Resolving the Uncertainty of Preterm Symptoms: Women’s Experiences With the Onset of Preterm Labor

Objective: To describe expectant women\u27s experiences with the onset of preterm labor. Design: Qualitative, using grounded theory methods. Setting: Southwestern tertiary women\u27s hospital. Participants: Thirty pregnant women who were less than 35 weeks gestation, had experienced preterm labor within the past 7 days, and had no previous experience with preterm labor. Data Source: Taped and transcribed interviews. Results: Themes that emerged from the interview data included the following: recognition and naming of sensations, a consistent pattern of attribution of symptoms, the threat or risk inferred by the attributed cause of the symptom pattern, the associated certainty or uncertainty about these attributions, the process of interpreting and verifying symptom meaning, and the decision to self-manage the symptoms or engage health care assistance. The core process of women experiencing the onset of preterm labor symptoms was identified as resolving the uncertainty of preterm labor symptoms: recognizing and responding to the possibilities. Conclusions: Preterm labor often is not within expectant women\u27s consciousness. They may attribute the symptoms to nonthreatening causes, which results in delays in seeking care for preterm labor. Education about symptom patterns at the onset of preterm labor will increase the probability that women and their health care providers will recognize and interpret the early, subtle symptoms that herald the onset of preterm labor. Uncertainty in illness theory and attribution theory offer frameworks for understanding women\u27s experiences with the onset of preterm labor

Prediction of sustained harmonic walking in the free-living environment using raw accelerometry data

Objective. Using raw, sub-second level, accelerometry data, we propose and validate a method for identifying and characterizing walking in the free-living environment. We focus on the sustained harmonic walking (SHW), which we define as walking for at least 10 seconds with low variability of step frequency. Approach. We utilize the harmonic nature of SHW and quantify local periodicity of the tri-axial raw accelerometry data. We also estimate fundamental frequency of observed signals and link it to the instantaneous walking (step-to-step) frequency (IWF). Next, we report total time spent in SHW, number and durations of SHW bouts, time of the day when SHW occurred and IWF for 49 healthy, elderly individuals. Main results. Sensitivity of the proposed classification method was found to be 97%, while specificity ranged between 87% and 97% and prediction accuracy between 94% and 97%. We report total time in SHW between 140 and 10 minutes-per-day distributed between 340 and 50 bouts. We estimate the average IWF to be 1.7 steps-per-second. Significance. We propose a simple approach for detection of SHW and estimation of IWF, based on Fourier decomposition. The resulting approach is fast and allows processing of a week-long raw accelerometry data (approx. 150 million measurements) in relatively short time (~half an hour) on a common laptop computer (2.8 GHz Intel Core i7, 16 GB DDR3 RAM)

Working Partnerships, Partnerships Working

Involvement in community partnerships at Virginia Commonwealth University has its roots in the institution\u27s history. The Medical College of Virginia, founded in1838, and the Richmond Professional Institute, founded in 1917, both sought to extend knowledge into the community to change peoples\u27 lives for the better. Today, the VCU campuses are even more entwined with the City of Richmond -- physically, and increasingly so as a partner in the economic and social challenges and opportunities facing the City

Local health department use of Twitter to disseminate diabetes information, United States

INTRODUCTION: Diabetes may affect one-third of US adults by 2050. Adopting a healthful diet and increasing physical activity are effective in preventing type 2 diabetes and decreasing the severity of diabetes-related complications. Educating and informing the public about health problems is a service provided by local health departments (LHDs). The objective of this study was to examine how LHDs are using social media to educate and inform the public about diabetes. METHODS: In June 2012 we used NVivo 10 to collect all tweets ever posted from every LHD with a Twitter account and identified tweets about diabetes. We used a 2010 National Association of County and City Health Officials survey to compare characteristics of LHDs that tweeted about diabetes with those that did not. Content analysis was used to classify each tweet topic. RESULTS: Of 217 LHDs with Twitter accounts, 126 had ever tweeted about diabetes, with 3 diabetes tweets being the median since adopting Twitter. LHDs tweeting about diabetes were in jurisdictions with larger populations and had more staff and higher spending than LHDs not tweeting about diabetes. They were significantly more likely to employ a public information specialist and provide programs in diabetes-related areas. There was also a weak positive association between jurisdiction diabetes rate and the percentage of all tweets that were about diabetes (r = .16; P = .049). CONCLUSION: LHDs are beginning to use social media to educate and inform their constituents about diabetes. An understanding of the reach and effectiveness of social media could enable public health practitioners to use them more effectively

Degradation and forgone removals increase the carbon impact of intact forest loss by 626%

Intact tropical forests, free from substantial anthropogenic influence, store and sequester large amounts of atmospheric carbon but are currently neglected in international climate policy. We show that between 2000 and 2013, direct clearance of intact tropical forest areas accounted for 3.2% of gross carbon emissions from all deforestation across the pantropics. However, full carbon accounting requires the consideration of forgone carbon sequestration, selective logging, edge effects, and defaunation. When these factors were considered, the net carbon impact resulting from intact tropical forest loss between 2000 and 2013 increased by a factor of 6 (626%), from 0.34 (0.37 to 0.21) to 2.12 (2.85 to 1.00) petagrams of carbon (equivalent to approximately 2 years of global land use change emissions). The climate mitigation value of conserving the 549 million ha of tropical forest that remains intact is therefore significant but will soon dwindle if their rate of loss continues to accelerate

Potential of Human Umbilical Cord Blood Mesenchymal Stem Cells to Heal Damaged Corneal Endothelium

Purpose: To test the feasibility of altering the phenotype of umbilical cord blood mesenchymal stem cells (UCB MSCs) toward that of human corneal endothelial cells (HCEC) and to determine whether UCB MSCs can “home” to sites of corneal endothelial cell injury using an ex vivo corneal wound model. Methods: RNA was isolated and purified from UCB MSCs and HCECs. Baseline information regarding the relative gene expression of UCB MSCs and HCEC was obtained by microarray analysis. Quantitative real-time PCR (q-PCR) verified the microarray findings for a subset of genes. The ability of different culture media to direct UCB MSCs toward a more HCEC-like phenotype was tested in both tissue culture and ex vivo corneal endothelial wound models using three different media: MSC basal medium (MSCBM), a basal medium used to culture lens epithelial cells (LECBM), or lens epithelial cell-conditioned medium (LECCM). Morphology of the MSCs was observed by phase-contrast microscopy or by light microscopic observation of crystal violet-stained cells. Immunolocalization of the junction-associated proteins, zonula occludins-1 (ZO1) and N-cadherin, was visualized by fluorescence confocal microscopy. Formation of cell-cell junctions was tested by treatment with the calcium chelator, EGTA. A second microarray analysis compared gene expression between UCB MSCs grown in LECBM and LECCM to identify changes induced by the lens epithelial cell-conditioned culture medium. The ability of UCB MSCs to “home” to areas of endothelial injury was determined using ZO1 immunolocalization patterns in ex vivo corneal endothelial wounds. Results: Baseline microarray analysis provided information regarding relative gene expression in UCB MSCs and HCECs. MSCs attached to damaged, but not intact, corneal endothelium in ex vivo corneal wounds. The morphology of MSCs was consistently altered when cells were grown in the presence of LECCM. In tissue culture and in ex vivo corneal wounds, UCB MSC treated with LECCM were elongated and formed parallel sheets of closely apposed cells. In both tissue culture and ex vivo corneal endothelial wounds, ZO1 and N-cadherin localized mainly to the cytoplasm of UCB MSCs in the presence of MSCBM. However, both proteins localized to cell borders when UCB MSCs were grown in either LECBM or LECCM. This localization was lost when extracellular calcium levels were reduced by treatment with EGTA. A second microarray analysis showed that, when UCB MSCs were grown in LECCM instead of LECBM, the relative expression of a subset of genes markedly differed, suggestive of a more HCEC-like phenotype. Conclusions: Results indicate that UCB MSCs are able to “home” to areas of injured corneal endothelium and that the phenotype of UCB MSCs can be altered toward that of HCEC-like cells. Further study is needed to identify the specific microenvironmental conditions that would permit tissue engineering of UCB MSCs to replace damaged or diseased corneal endothelium

Derived environment effects: A representational approach

Derived environment effects involve either overapplication or underapplication of phonological rules in phonological or morphological environments. This paper focuses on underapplication effects in both phonological and morphological environments, which are treated as resulting from representational differences between derived and non-derived environments at the appropriate level. The Government and Dependency Phonology notions of head and dependent are utilised to this end. Thus, phonologically derived environment effects result from melodic structure that differentiates branching from immediate dominance relations between elements, allowing phonological processes to target a segment of one melodic configuration to the exclusion of another. Morphologically derived environment effects, on the other hand, involve representational differences at the constituent structure level, corresponding to the fact that morphological effects are a result of junctural or morpheme-integrity effects. In the latter case, head-dependent relations are defined as holding over domains, thereby differentiating affixal from non-affixal material, while in the former junctural effects the representational difference is defined at the CV tier, with phonological processes being sensitive to the presence of empty V and C positions. © 2008 Elsevier B.V. All rights reserved

Protein Tyrosine Phosphatase-1B (PTP1B) Helps Regulate EGF-induced Stimulation of S-phase Entry in Human Corneal Endothelial Cells

Purpose: Human corneal endothelial cells (HCEC), particularly from older donors, only proliferate weakly in response to EGF. The protein tyrosine phosphatase, PTP1B, is known to negatively regulate EGF-induced signaling in several cell types by dephosphorylating the epidermal growth factor receptor (EGFR). The current studies were conducted to determine whether PTP1B plays a role in regulating cell cycle entry in HCEC in response to EGF stimulation. Methods: Donor corneas were obtained from the National Disease Research Interchange and accepted for study based on established exclusion criteria. PTP1B was localized in the endothelium of ex vivo corneas and in cultured cells by immunocytochemistry. Western blot analysis verified PTP1B protein expression in HCEC and then compared the relative expression of EGFR and PTP1B in HCEC from young (60 years old). The effect of inhibiting the activity of PTP1B on S-phase entry was tested by comparing time-dependent BrdU incorporation in subconfluent HCEC incubated in the presence or absence of the PTP1B inhibitor, CinnGEL 2Me, before EGF stimulation. Results: PTP1B was localized in a punctate pattern mainly within the cytoplasm of HCEC in ex vivo corneas and cultured cells. Western blots revealed the presence of three PTP1B-positive bands in HCEC and the control. Further western blot analysis showed no significant age-related difference in expression of EGFR (p=0.444>0.05); however, PTP1B expression was significantly higher in HCEC from older donors (p=0.024<0.05). Pre-incubation of HCEC with the PTP1B inhibitor significantly increased (p=0.019<0.05) the number of BrdU positive cells by 48 h after EGF stimulation. Conclusions: Both immunolocalization and western blot studies confirmed that PTP1B is expressed in HCEC. Staining patterns strongly suggest that at least a subset of PTP1B is localized to the cytoplasm and most likely to the endoplasmic reticulum, the known site of EGFR/PTP1B interaction following EGF stimulation. PTP1B expression, but not EGFR expression, was elevated in HCEC from older donors, suggesting that the reduced proliferative activity of these cells in response to EGF is due, at least in part, to increased PTP1B activity. The fact that inhibition of PTP1B increased the relative number of cells entering S-phase strongly suggests that PTP1B helps negatively regulate EGF-stimulated cell cycle entry in HCEC. These results also suggest that it may be possible to increase the proliferative activity of HCEC, particularly in cells from older donors, by inhibiting the activity of this important protein tyrosine phosphatase

Becoming-Bertha: virtual difference and repetition in postcolonial 'writing back', a Deleuzian reading of Jean Rhys’s Wide Sargasso Sea

Critical responses to Wide Sargasso Sea have seized upon Rhys’s novel as an exemplary model of writing back. Looking beyond the actual repetitions which recall Brontë’s text, I explore Rhys’s novel as an expression of virtual difference and becomings that exemplify Deleuze’s three syntheses of time. Elaborating the processes of becoming that Deleuze’s third synthesis depicts, Antoinette’s fate emerges not as a violence against an original identity. Rather, what the reader witnesses is a series of becomings or masks, some of which are validated, some of which are not, and it is in the rejection of certain masks, forcing Antoinette to become-Bertha, that the greatest violence lies

An Exemplar for Teaching and Learning Qualitative Research

In this article, we outline a course wherein the instructors teach students how to conduct rigorous qualitative research. We discuss the four major distinct, but overlapping, phases of the course: conceptual/theoretical, technical, applied, and emergent scholar. Students write several qualitative reports, called qualitative notebooks, which involve data that they collect (via three different types of interviews), analyze (using nine qualitative analysis techniques via qualitative software), and interpret. Each notebook is edited by the instructors to help them improve the quality of subsequent notebook reports. Finally, we advocate asking students who have previously taken this course to team-teach future courses. We hope that our exemplar for teaching and learning qualitative research will be useful for teachers and students alike