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Search Results: 1 - 10 of 402232 matches for " Kathleen M. Powis "
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Cotrimoxazole Prophylaxis and Risk of Severe Anemia or Severe Neutropenia in HAART-Exposed, HIV-Uninfected Infants
Scott Dryden-Peterson, Oluwemimo Jayeoba, Michael D. Hughes, Haruna Jibril, Kenneth McIntosh, Taolo A. Modise, Aida Asmelash, Kathleen M. Powis, Max Essex, Roger L. Shapiro, Shahin Lockman
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0074171
Abstract: Background Prophylactic cotrimoxazole is recommended for infants born to HIV-infected mothers. However, cotrimoxazole may increase the risk of severe anemia or neutropenia. Methods We compared the proportion of HIV-exposed uninfected (HIV-EU) infants experiencing incident severe anemia (and separately, severe neutropenia) between a prospective cohort receiving prophylactic cotrimoxazole from 1 to 6 months vs. infants from two prior trials who did not receive cotrimoxazole. Infants were from rural and urban communities in southern Botswana. Results A total of 1705 HIV-EU infants were included. Among these 645 (37.8%) were fed with iron-supplemented formula from birth. Severe anemia developed in 87 (5.1%) infants, and severe neutropenia in 164 (9.6%) infants. In an analysis stratified by infant feeding method, there were no significant differences in the risk of severe anemia by prophylactic cotrimoxazole exposure–risk difference, ?0.69% (95% confidence interval [CI] ?2.1 to 0.76%). Findings were similar in multivariable analysis, adjusted odds ratio (aOR) 0.35 (95% CI 0.07 to 1.65). There were also no significant differences observed for severe neutropenia by cotrimoxazole exposure, risk difference 2.0% (95% CI ?1.3 to 5.2%) and aOR 0.80 (95% CI 0.33 to 1.93). Conclusions Severe anemia and severe neutropenia were infrequent among HIV-exposed uninfected infants receiving cotrimoxazole from 1–6 months of age. Concerns regarding hematologic toxicity should not limit the use of prophylactic cotrimoxazole in HIV-exposed uninfected infants. ClinicalTrials.gov Registration Numbers NCT01086878 (http://clinicaltrials.gov/show/NCT010868?78), NCT00197587 (http://clinicaltrials.gov/show/NCT001975?87), and NCT00270296 (http://clinicaltrials.gov/show/NCT002702?96).
Aberrant NF-KappaB Expression in Autism Spectrum Condition: A Mechanism for Neuroinflammation
Adam M. H. Young,John Suckling,Simon J. Powis
Frontiers in Psychiatry , 2011, DOI: 10.3389/fpsyt.2011.00027
Abstract: Autism spectrum condition (ASC) is recognized as having an inflammatory component. Post-mortem brain samples from patients with ASC display neuroglial activation and inflammatory markers in cerebrospinal fluid, although little is known about the underlying molecular mechanisms. Nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) is a protein found in almost all cell types and mediates regulation of immune response by inducing the expression of inflammatory cytokines and chemokines, establishing a feedback mechanism that can produce chronic or excessive inflammation. This article describes immunodetection and immunofluorescence measurements of NF-κB in human post-mortem samples of orbitofrontal cortex tissue donated to two independent centers: London Brain Bank, Kings College London, UK (ASC: n = 3, controls: n = 4) and Autism Tissue Program, Harvard Brain Bank, USA (ASC: n = 6, controls: n = 5). The hypothesis was that concentrations of NF-κB would be elevated, especially in activated microglia in ASC, and pH would be concomitantly reduced (i.e., acidification). Neurons, astrocytes, and microglia all demonstrated increased extranuclear and nuclear translocated NF-κB p65 expression in brain tissue from ASC donors relative to samples from matched controls. These between-groups differences were increased in astrocytes and microglia relative to neurons, but particularly pronounced for highly mature microglia. Measurement of pH in homogenized samples demonstrated a 0.98-unit difference in means and a strong (F = 98.3; p = 0.00018) linear relationship to the expression of nuclear translocated NF-κB in mature microglia. Acridine orange staining localized pH reductions to lysosomal compartments. In summary, NF-κB is aberrantly expressed in orbitofrontal cortex in patients with ASC, as part of a putative molecular cascade leading to inflammation, especially of resident immune cells in brain regions associated with the behavioral and clinical symptoms of ASC.
A Concept Analysis of Mentoring in Nursing Leadership  [PDF]
Alexis Kathleen Hodgson, Judith M. Scanlan
Open Journal of Nursing (OJN) , 2013, DOI: 10.4236/ojn.2013.35052
Abstract:

Attention in the literature has been given to the critical state of nursing leadership development. There is a need to identify effective ways to sustain and develop nursing leaders. Mentoring has been identified as an invaluable tool to attract and retain new nurse leaders. Examining the concept of mentoring in nursing leadership provides a greater understanding of its importance in today’s healthcare system. The concept of mentoring will be analyzed using the framework developed by Walker and Avant. A literature review was conducted to examine the current usage of the concept of mentoring. Consistent with Walker and Avant’s framework, defining attributes, antecedents, and consequences of mentoring have been identified. Further illustration of this concept is provided by describing model, borderline, related, and contrary cases. Demonstrating the occurrence of the concept of mentoring, Empirical referents will also be explored.

Compilation and Analysis of Atherosclerosis Gene Expression Data  [PDF]
Michelle L. Booze, Kathleen M. Eyster
Advances in Biological Chemistry (ABC) , 2015, DOI: 10.4236/abc.2015.52011
Abstract: The objective of this project was to search for consensus in differential gene expression data and in regulation of differentially expressed genes among DNA microarray studies of atherosclerotic vessels and plaque. Seventeen DNA microarray studies of atherosclerosis were analyzed. Only 19 genes were found to be differentially expressed in 3 or more of the studies. The nineteen genes belong to classic gene ontologies known to be involved in atherosclerosis: immunity and defense, metabolism, proteases, receptors, and signal transduction. Four bioinformatics programs (TRED, rVISTA, JASPAR, and Ariadne Pathways) were used to further analyze the promoter regions and common upstream regulators of the 19 genes. Twelve of the genes shared nine common upstream regulators, many of them known to affect atherosclerosis, and one possible new pathway was identified that may be involved in this disease.
Getting by with a Little Help from My Friends: Mental Rotation Ability after Tacit Peer Encouragement  [PDF]
Sheila Brownlow, Amanda J. Janas, Kathleen A. Blake, Kathleen T. Rebadow, Lindsay M. Mello
Psychology (PSYCH) , 2011, DOI: 10.4236/psych.2011.24057
Abstract: We examined how Mental Rotation (MR) ability was improved by presenting information that the task was one that could be accomplished. This information purportedly came from either peers or the experimenter. Men and women students completed 10 MR items from the Purdue Visualization of Rotations Test (Bodner & Guay, 1997) and provided self-reports about their confidence in their abilities to perform rotations, background skills and experiences, and effort with the task. The peer-presentation technique improved performance on MR, as both men and women who read that other students had previously managed the tasks performed better than those who merely heard about the tasks, leaving an implied difficulty unaddressed or “in the air.” When self-reported confidence in MR ability was held constant there were no gender differences in MR performance. The results suggest that appropriate peer models may improve performance on cognitive tasks, perhaps by increasing confidence in ability.
Xenobiotic Exposure and Autoimmune Hepatitis
Kathleen M. Gilbert
Hepatitis Research and Treatment , 2010, DOI: 10.1155/2010/248157
Abstract: Although genetics contributes to the development of autoimmune diseases, it is clear that “environmental” factors are also required. These factors are thought to encompass exposure to certain drugs and environmental pollutants. This paper examines the mechanisms that normally maintain immune unresponsiveness in the liver and discusses how exposure to certain xenobiotics such as trichloroethylene may disrupt those mechanisms and promote autoimmune hepatitis. 1. Immunological Characteristics of Autoimmune Hepatitis Autoimmune hepatitis (AIH) is a disease characterized by progressive liver inflammation of unknown etiology that may advance to fibrosis. The inflammation encompasses both cell-mediated cytotoxicity by infiltrating lymphocytes and the production of autoantibodies. Although not restricted to AIH, many patients with AIH make autoantibodies specific for asialoglycoprotein receptor (ASGPR) [1] and alcohol dehydrogenase (ADH) [2]. Type 1 AIH is characterized by circulating antinuclear antibodies (ANA) and smooth-muscle antibodies (SMA) [3]. Some individuals may have antineutrophil cytoplasmic autoantibodies (ANCA), antibodies to soluble liver antigens or liver pancreas (anti-SLA/LP). Type 2 AIH is associated with antibodies against liver-kidney microsome 1 (LKM-1) and/or antibodies against liver cytosol 1 antigen (LC1) [4]. LKM-1 autoantibodies react with linear epitopes within cytochrome P450 2D6 (CYP2D6), a phase-I drug- and toxicant-metabolizing enzyme in the liver, and perhaps major antigen target of type 2 AIH. Diagnosis of AIH usually involves more than the measurement of autoantibodies since patients may express them intermittently or produce antibodies that are not part of the standard repertoire. As described in Table 1 a definitive diagnosis of AIH is multifactorial. One classic indicator of AIH is liver pathology associated with lymphocyte infiltration of portal region. The liver infiltrate includes macrophages, antibody-secreting plasma cells, and T lymphocytes of both CD4+ and CD8+ subsets. Several investigators have reported a predominance of CD4+ T cells in the liver infiltrate, while others have reported a predominance of CD8+ T cells [5–7]. Regardless of the exact cell makeup the periportal lymphocyte infiltration characteristic of AIH differs from other autoimmune liver diseases such as primary biliary cirrhosis and autoimmune cholangitis in which lymphocytes instead target the bile ducts. Table 1: Revised scoring system of the international autoimmune hepatitis group. The specificity of the T cells that infiltrate the liver in AIH
Schools of Excellence AND Equity? Using Equity Audits as a Tool to Expose a Flawed System of Recognition
Kathleen M Brown
International Journal of Education Policy and Leadership , 2010,
Abstract: The purpose of this article is to demonstrate how equity audits can be used as a tool to expose disparate achievement in schools that, on the surface and to the public, appear quite similar. To that end, the researcher probed beyond surface-level performance composite scores into deeper, more hidden data associated with state-recognized "Honor Schools of Excellence." How is "excellence" defined and operationalized in these schools? Are these schools "excellent" for all students? Can a school really be classified by the state as "excellent" and yet still have significant "gaps" and disparities? If so, is the state's formula used to identify exemplary schools too simple, dogmatic, and institutionally flawed? Through the use of equity audits, quantitative data was collected to scan for systemic patterns of equity and inequity across multiple domains of student learning and activities within 24 elementary schools. The intent was to document and distinguish between schools that are promoting and supporting both academic excellence (small gap schools; SGS) and systemic equity and schools that are not (large gap schools; LGS). Results reveal that although demographic, teacher quality, and programmatic audits all indicated a fair amount of equity between SGS and LGS, the achievement audit between both types of schools indicated great disparities. By controlling for or eliminating some of the external variables and internal factors often cited for the achievement gaps between white middle-class children and children of color or children from low-income families, the findings from this study raise more questions than answers. Results do indicate that equity audits are a practical, easy-to-apply tool that educators can use to identify inequalities objectively.
Why Shouldn’t Rural Kids Have It All? Place-conscious Leadership in an Era of Extralocal Reform Policy Por qué los ni os rurales no deberían tenerlo todo? Liderazgo con consciencia del lugar en una era de reforma política deslocalizada Por que crian as da zona rural n o deveriam ter tudo? Lideran a com consciência do espa o local em uma era de reforma política deslocalizada
Kathleen M. Budge
Education Policy Analysis Archives , 2010,
Abstract: This article explores school and community leaders' beliefs about standards-based reform and the purposes of local schooling in a single rural community in the western United States. The study used interviews of 11 community and school leaders in the community. Participants engage in a balancing act between serving local interests and satisfying extralocal mandates. They care about both the students they serve and the place they inhabit, and their own assessment of the educational enterprise indicated that state and federal policy had had little constructive influence on either. The conclusion explores critical place-consciousness as a possible tool to refocus rural educators' attention on the intent of the standards-based movement and to ensure that schooling supports individual student success and the needs of rural communities. Este artículo explora las creencias de directivos escolares y comunitarios acerca de las reformas basadas en estándares y los objetivos de las comunidades locales sobre la escolarización en una zona rural en el oeste de los Estados Unidos. Este estudio realizó 11 entrevistas con líderes comunitarios y escolares en una comunidad rural. Los entrevistados intentaban equilibrar el servicio de los intereses locales y el cumplimiento de mandatos extralocales de estandarización. Estos lideres se preocupan tanto con los estudiantes que atienden, el lugar que habitan y sus evaluaciones sobre la tarea educativa, indicando que las políticas estatales y federales fueron de poco influencia constructiva. Las conclusiones de esta investigación analizan el concepto de "conciencia-de lugar crítica" como una herramienta útil para enfocar la atención de los educadores rurales acerca de la intencionalidad de las reformas basadas en estándares y para garantizar que las escuelas ayuden a cada estudiante y atiendan las necesidades de las comunidades rurales. Este artigo explora as cren as das lideran as escolares e comunitárias sobre as reformas baseadas em normas estandardizadas bem como os objetivos das comunidades locais sobre a escolariza o em uma zona rural no oeste dos Estados Unidos. Este estudo realizou 11 entrevistas com líderes comunitários e escolares em uma comunidade rural. Os entrevistados buscavam um equilíbrio entre servir os interesses locais e as normas extra-locais de estandariza o. Esses líderes est o preocupados com os alunos a quem atendem, com o lugar onde vivem e com a própria avalia o do processo de ensino, indicando que as políticas estaduais e federais têm tido pouca influência construtiva. Os resultados desta pesquisa
Social meanings and understandings in patient-nurse interaction in the community practice setting: a grounded theory study
Stoddart Kathleen M
BMC Nursing , 2012, DOI: 10.1186/1472-6955-11-14
Abstract: Background The patient-nurse relationship is a traditional concern of healthcare research. However, patient-nurse interaction is under examined from a social perspective. Current research focuses mostly on specific contexts of care delivery and experience related to medical condition or illness, or to nurses’ speciality. Consequentially, this paper is about the social meanings and understandings at play within situated patient-nurse interaction in the community practice setting in a transforming healthcare service. Methods Grounded theory methodology was used and the research process was characterised by principles of theoretical sensitivity and constant comparative analysis. The field of study was four health centres in the community. The participants were patients and nurses representative of those attending or working in the health centres and meeting there by scheduled appointment. Data collection methods were observations, informal interviews and semi-structured interviews. Results Key properties of ‘Being a good patient, being a good nurse’, ‘Institutional experiences’ and ‘Expectations about healthcare’ were associated with the construction of a category entitled ‘Experience’. Those key properties captured that in an evolving healthcare environment individuals continually re-constructed their reality of being a patient or nurse as they endeavoured to perform appropriately; articulation of past and present healthcare experiences was important in that process. Modus operandi in role as patient was influenced by past experiences in healthcare and by those in non-healthcare institutions in terms of engagement and involvement (or not) in interaction. Patients’ expectations about interaction in healthcare included some uncertainly as they strived to make sense of the changing roles and expertise of nurses and, differentiating between the roles and expertise of nurses and doctors. Conclusions The importance of social meanings and understandings in patient-nurse interaction is not fully apparent to nurses, but important in the patient experience. Seeking understanding from a social perspective makes a contribution to enhancing knowledge about patient-nurse interaction with subsequent impact on practice, in particular the development of the patient-nurse relationship. The implications are that the meanings and understandings patients and nurses generate from experiences beyond and within their situated interaction are pivotal to the development of their relationship in the transforming community healthcare environment.
Framing the social in biomedical HIV prevention trials: a 20-year retrospective
MacQueen Kathleen M
Journal of the International AIDS Society , 2011, DOI: 10.1186/1758-2652-14-s2-s3
Abstract: Biomedical research is critical to identifying effective and safe interventions, such as vaccines, microbicides, male circumcision and antiretrovirals, for prevention. Funding for clinical prevention trials is highly competitive and the benchmarks of success ultimately reduce to quickly enrolling a select group of people at risk, keeping them enrolled, and inducing them to be compliant with trial requirements - all at the lowest cost possible. Juxtaposed with this reality is the fact that HIV is situated with poverty, exploitation, assaults on human dignity, and human rights abuses. The result is a complex web of ethical challenges that are socially constructed along lines of wealth and power. While social science research methods are commonly employed to examine such topics, they have played a marginal role in biomedical HIV prevention research. Why? To answer this question, a core set of persistent interlocking social, behavioural and ethical challenges to biomedical HIV prevention research are described. A critique is offered on how the social has been framed relative to the behavioural, ethical and biomedical components. Examples of how this framing has devalued social knowledge are provided, including the conflation of qualitative research with anecdotal reporting, a bias toward brevity and accuracy over external validity, and difficulties in distinguishing between a moral understanding of social norms and achieving a moral outcome when confronted with ethical challenges in research. Lastly, opportunities are identified for enhancing the success of biomedical HIV prevention research through development of a coherent programme of social science research. Recommendations are offered for reframing the social as a valid domain of scientific inquiry in this highly applied and interdisciplinary context.
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