Being differently abled: disability through the lens of hierarchy of binaries and Bitso-lebe-ke Seromo

Background: Despite its acceptability, the term disability has not been able to shirk the sense of incompleteness, lack, deprivation and incapacitation embodied in the prefix 'dis-'. The current wave of anti-discrimination on disability issues, calls for constant re-examination of the language and the appellations we use in respect of people with disabilities. Objectives: The aim of this study is to subject the term disability to some relevancy litmus test with a view to prevent it from acquiring Lyotard's 'grand narrative' and to propose and argue for the term 'differently abled' because of its transformative and anti-discriminatory slant. Method: The study took the form of a literature review using the optic of Derrida's hierarchy of binaries and the Sesotho proverb, 'Bitso-lebe-ke seromo', (A bad name is ominous) to explore the connotations of the term disability as a disenfranchising social construct. Results: Read through the lens of Derrida's idea of difference, disability as a concept has no inherent meaning and its meaning derives from its being differentiated from other concepts. Viewed through the lens of Bitso-lebe-ke seromo and read in the context of its deep symbolical significance, the term disability holds immense spiritual power. Conclusion: The study concludes that the term disability or disabled is exclusionary, stigmatizing, and anti-transformational. As such it embodies imperfection, incapacitation and inferiority. Not only is it ominous, it places upon people with disability the perpetual mark of unattractiveness. Against this background the term differently abled seems to convey more empowering overtones than the term disability

Atopic Patients Who Fulfilled Rome III Criteria for Irritable Bowel Syndrome Had Higher Animal Danders Sensitization

Background/Aims@#The relationship between animal exposure and irritable bowel syndrome (IBS) is debated. Epidemiological studies have shown that atopy is more prevalent in IBS patients and vice versa. We set out to examine the association between animal danders sensitization and IBS-like symptoms in atopic patients. @*Methods@#We recruited 69 consecutive atopic patients from the allergy clinic of a tertiary hospital. Subjects completed validated bowel questionnaires, underwent skin prick test, blood was collected for serum total immunoglobulin E, and ImmunoCAP immune solidphase allergen chip (ISAC) IgE multiplex assay. @*Results@#Twenty-eight (41.0%) atopic patients fulfilled the Rome III IBS criteria (atopy-IBS). There were no differences in gender, age, pet ownership, total serum IgE, or food allergen sensitization between atopy-IBS group and atopy-non-IBS group. We found that atopy- IBS group had significantly higher number of positive skin prick test for cat dander (64.3% vs 24.4%, P < 0.001), dog dander (64.3% vs 41.5%, P = 0.015) and weed pollens (32.1% vs 14.6%, P = 0.050) compared to atopy-non-IBS group. Out of 112 components from 51 allergen sources (both aeroallergen and food allergens), only Fel d1 (a major cat dander antigen) IgE is significantly higher in atopy-IBS group than atopy-non-IBS group (21.4% vs 2.4%, P = 0.029). Majority of atopy-IBS patients had mixed-type IBS. @*Conclusions@#We demonstrated an association between animal danders sensitization, in particular cat dander sensitization, and IBS-like symptoms in atopic patients. Future studies are needed to explore the relationship between aeroallergen and functional gastrointestinal disorders. Sensitization may be related to the pathophysiology of IBS or it could be that we are missing aeroallergen-induced gut allergy.

Treatment adherence and level of control in moderate persistent asthma in children and adolescents treated with fluticasone and salmeterol / Adesão ao tratamento e nível de controle da asma persistente moderada em crianças e adolescentes tratados com fluticasona e salmeterol

Abstract Objective: There is a scarcity of studies that assessed the association between adherence to combination therapy and asthma control in pediatric patients. The authors investigated the association between adherence to fluticasone propionate/salmeterol xinafoate combination-metered aerosol and the level of asthma control in children. Methods: This was a prospective observational study of 84 patients aged 5-16 years with moderate persistent asthma, who remained uncontrolled despite the use of 1000 µg/day of inhaled nonextrafine-hydrofluoric alkane-beclomethasone dipropionate in the three months prior to study enrollment. Participants were prescribed two daily doses of FP (125 µg)/salmeterol xinafoate (25 µg) combination by metered aerosol/spacer for six months. Adherence rates were assessed using the device's dose counter after the 2nd, 4th, and 6th months of follow up. Asthma control was assessed using a simplified Global Initiative for Asthma 2014 Report classification. Results: Mean adherence rates after the second, fourth, and sixth months were 87.8%, 74.9%, and 62.1% respectively, for controlled asthma, and 71.7%, 56.0%, and 47.6% respectively, for uncontrolled asthma (all p-values ≤ 0.03). The proportion of children achieving asthma control increased to 42.9%, 67.9% and 89.3% after the 2nd, 4th and 6th months of follow-up, respectively (p ≤ 0.001). Conclusion: Adherence rates between 87.8% in the 2nd month and 62.1% in the 6th month were strong determinants of asthma control.

Resumo Objetivo: São escassos os estudos que avaliaram a relação entre a taxa de adesão à combinação de proprionato de fluticasona/xinafoato de salmeterol e o nível de controle da asma na infância. O presente estudo teve como objetivo avaliar essa relação. Métodos: Estudo prospectivo observacional com 84 participantes, de 5 a 16 anos, todos eles com asma persistente moderada que permaneceram não controlados apesar do uso de 1.000 µg/dia de dipropionato de beclometasona em partículas não extrafinas nos três meses que antecederam a admissão no estudo. Os participantes receberam prescrição de 125 µg de propionato de fluticasona e 25 µg xinafoato de salmeterol através de inalador pressurizado, duas vezes ao dia, e foram avaliados após o 2°, 4° e 6° meses de tratamento. A taxa de adesão foi obtida por meio do contador analógico de doses incorporado ao inalador. A classificação do nível de controle da asma foi baseada numa simplificação das recomendações da Global Initiative for Asthma. Resultados: As taxas de adesão aos 2, 4 e 6 meses para a asma controlada foram 87,8%, 74,9% e 62,1% e para a asma não controlada de 71,7%, 56,0% e 47,6% (p ≤ 0,03), respectivamente. A proporção de pacientes com asma controlada elevou- se para 42,9%, 67,9% e 89,3% nas três avaliações subsequentes (p ≤ 0,001). Conclusões: Taxas de adesão entre 87,8% no 2° mês e de 62,1% no 6° mês foram determinantes para o nível de controle da asma.

Application of an Enzymatic Extract from Aspergillus niger as Coagulant for Cheddar Cheese Manufacture

Abstract The coagulation of milk by a serin protease from Aspergillus niger NRRL3 was studied by rheology. Cheddar-type cheese was manufactured using 3.5% (v/v) of fungal enzymatic extract and fermentation-produced chymosin was used as control coagulant. Full composition and ripening of both kinds of Cheddar cheese were studied. Differences in the proteolysis of caseins, not only during cheese manufacture but also during ripening, affected cheese composition, texture and peptide profile. Microbial development during ripening was not affected by the coagulant used.

Development of a Virtual Diabetes Register using Information Technology in New Zealand / 대한의료정보학회지

OBJECTIVES: The purpose of this study was to consider a Virtual Diabetes Registry System (VDR) and to investigate what it is and how it is used in New Zealand. New Zealand has specified diabetes mellitus (DM) as a national health priority. The Ministry of Health requires an accurate method for tracking the number of people with diagnosed with DM in the population. METHODS: We combined five national databases, all of which included a unique patient identifier: hospital admissions coded for DM, outpatient attendances for DM, DM retinal screening, prescriptions of specific anti-diabetic therapies, laboratory orders for HbA1c, as well as Primary Health Organisation (PHO) enrolments and national mortality. The algorithm was progressively modified to improve sensitivity and specificity, and it was validated against primary care registers. The algorithm was still being used in 2014. RESULTS: The prevalence of diagnosed diabetes in New Zealand at December 31, 2009 was 189,256 (4.4% of whole population). The VDR is now used to determine the official diagnosed diabetes prevalence in New Zealand; it is also used to determine the denominator of the health targets that the Ministry of Health should achieve for diabetes service indicators in New Zealand. CONCLUSIONS: This method appears to be superior to any other practicable national survey and to be both accurate and robust. The VDR has become an invaluable tool for monitoring prevalence and the policy making process, and for supporting clinical quality improvement.

Understanding the Rise in Cardiovascular Diseases in Africa : Harmonising H3Africa Genomic Epidemiological Teams and Tools : Cardiovascular Topic

Cardiovascular diseases; principally ischaemic heart disease and stroke; are the leading causes of global mortality and morbidity. Together with other non-communicable diseases; they account for more than 60 of global deaths and pose major social; economic and developmental challenges worldwide. In Africa; there is now compelling evidence that the major cardiovascular disease (CVD) risk factors are on the rise; and so are the related fatal and non-fatal sequelae; which occur at significantly younger ages than seen in high-income countries. In order to tackle this rising burden of CVD; the H3Africa Cardiovascular Working Group will hold an inaugural workshop on 30 May 2014 in Cape Town; South Africa. The primary workshop objectives are to enhance our understanding of the genetic underpinnings of the common major CVDs in Africa and strengthen collaborations among the H3Africa teams and other researchers using novel genomic and epidemiological tools to contribute to reducing the burden of CVD on the continent

Development of a lung cancer vaccine by transfecting dendritic cells with rAAV/CEA / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the feasibility of preparing a therapeutic lung cancer vaccine by transfecting dendritic cells (DCs) with adeno-associated virus vector carrying carcino-embryonic antigen gene (rAAV/CEA).</p><p><b>METHODS</b>Adherent cells (monocytes) isolated from the peripheral blood of a healthy donor were infected with rAAV/CEA virus stock or pulsed with CEA peptide (control). The monocytes in both groups were induced into mature DCs with recombinant human GM-CSF, IL-4 and TNF-α. At day 7 of induction, the mature DCs were harvested and mixed with T lymphocytes. T cell proliferation stimulated by the DCs was assessed with (3)H-thymidine uptake, and the expression of IL-4, IFN-γ, CD8, CD4, CD25 and CD69 in cytotoxic T lymphocytes (CTL) was analyzed with flow cytometry. The cytotoxicity of the CTL against the target CEA-positive lung cancer A549 cells was tested by (51)Cr releasing assay.</p><p><b>RESULTS</b>The DCs transfected with rAAV/CEA strongly stimulated the proliferation of the T cell populations, and the induced CTL showed high expressions of CD8, CD69 and IFN-γ. The transfected DCs exhibited a high killing ability of CEA-positive lung cancer cells, and the killing showed a CEA antigen specificity and was limited by MHC I. These results suggested the ability of rAAV/CEA-transfected DCs in generating specific cellular immunity in vitro.</p><p><b>CONCLUSION</b>It is feasible to prepare therapeutic lung cancer vaccines by transfecting DCs with rAAV/CEA.</p>

Radiological outcome of short segment posterior stabilisation and fusion in thoracolumbar spine acute fracture

<p><b>INTRODUCTION</b>The optimal management of thoracolumbar spine fractures remains a matter of controversy. The current literature implies that the use of short-segment pedicle screw fixation may be inappropriate because of its high reported failure rate. The purpose of this study is to report the short-term results of thoracolumbar burst and compression fractures treated with short-segment pedicle instrumentation.</p><p><b>MATERIALS AND METHODS</b>From 2002 to 2007, 19 patients with thoracolumbar acute traumatic fractures were instrumented with posterior short-segment pedicle screws. The patients' case notes, operation records, preoperative and postoperative radiographs (sagittal index, anterior body compression and regional kyphosis), computed tomography scans, neurological findings (Frankel functional classification), and follow-up records up to 18 months were reviewed.</p><p><b>RESULTS</b>A statistically significant difference was found between the patients' preoperative, postoperative and follow-up sagittal index, anterior body compression and regional kyphosis measurement. One case resulted in screw pedicle screw pullout and subsequently, kyphotic deformity. The patient underwent revision surgery to long-segment posterior instrumentation and fusion. None of the patients showed an increase in neurological deficit.</p><p><b>CONCLUSION</b>In conclusion, the short-term follow-up results suggest a favourable outcome for short-segment instrumentation. Load shearing classification is essential for the selection of patient for short-segment instrumentation. However, the long-term follow-up evaluation will be needed to verify our findings.</p>

Effects of two different antigen-loading methods on the activity of dendritic cell vaccine for colorectal carcinoma cell inhibition in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the changes in the activity of dendritic cells (DCs) after carcino-embryonic antigen (CEA) gene transfection mediated by recombinant adeno-associated virus type2 (rAAV) and tumor cell lysate.</p><p><b>METHODS</b>Immature DCs isolated from peripheral blood monocytes of HLA-A11-positive healthy volunteers were infected with the rAAV carrying CEA gene or loaded with tumor cell lysate. The surface markers of the DCs such as CD40, CD 1alpha, and CD86 were analyzed by flow cytometry. Interleukin-12 (IL-12) in the supernatants of DCs and interferon-gamma (IFN-gamma) released by the cytotoxic T lymphocytes (CTLs) were determined by ELISA detection kit. The specific killing activity of CTL against LoVo cells was assessed by MTT assay.</p><p><b>RESULTS</b>The DCs following antigen loading with the two methods both highly expressed CD40, CD86 and IL-12, and induced specific CTL that specifically recognized and killed LoVo cells, but the killing effect resulting from rAAV infection of the DCs was much better than that induced by tumor cell lysate loading.</p><p><b>CONCLUSION</b>Both methods of antigen loading can induce mature DCs from peripheral blood monocyte cells, but rAAV infection of the DCs can be more effective than tumor cells lysate loading. DCs infected with rAAV may have the potential to serve as an adjuvant immunotherapy for patients with colorectal carcinoma.</p>

Translational control of ceruloplasmin gene expression: Beyond the IRE

Translational control is a common regulatory mechanism for the expression of iron-related proteins. For example, three enzymes involved in erythrocyte development are regulated by three different control mechanisms: globin synthesis is modulated by heme-regulated translational inhibitor; erythroid 5-aminolevulinate synthase translation is inhibited by binding of the iron regulatory protein to the iron response element in the 5'-untranslated region (UTR); and 15-lipoxygenase is regulated by specific proteins binding to the 3'-UTR. Ceruloplasmin (Cp) is a multi-functional, copper protein made primarily by the liver and by activated macrophages. Cp has important roles in iron homeostasis and in inflammation. Its role in iron metabolism was originally proposed because of its ferroxidase activity and because of its ability to stimulate iron loading into apo-transferrin and iron efflux from liver. We have shown that Cp mRNA is induced by interferon (IFN)-ã in U937 monocytic cells, but synthesis of Cp protein is halted by translational silencing. The silencing mechanism requires binding of a cytosolic inhibitor complex, IFN-Gamma-Activated Inhibitor of Translation (GAIT), to a specific GAIT element in the Cp 3'-UTR. Here, we describe our studies that define and characterize the GAIT element and elucidate the specific trans-acting proteins that bind the GAIT element. Our experiments describe a new mechanism of translational control of an iron-related protein and may shed light on the role that macrophage-derived Cp plays at the intersection of iron homeostasis and inflammation.

Huli oral health

The Tari oral health study was conducted in 1985 and aimed to provide an oral health profile of a rural highlands community. The sample was selected from the database of the Tari Research Unit, Southern Highlands Province, Papua New Guinea and consisted of 815 Huli people aged from 3 to 64 years, in seven age groups, who were examined for oral health status and had completed an interview-questionnaire. A wide range of oral health status was seen, ranging from excellent to very poor. Dental caries and periodontal disease were common in the population. Oral habits such as smoking and betelnut chewing were associated with an increase in leukoplakia, which may lead to oral cancer in some people. Dental caries varied in prevalence and severity. Higher decayed, missing and filled teeth scores in the primary teeth of young children were associated with defective tooth formation (hypoplasia) linked to maternal and childhood illnesses and nutritional deficiencies. Older adults had the worst oral health, with the 45-64 year old group having a caries prevalence of 95% and a decayed, missing and filled teeth score of 14.7. Root surface caries, seen as a consequence of poor oral hygiene and gum recession, was the major site of caries attack in the older Hull. The public oral health services are unable to reach a large proportion of the rural population, and people continue to use traditional herbal and folk remedies. Many seek the skills of local tooth extractors who use six-inch nails with no anaesthetic.

Clinicopathological profile of Wilms' tumor.

The profile of renal tumors in children less than 15 years of age during the period 1991-1997 is presented. Among the 37 children with kidney tumors, 29 (78.4%) had Wilms' tumor. There was also a 20-year-old female with Wilms' tumor. The median age at presentation was 2.6 years (range 2.5 months to 20 years). 66.7% of the cases diagnosed were < or = 3 years and 90% were < or = 6 years. Five cases were under one year of age. The male to female ratio was 2:1. Twenty-two cases (73.3%) were triphasic and 7 (23.3%) were biphasic. Only one case was monophasic with blastemal component. Five cases (16.7%) showed nephrogenic rests in the uninvolved renal parenchyma and one case had nephroblastomatosis. The tumor was favorable in 26 cases (86.7%) and unfavorable in 4. Fourteen cases were in-patients while 16 were outside referrals. The pathological (10 cases whose specimens were sent from other centers) and clinicopathological (13 hospitalized patients) staging showed 10 cases (43.5%) with stage 1, 4 cases (17.4%) with stage 2, and 7 cases (30.4%) with stage 3. In two cases (8.7%), there was stage 4 disease. The length of the follow-up period in the 13 hospitalized patients ranged from 7 days to 5 years 5 months (median 14 months). There was one recurrence and one death after 2 years of diagnosis.

Laparoscopía en ginecología / Laparoscopy in gynecology

Se presenta la experiencia con laparoscopia y Cirugía Ginecológica Translaparoscópica del Servicio de Ginecología, Mastología y Reproducción del Hospital Francés de Buenos Aires, entre los años 1975 y 1995. El tiempo de estudio se subdivide en tres etapas: 1975/1980; 1981/1992 y 1992/1995, mostrando el incremento en el uso de esta metodología diagnóstica y terapéutica. Se describe la técnica laparoscópica con el equipamiento que se cuenta para su realización, así como los gestos quirúrgicos endoscópicos básicos, como son diéresis, hemostasia, suturas. Se describen las indicaciones y técnicas quirúrgica de 544 cirugías ginecológicas translaparoscópicas reazlizadas entre 1992 y 1995, como ser salpingectomía, sapingostomía, miomectomía, histerectomía vaginal asistidas translaparoscópica, colposuspensión de Burch, linfadenectomía pelviana, etc. Se analizan los resultados de la evolución postoperatoria y se revisan las complicaciones del método. Se concluye con la importancia que el método ha adquirido en la práctica quirúrgica entre equipamiento, entrenamiento y enfermedad para obtener el éxito de la Cirugía. Se plantea el futuro de este tipo de cirugía especialmente con los resultados a largo plazo que deben esperarse, especialmente en cirugías oncoloógicas

Imaginando e raciocinando dedutivamente: um estudo entre crianças / Imagining and reasoning deductively: a survey among children

Dias e Harris (1988a, b) sugerem que qualquer instruçäo que incentive a ativaçäo da imaginaçäo, ajuda as crianças a criar um mundo mental, o qual podem, temporariamente, considerar como verdadeiro e usar como base para raciocinar dedutivamente, mesmo que este mundo vá de encontro aos seus conhecimentos empíricos. Neste estudo, averigua se cada uma dessas variáveis é realmente efetiva em ajudar o raciocínio das crianças com problemas silogísticos cujo conteúdo vai de encontro à experiência diária. Os sujeitos säo 48 crianças de 4 a 5 anos e 6 meses, que frequentam o maternal de duas escolas do 1§ grau menor na cidade de Oxford, Inglaterra. Apresenta às crianças, problemas em uma dentre oito condiçöes. Estas condiçöes foram derivadas de cada possível combinaçäo das seguintes variáveis: referência ou näo a um planeta de faz-de-conta, instruçäo ou näo para o uso de imagens visuais, uso ou näo de entonaçäo de voz de contar histórias. Os dados apontam que apenas em uma condiçäo (sem referência a um planeta de faz-de-conta, sem instruçäo para uso de imagens mentais e entonaçäo de voz normal) o desempenho das crianças foi muito baixo. Elas ofereceram poucas respostas corretas e poucas justificativas teóricas, recorrendo em geral às justificativas arbitrárias e empíricas. Nas demais condiçöes, o desempenho das crianças foi bom e as justificativas teóricas ocorreram frequentemente. Os resultados indicam que a adiçäo de uma das variáveis - ou o uso da instruçäo com planeta, ou imaginaçäo, ou uma entonaçäo de faz-de-conta é suficiente para fazer com que as crianças raciocinem dedutivamente

Regras morais e convencionais no raciocínio de crianças / Moral and conventional rules in children reasoning

Uma apresentaçäo de brincadeira de faz-de-conta pode ser usada para induzir crianças a criarem um mundo independente, onde os eventos podem ocorrer diferentemente daqueles do mundo empírico, facilitando assim a ocorrência de raciocínio dedutivo com base em premissas contrárias aos fatos (Dias e Harris, 1988a, b, c; no prelo a e b). Analisou-se entäo, se a criaçäo deste mundo de faz de conta proporciona o mesmo efeito em problemas silogísticos que contêm premissas contrárias aos domínios morais ou convencionais. Os resultados mostram que, em nenhuma das três amostras estudadas (crianças brasileiras e inglesas de NSE médio, e crianças brasileirs de orfanatos), houve distinçäo entre regras morais e convencionais como encontrado por Turiel (1983). O contexto de brincadeira favoreceu, como nos estudos anteriores, o desempenho das crianças inglesas e brasileiras de NSE médio. No entanto, as crianças brasileiras de orfanatos raciocinaram similarmente em ambos os contextos, como acontece quando o conteúdo dos problemas está de acordo com a experiência dos sujeitos (ver Hawkins, Pea, Glick & Scribner, 1984; Dias e Harris, 1988a, c). Para estas crianças, afirmaçöes que representam violaçöes de regras morais,convencionais ou empíricas para as outras amostras, pareciam ser aceita como verdades empíricas, facilitando seu desempenho mesmo em problemas apresentados verbalmente, sem necessidade do contexto de brincadeira

O efeito da brincadeira de "faz-de-conta" no raciocínio dedutivo / The effect of the \"make believe\" in the deductive reasoning

Um modo de raciocínio dedutivo ou "teórico" é difícil de ser elicitado em crianças. Neste estudo, perguntamos se um contexto de "faz-de-conta" ajudaria crianças de cinco a seis anos de idade a exibir tal raciocínio, mesmo em problemas silogísticos, cujo conteúdo fosse contrário ao conhecimento prático das crianças. As premissas foram apresentadas dentro de um contexto de brincadeira de "faz-de-conta", usando brinquedos e representaçäo, ou em um modo verbal comum. O desempenho das crianças na apresentaçäo da brincadeira de "faz-de-conta" foi mais dedutivo ou 'teórico' que na apresentaçäo em um modo verbal padräo, particularmente quando os problemas incluíam fatos contrários a experiência prática das crianças em suas premissas