This thesis presents the experimental work performed on the spectrin protein. The aim of the work was to study the direct interactions of spectrin, the cytoskeleton of RBCs, with membrane lipid to determine its effects on the mechanical properties of the lipid bilayer. Motivation for this work came from a lack of unanimity in the field of spectrin, and the hypothesized potential of the protein to perforate giant unilamellar vesicles. The work aimed to investigate and determine how spectrin-lipid interactions influence membrane mesoscopic morphology and biophysics in ways that could ultimately be important to cellular function. For this purpose, a protocol was implemented to take into account the different aspects of the binding. Direct visualisation of the spectrin-lipid interaction and distribution was achieved using confocal fluorescence microscopy. Changes in the mechanical properties of the membrane were investigated using the micropipette aspiration technique. Finally the thermodynamics of the interaction were considered with isothermal titration calorimetry experiments. This allowed evaluation of the protein-lipid interaction in a complete and coherent manner. Experiments were also performed on another elastic protein, alpha-elastin, for comparison. In addition to its similarities with spectrin (both possess hydrophobic domains and entropy elasticity), elastin is auto-fluorescent which makes it an attractive model protein. Elastin was also used as a sample model to implement new techniques using nonlinear optics microscopy.

Community colleges are challenged to find their next set of leaders who can respond to the diverse challenges of leading the institution. This study examined the impact of institutional and personal factors on faculty aspirations to leadership roles within the community college through the utilization of the Social Cognitive Career Theory framework. A case study research design utilizing mixed-methods investigated the perceived and preferred organizational culture(s) and the manner in which institutional and personal factors influence faculty aspirations to assume leadership roles at Southcentral Kentucky Community and Technical College. The findings of the research indicate that affecting change and being asked to lead are personal factors of influence that motivate faculty to aspire to formal leadership positions within the community college. On the other hand, the challenge of formal leadership roles, family and work-life balance might dissuade faculty aspirations of faculty to formal leadership roles. The study reveals that organizational culture was a positive factor of institutional influence. This study advances the field of educational leadership in that a number of personal and institutional factors influence the aspirations of faculty as they consider movement into formal leadership position within the community college. The findings identify the need for research across multiple institutions and the need to expand Social Cognitive Career Theory to include personal-cognitive barriers of race and gender.

Thesis (PhD)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Although transthoracic ultrasonography is a well established modality, it is still underutilised by chest physicians. The aim of this research project was to investigate the feasibility, diagnostic yield and safety of ultrasound(US)-assisted transthoracic biopsies performed by clinicians in various settings relevant to daily practice of respiratory medicine. We conducted four clinical trials which are summarised below: 1. In a prospective study on the feasibility of US-assisted transthoracic fine needle aspiration (TTFNA) of drowned lung secondary to a proximal mass lesion, a novel indication for US-assisted TTFNA was described. TTFNA passes >20mm from the visceral pleura had a sensitivity of 74.2% and were also more likely to contain malignant cells than more superficial passes. The surprisingly high yield and the fact that no serious complications were observed validated this approach, which may be an alternative to bronchoscopy. 2. In the largest single-centre study on US-assisted TTFNA with rapid on-site evaluation (ROSE) and cutting needle biopsy (CNB) in the setting of superior vena cava (SVC) syndrome ever reported, we were able to accurately diagnose 96% of all patients who presented with an associated mass lesion that abutted or infiltrated the chest wall. No pneumothoraces or major haemorrhage was caused. We also validated the single-session approach, and were able to conclude that US-assisted TTFNA (with ROSE) is the initial investigation of choice in suspected bronchogenic carcinoma, whereas both TTFNA and CNB need to be performed in all other cases. 3. We continued to validate the novel single-session sequential approach in a study on anterosuperior mediastinal masses. US-assisted TTFNA with ROSE was performed on 45 consecutive patients, immediately followed by CNB where a provisional diagnosis of epithelial carcinoma or probable tuberculosis (TB) could not be established. An accurate cytological diagnosis was made in 73.3%, and was more likely to be diagnostic in epithelial carcinoma and TB than all other pathology (p<0.001). CNB yielded a diagnosis in 88.2%. Overall 93.3% of patients were diagnosed by the single-session approach. No pneumothorax or major haemorrhage was observed. 4. In a prospective study, we compared US-assisted Abrams and Tru-Cut needle biopsies with regard to their yield for pleural TB. Pleural biopsy specimens obtained with Abrams needles contained pleural tissue in 91.0% of cases and were diagnostic in 81.8%, whereas Tru-Cut needle biopsy specimens only contained pleural tissue in 78.7% (p=0.015) and were diagnostic in 65.2% (p=0.022). In conclusion, we investigated the feasibility of US-assisted biopsies performed by respiratory physicians in various settings, and consistently found acceptable to very high diagnostic yields with minimal complications. Furthermore, we were able to validate a novel indication for US-assisted TTFNA (US-assisted TTFNA of drowned lung), validate the use of a single-session sequential approach (USassisted TTFNA with ROSE followed by CNB where indicated) in at least two clinical settings (SVC syndrome and anterosuperior mediastinal masses) and we were able to show that US-assisted Abrams needle biopsy is superior to Tru-Cut needles biopsy when histological confirmation of TB pleuritis is required. / AFRIKAANSE OPSOMMING: Alhoewel transtorakale ultrasonografie ‘n gevestigde modaliteit is, word dit onderbenut deur pulmonoloë. Die doel van hierdie navorsingsprojek was om die praktiese uitvoerbaarheid, diagnostiese opbrengs en veiligheid van sonargerigte transtorakale biopsies uitgevoer deur klinici in verskeie situasies relevant tot die alledaagse praktyk te ontleed. Ons het vier kliniese proewe uitgevoer wat hieronder opgesom word: 1. In ‘n prospektiewe studie oor die praktiese uitvoerbaarheid van sonargerigte transtorakale fyn naald aspirasie (TTFNA) van areas van obstruktiewe pneumonitis sekondêr tot proksimale massa letsels, is ‘n nuwe indikasie vir sonargerigte TTFNA beskryf. TTFNA aspirasies wat >20mm van die visserale pleura geneem is, het ‘n sensitiwiteit van 74.2% gehad en was meer geneig om maligne selle op te lewer as meer oppervlakkige aspirasies. Die verbasende hoë diagnostiese sensitiwiteit en afwesigheid van ernstige komplikasies het die praktiese waarde van hierdie benadering bevestig. 2. In die grootste studie nog oor sonargerigte TTFNA met spoedige in-teater evalusies (SITE) en sny-naald biopsie (SNB) in die teenwoordigheid van superior vena cava (SVC) sindroom, kon ons 96% van pasiënte wat presenteer het met ‘n geassosieerde massa letsel wat die borskaswand betrek, akkuraat diagnoseer. Geen pneumotoraks of major bloeding is waargeneem nie. Ons kon ook die praktiese uitvoerbaarheid van ‘n enkelsessie benadering bevestig en kon tot die gevolgtrekking kom dat sonargerigte TTFNA (met SITE) die aanvanklike ondersoek van keuse is waar bronguskarsinoom vermoed word, maar dat beide TTFNA en SNB noodsaaklik is in ander gevalle. 3. Ons het voortgegaan om die waarde van die nuwe enkel-sessie benadering te bevestig in ‘n studie oor antero-superior mediastinale massas. Sonargerigte TTFNA met SITE is uitgevoer op 45 pasiënte en in gevalle waar ‘n voorlopige diagnose van epiteliale karsinoom of waarskynlike tuberkulose (TB) nie bevestig kon word nie, is dit onmiddelik gevolg deur SNB. ‘n Akkurate sitologiese diagnose is gemaak in 73.3% van gevalle en meer algemeen in epiteliale karsinoom en TB as ander patologie (p<001). SNB was diagnosties in 88.2%. In 93.3% kon ‘n diagnose verkry word met die enkel-sessie benadering. Geen pneumotoraks of major bloeding is waargeneem nie. 4. In ‘n prospektiewe studie is sonargerigte Abrams naald en Tru-Cut naald biopsies se opbrengs vir pleurale TB met mekaar vergelyk. Pleurale biopsie monsters wat met ‘n Abrams naalde geneem is, het pleurale weefsel in 91.0% gevalle getoon en was diagnosties in 81.8%, vergeleke met Tru-Cut naalde wat slegs in 87.7% pleurale weefsel opgelewer het (p=0.015) en wat net in in 65.2% diagnosties was (p=0.022). Opsommend het ons die praktiese uitvoerbaarheid van sonargerigte biopsies uitgevoer deur pulmonoloë in veskeie kliniese situasies nagevors, en het deurlopend aanvaarbare tot hoë diagnostiese opbrengste gevind met minimale komplikasies. Verder kon ons ‘n nuwe indikasie vir sonargerigte TTFNA beskryf en evalueer (sonargerigte TTFNA van obstruktiewe pneumonitis); ‘n enkel-sessie sekwensiële benadering se waarde bevestig (sonargerigte TTFNA met SITE, gevolg deur SNB waar aangedui) in ten minste twee kliniese situasies (SVC sindroom en anterosuperior mediastinale massas); en was dit moontlik om te bewys dat UK-geleide Abrams naald biopsies superior tot Tru-cut naald biopsies is in die histologiese bevestiging van TB pleuritis.

Thesis (PhD (Pathology. Anatomical Pathology))--University of Stellenbosch, 2009. / Dissertation presented for a PhD degree in anatomical pathology at Stellenbosch University. / ENGLISH ABSTRACT: Expediting a diagnosis of tuberculosis in children, particularly those who are immunocompromised due to HIV/AIDS, is essential, as they are vulnerable to develop severe forms of disease due to their immature or compromised immune systems. A significant percentage of children (8 to 10%) with TB have TB lymphadenitis, in isolation, or in combination with other disease manifestations. Fine needle aspiration biopsy (FNAB) is a simple and minimally invasive procedure well tolerated by children. It may be performed as an outpatient procedure by clinicians as well as nurses, and excellent results can be achieved with training in the correct procedure. The aim of this dissertation was to demonstrate that FNAB may contribute significantly to the diagnosis of mycobacterial lymphadenitis, with particular reference to children TB suspects. We first established that TB lymphadenitis is a common clinical problem in children in TB endemic areas and that FNAB is an efficient simple and effective diagnostic modality in children with peripheral lymphadenopathy. We then proceeded to document the diagnostic yield and time to diagnosis of FNAB compared to conventional laboratory specimens collected in children. We investigated the value of additional diagnostic modalities such as autofluorescence in improving the ability of cytology to make a definitive diagnosis of mycobacterial infection based on cytomorphology and identification of the organism. In countries where organisms such as Mycobacterium bovis BCG and nontuberculous mycobacteria are prevalent, culture with subsequent speciation is essential. The amount of material harvested during FNAB is minuscule, and requires immediate bedside inoculation for optimal yields. We developed an inexpensive and effective transport medium to facilitate mycobacterial culture from FNAB, even if this is collected at an outside facility. It is ideally suited for use in clinics and rural hospitals as it is stable at room temperature, maintains viability of the organism for seven days, and the closed lid format reduces contamination. Mycobacterial culture even using liquid-based media, takes up to 6 weeks, and this delay is unacceptable particularly in children. We developed a Nucleic Acid Amplification Technique (NAAT) using High Resolution Melt Analysis and applied this novel technique to FNAB specimens submitted in transport medium. Although sensitivity remained suboptimal, the technique is highly specific, simple and rapid. Its use could be incorporated into routine microbiology laboratories, to assist with rapid diagnosis while cultures are pending. We collected a solid body of evidence, which will promote the use of FNAB in suspected mycobacterial lymphadenopathy, particularly in children in resource-limited countries. The utilisation of the diagnostic methods identified will expedite speciation and allow early and appropriate initiation of therapy. This is in keeping with Millennium Development Goal 6: to combat TB by early detection of new cases and effective treatment. / AFRIKAANSE OPSOMMING: Kinders met tuberkulose (TB), en veral diegene met gekompromiteerde immuniteit as gevolg van MIV/VIGS, het ‘n verhoogde neiging om ernstige siektebeelde te ontwikkel vanweë hul onvolwasse of gekompromiteerde immuunsisteme. ‘n Spoedige diagnose van TB in kinders is dus noodsaaklik. ‘n Betekenisvolle persentasie van kinders (8 tot 10%) met TB het TB limfadenitis met of sonder meegaande ander siekteverskynsels. Fynnaaldaspirasiebiopsie (FNAB) is ‘n eenvoudige en minimale indringende prosedure wat geredelik deur kinders aanvaar word. Geneeshere en verpleegkundiges wie toepaslike opleiding in die uitvoering van FNAB ontvang het, kan die prosedure op buitepasiënte uitvoer en uitstekende resultate behaal. Die doel van hierdie studie was om aan te toon dat FNAB betekenisvol kan bydra tot die diagnose van mikobakteriële limfadenitis in veral kinders met vermoedelike TB. Daar was eerstens bevestig dat TB limfadenitis ‘n algemene kliniese probleem is in kinders in TB endemiese areas en dat FNAB ‘n doeltreffende, eenvoudige en effektiewe diagnostiese modaliteit is in kinders met perifere limfadenopatie. Vervolgens was FNAB se diagnostiese opbrengs en die tydsverloop tot diagnose vergelyk met dié van konvensionele laboratoriummonsters wat in kinders verkry word. Die bydrae van verdere diagnostiese modaliteite soos outofluoressensie tot ‘n verbetering in sitologie se rol in die diagnose van mikobakteriële infeksie, soos gebaseer op sitomorfologie en identifisering van organismes, is ondersoek. In lande waar organismes soos Mycobacterium bovis BCG en nie-tuberkuleuse mikobakterië heersend is, is kultuur en spesiebepaling noodsaaklik. Die hoeveelheid materiaal wat met FNAB verkry word is baie min en vereis onmiddellike okulasie vir die beste resultate. Tydens hierdie studie is ‘n goedkoop en effektiewe vervoermedium ontwikkel om mikobakteriële kultuur van FNAB verkreë monsters te fasiliteer, selfs al is die monster vanaf ‘n buite fasiliteit bekom. Die vervoermedium is baie geskik vir gebruik in klinieke en plattelandse hospitale. Dit is stabiel by kamertemperatuur, handhaaf lewensvatbaarheid van organismes vir sewe dae, en die geslote dekselformaat verminder kontaminasie. Mikobakteriële kultuur neem tot ses weke, selfs met die gebruik van vloeistofgebaseerde mediums. Sodanige vertraging in die diagnose is veral in kinders onaanvaarbaar. Tydens hierdie studie is ‘n Nukleïnsuur Amplifikasietegniek ontwikkel deur die aanwending van Hoë Resolusie Smeltanalise en is hierdie nuwe tegniek toegepas op FNAB verkreë monsters wat in die vermelde vervoermedium versamel was. Alhoewel sensitiwiteit nie optimaal was nie, is die tegniek baie spesifiek, eenvoudig en vinnig. Dit kan in roetine mikrobiologie laboratoriums gebruik word om vinnige diagnose te bewerkstellig terwyl daar gewag word vir die kultuur se resultaat. Hierdie studie bied omvattende bewys ter ondersteuning van die gebruik van FNAB in veral kinders met vermoedelike mikobakteriële limfadenopatie in lande met beperkte hulpbronne. Die toepassing van die diagnostiese metodes wat in hierdie studie identifiseer is sal spesiebepaling bespoedig en vroegtydige en toepaslike behandeling verseker. Dit stem ooreen met Millennium Ontwikkelingsdoelwit 6: om TB te beveg deur vroeë opsporing van nuwe gevalle en effektiewe behandeling.

As individuals, college students make choices that both reflect their past lives and constitute their futures. In this research I examine the ways five college sophomores built their lives in the complex world of a research university campus. Using case study analysis I look at how the students negotiated the considerable academic and social demands of their daily lives. College impact models and literature about theories of practice and decision making inform the analysis. Human agency and fields of practice help to explain the behaviors of these students. The research reveals that students take a myriad of paths to negotiate the intricacies of the college context and construct their lives, but that they are guided along those paths by their goals for the future. I interviewed five sophomores at a Doctoral/Extensive university repeatedly over one semester. I discovered that their families and their pre-college academic experiences mattered throughout their first few semesters as they learned to play the college game. Survival depended on their backgrounds, their skills, and the strategies they used to adapt to their new environment. The extent and quality of their interaction with peers, faculty, and other adults on campus also reflected their instrumentalism and indicated their efforts to find a space within the larger campus. Their adjustment to the field of the academy showed a commitment to vocational goals in the long and short term. My analysis illuminates the idiosyncratic process of choosing a major and the nature of a students commitment to a discipline. Taken together, these categories of student life show a complex building process with some similarities and many individual variations.

L'objet de cette recherche est d'analyser les différences d'aspirations et de choix d'orientation à l'entrée dans l'enseignement supérieur. Il s'agit plus particulièrement de déterminer dans quelle mesure les choix « individuels », qui ne sont pas sans incidence sur la construction des inégalités scolaires, dépendent du contexte de scolarisation. En effet, puisque le caractère diversifié des contextes de scolarisation n'est, en France, plus à démontrer, la première partie de ce travail invite, sur la base des travaux issus de la sociologie de l'éducation et de la littérature anglo-saxonne, à considérer les dimensions contextuelles comme pouvant être à l'origine des choix scolaires et des aspirations. Cette question, non explorée en France, pour ce palier d'orientation, a donc été l'objet du travail empirique de la deuxième partie qui a reposé principalement sur un couplage des données du Panel 95 de la DEP et des données IPES ainsi que sur une enquête originale menée auprès d'étudiants. Au terme d'analyses quantitatives multivariées il est mis en évidence que l'environnement scolaire constitue un facteur jouant de manière significative sur les aspirations des lycéens (probabilité d'envisager un type de cursus plutôt qu'un autre et durée des études envisagée). L'environnement scolaire joue de manière significative sur les choix d'études des jeunes à caractéristiques scolaires comparables et à origine sociale donnée. L'effet contextuel mis en évidence est de double nature : agissent conjointement la composition sociale de l'établissement et l'offre locale d'enseignement supérieur (principalement la présence dans l'établissement d'une CPGE). Dans de nombreux cas de figure, les effets cumulés de l'environnement scolaire sont au moins d'importance égale à ceux connus de l'origine sociale individuelle auxquels ils se cumulent. Au total, les préférences des individus, situées dans des contextes inégaux ne sont pas insensibles à l'organisation du système éducatif.

It would be beneficial to incorporate transmembrane proteins (TMPs) into biosensors, because TMPs are important for cell function in healthy and diseased states. These devices would employ an artificial cell membrane to maintain TMP function since cell membranes, which are mostly lipids, are necessary for the TMPs to function. These artificial lipid membranes must be robust for sensor applications. The ruggedness of these artificial membranes can be increased by using polymerizable lipids. Some polymerized lipid membranes exhibit increased stability, while successfully incorporating TMPs.Some polymerized membranes do not support the activity of certain TMPs, while maintaining the function of others. It is believed the physical properties of the membranes are important for TMP function. Some important physical properties of polymerizable lipid membranes have not yet been measured. Here, fluidity and mechanical properties of polymerizable dienoylPC lipid membranes were investigated.Fluorescence Recovery After Photobleaching was used to measure the fluidity of polymerizable dienoylPC membranes. Unpolymerized, UV-polymerized, and redox-polymerized membranes were investigated. Three types of membranes were found: fluid, partially fluid, and immobile. Unpolymerized and some polymerized membranes were fluid, while only polymerized membranes were partially fluid or immobile. Polymer size is believed to cause the differences in fluidity. This study highlights how polymerization parameters can influence membrane fluidity.Micropipette Aspiration was used to measure the mechanical properties of Giant Unilamellar Vesicles (GUVs) composed of dienolyPC lipids. Unpolymerized and UV-polymerized GUVs were investigated. Strength measurements showed that denoylPC GUVs were stronger than sorbylPC GUVs. Area expansion moduli of denoylPCs and mono-SorbPC GUVs were slightly lower than SOPC GUVs, while bis-SorbPC GUVs were substantially easier to stretch. The bending moduli of all GUVs was similar. UV-polymerization had no significant effect on the parameters. The difference in strength between denoylPCs and sorbylPCs is hypothesized to be due to the porous nature of sorbylPCs. It is thought UV-polymerization of these GUVs created polymers too small to significantly alter mechanical properties.It was demonstrated that some stable membranes are also fluid, which is important for the function of certain TMPs. A correlation cannot be made between the bending and stretching moduli of polymerizable membranes and function of TMPs.

Ultrasound imaging is a rapid and noninvasive tool ideal for the imaging of soft tissue infections and is associated with a change of clinician management plans in 50% of cases. We developed a realistic skin abscess diagnostic and therapeutic training model using fresh frozen cadavers and common, affordable materials. Details for construction of the model and suggested variations are presented. This cadaver-based abscess model produces high-quality sonographic images with internal echogenicity similar to a true clinical abscess, and is ideal for teaching sonographic diagnostic skills in addition to the technical skills of incision and drainage or needle aspiration.

Die Qualität des Arbeitslebens ist eine wichtige Dimension der Lebensqualität und findet in vielen modernen Wohlfahrtsmaßen Berücksichtigung. Sowohl objektive als auch subjektive Indikatoren kommen bei der Messung der Arbeitsplatzqualität zur Anwendung. Anhand von Daten einer Bevölkerungsbefragung wird gezeigt, dass von hoher Arbeitszufriedenheit, die mittels Single-Item-Fragen gemessen wird, nicht einfach auf gute Arbeitsbedingungen geschlossen werden kann. Arbeitszufriedenheit erweist sich als komplexes Konstrukt, in dem Adaptions- und Vergleichsprozesse eine wichtige Rolle spielen.

UA Open Access Publishing Fund / Background: Noninvasive positive-pressure ventilation (NIPPV) use has increased in the treatment of patients with respiratory failure. However, despite decreasing the need for intubation in some patients, there are no data regarding the risk of intubation-related complications associated with delayed intubation in adult patients who fail NIPPV. The objective of this study is to evaluate the odds of a composite complication of intubation following failed NIPPV compared to patients intubated primarily in the medical intensive care unit (ICU). Methods: This is a single-center retrospective cohort study of 235 patients intubated between 1 January 2012 and 30 June 2013 in a medical ICU of a university medical center. A total of 125 patients were intubated after failing NIPPV, 110 patients were intubated without a trial of NIPPV. Intubation-related data were collected prospectively through a continuous quality improvement (CQI) program and retrospectively extracted from the medical record on all patients intubated on the medical ICU. A propensity adjustment for the factors expected to affect the decision to initially use NIPPV was used, and the adjusted multivariate regression analysis was performed to evaluate the odds of a composite complication (desaturation, hypotension, or aspiration) with intubation following failed NIPPV versus primary intubation. Results: A propensity-adjusted multivariate regression analysis revealed that the odds of a composite complication of intubation in patients who fail NIPPV was 2.20 (CI 1.14 to 4.25), when corrected for the presence of pneumonia or acute respiratory distress syndrome (ARDS), and adjusted for factors known to increase complications of intubation (total attempts and operator experience). When a composite complication occurred, the unadjusted odds of death in the ICU were 1.79 (95% CI 1.03 to 3.12). Conclusions: After controlling for potential confounders, this propensity-adjusted analysis demonstrates an increased odds of a composite complication with intubation following failed NIPPV. Further, the presence of a composite complication during intubation is associated with an increased odds of death in the ICU.