Negotiating the boundaries of the medical model: Experiences of people with epilepsy.

People with epilepsy (PWE) continually report dissatisfaction with the support they receive, particularly in regard to their psychological wellbeing. With its focus on optimal seizure control, epilepsy treatment is entrenched in the medical model of illness, despite growing evidence of the broader psychosocial impact of the condition. This study aimed to explore how PWE experience healthcare in the context of their lives.

Epilepsy, identity, and the experience of the body.

Living with a chronic condition can challenge a person's identity, yet there is a paucity of research exploring this experience for people with epilepsy and particularly for those diagnosed in adulthood. Consequently, through an interpretative phenomenological approach, the current study aimed to explore what the experience of adult-onset epilepsy meant for a person's identity. Thirty-nine people with adult-onset epilepsy from across the UK took part in up to two semi-structured interviews.

Genetic Research Using Archival Tissue: Ethical, Social, and Legal Considerations in the United Arab Emirates.

Pathological archival tissue has been used as a source of research material for many years. The advancement in molecular techniques led to an escalated interest in genetic research on archival tissue. Research on archival tissue has been used without obtaining consents from patients, although the ethical justification for such a practice is unlikely to apply for genetic research that involves whole genome sequencing, for instance.

The experience of living with adult-onset epilepsy.

The incidence and prevalence of adults diagnosed with epilepsy is higher compared to those diagnosed in childhood, yet the experience of living with adult-onset epilepsy has rarely been examined. Hence, the current study took a phenomenological approach to examining the experience of living with epilepsy following diagnosis in adulthood. Semi-structured interviews were conducted with 39 people from across the UK, diagnosed with epilepsy between the ages of eighteen and sixty, at two points in time, six months apart.

Reflections on leadership.

Webster's dictionary offers numerous synonyms and related words for the word lead; the list includes words such as chief, commanding, first, foremost, high, preeminent, controlling, directing, reigning, sovereign, and superior. Some individuals (perhaps too many) in positions of authority rely very heavily on characteristics associated with these terms. Abusive leaders exploit their power and "lead" through intimidation and their ability to withhold rewards and distribute punishment.

Treatment decision making in breast cancer: a longitudinal exploration of women's experiences.

Objectives: To explore the lived experience of breast cancer in relation to the treatment decision-making process over time.

Design: Adopting a hermeneutic phenomenological approach, semi-structured interviews were undertaken at three points in time during the year following diagnosis.

Methods: After ethical approval had been obtained, 20 women who were recently diagnosed with breast cancer were recruited from a Symptomatic Breast Cancer Unit in the North East of England.

Environmental scanning: allied health leaders' selection of strategic information.

In environmental scanning, deans and directors of allied health units face the task of making sense of volumes of information from their internal and external environments. A study was conducted to detail the information processing of 108 allied health deans and directors of institutional members of the Association of Schools of Allied Health Professions. The study was a survey that included basic demographic questions and two scenarios, each representing a strategic situation.

Effect of ingested interferon-alpha on beta-cell function in children with new-onset type 1 diabetes.

Objective: To evaluate the safety and efficacy of ingested human recombinant interferon-alpha (hrIFN-alpha) for preservation of beta-cell function in young patients with recent-onset type 1 diabetes.

Research Design And Methods: Subjects aged 3-25 years in whom type 1 diabetes was diagnosed within 6 weeks of enrollment were randomly assigned to receive ingested hrIFN-alpha at 5,000 or 30,000 units or placebo once daily for 1 year. The primary outcome was change in C-peptide secretion after a mixed meal.

"Maybe it could be a heart attack . . . but i'm only 31": Young men's lived experience of myocardial infarction--an exploratory study.

This study examines the lived experience of myocardial infarction (MI) in younger men. Seven men, aged between 32 and 58, all of whom had suffered MI within the previous 12 months, were interviewed. Thematic analysis of the interview transcripts revealed four main themes.

'Nobody likes a back bore'--exploring lay perspectives of chronic pain: revealing the hidden voices of nonservice users.

Chronic pain is pain that persists beyond 12 weeks or that lasts beyond the expected duration of healing. The chronic pain sufferer also often experiences associated anxiety, depression and stress. An exploratory qualitative approach was adopted by the authors to explore what it is like to live with chronic pain from a sample of people who had not accessed secondary or tertiary health services.

'Why can't they do anything for a simple back problem?' A qualitative examination of expectations for low back pain treatment and outcome.

In order to examine expectations for pain treatment and outcome and to determine whether they are influential in maintaining health service consumption 16 adults suffering from chronic pain were interviewed. Transcripts were subjected to thematic analysis. The six main themes to emerge were labelled: Unmet Expectations; Health Professionals; the Importance of Self; Getting Something Done; Back to Square One; and Perceptions of the Future with Ruminations on the Past.

Persistent clusters of mortality in the United States.

We explored how place shapes mortality by examining 35 consecutive years of US mortality data. Mapping age-adjusted county mortality rates showed both persistent temporal and spatial clustering of high and low mortality rates. Counties with high mortality rates and counties with low mortality rates both experienced younger population out-migration, had economic decline, and were predominantly rural.

Short-term prospective memory deficits in chronic back pain patients.

Objective: Chronic pain, particularly low back pain, is widespread. Although a great deal is known about the impact that this has on quality of life and physical activity, relatively little has been established regarding the more cognitive effects of pain. This study aims to find out whether individuals with chronic pain experience memory deficits in prospective memory (PM), the process of remembering to do things at some future point in time.

Connecting allied health students to rural communities.

Context: Statewide studies indicate a continuing shortfall of personnel in several allied health disciplines in rural Georgia. National trends indicate lagging enrollment in allied health education programs, suggesting that the workforce shortages will worsen.

Purpose: This article describes the efforts of the School of Allied Health Sciences at the Medical College of Georgia to increase allied health student participation in interdisciplinary health care services in rural areas of the state during fiscal years 2001-2003.

Prior elevation of IL-18 promotes rapid early IFN-gamma production during staphylococcal infection.

Systemic Staphylococcus aureus infection is associated with significant morbidity and mortality arising from both bacterial and host immune factors. IL-18 is a pro-inflammatory cytokine of the IL-1 superfamily that exhibits broad functional effects in innate and acquired immune responses and which has been found in high levels in several chronic inflammatory and autoimmune diseases. Over-expression of IL-18 may promote early resolution of infection or could promote a detrimental exaggerated immune response.

A brief visual primer for the mapping of mortality trend data.

Maps are increasingly used to visualize and analyze data, yet the spatial ramifications of data structure are rarely considered. Data are subject to transformations made throughout the research process and then used to map, visualize and conduct spatial analysis. We used mortality data to answer three research questions: Are there spatial patterns to mortality, are these patterns statistically significant, and are they persistent across time? This paper provides differential spatial patterns by implementing six data transformations: standardization, cut-points, class size, color scheme, spatial significance and temporal mapping.

Detection of cytoplasmic CD antigens within normal human peripheral blood leucocytes.

Polymorphonuclear neutrophils (PMNs) are capable of synthesizing various pro-inflammatory cytokines which may indirectly influence specific immune responses. PMNs may also have the capacity to present foreign peptides to helper T cells (Th cells). In support of this hypothesis, recent studies have shown that neutrophils, when activated by the correct combination of cytokines, can be induced to express cell surface major histocompatibility complex (MHC) Class II (DR) antigen, CD80 (B7.

A novel anti-inflammatory role for simvastatin in inflammatory arthritis.

3-Hydroxy-3-methylglutaryl-CoA reductase inhibitors (statins) exert favorable effects on lipoprotein metabolism, but may also possess anti-inflammatory properties. Therefore, we explored the activities of simvastatin, a lipophilic statin, in a Th1-driven model of murine inflammatory arthritis. We report in this study that simvastatin markedly inhibited not only developing but also clinically evident collagen-induced arthritis in doses that were unable to significantly alter cholesterol concentrations in vivo.

CD4+CD25+ regulatory T cells suppress differentiation and functions of Th1 and Th2 cells, Leishmania major infection, and colitis in mice.

Regulatory T cells play a major role in modulating the immune response. However, most information on these cells centers on autoimmunity, and there is also considerable controversy on the functional characteristics of these cells. Here we provide direct in vitro and in vivo evidence that CD4+CD25+ regulatory T cells inhibit the differentiation and functions of both Th1 and Th2 cells.

Nitric oxide preferentially induces type 1 T cell differentiation by selectively up-regulating IL-12 receptor beta 2 expression via cGMP.

Nitric oxide plays an important role in immune regulation. We have shown that although high concentrations of NO generally were immune-suppressive, low concentrations of NO selectively enhanced the differentiation of T helper (Th)1 cells but not Th2 cells. This finding provided an explanation for the crucial role of NO in defense against intracellular pathogens.

Colony-stimulating factor-1 suppresses responses to CpG DNA and expression of toll-like receptor 9 but enhances responses to lipopolysaccharide in murine macrophages.

During bacterial infections, the balance between resolution of infection and development of sepsis is dependent upon the macrophage response to bacterial products. We show that priming of murine bone marrow-derived macrophages (BMMs) with CSF-1 differentially regulates the response to two such stimuli, LPS and immunostimulatory (CpG) DNA. CSF-1 pretreatment enhanced IL-6, IL-12, and TNF-alpha production in response to LPS but suppressed the same response to CpG DNA.