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Search Results: 1 - 10 of 5052 matches for " Karen Gehrs "
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Clinical validation of a genetic model to estimate the risk of developing choroidal neovascular age-related macular degeneration
Gregory S Hageman, Karen Gehrs, Serguei Lejnine, Aruna T Bansal, Margaret M DeAngelis, Robyn H Guymer, Paul N Baird, Rando Allikmets, Cosmin Deciu, Paul Oeth, Lorah T Perlee
Human Genomics , 2011, DOI: 10.1186/1479-7364-5-5-420
Abstract: Many diseases of ageing characterised by complex inheritance patterns are progressive; the individual may be asymptomatic in the early stages. One of these diseases, age-related macular degeneration (AMD), is the most common cause of visual impairment and the leading cause of blindness in the elderly population in the developed world. The prevalence of AMD increases with advancing age in all populations studied. Thus, in developed nations such as the USA, UK, Canada and Australia, with increasingly aged populations, the condition affects a progressively larger segment of the population and has become a major public health issue. Early- or late-stage AMD is present in 15 per cent of individuals over the age of 60 years [1]. It is estimated that there are currently 9.1 million patients in the USA with AMD, of which 1.7 million suffer with the vision-threatening late-stage complications of choroidal neovascularisation (CNV) or geographic atrophy [1]. Moreover, it is predicted that the number of cases of early AMD will increase to 17.8 million by 2050 and, if untreated, cases of late-stage blinding AMD will increase to 3.8 million [1]. It has been determined that vision loss from AMD decreases quality of life by 60 per cent, similar to the experience of dealing with a stroke that requires intensive nursing care [2].The clinical presentation and natural course of AMD are highly variable. The disease may present as early as the fifth decade of life or as late as the ninth decade. The clinical symptoms of AMD range from no visual disturbances in early disease to profound loss of central vision in the advanced late stages of the disease. Some patients never progress beyond early AMD; however, in 10-15 per cent of Caucasian patients with early-stage disease, the condition progresses to an exudative neovascular (or 'wet' form) or geographic atrophic (or 'dry' form) AMD, which threatens vision. The phenotype is characterised by development of subretinal choroidal neovascular c
Defending the Self in a Total Institution: Staff Prompting and Patient Burlesque  [PDF]
Karen Bettez Halnon
Sociology Mind (SM) , 2012, DOI: 10.4236/sm.2012.24060
Abstract: This paper offers an analysis of forms of social interaction between direct care staff and patient members of a state institution for the “Mentally Retarded” (MR) and dually-diagnosed (MR with a mental disorder diagnosis) located in the northeastern United States. This work’s significance is that it updates and extends Erving Goffman’s (1961) classic study of the underlife of total institutions. It does so by delineating a sub-type of secondary adjustment to total institutions, termed ancillary adjustment. Ancillary adjustment is defined as performances of patient role that undercut the institution’s official prescription for patient identity toward normalizing direct staff member identity. It is shown how ancillary adjustment arose as an unintended consequence of the institutional reforms of the 1970s, or how, under a professionally reformed and bureaucratized “New School”, direct care staff members experienced themselves as disempowered and discredited as “normal” professionals and defensively and repeatedly cued hyper-stigmatized comedic spectacles through types of staff-patient interaction termed staff prompting and patient burlesque. This paper is based on a three-year fieldwork study entitled Defending the Self in an Institution for the Mentally Retarded that utilized Glaser and Strauss’ (1967) and Strauss and Corbin’s (1990) grounded theory methods for qualitative research.
Embracing Empowerment in the Healthcare of the United States  [PDF]
Bozena Padykula, Karen Wexell
Open Journal of Leadership (OJL) , 2013, DOI: 10.4236/ojl.2013.24013

The United States experiences an economic and healthcare crisis that calls for change. Transformational leadership model by Kouzes and Posner (2003) defines traits that are important to embrace by today’s healthcare leaders in promoting organizational change. To promote growth, engaging and empowering all members in the organization opens the door for collaborative work intentionally establishing sustainable healthcare outcomes. Since nurses play a significant role in US and global healthcare systems, healthcare organizations demand empowered nursing leaders that have an equal voice. The significance of this review to the future is to awaken nursing leaders to step away from a dependent mode and to step forward to an empowered mode.

Plasma cell pleocytosis in HSV-2 aseptic meningitis  [PDF]
Rohit Kalia, Karen Hennessey
Open Journal of Internal Medicine (OJIM) , 2013, DOI: 10.4236/ojim.2013.34026

Plasma cell pleocytosis has been seen in cerebrospinal fluid (CSF) analysis of patients with multiple myeloma, multiple sclerosis, leukemia, west nile encephalitis and lymphoma. There also have been some anecdotal reports suggesting the presence of plasma cells in CSF as possible early indicator of WNV encephalitis. We describe a case of plasma cell pleocytosis in CSF due to HSV-2 meningitis, adding it to the list of possible etiologies for the same. 

The Role of Technology in the Marketing Communications Industry: An Exploratory Study of the Impact of North American Influence on Local Business in Trinidad and Tobago  [PDF]
Prahalad Sooknanan, Karen Crichlow
Advances in Journalism and Communication (AJC) , 2014, DOI: 10.4236/ajc.2014.23009
Abstract: New communication technologies such as the Internet are causing sweeping changes within the global marketing communications industry. Therefore, the implications of e-marketing for business in Trinidad and Tobago are profound as seen in a national plan to address this need. This study examines the efforts of local businesses and consumers to get on the e-marketing bandwagon already commonplace in the U.S. Two surveys were conducted among local businesses and local consumers to determine their readiness and/or success. In spite of governmental efforts to expand Internet capabilities, lethargy and lack of access still plague local businesses. This contrasts with local consumers who are more receptive to e-marketing expressing an increasing demand for online information. It is therefore imperative for the T&T government to address the deficiencies in its ICT plan so that local businesses and consumers can catch up with the rest of the world before the gap widens to a point where it becomes impossible to do so.
Development, Dependency and HIV Risk in Kiribati  [PDF]
Karen McMillan, Heather Worth
World Journal of AIDS (WJA) , 2014, DOI: 10.4236/wja.2014.42028

A study was undertaken in Kiribati, a small Pacific island nation, that has a low-level HIV epidemic but a high incidence of STIs among seafarers, their spouses (and children), and those involved in sex work. There are connections between development and dependency and HIV risk in Kiribati. Kiribati is a peripheral and dependent small island state underwritten by conditional aid and financial assistance and advice from donor countries, entwined in, and subject to, external globalising processes. We found two major factors related to Kiribati’s dependency engendered HIV risk. The first is Kiribati’s reliance on transnational seafaring. Long periods away from home, shipboard and port mateship cultures, and infrequent condom use in casual and paid sexual relations while in overseas ports, exacerbated by heavy alcohol use, have rendered i-Kiribati seafarers vulnerable to HIV. The second factor is related to the labour force participation of young women, which is extremely limited. In this context, some young i-Kiribati women choose to work on board, foreign fishing vessels selling sex. They stay with one client while on board a boatfor up to three monthsand sex work is not only an economic transaction, but also emotional and affective labour. It is a pattern that makes consistent condom use problematic. Having multiple sequential seafarer partners may in fact generate considerable HIV vulnerability.

But You Promised: Children’s Judgments of Broken Promises  [PDF]
Karen Hussar, Jared Horvath
Psychology (PSYCH) , 2013, DOI: 10.4236/psych.2013.412152

Current conceptions regarding children’s understanding of promises (and promise breaking) rely upon absolute distinction: namely, a promise versus a non-promise. The current study expands the understanding of children’s judgments of broken promises to include more nuanced, refined descriptions. Utilizing a four-point rating scale—ranging from “OK” to “very bad”—forty children aged 6 to 10 judged story cards depicting characters breaking commitments not to engage in specific behaviors across three different domains (moral, social-conventional, and personal). Analyses indicated that children judge broken promises in the moral domain more severely than those in the social-conventional domain and broken promises in the social-conventional domain more severely than those in the personal domain. Therefore, children appear to judge broken commitments on a sliding scale in much the same way they judge actions from the moral, social-conventional and personal domains. Results from the current study also suggest an inverse pattern of judgment with regards to broken commitments. Specifically, it appears that the more severely an initial action is judged, the less severely its concurrent commitment condition is judged; and vice versa. These findings help refine our understanding of childhood interpretations of broken promises and engender several unique ideas for future research in this field.

Addressing the challenges of patient-centred design
Karen Ryan,Karen LaBat
Australasian Medical Journal , 2009,
Abstract: Patient-centred design is a relatively new term, but a longstanding concept in clinical practice. This discussion looks at patient-centred design and explores the relationships of patient-centred design to universal design, user-centred design and the newer human-centred design. It also explores why interdisciplinary approaches are needed for patient-centred design and how interdisciplinary collaboration works to address the challenges of patient centred design. Successful patient-centred solutions can grow from collaborations which include shared visions, understanding of both the nature and degree of variation in the patient,materials, and the designed solution, clear regular communication among all parties with careful definition of terms, and respect for the inherent cultures of all disciplines involved.
Evaluation of 20 Macro and Trace Mineral Concentrations in Commercial Goat Milk Yogurt and Its Cow Milk Counterpart  [PDF]
Karen Hernandez, Young W. Park
Food and Nutrition Sciences (FNS) , 2014, DOI: 10.4236/fns.2014.510098

Concentrations of 20 different minerals in commercial goat milk yogurt (CGY) and its cow milk yogurt (CCY) counterpart were evaluated in reference to goat milk yogurt manufactured from Fort Valley State University (FVGY), Fort Valley, GA, USA. Three different lots of CGY and CCY each were purchased from local retail stores at Warner Robins, GA, and 3 batches of FVGY were made using goat milk from the University milking herd. All 3 types of experimental yogurts were stored at 4°C refrigerator for 4 weeks. Twenty major and trace minerals were analyzed by an Inductively Coupled Plasma Optical Emissions Spectrometer (Thermo Jarrel Ash Enviro 36, Worchester, MA), using argon as the carrier gas and the EPA method 6010. Total solids (TS) content (%) of FVGY, CGY and CCY products were 11.03, 13.1 and 11.3, respectively, indicating CGY had higher TS than the CCY and FVGY yogurt. Respective mean mineral concentrations (ppm, wet basis) of FVGY, CGY and CCY were: Ca 1057, 1162, 1160; P 838, 974, 929; K 1327, 1717, 1208; Mg 102, 133, 113; Na 545, 449, 475; Fe 4.28, 3.33, 2.11; Mn 0.24, 0.19, 0.13; Cu 10.5, 9.85, 7.22; Zn 17.5, 11.7, 11.8. Levels of all macro minerals except potassium were higher in commercial goat and cow yogurts than FVGY, which may be due to the higher TS contents. FVGY had higher Fe, Mn, Cu and Zn than both commercial products. The heavy metal (Pb, Cd and Ni) contents (ppm) appeared to be normal range, while Al contents of FVGY, CGY and CCY were 11.9, 8.66 and 7.65, respectively, which were higher than those of Pb, Cd and Ni. Both commercial products contained higher major mineral contents than the university yogurt, which might be attributable to the differences in diet, breed, and stage of lactation of milking animals, as well as the tapioca additive used in the commercial products.

Exercise Protects Bone after Stroke, or Does It? A Narrative Review of the Evidence
Karen Borschmann
Stroke Research and Treatment , 2012, DOI: 10.1155/2012/103697
Abstract: Physical inactivity contributes to accelerated bone loss after stroke, leading to heightened fracture risk, increased mortality, and reduced independence. This paper sought to summarise the evidence for the use of physical activity to protect bone in healthy adults and adults with stroke, and to identify international recommendations regarding any means of bone protection after stroke, in order to guide rehabilitation practice and future research. A search was undertaken, which identified 12 systematic reviews of controlled trials which investigated the effect of physical activity on bone outcomes in adults. Nine reviews included healthy adults and three included adults with stroke. Twenty-five current international stroke management guidelines were identified. High-impact loading exercise appears to have a site-specific effect on the microarchitecture of healthy postmenopausal women, and physical activity has a small effect on enhancing or maintaining bone mineral density in chronic stroke patients. It is not known whether this translates to reduce fracture risk. Most guidelines included recommendations for early mobilisation after stroke and falls prevention. Two recommendations were identified which advocated exercise for the prevention bone loss after stroke, but supporting evidence was limited. Research is required to determine whether targeted physical activity can protect bone from early after stroke, and whether this can reduce fracture risk. 1. Introduction Stroke-related impairments and inactivity contribute to the accelerated development of osteoporosis [1–3]. Combined with a high rate of falls [4–6], stroke survivors are particularly vulnerable to fall-related injuries, especially fractures. The risk of fracture after stroke is 1.5- to fourfold compared to age-matched controls [7], and fractures after stroke reduce the ability to regain independent walking and increase mortality [8]. Bone maintains its strength through the modulation of its remodelling activity (bone turnover), adapting its structural and material properties in response to its loading environment [9]. Loads on bone are generated by ground reaction forces and muscle activity. Immobility from hemiplegia or extended bed rest decreases loads and thus contributes to increased removal of bone [10]. Conversely, during adulthood, mechanical loading of bone can contribute to maintenance of bone strength by maintaining bone mass, and vigorous high-impact loading may have a small capacity to increase bone mass [10]. Physical activity levels are often very low among acute stroke
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