The Bronchiectasis Exacerbation Diary:a novel patient-reported outcome for non-cystic fibrosis bronchiectasis

Bronchiectasis is a chronic, progressive lung disease believed to result from a vicious cycle of infection and inflammation, with symptoms of chronic cough with sputum production, chronic fatigue, rhinosinusitis, chest pain, breathlessness and haemoptysis. There are currently no established instruments to monitor daily symptoms and exacerbations for use in clinical trials. Following a literature review and three expert clinician interviews, we conducted concept elicitation interviews with 20 patients with bronchiectasis to understand their personal disease experience. Findings from literature and clinician feedback were used to develop a draft version of the Bronchiectasis Exacerbation Diary (BED), which was designed to monitor key symptoms on a daily basis and during exacerbations. Patients were eligible to be interviewed if they were US residents aged ≥18 years, had a computed tomography scan–confirmed diagnosis of bronchiectasis with ≥two exacerbations in the previous 2 years and had no other uncontrolled respiratory conditions. Four waves of five patient interviews each were conducted. Patients (n=20) had a mean±SD age of 53.9±12.8 years, and most were female (85%) and white (85%). A total of 33 symptoms and 23 impacts arose from the patient concept elicitation interviews. The BED was revised and finalised based upon patient feedback. The final BED is a novel, eight-item patient-reported outcome (PRO) instrument for monitoring key exacerbation symptoms on a daily basis with content validity established through comprehensive qualitative research and direct patient insight. The BED PRO development framework will be completed following psychometric evaluations of the data from a phase 3 bronchiectasis clinical trial

Alcoholism and Intimate Partner Violence: Effects on Children’s Psychosocial Adjustment

It is widely recognized that alcoholism and relationship violence often have serious consequences for adults; however, children living with alcoholic parents are susceptible to the deleterious familial environments these caregivers frequently create. Given the prevalence of IPV among patients entering substance abuse treatment, coupled with the negative familial consequences associated with these types of behavior, this review explores what have been, to this point, two divergent lines of research: (a) the effects of parental alcoholism on children, and (b) the effects of children’s exposure to intimate partner violence. In this article, the interrelationship between alcoholism and IPV is examined, with an emphasis on the developmental impact of these behaviors (individually and together) on children living in the home and offers recommendations for future research directions

Evidence-Based Guidelines for Empirical Therapy of Neutropenic Fever in Korea

Neutrophils play an important role in immunological function. Neutropenic patients are vulnerable to infection, and except fever is present, inflammatory reactions are scarce in many cases. Additionally, because infections can worsen rapidly, early evaluation and treatments are especially important in febrile neutropenic patients. In cases in which febrile neutropenia is anticipated due to anticancer chemotherapy, antibiotic prophylaxis can be used, based on the risk of infection. Antifungal prophylaxis may also be considered if long-term neutropenia or mucosal damage is expected. When fever is observed in patients suspected to have neutropenia, an adequate physical examination and blood and sputum cultures should be performed. Initial antibiotics should be chosen by considering the risk of complications following the infection; if the risk is low, oral antibiotics can be used. For initial intravenous antibiotics, monotherapy with a broad-spectrum antibiotic or combination therapy with two antibiotics is recommended. At 3-5 days after beginning the initial antibiotic therapy, the condition of the patient is assessed again to determine whether the fever has subsided or symptoms have worsened. If the patient's condition has improved, intravenous antibiotics can be replaced with oral antibiotics; if the condition has deteriorated, a change of antibiotics or addition of antifungal agents should be considered. If the causative microorganism is identified, initial antimicrobial or antifungal agents should be changed accordingly. When the cause is not detected, the initial agents should continue to be used until the neutrophil count recovers

A Continuous Measure of Gross Primary Production for the Conterminous U.S. Derived from MODIS and AmeriFlux Data

The quantification of carbon fluxes between the terrestrial biosphere and the atmosphere is of scientific importance and also relevant to climate-policy making. Eddy covariance flux towers provide continuous measurements of ecosystem-level exchange of carbon dioxide spanning diurnal, synoptic, seasonal, and interannual time scales. However, these measurements only represent the fluxes at the scale of the tower footprint. Here we used remotely-sensed data from the Moderate Resolution Imaging Spectroradiometer (MODIS) to upscale gross primary productivity (GPP) data from eddy covariance flux towers to the continental scale. We first combined GPP and MODIS data for 42 AmeriFlux towers encompassing a wide range of ecosystem and climate types to develop a predictive GPP model using a regression tree approach. The predictive model was trained using observed GPP over the period 2000-2004, and was validated using observed GPP over the period 2005-2006 and leave-one-out cross-validation. Our model predicted GPP fairly well at the site level. We then used the model to estimate GPP for each 1 km x 1 km cell across the U.S. for each 8-day interval over the period from February 2000 to December 2006 using MODIS data. Our GPP estimates provide a spatially and temporally continuous measure of gross primary production for the U.S. that is a highly constrained by eddy covariance flux data. Our study demonstrated that our empirical approach is effective for upscaling eddy flux GPP data to the continental scale and producing continuous GPP estimates across multiple biomes. With these estimates, we then examined the patterns, magnitude, and interannual variability of GPP. We estimated a gross carbon uptake between 6.91 and 7.33 Pg C yr{sup -1} for the conterminous U.S. Drought, fires, and hurricanes reduced annual GPP at regional scales and could have a significant impact on the U.S. net ecosystem carbon exchange. The sources of the interannual variability of U.S. GPP were dominated by these extreme climate events and disturbances

Climate control of terrestrial carbon exchange across biomes and continents

Peer reviewe

Israeli journalists as an interpretive memory community: The case study of “Haolam Hazeh”

This dissertation explores the ways in which the professional identity of Israeli journalists has been constructed, negotiated and articulated through the years. The study\u27s guiding theoretical framework views mass media communication as a process through which communities share and negotiate information, values and beliefs. The extension of this approach implements its analysis with regards to the journalistic community, arguing that journalists are not only members of a professional group but also members of an interpretive community. While journalists tend to portray their work as objective, individualistic, immediate and informative, the interpretive community frame depicts that work as value-laden, communal, continuous and narrativistic. This exploration of the Israeli journalism as an interpretive community focuses on stories that were narrated, through the years about the radical and sensational weekly Haolam Hazeh (1937–1993). At certain stages, the weekly offered an alternative to mainstream Israeli journalism in a variety of dimensions such as choices of content and style, the relations between journalists and the political establishment, and especially Haolam Hazeh\u27s revolutionary formulation of its social criticism through professional journalistic tools. Correspondingly, Haolam Hazeh was used by the mainstream journalistic community of the 1950s and 1960s as a “functional transgressor”: the strategic public denunciation of the weekly was articulated in order to define the boundaries and inner-hierarchies of the journalistic community and to enforce normative standards. At the same time, however, Haolam Hazeh was also utilized by the Israeli press as a source of professional inspiration, a de-facto journalism school, and as an unofficial channel for exploring themes that were unacceptable to the mainstream community. Thus, Haolam Hazeh \u27s existence as such a paradoxical phenomenon underscores the inner contradictions that delineated the Israeli journalistic community during that formative era and the ways in which they were resolved. The investigation of later journalistic accounts of Haolam Hazeh\u27s story shows that the weekly is nowadays positioned as a precursor of contemporary critical Israeli journalism. The current construction of Haolam Hazeh as a constituting memory of Israeli journalism, through narratives that address both past and present themes, is utilized to reinforce Israeli journalists\u27 status as independent and authoritative public narrators

Israeli journalists as an interpretive memory community: The case study of “Haolam Hazeh”

This dissertation explores the ways in which the professional identity of Israeli journalists has been constructed, negotiated and articulated through the years. The study\u27s guiding theoretical framework views mass media communication as a process through which communities share and negotiate information, values and beliefs. The extension of this approach implements its analysis with regards to the journalistic community, arguing that journalists are not only members of a professional group but also members of an interpretive community. While journalists tend to portray their work as objective, individualistic, immediate and informative, the interpretive community frame depicts that work as value-laden, communal, continuous and narrativistic. This exploration of the Israeli journalism as an interpretive community focuses on stories that were narrated, through the years about the radical and sensational weekly Haolam Hazeh (1937–1993). At certain stages, the weekly offered an alternative to mainstream Israeli journalism in a variety of dimensions such as choices of content and style, the relations between journalists and the political establishment, and especially Haolam Hazeh\u27s revolutionary formulation of its social criticism through professional journalistic tools. Correspondingly, Haolam Hazeh was used by the mainstream journalistic community of the 1950s and 1960s as a “functional transgressor”: the strategic public denunciation of the weekly was articulated in order to define the boundaries and inner-hierarchies of the journalistic community and to enforce normative standards. At the same time, however, Haolam Hazeh was also utilized by the Israeli press as a source of professional inspiration, a de-facto journalism school, and as an unofficial channel for exploring themes that were unacceptable to the mainstream community. Thus, Haolam Hazeh \u27s existence as such a paradoxical phenomenon underscores the inner contradictions that delineated the Israeli journalistic community during that formative era and the ways in which they were resolved. The investigation of later journalistic accounts of Haolam Hazeh\u27s story shows that the weekly is nowadays positioned as a precursor of contemporary critical Israeli journalism. The current construction of Haolam Hazeh as a constituting memory of Israeli journalism, through narratives that address both past and present themes, is utilized to reinforce Israeli journalists\u27 status as independent and authoritative public narrators