Between Abnormal "Otherness" to Groundbreaking "Uniqueness": The Family-Construction Process of the GLBT Family.

The GLBT family is a new postmodern phenomenon demonstrating the accomplishments of marginal groups seeking acceptance within mainstream society. The article is based on a qualitative phenomenological study conducted in Israel during 2012, providing a theoretical model combining a vast number of GLBT parenting options ranging from surrogacy, sperm donation, adoption, and co-parenting. The research consisted of 50 personal interviews that concentrated on the family experiences of couples of gay men and lesbian woman who opted to bring a child into their families. Analysis of the data points to a process of empowerment where societal norms in respect to gender, parenting, and family are deconstructed and then reconstructed. The theoretical model conceptualizes three parenting challenges that highlight the respondent's family experience: "Otherness," belonging, and self-actualization. Research shows that every period of family life addresses a different segment, where one of the three challenges becomes the dominant experience.

Reed-Sternberg cells in Hodgkin's lymphoma present features of cellular senescence.

Hodgkin's Lymphoma (HL) is one of the most prevailing malignancies in young adults. Reed-Sternberg (RS) cells in HL have distinctive large cell morphology, are characteristic of the disease and their presence is essential for diagnosis. Enlarged cells are one of the hallmarks of senescence, but whether RS cells are senescent has not been previously investigated. Here we show that RS cells have characteristics of senescent cells; RS cells in HL biopsies specifically express the senescence markers and cell cycle inhibitors p21Cip1 and p16INK4a and are negative for the proliferation marker Ki-67, suggesting that these cells have ceased to proliferate. Moreover, the RS-like cells in HL lines, stained specifically for senescence-associated ß-galactosidase (SA-ß-gal). Oxidative stress promoted senescence in these cells as demonstrated by their staining for p21Cip1, p16INK4a, p53 and γH2AX. Senescent cells produce copious amounts of inflammatory cytokines termed 'senescence-associated secretory phenotype' (SASP), primarily regulated by Nuclear Factor κB (NF-κB). Indeed, we show that NF-κB activity and NF-κB-dependent cytokines production (e.g., IL-6, TNF-α, GM-CSF) were elevated in RS-like cells. Furthermore, NF-κB inhibitors, JSH-23 and curcumin reduced IL-6 secretion from RS-like cells. Thus, defining RS cells as senescent offers new insights on the origin of the proinflammatory microenvironment in HL.

PKCη promotes senescence induced by oxidative stress and chemotherapy.

Senescence is characterized by permanent cell-cycle arrest despite continued viability and metabolic activity, in conjunction with the secretion of a complex mixture of extracellular proteins and soluble factors known as the senescence-associated secretory phenotype (SASP). Cellular senescence has been shown to prevent the proliferation of potentially tumorigenic cells, and is thus generally considered a tumor suppressive process. However, some SASP components may act as pro-tumorigenic mediators on premalignant cells in the microenvironment. A limited number of studies indicated that protein kinase C (PKC) has a role in senescence, with different isoforms having opposing effects. It is therefore important to elucidate the functional role of specific PKCs in senescence. Here we show that PKCη, an epithelial specific and anti-apoptotic kinase, promotes senescence induced by oxidative stress and DNA damage. We further demonstrate that PKCη promotes senescence through its ability to upregulate the expression of the cell cycle inhibitors p21(Cip1) and p27(Kip1) and enhance transcription and secretion of interleukin-6 (IL-6). Moreover, we demonstrate that PKCη creates a positive loop for reinforcing senescence by increasing the transcription of both IL-6 and IL-6 receptor, whereas the expression of IL-8 is specifically suppressed by PKCη. Thus, the presence/absence of PKCη modulates major components of SASP. Furthermore, we show that the human polymorphic variant of PKCη, 374I, that exhibits higher kinase activity in comparison to WT-374V, is also more effective in IL-6 secretion, p21(Cip1) expression and the promotion of senescence, further supporting a role for PKCη in senescence. As there is now considerable interest in senescence activation/elimination to control tumor progression, it is first crucial to reveal the molecular regulators of senescence. This will improve our ability to develop new strategies to harness senescence as a potential cancer therapy in the future.

Uncomplicated general anesthesia in the elderly results in cognitive decline: does cognitive decline predict morbidity and mortality?

Elderly surgical patients constitute a unique surgical group. They require special consideration in order to preempt the long term adverse effects of anesthesia. This paper examines the proposition that general anesthesia causes harm to elderly patients with its impact being felt long after the anesthetic agents are cleared from the body. One complication, Postoperative Cognitive Decline (POCD), is associated with the administration of anesthesia and deep sedation. Its' occurrence may herald an increase in morbidity and mortality. Based on both human and animal data, this paper outlines a unitary theoretical framework to explain these phenomena. If this hypothesis proves to be correct, anesthesiologist should consider regional rather than general anesthesia for equivalent surgical procedures to reduce POCD and consequently achieving superior patient outcome.

Off-pump coronary artery bypass grafting in a patient with Child class C liver cirrhosis awaiting liver transplantation.

We report the case of a Child class C cirrhotic patient who was diagnosed with coronary artery disease in the course of his pretransplantation evaluation. He underwent off-pump coronary artery bypass grafting (OPCAB), which was complicated with acute renal failure. The morbidity and mortality associated with cardiac operation in patients with cirrhosis is discussed, and the potential advantage of OPCAB in this patient population is emphasized.

Fibrin microbeads (FMB) as a 3D platform for kidney gene and cell therapy.

Cell and gene therapy may alter the outcome of renal diseases, such as hereditary nephropathies, acute and chronic glomerulonephritis and allograft nephropathy. However, owing to blockade of many viral and cellular vehicles by the complex glomerular architecture, the exact nature of gene and cell delivery into specific renal compartments remains currently unknown. To study the interaction of viral vectors with a variety of renal cells and mesenchymal stem cells (MSCs), we employed a novel biological three-dimensional (3D) matrix comprised of fibrin microbeads (FMB) in comparison to monolayer cell culture. Our studies showed that renal cells of both established and primary lines can grow efficiently on FMB and differentiate into epithelial structures, as shown by electron microscopy. Gene delivery into renal cells in 3D was observed for several viral vectors and growth in 3D on FMB conferred resistance to renal cancer cells in the context of oncolytic adenoviruses. Finally, MSCs from various rodent species attached to FMB, grew robustly, survived for several weeks and could efficiently be transduced on FMB. Thus, on the basis of growth, differentiation and transduction of renal cells in 3D, FMB emerge as a novel 3D cellular microenvironment that differs substantially from monolayer cell cultures.

Alternative modalities of help within socio-political and ethnic minorities: self-help among Arabs living in Israel.

The present paper deals with alternative modalities of help within sociopolitical and ethnic minorities. It explores the phenomenon of self-help as one modality of help within the Arab population living in Israel. The analysis is based on four research studies, which incorporate the perspectives of lay people, professionals, self-help group members, and students in the helping professions, regarding definitional issues associated with the concept of self-help and attitudes toward such a modality of help. Findings obtained from the four studies reported here suggest that a natural fit exists between the Arab culture and such a helping modality as self-help organizations. Based on the findings, practical recommendations are outlined for use in the area of social work with socio-political and ethnic minorities.

Experiences of "not belonging" in collectivistic communities: narratives of gays in kibbutzes.

The kibbutz is a uniquely Israeli phenomenon which is currently undergoing major changes, both ideologically and practically. It has attracted worldwide sociological and psychological research attention due to its unique characteristics, particularly in relation to communal child-rearing, education, and family life. The purpose of this paper is to understand the life experiences of homosexuals who experienced their adolescence on kibbutzes during the 1970s. In this study, the life experiences often gay men who still live on the kibbutz or have spent significant periods of their lives on it are examined from their own perspectives in order to understand how they view the connection between homosexuality and kibbutz life. Researching such a topic by utilizing a qualitative research paradigm approach enriches our understanding of the meanings associated with being different and the various ways in which marginality is perceived and experienced within the communal life of the kibbutz. A purposive sample of 10 gay men was recruited, and the age of participants ranged from 17-45. At the time of the interviews, six interviewees still lived on the kibbutz. Each participant was interviewed in-depth, with interviews lasting between one-and-a-half to two hours. All interviews were recorded, transcribed, and analyzed. Two methods were used to analyze the data: analytic induction and constant comparison analysis. The findings suggest an interesting dynamic regarding the experiences of gay men in their transition from one total institution, the kibbutz, to another total institution, the army. Paradoxically, life in the army, which is undoubtedly a restricted system, is accompanied by experiences of freedom and actualization of self when compared to life in the kibbutz. The findings are discussed within the frameworks of differentness and marginality, homosexuality theory from both psychological and sociological perspectives, and the unique ideological and practical aspects of kibbutz life.

Commitment among Arab adolescents in Israel.

Arab adolescents' commitments to their own self-development, their family, their extended family, the Arab people, and their village were explored. The sample consisted of 662 Arab adolescents in 12th grade in 7 high schools in Arab villages, Arab towns, and mixed towns (Jews and Arabs) in Israel. The findings reflect the unique situation of Arab adolescents living in Israel. The polarity found between individualistic and collectivistic ideas, in terms of commitment, illustrates the cultural transformation that Arab society in Israel is currently undergoing.

An experiential attitude change: social work students and homosexuality.

This paper describes and analyzes an attitude change among third year undergraduate social work students in a major university in Israel. The subject of attitudes towards homosexuality, while receiving extensive theoretical attention, lacks documentation of actual change in attitudes. This paper is an attempt to fill the gap by using a quasi-experimental non-equivalent control group design evaluation of the impact of an elective course on homosexuality on students' attitudes. The experimental group was comprised of 31 students who enrolled in an elective course, entitled "Individual, familial, and social aspects of homosexuality." The course combined theoretical as well as experiential frameworks. The control group was comprised of 56 third-year social work students who did not enroll in the course. Both quantitative and qualitative methodologies were employed in comparing the two groups prior to and following the intervention. Specifically, a 25-item questionnaire was used to measure homophobia attitudes, and an open-ended question was used to qualitatively explore the students' associations with the term "homosexuality." Findings are discussed within the frameworks of the current literature regarding attitudes towards homosexuality, attitude change, social work education, and the unique situation in Israel.

Israeli professionals' knowledge and attitudes towards AIDS.

This paper explores Israeli professionals' knowledge about and attitudes towards AIDS. While AIDS in Israel is not generally considered to be a pressing crisis, the aim of the research is to document and analyze what professionals in the helping professions know and how they feel about AIDS. The study also explores thoughts and feelings concerning AIDS-related education and training. The study sample consists of 370 professionals, including social workers, nurses, occupational therapists, psychologists, and special education teachers and counselors. Results indicate that professionals' knowledge scores were significantly higher than their attitude scores. Significant differences were found according to nationality and perception of adequate training. Jews were more knowledgeable than Arabs, and those who perceived their AIDS-related training as adequate were more knowledgeable than those who did not. The attitude scores related to both gender and nationality. Women scored higher than men, and again Jews scored higher than Arabs. Two regression models predicting both knowledge and attitude are presented and their implications are discussed. As far as differences among the various professional groups, no differences appear in their knowledge scores; however, nurses scored significantly lower on the attitude scale than did the other groups.

The discovery that an offspring is gay: parents', gay men's, and lesbians' perspectives.

This study explores and integrates parents', gay men's, and lesbians' perceptions of the "coming out" process. The research employed a sample of thirty-two gay and lesbian young adults and twenty-seven parents. It investigated how family dynamics prior to the discovery of homosexuality could be related to post-discovery experiences on parts of both children and parents. In-depth interviews were conducted with all participants. Two bodies of literature enriched the theoretical framework for this study: self-disclosure literature and the literature pertaining to homosexual identity formation. Findings of this study call for educating parents about homosexuality prior to the actual act of disclosure. Ensuring that parents do not learn about homosexuality while finding out that their child is gay potentially eases parents' adjustment to the discovery and thus may also improve the emotional dynamics within the family.

Attitudes of superintendents of institutions for the mentally retarded towards deinstitutionalization: a cross-cultural perspective.

A cross-cultural study was conducted on the attitudes of superintendents of institutions regarding deinstitutionalization in the United States and in Israel. The attitudes of 29 superintendents from Israel were compared with the attitudes of 181 American superintendents. The most general finding was that in spite of important legislative and demographic differences, in both countries the attitudes were neither highly in favor nor strongly against deinstitutionalization. Most respondents in both countries believed that the parents of the mentally retarded do not generally support deinstitutionalization.