Circle talks as situated experiential learning: Context, identity, and knowledgeability in \u27learning from reflection\u27

This article presents research that used ethnographic and sociolinguistic methods to study ways participants learn through reflection when carried out as a “circle talk.” The data indicate that participants in the event (a) invoked different contextual frames that (b) implicated them in various identity positions, which (c) affected how they could express their knowledge. These features worked together to generate socially shared meanings that enabled participants to jointly achieve conceptualization—the ideational role “reflection” is presumed to play in the experiential learning process. The analysis supports the claim that participants generate new knowledge in reflection, but challenges individualistic and cognitive assumptions regarding how this occurs. The article builds on situated views of experiential learning by showing how knowledge can be understood as socially shared and how learning and identity formation are mutually entailing processes

Cerebrovascular Accident in a Patient with Polycythemia: a Case Report

Polycythemia vera is not only a clonal disease that causes hematopoietic stem cells, but also a pathology that often leads to thrombotic complications. Thrombosis can have different localization and is clinically manifested by stroke, myocardial infarction, deep vein thrombosis of the lower extremities, pulmonary embolism, thrombosis of the veins of internal organs and other conditions. One of the most formidable thrombotic complications is acute cerebrovascular accident. The heterogeneity of the possible causes of acute cerebrovascular accident requires a careful approach to differential diagnosis for timely diagnosis and individual, pathogenetically grounded selection of means of long-term antithrombotic therapy. The presented clinical case of the development of cerebrovascular accident in a patient with polycythemia vera demonstrates the importance of an informal approach to diagnosis, as well as interdisciplinary interaction for finding the true cause of the development of acute cerebrovascular accident and the appointment of pathogenetically based treatment, aimed, among other things, at the prevention of repeated episodes of acute cerebrovascular accident and others. thrombotic complications

A cytogenetic follow-up of some highly irradiated victims of the Chernobyl accident

Altres ajuts: The authors wish to thank INTAS (research grant no. 97-1152) for financial support for this workA follo w-up of 10 highly irradiated men, mostly reactor crew, from the Chernobyl accident is described. Their pre-accident medical conditions and relevant medical status approximately 10-13 y later are listed. A comparison is made between estimates of their average whole-body penetrating radiation doses derived from several biological parameters. First estimates were based on their presenting severity of prodromal sickness, early changes in blood cell counts and dicentric chromosome aberrations in lymphocytes. In three cases ESR measurements on tooth enamel were also made. Retrospective dosimetry using FISH translocations was attempted 10-13 y later. This showed good agreement for those patients with the lower earlier dose estimates, up to about 3 Gy. For the others, extending up to about 12 Gy, the translocations indicated lower values, suggesting that in these cases translocations had somewhat declined. Repeated chromosomal examinations during the follow-up period showed an expected decline in dicentric frequencies. The pattern of decline was bi-phasic with a more rapid first phase, with a half-life of ∼4 months followed by a slower decline with half-lives around 2-4 y. The rapid phase persisted for a longer time in those patients who had received the highest doses. 10-13 y later dicentric levels were still above normal background, but well below the translocation frequencies

Beeldcultuur, een drieluik.I: Deconstructie van het fenomeen culturele studies

An important process in glass manufacture is the forming of the product. The forming process takes place at high rate, involves extreme temperatures and is characterised by large deformations. The process can be modelled as a coupled thermodynamical/mechanical problem including the interaction between glass, air and equipment. In this paper a general mathematical model for glass forming is derived, which is specified for different forming processes, in particular pressing and blowing. The model should be able to correctly represent the flow of the glass and the energy exchange during the process. Various modelling aspects are discussed for each process, while several key issues, such as the motion of the plunger and the evolution of the glass-air interfaces, are examined thoroughly. Finally, some examples of process simulations for existing simulation tools are provided

The efficacy of the combination of eribulin and trastuzumab in advanced HER2-positive breast cancer: the results of Russian observational study

The article presents the experience of 19 Russian medical institutions on the use of eribulin in combination with trastuzumab in various treatment lines of metastatic HER2+ breast cancer in routine clinical practice. Aim. The main objective of this retrospective observational study was to evaluate the efficacy and tolerability of eribulin and trastuzumab combo in HER2+ breast cancer patients pretreated with anthracyclines and taxanes. The analysis included 60 patients who received at least 2 cycles of eribulin in combination with trastuzumab. 2 patients (3.3%) received treatment as the 1st line, as the 2nd 14 (23.3%), as the 3rd 16 (26.7%), and as the 4th and more 28 (46.7%). Materials and methods. Complete response was achieved in 2 (3.3%) patients, partial response in 9 (15%), stable disease in 33 (55%), stabilization for more than 6 months in 11 (18.3%), disease progression was detected in 16 (26.7%) patients. The objective response rate was 18.3% in the whole group, the clinical benefit rate 36.7%. Results. The objective response rate in the group of the luminal subtype (ER/PR+HER2+) was 26.9%, in HER2-overexpressed subtype (ER-PR-HER2+) 8.8% and 64.7%, respectively, disease progression was recorded 2.3 times more often 35.3% versus 15.5% in the luminal subtype group. The median progression-free survival in patients with HER2+ breast cancer was 4.95 months (95% confidence interval CI 3.048.29 months), in luminal subtype 6.38 months (95% CI 3.338.54 months), in non-luminal 4.44 months (95% CI 2.47.96 months); p=0.306. The treatment was well tolerated, the spectrum of adverse events corresponded to the eribulin toxicity profile. Conclusions. The uniqueness of this study lies in the fact that on a large clinical material from the standpoint of real clinical practice, a very promising treatment regimen that is not used routinely in a number of countries has been studied, its effectiveness and satisfactory tolerance have been confirmed

Pathogen reduction/inactivation of products for the treatment of bleeding disorders:what are the processes and what should we say to patients?

Patients with blood disorders (including leukaemia, platelet function disorders and coagulation factor deficiencies) or acute bleeding receive blood-derived products, such as red blood cells, platelet concentrates and plasma-derived products. Although the risk of pathogen contamination of blood products has fallen considerably over the past three decades, contamination is still a topic of concern. In order to counsel patients and obtain informed consent before transfusion, physicians are required to keep up to date with current knowledge on residual risk of pathogen transmission and methods of pathogen removal/inactivation. Here, we describe pathogens relevant to transfusion of blood products and discuss contemporary pathogen removal/inactivation procedures, as well as the potential risks associated with these products: the risk of contamination by infectious agents varies according to blood product/region, and there is a fine line between adequate inactivation and functional impairment of the product. The cost implications of implementing pathogen inactivation technology are also considered

CHOLESTEROL PARADOX IN PATIENTS WITH CHRONIC CARDIAC INSUFFICIENCY MODERN STATE OF THE PROBLEM

Chronic cardiac insufficiency (CCI) is a wide-spread disease among the population of the Russian Federation and, as a rule, it is related to presence of the ischemic heart disease (IHD). Hypercholesterinemia is the major risk factor of IHD development but, however paradoxical it might seem, IHD patients often present a low cholesterol level, which, in its turn, is associated with the bad forecast. Reduction of the cholesterol level by statins reduces the incidence and mortality rate in IHD patients without CCI and possible improves the forecast in patients with CCI. But results of a number of studies testify that the high cholesterol level in patients with CCI is associated with better survival rates. This article provides data on the cholesterol paradox in CCI patients, its possible mechanisms and modern algorithms of the above-stated patients group management

Basic principles of primary prevention of type 2 diabetes mellitus

Type 2 diabetes mellitus is one of the main health problems not only in our country, but also in the world. Due to the steady rise in the number of persons with DM, it is extremely important to pay due attention to preventive measures aimed at reducing the prevalence of type 2 diabetes. The article describes the main principles of primary non-drug prevention of type 2 diabetes mellitus