Socio-phenomenology and conversation analysis: interpreting video lifeworld healthcare interactions

This article uses a socio-phenomenological methodology to develop knowledge and understanding of the healthcare consultation based on the concept of the lifeworld. It concentrates its attention on social action rather than strategic action and a systems approach. This article argues that patient-centred care is more effective when it is informed through a lifeworld conception of human mutual shared interaction. Videos offer an opportunity for a wide audience to experience the many kinds of conversations and dynamics that take place in consultations. Visual sociology used in this article provides a method to organize video emotional, knowledge and action conversations as well as dynamic typical consultation situations. These interactions are experienced through the video materials themselves unlike conversation analysis where video materials are first transcribed and then analysed. Both approaches have the potential to support intersubjective learning but this article argues that a video lifeworld schema is more accessible to health professionals and the general public. The typical interaction situations are constructed through the analysis of video materials of consultations in a London walk-in centre. Further studies are planned in the future to extend and replicate results in other healthcare services. This method of analysis focuses on the ways in which the everyday lifeworld informs face-to-face person-centred health care and supports social action as a significant factor underpinning strategic action and a systems approach to consultation practice

Συγκριτική μελέτη της έκφρασης της κερατίνης 8 και της γλυκοζυλιωμένης ομάδας της H στο μυομήτριο και στα λειομυώματά του

Στην εργασία αυτή μελετήθηκαν ανοσοϊστοχημικώς 50 περιπτώσεις λειομυωμάτων με το παρακείμενο μυομήτριό τους και 5 περιπτώσεις λειομυοσαρκωμάτων με το παρακείμενο μυομήτριό τους για να ανιχνευθεί σ΄αυτά η κατανομή της κερατίνης 8 και του επιτοπίου Η που περιέχεται στο μόριο της κερατίνης 8 και περιλαμβάνει και το μοναδικό σάκχαρο της κερατίνης 8 που είναι η Ο-Ν ακετυλογλυκoζαμίνη. Η μελέτη του υλικού έδωσε τα ακόλουθα αποτελέσματα: Η κερατίνη 8 δεν εντοπίστηκε σε καμία περίπτωση λειομυώματος, λειομυοσαρκώματος ή μυομητρίου. Το επιτόπιο Η παρουσίασε έντονη έκφραση στο 46% και μέτρια έκφραση στο 54% των περιπτώσεων των λειομυωμάτων. Το επιτόπιο Η παρουσίασε έντονη έκφραση στο 40% και μέτρια έκφραση στο 60% των περιπτώσεων των λειομυοσαρκωμάτων. Το επιτόπιο Η δεν παρουσίασε διαφορά στην έκφρασή του ανάμεσα στα λειομυώματα και στο παρακείμενο μυομήτριό τους και στα λειομυοσαρκώματα και στο παρακείμενο μυομήτριό τους. Το επιτόπιο Η στις λείες μυϊκές ίνες του φυσιολογικού μυομητρίου και στις λείες μυϊκές ίνες των λειομυωμάτων βρίσκεται σε τέσσερα πολυπεπτίδια με μοριακά βάρη 100.000, 61.000, 59.000 και 54.000 που παράγονται όλα και από τα φυσιολογικά και από τα καλοήθη νεοπλασματικά λεία μυϊκά κύτταρα, όπως αποδείχθηκε με τη μέθοδο των ανοσοαποτυπωμάτων (immunoblotting). Η κερατίνη 8 δεν βρέθηκε στις λείες μυϊκές ίνες είτε του μυομητρίου ή των λειομυωμάτων όπως αποδείχθηκε με τη μέθοδο των ανοσοαποτυπωμάτων (immunoblotting). Τελικά συμπεραίνεται, ότι η κερατίνη 8 χωρίς να βρίσκεται στα λεία μυϊκά κύτταρα του μυομητρίου, των λειομυωμάτων και των λειομυοσαρκωμάτων μοιράζεται το επιτόπιό της Η που περιέχει και το μοναδικό σάκχαρό της, που είναι η Ο-Ν ακετυλογλυκοζαμίνη με τέσσερα άλλα άσχετα πολυπεπτίδια που παράγονται από τα φυσιολογικά και τα νεοπλασματικά λεία μυϊκά κύτταρα. Αυτό αφ΄ ενός πρέπει να λαμβάνεται υπ΄ όψη στις ανοσοϊστοχημικές μεθόδους, όταν χρησιμοποιούνται αντισώματα εναντίον της κερατίνης 8 γιατί μπορεί να υπάρξει διασταυρούμενη αντίδραση και να παρατηρηθούν ψευδώς θετικά αποτελέσματα με κίνδυνο ένα άτυπο λειομύωμα, ένα αδιαφοροποίητο λειομυοσάρκωμα και ένα αδιαφοροποίητο μεταστατικό λειομυοσάρκωμα να εκληφθούν σαν καρκινώματα. Αφετέρου συμβάλλει περισσότερο στην κατανόηση της γλυκοζυλίωσης με Ο-Ν-Ακετυλογλυκοζαμίνη στην βιολογία του μυομητρίου και των νεοπλασμάτων του. Μελλοντική περαιτέρω ταυτοποίηση των πεπτιδίων που φέρουν το επιτόπιο Η θα συμβάλλει στην ανίχνευση των οδών που εμπλέκονται τα τέσσερα αυτά πολυπεπτίδια ρίχνοντας περισσότερο φως στις οδούς της γλυκοζυλίωσης με Ο-Ν-Ακετυλογλυκοζαμίνη αναφορικά με την βιολογία του μυομητρίου και των λειομυωμάτων και λειομυοσαρκωμάτων του.In this study, fifty cases of uterine leiomyomas with their adjacent myometrium and five cases of uterine leiomyosarcomas with their adjacent myometrium were investigated immunohistochemically in order to detect the distribution of the keratin 8 and its glycosylated group H, which represents the epitope H which includes the sugar O -linked N - acetyl glycosamine residue in a specific conformation and/or environment. The study of this material gave the following results: The keratin 8 was not detected in any case of leiomyomas, leiomyosarcomas and myometrial tissues. The epitope H showed high expression in 46% and moderate expression in 54% of the cases of leiomyomas. The epitope H showed high expression in 40% and moderate expression in 60% of the cases of leiomyosarcomas. The epitope H did not show any difference in its expression among leiomyomas and their adjacent myometrium and among leiomyosarcomas and their adjacent myometrium. The epitope H in the normal smooth muscle cells of the myometrium and in the smooth muscle cells of the leiomyomas is located in four polypeptide chains with molecular weights 100.000, 61.000, 59.000 and 54.000 which all are produced by both the normal and benign neoplastic smooth muscle cells as it was revealed by western blotting and immunoblotting studies. The cytokeratin 8 was not detected in the normal and benign neoplastic smooth muscle cells as it was revealed by western blotting and immunoblotting studies. Finally, it is concluded that, although keratin 8 is not present in the smooth muscle cells of the myometrium, leiomyomas and leiomyosarcomas, it shares its epitope H which contains the sugar O-linked N- Acetylglucosamine residue in a specific conformation and/or environment with other four unrelated polypeptides which all are produced by the normal myometrial and the benign neoplastic uterine smooth muscle cells. This finding from one point of view has to be taken into consideration when anti-keratin 8 antibodies are used for immunohistochemistry due to the risk of cross- reactivity resulting in false positive findings and from the other point of view it contributes more knowledge into the biology of the myometrium and its neoplasms. Future further identification and characterization of the four polypeptides, which bear the epitope H, might shed more light in the pathways of the glycosylation with O-linked N-Acetylglucosamine, which are involved in the biology of the myometrium and in the pathology of the uterine leiomyomas and leiomyosarcomas

Dual-band implantable antennas for medical telemetry: a fast design methodology and validation for intra-cranial pressure monitoring

WOS:000323538100010 (Nº de Acesso Web of Science)In this study, we suggest and experimentally validate a methodology for fast and optimized design of dual-band implantable antennas for medical telemetry (MICS, 402-405 MHz, and ISM, 2400-2480 MHz). The methodology aims to adjust the design of a parametric dual-band antenna model towards optimally satisfying the requirements imposed by the antenna-fabrication procedure and medical application in hand. Design is performed in a systematic, fast, and accurate way. To demonstrate its effectiveness, the proposed methodology is applied to optimize the parametric antenna model for intra-cranial pressure (ICP) monitoring given a specific antenna-fabrication procedure. For validation purposes, a prototype of the optimized antenna is fabricated and experimentally tested. The proposed antenna is further evaluated within a 13-tissue anatomical head model in terms of resonance, radiation, and safety performance for ICP monitoring. Extensive parametric studies of the optimized antenna are, finally, performed. Feasibility of the proposed parametric antenna model to be optimally re-adjusted for various scenarios is demonstrated, and generic guidelines are provided for implantable antenna design. Dual-band operation is targeted to ensure energy autonomy for the implant. Finite Element (FE) and Finite Difference Time Domain (FDTD) simulations are carried out in homogeneous rectangular and anatomical head tissue models, respectively

Retrograde mesenteric perfusion from the deep femoral artery in a patient with a recurrent anastomotic aneurysm in the groin: a case report

In patients with atherosclerotic disease in two of the three main vessels in the splanchnic circulation, symptoms of chronic mesenteric ischemia may arise, depending on the disease chronicity and the presence of mesenteric collateral pathways. The most commonly described collateral pathways are between the celiac artery (CA), superior mesenteric artery (SMA), and inferior mesenteric artery (IMA); and between the IMA and the internal iliac artery (IIA). Another collateral network between the deep femoral artery and the IIA can also become important, especially in patients with aorto-iliac occlusion. Here we report a patient with a symptomatic anastomotic aneurysm of the right femoral artery after a previous aorto-bi-femoral bypass. This patient’s bowel viability relied on a well-developed collateral network from the ipsilateral deep femoral artery. This unusual anatomy required special surgical considerations and planning, to minimize the risk of perioperative mesenteric ischemia. During open repair, distal femoral debranching with a distal-to-proximal anastomotic sequence allowed minimizing of the ischemic time, and avoidance of potential ischemic complications from the visceral circulation. This case emphasizes the importance and benefit of the deep femoral artery and its collaterals as a reserve network of the splanchnic circulation. Favorable outcomes can be achieved with careful analysis of the preoperative imaging and proper planning, with adaptation of the surgical strategy

Introduction: temporality in interaction

The authors establish a phenomenological perspective on the temporal constitution of experience and action. Retrospection and projection (i.e. backward as well as forward orientation of everyday action), sequentiality and the sequential organization of activities as well as simultaneity (i.e. participants’ simultaneous coordination) are introduced as key concepts of a temporalized approach to interaction. These concepts are used to capture that every action is produced as an inter-linked step in the succession of adjacent actions, being sensitive to the precise moment where it is produced. The adoption of a holistic, multimodal and praxeological perspective additionally shows that action in interaction is organized according to several temporal orders simultaneously in operation. Each multimodal resource used in interaction has its own temporal properties

Investigating child participation in the everyday talk of a teacher and children in a preparatory year

In early years research, policy and education, a democratic perspective that positions children as participants and citizens is increasingly emphasized. These ideas take seriously listening to children’s opinions and respecting children’s influence over their everyday affairs. While much political and social investment has been paid to the inclusion of participatory approaches little has been reported on the practical achievement of such an approach in the day to day of early childhood education within school settings. This paper investigates talk and interaction in the everyday activities of a teacher and children in an Australian preparatory class (for children age 4-6 years) to see how ideas of child participation are experienced. We use an interactional analytic approach to demonstrate how participatory methods are employed in practical ways to manage routine interactions. Analysis shows that whilst the teacher seeks the children’s opinion and involves them in decision-making, child participation is at times constrained by the context and institutional categories of “teacher” and “student” that are jointly produced in their talk. The paper highlights tensions that arise for teachers as they balance a pedagogical intent of “teaching” and the associated institutional expectations, with efforts to engage children in decision-making. Recommendations include adopting a variety of conversational styles when engaging with children; consideration of temporal concerns and the need to acknowledge the culture of the school

Combined Endovascular/Surgical Management of a Ruptured Para-Anastomotic Aneurysm of the Left Common Iliac Artery#

A 75-year old man presented with signs and symptoms of acute abdomen and a clinical picture of hypovolemic shock. An emergency CT scan revealed a ruptured para-anastomotic left common iliac artery aneurysm. The patient had undergone an elective abdominal aortic aneurysm repair operation and placement of an aortoiliac bifurcated graft 10 years before. Para-anastomotic aneurysms had developed in all 3 (aortic and the 2 iliac) anastomosis. As the patient was highrisk, a combined endovascular/surgical approach was undertaken. The patient was discharged 4 days later