2,637 research outputs found

    Perioperative Goal-Setting Consultations by Surgical Colleagues: A New Model for Supporting Patients, Families, and Surgeons in Shared Decision Making

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    Patients with postoperative complications are often subjected to prolonged life-sustaining treatment based on erroneous assumptions about their goals of care. Shared decision making is an evidence-based approach that helps ensure patients’ wishes and values are honored in their course of treatment. Perioperative palliative care can help create goal-concordant trajectories of care for high risk, seriously ill, or complicated patients, through sophisticated prognostication, higher-level communication, and recommendations based on the best available evidence and patients’ stated goals and priorities. Here, we present a surgeon-to-surgeon consultative model that surmounts many barriers to perioperative palliative care consultation and, as illustrated in the cases presented herein, offers profound and unique benefits for patients, families, and surgeons alike. While the support of a surgical colleague with palliative care skills can be helpful postoperatively in the setting of unanticipated outcomes or prolonged recovery, it is particularly beneficial when accessed preoperatively for the purposes of goal-concordant decision making and advance care planning. We encourage both individuals and professional societies to develop and expand the niche for surgeons interested in assisting with goal setting and shared decision making for patients on a consultative basis, particularly in the preoperative period

    CaMKII-dependent SR Ca leak contributes to doxorubicin-induced impaired Ca handling in isolated cardiac myocytes

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    Doxorubicin (DOX) is one of the most effective chemotherapeutic agents, but cardiotoxicity limits DOX therapy. Although the mechanisms are not entirely understood, reactive oxygen species (ROS) appear to be involved in DOX cardiotoxicity. Ca/calmodulin dependent protein kinase II (CaMKII) can be activated by ROS through oxidation and is known to contribute to myocardial dysfunction through Ca leakage from the sarcoplasmic reticulum (SR). We hypothesized that CaMKII contributes to DOX-induced defects in intracellular Ca ([Ca](i)) handling. Cardiac myocytes were isolated from wild-type (WT) adult rat hearts and from mouse hearts lacking the predominant myocardial CaMKII delta(-/-), KO) vs. WT. Isolated cardiomyocytes were investigated 30 min after DOX (10 mu mol/L) superfusion, using epifluorescence and confocal microscopy. Intracellular ROS-generation ([ROS](i)) and [Ca](i) handling properties were assessed. In a subset of experiments, KN-93 or AIP (each 1 mu mol/L) were used to inhibit CaMKII. Melatonin (Mel, 100 mu mol/L) served as ROS-scavenger. Western blots were performed to determine the amount of CaMKII phosphorylation and oxidation. DOX increased [ROS](i) and led to significant diastolic [Ca](i) overload in rat myocytes. This was associated with reduced [Ca](i) transients, a 5.8-fold increased diastolic SR Ca leak and diminished SR Ca content. ROS-scavenging partially rescued Ca handling. Western blots revealed increased CaMKII phosphorylation, but not CaMKII oxidation after DOX. Pharmacological CaMKII inhibition attenuated diastolic [Ca](i) overload after DOX superfusion and led to partially restored [Ca](i) transients and SR Ca content, presumably due to reduced Ca spark frequency. In line with this concept, isoform-specific CaMKII delta-KO attenuated diastolic [Ca](i) overload and Ca spark frequency. DOX exposure induces CaMKII-dependent SR Ca leakage, which partially contributes to impaired cellular [Ca](i) homeostasis. Pharmacological and genetic CaMKII inhibition attenuated but did not completely abolish the effects of DOX on [Ca](i). In light of the clinical relevance of DOX, further investigations seem appropriate to determine if CaMKII inhibition could reduce DOX-induced cardiotoxicity. (C) 2011 Elsevier Ltd. All rights reserved

    'The cracked mirror': Anne Sexton's poetics of self-representation

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    This thesis re-evaluates the work of the poet Anne Sexton (1928-1974), concentrating, in particular, on the indeterminacies, contradictions and aporia which it finds to be characteristic of her ostensibly frank and self-revelatory writing. The study is based on a close textual analysis of Sexton's writing, is informed by oststructuralist theories, and is sustained by an examination and discussion of archive collections of her previously unpublished papers. In seeking an understanding of Sexton's poetics, the thesis identifies and interrogates the strategies of denial and obfuscation apparent in her own explication of her work - principally, by scrutiny of the unpublished, and previously unresearched, drafts of a series of lectures which she delivered in 1972. Chapters One and Two consider the origins of `confessional' or - Sexton's preferred term - 'personal' poetry and reassess her place within contemporary poetry. They suggest that Sexton's writing is engaged in a process of negotiation and contestation, both with the boundaries and expectations of confessionalism, and with the strictures of T. S. Eliot's theory of `impersonality'. In support of these arguments, Chapter Two offer a reading of Sexton's little-known poem, `Hurry Up Please It's Time', alongside its intertext, Eliot's The Waste Land. Chapter Three reassesses received views of the supposedly beneficial interrelationship between confessional speaker and reader. It examines Sexton's appropriation of dramatic masks and personae and her use of metaphors of striptease and prostitution, and suggests that these are employed simultaneously to appease and to repel an intrusive audience. Similarly, Chapters Four and Five trace Sexton's problematisation of two previously-accepted tenets of confessional poetry: its status as autobiography and its truthfulness, drawing attention to the techniques employed in order to give the impression of both. Chapter Six considers Sexton's problematic engagement with a language which is not malleable, transparent, and referential but, rather, is experienced as uncooperative and occlusive. Finally, the thesis recuperates Sexton from the common charge of narcissism, arguing that it is the writing, rather than the poet, which is self-reflexive and self-conscious. In this respect, it concludes that her work - perhaps unexpectedly - anticipates many of the tendencies of postmodernist writing

    Interview: Anne-Marie Fortier

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    This paper is an edited version of an email interview conducted by Debra Ferreday and Adi Kuntsman with Anne-Marie Fortier, the author of Multicultural Horizons: Diversity and the Limits of the Civil Nation (Routledge, 2008). Fortier’s work has been informative in the development of some of the arguments explored in this special issue; in their conversation Ferreday and Kuntsman asked her to comment on the ideas of haunting, racial imaginaries, nostalgia, national anxieties, political feelings and hopes for the future

    Anne Moody History Project Recognized by the Mississippi Department of Corrections: Warden and Staff Praised for Work Honoring Anne Moody, author of Coming of Age in Mississippi

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    Copyright (c) 2019 by Roscoe Barnes III#AnneMoodyThis is a news report about the retirement of Warden Jody Bradley and the praise he and his staff received for their work at Wilkinson County Correctional Facility (WCCF), Woodville, Miss. Commissioner Pelicia E. Hall of the Mississippi Department of Corrections (MDOC) honored Bradley with a letter of congratulations. In that same letter, she commended him and his team for their work with the Anne Moody History Project (AMHP). AMHP is a staff-led community service endeavor created to promote and help preserve the legacy of civil rights pioneer Anne Moody, author of Coming of Age in Mississippi.To learn more about Anne Moody, see her research page here: http://roscoereporting.blogspot.com/p/anne-moody.html#ComingOfAgeinMississippi</div

    Consumption Growth and Agricultural Shocks in Rural Madagascar

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    The aim of this paper is to evaluate the effect of rainfall and agricultural shocks on consumption growth in Madagascar. We are also interested in the impact of local endowments in infrastructures and social services on consumption growth. To achieve this goal, a micro model of household consumption growth is estimated thanks to household panel data collected by the Reseau des Observatoires Ruraux (ROR) between 1999 and 2004. Additional data sources include the 2001 communes census organized by the Ilo program of Cornell University. Altogether these different data sources make an unusually rich data set, at least when considered with developing country standards. We use panel data fixed effect estimation technique to remove unobserved household and community level time invariant heterogeneity. We find that production shocks have a substantial impact on consumption growth and we find sign of persistence of rainfall shocks. Roads and education seems to improve household’s consumption growth and remotness decreases it.risks, growth, poverty, Food Security and Poverty,

    Interactive Computing and Causality

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    @inproceedings{ci-nicolle-2006, author = {Nicolle, Anne}, title = {Interactive Computing and Causality}, booktitle = {i-C&P, computers and philosophy, an international conference}, year = {2006}, address = {Laval}, month = {mai}, note = {8 p. à paraître}, country = {FR} }International audienc

    Fifty Years of Training String Teachers on the UT Austin Campus: An Interview with Phyllis Young

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    To commemorate the fiftieth anniversary of the University of Texas String Project, Anne Witt spoke with Phyllis Young, who served as the String Project director from 1958 to 1993. Phyllis Young teaches cello and string pedagogy at the University of Texas at Austin, where she holds the Parker C. Fielder Regents Professorship in Music. She was the first female president of ASTA, from 1978 through 1980, and is the author of The String Play, published by the University of Texas Press, and Playing the String Game, published by Shar Publications. The following comments are those of Phyllis Young, recorded during her interview with Anne Witt in the spring of 1998. </jats:p
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