A rare case of postpartum thrombocytosis. Differential diagnosis and management

This is a case of a 43-year-old primigravida primipara woman who presented in our Department in 36 weeks gestational age and underwent caesarean section due to preeclampsia. From her history, it was known that her pregnancy was an in vitro fertilization (IVF) result. She also received low molecular weight heparin because of thrombophilia (protein S insufficiency). We present this case of postpartum thrombocytosis and discuss the differential diagnosis of this condition through the presentation of its management.

This battle was not over: Parade’s End as a transitional text in the development of ‘disenchanted’ First World War literature.

This chapter argues that the novels of Ford's Parade's End tetralogy occupy a significant place in the development of "disenchanted" fiction about the First World War. The values of Ernest Raymond's patriotic Tell England are contrasted with those of C. E Montague's Disenchantment, providing a brief synopsis of the early 1920s response to the conflict. Parade's End is seen as introducing several key themes in to the post-First World War discursive field, including national identity, psychology, memory, and time. The presentation of these aligned with the formal aspects of the novel, allows it to push the boundaries of the readerly horizon of expectations. Frayn argues that Ford's readership, though moderately-sized, was influential from a literary point of view, and thus facilitated the reception of later, more vitriolic, criticisms of war.

Art-Map: concept of moving curatorial project and its practical realization in Aveiro

In this dissertation, I present the results of a project which aim was to find out and try an effective model of independent curatorial project executable in small and medium cities in Portugal. The concept of Moving Curatorial Project ARTMAP is a result of theoretical research and reflection about municipal exhibition spaces and possibility of presentation of the contemporary art in these spaces. To test if this curatorial project is realizable and if there are conditions to continue it, a first trial was implemented in Aveiro. A curated international exhibition, entitled “A Poética do Visual" occupied two municipal and two private gallery spaces and brought together 111 artists from 25 different countries. The art event was carried out in collaboration with the Municipality of Aveiro and the University of Aveiro, and involved several private cultural spaces in the city. This first experience showed that there are all conditions for the presentation of contemporary art in small and medium size locations in Portugal, and for this project to be replicated in other regions of the country.

Influences and benefits of role models on social media.

The current paper examined three research questions. First, what are the perceived benefits for social network users who have role models online? Second, to what extent does having role models online influence one’s self-presentation on social media? And finally, are users who expect more in return (greater reciprocity) more likely to have role models on social media? Using two opportunity survey samples and exploratory analyses, study 1 (N = 236) demon-strated that having role models was associated with greater perceived support for one’s career aspirations, and perceived access to information. The results of study 2 (N = 192) revealed that participants who had role models online reported that their online profile presented a more realistic self-presentation of values and pri-orities, as well as having higher reciprocity expectation.

Non-acute Transient Reversible Adrenal Insufficiency in a Survivor of Critical Illness: A Lesser-known Cause of Primary Adrenal Insufficiency

Objectives: Primary adrenal insufficiency AI is regarded as a progressive disease needing lifelong replacement therapy, but this may not always be the case. Material and methods: A non-acute presentation of AI following a hypotensive episode caused by blood loss was investigated. Results: Adrenal function fully recovered without treatment. Conclusions: There should be a high index of suspicion and a low threshold for performing tests of adrenal function in survivors of critical illness and severe hypotensive episodes.

Cassius Dio's speeches and the collapse of the Roman Republic

This thesis argues that Cassius Dio used his speeches of his Late Republican and Augustan narratives as a means of historical explanation. I suggest that the interpretative framework which the historian applied to the causes and success of constitutional change can be most clearly identified in the speeches. The discussion is divided into eight chapters over two sections. Chapter 1 (Introduction) sets out the historical, paideutic, and compositional issues which have traditionally served as a basis for rejecting the explanatory and interpretative value of the speeches in Dio’s work and for criticising his Roman History more generally. Section 1 consists of three methodological chapters which respond to these issues. In Chapter 2 (Speeches and Sources) I argue that Dio’s prosopopoeiai approximate more closely with the political oratory of that period than has traditionally been recognised. Chapter 3 (Dio and the Sophistic) argues that Cassius Dio viewed the artifice of rhetoric as a particular danger in his own time. I demonstrate that this preoccupation informed, credibly, his presentation of political oratory in the Late Republic and of its destructive consequences. Chapter 4 (Dio and the Progymnasmata) argues that although the texts of the progymnasmata in which Dio will have been educated clearly encouraged invention with a strongly moralising focus, it is precisely his reliance on these aspects of rhetorical education which would have rendered his interpretations persuasive to a contemporary audience. Section 2 is formed of three case-studies. In Chapter 5 (The Defence of the Republic) I explore how Dio placed speeches-in-character at three Republican constitutional crises to set out an imagined case for the preservation of that system. This case, I argue, is deliberately unconvincing: the historian uses these to elaborate the problems of the distribution of power and the noxious influence of φθόνος and φιλοτιμία. Chapter 6 (The Enemies of the Republic) examines the explanatory role of Dio’s speeches from the opposite perspective. It investigates Dio’s placement of dishonest speech into the mouths of military figures to make his own distinctive argument about the role of imperialism in the fragmentation of the res publica. Chapter 7 (Speech after the Settlement) argues that Cassius Dio used his three speeches of the Augustan age to demonstrate how a distinctive combination of Augustan virtues directly counteracted the negative aspects of Republican political and rhetorical culture which the previous two case-studies had explored. Indeed, in Dio’s account of Augustus the failures of the res publica are reinvented as positive forces which work in concert with Augustan ἀρετή to secure beneficial constitutional change.

Equality of opportunity, cultural diversity and claims for fairness

The present paper examines some of the tensions, problems and challenges associated with claims for equality of opportunity (the fairness argument). The introductory part identifies three separate forms of justification for public education, including the argument associated with equality of opportunity. Part II examines in detail two questions that reveal part of the anatomy of equality of opportunity: (1) what an opportunity is, and (2) when individuals’ opportunities are equal. This is followed by a presentation of the two basic principles of equality of opportunity: (1) the principle of non-discrimination, and (2) the “levelling the playing field” principle. The next part takes up the multiculturalist hypothesis advanced by minority groups for the accommodation and recognition of cultural diversity. This is followed by the identification of a set of claims comprising the “fairness argument”. The last section focuses on the “currency problem” associated with cultural diversity as a form of “unfair disadvantage”. Part V examines two of the major shortcomings associated with the multicultural conception of equality of opportunity, while the concluding part discusses some of the questions that must be answered by any conception of equal opportunities. (DIPF/Orig.)

Is There More to This Case than Mere Pulmonary Alveolar Proteinosis? A Clinical Case Presentation

Introduction: Pulmonary alveolar proteinosis (PAP) is a rare disease, associated with excess accumulation of surfactant proteins and lipids in the alveoli. Clinical presentation: We report the case of a 46-year-old woman with a combined presentation of PAP, myelodysplasia and recurrent miscarriages. Conclusions: The concomitant presentation of the above might be compatible with a mutation of the haematopoietic transcription factor gene GATA2.

THE CONTRIBUTION OF THE GEOGRAPHY OF DISABILITY TO THE DEVELOPMENT OF ‘ACCESSIBLE TOURISM’

The article presents an outline of the evolution of the geography of disability (since the 1930s) taking into account significant issues in the creation of theoretical foundations as well as practical action in ‘accessible tourism’. It may be considered a review. Based on an analysis of literature, the first section presents a definition of ‘accessible tourism’ and the development of the geography of disability, the result of which is the geographical model of disability. The second section is a synthetic presentation of the effect of geographical research on the development of theoretical accessible tourism concepts and their implications in practice. The final conclusions highlight the need to identify the level of detail in universal design principles applied to buildings, spaces, services, which are to fulfil the criteria of accessibility for people with various types of disability.

EXAMINING THE IMPLEMENTATION CHALLENGES OF PROJECT-BASED LEARNING: A CASE STUDY

Title of Thesis: Thesis directed by: ABSTRACT EXAMINING THE IMPLEMENTATION CHALLENGES OF PROJECT-BASED LEARNING: A CASE STUDY Stefan Frederick Brooks, Master of Education, 2016 Professor and Chair Francine Hultgren Teaching and Learning, Policy and Leadership Department Project-based learning (PjBL) is a common instructional strategy to consider for educators, scholars, and advocates who focus on education reform. Previous research on PjBL has focused on its effectiveness, but a limited amount of research exists on the implementation challenges. This exploratory case study examines an attempted project- based learning implementation in one chemistry classroom at a private school that fully supports PjBL for most subjects with limited use in mathematics. During the course of the study, the teacher used a modified version of PjBL. Specifically, he implemented some of the elements of PjBL, such as a driving theme and a public presentation of projects, with the support of traditional instructional methods due to the context of the classroom. The findings of this study emphasize the teacher’s experience with implementing some of the PjBL components and how the inherent implementation challenges affected his practice.

Hansen Neuropathy: Still a Possible Diagnosis in the Investigation of a Peripheral Neuropathy

INTRODUCTION: Leprosy is still one of the most frequent causes of peripheral neuropathy. Although regarded as eradicated in Portugal, is still documented in neuropathological study of patients with clinical peripheral neuropathy without proper diagnosis.

With or without you: does partner satisfaction and partner-directed violence influence the presence of a partner on women's Facebook cover profile photographs?

Social network sites (SNSs) provide new opportunities for online self-presentation of millions of users. The cover profile photograph (CPP) along with written information regarding relationship status is a central component of online self-presentation, although their associations with actual romantic relationships are not clear. We investigated relationships between the presence of a current romantic partner on the CPP and the displayed relationship status and partner satisfaction, partner-directed violence and women's intrasexual competition with peers. A total of 28 % of the 158 women with a Facebook profile and being involved in a romantic relationship had their romantic partners on their CPP. As predicted, women with their partners on the CPP were more satisfied with their romantic relationship than others. Furthermore, women who did not have their partner on the CPP tended to conceal or lie in their displayed mating status suggesting that this may be a strategy how to attract another potential mate. The partner-directed violence and intrasexual competition hypotheses were not supported. Overall, the CPP and an honestly displayed relationship status is an expression of relationship satisfaction amongst women.

“NYAM CHIEM” RECONSTRUCTING AND PERFORMING NIGHTMARE: A DANCE RESEARCH IN PERFORMANCE OF SLEEP PARALYSIS.

This paper is a documentation of a practice-based dance work of the creative process, research and performance presentation of the piece “Nyam chiem.” This thesis examines the phenomenon of sleep paralysis through a personal reflexive research. The work challenges the notion that sleep paralysis is evil, revealing the phenomenon as a part of the human experience. The research is in two parts, practical and theory. The practical component includes; dance rehearsals, and staging of the piece as presentation. The theoretical component includes the documentation of the work in a written format capturing my personal stories, and salient issues arising from the process into a scholarly paper.

Effect of vitamin D supplementation on bone status, glucose homeostasis and immune function in children with vitamin D deficiency

Background: Between 1961-1971 vitamin D deficiency was recognized as a public health issue in the UK, because of the lack of effective sunlight and the population mix [1, 2]. In recent years, health care professionals have cited evidence suggesting a re-emergence of the vitamin D deficiency linked to a number of health consequences as a concern [3-6]. Evidence from observational studies has linked low vitamin D status with impairment in glucose homeostasis and immune dysfunction [7-9]. However, interventional studies, particularly those focused on paediatric populations, have been limited and inconsistent. There is a need for detailed studies, to clarify the therapeutic benefits of vitamin D in these important clinical areas. Objective: The aims of this PhD thesis were two-fold. Firstly, to perform preliminary work assessing the association between vitamin D deficiency and bone status, glucose homeostasis and immune function, and to explore any changes in these parameters following short term vitamin D3 replacement therapy. Secondly, to assess the effectiveness of an electronic surveillance system (ScotPSU) as a tool to determine the current incidence of hospital-based presentation of childhood vitamin D deficiency in Scotland. Methods: Active surveillance was performed for a period of two years as a part of an electronic web-based surveillance programme performed by the Scottish Paediatric Surveillance Unit (ScotPSU). The validity of the system was assessed by identifying cases with profound vitamin D deficiency (in Glasgow and Edinburgh) from the regional laboratory. All clinical details were checked against those identified using the surveillance system. Thirty-seven children aged 3 months to 10 years, who had been diagnosed with vitamin D deficiency, were recruited for the bone, glucose and immunity studies over a period of 24 months. Twenty-five samples were analysed for the glucose and bone studies; of these, 18 samples were further analysed for immune study. Treatment consisted of six weeks taking 5000 IU units cholecalciferol orally once a day. At baseline and after completion of treatment, 25 hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), alkaline phosphatase (ALP), collagen type 1 cross-linked C-telopeptide (CTX), osteocalcin (OCN), calcium, phosphate, insulin, glucose, homeostasis model assessment index, estimated insulin resistance (HOMA IR), glycated hemoglobin (HbA1c), sex hormone binding globulin (SHBG), lipids profiles, T helper 1 (Th1) cytokines (interleukin-2 ( IL-2), tumor necrosis factors-alpha (TNF-α), interferon-gamma (INF-γ)), T helper 2 (Th2) cytokines (interleukin-4 (IL-4), interleukin-5 (IL-5), interleukin-6 (IL-6)), T helper 17 (Th17) cytokine (interleukin-17 (IL-17)), Regulatory T (Treg) cytokine (interleukin-10 (IL-10)) and chemokines/cytokines, linked with Th1/Th2 subset balance and/or differentiation (interleukin-8 (IL-8), interleukin-12 (IL-12), eosinophil chemotactic protein ( EOTAXIN), macrophage inflammatory proteins-1beta (MIP-1β), interferon-gamma-induced protein-10 (IP-10), regulated on activation, normal T cell expressed and secreted (RANTES), monocyte chemoattractant protein-1(MCP-1)) were measured. Leukoocyte subset analysis was performed for T cells, B cells and T regulatory cells and a luminex assay was used to measure the cytokiens. Results: Between September 2009 and August 2011, 163 cases of vitamin D deficiency were brought to the attention of the ScotPSU, and the majority of cases (n = 82) were reported in Glasgow. The cross-validation checking in Glasgow and Edinburgh over a one-year period revealed only 3 (11%) cases of clearly symptomatic vitamin D deficiency, which had been missed by the ScotPSU survey in Glasgow. While 16 (67%) symptomatic cases had failed to be reported through the ScotPSU survey in Edinburgh. For the 23 children who are included in bone and glucose studies, 22 (96%) children had basal serum 25(OH)D in the deficiency range (< 50 nmol/l) and one (4%) child had serum 25(OH)D in the insufficiency range (51-75 nmol/l). Following vitamin D3 treatment, 2 (9%) children had final serum 25(OH)D lower than 50 nmol/l, 6 (26%) children had final serum 25(OH)D between >50-75 nmol/l, 12 (52%) children reached a final serum 25(OH)D >75-150 nmol/l and finally 3 (13%) exceeded the normal reference range with a final 25(OH)D >150 nmol/l. Markers for remodelling ALP and PTH had significantly decreased (p = 0.001 and <0.0001 for ALP and PTH respectively). In 17 patients for whom insulin and HOMA IR data were available and enrolled in glucose study, significant improvements in insulin resistance (p = 0.04) with a trend toward a reduction in serum insulin (p = 0.05) was observed. Of those 14 children who had their cytokines profile data analysed and enrolled in the immunity study, insulin and HOMA IR data were missed in one child. A significant increase in the main Th2 secreted cytokine IL-4 (p = 0.001) and a tendency for significant increases in other Th2 secreted cytokines IL-5 (p = 0.05) and IL-6 (p = 0.05) was observed following vitamin D3 supplementation. Conclusion: An electronic surveillance system can provide data for studying the epidemiology of vitamin D deficiency. However, it may underestimate the number of positive cases. Improving vitamin D status in vitamin D deficient otherwise healthy children significantly improved their vitamin D deficient status, and was associated with an improvement in bone profile, improvements in insulin resistance and an alteration in main Th2 secreting cytokines.

Proposed network of mobile libraries: alternative information to rural communities in Costa Rica

This study examines the services provided by the bookmobile of SINABI-Public Libraries in rural communities visited Costa Rica during 2009 and 2010 according to the sample selected for the presentation of a proposed Mobile Library Network to Costa Rica.Each country has very heterogeneous populations and the populations in unfavorable geographical areas (rural or urban fringe areas) and areas without library service or cultural institution, they have specific information needs. By its terms can not exercise the right to information, while urban areas have greater influence and social advantage to have easy access to various information resources.The mobile library services are presented as an ideal tool to deliver library services to any population, mainly those remote communities and vulnerable state as rural areas. Bookmobile is defined as any means of transport (buses, trains, boats, motorcycles, boats, animals, etc.), which shifts documentary material.