia undergoing HSCT will assist health care professionals in providing holistic care to the patients. Objectives: The aim of the present study was exploring the perceived threat in adults with leukemia undergoing HSCT. Patients and Methods: This article is part of a longitudinal qualitative study which used the grounded theory approach and was conducted in 2009-2011. Ten adults with acute leukemia scheduled for HSCT were recruited from the Hematology–Oncology Research Center and Stem Cell Transplantation, Shariati Hospital in Tehran, Iran. A series of pre-transplant and post-transplant in-depth interviews were held in the hospital’s HSCT wards. Totally, 18 interviews were conducted. Three written narratives were also obtained from the participants. The Corbin and Strauss approach was used to analyze the data. Results: Perceived threat was one of the main categories that emerged from the data. This category included four subcategories, "inattention to the signs and symptoms", "doubt and anxiety", "perception of danger and time limitation" and "change of life conditions", which occurred in linear progression over time. Conclusion: Suffering from leukemia and experiencing HSCT are events that are uniquely perceived by patients. This threatening situation can significantly effect perception of patients and cause temporary or permanent alterations in patients' lives. Health care professionals can help these patients by deeper understanding of their experiences and effective interventions. PMID:25414863

Contextual Facilitators and Maintaining of Compassion-Based Care: An Ethnographic Study.

PubMed

Babaei, Sima; Taleghani, Fariba; Keyvanara, Mahmoud

2017-01-01

Compassion is an important part of nursing. It fosters better relationships between nurses and their patients. Moreover, it gives patients more confidence in the care they receive. Determining facilitators of compassion are essential to holistic care. The purpose of this study was to explore these facilitators. This ethnographic study was conducted in 2014-2015 with 20 nurses, 12 patients, and 4 family members in the medical and surgical wards. Data collection was done through observations and in-depth semi-structured interviews with purposive sampling. The study was carried out in 15 months. Data analysis was performed using constant comparison based on Strauss and Corbin. Data analysis defined three main themes and eight subthemes as the fundamentals of compassion-based care. Nurses' personal factors with subcategories of personality, attitudes, and values and holistic view; and socio-cultural factors with subcategories of kindness role model, religious, and cultural values are needed to elicit compassionate behaviors. Initiator factors, with subcategories of patient suffering, patient communication demands, and patient emotional and psychological necessity are also needed to start compassionate behaviors. The findings of this study showed that nurses' communication with patients is nurse's duty in order to understand and respect the needs of patients. Attention should be paid to issues relating to compassion in nursing and practice educational programs. Indeed, creating a care environment with compassion, regardless of any shortcomings in the work condition, would help in the development of effective nursing.

Parenting work and autism trajectories of care.

PubMed

Singh, Jennifer S

2016-09-01

This study investigates the work and care associated with raising a child with disabilities in the United States. Based on in-depth interviews with parents who have a child with autism, it develops the notion of parenting work and trajectories of care to investigate how parents navigate and coordinate the challenges of getting an autism diagnosis, obtaining educational services, and re-contextualising the possibilities for the future. I argue that parents embody a complex mix of love, hope, and responsibility in parenting work and trajectories of care that expands temporal and social elements of illness work and trajectories initially developed by Anselm Strauss and colleagues. This type of parenting work changes over time and is influenced by social structural forces and relationships in which the care takes place. The re-articulation of these analytic tools also begins to untangle the intricate mix of both medical and social models of disability that parents embrace and continuously negotiate. This study demonstrates how parents accept the medical model of disability by seeking and pushing for a clinical autism diagnosis and subsequent treatments, while at the same time challenge the limits placed on their children by providing them with opportunities, possible futures, and a sense of personhood. A Virtual Abstract of this paper can be accessed at: https://www.youtube.com/watch?v=x0UmGvpcjeQ. © 2016 Foundation for the Sociology of Health & Illness.

How Does Culture Shape Roles and Relationships in Taiwanese Family Caregiving for an Adolescent With Cancer?

PubMed

Yeh, Li-Chyun; Kellet, Ursula; Henderson, Saras; Chen, Kang-Hua

2015-01-01

Chinese culture plays a significant part in how Taiwanese families view life events. Caregivers envisage themselves as guardians of their children in all facets of family life, including wellness and strive to maintain harmonious relationships within the family. However, it remains unclear what impact caring for an adolescent with cancer has on family roles and relationships in Taiwanese families, nor are the processes for managing change in family roles and relationships associated with caregiving well understood. This study explores the impact of caregiving for an adolescent with cancer on the roles and relationships within Taiwanese families. Seven families were recruited from a medical hospital in Taiwan. Data were collected through qualitative interviews and analyzed following Strauss and Corbin's grounded theory. The core category, underpinned by Chinese culture, proved to be experiencing the broken chain of family life. This was the central issue brought about by 4 consequences for the broken chain of family life. The expression "the broken chain of family life" encapsulates how important Chinese cultural values are in defining caregiver task performance. The findings have implications for Taiwanese families in perceiving, adjusting to, and fulfilling the altered roles and relationships associated with caring for an adolescent with cancer at home. The delivery of exceptional care and services depends on gaining insight into how caregiving influences family roles and relationships. How families failed to manage the process of caregiving provides valuable insight for informing and providing recommendations for services and support.

Treatment of Eosinophilic Granulomatosis with Polyangiitis: A Review.

PubMed

Raffray, Loïc; Guillevin, Loïc

2018-05-15

Eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome) is a rare type of anti-neutrophil cytoplasm antibody-associated vasculitis. Nevertheless, eosinophilic granulomatosis with polyangiitis stands apart because it has features of vasculitis and eosinophilic disorders that require targeted therapies somewhat different from those used for other anti-neutrophil cytoplasm antibody-associated vasculitides. Considerable advances have been made in understanding the underlying pathophysiology of eosinophilic granulomatosis with polyangiitis that have highlighted the key role of eosinophils and opened new therapeutic opportunities. Its conventional treatment relies mainly on agents that decrease inflammation: corticosteroids and immunosuppressant adjunction for severe manifestations. New therapeutic approaches are needed for refractory disease, relapses and issues associated with corticosteroid dependence, especially for asthma manifestations. Drugs under evaluation mostly target eosinophils and B cells. Results of low-evidence-based trials suggested possible efficacies of biologicals: B-cell-blocking rituximab and anti-immunoglobulin E omalizumab. Recently, the first large-scale randomised controlled trial on eosinophilic granulomatosis with polyangiitis proved the efficacy of anti-interleukin-5 mepolizumab. That finding opens a new era in eosinophilic granulomatosis with polyangiitis management, with mepolizumab approval but also in future drug evaluations and trial designs for eosinophilic granulomatosis with polyangiitis. Additional studies are needed to determine which patients would benefit most from targeted therapies and achieve personalised treatment for patients with eosinophilic granulomatosis with polyangiitis. Herein, we review eosinophilic granulomatosis with polyangiitis characteristics and provide an overview of established and novel pharmacological agents.

'Getting back to real living': A qualitative study of the process of community reintegration after stroke.

PubMed

Wood, Jennifer P; Connelly, Denise M; Maly, Monica R

2010-11-01

To examine the process of community reintegration over the first year following stroke, from the patient's perspective. Qualitative, longitudinal, grounded theory study involving ten participants. During the first year post discharge from inpatient rehabilitation, 46 one-on-one semi-structured interviews were conducted with ten participants. Interviews were completed with participants before discharge from inpatient stroke rehabilitation and in their homes at two weeks, three months, six months and one year post discharge. Analysis was guided by grounded theory methods described by Corbin and Strauss. Four women and six men (mean age 59.6 ± 18.0, all with left hemiparesis and without aphasia) who had sustained their first hemispheric stroke and were returning to the community following inpatient rehabilitation. The process of community reintegration after stroke involved transitioning through a series of goals: gaining physical function, establishing independence, adjusting expectations and getting back to real living. The ultimate challenge for stroke survivors during this process of community reintegration was to create a balance between their expectations of themselves and their physical capacity to engage in meaningful roles. Over the first year after stroke, participants reported that the process of community reintegration was marked by ongoing changes in their goals. Formal and informal caregivers need to work with stroke survivors living in the community to facilitate realistic and achievable goal setting. Tools which identify meaningful activities should also be incorporated to provide stroke survivors with the opportunity to contribute and engage with others in the community.

Earth Observations taken by the Expedition 13 crew

NASA Image and Video Library

2006-05-12

ISS013-E-18319 (12 May 2006) --- Munich International Airport, Germany is featured in this image photographed by an Expedition 13 crewmember on the International Space Station. The Franz Joseph Strauss, or Munich, International Airport served 29 million passengers in 2005, making it the second-busiest airport (behind Frankfurt) in Germany. It is the busiest airport in Germany in terms of domestic passengers, serving over 9 million travelers during 2005. The airport serves the Bayern (Bavaria) region of southeastern Germany, and is a hub for the Lufthansa airline. Like other large international airports around the world, the facility occupies portions of multiple municipalities: Freising, Oberding, Hallbergmoos, and Marzling. The village of Franzheim was demolished, and its 500 residents relocated, during the airport construction. The airport is located 31 kilometers to the northeast of Munich; rather than being an extension of the metropolis, it is surrounded by agricultural fields and small towns. Expansion of the airport occurred in 2003 with the additional of Terminal 2, designed specifically to accommodate the needs of Lufthansa and its partner airlines. This view taken is sufficiently detailed to distinguish individual airplanes on the terminal apron as well as the dark gray-blue rooftop of Terminal 2. The white concrete airport runways are 4 kilometers in length. Surrounding agricultural fields in active use are a variety of shades of green, while the exposed soil of fallow fields are brown to tan.

Elderly self-management: a qualitative study

PubMed Central

Ravanipour, Maryam; Salehi, Shayesteh; Taleghani, Fariba; Abedi, Heidar Ali

2010-01-01

BACKGROUND: The population of elderly in Iran and in the world is increasing. It is predicted that the population of elderly reaches to 10 millions in Iran by the year 2019. Elders more than other age groups are at risk of chronic diseases and health problems; and elderly affects their self-management and makes them feel disabled. Since the knowledge of self-management for Iranian elderly is not well developed, this paper aimed to determine the concept of self-management for Iranian elders. METHODS: This was a qualitative study with grounded theory approach on Iranian elderly self-management. Data were collected through deep interviews with 26 participants in a period of one year and were analyzed using a Strauss Corbin analysis method. RESULTS: Self-management in the context of power means using different managing methods in dealing with daily life needs, especially in interactions with others in a way that accelerates affairs with efficiency and satisfaction. The main categories emerged from this qualitative study included: managing plans, managing life goals and policies, persuading the desired goals, managing self-care, directing others, coordinating and consulting with others. CONCLUSIONS: The findings of this study provided a deep understanding of elderly perceptions of self-management in their lives. These findings can be a baseline for future researches on developing effective health interventions such as developing a nursing model for increasing the elderly self-management abilities in Iran. Such a model can provide a strong basis for nursing care. PMID:21589781

[Being cared for and caring: living with multiple chronic diseases (Leila)-a qualitative study about APN contributions to integrated care].

PubMed

Müller-Staub, Maria; Zigan, Nicole; Händler-Schuster, Daniela; Probst, Sebastian; Monego, Renate; Imhof, Lorenz

2015-04-01

Living with multiple chronic diseases is complex and leads to enhanced care needs. To foster integrated care a project called "Living with chronic disease" (Leila) was initiated. The aim was to develop an Advanced Practice Nursing (APN) service in collaboration with medical centers for persons who are living with multiple chronic diseases. The following research questions were addressed: 1. What are patients' experiences, referring physicians and APNs with the Leila-Service? 2. How are referral processes performed? 3. How do the involved groups experience collaboration and APN role development? A qualitative approach according grounded theory of Corbin and Strauss was used to explore the experiences with the Leila project and the interaction of the persons involved. 38 interviews were conducted with patients who are living with multiple chronic diseases, their APN's and the referring physicians. The findings revealed "Being cared for and caring" as main category. The data demonstrated how patients responded to their involvement into care and that they were taken as serious partners in the care process. The category "organizing everyday life" describes how patients learned to cope with the consequences of living with multiple chronic diseases. "Using all resources" as another category demonstrates how capabilities and strengths were adopted. The results of the cooperation- and allocation processes showed that the APN recognition and APN role performance have to be negotiated. Prospective APN-services for this patient population should be integrated along with physician networks and other service providers including community health nursing.

Experiences of family carers of older people with mental health problems in the acute general hospital: a qualitative study.

PubMed

Clissett, Philip; Porock, Davina; Harwood, Rowan H; Gladman, John R F

2013-12-01

To explore the experiences of family carers of people with cognitive impairment during admission to hospital. Providing appropriate care in acute hospitals for people with co-morbid cognitive impairment, especially dementia or delirium or both, is challenging to healthcare professionals. One key element is close working with family members. Qualitative interview study. Semi-structured interviews with family carers of 34 older people who had been admitted to a UK general hospital and had co-morbid cognitive impairment. Interviews conducted in 2009 and 2010. Analysis was undertaken using Strauss and Corbin's framework. The findings elaborate a core problem, 'disruption from normal routine' and a core process, 'gaining or giving a sense of control to cope with disruption'. Family carers responded to disruption proactively by trying to make sense of the situation and attempting to gain control for themselves or the patient. They tried to stay informed, communicate with staff about the patient and plan for the future. The interaction of the core problem and the core process resulted in outcomes where family members either valued the support of hospital staff and services or were highly critical of the care provided. Family carers are not passive in the face of the disruption of hospitalization and respond both by trying to involve themselves in the care and support of their relative and by trying to work in partnership with members of staff. Nurses need to foster this relationship conscientiously. © 2013 John Wiley & Sons Ltd.

The balancing act: meeting the needs of all children including an adolescent with disabilities.

PubMed

Koch, Cecelia; Mayes, Rachel

2012-09-01

The aim of this study was to explore parents' experiences and strategies used when meeting the needs of all their children, including an adolescent with disabilities. A qualitative study design was employed. The study was conducted in two phases. (i) Secondary analysis of ecocultural interviews with 12 parent-carers of more than one child, including an adolescent (10-21 years) with intellectual disabilities. (ii) In-depth, semi-structured interviews with a sub-sample (n = 4) of parent-carers. Data was analysed using Strauss & Corbin's (1998) constant comparative method. Parents balanced their children's needs through a combination of strategies driven by their goals, beliefs and values. Parents found this very challenging. They were always conscious of the needs of all of their children, although they could not necessarily meet all their children's needs equally. Strategies that attended to all children simultaneously were preferred by most parents, but could not always be used. Parents, at times, used strategies that prioritized the needs of the adolescent with disabilities or siblings. Findings add to knowledge on what families of adolescents with disabilities do day to day and specifically reveal how these parents meet the needs of their children. Practitioners, together with disability and mainstream services and systems, need to recognize parents' goals, beliefs and values and the needs of the adolescent with disabilities. This will effectively aid the adolescent with disabilities, their siblings, parents and the whole of family life. © 2012 Blackwell Publishing Ltd.

Spirituality in survivors of myocardial infarction

PubMed Central

Momennasab, Marzieh; Moattari, Marzieh; Abbaszade, Abbas; Shamshiri, Babak

2012-01-01

Background: Life-threatening and stressful events, such as myocardial infarction (MI) can lead to an actual crisis, which affects the patients spiritually as well as physically, psychologically, and socially. However, the focus of health care providers is on physical needs. Furthermore, the spirituality of the patients experiencing heart attack in the light of our cultural context is not well addressed in the literature. This study is aimed at exploring the spiritual experiences of the survivors of the MI. Materials and Methods: In this qualitative research a grounded theory approach was used. Key informants were 9 MI patients hospitalized in the coronary care units of 3 hospitals in Shiraz. In addition, 7 nurses participated in the study. In-depth interviews and a focus group were used to generate data. Data analysis was done based on Strauss and Corbin method. Constant comparison analysis was performed until data saturation. Results: Five main categories emerged from the data, including perceived threat, seeking spiritual support, referring to religious values, increasing faith, and realization. The latter with its 3 subcategories was recognized as core category and represents a deep understanding beyond knowing. At the time of encountering MI, spirituality provided hope, strength, and peace for the participants. Conclusion: Based on the results we can conclude that connecting to God, religious values, and interconnectedness to others are the essential components of the participants’ spiritual experience during the occurrence of MI. Spirituality helps patients to overcome this stressful life-threatening situation. PMID:23853646

Reliability and validity of the DSM-IV diagnostic category of schizoaffective disorder: preliminary data.

PubMed

Maj, M; Pirozzi, R; Formicola, A M; Bartoli, L; Bucci, P

2000-01-01

Concerns have been expressed about the reliability and validity of the DSM-IV criteria for schizoaffective disorder, but no systematic study has been published up to now. The Cohen's kappa for the individual items of the DSM-IV definition of schizoaffective disorder, manic episode and major depressive episode was evaluated in 150 patients independently interviewed by two psychiatrists using the Composite International Diagnostic Interview. The two-year outcome of patients with a consensus DSM-IV diagnosis of schizoaffective disorder was compared to that of patients with DSM-IV schizophrenia and schizophreniform disorder, using the Strauss-Carpenter Outcome Scale. The Cohen's kappa was 0.22 for the diagnosis of schizoaffective disorder, 0.71 for that of manic episode, and 0.82 for that of major depressive episode. Schizoaffective patients had a significantly better outcome than those with schizophrenia but a worse outcome than those with schizophreniform disorder. The inter-rater reliability of the DSM-IV criteria for schizoaffective disorder is not satisfactory. The better outcome of DSM-IV schizoaffective disorder compared with schizophrenia seems to depend more on the inclusion, in the definition of schizophrenia but not in that of schizoaffective disorder, of the six-month duration and functional impairment criteria than on the different symptomatological patterns of the two conditions. The size of the sample of patients fulfilling DSM-IV criteria for schizoaffective disorder was small. The study suggests that the clinical implications of the currently problematic diagnosis of schizoaffective disorder may be modest.

The process of confrontation with disability in patients with spinal cord injury

PubMed Central

Ahmadzadeh, Gholamhossein; Kouchaki, Anahita; Malekian, Azadeh; Aminorro’aya, Mahin; Boroujeni, Ali Zargham

2010-01-01

BACKGROUND: Spinal injury can establish severe psychological outcomes for the patient and his/her family which requires high adjustment. Health system staff would be able to play their roles well in caring these patients provided with knowing what steps spinal injured people should pass to handle their disability and also what assistance they need in what stages from what sources. This study aimed to explain the process of confrontation with disability in spinal cord injured patients. METHODS: This was a qualitative study with grounded theory approach which was performed in Strauss and Corbin proposed method on twenty people with spinal cord injury who had past at least three months from their spinal injury. Sampling was done in purposive and theoretical method, and analysis of the results was also performed during constant comparative process. RESULTS: Central concept in the data was support which was associated with other concepts and affected them. The patients, with the help of internal and external support could overcome their main problem that was disability feeling and dependency on others and find a new definition for the self, and ultimately achieve the sense of independence and autonomy. CONCLUSIONS: Knowing the process of confrontation with disability along with better understanding of spinal cord injured people would help health system staff to actualize and support their potentials much better through strengthening internal resources and providing appropriate supportive services of each individual. PMID:22069411

Anxiety of women employees and the process of maternal role.

PubMed

Ahmadifaraz, Mansoureh; Foroughipour, Azam; Abedi, Heidarali; Azarbarzin, Mehrdad; Dehghani, Leila; Meamar, Rokhsareh

2013-05-01

Regarding the social and economic changes and developments, the increasing presence of working women in the present society and their important role in the family, paying more attentions to the importance of maternal role among working women who face multiple roles seems to be necessary. Hence, the process of maternal role among working women has been investigated in this study. The grounded theory approach is used in this qualitative research. In-depth and unstructured interviews were the main way in collecting the data. Initially, the targeted sampling was started and continued gradually to the data saturation, in the form of theoretical sampling based on the obtained classes. The data was analyzed using Strauss and Corbin analysis. Accuracy and validity by four criteria in this study included: Credibility, dependability, Confirmable potential, Transferability or Fittingness. Data analysis led to the identification of the core variable of role conflict. The main classes of occupied mothers' experiences included: different pregnancy experience, returning concerns, supportive umbrella, role assignation, role overlap, role strain, gradual acceptance, satisfaction and erosion. The acceptance of numerous roles such as maternal and marital roles by working women creates various role expectations of them from their children, spouses, family and the society which in turn forces them to meet both family and job requirements and expectations; This causes role conflict in working mothers and endure a lot of pressure and stress, that can influences of mental and physical health of the mothers.

Anxiety of Women Employees and The Process of Maternal Role

PubMed Central

Ahmadifaraz, Mansoureh; Foroughipour, Azam; Abedi, Heidarali; Azarbarzin, Mehrdad; Dehghani, Leila; Meamar, Rokhsareh

2013-01-01

Introduction: Regarding the social and economic changes and developments, the increasing presence of working women in the present society and their important role in the family, paying more attentions to the importance of maternal role among working women who face multiple roles seems to be necessary. Hence, the process of maternal role among working women has been investigated in this study. Methods: The grounded theory approach is used in this qualitative research. In-depth and unstructured interviews were the main way in collecting the data. Initially, the targeted sampling was started and continued gradually to the data saturation, in the form of theoretical sampling based on the obtained classes. The data was analyzed using Strauss and Corbin analysis. Accuracy and validity by four criteria in this study included: Credibility, dependability, Confirmable potential, Transferability or Fittingness. Results: Data analysis led to the identification of the core variable of role conflict. The main classes of occupied mothers’ experiences included: different pregnancy experience, returning concerns, supportive umbrella, role assignation, role overlap, role strain, gradual acceptance, satisfaction and erosion. Conclusions: The acceptance of numerous roles such as maternal and marital roles by working women creates various role expectations of them from their children, spouses, family and the society which in turn forces them to meet both family and job requirements and expectations; This causes role conflict in working mothers and endure a lot of pressure and stress, that can influences of mental and physical health of the mothers. PMID:23776735

[Perception of UCI nurses in relation with satisfactory care: convergences and divergences with the perception of critical patients].

PubMed

Jover-Sancho, C; Romero-García, M; Delgado-Hito, P; de la Cueva-Ariza, L; Solà-Solé, N; Acosta-Mejuto, B; Ricart-Basagaña, M T; Solà-Ribó, M; Juandó-Prats, C L

2015-01-01

Explore convergences and divergences between perception of nurses and of critically ill patients, in relation to the satisfactory care given and received. It is part of a larger qualitative study, according to the Grounded Theory. Carried out in 3 intensive care units with 34 boxes. Sampling theoretical profiles with n=19 patients and n=7 nurses after data saturation. Recruitment of patients included in the profiles of elderly and long-stay got stretched over some time due to the low incidence of cases. Data collection consisted of: in-depth interview to critically ill patients, group discussion of expert nurses in the critical care patient and field diary. Analysis themed on Grounded Theory according Strauss and Corbin: open coding, axial and selective. Analysis followed criteria of Guba and Lincoln rigor, Calderón quality and Gastaldo and McKeever ethical reflexivity. There was a favorable report from the ethical committee of the Hospital and informed consent of the participants. Four matching categories were found: professional skills, human, technical and continued care. Combination of these elements creates feelings of security, calmness and feeling like a person, allowing the patient a close and trusting relationship with the nurse who takes individualized care. Not divergent categories were found. Perceptions of nurses in relation to care match perceptions of critically ill patients in both the definition and dimensions upon satisfactory care. Copyright © 2014 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

Comparison of different types of medium scale field rainfall simulators

NASA Astrophysics Data System (ADS)

Dostál, Tomáš; Strauss, Peter; Schindewolf, Marcus; Kavka, Petr; Schmidt, Jürgen; Bauer, Miroslav; Neumann, Martin; Kaiser, Andreas; Iserloh, Thomas

2015-04-01

Rainfall simulators are used in numerous experiments to study runoff and soil erosion characteristics. However, they usually differ in their construction details, rainfall generation, plot size and other technical parameters. As field experiments using medium to large scale rainfall simulators (plot length 3 - 8 m) are very much time and labor consuming, close cooperation of individual teams and comparability of results is highly desirable to enlarge the database of results. Two experimental campaigns were organized to compare three field rainfall simulators of similar scale (plot size), but with different technical parameters. The results were then compared, to identify parameters that are crucial for soil loss and surface runoff formation and test if results from individual devices can be reliably compared. The rainfall simulators compared were: field rainfall simulator of CTU Prague (the Czech Republic) (Kavka et al., 2012; EGU2015-11025), field simulator of BAW (Austria) (Strauss et al., 2002) and field simulator of TU Bergakademie Freiberg (Germany) (Schindewolf & Schmidt 2012). The device of CTU Prague is usually applied to a plot size of 9,5 x 2 m employing 4 nozzles SS Full Jet 40WSQ mounted on folding arm, working pressure is 0.8 bar, height of nozzles is 2.65 m. The intensity of rainfall is regulated electronically, which leaves the nozzle opened only for certain time. The rainfall simulator of BAW is constructed as a modular system, which is usually applied for a length of 5 m (area 2 x 5 m), using 6 nozzles SS Full Jet 40WSQ. Usual working pressure is 0.25 bar. Elevation of nozzles is 2.6 m. The intensity of rainfall is regulated electronically, which leaves the nozzle opened only for certain time. The device of TU Bergakademie Freiberg is also standard modular system, working usually with a plot size of 3 x 1 m, using 3 oscillating VeeJet 80/100 nozzles with an usual operating pressure of 0.5 bar. Intensity is regulated by the frequency of sweeps above

Clinical Characteristics and Treatment Response of Peripheral Neuropathy in the Presence of Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss Syndrome): Experience at a Single Tertiary Center.

PubMed

Cho, Hye Jin; Yune, Sehyo; Seok, Jin Myoung; Cho, Eun Bin; Min, Ju Hong; Seo, Yeon Lim; Lee, Byung Jae; Kim, Byoung Joon; Choi, Dong Chull

2017-01-01

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic small-vessel vasculitis accompanied by asthma, eosinophilia, and eosinophilic inflammation of various tissues including the peripheral nerves. This study investigated the clinical course and long-term outcomes of peripheral neuropathy in patients with EGPA. Seventy-one patients with physician-diagnosed EGPA were identified at Samsung Medical Center between January 1995 and April 2014. Sixty-one of these patients were followed-up for more than 1 year and received corticosteroid therapy with or without intravenous cyclophosphamide pulse therapy for 6 to 18 months. Medical records of the 61 patients including demographic data, clinical features, laboratory and pathological findings, treatments, and outcomes were reviewed. Peripheral neuropathy as a manifestation of EGPA was present in 46 (75%) of the 61 patients. The mean follow-up duration of the patients with neuropathy was 6.4 years (range 1.2-18.8 years). The scores on the neurological functional disability scale before and after the combination treatment with corticosteroid and cyclophosphamide were 2.43±0.86 and 0.54±0.95 (mean±SD; p<0.001), respectively. The peripheral neuropathy relapsed in one patient. The long-term clinical outcome of peripheral neuropathy in patients with EGPA receiving initial corticosteroid and cyclophosphamide combination therapy was favorable with a very low relapse rate.

["Acute human glanders". Contribution for the scientific history of the Museum of pathological anatomy established in Trieste Hospital].

PubMed

Braulin, F

2005-12-01

The Museum of Pathological Anatomy of the Regina Elena City Hospital of Trieste houses various pathological preparations of infective and contagious diseases, dating back to the early 1900's (ileo-typhus, dysentery, tuberculosis, syphillis, pulmonary plague, etc.) together with their relative diagnostic certificates. These bear witness to the key role of the Hospital's Anatomical Institute (in operation operating since 1872) during the height of the Pasteurian age. In fact, the Institute houses several anatomical-pathological preparations from a fatal clinical case of "acute human glanders". These preparations were correlated by laboratory animal experiments using Strauss' method and emblematically recall the eziological determinism of the new bacteriological science. The preparations served in their day not only as indisputable diagnostic evidence, but can now be considered a promotional metaphor of the scientific mission the Triestine Anatomical Institutés Director, Dr. Enrico Ferrarri (a disciple of Richard Paltauf), endeavored to assign to the Triestine Pathological and Anatomical Institute by strenghthening it with new laboratory methodologies. The establishment of a new "predominant and determining vision" in the international diagnostics of infectious disease was also emerging from the Haspurg city's hospital medicine. Indeed, it was here that in 1907, the brief scientific debate focussing on the cadaver of a coachman who had been infected by a glanders-infected horse was apparently taking place only locally. Yet, it can now be seen as referring to what was happening on the international scale, in a setting that after a century of empiricism and morphologism, was characterized by the progressive penetration of laboratory medicine into clinical-anatomical medicine.

Conceptualisation of self-management intervention for people with early stage dementia.

PubMed

Martin, Faith; Turner, Andrew; Wallace, Louise M; Bradbury, Nicola

2013-06-01

Dementia is a major challenge for health and social care services. People living with dementia in the earlier stages experience a "care-gap". Although they may address this gap in care, self-management interventions have not been provided to people with dementia. It is unclear how to conceptualise self-management for this group and few published papers address intervention design. Initial focusing work used a logic mapping approach, interviews with key stakeholders, including people with dementia and their family members. An initial set of self-management targets were identified for potential intervention. Self-management for people living with dementia was conceptualised as covering five targets: (1) relationship with family, (2) maintaining an active lifestyle, (3) psychological wellbeing, (4) techniques to cope with memory changes, and (5) information about dementia. These targets were used to focus literature reviewing to explore an evidence base for the conceptualisation. We discuss the utility of the Corbin and Strauss (Unending work and care: managing chronic illness at home. Jossey-Bass, Oxford, 1988) model of self-management, specifically that self-management for people living with dementia should be conceptualised as emphasising the importance of "everyday life work" (targets 1 and 2) and "biographical work" (target 3), with inclusion of but less emphasis on specific "illness work" (targets 4, 5). We argue that self-management is possible for people with dementia, with a strengths focus and emphasis on quality of life, which can be achieved despite cognitive impairments. Further development and testing of such interventions is required to provide much needed support for people in early stages of dementia.

[What's new in internal medicine?].

PubMed

Blétry, O; Sene, T; Kahn, J-E; Ackermann, F; Charles, P; Leport, J; Piette, A-M

2009-12-01

Among diagnostic progress over the last three years in internal medicine, Antisynthetase Syndrome is now more easily recognised with the diffusion of laboratory tests for research of antibodies against tRNA synthetases (Anti JO1, anti PL7, Anti PL12). In two third of cases, these antibodies are found despite absence of antinuclear antibodies. Hence, we have to search them specifically in patients with polyarthritis associated with myositis, cutaneous manifestations (Raynaud phenomenom and "mechanic'hands") and interstitial lung disease. Discovery of asymptomatic mutation in the L ferritin coding sequence help us to better understand the "unexplained" hyperferritinemia. Initially described by japonese gastroenterologists, auto immune pancreatitis in fact a part of a systemic sclerosing disease with a biochemical hallmark: in crease of a subclass of immunoglobulins G (IgG4). A new pediatric disease due to a deficiency of the interleukin1 receptor antagonist (multifocal aseptic osteitis, periostitis, stomatitis, disseminated pustulosis) help us to better understand unexplained auto inflammatory diseases. The therapeutic progress is primarily due to an explosion of biological therapies, particularly four of them very useful for internists (in an off label use) : Interleukin 1 inhibitors (anakinra, Canakinumab) to treat some auto inflammatory diseases (cryopirin associated periodic syndromes and deficency of interleukin 1 receptor antagonist), monoclonal antibody against interleukin 5 (mepolizumab) to treat some hypereosinophilic syndromes and Churg and Strauss angiitis, interleukin 6 inhibitiors to treat multifocal Castleman's disease and adult Still disease, a monoclonal antibody against vascular endothelial growth factor (Bevacizumab) to treat hereditary hemorrhagic telangiectasia. Copyright 2009 Elsevier Masson SAS. All rights reserved.

Health professionals' decision-making in wound management: a grounded theory.

PubMed

Gillespie, Brigid M; Chaboyer, Wendy; St John, Winsome; Morley, Nicola; Nieuwenhoven, Paul

2015-06-01

To develop a conceptual understanding of the decision-making processes used by healthcare professionals in wound care practice. With the global move towards using an evidence-base in standardizing wound care practices and the need to reduce hospital wound care costs, it is important to understand health professionals' decision-making in this important yet under-researched area. A grounded theory approach was used to explore clinical decision-making of healthcare professionals in wound care practice. Interviews were conducted with 20 multi-disciplinary participants from nursing, surgery, infection control and wound care who worked at a metropolitan hospital in Australia. Data were collected during 2012-2013. Constant comparative analysis underpinned by Strauss and Corbin's framework was used to identify clinical decision-making processes. The core category was 'balancing practice-based knowledge with evidence-based knowledge'. Participants' clinical practice and actions embedded the following processes: 'utilizing the best available information', 'using a consistent approach in wound assessment' and 'using a multidisciplinary approach'. The substantive theory explains how practice and evidence knowledge was balanced and the variation in use of intuitive practice-based knowledge versus evidence-based knowledge. Participants considered patients' needs and preferences, costs, outcomes, technologies, others' expertise and established practices. Participants' decision-making tended to be more heavily weighted towards intuitive practice-based processes. These findings offer a better understanding of the processes used by health professionals' in their decision-making in wound care. Such an understanding may inform the development of evidence-based interventions that lead to better patient outcomes. © 2014 John Wiley & Sons Ltd.

Literacy learning in secondary school science classrooms: A cross-case analysis of three qualitative studies

NASA Astrophysics Data System (ADS)

Dillon, Deborah R.; O'Brien, David G.; Moje, Elizabeth B.; Stewart, Roger A.

The purpose of this cross-case analysis is to illustrate how and why literacy was incorporated into science teaching and learning in three secondary classrooms. Research questions guiding the analysis include: (a) How were literacy events shaped by the teachers' philosophies about teaching science content and teaching students? and (b) How was literacy (reading, writing, and oral language) structured by the teachers and manifested in science lessons? The methodology of ethnography and the theoretical framework of symbolic interactionism were employed in the three studies on which the cross-case analysis was based. The researchers assumed the role of participant observers, collecting data over the period of 1 year in each of the three classrooms. Data, in the form of fieldnotes, interviews, and artifacts, were collected. In each study, data were analyzed using the constant comparative method (Glaser & Strauss, 1967) to determine patterns in the teachers' beliefs about learning and how these influenced their choice of literacy activities. The cross-case analysis was conducted to determine patterns across the three teachers and their classrooms. The findings from this analysis are used to compare how the teachers' philosophies of teaching science and their beliefs about how students learn influenced their use of literacy practices during lessons. Specifically, each teacher's use of literacy activities varied based on his or her beliefs about teaching science concepts. Furthermore, reading, writing, and oral language were important vehicles to learning science concepts within daily classroom activities in the three classrooms.Received: 1 April 1993; Revised: 30 August 1993;

Premorbid functioning of patients with first-episode nonaffective psychosis: a comparison of deterioration in academic and social performance, and clinical correlates of Premorbid Adjustment Scale scores.

PubMed

Monte, Ralph C; Goulding, Sandra M; Compton, Michael T

2008-09-01

Motivated by a previous study among male veterans [Allen, D.N., Frantom, L.V., Strauss, G.P., van Kammen, D.P., 2005. Differential patterns of premorbid academic and social deterioration in patients with schizophrenia. Schizophr. Res. 75, 389-397], the present analysis examined: (1) patterns of premorbid academic and social functioning during childhood, early adolescence, and late adolescence, and (2) associations between these premorbid functioning dimensions and a number of clinical variables. Data on premorbid functioning were collected using the Premorbid Adjustment Scale (PAS) in 95 hospitalized first-episode patients. Analyses were similar to those conducted by Allen and colleagues (2005). Deterioration was evident in both academic and social functioning from childhood to early adolescence, along with a pronounced/accelerated deterioration in academic functioning from early adolescence to late adolescence, occurring in both male and female patients. Age at onset of prodromal symptoms was predicted by childhood/early adolescent/late adolescent academic functioning scores, and age at onset of psychotic symptoms was significantly associated only with childhood academic functioning. Severity of negative symptoms was predicted by childhood and late adolescent social functioning scores, and severity of general psychopathology symptoms was predicted by late adolescent academic functioning, as well as childhood and late adolescent social functioning scores. Consistent with prior findings, deterioration in premorbid functioning appears to be more pronounced in the academic than social dimension of the PAS. Some PAS scores are predictive of ages at onset of prodrome/psychosis and severity of psychotic symptoms. Ongoing research on premorbid adjustment in schizophrenia may have implications for future prevention goals.

Rigour and grounded theory.

PubMed

Cooney, Adeline

2011-01-01

This paper explores ways to enhance and demonstrate rigour in a grounded theory study. Grounded theory is sometimes criticised for a lack of rigour. Beck (1993) identified credibility, auditability and fittingness as the main standards of rigour for qualitative research methods. These criteria were evaluated for applicability to a Straussian grounded theory study and expanded or refocused where necessary. The author uses a Straussian grounded theory study (Cooney, In press) to examine how the revised criteria can be applied when conducting a grounded theory study. Strauss and Corbin (1998b) criteria for judging the adequacy of a grounded theory were examined in the context of the wider literature examining rigour in qualitative research studies in general and grounded theory studies in particular. A literature search for 'rigour' and 'grounded theory' was carried out to support this analysis. Criteria are suggested for enhancing and demonstrating the rigour of a Straussian grounded theory study. These include: cross-checking emerging concepts against participants' meanings, asking experts if the theory 'fit' their experiences, and recording detailed memos outlining all analytical and sampling decisions. IMPLICATIONS FOR RESEARCH PRACTICE: The criteria identified have been expressed as questions to enable novice researchers to audit the extent to which they are demonstrating rigour when writing up their studies. However, it should not be forgotten that rigour is built into the grounded theory method through the inductive-deductive cycle of theory generation. Care in applying the grounded theory methodology correctly is the single most important factor in ensuring rigour.

A grounded theory study of Swedish women's experiences of inflammatory symptoms of the breast during breast feeding.

PubMed

Kvist, Linda J; Larsson, Bodil Wilde; Hall-Lord, Marie Louise

2006-06-01

to gain an understanding of the experiences of women who have had an episode of inflammatory symptoms of the breast during lactation. a grounded theory approach, inspired by Glaser and Strauss, was used in an interview study. the study was carried out at a midwife-led breast-feeding clinic in Sweden. the strategic sample consisted of 14 mothers, all of whom had had an episode of breast inflammation between 10 and 22 weeks before the interview. Nine were primiparous. Ages ranged between 24 and 38 years. the analysis resulted in the emergence of one core category and five conceptual categories. The core category was 'the will to breast feed', and the five conceptual categories were 'perspectives on breast feeding', 'personal strategies', 'enduring and adjustment', 'support' and 'causal frameworks'. The core category was reflected in all the other categories and was dependent on them. an episode of breast inflammation is a possible threat to the maintenance of breast feeding, but the will to breast feed may make it possible for mothers to withstand physical and emotional difficulties caused by the illness. Breast-feeding mothers may have chosen a goal for the length of time they wish to breast feed, and the attainment of this goal is prestige-filled. Midwives, throughout the chain of care, could improve the amount and type of information given about the demands and possible complications of breast feeding. The availability of immediate clinical expertise for these mothers is an important factor, and health-care planners should be aware of this.

Mobilizing male opinion leaders’ support for family planning to improve maternal health: a theory-based qualitative study from Pakistan

PubMed Central

Azmat, Syed Khurram

2011-01-01

Purpose Pakistan is a patriarchal society in which male opinion leaders play an important role in determining health-seeking behaviors pertaining to family planning (FP) among their respective communities. This research focuses on cataloguing the perceptions of opinion leaders (clergymen, health professionals, and social workers) about the barriers for using services and practical solutions for promoting FP in the slums of Karachi, Pakistan. Materials and methods A qualitative study using an open-ended, semistructured interview schedule with hypothetical scenarios and in-depth interviews with a purposive sample of 45 opinion leaders (25 mosque imams/clergymen, 12 nonallopathic health professionals, and eight social workers/activists) was conducted in 2006–2007 in Karachi, Pakistan. Transcripts were coded thematically utilizing NVivo by using an adapted constant comparison analysis process as described by Strauss and Corbin. Results Seven key themes were derived from the in-depth interviews. Five themes provide insight into the opinion leaders’ perceptions of barriers to FP and modern contraception methods. Among the barriers religious taboos and cultural pressures were particularly note-worthy. Two themes offered opportunities for more effective development and implementation of FP programs. Conclusion It is evident from the study that opinion leaders in the community and the clergy lack the understanding of the importance of birth spacing. However, because they have a great deal of influence on the community at large, it is imperative to interact with them to build their capacity in order to propagate the messages of FP and improve maternal health and reproductive health in general. PMID:22247617

Perspectives on quality of care for people who experience disability.

PubMed

Fadyl, Joanna K; McPherson, Kathryn M; Kayes, Nicola M

2011-01-01

Quality of care is considered to be of central importance in healthcare, disability services and rehabilitation. People experiencing disability often access a range of health and social care services; for some, these services are integral parts of daily life. Little research has explored perspectives of disabled people regarding what constitutes good quality care. This qualitative study aimed to explore and synthesise these perspectives to build a better picture of what constitutes good-quality care for disabled people in New Zealand. Qualitative focus groups and interviews were conducted with a range of participants including people with physical, sensory and/or intellectual impairment; informal and formal carers; and health and social care professionals. Data analysis used constant comparison methods as described in Strauss and Corbin (1998) to determine the factors of most importance and how they contributed to quality of care in health and social care services from the perspectives of people who use these services. Thirty-one participants took part, representing a range of ages and disabilities. Three main themes identified from data analysis were: (1) technical competence of care service and professionals; (2) a 'human' approach to service provision; and (3) context-appropriate response to needs. Findings offer a service-user perspective on what makes a difference to quality of care for people experiencing disability. They suggest that to provide context-appropriate care which addresses individual needs, the right mix of technical competence and a 'human' approach to care is needed. The mix required for the 'right' balance may depend on the type of service.

Genome-Wide Mutation Rate Response to pH Change in the Coral Reef Pathogen Vibrio shilonii AK1.

PubMed

Strauss, Chloe; Long, Hongan; Patterson, Caitlyn E; Te, Ronald; Lynch, Michael

2017-08-22

Recent application of mutation accumulation techniques combined with whole-genome sequencing (MA/WGS) has greatly promoted studies of spontaneous mutation. However, such explorations have rarely been conducted on marine organisms, and it is unclear how marine habitats have influenced genome stability. This report resolves the mutation rate and spectrum of the coral reef pathogen Vibrio shilonii , which causes coral bleaching and endangers the biodiversity maintained by coral reefs. We found that its mutation rate and spectrum are highly similar to those of other studied bacteria from various habitats, despite the saline environment. The mutational properties of this marine bacterium are thus controlled by other general evolutionary forces such as natural selection and genetic drift. We also found that as pH drops, the mutation rate decreases and the mutation spectrum is biased in the direction of generating G/C nucleotides. This implies that evolutionary features of this organism and perhaps other marine microbes might be altered by the increasingly acidic ocean water caused by excess CO 2 emission. Nonetheless, further exploration is needed as the pH range tested in this study was rather narrow and many other possible mutation determinants, such as carbonate increase, are associated with ocean acidification. IMPORTANCE This study explored the pH dependence of a bacterial genome-wide mutation rate. We discovered that the genome-wide rates of appearance of most mutation types decrease linearly and that the mutation spectrum is biased in generating more G/C nucleotides with pH drop in the coral reef pathogen V. shilonii . Copyright © 2017 Strauss et al.

Determining the disease management process for epileptic patients: A qualitative study.

PubMed

Hosseini, Nazafarin; Sharif, Farkhondeh; Ahmadi, Fazlollah; Zare, Mohammad

2016-01-01

Epilepsy exposes patients to many physical, social, and emotional challenges. Thus, it seems to portray a complex picture and needs holistic care. Medical treatment and psychosocial part of epilepsy remain central to managing and improving the patient's qualify of life through team efforts. Some studies have shown the dimensions of self-management, but its management process of epilepsy patients, especially in Iran, is not clear. This study aimed to determine the disease management process in patients with epilepsy in Iran. This qualitative approach and grounded theory study was conducted from January 2009 to February 2012 in Isfahan city (Iran). Thirty-two participants were recruited by the goal-oriented, and snowball sample selection and theoretical sampling methods. After conducting a total of 43 in-depth interviews with the participants, the researchers reached data saturation. Data were analyzed using Strauss and Corbin method. With a focus on disease management process, researchers found three main themes and seven sub-themes as a psychosocial process (PSP). The main themes were: perception of threat to self-identity, effort to preserve self-identity, and burn out. The psychosocial aspect of the disease generated one main variable "the perception of identity loss" and one central variable "searching for self-identity." Participants attributed threat to self-identity and burn out to the way their disease was managed requiring efforts to preserve their identity. Recommendations consist of support programs and strategies to improve the public perception of epilepsy in Iran, help patients accept their condition and preserve self-identity, and most importantly, enhance medical management of epilepsy.

Grounded theory in music therapy research.

PubMed

O'Callaghan, Clare

2012-01-01

Grounded theory is one of the most common methodologies used in constructivist (qualitative) music therapy research. Researchers use the term "grounded theory" when denoting varying research designs and theoretical outcomes. This may be challenging for novice researchers when considering whether grounded theory is appropriate for their research phenomena. This paper examines grounded theory within music therapy research. Grounded theory is briefly described, including some of its "contested" ideas. A literature search was conducted using the descriptor "music therapy and grounded theory" in Pubmed, CINAHL PsychlNFO, SCOPUS, ERIC (CSA), Web of Science databases, and a music therapy monograph series. A descriptive analysis was performed on the uncovered studies to examine researched phenomena, grounded theory methods used, and how findings were presented, Thirty music therapy research projects were found in refereed journals and monographs from 1993 to "in press." The Strauss and Corbin approach to grounded theory dominates the field. Descriptors to signify grounded theory components in the studies greatly varied. Researchers have used partial or complete grounded theory methods to examine clients', family members', staff, music therapy "overhearers," music therapists', and students' experiences, as well as music therapy creative products and professional views, issues, and literature. Seven grounded theories were offered. It is suggested that grounded theory researchers clarify what and who inspired their design, why partial grounded theory methods were used (when relevant), and their ontology. By elucidating assumptions underpinning the data collection, analysis, and findings' contribution, researchers will continue to improve music therapy research using grounded theory methods.

A grounded theory of successful aging among select incarcerated older Filipino women.

PubMed

Lucas, Heizel Mae; Lozano, Carl James; Valdez, Les Paul; Manzarate, Rowena; Lumawag, Fortuna Angelli Jolyn

Across the literature, impairment and disability among the older people have been associated with a decline in meeting their special needs. Failure in meeting such needs may cause deterioration of function and threaten successful aging. Accordingly, successful aging studies were carried out among males, in health care institutions, and in communities. In spite of these, the process by which successful aging is experienced by incarcerated older women remains to be a blank spot in research. This study purports to describe the process by which incarcerated older Filipino women experience successful aging. Strauss and Corbin's grounded theory design was employed. Semistructured interviews were conducted among 15 purposively selected incarcerated older Filipino from a Philippine penal institution exclusive for women. Further, data gathered was reduced to field text and was analyzed through open, axial and selective coding. Finally, truthfulness and trustworthiness of the findings were established through member checking. The study generated "The Road to Success Model". Interestingly, five phases relative to successful aging emerged, namely: Struggling, Remotivating, Reforming, Reintegrating and Sustaining. These phases describe how select incarcerated older Filipino women undergo transformation towards successful aging. Similar to a road, each phase is considered a station where one must pass through in order to get to the destination. Findings of the study serve as an impetus for structural and procedural changes in prison, with a view to providing an environment conducive to successful aging and appropriate recognition to the older prisoner's efforts to achieve successful aging. Copyright © 2018 Elsevier B.V. All rights reserved.

Adolescents Confusion in Receiving Health Services: A Qualitative Study

PubMed Central

Azh, Nezal; Ozgoli, Giti; Ardalan, Gelayol

2017-01-01

Introduction Providing health services for adolescents requires exploration of hidden factors from the perspective of adolescents, providers, and key individuals. Understanding the process of providing health services from adolescents point of view will help receiving and continuation of services. Although many studies have been conducted in Iran on adolescents health needs, few studies have dealt with provision of these services to adolescents. Aim The present study aimed to explain the adolescents and key informants’ perception of healthcare provision. Materials and Methods The present qualitative study was conducted according to grounded theory. Data were collected using deep semi-structured individual interviews and group discussion. Participants were selected through purposive sampling followed by theoretical sampling. Participants in present study were 65 adolescents, nine youths (19-24-year-old), and 19 parents and key people involved in providing health services. Adolescents and their parents were selected from different parts of Tehran. Data collection continued until data saturation, and was analysed using Corbin-Strauss (2008) method. Results Issues relating to adolescents perception of the process of providing services included health concerns, society’s inappropriate behaviours, and weakness of the health services system in responding to adolescents needs, which as underlying factors contributed to adolescents confusion in receiving services and their proper coping with puberty. Conclusion Due to lack of education on how to manage puberty by parents, schools, society, and the health system, participating adolescents from Tehran were confused about receiving information and unable to manage puberty problems. Solving this problem requires continuity of services and interaction of family, school and community. PMID:28658809

Knowledge about hereditary cancer of women with family histories of breast, colorectal, or both types of cancer.

PubMed

Campacci, N; de Lima, J O; Ramadan, L; Palmero, E I

2015-03-01

Usually, the mass media do not address hereditary cancer and their risk factors, nor are these topics discussed at the community level. We used an informative guide on cancer and hereditary cancer, followed by a questionnaire on these topics to investigate the relevant knowledge among women at high risk for hereditary breast and/or colorectal cancer from a population-based cohort. The cohort was composed of 81 Brazilian women with positive family histories of breast and/or colorectal cancer. Strauss and Corbin's Grounded Theory was used for qualitative analysis. The average age of the cohort was 49.9 years old. Three participants (3.9%) were illiterate, 45 (59.2%) had attended elementary school, 14 (18.4%) had secondary school, and 14 (18.4%) held higher education degrees. A total of 47 (54.3%) volunteers were unable to fully understand the information provided in the guide because they did not know the meaning of words such as metastasis, malignant, hereditary, sporadic, or oncogenetics. Notwithstanding, the acceptance of the educational tool utilized was satisfactory, and it enhanced the volunteers' interest in a better understanding of cancer and heredity. Thereby, we concluded that the low knowledge of this important subject and the unawareness about fundamental terms required for the comprehension of this specific type of neoplasm made us believe that the use of the informative guide can provide a great value when used previously to the genetic counseling consultations. Besides, educational tools of easy understanding should be part of everyday clinical practice, from primary to specialized patient care.

Obsessive compulsive symptoms are associated with better functioning independently of cognition in schizophrenia.

PubMed

Kontis, Dimitrios; Theochari, Eirini; Nikolakopoulou, Mary; Andreopoulou, Angeliki; Vassos, Dimitrios; Grigoriou, Vasileios; Vassilouli, Spyridoula; Giannakopoulou, Dimitra; Kouloumbi, Maria; Tsaltas, Eleftheria

2016-10-01

Although the relationship of obsessive-compulsive symptoms (OCSs) with both cognition and social functioning (SF) has already been the focus of research in schizophrenia, the moderation of the relationship of OCSs with SF by cognition has not been explored to date. We investigated the association of OCSs with SF and its interaction with cognition in schizophrenia. We recruited 110 schizophrenia patients and assessed OCSs (Yale-Brown Scale), schizophrenia symptoms (Positive and Negative Syndrome Scale), SF (Strauss-Carpenter Scale) and cognition. 51 patients had one obsessive-compulsive symptom or more, whereas 59 patients had no obsessive compulsive-symptom, according to the Yale-Brown Scale. We mainly investigated: a) the predictive effect of OCSs on SF, controlling for cognition, illness duration and symptoms' severity and b) the moderating effect of cognition on the OCSs-SF relationship. The mean score of OCSs for patients having at least one symptom was 13.43 (SD=8.32). Higher OCSs predicted increased SF (B=0.98, t=2.41, df=88, p=0.018). This relationship was driven by the association of compulsions with job functioning (B=0.074, t=2.029, df=88, p=0.046). Patients without OCSs demonstrated worse functioning compared with those having at least one obsessive-compulsive symptom (mean difference=2.496, t=3.732, df=88, p<0.001). We failed to find evidence that cognition moderates the effect of OCSs on SF. There may be a beneficial effect of OCSs on SF in patients with schizophrenia which is independent of their cognitive performance. Copyright © 2016 Elsevier Inc. All rights reserved.

Mexican American Women’s Perspectives on a Culturally Adapted Cognitive-Behavioral Therapy Guided Self-Help Program for Binge Eating

PubMed Central

Shea, Munyi; Cachelin, Fary M.; Gutierrez, Guadalupe; Wang, Sherry; Phimphasone, Phoutdavone

2015-01-01

The prevalence of bulimia nervosa (BN) and binge eating disorder (BED) among Latinas is comparable to those of the general population; however, few interventions and treatment trial research have focused on this group. Cognitive-behavioral therapy (CBT) is the treatment of choice for binge eating related disorders. CBT-based guided self-help (CBTgsh)—a low-cost minimal intervention—has also been shown effective in improving binge eating related symptom, but the effectiveness of the CBTgsh among ethnic minority women is not well understood. Cultural adaptation of evidence-based treatments can be an important step for promoting treatment accessibility and engagement among underserved groups. This qualitative study was part of a larger investigation that examined the feasibility and efficacy of a culturally adapted CBTgsh program among Mexican American women with binge eating disorders. Post-treatment focus groups were conducted with 12 Mexican American women with BN or BED who participated in the intervention. Data were analyzed with the grounded theory methodology (Corbin & Strauss, 2008). Three themes emerged from the data: 1) eating behavior and body ideals are socially and culturally constructed, 2) multifaceted support system is crucial to Mexican American women’s treatment engagement and success, and 3) the culturally adapted CBTgsh program is feasible and relevant to Mexican American women’s experience, but it can be strengthened with increased family and peer support. The findings provide suggestions for further adaptation and refinement of the CBTgsh, and implications for future research as well as early intervention for disordered eating in organized care settings. PMID:26462112

Proteolytic processing and activation of Clostridium perfringens epsilon toxin by caprine small intestinal contents.

PubMed

Freedman, John C; Li, Jihong; Uzal, Francisco A; McClane, Bruce A

2014-10-21

Epsilon toxin (ETX), a pore-forming toxin produced by type B and D strains of Clostridium perfringens, mediates severe enterotoxemia in livestock and possibly plays a role in human disease. During enterotoxemia, the nearly inactive ETX prototoxin is produced in the intestines but then must be activated by proteolytic processing. The current study sought to examine ETX prototoxin processing and activation ex vivo using the intestinal contents of a goat, a natural host species for ETX-mediated disease. First, this study showed that the prototoxin has a KEIS N-terminal sequence with a molecular mass of 33,054 Da. When the activation of ETX prototoxin ex vivo by goat small intestinal contents was assessed by SDS-PAGE, the prototoxin was processed in a stepwise fashion into an ~27-kDa band or higher-molecular-mass material that could be toxin oligomers. Purified ETX corresponding to the ~27-kDa band was cytotoxic. When it was biochemically characterized by mass spectrometry, the copresence of three ETX species, each with different C-terminal residues, was identified in the purified ~27-kDa ETX preparation. Cytotoxicity of each of the three ETX species was then demonstrated using recombinant DNA approaches. Serine protease inhibitors blocked the initial proteotoxin processing, while carboxypeptidase inhibitors blocked further processing events. Taken together, this study provides important new insights indicating that, in the intestinal lumen, serine protease (including trypsin and possibly chymotrypsin) initiates the processing of the prototoxin but other proteases, including carboxypeptidases, then process the prototoxin into multiple active and stable species. Importance: Processing and activation by intestinal proteases is a prerequisite for ETX-induced toxicity. Previous studies had characterized the activation of ETX using only arbitrarily chosen amounts of purified trypsin and/or chymotrypsin. Therefore, the current study examined ETX activation ex vivo by natural

Approaches to Numerical Relativity

NASA Astrophysics Data System (ADS)

d'Inverno, Ray

2005-07-01

. Self-gravitating thin disks around rotating black holes A. Lanza; 24. An ADI and causal reconnection Gabrielle D. Allen and Bernard F. Schutz; 25. Time-symmetric ADI and causal reconnection Miguel Alcubierre and Bernard F. Schutz; 26. The numerical study of topological defects E. P. S. Shellard; 27. Computations of bubble growth during the cosmological quark-hadron transition J. C. Miller and O. Pantano; 28. Initial data of axisymmetric gravitational waves with a cosmological constant Ken-Ichi Nakao, Kei-Ichi Maeda, Takashi Nakamura and Ken-Ichi Oohara.

Ethical behavior of nurses in decision-making in Iran

PubMed Central

Ebrahimi, Hossein; Nikravesh, Mansoure; Oskouie, Fatemeh; Ahmadi, Fazlollah

2015-01-01

Background: Ethical caring is an essential in nursing practice. Nurses are confronted with complex situations in which they are expected to autonomously make decisions in delivering good care to patients. Although a wide range of studies have examined ethical behavior of nurses, there are still many issues requiring further investigation. The aim of this article is to describe the ethical behavior of nurses in decision-making in patients’ care in Iran. Materials and Methods: This study was conducted through grounded theory method. Participants were 17 Iranian nurses, employed in Tabriz University of Medical Sciences hospitals. Unstructured, semi-structured, and in-depth interviews were used for data gathering. Interviews were transcribed and coded according to Strauss and Corbin method in open, axial, and selective coding. Results: Nurses showed three major approaches in ethical behavior: Beyond the legal duty and protection of the patients, which includes dedication and full availability to nurses’ job and the client, spending time for the patients and delayed exit from the workplace, and arbitrary practice; legal duty and the protection of patients and nurses, which includes caretaking for the patient, responding to the client, and implementing the physician's prescription; and below the legal duty and the protection of one's self, that is, finding evidence and having witness in case of false documentation, and shortcoming, negligence, and mistake. Conclusions: Because of the importance of the ethical behavior of nurses in decision-making, it is necessary to find ways to promote moral reasoning and moral development of nurses. Empowerment of nurses, nurse educators, and nursing students to acquire knowledge and develop ethical behavior skills is important. PMID:25709704

Therapeutic immunomodulation in systemic vasculitis: taking stock.

PubMed

Puéchal, Xavier; Guillevin, Loïc

2013-07-01

Current data on therapeutic immunomodulation used to treat systemic vasculitides are reviewed in this paper, which also discusses ongoing and future developments in the field. In vasculitides associated with anti-neutrophil cytoplasmic antibodies, rituximab is a validated induction treatment that can serve as an alternative to cyclophosphamide and must be followed by maintenance treatment. In addition, the usefulness of rituximab as maintenance treatment was established recently. Immunoglobulins can be helpful adjuncts, most notably in patients with severe immunodepression. Plasmapheresis is indicated in patients with severe renal failure and may have a role in the treatment of alveolar hemorrhage syndromes. Mepolizumab has produced encouraging preliminary results in eosinophilic granulomatosis with polyangiitis (Churg-Strauss). Rituximab can be used in cryoglobulinemic vasculitis associated with hepatitis C virus infection when antiviral therapy fails or the disease is severe. Very low doses of interleukin-2 may be helpful in refractory forms. Rituximab is also an option in essential mixed cryoglobulinemia with uncontrolled vasculitis despite glucocorticoid and/or immunosuppressive treatment. In polyarteritis nodosa associated with the hepatitis B virus, a combination of short-course glucocorticoids, plasmapheresis, and antiviral therapy produces excellent outcomes. Intravenous immunoglobulins are used to treat Kawasaki disease, in which they diminish the incidence of coronary artery aneurysms. Several prospective controlled trials are currently assessing tocilizumab in giant-cell arteritis. Rituximab has useful effects in systemic vasculitis associated with rheumatoid arthritis. In Goodpasture's syndrome, plasmapheresis is indicated to clear the antibodies to glomerular membrane antigen, which can induce glomerulonephritis. Copyright © 2012 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

Empowering Education: A New Model for In-service Training of Nursing Staff.

PubMed

Chaghari, Mahmud; Saffari, Mohsen; Ebadi, Abbas; Ameryoun, Ahmad

2017-01-01

In-service training of nurses plays an indispensable role in improving the quality of inpatient care. Need to enhance the effectiveness of in-service training of nurses is an inevitable requirement. This study attempted to design a new optimal model for in-service training of nurses. This qualitative study was conducted in two stages during 2015-2016. In the first stage, the Grounded Theory was adopted to explore the process of training 35 participating nurses. The sampling was initially purposeful and then theoretically based on emerging concept. Data were collected through interview, observation and field notes. Moreover, the data were analyzed through Corbin-Strauss method and the data were coded through MAXQDA-10. In the second stage, the findings were employed through 'Walker and Avants strategy for theory construction so as to design an optimal model for in-service training of nursing staff. In the first stage, there were five major themes including unsuccessful mandatory education, empowering education, organizational challenges of education, poor educational management, and educational-occupational resiliency. Empowering education was the core variable derived from the research, based on which a grounded theory was proposed. The new empowering education model was composed of self-directed learning and practical learning. There are several strategies to achieve empowering education, including the fostering of searching skills, clinical performance monitoring, motivational factors, participation in the design and implementation, and problem-solving approach. Empowering education is a new model for in-service training of nurses, which matches the training programs with andragogical needs and desirability of learning among the staff. Owing to its practical nature, the empowering education can facilitate occupational tasks and achieving greater mastery of professional skills among the nurses.

[Usefulness of analyzing ANCA changes for diagnosis of Wegener's granulomatosis].

PubMed

Wiatr, E; Labecka, H; Płodziszewska, M; Maziarka, D; Wawrzyńska, L; Zych, J; Jarzabek-Chorzelska, M; Kuś, J; Chorzelski, T; Rowińska-Zakrzewska, E

1999-01-01

ANCA were described in 1982 as sensitive and specific markers for active Wegener's granulomatosis (WG). We analysed the results of ANCA test performed in 298 patients hospitalized in Institute of Tuberculosis and Lung Diseases in the period 1990-1998 because of different symptoms and syndromes of respiratory system which could be symptoms of WG. Presence of c-ANCA, p-ANCA and other not well defined types of ANCA in the titer greater than 1:40 in the serum was regarded as positive result of test. We found it in 60 patients. In 47 WG pts ANCA were present in 40 of 42 pts with active disease and 1 of 5 in remission. Further 19 positive results were found in a group of 251 patients with other diseases: 1 of 4 pts with Churg-Strauss syndrome, 1 of 2 with pulmonary renal syndrome, 5 of 28 with connective tissue diseases, 1 of 21 with tuberculosis, 1 of 23 with sarcoidosis, 1 of 6 with histiocytosis, 3 of 11 with hypersensitivity pneumonitis, 1 (lymphoma) of 34 with neoplasms, 1 of 20 with pulmonary fibrosis, 1 of 8 with cardiac failure, 1 of 5 with pleural fluid, 1 of 10 pneumoconiosis and toxic reactions (after furagin), 1 of 6 with BOOP. Sensitivity of ANCA test in our material is 87%, specificity = 95%, and positive prevalence accuracy is 68%. It means that 32% of the patients with positive results could be inappropriate treated as WG. ANCA test could be not used as a screening test. Results of ANCA test alone cannot be used as basis for treatment. ANCA test is a helpful tool in diagnosing of WG.

Automated GMA welding of austenitic stainless steel pipe

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tahash, G.J.

1996-12-31

The study focused on reducing weld cycle times of rotatable subassemblies (spools) using automated welding equipment. A unique automatic Gas Metal Arc Welding (GMAW) system was used to produce a series of pipe to pipe welds on 141 mm (5 in.) schedule 80 seamless stainless steel pipe. After manual tack welding, the adaptive control system welded the root pass of the argon gas backed open vee groove circumferential butt joints in the IG rotated position with short circuiting transfer GMAW. The fill and cover passes were welded automatically with spray transfer GMAW. Automatic welding cycle times were found to bemore » 50--80 percent shorter than the current techniques of roll welding with Shielded Metal Arc Welding and manual Gas Tungsten Arc Welding. Weld costs ({Brit_pounds}/m), including amortization, for the various systems were compared. The cost of automated GMA welds was virtually equivalent to the most competitive methods while depositing 75% more filler metal per year. Also investigated were metallurgical effects generated by weld thermal cycling, and the associated effects on mechanical properties of the weld joint. Mechanical properties of the welds met or exceeded those of the base metal. Sensitization of the pipe did not occur in the heat affected zone (HAZ), based on the absence of evidence of intergranular attack in modified Strauss corrosion tests and despite the fact of interpass temperatures well above recommended maximums. Cooling rates of 3--5 C/s in the heat affected zone of the four pass welds were measured by thermocouple technique and found to be within the non-sensitizing range for this alloy.« less

From Negligence to Perception of Complexities in Adherence to Treatment Process in People with Diabetes: A Grounded Theory Study.

PubMed

Mousavizadeh, Seyedeh Narjes; Ashktorab, Tahereh; Ahmadi, Fazlollah; Zandi, Mitra

2018-03-01

Poor adherence of patients with type 2 diabetes to treatment is one of the most complex and important clinical concerns. It is the main issue of the present decade and acknowledged as a challenge to control and treat diabetes. This study was carried out to explore and understand how adherence to treatment process occurs among Iranian patients with type 2 diabetes. The present study is qualitative with grounded theory approach. The data were collected from December 2015 to July 2016 in Tehran (Iran) through individual semi-structured in-depth interviews, field notes, and memos from 21 patients with type 2 diabetes; combined with two members of their families and a healthcare professional. The data were analyzed based on Corbin and Strauss constant comparative analysis (2008). Adherence to treatment is a transitional, interactive, and continuous process. For patients with diabetes, this process includes unperceived threat in diagnosis time (poor knowledge and skills, bottleneck of dependencies, superficial understanding of the new situation), bitter belief (downhill quality of life, physical and emotional treatment feedbacks), and adaptation to treatment (self-care dominance, regimen integration in daily activities). The process of adherence to treatment was influenced by knowledge and skill, social support, beliefs and values, psychological characteristics of people, and the nature of diabetes. Adherence to treatment in Iranian people with diabetes depends on the family and social context, which is challenging for the patient and leads to the negligence of health behaviors. It is vital for healthcare providers to identify these factors to encourage patients to adhere and commit to treatment in order to prevent irreversible complications of diabetes.

Development and Validation of Case-Finding Algorithms for the Identification of Patients with ANCA-Associated Vasculitis in Large Healthcare Administrative Databases

PubMed Central

Sreih, Antoine G.; Annapureddy, Narender; Springer, Jason; Casey, George; Byram, Kevin; Cruz, Andy; Estephan, Maya; Frangiosa, Vince; George, Michael D.; Liu, Mei; Parker, Adam; Sangani, Sapna; Sharim, Rebecca; Merkel, Peter A.

2016-01-01

Purpose To develop and validate case-finding algorithms for granulomatosis with polyangiitis (Wegener’s, GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (Churg-Strauss, EGPA). Methods 250 patients per disease were randomly selected from 2 large healthcare systems using the International Classification of Diseases version 9 (ICD9) codes for GPA/EGPA (446.4) and MPA (446.0). 16 case-finding algorithms were constructed using a combination of ICD9 code, encounter type (inpatient or outpatient), physician specialty, use of immunosuppressive medications, and the anti-neutrophil cytoplasmic antibody (ANCA) type. Algorithms with the highest average positive predictive value (PPV) were validated in a third healthcare system. Results An algorithm excluding patients with eosinophilia or asthma and including the encounter type and physician specialty had the highest PPV for GPA (92.4%). An algorithm including patients with eosinophilia and asthma and the physician specialty had the highest PPV for EGPA (100%). An algorithm including patients with one of the following diagnoses: alveolar hemorrhage, interstitial lung disease, glomerulonephritis, acute or chronic kidney disease, the encounter type, physician specialty, and immunosuppressive medications had the highest PPV for MPA (76.2%). When validated in a third healthcare system, these algorithms had high PPV (85.9% for GPA, 85.7% for EGPA, and 61.5% for MPA). Adding the ANCA type increased the PPV to 94.4%, 100%, and 81.2% for GPA, EGPA, and MPA respectively. Conclusion Case-finding algorithms accurately identify patients with GPA, EGPA, and MPA in administrative databases. These algorithms can be used to assemble population-based cohorts and facilitate future research in epidemiology, drug safety, and comparative effectiveness. PMID:27804171

Exploring the role of the dental hygienist in reducing oral health disparities in Canada: A qualitative study.

PubMed

Farmer, J; Peressini, S; Lawrence, H P

2018-05-01

Reducing oral health disparities has been an ongoing challenge in Canada with the largest burden of oral disease exhibited in vulnerable populations, including Aboriginal people, the elderly, rural and remote residents, and newcomers. Dental hygienists are a unique set of professionals who work with and within communities, who have the potential to act as key change agents for improving the oral health of these populations. The purpose of this qualitative study was to explore, from the dental hygiene perspective, the role of dental hygienists in reducing oral health disparities in Canada. Dental hygienists and key informants in dental hygiene were recruited, using purposeful and theoretical sampling, to participate in a non-directed, semi-structured one-on-one in-depth telephone interview using Skype and Call Recorder software. Corbin and Strauss's grounded theory methodology was employed with open, axial, and selective coding analysed on N-Vivo Qualitative software. The resulting theoretical framework outlines strategies proposed by participants to address oral health disparities; these included alternate delivery models, interprofessional collaboration, and increased scope of practice. Participants identified variation in dental care across Canada, public perceptions of oral health and dental hygiene practice, and lack of applied research on effective oral health interventions as challenges to implementing these strategies. The research confirmed the important role played by dental hygienists in reducing oral health disparities in Canada. However, due to the fragmentation of dental hygiene practice across Canada, a unified voice and cohesive action plan is needed in order for the profession to fully embrace their role. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Determining the disease management process for epileptic patients: A qualitative study

PubMed Central

Hosseini, Nazafarin; Sharif, Farkhondeh; Ahmadi, Fazlollah; Zare, Mohammad

2016-01-01

Background: Epilepsy exposes patients to many physical, social, and emotional challenges. Thus, it seems to portray a complex picture and needs holistic care. Medical treatment and psychosocial part of epilepsy remain central to managing and improving the patient's qualify of life through team efforts. Some studies have shown the dimensions of self-management, but its management process of epilepsy patients, especially in Iran, is not clear. This study aimed to determine the disease management process in patients with epilepsy in Iran. Materials and Methods: This qualitative approach and grounded theory study was conducted from January 2009 to February 2012 in Isfahan city (Iran). Thirty-two participants were recruited by the goal-oriented, and snowball sample selection and theoretical sampling methods. After conducting a total of 43 in-depth interviews with the participants, the researchers reached data saturation. Data were analyzed using Strauss and Corbin method. Results: With a focus on disease management process, researchers found three main themes and seven sub-themes as a psychosocial process (PSP). The main themes were: perception of threat to self-identity, effort to preserve self-identity, and burn out. The psychosocial aspect of the disease generated one main variable “the perception of identity loss” and one central variable “searching for self-identity.” Conclusions: Participants attributed threat to self-identity and burn out to the way their disease was managed requiring efforts to preserve their identity. Recommendations consist of support programs and strategies to improve the public perception of epilepsy in Iran, help patients accept their condition and preserve self-identity, and most importantly, enhance medical management of epilepsy. PMID:26985223

Progranulin antibodies in autoimmune diseases.

PubMed

Thurner, Lorenz; Preuss, Klaus-Dieter; Fadle, Natalie; Regitz, Evi; Klemm, Philipp; Zaks, Marina; Kemele, Maria; Hasenfus, Andrea; Csernok, Elena; Gross, Wolfgang L; Pasquali, Jean-Louis; Martin, Thierry; Bohle, Rainer Maria; Pfreundschuh, Michael

2013-05-01

Systemic vasculitides constitute a heterogeneous group of diseases. Autoimmunity mediated by B lymphocytes and their humoral effector mechanisms play a major role in ANCA-associated vasculitis (AAV) as well as in non-ANCA associated primary systemic vasculitides and in the different types of autoimmune connective tissue disorders and rheumatoid arthritis. In order to detect autoantibodies in systemic vasculitides, we screened protein macroarrays of human cDNA expression libraries with sera from patients with ANCA-associated and ANCA-negative primary systemic vasculitides. This approach led to the identification of antibodies against progranulin, a 88 kDA secreted glycoprotein with strong anti-inflammatory activity in the course of disease of giant-cell arteritis/polymyalgia rheumatica (14/65), Takayasu's arteritis (4/13), classical panarteritis nodosa (4/10), Behcet's disease (2/6) and in the course of disease in granulomatosis with polyangiitis (31/75), Churg-Strauss syndrome (7/23) and in microscopic polyangiitis (7/19). In extended screenings the progranulin antibodies were also detected in other autoimmune diseases such as systemic lupus erythematosus (39/91) and rheumatoid arthritis (16/44). Progranulin antibodies were detected only in 1 of 97 healthy controls. Anti-progranulin positive patients with systemic vasculitides, systemic lupus erythematosus or rheumatoid arthritis had significant lower progranulin plasma levels, indicating a neutralizing effect. In light of the anti-inflammatory effects of progranulin, progranulin antibodies might exert pro-inflammatory effects thus contributing to the pathogenesis of the respective autoimmune diseases and might serve as a marker for disease activity. This hypothesis is supported by the fact that a positive progranulin antibody status was associated with active disease in granulomatosis with polyangiitis. Copyright © 2012 Elsevier Ltd. All rights reserved.

Self-reported interpersonal problems and impact messages as perceived by significant others are differentially associated with the process and outcome of depression therapy.

PubMed

Altenstein-Yamanaka, David; Zimmermann, Johannes; Krieger, Tobias; Dörig, Nadja; Grosse Holtforth, Martin

2017-07-01

Interpersonal factors play a major role in causing and maintaining depression. This study sought to investigate how patients' self-perceived interpersonal problems and impact messages as perceived by significant others are interrelated, change over therapy, and differentially predict process and outcome in psychotherapy of depression. For the present study, we used data from 144 outpatients suffering from major depression that were treated within a psychotherapy study. Interpersonal variables were assessed pre- and posttherapy with the self-report Inventory of Interpersonal Problems-Circumplex Scale (IIP-32; Thomas, Brähler, & Strauss, 2011) and with the informant-based Impact Message Inventory (Caspar, Berger, Fingerle, & Werner, 2016). Patients' levels on the dimensions of Agency and Communion were calculated from both measures; their levels on Interpersonal Distress were measured with the IIP. Depressive and general symptomatology was assessed at pre-, post-, and at 3-month follow-up; patient-reported process measures were assessed during therapy. The Agency scores of IIP and IMI correlated moderately, but the Communion scores did not. IIP Communion was positively associated with the quality of the early therapeutic alliance and with the average level of cognitive-emotional processing during therapy. Whereas IIP Communion and IMI Agency increased over therapy, IIP Distress decreased. A pre-post-decrease in IIP Distress was positively associated with pre-postsymptomatic change over and above the other interpersonal variables, but pre-post-increase in IMI Agency was positively associated with symptomatic improvement from post- to 3-month follow-up. These findings suggest that significant others seem to provide important additional information about the patients' interpersonal style. (PsycINFO Database Record (c) 2017 APA, all rights reserved).