20. Netting Without a Knot.

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Towards optimal care in inflammatory bowel disease:Thiopurines, tofacitinib and impact on working life

In this thesis, we aimed for further optimization of IBD care by evaluating efficacy and safety of ‘old’ and ‘new’ oral immunomodulators (thiopurines and tofacitinib) and by focusing on the disease impact on working life. Optimized mercaptopurine treatment based on therapeutic drug monitoring (TDM) is superior to placebo to achieve combined clinical remission and endoscopic improvement in ulcerative colitis (UC) patients after one year. TDM did not prevent drug-related adverse events or drug withdrawal. Thiopurine methyltransferase (TPMT) and nudix hydrolase 15 (NUDT15) gene polymorphisms and high levels of 6-thioguanine nucleotides (6-TGN) and 6-methylmercaptopurine (6-MMP) are associated with development of thiopurine-induced leukopenia. In a ‘real-world’ cohort, tofacitinib leads to corticosteroid-free clinical remission and endoscopic improvement in 39% of UC patients after one year. The tofacitinib safety profile is acceptable given its efficacy in this refractory population. In the majority of UC patients, tofacitinib reduces histological inflammation and induces a substantial decline of total STAT1, STAT3 and STAT5 expression in colonic mucosa. Low STAT1 expression after treatment is associated with tofacitinib response and presumably reflects the degree of histological inflammation. High JAK2 baseline expression seem associated with tofacitinib non-response.Over half of the IBD patients report work productivity loss, predominantly caused by ‘on-the-job’ productivity loss (presenteeism). Fatigue is the most frequently reported reason for work productivity loss by IBD patients. Reduced health-related quality of life (HRQL) and fatigue lead to increased work productivity loss and considerable indirect healthcare costs. IBD-related problems negatively influence quality of working life (QWL). Fatigue, reduced HRQL and work productivity loss are associated with declined QWL

Algae production pilot open ponds Lelystad : Results 2013 - 2015

In 2012 two open microalgae ponds (one indoor and one outdoor, both 250 m2) were built at the ACRRES pilot site in Lelystad. Both ponds are connected to an anaerobic digester and utilise excess heat and flue gas (CO2) from the Combined Heat and Power unit (CHP). In this report the results of the algae production monitoring and the additional experiments are given for the period 2013-2015

Activity calculator: a method for achieving a balanced lifestyle for people with chronic fatigue

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Mothers’ perceptions of family centred care in neonatal intensive care units

Objective To explore mothers’ perceptions of family centred care (FCC) in neonatal intensive care units (NICUs) in England. Design The qualitative experiences of 12 mothers from three NICUs in the UK were elicited using individual interviews. A thematic network analysis was conducted on the transcribed interviews Main outcome measures A central global theme supported by a number of organizing themes were developed reflecting the views of the mothers and their experiences of FCC. Results A global theme of “Finding My Place” was identified, supported by six organizing themes: Mothering in Limbo; Deference to the Experts; Anxious Surveillance; Muted Relations, Power Struggles and Consistently Inconsistent. Mothers experienced a state of liminality and were acutely sensitive to power struggles, awkward relationships and inconsistencies in care. To try to maintain their equilibrium and protect their baby they formed deferential relationships with health professionals and remained in a state of anxious surveillance. Conclusions This study illustrates that despite the rhetoric around the practice of FCC in NICUs, there was little in the mother's narratives to support this. It is of the utmost importance to minimize the consequences of the liminal experience, to improve staff–mother interactions and to facilitate mothers’ opportunities to be primary caregivers

Illuminating Vestige: Amateur Archaeology and the Emergence of Historical Consciousness in Rural France

This article provides a historical ethnography of an abrupt and transient awakening of interest in Roman vestige during the 1970s in rural France, and explores its implications for comparative understanding of historical consciousness in Western Europe. Drawing on ethnographic fieldwork in Languedoc, and particularly the commune of Monadières, it details a vogue for collecting pottery shards scattered in a nearby lagoon that developed among local inhabitants. The article frames this as a ritualized “expressive historicity” emergent from political economic restructuring, cultural transformation, and time-space compression. It analyses the catalyzing role of a historian who introduced discursive forms into the commune for symbolizing the shards, drawn from regionalist and socialist historiography, which local people adapted to rearticulate the historicity of lived experience as a novel, hybrid genre of “historical consciousness.” These activities are conceptualized as a “reverse historiography.” Elements of historiographical and archaeological discourses—for example, chronological depth, collation and evaluation of material relics—are reinvented to alternate ends, partly as a subversive “response” to contact with such discourses. The practice emerges as a mediation of distinct ways of apprehending the world at a significant historical juncture. Analysis explores the utility of new anthropological theories of “historicity”—an alternative to the established “historical idiom” for analyzing our relations with the past—which place historiography within the analytical frame, and enable consideration of the temporality of historical experience. Findings suggest that the alterity of popular Western cultural practices for invoking the past would reward further study

The sound of violets: the ethnographic potency of poetry?

This paper takes the form of a dialogue between the two authors, and is in two halves, the first half discursive and propositional, and the second half exemplifying the rhetorical, epistemological and metaphysical affordances of poetry in critically scrutinising the rhetoric, epistemology and metaphysics of educational management discourse. Phipps and Saunders explore, through ideas and poems, how poetry can interrupt and/or illuminate dominant values in education and in educational research methods, such as: • alternatives to the military metaphors – targets, strategies and the like – that dominate the soundscape of education; • the kinds and qualities of the cognitive and feeling spaces that might be opened up by the shifting of methodological boundaries; • the considerable work done in ethnography on the use of the poetic: anthropologists have long used poetry as a medium for expressing their sense of empathic connection to their field and their subjects, particularly in considering the creativity and meaning-making that characterise all human societies in different ways; • the particular rhetorical affordances of poetry, as a discipline, as a practice, as an art, as patterned breath; its capacity to shift phonemic, and therewith methodological, authority; its offering of redress to linear and reductive attempts at scripting social life, as always already given and without alternative

Suspended liminality: Vacillating affects in cyberbullying/research

This paper develops a concept of liminal hotspots in the context of i) a secondary analysis of a cyberbullying case involving a group of school children from a Danish school, and ii) an altered auto-ethnography in which the authors ‘entangle’ their own experiences with the case analysis. These two sources are used to build an account of a liminal hotspot conceived as an occasion of troubled and suspended transformative transition in which a liminal phase is extended and remains unresolved. The altered auto-ethnography is used to explore the affectivity at play in liminal hotspots, and this liminal affectivity is characterised in terms of volatility, vacillation, suggestibility and paradox

“Savages Who Speak French”: Folklore, Primitivism and Morals in Robert Hertz

Hertz's analysis of the Alpine cult of Saint Besse apparently marks a break from his studies of death, sin and the left to folkloric studies. This analysis helps one to understand the personality of Robert Hertz. His sociological curiosity about folklore reveals his ambiguous position in social sciences at the beginning of the twentieth century. His text appears to be a variation from the Durkheimian norm, but another reading could suggest that Hertz continued and went beyond Durkheimian thought to something between sociology of the modern world and engaged socialism. Through this study, Hertz linked his political ideals, his work in ethnology and his desire for social involvement. The cult of Saint Besse perpetuated as much religious tradition as local identity. The Alpine people were presented in the text as wilful perpetuators of an ideal social order, whose loss for his contemporary city dwellers Hertz feared. The alpine Other, marked by a material and moral backwardness, represented for activist and socialist Hertz one of the paths of balanced social organization that stabilized the identity of a group across time if it fit rather well into the folkloric stereotypes of the beginning of the twentieth century. Finally, by linking events in Herz's life (e.g., the accidental Alpine death of his father), this article suggests that the legend of Saint Besse embodied several recurring motifs in Hertz' career: the accidental deaths of saint and father by falls, the military role of the saint and of Hertz himself