Textual reading in digitised classrooms: Reflections on reading beyond the internet

Modern and Contemporary Studie

Multicentric Castleman's disease and Kaposi's sarcoma in a cyclosporin treated, HIV-1 negative patient: case report

BACKGROUND: Multicentric Castleman's disease (MCD) is a rare disease, but is more frequent in AIDS patients. MCD has only been reported twice before in patients receiving immunosuppressive therapy after renal transplantation, and never in patients receiving immunosuppressive therapy without transplantation. About half of the cases of MCD are human herpesvirus 8 (HHV8) - related, in contrast to Kaposi's sarcoma, a more common complication arising after immunosuppression, where the virus is found in virtually all cases. CASE PRESENTATION: We report a HIV-1 negative, non-transplant patient who developed HHV8-associated multicentric Castleman's disease and Kaposi's sarcoma after 17 years of immunosuppressive treatment with cyclosporin A for a minimal change nephropathy. Chemotherapy with liposomal doxorubicin resolved both symptoms of multicentric Castleman's disease and Kaposi's sarcoma in this patient. A concomitant decline in the HHV8 viral load in serum/plasma, as determined by a quantitative real-time PCR assay, was observed. CONCLUSIONS: Multicentric Castleman's disease can be a complication of cyclosporin A treatment. Both multicentric Castleman's disease and Kaposi's sarcoma in this patient were responsive to liposomal doxorubicin, the treatment of choice for Kaposi's sarcoma at the moment, again suggesting a common mechanism linking both disorders, at least for HHV8-positive multicentric Castleman's disease and Kaposi's sarcoma.HHV8 viral load measurements can be used to monitor effectiveness of therap

Ebookness

Since the mid-2000s, the ebook has stabilized into an ontologically distinct form, separate from PDFs and other representations of the book on the screen. The current article delineates the ebook from other emerging digital genres with recourse to the methodologies of platform studies and book history. The ebook is modelled as three concentric circles representing its technological, textual and service infrastructure innovations. This analysis reveals two distinct properties of the ebook: a simulation of the services of the book trade and an emphasis on user textual manipulation. The proposed model is tested with reference to comparative studies of several ebooks published since 2007 and defended against common claims of ebookness about other digital textual genres

Association of 5' estrogen receptor alpha gene polymorphisms with bone mineral density, vertebral bone area and fracture risk

This study investigates the influence of genetic variation of the estrogen receptor alpha (ESR1) gene locus on several bone parameters in 2042 individuals of The Rotterdam Study, a prospective population-based cohort study of elderly subjects. We analysed three polymorphic sites in the 5' region of the ESR1 gene; a (TA)(n)-repeat in the promoter region, and molecular haplotypes of the PvuII and XbaI RFLPs in intron 1, and inferred long-range haplotypes (LRH) thereof. We observed only three of the possible four PvuII-XbaI haplotypes in our population. A comparison with other Caucasian populations showed similar haplotype frequencies, while in Asian and African populations these were different. Linkage disequilibrium (LD) analysis between the PvuII-XbaI haplotype and the (TA)(n) repeat showed strong LD between the two sites. Reconstruction of long range haplotypes over the entire 5' region, revealed six frequent LRH. In men, we did not observe an association between the ESR1 polymorphisms studied

Ontsmetting van teeltsystemen bij potplanten : Informatiebrochure

Teelt van potplanten in Nederland vindt plaats in recirculerende teeltsystemen. Vanaf begin jaren tachtig zijn verschillende systemen ontwikkeld waarbij watergift plaatsvindt door eb en vloed, bevloeiingsmatten, druppelaars of met een regenleiding. Direct na de introductie van recirculerende teeltsystemen werd rekening gehouden met mogelijke verspreiding van ziekteverwekkers. Aantasting van een enkele plant kan door retourwater overgaan op omringende planten. Bovendien kunnen ziekten en plagen die aan het einde van de voorgaande teelt aanwezig waren, eenvoudig in het nieuwe gewas de kop opsteken. In deze publicatie wordt bepaald wat de risico’s zijn voor aantasting en verspreiding van ziekten en plagen die in dit gewas op kunnen treden. Vervolgens worden mogelijkheden voor ontsmetting van retourwater beschreven en wordt aangegeven hoe het teeltsysteem optimaal gereinig en ontsmet kan worden. Hiervoor worden zowel resultaten uit onderzoek als praktijkervaringen als informatiebron gebruikt. Afsluitend worden een aantal eigenschappen genoemd waar een "ideaal" teeltsysteem aan zou kunnen voldoen om een optimale ontsmetting mogelijk te maken. Daarnaast wordt een beknopte checklist beschreven om problematiek van ziekten en plagen in kaart te brenge

A qualitative study of GPs' views towards obesity : are they fighting or giving up?

Objectives: Several studies indicate that general practitioners (GPs) are not taking the issue of obesity as seriously as they should. Therefore, the aim of this study was to understand GPs' views about obesity and obese people and how these professionals perceive their role in the treatment of this disease. Study design: Qualitative study using semi-structured interviews. Methods: Sixteen semi-structured interviews were conducted with Portuguese GPs. Data were analyzed according to thematic analysis procedures. Results: GPs are negative about their own role in obesity treatment. Although they believe it is part of their job to advise obese patients on the health risks of obesity, the majority of doctors think they are not making any difference in getting their patients to make long term lifestyle changes. GPs hold negative attitudes towards these patients blaming them for being unmotivated and non-compliant and are also pessimistic about their ability to lose weight. Doctors are facing a dilemma in their practices: they want to play an active role but, due to a set of negative beliefs and perceived barriers, they are playing a relatively passive role, feeling defeated and unmotivated, which is reflected in a decrease of efforts and a willing to give up on most of the cases. Conclusions: This issue should be taken in to account during physicians' education since doctors should be aware of how their own beliefs and attitudes influence their behaviour and practices, compromising, therefore, the adherence to and the success in obesity treatment. They seem to need more precise guidelines and better tools for screening and management of obesity, more referral options, and improved coordination with other specialitie

Raising positive expectations helps patients with minor ailments: A cross-sectional study

Background: Consultations for minor ailments constitute a large part of the workload of general practitioners (GPs). As medical interventions are not always available, specific communication strategies, such as active listening and positive communication, might help GPs to handle these problems adequately. This study examines to what extent GPs display both strategies during consultations for minor ailments and investigates how each of these relate to the patients' perceived health, consultation frequency and medication adherence. Methods: 524 videotaped consultations between Dutch GPs and patients aged 18 years or older were selected. All patients presented a minor ailment, and none of them suffered from a diagnosed chronic illness. The observation protocol included the validated Active Listening Observation Scale (ALOS-global), as well as three domains of positive communication, i.e. providing reassurance, a clear explanation, and a favourable prognosis. Patients completed several questionnaires before, immediately after, and two weeks after the consultation. These included measures for state anxiety (STAI), functional health status (COOP/ WONCA charts) and medication adherence (MAQ). Consultation frequency was available from an ongoing patient registration. Data were analysed using multivariate regression analyses. Results: Reassurance was related to patients' better overall health. Providing a favourable prognosis was linked to patients feeling better, but only when accompanied by a clear explanation of the complaints. A clear explanation was also related to patients feeling better and less anxious, except when patients reported a low mood pre-visit. Active listening alone was positively associated with patients feeling worse. Among patients in a good mood state, active listening was associated with less adherence. Conclusion: To some extent, it seems helpful when GPs are at the same time clear and optimistic about the nature and course of minor ailments. Yet, it does not seem helpful always and in all cases, e.g. when patients feel low upon entering the consulting room. Although communication strategies might to some extent contribute to the management of minor ailments, the results of this observational study also indicate that it is important for a physician to pay attention to the mood of the patient who enters the consulting room. (aut. ref.