Unforeseen Finding Research Articles

Parents' perspectives on the unforeseen finding of a fetal sex chromosomal aneuploidy

To investigate the parental perspectives of being confronted with an unforeseen fetal sex chromosomal aneuploidy (SCA), in light of the fact that this accidental finding is avoidable by rapid aneuploidy detection (RAD). Exploratory qualitative interview study. We conducted 16 semi-structured interviews with parents who decided to continue pregnancy after the unforeseen finding of a fetal SCA. The communication of the unforeseen finding of SCA; the informed decision-making process concerning the pregnancy follow-up and the child and its future were the extracted themes. Parents were not prepared to accidental findings in routine prenatal diagnostics. All started an unguided search on the Internet. It is not at all clear whether parents have preference for an RAD test with X and Y probes Parents were satisfied with the post-test professional information they received to make an informed decision, whereas after birth questions still remained to be answered. Parents' perspectives may serve as major contributors to research on the question whether or not the X and Y probes should be standard included for purposes of RAD. The fact that RAD has the possibility to avoid accidental findings of SCAs, brings up the question whether any benefits outweigh the potential harms.

The antipsychotics olanzapine, risperidone, clozapine, and haloperidol are D2-selective ex vivo but not in vitro.

In a recent human [(11)C]-(+)-PHNO positron emission tomography study, olanzapine, clozapine, and risperidone occupied D2 receptors in striatum (STR), but, despite their similar in vitro D2 and D3 affinities, failed to occupy D3 receptors in globus pallidus. This study had two aims: (1) to characterize the regional D2/D3 pharmacology of in vitro and ex vivo [(3)H]-(+)-PHNO binding sites in rat brain and (2) to compare, using [(3)H]-(+)-PHNO autoradiography, the ex vivo and in vitro pharmacology of olanzapine, clozapine, risperidone, and haloperidol. Using the D3-selective drug SB277011, we found that ex vivo and in vitro [(3)H]-(+)-PHNO binding in STR is exclusively due to D2, whereas that in cerebellar lobes 9 and 10 is exclusively due to D3. Surprisingly, the D3 contribution to [(3)H]-(+)-PHNO binding in the islands of Calleja, ventral pallidum, substantia nigra, and nucleus accumbens was greater ex vivo than in vitro. Ex vivo, systemically administered olanzapine, risperidone, and haloperidol, at doses occupying approximately 80% D2, did not occupy D3 receptors. Clozapine, which also occupied approximately 80% of D2 receptors ex vivo, occupied a smaller percentage of D3 receptors than predicted by its in vitro pharmacology. Across brain regions, ex vivo occupancy by antipsychotics was inversely related to the D3 contribution to [(3)H]-(+)-PHNO binding. In contrast, in vitro occupancy was similar across brain regions, independent of the regional D3 contribution. These data indicate that at clinically relevant doses, olanzapine, clozapine, risperidone, and haloperidol are D2-selective ex vivo. This unforeseen finding suggests that their clinical effects cannot be attributed to D3 receptor blockade.

Computer mediated communication and informalization of discourse: The influence of culture and subject matter

This article compares the language used in four online written asynchronous fora in English, Spanish and Catalan about football. We pay special attention to the use of informal, conversational language in these written texts. The results are then compared to a previous analysis of online fora in the three languages about a more serious topic, the Israeli-Palestinian conflict. Our initial hypotheses were that the linguistic behaviour in the English fora would show more informal, conversational characteristics than the Spanish and Catalan fora and that the fora about football would be more conversational than those about the Israeli-Palestinian conflict. Our study largely confirms that, in the discussion groups studied, online asynchronous computer mediated communication in English displayed markedly more oral elements than in Catalan and Spanish, both in fora devoted to a serious topic and in fora devoted to sport. While the Catalan and Spanish showed more informal, conversational elements than the corresponding fora about politics, this topic related difference was not so clear in the case of the English fora. Another unforeseen finding was that the English asynchronous forum devoted to sport displayed a number of features associated with synchronous CMC.

The applicability of an operations management approach to councils' waste services

PurposeThis paper arises from a study examining the causality of change by exploring whether best value and performance management had caused change within councils' waste services. The purpose of this paper is to represent one of the unforeseen findings arising from the research programme.Design/methodology/approachThe paper was an exploratory, inductive theory‐building study using a practitioner‐researcher approach to develop a conceptual model based upon a literature review and a case study research methodology.FindingsThe paper finds that, despite much publicity, the cases studied did not use performance management frameworks to structure change and, in this regard, operations management may offer a better approach by which councils could include operational service delivery within the development of corporate strategy. Research limitations/implications – The practitioner‐researcher approach provided particular insights to this paper, which may not be apparent otherwise. One of the principal findings was that there appeared to be an absence of coordinated independent research relating to management theory and councils' service delivery, as opposed to private sector applications of theory and practice, which appears unbalanced, especially given that the public sector is one of the largest employers in the UK. Simply transferring private sector performance management approaches without scrutiny and amendment to the different cultural and structural working environment within councils would appear imperfect and likely to create ad hoc success. These findings relate specifically to councils' waste services but may have a relevance outwith these operations.Practical implicationsThis paper recommended that further research should be conducted to develop a greater understanding of council management practice and how this could be positively affected. Simply recommending the transposition of private sector approaches was unlikely to work and, similarly, the current hands‐off approach adopted both between government and councils and between councils' corporate centres and their operational services suggested the emergence of strategic/operational divides. This could be overcome with a more balanced approach and secondments between the different tiers.Originality/valueAs practitioner‐research, this paper provides an insight into how councils' waste services are prioritizing change, which highlights the emergence of an apparent, growing dislocation between different government tiers. These findings emerge following case study research from a service whose perspectives on management theory rarely get expressed, due to the demands arising from daily operational delivery.

Becoming a Nonexpert and Other Strategies for Managing Fieldwork Dilemmas in the Criminal Justice System

In this article, the author presents three fieldwork strategies for managing role conflict in criminal justice settings. One of the most critical issues for ethnographers immersed in fieldwork is balancing the tension between the researcher and participant-observation roles. Ethnographers in criminal justice settings as well as other types of street-level bureaucracies are commonly confronted with dilemmas involving physical risk, highly sensitive data, marginalized clientele, and the exploitive use of power and domination by institutional gatekeepers. Researchers venturing into challenging fieldwork settings, such as criminal justice environments, must be highly attuned to the constraints and opportunities for collecting data. The author argues that these strategies can augment ethnographers' “data collection toolkit” to better address fieldwork problems. In addition, deploying these strategies can help to reveal unforeseen findings in the study.

Persistence of elevated rabies prevention costs following post-epizootic declines in rates of rabies among raccoons ( Procyon lotor)

Determining the benefits to cost relationships among different approaches to rabies control and prevention has been hindered by the inherent temporal variability in the dynamics of disease among wildlife reservoir hosts and a tangible and objective measure of the cost of rabies prevention. A major and unavoidable component of rabies prevention programs involves diagnostic testing of animals and the subsequent initiation of appropriate public health responses. The unit cost per negative and positive diagnostic test outcome can be reasonably estimated. This metric when linked to methodologies subdividing the epizootic process into distinct temporal stages provided the requisite detail to estimate benefits derived from rabies control strategies. Oral rabies vaccine (ORV), for prevention of the raccoon-associated variant of rabies, has been distributed in Ohio and adjoining states in an effort to develop an immune barrier to the westward spread of epizootic raccoon rabies. The costs of ORV delivery have been quantified. Herein, the cost structures required to assess the benefits accrued by prevention were developed. A regression model was developed effectively predicting ( r 2 = 0.70) the total number of rabies diagnostic tests performed by 53 counties in five northeastern (NE) states from 1992 to 2001. Five temporal stages sufficed to capture the range of variability in the raccoon rabies epizootic process. Unit costs, dollars per diagnostic test outcome, were calculated for negative and positive results from published reports. Ohio counties were matched to NE counties based on similar socioeconomic characters. A “pseudo-epizootic” of raccoon rabies was introduced into Ohio and the costs savings from ORV were derived as the excess costs imposed by epizootic spread throughout the state. At 46 km/year (range modeled, 30–60 km/year), the pseudo epizootic spread, and reached the enzootic stage, in all Ohio counties by year 13 (range modeled, 11–17 years). Cumulative excess costs for Ohio ranged between $11 and $21 million; counties of low socioeconomic status experienced the greatest relative excess costs. The costs for rabies prevention activities reached apices during the epizootic stage of raccoon rabies (2.7–10.8 times baseline) an unforeseen finding indicated elevated costs persisted (1.7–7.2 times baseline) into the enzootic stage.