Effect of mycophenolate mofetil on the white blood cell count and the frequency of infection in systemic lupus erythematosus.

Leukopenia is a common manifestation of SLE. Addition of immunosuppressive therapy in a SLE patient who is already leukopenic is a clinical concern. It could worsen leukopenia, increase the risk of infection, or both. The aim of this study was to analyze the immediate effect of mycophenolate mofetil on the white blood cell count and the rate of infection in SLE patients. Two hundred and forty-four patients within the Hopkins Lupus Cohort who were newly started on mycophenolate mofetil were included in the study. The white blood cell count and interval infection history on the day mycophenolate mofetil was started were compared with the white blood cell count and interval infection history at the next visit. The study was based on 244 patients who began taking mycophenolate mofetil in the cohort. The study population included 47 % African Americans, 44 % Caucasians, and 9 % other ethnicities. There was a slight but not statistically significant increase in the white blood cell count (6.63 vs. 7.01), after starting mycophenolate mofetil. Patients with a baseline white blood cell count \u3c3000/mm(3) did have a statistically significant increase in the white blood cell count after starting mycophenolate mofetil (2.57 vs. 5.13, P = 0.0047). We also found a statistically significant increase in the risk of bacterial infection (but not viral infection) after starting mycophenolate mofetil (4 vs. 9 %, P = 0.0036). Leukopenia does not worsen with mycophenolate mofetil. However, mycophenolate mofetil appears to slightly increase the rate of bacterial (but not viral) infection

Paraphilias: definition, diagnosis and treatment

There is a great deal of controversy concerning paraphilia, and defining what is normal versus deviant or disordered, given that this is to some degree dependent on cultural views of acceptability. In this article, we outline these issues and describe recent progress in diagnosing and treating paraphilias

The schooling experiences of African youth from refugee backgrounds in South Australia: key findings and implications for educational practice

This chapter appears in 'Transforming the Future of Learning with Educational Research' edited by Helen Askell-Williams. Copyright 2015, IGI Global, www.igi-global.com. Posted by permission of the publisher.African students from refugee backgrounds constitute a special group in Australian schools because of their complex lives and previous schooling and life experiences that are unlike most of their non-refugee peers. This chapter draws upon findings from a collaborative, longitudinal case study that sought to understand the education and career pathways of African students from refugee backgrounds from the perspectives of African youth, educators, service providers, and South Australian African community leaders and elders. Qualitative analysis revealed six key influences that shape these pathways: previous schooling; English language skills; Australian schooling challenges and support; family support, academic achievement; and post-school preparation. This chapter presents the case study of a single student that, although unique in its circumstances, is representative of key findings from the larger study. Implications for educational practice are then described with a view to facilitating educational participation and success amongst this particular group of young people

“You say potato, I say potato” Mapping Digital Preservation and Research Data Management Concepts towards Collective Curation and Preservation Strategies

This paper explores models, concepts and terminology used in the Research Data Management and Digital Preservation communities. In doing so we identify several overlaps and mutual concerns where the advancements of one professional field can apply to and assist another. By focusing on what unites rather than divides us, and by adopting a more holistic approach we advance towards collective curation and preservation strategies. &nbsp

“You say potato, I say potato” Mapping Digital Preservation and Research Data Management Concepts towards Collective Curation and Preservation Strategies

This paper explores models, concepts and terminology used in the Research Data Management and Digital Preservation communities. In doing so we identify several overlaps and mutual concerns where the advancements of one professional field can apply to and assist another. By focusing on what unites rather than divides us, and by adopting a more holistic approach we advance towards collective curation and preservation strategies. &nbsp

Summer Institute on Climate Information for Public Health 2010

Now that the world’s attention is focused on climate variability and climate change adaptation, it is essential, not only for public health communities, but also for planners in central government, to understand the role climate plays in driving disease burden and impacting economic growth. Public health emerges as the final common pathway for all impacts of climate variability and climate change on individuals as well as societies

Reconsidering the origins of protest in South Africa: some lessons from Cape Town and Pietermaritzburg

Protest politics in South Africa has a long history and has been deployed differentially in different historical moments. Whereas protests formed an important vehicle during the fight against apartheid, their rebirth and propulsion to the centre of the struggles in the post-apartheid dispensation have come as a surprise to many. A majority of these protests, so-called ‘service delivery protests’, are reported as emanating from communities’ dissatisfaction with municipal service delivery as well as problems relating to lack of communication between council and councillors on the one hand and citizens on the other. In this article, we interrogate data from five study sites located in Cape Town and Pietermaritzburg. While we found support for the importance of service delivery, our data contradicts many widely held assertions as regards what causes these protests. We were able to show, for example, that these so-called ‘service delivery protests’ may actually emanate from reasons that extend beyond service delivery. Since our data indicates that levels of participation in Cape Town are higher than in Pietermaritzburg on the one hand, illustrating perhaps the different provincial contexts, there is also variation between the relatively high participation rates of the ‘black African’ sites of Langa and Khayelitsha, on the one hand, and the lower rates of the ‘coloured’ site of Bonteheuwel, on the other, which we ascribe to the disengagement of the community in Cape Town, from both local and national politics.Department of HE and Training approved lis

Emergency Care Handover (ECHO study) across care boundaries : the need for joint decision making and consideration of psychosocial history

Background: Inadequate handover in emergency care is a threat to patient safety. Handover across care boundaries poses particular problems due to different professional, organisational and cultural backgrounds. While there have been many suggestions for standardisation of handover content, relatively little is known about the verbal behaviours that shape handover conversations. This paper explores both what is communicated (content) and how this is communicated (verbal behaviours) during different types of handover conversations across care boundaries in emergency care. Methods: Three types of interorganisational (ambulance service to emergency department (ED) in ‘resuscitation’ and ‘majors’ areas) and interdepartmental handover conversations (referrals to acute medicine) were audio recorded in three National Health Service EDs. Handover conversations were segmented into utterances. Frequency counts for content and language forms were derived for each type of handover using Discourse Analysis. Verbal behaviours were identified using Conversation Analysis. Results: 203 handover conversations were analysed. Handover conversations involving ambulance services were predominantly descriptive (60%–65% of utterances), unidirectional and focused on patient presentation (75%–80%). Referrals entailed more collaborative talk focused on the decision to admit and immediate care needs. Across all types of handover, only 1.5%–5% of handover conversation content related to the patient's social and psychological needs. Conclusions: Handover may entail both descriptive talk aimed at information transfer and collaborative talk aimed at joint decision-making. Standardisation of handover needs to accommodate collaborative aspects and should incorporate communication of information relevant to the patient's social and psychological needs to establish appropriate care arrangements at the earliest opportunity