Crossing nepantla: Older Khmer women\u27s passage to healing in diaspora.

Using critical feminist border ethnography, the thesis explores the healing of older Khmer women who endured the Khmer Rouge genocide and subsequent migration to Australia. A conceptual framework was developed to describe the process from immense suffering to embodied healing, thus contributing to international feminist justice work and decolonising academic research in the healing of women genocide survivors

Can balance function tests predict disability in older adults with peripheral vestibular hypofunction?

Introduction: The Dizziness Handicap Inventory (DHI) is a 25-item self-assessment questionnaire used to evaluate perceived disability from dizziness. The predictive validity of Timed Up and Go (TUG), Dynamic Gait Index (DGI), and modified Clinical Test of Sensory Integration of Balance (mCTSIB) on disability as shown by DHI has not been established specific to older adults with peripheral vestibular hypofunction. The purpose of this study is to investigate if the TUG, DGI, and mCTSIB are significant and strong predictors of the disability from dizziness as represented by the DHI scores in older adults with peripheral vestibular hypofunction. Methods: A Correlational, Retrospective Design was used to investigate the predictors of the DHI score. Data was collected retrospectively on the 17 patients in the main study ‘The Impact of Prescribed Walking on Dizziness in Seniors with Vestibular Hypofunction: A Pilot Randomized Controlled Trial’ and from physical therapy medical charts (n=24) from June 2015 to June 2018. Only medical charts of those 65 years and older who underwent vestibular physical therapy and contain all four outcome measures (DHI, DGI, mCTSIB, and TUG) were included in the study. Dizziness related to central nervous disorder were excluded. Results: There was a significant fair inverse correlation between DHI and mCTSIB (r = -0.381, p = 0.01) and DGI (r = -0.322, p = 0.01), and a fair correlation with TUG (r = 0.396, p = 0.03). The mCTSIB, TUG, and DGI accounted for 10% of the variance in the DHI, however, this predictive relationship was not found to be significant. Discussion: In this limited sample size, the TUG, DGI, and mCTSIB tests are not significant and strong predictors of dizziness-related disability as represented by the DHI scores in older adults with peripheral vestibular dysfunction. This study should be replicated as a large-scale prospective study with stratification of severity of dizziness to improve the generalizability of findings

Effect of preoperative sonographic mapping on vascular access outcomes in hemodialysis patients

Effect of preoperative sonographic mapping on vascular access outcomes in hemodialysis patients.BackgroundCurrent DOQI guidelines encourage placing arteriovenous (AV) fistulas in more hemodialysis patients. However, many new fistulas fail to mature sufficiently to be useable for hemodialysis. Preoperative vascular mapping to identify suitable vessels may improve vascular access outcomes. The present study prospectively evaluated the effect of routine preoperative vascular mapping on the type of vascular accesses placed and their outcomes.MethodsDuring a 17-month period, preoperative sonographic evaluation of the upper extremity arteries and veins was obtained routinely. The surgeons used the information obtained to plan the vascular access procedure. The types of access placed, their initial adequacy for dialysis, and their long-term outcomes were compared to institutional historical controls placed on the basis of physical examination alone.ResultsThe proportion of fistulas placed increased from 34% during the historical control period to 64% with preoperative vascular mapping (P < 0.001). When all fistulas were assessed, the initial adequacy rate for dialysis increased mildly from 46 to 54% (P = 0.34). For the subset of forearm fistulas, the initial adequacy increased substantially from 34 to 54% (P = 0.06); the greatest improvement occurred among women (from 7 to 36%, P = 0.06) and diabetic patients (from 21 to 50%, P = 0.055). In contrast, the initial adequacy rate of upper arm fistulas was not improved by preoperative vascular mapping (59 vs. 56%, P = 0.75). Primary access failure was higher for fistulas than grafts (46.4 vs. 20.6%, P = 0.001), but the subsequent long-term failure rate was higher for grafts than fistulas (P < 0.05). Moreover, grafts required a threefold higher intervention rate (1.67 vs. 0.57 per year, P < 0.001) to maintain their patency. The overall effect of this strategy was to double the proportion of patients dialyzing with a fistula in our population from 16 to 34% (P < 0.001).ConclusionsRoutine preoperative vascular mapping results in a marked increase in placement of AV fistulas, as well as an improvement in the adequacy of forearm fistulas for dialysis. This approach resulted in a substantial increase in the proportion of patients dialyzing with a fistula in our patient population. Fistulas have a higher primary failure rate than grafts, but have a lower subsequent failure rate and require fewer procedures to maintain their long-term patency

Distributed computing practice for large-scale science and engineering applications

It is generally accepted that the ability to develop large-scale distributed applications has lagged seriously behind other developments in cyberinfrastructure. In this paper, we provide insight into how such applications have been developed and an understanding of why developing applications for distributed infrastructure is hard. Our approach is unique in the sense that it is centered around half a dozen existing scientific applications; we posit that these scientific applications are representative of the characteristics, requirements, as well as the challenges of the bulk of current distributed applications on production cyberinfrastructure (such as the US TeraGrid). We provide a novel and comprehensive analysis of such distributed scientific applications. Specifically, we survey existing models and methods for large-scale distributed applications and identify commonalities, recurring structures, patterns and abstractions. We find that there are many ad hoc solutions employed to develop and execute distributed applications, which result in a lack of generality and the inability of distributed applications to be extensible and independent of infrastructure details. In our analysis, we introduce the notion of application vectors: a novel way of understanding the structure of distributed applications. Important contributions of this paper include identifying patterns that are derived from a wide range of real distributed applications, as well as an integrated approach to analyzing applications, programming systems and patterns, resulting in the ability to provide a critical assessment of the current practice of developing, deploying and executing distributed applications. Gaps and omissions in the state of the art are identified, and directions for future research are outlined

Anti-neutrophil cytoplasmic antibodies:Current diagnostic and pathophysiological potential

Rapidly progressive glomerulonephritis (RPGN) is a clinical syndrome characterized by rapid deterioration of renal function occurring within days or weeks together with signs of glomerulonephritis, that is, proteinuria and hematuria with cellular casts. The syndrome is, in many cases, histopathologically manifested as fibrinoid necrosis of the capillary wall with extracapillary proliferation and crescent formation [1]. This so-called necrotizing crescentic glomerulonephritis (NCGN) is seen in 5 to 15% of renal biopsies in most series [1–3]. Although it is infrequent, the importance of the condition is illustrated by the fact that most cases of NCGN, if left untreated, develop renal failure within days or weeks [1]. Based on immunohistopathology NCGN can be subdivided into three distinct categories. The first one, occurring in 2 to 20% of the cases and characterized by linear staining of the glomerular capillary wall for immunoglobulin and complement, has classically been described as anti-glomerular basement membrane (GBM) disease. It is associated with autoantibodies to structural antigens of the GBM, in particular to the first globular noncollagen domain of collagen type IV [4]. The antibodies are considered of pathogenetic significance. The second category, comprising 15 to 50% of cases, is characterized by granular deposits of immunoglobulin and complement suggesting that immune complexes are pathogenetically involved. This type occurs in conjunction with systemic autoimmune diseases such as lupus erythematosus, in cases of post-infectious glomerulonephritis, IgA nephropathy or Henoch-Schönlein purpura, or as an idiopathic variety. The third group of NCGN, occurring in 40 to 80%, demonstrates only a few or no immune deposits and is designated as pauci-immune NCGN [1–3, 5, 6]. Pauci-immune NCGN occurs as part of Wegener's granulomatosis (WG) or related conditions, or without systemic vasculitis (idiopathic NCGN). The pathophysiology of this pauci-immune type of NCGN has not been elucidated. Within the last decade, however, it has been recognized that the condition is associated with autoantibodies to cytoplasmic components of neutrophils (anti-neutrophil cytoplasmic antibodies or ANCA).ANCA were first described in 1982 by Davies et al in a few patients with segmental necrotizing glomerulonephritis [7]. Only in 1985 did it become apparent that ANCA are a sensitive and specific marker for Wegener's granulomatosis (WG) [8]. Later on, ANCA were described in patients with microscopic polyarteritis [9]. Falk and Jennette, in 1988, showed that ANCA are also associated with the idiopathic form of pauci-immune NCGN [10]. These data have now been confirmed by many groups and support the view that ANCA-associated glomerulonephritis and vasculitis is, indeed, a distinct disease category. A number of studies, in addition, have suggested that ANCA are involved in the pathophysiology of the aforementioned disorders. As ANCA, however, have recently also been detected in a wide range of inflammatory and infectious conditions, a critical reappraisal of the diagnostic significance of ANCA-testing seems justified.In this review we will evaluate the current state of ANCA-testing as well as elaborate on the pathophysiological role of the autoantibodies in necrotizing glomerulonephritis and vasculitis. Data presented recently at the Fifth International Workshop on ANCA, held in Cambridge, United Kingdom, will be included [11]. As such, it adds to previous reviews on ANCA that were published following the Second [12], Third [13], and Fourth [14] Workshops on ANCA

Design and characterization of the SPT-3G receiver

The SPT-3G receiver was commissioned in early 2017 on the 10-meter South Pole Telescope (SPT) to map anisotropies in the cosmic microwave background (CMB). New optics, detector, and readout technologies have yielded a multichroic, high-resolution, low-noise camera with impressive throughput and sensitivity, offering the potential to improve our understanding of inflationary physics, astroparticle physics, and growth of structure. We highlight several key features and design principles of the new receiver, and summarize its performance to date

Promoting the Cal Poly Dairy Science Department through Advertising

Promotion and advertising is a key aspect in a successful dairy operation. It allows for elite cows, offspring, and students to be showcased not only locally but nationwide as well and it has potential of allowing other industry professionals to invest in the quality genetics being advertised. This article gives a step by step guide showing how to successfully organize a photo shoot, submit the photo to the Holstein World Collegiate Issue, gather material necessary to creating an ad showcasing the cows at Cal Poly as well as updating the website