Treatment of Recurrent Focal Segmental Glomerulosclerosis in Pediatric Kidney Transplant Recipients: Effect of Rituximab

Recurrence of focal segmental glomerulosclerosis (FSGS) after renal transplantation is a complication that often leads to graft loss. There is no consensus on the optimal treatment of recurrent FSGS. Rituximab, a monoclonal antibody to CD20, may be a useful treatment of this complication. Methods. We report four pediatric cases of recurrent FSGS treated with rituximab and plasmapheresis. Results. Four children (2M/2F), age 15.3 ± 2.6, with recurrent FSGS posttransplant were identified. Four doses of rituximab were administered 171 ± 180 days posttransplant and 114 ± 169 days after the start of plasmapheresis. Three children responded with complete remission, one of whom relapsed after four months. One child had a partial response with a decrease in proteinuria that was not sustained. No adverse side effects were reported during treatment or followup (mean 22.5 months). Conclusions. Rituximab is a safe and well-tolerated ancillary treatment for recurrent FSGS in pediatric patients in conjunction with plasmapheresis

An introduction to Elinor Glyn : her life and legacy

This special issue of Women: A Cultural Review re-evaluates an author who was once a household name, beloved by readers of romance, and whose films were distributed widely in Europe and the Americas. Elinor Glyn (1864–1943) was a British author of romantic fiction who went to Hollywood and became famous for her movies. She was a celebrity figure of the 1920s, and wrote constantly in Hearst's press. She wrote racy stories which were turned into films—most famously, Three Weeks (1924) and It (1927). These were viewed by the judiciary as scandalous, but by others—Hollywood and the Spanish Catholic Church—as acceptably conservative. Glyn has become a peripheral figure in histories of this period, marginalized in accounts of the youth-centred ‘flapper era’. Decades on, the idea of the ‘It Girl’ continues to have great pertinence in the post-feminist discourses of the twenty-first century. The 1910s and 1920s saw the development of intermodal networks between print, sound and screen cultures. This introduction to Glyn's life and legacy reviews the cross-disciplinary debate sparked by renewed interest in Glyn by film scholars and literary and feminist historians, and offers a range of views of Glyn's cultural and historical significance and areas for future research

Care for perinatal illness in rural Nepal: a descriptive study with cross-sectional and qualitative components

BACKGROUND: Maternal, perinatal and neonatal mortality rates remain high in rural areas of developing countries. Most deliveries take place at home and care-seeking behaviour is often delayed. We report on a combined quantitative and qualitative study of care seeking obstacles and practices relating to perinatal illness in rural Makwanpur district, Nepal, with particular emphasis on consultation strategies. METHODS: The analysis included a survey of 8798 women who reported a birth in the previous two years [of whom 3557 reported illness in their pregnancy], on 30 case studies of perinatal morbidity and mortality, and on 43 focus group discussions with mothers, other family members and health workers. RESULTS: Early pregnancy was often concealed, preparation for birth was minimal and trained attendance at birth was uncommon. Family members were favoured attendants, particularly mothers-in-law. The most common recalled maternal complications were prolonged labour, postpartum haemorrhage and retained placenta. Neonatal death, though less definable, was often associated with cessation of suckling and shortness of breath. Many home-based care practices for maternal and neonatal illness were described. Self-medication was common. There were delays in recognising and acting on danger signs, and in seeking care beyond the household, in which the cultural requirement for maternal seclusion, and the perceived expense of care, played a part. Of the 760 women who sought care at a government facility, 70% took more than 12 hours from the decision to seek help to actual consultation. Consultation was primarily with traditional healers, who were key actors in the ascription of causation. Use of the government primary health care system was limited: the most common source of allopathic care was the district hospital. CONCLUSIONS: Major obstacles to seeking care were: a limited capacity to recognise danger signs; the need to watch and wait; and an overwhelming preference to treat illness within the community. Safer motherhood and newborn care programmes in rural communities, must address both community and health facility care to have an impact on morbidity and mortality. The roles of community actors such as mothers-in-law, husbands, local healers and pharmacies, and increased access to properly trained birth attendants need to be addressed if delays in reaching health facilities are to be shortened

Welfare Recipiency, Job Separation Outcomes, and Postseparation Earnings: Insight from Linked Personnel and State Administrative Data

This paper uses a unique personnel data set and state administrative data to follow welfare and nonwelfare hires who separate from similar jobs with the same firm. Welfare hires are more likely to separate from their job and are more likely to be on welfare after separation compared with similarly low-skilled nonwelfare hires. Those not returning to welfare, however, are no more or less likely to have moved on to a lower- or higher-paying job than nonwelfare hires

Asymmetric Labor Force Participation Decisions over the Business Cycle: Evidence from U.S. Microdata

The purpose of this paper is to explore the microfoundations of the observed asymmetric movement in aggregate unemployment rates. Using U.S. data, we find that individual labor force participation responds asymmetrically to changes in local labor market conditions, consistent with the pattern of movements in the aggregate unemployment rate. Differences in the asymmetry and sensitivity of labor force participation decisions are found across gender, age, and education groups, and these differences are used to anticipate changes in the aggregate movements as population characteristics change over time