Community indicators: a framework for observing and supporting community activity on Cloudworks

Cloudworks (Cloudworks.ac.uk) is a social networking site designed for sharing, finding and discussing learning and teaching ideas and experiences. Design and development of the site has been based on an iterative analysis, development and implementation approach, underpinned by ongoing research and evaluation. To this end, we have been seeking to establish strategies to enable us to systematically position transactions and emerging patterns of activity on the site so that we can more reliably use the empirical evidence we have gathered (Galley, 2009a, Galley 2009b, Alevizou et al., 2010a, Conole et al, 2010). In this paper we will introduce a framework we have developed for observing and supporting community development on the site. In building our framework we have used empirical evidence gathered from the site, then related it to the literature from a range of disciplines concerned with professional and learning communities. We link research relating to distance learning communities with studies into Computer Mediated Communication (CMC), self-organising communities on the web, and wider research about the nature of learning organisations and continuous professional development. We argue that this framework can be used to capture the development of productive communities in the space (i.e. how far cohesive, productive groups can be said to be emerging or not) and also help focus futur

Premenstrual dysphoric disorder: A critical review of its phenomenology, etiology, treatment and clinical status

Background: Premenstrual Dysphoric Disorder (PMDD) is a newly recognized diagnostic entity in the DSM-5, characterized by intense mood and cognitive fluctuations accompanied by distressing physical symptoms. PMDD symptoms typically arise after ovulation and gradually resolve after the onset of menstruation. With an estimated prevalence of 3-8% in the general female population, PMDD is a chronic and impairing disorder that affects significantly women’s quality of life and everyday functioning. Objective: The aim of this article is to review the existing literature on biological, genetic and psychological etiological factors in PMDD and to discuss corresponding treatment considerations. Results: Fluctuations in the functions of sex hormones, serotonin and GABA neurotransmitters, as well as personality traits related to stress and vulnerability to negative effect are implicated in the development of PMDD. Available evidence-based treatments include a number of hormonal therapies and antidepressant medications, while there is accumulating evidence for the clinical utility of psychotherapeutic interventions. Controversies in the diagnostic validity of PMDD mainly concern the asserted social constructiveness of the disorder and the difficulty to validly distinguish PMDD from other mood disorders with similar symptomatology. Conclusion: Controversies pertaining to the clinical nature and taxonomy of PMDD are highlighted and recommendations are offered, focusing on the need to identify biomarkers for PMDD and to investigate possible efficacy of non-pharmacological, psychotherapeutic interventions to address PMDD. © 2018 Bentham Science Publishers

The role of the protein-binding on the mode of drug action as well the interactions with other drugs

Drug transport and disposition are influenced by a non-specific and reversible drug binding to plasma and tissues proteins. Albumin and a1 acid glycoprotein are the most important transport proteins of the blood. Albumin possesses specific sites for acidic and basic drug binding and can interact with them in the plasma since a third site is trapped only by digoxin. Diseases and stress conditions induce conformational changes either in plasma or in tissue proteins by the synthesis of endogenous substances which can strong interfere with the amount of the free pharmacological effective drug ratio. This may affect the binding of drugs in target molecules inducing significant pharmacokinetic alterations. Stress conditions are associated with FFA increase in serum playing an antagonistic role with other acidic molecules (e.g. ampicillin) to the same binding site. The bounded drug is displaced and freer ratio is available to interact with various organ receptors leading to pharmacological effect enhancement and therefore to side effects manifestation such as seizures. Furthermore conjunctive tissues diseases, ageing, prolonged bleeding, starvation or diseases affecting protein profile, characterized by reduced total plasma proteins, followed by albumin decrease and lessen binding sites lead to more free drug availability enhancing its pharmacological effect. Increased a1-acid glycoprotein the acute phase protein as by heart infraction or liver morbidities (e.g CC14 intoxication) mainly occupied from basic substances, in the case of cationic drug treatment resulted to the enhancement of them and consequently to pronounced effectiveness. In addition, renal failure reduced free fractions of many acidic drugs. It may be concluded that by narrowed therapeutic index of a medicine, and when drug/drug or drug/disease interactions are anticipated, drug monitoring seems to be necessary for its dosage adjustment

The Influence of Diphenhydramine Administration on Lidocaine Protein Binding in Rat Serum and Tissues

Lidocaine is an amide type local anaesthetic and diphenhydramine is a first-generation antihistamine drug. The aim of the present study was to investigate the influence of diphenhydramine co-administration on the extent of lidocaine binding to rat serum and maxillofacial tissue proteins in order to determine a possible synergistic action that could enhance lidocaine’s anaesthetic/analgesic activity. Twenty-eight Wistar rats divided in 4 groups (I, II, Ill, IV) received lidocaine in the masseter muscle. Groups II and IV received diphenhydramine per os 2 h before lidocaine administration. Groups I and II were sacrificed after 15 min and groups III and IV 30 min after lidocaine injection. Masseter and mandible samples were isolated and incubated in NaCl 0.9% solution while serum was obtained through blood centrifugation. Free lidocaine fraction in the tissues’ incubation medium and the serum was obtained through ultrafiltration and determined by radioscopic method in a beta-counter Lidocaine’s free fraction levels (mu g g(-1)) were enhanced after 15 min under diphenhydramine co-administration in all samples from (7.1319 +/- 1.4066) x 10(-4) to (12.1097 +/- 3.7528) x 10(-4) in serum, from 0.9339 +/- 0.3077 to 2.6791 +/- 1.1648 in masseter (p<0.01) and from 0.3898 +/- 0.0879 to 0.6918 +/- 0.2743 in mandible (p<0.05). A statistically significant increase in free anaesthetic levels was also noticed after 30 min in serum from (8.6227 +/- 0.6902) x 10(-4) to (13.9518 +/- 4.9849) x 10(-4) (p<0.05). Lidocaine’s increase could probably be attributed to mechanisms influencing its protein binding properties. Consequently, a possible synergistic action of the two drugs’ combination is demonstrated which could enhance lidocaine’s anaesthetic action, affecting depth and duration of anaesthesia

Self-tracking among young people: lived experiences, tensions and bodily outcomes

Self-tracking enables people to quantify and measure lifestyle and fitness activities and experiences. Our study focuses on the role of self-tracking in young people’s relationship with their body and their lived, ‘fleshy’ experiences in the social world. We draw on twenty-three in-depth interviews with young people using a life story approach. Our findings show that self-tracking affords young people to engage in different types of ‘body work’, to care for and transform their body that is in constant flux by treating it as either a ‘private’ or ‘shared’ project. We contribute to ongoing debates about the role of self-tracking in young people’s lives by offering a holistic approach that considers the individual and social circumstances that render self-tracking an ongoing, iterative, cumulative, and embodied process of discovery, learning, and lived and ‘fleshy’ experience

Limitations and Technical Considerations of Ultrasound-Guided Peripheral Nerve Blocks: Edema and Subcutaneous Air

Objective: Despite advantages of ultrasound-guided peripheral nerve blocks as compared with established techniques, various limitations may exist. We present 2 trauma patients in whom the usefulness of ultrasound techniques was limited by edema and subcutaneous air. Case Report: Two male patients were admitted to the Intensive Care Unit due to multiple trauma. In the first patient, tissue edema and obesity (body mass index, calculated as weight [kg]/height [m2] = 35), and in the second patient, subcutaneous emphysema, were significant limitations for the application of ultrasound-guided peripheral nerve blocks. These factors made 2-dimensional ultrasound imaging difficult despite the use of tissue harmonic technique and advanced ultrasound equipment. Neurostimulation technique alone, or combined with ultrasound imaging eventually led to successful nerve block. Conclusions: Ultrasound technique limitations do exist. We present 2 conditions, edema and subcutaneous air, which contributed to ultrasound failure to provide a clear image of the targeted nerves. © 2008 American Society of Regional Anesthesia and Pain Medicine

Do clinically insignificant tumors of the prostate exist?

Background: The discrepancy between minimal disease on biopsy and disease found in the subsequent prostatectomy specimen, in terms of the size and grade of tumor, extracapsular extension or positive margins, led several authors to dispute the existence of clinically insignificant impalpable tumors of the prostate. However, considering that prostate-specific antigen (PSA) is an indicator of prostate malignancy and since many impalpable prostatic carcinomas (PCs) are detected by a combination of PSA, transurethral ultrasound and needle biopsy (T1c), in the era of PSA screening, it is expected that most of the impalpable tumors found incidentally at transurethral resection of the prostate (stage T1a/b), could be clinically insignificant. Aim: The aim of this study was to identify the characteristics of latent, impalpable PCs and to analyze the incidence of clinically insignificant PCs among hypothetical stage T1 prostate cancers in tumors found incidentally at postmortem examination. Methods: We examined 40 cases of impalpable PCs found in 212 prostate autopsy specimens of men between 30 and 98 years of age who died of diseases other than carcinoma of the prostate and related conditions. Results: Most of T1 histological PCs (57.5%) had a Gleason score between 2 and 4, while 30% had Gleason score between 5 and 6. Only 5 (12.5%) had a Gleason score above 7. Twenty-nine of 40 stage T1 histological cancers (67.5%) had volume of <1 cm3. The highest volume tumors were those of intermediate and high grade (Gleason sums 5-8). Among tumors with volumes of <1 cm3, 96.55% were confined within the prostatic capsule. Conclusions: The majority of impalpable PCs were low-volume, well-differentiated tumors corresponding to clinically insignificant neoplasms. Similar characteristics could be attributed to most of the impalpable carcinomas detected after prostatectomy in clinical practice. Copyright © 2008 S. Karger AG