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Case Report: Bartonella quintana-associated Neuroretinitis
Get PDFBackground: Neuroretinitis is a self-limiting condition which typically causes monocular vision loss with good potential for visual recovery. It may be idiopathic or associated with infectious or inflammatory conditions which can carry systemic implications. Neuroretinitis classically presents with disc edema followed by development of a macular star pattern of exudates. It is most commonly attributed to Cat Scratch Disease, or Bartonella henselae infection. However, there have been few published reports of Bartonella quintana associated neuroretinitis.
Case Report: A 60-year-old patient presented with unilateral vision loss preceded by flu-like illness. The patient had exposure to a recently adopted cat. Fundus examination revealed a stellate pattern of exudates in the macula of the affected eye with questionable sectoral optic disc edema. Serologic testing revealed a positive titer for Bartonella quintana IgG antibody, but negative Bartonella henselae testing. This report highlights a rare case of neuroretinitis related to B. quintana infection.
Conclusion: While neuroretinitis is generally considered to be self-limiting, it may be related to a systemic infection, such as B. henselae and B. quintana. Both B. henselae and B. quintana may present with ocular findings in the setting of nonspecific systemic symptoms. A thorough ophthalmic examination and history in conjunction with serologic testing can help to establish a diagnosis and prompt consideration of further testing or treatment for concurrent systemic disease
The Successful Military Retirement Transition: A Phenomenology of a Journey to Becoming Full
Get PDFResearch Focus. Change and transition are life constants and are uniquely defined by the individual experiencing them—whether expected or unexpected, positive, negative, or neutral. Only the individual can determine the nature and impact of a transition experience. Military members transitioning from the military environment to civilian life after retirement experience change and transition on several levels—a career shift, a forfeiture of role and status as a military member, a lifestyle change, financial instability, a culture shift, and a loss of military community and friendships, to name a few. This transition represents an exit from, not just a job, but a way of life within a tight-knit community with strong social bonds and a sense of purpose as an integral part of the military—something bigger than myself—to becoming an individual in the larger civilian society. The military retirement transition requires concurrent life adjustments on several fronts at once, making this transition a complex and unique transition experience.
Research Methods. There are ample examples in the literature of transition challenges, especially regarding veterans with service-connected physical or mental health issues that hinder their transition to civilian life. However, many veterans have successful outcomes once they have adequately addressed the culture shock of leaving the military ‘ecosystem’ and re-establish their new role identity as a veteran. This study explores what happens during the successful military retirement transition as a phenomenon. Phenomenological analysis uncovered the description and essence of the successful military retirement transition. This exploration of the lived experiences of military retirees provided insights clarifying the military retirement transition experience from the perspective of successful transitions.
Research Results/Findings. A conceptual model and four overarching themes—the unified essences—emerged from the phenomenological analysis to clearly define the phenomenon: learning in transition, uniqueness of the transition experience, leveraging military experience, and freedom post-transition. Together, these overarching themes comprise the central characteristics of the phenomenon and are interwoven and interdependent to contribute to the general description of the successful military retirement transition phenomenon. The description consists of a general narrative and these four unified essences of the phenomenon. It reads: The successful military retirement transition is a multidimensional, complex, psychological process, a phenomenon comprised of a minimum of three simultaneous transitions for the military member: (1) a retirement from a career and a way of life after at least 20 years and (2) a career transition from a known to unknown organizational culture and (3) a shift in status and role identity upon leaving active-duty military service to become a veteran. These multiple, simultaneous transitions created a shift in the reality they have operated in for over two decades. Throughout the transition journey, each participant experienced (1) learning—about themselves, the transition process, and their new reality; (2) a unique transition experience, based on their situation, level of family support, their transition strategy, and newly emerging identity (what they wanted to do and who they wanted to be); (3) leveraging their experience to overcome challenges that arose and (4) finally finding freedom in their new reality. It is a journey to becoming ‘full,’ where the multiple losses experienced in the multiple transitions get exchanged for the things that make new veterans complete in their new lives, careers, and roles as civilian workers and members of the civilian community.
Conclusions from Research. There is a need to understand military civilian transitions better. Including a description and conceptual model of the successful military retirement transition adds a data point in understanding the military civilian transition process from the perspective of veterans who have successfully transitioned. The uniqueness and complexity of the military civilian transitions described in this study and highlighted in previous research also point to the need for a holistic approach to transition that is tailored to address the individual needs of each new veteran. Reflection and the addition of arts-based elements played a facilitating role in the successful outcomes of the participants and a key role in data collection and analysis for this study. The study highlights several implications for further research to facilitate successful outcomes for transitioning veterans
Minimum Rim Width and Lamina Cribrosa Depth in Non-Glaucomatous and Glaucomatous U.S. Veterans
Get PDFPurpose: Assess the utility of the MRW and lamina cribrosa depth measurements for detecting differences between non-glaucomatous and glaucomatous U.S. Veterans. Compare inter-eye differences of individuals with glaucoma.
Method: 38 subjects were recruited per group: Group 1 included one eye of non-glaucomatous participants, and Group 2 included each qualifying eye of participants with glaucoma. Analysis compared Group 1 with the more affected eye only of Group 2 participants, and separately between the more and less affected eyes of group 2 participants. MRW measurements were obtained with Heidelberg Eye Explorer© (HEYEX). Average lamina cribrosa depths were measured manually utilizing HEYEX.
Results: 26 subjects from Group 1 and 33 subjects from Group 2 were included. A significantly thinner MRW was found in glaucomatous eyes vs. non-glaucomatous eyes (210 µm vs. 309 µm; P \u3c .001). The normative database in HEYEX had an 85% sensitivity and 92% specificity to detect glaucomatous nerves. Among the 27 participants in Group 2 who had both eyes tested, eyes with more advanced visual field loss showed significantly thinner global MRW compared to fellow eyes (203 µm vs. 224 µm P = .03). Lamina cribrosa depths were non-significantly deeper in glaucomatous vs. non-glaucomatous eyes (476 µm vs. 429 µm P = .17).
Conclusions: The MRW parameter differentiates between glaucomatous and non-glaucomatous optic nerves. Lamina cribrosa depths were non-significantly deeper in glaucomatous vs. non-glaucomatous participants. Post-hoc inter-eye data analysis suggested that inter-eye differences in gMRW values of glaucomatous eyes reflect asymmetric damage as correlated with the visual fiel
Faculty and Staff Perceptions of Their Roles in Preparing Students for College and Career Readiness: A Qualitative Exploration of High Schools, Community Colleges, and Universities
Get PDFIn 2020, nearly half of Texas’s 385,000 public high school graduates were unprepared for college-level reading or math. Limited research reveals K-12 faculty perceive limited roles and responsibilities in the college process, relying heavily on guidance counselors and college admissions counselors for preparing students for college and careers. The purpose of this study was to help fill this gap by answering the central research question: How do high school and college-level faculty and staff prepare high school students for college and careers? I chose a qualitative, interpretive design to explore educators’ individual and shared social meanings and interpretations. I used purposeful sampling to identify 10 subjects in South Central Texas who taught math, English language arts, social studies, or science in a high school, community college, university, and regional education agency participating in an alignment partnership in 2019. My data collection included semi-structured interviews, observations, e-mails, and supplemental documents. To study this phenomenon, I incorporated tools from grounded theory informed by Glaser and Strauss, and Charmaz. My data analysis methods involved using Hahn’s coding technique to organize and format large quantities of data for coding. Finally, I also used member checking and triangulation of data to ensure accuracy of my data analysis and to increase validity. The College and Career Readiness Collaborative Theory emerged and illustrates how interaction and dialogue in an alignment partnership led a team of faculty and staff to (a) co-construct meaning, (b) align curriculum, (c) clarify expectations, (d) improve perceptions, and (e) reevaluate teaching decisions to better prepare students for college and careers. This study reinforces the need for faculty and staff collaboration and dialogue to clarify skills gaps in entry level college courses, college level expectations, instruction, meanings, and perceptions of college and career readiness. Finally, the study addresses the pandemic’s impact on college and career readiness and the achievement gap
A Comparative Exploration Into First Time in College Student Academic Performance in Face-to-Face Versus Remote Learning Environments
Get PDFIn spring 2020, the COVID-19 pandemic forced educational systems to transition into an emergency remote learning modality. This quantitative study compared retention and productive grade rates of two 16-week academic semesters and compared face-to-face (fall 2019) and remote (fall 2020) emergency remote instruction. The study sample was drawn from the core courses of History, English, and Speech at San Antonio College. Those courses were selected in part due to the high proportion of first time in college students who were considered a vulnerable population regarding performance and persistence. Additional variables (i.e., gender, veteran status, first-generation status, and socio-economic status) were examined to determine whether they were predictors of either productive grade rate or retention. The findings suggested no difference between productive grade rates but higher retention in the face-to-face semester. The findings also indicated that gender (female) was predictive in both modalities, but no other variables were. At a minimum, those results suggested the importance of local assessment of predictors of student success in general, and when making decisions related to remote learning in particular. Finally, results of this study suggested that despite concerns regarding the scholastic impact on students and faculty forced into emergency remote instruction, that did not adversely affect student outcomes
Understanding Perceptions of Professional Development in a Multi-Generational Learning Environment Among High School Teachers
Get PDFIn today’s workforce, individuals are staying in their respective professions longer and retiring at ages past 67, resulting in a generationally diverse workforce. Currently, teachers range from 21-80 years of age, working in the same profession and receiving the same professional development. Considering adult learning and the dynamics associated with individuals, it is important to understand that, historically, the professional development provided to this workforce is facilitated in a one-size-fits-all arrangement (Gregson & Sturko, 2007), instead of using diverse adult learning styles (Malik, 2015). The purpose of this study is to understand individual teachers’ perceptions of the efficacy of professional development received in a high school education setting. Additionally, this research focuses on generational differences and how these differences may impact the learning environment for high school teachers. The study utilized a qualitative instrumental case study. The participants were teachers, Grades 9-12, in a Central Texas high school, who fall into one of the following generations: Baby Boomers, Generation X, and Millennial
Impacts of Granite Quarrying: The Case of Subsistence Farmers in the São Pedro River Valley
Get PDFGranite quarrying constitutes an occupational hazard that compromises workers’ health, destroys the environment and negatively affects nearby communities (Azevedo et al., 2020; Ibrahim et al., 2019; Oktriani, Darmajanti, & Soesilo, 2017; Shaik et al., 2015). But the demand for granite and other decorative stones continues to grow (Gupta, 2018). Despite a decrease in imports/exports due to Covid-19 (Alves et al., 2020), today Brazil remains the number 1 granite exporter to the United States (US Geological Survey, 2021). In the last 30 years, the extraction of granite in Brazil has been continuous, particularly in the states of Espírito Santo (ES) and Minas Gerais (MG). In the Northeast of MG, granite extraction comes from an impoverished rural area heavily affected by drought. The São Pedro River Valley is part of this rural area known as Sertão. Environmentally, over the last decades, studies revealed factors that have severely altered and compromised this unique and fragile biome called Caatinga (Quintão et al., 2017). Despite patent land destruction, water contamination and scarcity, coupled with rural communities’ distress, the effects of granite extraction in the São Pedro River Valley remain scientifically unknown. This case study addressed this research gap. Qualitative data originated from rural communities’ testimonies. Participants were subsistence farmers whose livelihoods directly depended on local natural resources. The data emanated from content-based unstructured focus groups comprising 25 individuals. Data analysis consisted of Freire’s pedagogical approach and In Vivo coding. Qualitative data was cross-referenced with a geological report consisting of a soil analysis and interpretation. This study also gathered insights from a local Research Associate (RA), recent images and video recordings of the area. To preserve the authenticity and integrity of participants’ unique environment and circumvent limitations set by the current worldwide Covid-19 pandemic, the data collection was conducted remotely. This case study provided an in-depth understanding of an economic activity that compromises the sustainability and equitability of the human-environmental balance in the São Pedro River Valley