6,012 research outputs found

    It doesn't end with closure:Optimizing health care throughout life after esophageal atresia repair

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    Whole-genome sequencing of chronic lymphocytic leukemia identifies subgroups with distinct biological and clinical features.

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    The value of genome-wide over targeted driver analyses for predicting clinical outcomes of cancer patients is debated. Here, we report the whole-genome sequencing of 485 chronic lymphocytic leukemia patients enrolled in clinical trials as part of the United Kingdom's 100,000 Genomes Project. We identify an extended catalog of recurrent coding and noncoding genetic mutations that represents a source for future studies and provide the most complete high-resolution map of structural variants, copy number changes and global genome features including telomere length, mutational signatures and genomic complexity. We demonstrate the relationship of these features with clinical outcome and show that integration of 186 distinct recurrent genomic alterations defines five genomic subgroups that associate with response to therapy, refining conventional outcome prediction. While requiring independent validation, our findings highlight the potential of whole-genome sequencing to inform future risk stratification in chronic lymphocytic leukemia

    Soundscape in Urban Forests

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    This Special Issue of Forests explores the role of soundscapes in urban forested areas. It is comprised of 11 papers involving soundscape studies conducted in urban forests from Asia and Africa. This collection contains six research fields: (1) the ecological patterns and processes of forest soundscapes; (2) the boundary effects and perceptual topology; (3) natural soundscapes and human health; (4) the experience of multi-sensory interactions; (5) environmental behavior and cognitive disposition; and (6) soundscape resource management in forests

    A qualitative study exploring whether emotion work conducted by health visitors has an influence on their assessment and identification of children in need of care and protection?

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    There is an increased understanding that experiencing adversity in childhood can have a significantly negative impact on the long-term developmental wellbeing of children and young people, as well as their families and communities. Political and societal ambition is that such adverse experiences and their consequences are eradicated through preventative and early intervention measures taken by health, education, and social care practitioners on the identification of a child(ren) who requires support. Professionals working with children have become increasingly proficient in this type of work however no professional is infallible. As a result, many children and young people living with adverse circumstances can go unnoticed. For some this includes experiencing harm which often only comes to light when they have been significantly or fatally injured. Every child living in the United Kingdom is aligned with the universal health visiting service following birth to school entry. Health visitors play an essential role in “searching for health needs” through the “surveillance and assessment of the population’s health and wellbeing” (Nursing & Midwifery Council [NMC] 2004, page 11) . Such universal contact based on these core principles mean that health visitors are ideally positioned to identify children living in challenging situations but, like others, they can find this difficult on occasions. The purpose of this study is to explore whether health visitors view the emotion work they carry out as part of their role has an influence on their ability to assess, identify, and respond to children in need of care and protection. STUDY – METHOD: The study has been progressed qualitatively, using a reflexive ethnographic approach to interviews as the main data collection and analytic method with short periods of office-based observation. 16 health visitors who managed caseloads of between 100-450 pre-school children were observed and interviewed to understand their experiences, values, and beliefs. Gee’s (2014) toolkit was used to critically analyse the discourse shared during the interviews. FINDINGS: The emergent findings demonstrate that health visitors can be conceptualised as ‘applied clinical anthropologists’ in the way they develop relationships with families to gain access to their home environments. The approach taken is to gather information to the depth required for a social, bioecological assessment (Bronfenbrenner 2005) of a child in the context of their family and community system. Health visitors are welcomed by most families and are often successful in assessing and responding to child need. However, at times, the level of engagement necessary can be overwhelming for both the health visitor and parent/carer. This influences the level of child centred assessment obtained. The study has demonstrated that the influences on the work of the health visitor can be interpreted through a complex interplay of theoretical concepts. Firstly, Bourdieu’s “theory of practice” (Bourdieu & Wacquant 1992, page 4) provides the basis on which to understand why challenges and barriers arise during the relational work of the health visitor with the child and family. Secondly, Gross’ (2014) Emotion Regulation Framework and Hochschild’s (1983) theory of Emotional Labour, are utilised to consider how health visitors and families respond emotionally to these challenges. The study then goes on to demonstrate what impact these responses can have on the assessment of children. RECOMMENDATIONS: Implications for practice are that health visitors require increased rates of supervision. This should include an observational element. Educational programmes for health visitors, require a focus on promoting professional wellbeing with learning sessions on unconscious bias. Research and learning developments are suggested to influence assessment and decision-making practice. Research with other professional groups and children & families is recommended to build on the findings of this study in order to influence future safeguarding policy and practice to protect children

    Development of core competencies for field veterinary epidemiology training programs

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    A workforce with the adequate field epidemiology knowledge, skills and abilities is the foundation of a strong and effective animal health system. Field epidemiology training is conducted in several countries to meet the increased global demand for such a workforce. However, core competencies for field veterinary epidemiology have not been identified and agreed upon globally, leading to the development of different training curricula. Having a set of agreed core competencies can harmonize field veterinary epidemiology training. The Food and Agriculture Organization of the United Nations (FAO) initiated a collective, iterative, and participative process to achieve this and organized two expert consultative workshops in 2018 to develop core competencies for field veterinary epidemiology at the frontline and intermediate levels. Based on these expert discussions, 13 competencies were identified for the frontline and intermediate levels. These competencies were organized into three domains: epidemiological surveillance and studies; field investigation, preparedness and response; and One Health, communication, ethics and professionalism. These competencies can be used to facilitate the development of field epidemiology training curricula for veterinarians, adapted to country training needs, or customized for training other close disciplines. The competencies can also be useful for mentors and employers to monitor and evaluate the progress of their mentees, or to guide the selection process during the recruitment of new staff

    Effectiveness and safety of Levofloxacin containing regimen in the treatment of Isoniazid mono-resistant pulmonary Tuberculosis: a systematic review

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    BackgroundWe aimed to determine the effectiveness and safety of the Levofloxacin-containing regimen that the World Health Organization is currently recommending for the treatment of Isoniazid mono-resistant pulmonary Tuberculosis.MethodsOur eligible criteria for the studies to be included were; randomized controlled trials or cohort studies that focused on adults with Isoniazid mono-resistant tuberculosis (HrTB) and treated with a Levofloxacin-containing regimen along with first-line anti-tubercular drugs; they should have had a control group treated with first-line without Levofloxacin; should have reported treatment success rate, mortality, recurrence, progression to multidrug-resistant Tuberculosis. We performed the search in MEDLINE, EMBASE, Epistemonikos, Google Scholar, and Clinical trials registry. Two authors independently screened the titles/abstracts and full texts that were retained after the initial screening, and a third author resolved disagreements.ResultsOur search found 4,813 records after excluding duplicates. We excluded 4,768 records after screening the titles and abstracts, retaining 44 records. Subsequently, 36 articles were excluded after the full-text screening, and eight appeared to have partially fulfilled the inclusion criteria. We contacted the respective authors, and none responded positively. Hence, no articles were included in the meta-analysis.ConclusionWe found no “quality” evidence currently on the effectiveness and safety of Levofloxacin in treating HrTB.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022290333, identifier: CRD42022290333

    Decolonising Higher Education in the Era of Globalisation and Internationalisation

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    Conceived within a context of transdisciplinarity and pluriversalism, and in rigorous response to the Eurocentric, globalising and nationalising structures of power that undergird and inhabit contemporary praxis in higher education – especially in African higher education – this collection of essays brings to the on-going discourse on decolonisation fresh, rich, probing and multilayered perspectives that should accelerate the process of decolonisation, not only in higher education in Africa, but also in the global imaginary. A remarkable, courageous and potentially revolutionary achievement, this book deserves a special place on curricula throughout the world of higher education

    Stabilization and Resuscitation of Newborns

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    The majority of newborns do not need medical interventions to manage the neonatal transition after birth. However, every year millions of newborns worldwide require respiratory support immediately after birth, and another considerable number of newborns additionally require extensive resuscitation including chest compressions and drug administration. Despite a significant increase in knowledge and development of enhanced therapy strategies over the past few years, morbidity and mortality caused by failures in neonatal transition remain an important health issue. The purpose of this reprint is to support or introduce novel concepts and add information in the area of the “Stabilization and Resuscitation of Newborns”, aiming to improve neonatal care and, as the major objective, to enhance neuro-developmental outcomes
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