McArdle disease: a unique study model in sports medicine

McArdle disease is arguably the paradigm of exercise intolerance in humans. This disorder is caused by inherited deficiency of myophosphorylase, the enzyme isoform that initiates glycogen breakdown in skeletal muscles. Because patients are unable to obtain energy from their muscle glycogen stores, this disease provides an interesting model of study for exercise physiologists, allowing insight to be gained into the understanding of glycogen-dependent muscle functions. Of special interest in the field of muscle physiology and sports medicine are also some specific (if not unique) characteristics of this disorder, such as the so-called 'second wind' phenomenon, the frequent exercise-induced rhabdomyolysis and myoglobinuria episodes suffered by patients (with muscle damage also occurring under basal conditions), or the early appearance of fatigue and contractures, among others. In this article we review the main pathophysiological features of this disorder leading to exercise intolerance as well as the currently available therapeutic possibilities.

The Failure of American and British Propaganda in the Arab Middle East, 1945-1957: Unconquerable Minds

Vaughan, J. (2005). The Failure of American and British Propaganda in the Arab Middle East, 1945-1957: Unconquerable Minds. Basingstoke: Palgrave Macmillan. RAE2008

Propaganda by Proxy?: Britain, America, and Arab Radio Broadcasting, 1953-1957

Vaughn, James, ''Propaganda by Proxy': Britain, America and Arab Radio Broadcasting 1953-1957 ', Historical Journal of Film, Radio and Television (2002) 22(2) pp.157-172 RAE2008

‘Complementary & alternative medicine’ (CAM): ethical and policy issues

Editorial for Bioethics 2016. 30:(2)

Multimodal lexicography: The representation of meaning in electronic dictionaries

One finding of user studies is that information on meaning tends to be what diction¬ary users want most from their dictionaries. This is consistent with the traditional image of the dictionary as a repository of meanings of words, and this is also borne out in definitions of the item DICTIONARY itself as given in dictionaries. While this popular view has not changed much, the growing role of electronic dictionaries can change the lexicographers' approach to meaning repre¬sentation. Traditionally, paper dictionaries have explained words with words, using either a defi¬nition or an equivalent, and occasionally a line-drawn picture. However, a prominent feature of the electronic medium is its multimodality, and this offers potential for the description of meaning. While it is much easier to include pictorial content, electronic dictionaries can also hold media objects which paper cannot carry, such as audio, animation or video. Publishers are drawn by the attraction of these new options, but are they always functionally useful for the dictionary users? In this article, the existing evidence is examined, and informed guesses are offered where evidence is not yet available.

The Arab Spring as a Test of post-Lisbon Capabilities and Strategies of the European Union in North Africa

This study aims to present the conditions related to the European Union’s involvement in the Arab Spring, as well as examine the extent of this capability-based involvement in the first months of 2011 against the background of competence disputes between institutions and inter-governmental contentions. These considerations will be the basis for conclusions on the theoretical and practical viability of the European Union’s action in the region of North Africa, in terms of both interests defined in Brussels and representation of a jointly agreed position and undertaking practical actions in the international arena. These assumptions can facilitate a new perspective for the EU’s strategic approach framework in the region of North Africa.

Career choice in medicine

Background: Career Choice in Medicine is an important and problematic topic. Medical education has been framed as professional identity development, yet career choice has not been viewed as a matter of identity. My primary aim was to offer new insights by exploring career choice using Figured Worlds theory, a socio-cultural theory of identity. Graduate retention is a challenge for many countries, including Ireland. My secondary aim was to address a gap in the data on postgraduate trainees in Ireland and to use the Irish case to illustrate points transferable to other contexts. Methodology & Methods: This was a predominantly qualitative Mixed Methods programme of research. My qualitative studies were oriented towards social constructionism. I collated existing data from the Royal College of Physicians of Ireland (RCPI) and HSE-MET to describe trainees and their career paths. I surveyed Basic Specialist Training trainees (n=333) about their career plans. I surveyed new trainees (n=527) about their expectations of training and all RCPI trainees about their experiences of training (n=1246). I conducted semi-structured interviews with 18 medical students and doctors. A subgroup (n=6) provided longitudinal data. Figured Worlds theory and Gee’s discourse tools were used for analysis. Results: I have used the case of medical training and career choice in Ireland to explain how social, political and cultural context, and day to day experiences in the cultural world of medicine, shaped doctors’ career choices. My qualitative findings described a unifying model of career choice, consisting of priming, exposure, positioning and open-endedness, which can guide the design of interventions to shape and support career choice. Conclusion: My original contribution has been to demonstrate the fruitfulness of framing career choice in terms of identity development. This represents a turn in the conversation about career choice, which brings new starting points and moves the dialogue forward.

A strategy to advance the evidence base in palliative medicine: formation of a palliative care research cooperative group.

BACKGROUND: Palliative medicine has made rapid progress in establishing its scientific and clinical legitimacy, yet the evidence base to support clinical practice remains deficient in both the quantity and quality of published studies. Historically, the conduct of research in palliative care populations has been impeded by multiple barriers including health care system fragmentation, small number and size of potential sites for recruitment, vulnerability of the population, perceptions of inappropriateness, ethical concerns, and gate-keeping. METHODS: A group of experienced investigators with backgrounds in palliative care research convened to consider developing a research cooperative group as a mechanism for generating high-quality evidence on prioritized, clinically relevant topics in palliative care. RESULTS: The resulting Palliative Care Research Cooperative (PCRC) agreed on a set of core principles: active, interdisciplinary membership; commitment to shared research purposes; heterogeneity of participating sites; development of research capacity in participating sites; standardization of methodologies, such as consenting and data collection/management; agile response to research requests from government, industry, and investigators; focus on translation; education and training of future palliative care researchers; actionable results that can inform clinical practice and policy. Consensus was achieved on a first collaborative study, a randomized clinical trial of statin discontinuation versus continuation in patients with a prognosis of less than 6 months who are taking statins for primary or secondary prevention. This article describes the formation of the PCRC, highlighting processes and decisions taken to optimize the cooperative group's success.

ARAB MUSICIANS IN WASHINGTON, D.C. AREA: ETHNICITY AND IDENTITY

Musicians living in the Arab Diaspora around the Washington, D.C. metro area are a small group of multi-faceted individuals with significant contributions and intentions to propagate and disseminate their music. Various levels of identity are discussed and analyzed, including self-identity, group/ collective identity, and Arab ethnic identity. The performance and negotiation of Arab ethnic identity is apparent in selected repertoire, instrumentation, musical style, technique and expression, shared conversations about music, worldview on Arabic music and its future. For some musicians, further evidence of self-construction of one's ethnic identity entails choice of name, costume, and venue. Research completed is based on fieldwork, observations, participant-observations, interviews, and communications by phone and email. This thesis introduces concepts of Arabic music, discusses recent literature, reveals findings from case studies on individual Arab musicians and venues, and analyzes Arab identity and ethnicity in relation to particular definitions of identity found in anthropological and ethnomusicological writings. Musical lyrics, translations, transcriptions, quotes, discussions, analyses, as well as charts and diagrams of self-identity analyses are provided as evidence of the performance and negotiation of Arab identity.

The IGNITE network: a model for genomic medicine implementation and research.

BACKGROUND: Patients, clinicians, researchers and payers are seeking to understand the value of using genomic information (as reflected by genotyping, sequencing, family history or other data) to inform clinical decision-making. However, challenges exist to widespread clinical implementation of genomic medicine, a prerequisite for developing evidence of its real-world utility. METHODS: To address these challenges, the National Institutes of Health-funded IGNITE (Implementing GeNomics In pracTicE; www.ignite-genomics.org ) Network, comprised of six projects and a coordinating center, was established in 2013 to support the development, investigation and dissemination of genomic medicine practice models that seamlessly integrate genomic data into the electronic health record and that deploy tools for point of care decision making. IGNITE site projects are aligned in their purpose of testing these models, but individual projects vary in scope and design, including exploring genetic markers for disease risk prediction and prevention, developing tools for using family history data, incorporating pharmacogenomic data into clinical care, refining disease diagnosis using sequence-based mutation discovery, and creating novel educational approaches. RESULTS: This paper describes the IGNITE Network and member projects, including network structure, collaborative initiatives, clinical decision support strategies, methods for return of genomic test results, and educational initiatives for patients and providers. Clinical and outcomes data from individual sites and network-wide projects are anticipated to begin being published over the next few years. CONCLUSIONS: The IGNITE Network is an innovative series of projects and pilot demonstrations aiming to enhance translation of validated actionable genomic information into clinical settings and develop and use measures of outcome in response to genome-based clinical interventions using a pragmatic framework to provide early data and proofs of concept on the utility of these interventions. Through these efforts and collaboration with other stakeholders, IGNITE is poised to have a significant impact on the acceleration of genomic information into medical practice.

Epidemiological and nutrition transition in developing countries: impact on human health and development

Whereas common infectious and parasitic diseases such as malaria and the HIV/AIDS pandemic remain major unresolved health problems in many developing countries, emerging non-communicable diseases relating to diet and lifestyle have been increasing over the last two decades, thus creating a double burden of disease and impacting negatively on already over-stretched health services in these countries. Prevalence rates for type 2 diabetes mellitus and CVD in sub-Saharan Africa have seen a 10-fold increase in the last 20 years. In the Arab Gulf current prevalence rates are between 25 and 35% for the adult population, whilst evidence of the metabolic syndrome is emerging in children and adolescents. The present review focuses on the concept of the epidemiological and nutritional transition. It looks at historical trends in socio-economic status and lifestyle and trends in nutrition-related non-communicable diseases over the last two decades, particularly in developing countries with rising income levels, as well as the other extreme of poverty, chronic hunger and coping strategies and metabolic adaptations in fetal life that predispose to non-communicable disease risk in later life. The role of preventable environmental risk factors for obesity and the metabolic syndrome in developing countries is emphasized and also these challenges are related to meeting the millennium development goals. The possible implications of these changing trends for human and economic development in poorly-resourced healthcare settings and the implications for nutrition training are also discussed.