The Consequences of Not Looking at the Eosinophil Count: Pulmonary Infiltrates and Eosinophilia Syndrome (PIE) Probably Caused by Ciprofloxacin

Objectives: To describe a case of pulmonary infiltrates and eosinophilia (PIE syndrome) probably caused by ciprofloxacin. Materials and methods: A 64-year-old woman was admitted to our department with suspected hospital-acquired pneumonia and treated with antibiotics. She had no symptoms but had peripheral eosinophilia. She had recently been given ciprofloxacin for a urinary tract infection. Results: The patient spontaneously improved after exhaustive negative investigations. Conclusion: We concluded that this patient had PIE syndrome probably caused by ciprofloxacin.

Consequences of intercultural practices in Miguel Sousa Tavares' Equator

This article involves the analysis of a case-study, so I have chosen Equador by the Portuguese author Miguel Sousa Tavares. His book recreates the story of Sao Tome and Principe's people living under strict circumstances, while belonging to the Portuguese empire as one of its overseas' province. The forthcoming lines contain an approach to interculturality by analyzing these concrete circumstances. These lines also describe and study the differences between cultures - the Portuguese, as a European culture, and the Equatorial, as a colonized people's culture. The theme is old, but always relevant: the clash of value systems and the impossibility of forcibly overlaying one society on another. Slavery has existed as a common practice in most civilizations throughout history, based upon the superiority of a human being towards another. In socially hierarchized communities slavery was a major principle, almost a need. That way, some would benefit from exuberating privileges but many others only from hard working and giving their freedom up to be mistreated instead. In order to have a socially structured community, they were to be seriously and consciously neglected.

Studying the Causes and Consequences of Internal Labor Migration Using Survey and Administrative Data Sources

This dissertation comprises three chapters. The first chapter motivates the use of a novel data set combining survey and administrative sources for the study of internal labor migration. By following a sample of individuals from the American Community Survey (ACS) across their employment outcomes over time according to the Longitudinal Employer-Household Dynamics (LEHD) database, I construct a measure of geographic labor mobility that allows me to exploit information about individuals prior to their move. This enables me to explore aspects of the migration decision, such as homeownership and employment status, in ways that have not previously been possible. In the second chapter, I use this data set to test the theory that falling home prices affect a worker’s propensity to take a job in a different metropolitan area from where he is currently located. Employing a within-CBSA and time estimation that compares homeowners to renters in their propensities to relocate for jobs, I find that homeowners who have experienced declines in the nominal value of their homes are approximately 12% less likely than average to take a new job in a location outside of the metropolitan area where they currently reside. This evidence is consistent with the hypothesis that housing lock-in has contributed to the decline in labor mobility of homeowners during the recent housing bust. The third chapter focuses on a sample of unemployed workers in the same data set, in order to compare the unemployment durations of those who find subsequent employment by relocating to a new metropolitan area, versus those who find employment in their original location. Using an instrumental variables strategy to address the endogeneity of the migration decision, I find that out-migrating for a new job significantly reduces the time to re-employment. These results stand in contrast to OLS estimates, which suggest that those who move have longer unemployment durations. This implies that those who migrate for jobs in the data may be particularly disadvantaged in their ability to find employment, and thus have strong short-term incentives to relocate.

Long-term consequences of Hodgkin lymphoma therapy on T-cell lymphopoiesis

International audience

Influence of delayed cholecystectomy after acute gallstone pancreatitis on recurrence: consequences of lack of resources

Introduction: Acute pancreatitis is often a relapsing condition, particularly when its triggering factor persists. Our goal is to determine the recurrence rate of acute biliary pancreatitis after an initial episode, and the time to relapse, as well as to identify the risk factors for recurrence. Material and method: We included all patients admitted for a first acute gallstone pancreatitis event during four years. Primary endpoints included readmission for recurrence and time to relapse. Results: We included 296 patients admitted on a total of 386 occasions. The incidence of acute biliary pancreatitis in our setting is 17.5/100,000 population/year. In all, 19.6% of pancreatitis were severe (22.6% of severe acute pancreatitis for first episodes versus 3.6% for recurring pancreatitis), with an overall mortality of 4.4%. Overall recurrence rate was 15.5%, with a median time to relapse of 82 days. In total, 14.2% of patients relapsed after an acute pancreatitis event without cholecystectomy or endoscopic retrograde cholangio-pancreatography. Severe acute pancreatitis recur in 7.2% of patients, whereas mild cases do so in 16.3%, this being the only risk factor for recurrence thus far identified. Conclusions: Patients admitted for pancreatitis should undergo cholecystectomy as soon as possible or be guaranteed priority on the waiting list. Otherwise, endoscopic retrograde cholangio-pancreatography with sphincterotomy may be an alternative to surgery for selected patients.

The fiscal consequences of deflation : evidence from the golden age of globalization

We study the fiscal consequences of deflation on a panel of 17 economies in the first wave of globalization, between 1870 and 1914. By means of impulse response analyses and panel regressions, we find that a 1 percent fall in the price level leads to an increase in the public debt ratio of about 0.23- 0.32 pp. and accounting for trade openness, monetary policy and the exchange rate raises the absolute value of the coefficient on deflation. Moreover, the public debt ratio increases when deflation is also associated with a period of economic recession. For government revenue, lagged deflation comes out with a statistically significant negative coefficient, while government primary expenditure seems relatively invariant to changes in prices.

Application of the UK Foresight Obesity Model in Ireland: The Health and Economic Consequences of Projected Obesity Trends in Ireland

Given the scale of the current obesity epidemic and associated health consequences there has been increasing concern about the economic burden placed on society in terms of direct healthcare costs and indirect societal costs. In the Republic of Ireland these costs were estimated at €1.13 billion for 2009. The total direct healthcare costs for six major obesity related conditions (coronary heart disease & stroke, cancer, hypertension, type 2 diabetes and knee osteoarthritis) in the same year were estimated at €2.55 billion. The aim of this research is to project disease burden and direct healthcare costs for these conditions in Ireland to 2030 using the established model developed by the Health Forum (UK) for the Foresight: Tackling Obesities project.

Behavioural and neurochemical consequences of chronic gut microbiota depletion during adulthood in the rat

Gut microbiota colonization is a key event for host physiology that occurs early in life. Disruption of this process leads to altered brain development which ultimately manifests as changes in brain function and behaviour in adulthood. Studies using germ-free mice highlight the extreme impact on brain health that results from life without commensal microbes, however the impact of microbiota disturbances occurring in adulthood is less studied. To this end, we depleted the gut microbiota of 10-week-old male Sprague Dawley rats via chronic antibiotic treatment. Following this marked, sustained depletion of the gut bacteria, we investigated behavioural and molecular hallmarks of gut-brain communication. Our results reveal that depletion of the gut microbiota during adulthood results in deficits in spatial memory as tested by Morris water maze, increased visceral sensitivity and a greater display of depressive-like behaviours in the forced swim test. In tandem with these clear behavioural alterations we found change in altered CNS serotonin concentration along with changes in the mRNA levels of corticotrophin releasing hormone receptor 1 and glucocorticoid receptor. Additionally, we found changes in the expression of BDNF, a hallmark of altered microbiota-gut-brain axis signaling. In summary, this model of antibiotic-induced depletion of the gut microbiota can be used for future studies interested in the impact of the gut microbiota on host health without the confounding developmental influence of early-life microbial alterations.

The consequences of phenotypic plasticity on postglacial fishes

Phenotypic differences within a species significantly contribute to the variation we see among plants and animals. Plasticity as a concept helps us to understand some of this variation. Phenotypic plasticity plays a significant role in multiple ecological and evolutionary processes. Because plasticity can be driven by the environment it is more likely to produce beneficial alternative phenotypes than rare and often deleterious genetic mutations. Furthermore, differences in phenotypes that arise in response to the environment can affect multiple individuals from the same population (or entire populations) simultaneously and are therefore of greater evolutionary significance. This allows similar, beneficial alternative phenotypes to increase quickly within a single generation and allow new environments to produce and select for new phenotypes instantly. The direction of the present thesis is to increase our understanding of how phenotypic plasticity, coupled with contrasting environmental conditions, can produce alternative phenotypes within a population. Plasticity provides a source of variation for natural selection to act upon, and may lead to genetic isolation as a by-product. For example, there are multiple cases of polymorphic populations of fish, where groups belonging to multiple isolated gene pools, have arisen in sympatry. Here it is shown that although plasticity is important in sympatric speciation events, plasticity alone is not responsible for the frequency in which sympatric polymorphic populations occur. The most frequently observed differences among sympatric polymorphic populations are morphological differences associated with parts of the anatomy used in the detection, handling and capture of prey. Moreover, it is shown here that there are physiological effects associated with foraging on alternative prey that may significantly contribute towards ecological speciation. It is also shown in this study that anthropogenic abiotic factors can disrupt developmental processes during early ontogeny, significantly influencing morphology, and therefore having ecological consequences. Phenotypic structuring in postglacial fish is most frequently based around a divergence towards either pelagic or littoral benthic foraging specialisms. Divergences that deviate from this pattern are of greater scientific interest as they increase our understanding of how evolutionary processes and selection pressures work. Here we describe a rare divergence not based around the typical pelagic/littoral benthic foraging specialisms. Finally, in this study, the effectiveness of local level conservation policy shows that species of fish which are highly variable in their life history strategies are harder to effectively manage and often poorly represented at a local level.

Unlocking ecological history using fish remains: Eco-evolutionary consequences of exploitation in the Atlantic bluefin tuna

During recent decades, the health of ocean ecosystems and fish populations has been threatened by overexploitation, pollution, and anthropogenic-driven climate change. Due to a lack of long-term data, we have a poor understanding of when intensive exploitation began and what impact anthropogenic activities have had on the ecology and evolution of fishes. Such information is crucial to recover degraded and depleted marine ecosystems and fish populations, maximise their productivity in-line with historical levels, and predict their future dynamics. In this thesis, I evaluate anthropogenic impacts on the iconic Atlantic bluefin tuna (Thunnus thynnus; BFT), one of the longest and recently most intensely exploited marine fishes, with a tremendous cultural and economic importance. Using a long-time series of archaeological and archived faunal remains (bones) dating back to approximately two millennia ago, I apply morphological, isotopic, and genomic techniques to perform the first studies on long-term BFT size and growth, diet and habitat use, and demography and adaptation, and produce the first genome-wide data on this species. My findings suggest that exploitation had impacted BFT foraging behaviour by the ~16th century when coastal ecosystem degradation induced a pelagic shift in diet and habitat use. I reveal that BFT biomass began to decline much earlier than hitherto documented, by the 19th century, consistent with intensive tuna trap catches during this period and catch-at-size increasing. I find that BFT juvenile growth had increased by the early 1900s (and more dramatically by the 21st century) which may reflect an evolutionary response to size selective harvest–which I find putative genomic signatures of. Further, I observed that BFT foraging behaviours have been modified following overexploitation during the 20th century, which previously included a isotopically distinct, Black Sea niche. Finally, I show that despite biomass declining from centuries ago, BFT has retained genomic diversity.

Konttorinjohtajien organisaatioon sitoutuminen

Tutkielman tavoitteena on kuvata ja ymmärtää konttorinjohtajien organisaatioon sitoutumista, sitoutumisen taustalla olevia tekijöitä sekä sitoutumisesta aiheutuvia seurauksia. Tutkimus on luonteeltaan kvalitatiivinen, jossa tutkimusmetodina on käytetty teemahaastattelua. Tutkimuksen aineisto kerättiin kymmenellä yksilöhaastattelulla tutkimuksen kohteena olevan organisaation konttorinjohtajista. Haastattelut nauhoitettiin, jonka jälkeen ne litteroitiin ja analysoitiin teemoittain. Tutkimustulosten perusteella voidaan konttorinjohtajien organisaatioon sitoutumisen todeta olevan pääasiallisesti affektiivista. Organisaatioon sitoutumiseen vaikuttivat eniten työn itsenäisyyden aste, työtehtävien laaja-alaisuus ja haastavuus sekä työyhteisö ja ilmapiiri. Itsenäisyyden todettiin sitouttavan nimenomaan päätösvallan, vastuun, oman työn organisoinnin ja koko konttorin organisoinnin kautta. Tärkeimmäksi sitoutumisesta aiheutuvaksi seuraukseksi koettiin konttorin tuloksen kasvu.

Myyjien organisaatioon sitoutuminen ja esimiehen vaikutus sitoutumiseen. Case: Alko Oy

Tämän tutkielman tavoitteena on kuvata ja ymmärtää myyjien organisaatioon sitoutumista Alko Oy:ssä, sitä kuinka myyjät ovat sitoutuneita organisaatioon ja sitoutumiseen vaikuttavia tekijöitä. Tarkoituksena on selvittää ja ymmärtää esimiehen vaikutusta sitoutumiseen sekä sitä kuinka esimies voi edistää myyjien sitoutumista. Lisäksi tavoitteena on kartoittaa ja ymmärtää sitoutumisen seurauksia. Tutkimuksen teoreettinen viitekehys muodostuu organisaatioon sitoutumisen tutkimuksesta ja johtajuuden tutkimuksesta, erityisesti transformationaalisesta johtajuudesta ja sen vaikutuksesta sitoutumiseen. Tutkimus on luonteeltaan laadullinen ja pääasiallisena tutkimusmetodina on käytetty teemahaastattelua. Tutkimusaineisto kerättiin haastattelemalla 22 myyjää ja seitsemää esimiestä. Haastattelut nauhoitettiin ja litteroitiin. Haastattelujen lisäksi myyjille tehtiin kysely. Aineistoa analysoitiin teemoittain ja empiirisen aineiston analyysin tulkinta perustuu tutkimuksen teoreettiseen viitekehykseen. Tutkimustulosten mukaan myyjien sitoutuminen kohdeorganisaatiossa on hyvällä tai vähintään kohtuullisella tasolla ja se pohjautuu voimakkaimmin affektiiviseen ulottuvuuteen. Lisäksi sitoutuminen perustuu osittain jatkuvuuteen perustuvaan komponenttiin sekä pieneltä osin myös normatiiviseen. Affektiiviseen sitoutumiseen vaikuttavat merkittävimmin työn monipuolisuus, haastavuus ja mielekkyys, onnistumisen ja merkityksellisyyden tunteet sekä ilmapiiri. Jatkuvuuteen perustuvaan sitoutumiseen vaikuttavat eniten palkitseminen ja siihen liittyen osa-aikaisuus, joka jakoi myyjiä kahtia. Lisäksi työn monipuolisuudella, varmuudella sekä työllistymisvaihtoehdoilla ja perhesyillä on vaikutusta jatkuvuusperusteiseen sitoutumiseen. Normatiiviseen sitoutumiseen vaikuttavat voimakkaimmin positiivinen vapaaehtoinen vastavuoroisuus organisaatiota kohtaan sen toimintaan ja tekemiin investointeihin liittyen. Lisäksi normatiiviseen sitoutumiseen vaikuttavat sosialisaatio kasvatuksen myötä ja psykologinen sopimus odotuksineen. Esimiehen vaikutus sitoutumiseen korostuu tuloksissa ja esimiehen toiminnalla on merkittävin vaikutus affektiiviseen sitoutumiseen. Keskeisimpiä esimiehen vaikutuskeinoja myyjien sitoutumiseen ovat vastuun antaminen ja osallistaminen, palaute, avoin vuorovaikutus ja tiedonkulku sekä tasapuolisuus ja oikeudenmukaisuus toiminnassa. Myös esimiehen kannustavuus ja myyjien yksilöllinen huomiointi, osaamisen kehittämisen tukeminen sekä esimerkillinen toiminta ovat keskeisiä. Sitoutumisen seurauksista merkittävimpiä ovat vähäinen vaihtuvuus sekä työsuorituksen ja asiakaspalvelun laatu. Lisäksi organisaatiokansalaisuuskäyttäytymiseen liittyvät seikat, kuten parhaansa tekeminen, joustavuus ja itseohjautuvuus ovat keskeisiä sitoutumisen seurauksia.

Conceptualization and therapeutic treatment of a compulsive gambling case by Functional Analysis and Acceptance and Commitment Therapy

A clinical case of compulsive gambling is exposed in this article. The subject’s playing behaviour had both positive and negative consequences. The subject tried to practice control over the urge to play. As shown in the functional analysis, the failure to control the urge despite the best efforts worsened the problem due to its negative consequences. A variation of acceptance and commitment therapy (ACT) was applied in order to break down the fight-surrender vicious circle of the playing behaviour. Two treatment strategies were agreed upon: acceptance of the fact that both playing and not playing had negatives consequences and commitment to one of these options despite its disadvantages. Finally, it is proposed that this acceptance and commitment therapy is a useful therapeutic process as it decreases the suffering subject and eliminates the problem: playing bahaviour.