Patients’ anticipated actions following transient ischaemic attack symptoms: a qualitative vignette-based study

Background: Transient Ischaemic Attack (TIA) requires urgent investigation and management. Urgent management reduces the risk of subsequent stroke markedly, but non-presentation or delays in patient presentation to health services have been found to compromise timely management. We aimed to explore general practice patients' anticipated responses to TIA symptoms. Methods: This was a qualitative study employing semi-structured telephone interviews. Participants were recruited from respondents in an earlier quantitative study based in Australian general practices. Maximum variation purposive sampling of patients from that study (on the basis of age, rurality, gender and previous experience of stroke/TIA) continued until thematic saturation was achieved. After initial interviews explored knowledge of TIA and potential responses, subsequent interviews further explored anticipated responses via clinical vignettes containing TIA and non-TIA symptoms. Transcribed interviews were coded independently by two researchers. Data collection and analysis were concurrent and cumulative, using a process of iterative thematic analysis and constant comparison. A schema explaining participants' anticipated actions emerged during this process and was iteratively tested in later interviews. Results: Thirty-seven interviews were conducted and a 'spectrum of action', from watchful waiting (only responding if symptoms recurred) to summoning an ambulance immediately, was established. Intermediate actions upon the spectrum were: intending to mention the episode to a general practitioner (GP) at a routine appointment; consulting a GP non-urgently; consulting a general practitioner (GP) urgently; and attending an Emergency Department urgently. The substrate for decision-making relating to this spectrum operated via three constructs: the 'individual set' of the participant (their inherent disposition towards action in response to health matters in general), their 'discriminatory power' (the ability to discriminate TIA symptoms from non-TIA symptoms) and their 'effective access' to health-care services. Conclusions: Policies to improve patients' accessing care (and accessing care urgently) post-TIA should address these three determinants of anticipated action

Observational review and analysis of concussion : a method for conducting a standardized video analysis of concussion in rugby league

Background: Several professional contact and collision sports have recently introduced the use of sideline video review for club medical staff to help identify and manage concussions. As such, reviewing video footage on the sideline has become increasingly relied upon to assist with improving the identification of possible injury. However, as yet, a standardized method for reviewing such video footage in rugby league has not been published. The aim of this study is to evaluate whether independent raters reliably agreed on the injury characterization when using a standardized observational instrument to record video footage of National Rugby League (NRL) concussions. Methods: Video footage of 25 concussions were randomly selected from a pool of 80 medically diagnosed concussions from the 2013–2014 NRL seasons. Four raters (two naive and two expert) independently viewed video footage of 25 NRL concussions and completed the Observational Review and Analysis of Concussion form for the purpose of this inter-rater reliability study. The inter-rater reliability was calculated using Cohen’s kappa (κ) and intra-class correlation (ICC) statistics. The two naive raters and the two expert raters were compared with one another separately. Results: A considerable number of components for the naive and expert raters had almost perfect agreement (κ or ICC value ≥ 0.9), 9 of 22 (41%) components for naive raters and 21 of 22 (95%) components for expert raters. For the concussion signs, however, the majority of the rating agreement was moderate (κ value 0.6–0.79); both the naive and expert raters had 4 of 6 (67%) concussion signs with moderate agreement. The most difficult concussion sign to achieve agreement on was blank or vacant stare, which had weak (κ value 0.4–0.59) agreement for both naive and expert raters. Conclusions: There appears to be value in expert raters, but less value for naive raters, in using the new Observational Review and Analysis of Concussion (ORAC) Form. The ORAC Form has high inter-rater agreement for most data elements, and it can be used by expert raters evaluating video footage of possible concussion in the NRL

Foreword

The aim of this study is to explore the relationship between gender, discourse and technology, and the resulting construction of bodily norms, in a contemporary environment dominated by info- and bio-technologies. The premise from which this study starts is that the ‘intra-action’ between gender, discourse and technology plays a central role in shaping contemporary identities. The study is based on close readings of material from three case studies: cyberpunk fiction, (in)fertility weblogs and the World Health Organisation guidelines on naming of biotechnologies. The distinctive combination of the three case studies provides a unique perspective on the relationship between gender, discourse and technology, showing how it shifts across different contexts, and demonstrating the socio-historical contingency of the bodily norms produced therein. This study is comprised of three empirical texts, one theoretical text and a kappa. The analysis shows how innovative cyberpunk narratives challenge not only human/non-human boundaries, but also genre and gender conventions. The specific format of the blog allows women’s experiences of infertility to be heard and produces hybrid discourses which challenge contemporary authoritative discourses about femininity. The third case study explores the assignment of International Nonproprietary Names to new biotechnologies, and the implications of this on the construction of patients’ bodies. Finally, the theoretical text contributes to existing feminist analyses of technoscience by proposing a new tool called abject/noise for examining disruptions to discursive and bodily coherence. This tool is then tested on a series of documents about the assignment of International Nonproprietary Names to new biotechnologies. Throughout, the importance of ‘situated knowledges’ is emphasised, both in how gender, discourse and technology are understood, but also in the norms produced and the position of the researcher.Syftet med denna studie är att undersöka relationen mellan genus, diskurs och teknik och hur denna relation bidrar till att konstruera vissa typer av kroppsnormer, speciellt som vår samtid infärgas av informationsteknik och bioteknik. Utgångspunkten för denna studie är att ’intra-action’ mellan genus, diskurs och teknik spelar en central roll i utformningen av samtida identiteter. Studien bygger på närläsningar av material från tre fallstudier: cyberpunk-litteratur, in/fertilitetets-bloggar och Världs-hälsoorganisationens riktlinjer för namngivning av bioteknik. Kombinationen av de tre fallstudierna ger ett unikt perspektiv på relationen mellan genus, diskurs och teknik. Den visar hur relationen skiftar mellan olika sammanhang, och hur denna är kulturellt villkorad och därmed tillåter vissa kroppsliga normer att upstå och cirkulera. Denna undersökning består av tre empiriskt grundade texter, en mer teoretisk text och en kappa. Den försten analysen visar hur innovativa cyberpunk berättelser inte bara utmanar föreställningar kring det mänsklig / icke-mänskliga gränser, utan också själva genren i sig och dess kulturella konventionerna kring genus. Det specifika format webbloggen (eller blogg) i den andra fallstudien tillåter kvinnors upplevelser av infertilitet att höras och producerar genreöverlappningar och igen-kännanden som utmanar samtida normativ diskurser om reproduktiv kvinnlighet. Den tredje fallstudien undersöker tilldelningen av ett så kallat Internationellt generiskt namn till nya biotekniska produkter, och konsekvenserna detta får för konstruktionen av patienternas genusifierade kroppar. Slutligen bidrar den teoretiska texten till befintliga feministiska analyser av ’teknovetenskap’ genom att föreslå ett nytt verktyg som kallas ’abject/noise’ för att undersöka störningar i diskursiva och kroppsliga sammanhang. Detta verktyg testats sedan också analytiskt på dokumentar som rör tilldelningen av Internationellt generiskt namn till ny bioteknik. Genom hela avhandlingen läggs tonvikten på ’situerad kunskap’, både gäller hur genus, diskurs och teknik förstås kontextuellt, hur normer blir till och hur forskaren positionerar sig

Lineage-specific interface proteins match up the cell cycle and differentiation in embryo stem cells.

The shortage of molecular information on cell cycle changes along embryonic stem cell (ESC) differentiation prompts an in silico approach, which may provide a novel way to identify candidate genes or mechanisms acting in coordinating the two programs. We analyzed germ layer specific gene expression changes during the cell cycle and ESC differentiation by combining four human cell cycle transcriptome profiles with thirteen in vitro human ESC differentiation studies. To detect cross-talk mechanisms we then integrated the transcriptome data that displayed differential regulation with protein interaction data. A new class of non-transcriptionally regulated genes was identified, encoding proteins which interact systematically with proteins corresponding to genes regulated during the cell cycle or cell differentiation, and which therefore can be seen as interface proteins coordinating the two programs. Functional analysis gathered insights in fate-specific candidates of interface functionalities. The non-transcriptionally regulated interface proteins were found to be highly regulated by post-translational ubiquitylation modification, which may synchronize the transition between cell proliferation and differentiation in ESCs

Junior Recital: Christopher Malloy, saxophone

This recital is presented in partial fulfillment of requirements for the degree Bachelor of Music in Performance. Mr. Malloy studies saxophone with Sam Skelton.https://digitalcommons.kennesaw.edu/musicprograms/1459/thumbnail.jp

Upregulation of arylsulfatase B in carotid atherosclerosis is associated with symptoms of cerebral embolization

The aim of this study was to identify genes for which the expression within carotid atherosclerosis was reproducibly associated with the symptoms of cerebral embolization. Two publically available microarray datasets E-MEXP-2257 and GSE21545 were analysed using GeneSpring 11.5. The two datasets utilized a total of 22 and 126 carotid atherosclerosis samples, obtained from patients with and without symptoms of cerebral embolization, respectively. To assess whether the findings were reproducible we analysed carotid atherosclerosis samples from another 8 patients with and 7 patients without symptoms of cerebral embolization using real-time PCR. In vitro studies using VSMC were performed to assess the functional relevance of one of the validated genes. We identified 1624 and 135 differentially expressed genes within carotid atherosclerosis samples of symptomatic compared to asymptomatic patients using the E-MEXP-2257 and GSE21545 datasets, respectively (≥1.15-absolute fold-change, P < 0.05). Only 7 differentially expressed genes or 0.4% (7/1,752) were consistent between the datasets. We validated the differential expression of ARSB which was upregulated 1.15-fold (P = 0.029) in atherosclerosis from symptomatic patients. In vitro incubation of VSMCs with the ARSB inhibitor L-ascorbic acid resulted in marked upregulation of SIRT1 and AMPK. This study suggests that ARSB may represent a novel target to limit carotid embolization

Prospectus, November 11, 2009

https://spark.parkland.edu/prospectus_2009/1030/thumbnail.jp