Seeking to Do What’s Best for Baby: A Grounded Theory

Objective: The original purpose of this study was to develop a substantive theory that described the decision making process for women in a rural population to exclusively breastfeed to six months. But, as is characteristic of classic grounded theory, the research question changed during the data analysis process. The question that was revealed during analysis was: “What is the main concern of rural new mothers who are breastfeeding and how do they continually resolve that concern?” Design :Using a qualitative research approach, this study employed a classic grounded theory method. Population :The study population consisted of 19 women from VA or WV communities designated as rural using the Rural Health Information Hub and who reported planning to exclusively breastfeed. The participants’ ages ranged between 19 and 40 and majority of them self-reported as Caucasian (89.47%). The distance they traveled for health care was between 15 and 50 miles. More than half of the mothers reported returning to employment before their babies were weaned from breastfeeding. Variables studied: Reported experiences of exclusive breastfeeding through six months by rural mothers Methods: Both purposive and theoretical sampling was used to recruit candidates matching characteristics of interest to ensure information-rich data. The sample was accessed through a rural Virginia hospital system. Each participant was interviewed once in a location of their choosing and following completion of informed consent. Participants also completed a brief demographic questionnaire to assist the researcher in describing the population of the study. No note taking, video, or audio recordings were made during the interview. Constant comparative analysis began with the first interview and proceeded until data saturation occurred and a substantive theory emerged that explains how rural mothers resolved their concern of doing what they though best for their baby. Findings/Conclusions: The theory of seeking to do what’s best for baby emerged from the data and describes the process that a mother works through to succeed in her goal of doing what was best for baby. It consists of a temporal three-stage process. The stages are 1) pre-pregnancy nescience, 2) working through, and 3) succeeding or surrendering. The process is influenced by evolving internal conditions, basic social psychological processes, and basic social structural processes which account for most of the variation in the pattern of behavior. Implications: The results of this study begin to fill the gap in knowledge about the choices made by mothers to exclusively breastfeed to six months or to end the exclusive breastfeeding experience. The knowledge that previously exists does not fully explain the experience nor personalize the journey that occurs when exclusively breastfeeding. Additional research is called for to promote the practice of exclusive breastfeeding for both mothers and practitioners, as the lack of consistency in information and care impacts all mothers who are seeking to do what’s best for baby. The main practice consideration is to provide consistent education about breastfeeding by nurses and other health care professionals

Remains to be seen, worn and heard. An inquiry into anthropogenic debris investigated through contemporary jewellery objects

This research project explores the negative environmental impacts of anthropogenic debris by investigating these found materials within the medium of contemporary jewellery objects. Contemporary jewellery objects are a powerful artistic medium. We can wear jewellery on our bodies and carry it with us. Jewellery can sit on or through the body, and at the same time extend beyond our bodies. Jewellery objects can resonate their own space, to be watched, observed publicly or privately, inviting the wearer or voyeur to think, to enquire, to remember and to investigate. Jewellery objects arouse curiosity, can whisper, shout out or call irresistibly to be touched or held. Or these jewellery objects can speak without words in a universal language. As contemporary jewellery objects, they offer a new way in which to present the serious global issue of anthropogenic debris both marine and land-based. This selected interactive medium offers more than words, spreadsheets or diagrams on what has become an area of global scientific investigation, with current information on the quantities and distribution of anthropogenic debris across Australia limited and inconclusive. This project enables a personal collection of data from an Australian perspective that would traditionally be presented within the scientific community, to be shared with the jewellery community and wider general public as a three-dimensional research project. It allows this personal investigation to highlight how what we discard on a daily basis travels far and wide, impacting the environment, and therefore ourselves. This research is about ordinary, everyday materials presented to all who use and discard them. Through a body of work constructed entirely from discarded anthropogenic marine and land-based materials collected along Victorian, New South Wales and Western Australia coastal environs, this research aims to re-engage ourselves with the objects we use and discard on a daily basis to highlight these unsustainable ecological concerns. This project explores material and conceptual relationships between natural and built environs to form connections to and an understanding of where we reside within them, and how the influx of anthropogenic materials in the form of contemporary jewellery objects might incite references to natural places in lieu of natural materials traditionally associated with these areas as a second nature with underlying ecological concerns. This research seeks to offer conceptual contemplation within a body of work constructed entirely with anthropogenic debris as discarded materials that are subject to negative connotations, how they present themselves as a reflection of our material culture and as the heirlooms of our past, present and future, as remains to be seen, worn and heard

Structural analysis of IPC zeolites and related materials using positron annihilation spectroscopy and high-resolution argon adsorption

ETH authors thanks for the grant ETH 33 15-1. PE and JČ acknowledge the financial support from the Czech Science Foundation (P106/12/0189). JPR and JČ gratefully acknowledge the financial support from the European Union Seventh Framework Programme (FP7/ 2007-2013) under grant agreement no. 604307. HRTEM characterization was performed at the Advanced Microscopy Laboratory (LMA) and the research leading to these results has received funding from the European Union Seventh Framework Programme under Grant Agreement 312483 – ESTEEM2 (Integrated Infrastructure Initiative-I3).The advanced investigation of pore networks in isoreticular zeolites and mesoporous materials related to the IPC family was performed using high-resolution argon adsorption experiments coupled with the development of a state-of-the-art non-local density functional theory approach. The optimization of a kernel for model sorption isotherms for materials possessing the same layer structure, differing only in the interlayer connectivity (e.g. oxygen bridges, single- or double-four-ring building units, mesoscale pillars etc.) revealed remarkable differences in their porous systems. Using high-resolution adsorption data, the bimodal pore size distribution consistent with crystallographic data for IPC-6, IPC-7 and UTL samples is shown for the first time. A dynamic assessment by positron annihilation lifetime spectroscopy (PALS) provided complementary insights, simply distinguishing the enhanced accessibility of the pore network in samples incorporating mesoscale pillars and revealing the presence of a certain fraction of micropores undetected by gas sorption. Nonetheless, subtle differences in the pore size could not be discriminated based on the widely-applied Tao-Eldrup model. The combination of both methods can be useful for the advanced characterization of microporous, mesoporous and hierarchical materials.PostprintPeer reviewe

Secukinumab demonstrated sustained retention, effectiveness and safety in a real-world setting in patients with moderate-to-severe plaque psoriasis: long-term results from an interim analysis of the SERENA study.

Randomized controlled trials of secukinumab have shown sustained efficacy and a favourable safety profile in multiple manifestations of psoriatic disease. To assess the long-term, real-world retention, effectiveness and safety of secukinumab in routine clinical practice for the treatment of moderate-to-severe plaque-type psoriasis (PsO). SERENA (CAIN457A3403) is a large, ongoing, longitudinal, observational study conducted at 438 sites and 19 countries for an expected duration of up to 5 years in adult patients with moderate-to-severe PsO, psoriatic arthritis and ankylosing spondylitis. Patients received ≥16 weeks of secukinumab treatment before enrolment. This interim analysis presents data from PsO patients, who were enrolled in the study between October-2016 and October-2018 and were observed for ≥2 years. In total, 1756 patients (67.3% male) with a mean age of 48.4 years and body mass index of 28.8 kg/m <sup>2</sup> were included in the analysis. The secukinumab treatment retention rates after 1, 2 and 3 years in the study were 88.0%, 76.4% and 60.5%, respectively. Of the 648 patients who discontinued the study, the most common reasons included lack of efficacy (42.6%), adverse event (17.4%), physician decision (12.2%) and subject decision (11.6%). Mean ± SD absolute PASI was 21.0 ± 13.0 at the start of treatment (n = 1,564). At baseline, the mean ± SD PASI score reduced to 2.6 ± 4.8 and remained low at Year 1 (2.3 ± 4.3), Year 2 (1.9 ± 3.6) and Year 3 (1.9 ± 3.5). The safety profile of secukinumab during the SERENA study was consistent with its known safety profile, with no new safety signals reported. Particularly, low rates of inflammatory bowel disease (0.3%; Incidence Rate [IR]:0.15), candida infections (3.1%; IR:1.43) and MACE (0.9%; IR:0.37) were observed. Secukinumab showed high treatment persistence, sustained effectiveness and a favourable safety profile up to 3 years of follow-up in the real-world population of PsO patients observed in SERENA

On the Wegener granulomatosis associated region on chromosome 6p21.3

BACKGROUND: Wegener granulomatosis (WG) belongs to the heterogeneous group of systemic vasculitides. The multifactorial pathophysiology of WG is supposedly caused by yet unknown environmental influence(s) on the basis of genetic predisposition. The presence of anti-neutrophil cytoplasmic antibodies (ANCA) in the plasma of patients and genetic involvement of the human leukocyte antigen system reflect an autoimmune background of the disease. Strong associations were revealed with WG by markers located in the major histocompatibility complex class II (MHC II) region in the vicinity of human leukocyte antigen (HLA)-DPB1 and the retinoid X receptor B (RXRB) loci. In order to define the involvement of the 6p21.3 region in WG in more detail this previous population-based association study was expanded here to the respective 3.6 megabase encompassing this region on chromosome 6. The RXRB gene was analysed as well as a splice-site variation of the butyrophilin-like (BTNL2) gene which is also located within the respective region. The latter polymorphism has been evaluated here as it appears as a HLA independent susceptibility factor in another granulomatous disorder, sarcoidosis. METHODS: 150–180 German WG patients and a corresponding cohort of healthy controls (n = 100–261) were used in a two-step study. A panel of 94 microsatellites was designed for the initial step using a DNA pooling approach. Markers with significantly differing allele frequencies between patient and control pools were individually genotyped. The RXRB gene was analysed for single strand conformation polymorphisms (SSCP) and restriction fragment length polymorphisms (RFLP). The splice-site polymorphism in the BTNL2 gene was also investigated by RFLP analysis. RESULTS: A previously investigated microsatellite (#1.0.3.7, Santa Cruz genome browser (UCSC) May 2004 Freeze localisation: chr6:31257596-34999883), which was used as a positive control, remained associated throughout the whole two-step approach. Yet, no additional evidence for association of other microsatellite markers was found in the entire investigated region. Analysis of the RXRB gene located in the WG associated region revealed associations of two variations (rs10548957 p(allelic )= 0.02 and rs6531 p(allelic )= 5.20 × 10(-5), OR = 1.88). Several alleles of markers located between HLA-DPB1, SNP rs6531 and microsatellite 1.0.3.7 showed linkage disequilibrium with r(2 )values exceeding 0.10. Significant differences were not demonstrable for the sarcoidosis associated splice-site variation (rs2076530 p(allelic )= 0.80) in our WG cohort. CONCLUSION: Since a microsatellite flanking the RXRB gene and two intragenic polymorphisms are associated significantly with WG on chromosome 6p21.3, further investigations should be focussed on extensive fine-mapping in this region by densely mapping with additional markers such as SNPs. This strategy may reveal even deeper insights into the genetic contributions of the respective region for the pathogenesis of WG

Glutathione S-Transferase Ω 1 variation does not influence age at onset of Huntington's disease

BACKGROUND: Huntington's disease (HD) is a fully penetrant, autosomal dominantly inherited disorder associated with abnormal expansions of a stretch of perfect CAG repeats in the 5' part of the IT15 gene. The number of repeat units is highly predictive for the age at onset (AO) of the disorder. But AO is only modestly correlated with repeat length when intermediate HD expansions are considered. Circumstantial evidence suggests that additional features of the HD course are based on genetic traits. Therefore, it may be possible to investigate the genetic background of HD, i.e. to map the loci underlying the development and progression of the disease. Recently an association of Glutathione S-Transferase Ω 1 (GSTO1) and possibly of GSTO2 with AO was demonstrated for, both, Alzheimer's (AD) and Parkinson's disease (PD). METHODS: We have genotyped the polymorphisms rs4925 GSTO1 and rs2297235 GSTO2 in 232 patients with HD and 228 controls. RESULTS: After genotyping GSTO1 and GSTO2 polymorphisms, firstly there was no statistically significant difference in AO for HD patients, as well as secondly for HD patients vs. controls concerning, both, genotype and allele frequencies, respectively. CONCLUSION: The GSTO1 and GSTO2 genes flanked by the investigated polymorphisms are not comprised in a primary candidate region influencing AO in HD

An extended association screen in multiple sclerosis using 202 microsatellite markers targeting apoptosis-related genes does not reveal new predisposing factors

Apoptosis, the programmed death of cells, plays a distinct role in the etiopathogenesis of Multiple sclerosis (MS), a common disease of the central nervous system with complex genetic background. Yet, it is not clear whether the impact of apoptosis is due to altered apoptotic behaviour caused by variations of apoptosis-related genes. Instead, apoptosis in MS may also represent a secondary response to cellular stress during acute inflammation in the central nervous system. Here, we screened 202 apoptosis-related genes for association by genotyping 202 microsatellite markers in initially 160 MS patients and 160 controls, both divided in 4 sets of pooled DNA samples, respectively. When applying Bonferroni correction, no significant differences in allele frequencies were detected between MS patients and controls. Nevertheless, we chose 7 markers for retyping in individual DNA samples, thereby eliminating 6 markers from the list of candidates. The remaining candidate, the ERBB3 gene microsatellite, was genotyped in additional 245 MS patients and controls. No association of the ERBB3 marker with the disease was detected in these additional cohorts. In consequence, we did not find further evidence for apoptosis-related genes as predisposition factors in MS

Association study with Wegener granulomatosis of the human phospholipase Cγ2 gene

BACKGROUND: Wegener Granulomatosis (WG) is a multifactorial disease of yet unknown aetiology characterized by granulomata of the respiratory tract and systemic necrotizing vasculitis. Analyses of candidate genes revealed several associations, e.g. with α(1)-antitrypsin, proteinase 3 and with the HLA-DPB1 locus. A mutation in the abnormal limb mutant 5 (ALI5) mouse in the region coding for the hydrophobic ridge loop 3 (HRL3) of the phospholipaseCγ2 (PLCγ-2) gene, corresponding to human PLCγ-2 exon 27, leads to acute and chronic inflammation and granulomatosis. For that reason, we screened exons 11, 12 and 13 coding for the hydrophobic ridge loop 1 and 2 (HRL1 and 2, respectively) and exon 27 of the PLCγ-2 protein by single strand conformation polymorphism (SSCP), sequencing and PCR/ restriction fragment length polymorphism (RFLP) analyses. In addition, we screened indirectly for disease association via 4 microsatellites with pooled DNA in the PLCγ-2 gene. RESULTS: Although a few polymorphisms in these distinct exons were observed, significant differences in allele frequencies were not identified between WG patients and respective controls. In addition, the microsatellite analyses did not reveal a significant difference between our patient and control cohort. CONCLUSION: This report does not reveal any hints for an involvement of the PLCγ-2 gene in the pathogenesis of WG in our case-control study