Construction of suicidal ideation in medical records

In this paper we are interested in exploring discursive transformation of patients’ stories of suicidal ideation into medical discourses. In other words, we focus on how the narrated experience of suicidal thoughts made during the psychiatric assessment interview is recorded in the patients’ medical record. Our data come from recordings of psychiatric interviews, as well as the doctors’ notes in the medical records made after the interviews, collected in psychiatric hospitals in Poland. Assuming a constructionist view of discourse, we demonstrate that lived experience of suicide ideation resulting in stories of a complex and homogeneous group of “thoughts” is reduced to brief statements of fact of presence/existence. Exploration of the relationship between the interviews and the notes suggest a stark imposition of the medical gaze upon them. We end with arguments that discursive practices relegating lived experience from the focus of clinical practice deprives it of information which is meaningful and clinically significant

Language matters: a linguist’s view on medicine

Language matters. I have seen this simple statement more times than I care to remember. It is used by patients, nurses, psychologists, doctors and many other healthcare professionals. In this editorial I would like to offer a view of what a statement means to a linguist. And so, first, what we say does not just mean, it means something in a particular context; second, even more importantly, language does not consist only of words, and this is why medicine and medics should focus on their ‘way of speaking’

Current concepts on oxidative/carbonyl stress, inflammation and epigenetics in pathogenesis of chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is a global health problem, and current therapy for COPD is poorly effective and the mainstays of pharmacotherapy are bronchodilators. A better understanding of the pathobiology of COPD is critical for the development of novel therapies. In the present review, we have discussed the roles of oxidative/aldehyde stress, inflammation/immunity, and chromatin remodeling in the pathogenesis of COPD. Imbalance of oxidant/antioxidant balance caused by cigarette smoke and other pollutants/biomass fuels plays an important role in the pathogenesis of COPD by regulating redox-sensitive transcription factors (e.g. NF-κB), autophagy and unfolded protein response leading to chronic lung inflammatory response. Cigarette smoke also activates canonical/alternative NF-κB pathways and their upstream kinases leading to sustained inflammatory response in lungs. Recently, epigenetic regulation has been shown to be critical for the development of COPD because the expression/activity of enzymes that regulate these epigenetic modifications have been reported to be abnormal in airways of COPD patients. Hence, the significant advances made in understanding the pathophysiology of COPD as described herein will identify novel therapeutic targets for intervening COPD

A spatio-temporal analysis of groundwater level changes in relation to urban growth and groundwater recharge potential for Waukesha County, Wisconsin

The main objective of this study was to spatially and temporally analyze groundwater level changes using geographic information systems and spatial analysis with respect to urban development, groundwater water withdrawal, and groundwater recharge potential. The study focused on Waukesha County in southeastern Wisconsin, where urban development has been accelerating while groundwater has been declining during the last several decades. We analyzed data about groundwater withdrawal, groundwater level, land use/land cover, and precipitation utilizing correlation analysis, Geographically Weighted Regression (GWR), land-use change analysis, and map overlay. As a result, we found that (1) Urban areas increased faster in areas with high recharge potential than in areas with low or moderate recharge potential, (2) The effect of urban growth on groundwater level is highly variable by time and space, and (3) The changes in groundwater level are strongly related to the spatial distribution of groundwater withdrawal. The study pinpoints the need to consider the spatial unevenness of groundwater withdrawal in understanding the changes in groundwater level and groundwater recharge potential for better managing groundwater resources

Removing Compliance: Interpersonal and Social Factors Affecting Insight Assessments

This paper probes the format and underlying assumptions of insight conceptualizations and assessment procedures in psychiatry. It does so with reference to the often- neglected perspective of the assessed person. It delineates what the mental steps involved in an insight assessment are for the assessed person, and how they become affected by the context and dynamics of the clinical setting. The paper examines how expectations of compliance in insight assessment tools and procedures extend far beyond treatment adherence, to compliance with diagnostic language and the assessment relationship. Such compliance can be ethically problematic and not in line with human rights standards, notably the Convention on the Rights of Persons with Disabilities. Most importantly, it can be counterproductive in supporting an individual to gain better insight in the sense of self-knowledge. The paper concludes with guidelines for a new approach to insight. This new approach requires taking into account currently neglected components of insight, in particular its relational and social dimensions, through which a person’s insight operates and develops, and through which it could be supported. Concretely, this would mean removing the condition of compliance and reflecting on the influence of the clinician-patient relationship and assessment situation on insight

Robust methods for purification of histones from cultured mammalian cells with the preservation of their native modifications

Post-translational modifications (PTMs) of histones play a role in modifying chromatin structure for DNA-templated processes in the eukaryotic nucleus, such as transcription, replication, recombination and repair; thus, histone PTMs are considered major players in the epigenetic control of these processes. Linking specific histone PTMs to gene expression is an arduous task requiring large amounts of highly purified and natively modified histones to be analyzed by various techniques. We have developed robust and complementary procedures, which use strong protein denaturing conditions and yield highly purified core and linker histones from unsynchronized proliferating, M-phase arrested and butyrate-treated cells, fully preserving their native PTMs without using enzyme inhibitors. Cell hypotonic swelling and lysis, nuclei isolation/washing and chromatin solubilization under mild conditions are bypassed to avoid compromising the integrity of histone native PTMs. As controls for our procedures, we tested the most widely used conventional methodologies and demonstrated that they indeed lead to drastic histone dephosphorylation. Additionally, we have developed methods for preserving acid-labile histone modifications by performing non-acid extractions to obtain highly purified H3 and H4. Importantly, isolation of histones H3, H4 and H2A/H2B is achieved without the use of HPLC. Functional supercoiling assays reveal that both hyper- and hypo-phosphorylated histones can be efficiently assembled into polynucleosomes. Notably, the preservation of fully phosphorylated mitotic histones and their assembly into polynucleosomes should open new avenues to investigate an important but overlooked question: the impact of mitotic phosphorylation in chromatin structure and function

HDAC8 substrates: Histones and beyond

The lysine deacetylase family of enzymes (HDACs) was first demonstrated to catalyze deacetylation of acetyllysine residues on histones. In subsequent years, HDACs have been shown to recognize a large pool of acetylated nonhistone proteins as substrates. Recently, thousands of acetylated proteins have been discovered, yet in most cases, the HDAC that catalyzes deacetylation in vivo has not been identified. This gap has created the need for better in vivo, in vitro, and in silico approaches for determining HDAC substrates. While HDAC8 is the best kinetically and structurally characterized HDAC, few efficient substrates have yet been substantiated in vivo. In this review, we delineate factors that may be important for determining HDAC8 substrate recognition and catalytic activity, including structure, complex formation, and post‐translational modifications. This summary provides insight into the challenges of identifying in vivo substrates for HDAC8, and provides a good vantage point for understanding the variables important for predicting HDAC substrate recognition. © 2012 Wiley Periodicals, Inc. Biopolymers 99: 112–126, 2013.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94512/1/22135_ftp.pd