Clinical Relevance of Genetic Alterations in Acute Lymphoblastic Leukemia in Children with Down syndrome

__Abstract__ Hematopoiesis encompasses the process by which mature peripheral blood cells are generated by differentiation of hematopoietic stem cells (HSC) in the bone marrow (BM). The daughter cells of HSC’s, progenitor cells, can each commit to the myeloid or lymphoid differentiation pathways that lead to the production of one or more specific types of mature blood cells. These cells are then released in the peripheral blood. The myeloid lineage generates platelets, erythrocytes, granulocytes (basophils, neutrophils and eosinophils) and monocytes, whereas the lymphoid lineage differentiates into T and B-lymphocytes

Sectoral specialisation in the EU a macroeconomic perspective

This paper analyses trends in sectoral specialisation in the EU and concludes the following: 1) The European production structure appears more homogenous than that of the US. 2) While sectoral specialisation has shown a slight increase in some smaller euro area countries towards the end-1990s, it is too early to detect any potential impact of EMU. 3) Despite some changes in sectoral composition, the business cycles of euro area countries became more synchronised over the 1990s, which may be seen as reassuring from the point of view of the single monetary policy. 4) Sectoral re-allocation accounts for as much as 50% of the increase in labour productivity growth in business sector services in the euro area. 5) The slowdown of European labour productivity growth relative to the US since the mid-1990s is explained by a stronger performance in the US wholesale and retail trade, financial intermediation and high-tech manufacturing sectors.

Learning to deliver LGBT+ aged care: exploring and documenting best practices in professional and vocational education through the World Café method

Substantial evidence on the adverse impact of ageing on lesbian, gay, bisexual and transgender (LGBT+) populations through the lack of inclusive care services has highlighted the need for education and training of the health and social care workforce to enhance their skills, knowledge and capabilities in this area. We describe a cross-national collaboration across four European Union countries called BEING ME. This collaboration examined the current pedagogic environment within professional, vocational and community-based education to identify what is most valuable for addressing these needs. The World Café method enabled a process of structured learning and knowledge exchange between stakeholders resulting in: (a) identification of best practices in pedagogies, (b) generation of tailored co-produced educational resources, and (c) recommendations on how to improve the knowledge and capabilities of future care professionals in the area of LGBT+ affirmative practices. Combined with themes from the post-Café evaluation, our findings suggest that underpinning professional and vocational education with a person-in-environment perspective facilitates going some way to acknowledging the historical context of older LGBT+ people's lives. Addressing the unique needs of sub-populations within LGBT+ communities and setting these in the context of holistic and person-centred care may better enable the meeting of their unique diverse needs for ageing. Recommendations are made for learning and teaching strategies to support improved LGBT+ aged care

Watersense eindrapport

Dit rapport beschrijft de resultaten van het project WaterSense, dat liep van 2008 tot en met 2012. In het project zijn de mogelijkheden van sensortechnologie onderzocht voor waterbeheer door landbouwers, waterschappen en drinkwaterbedrijven. Het doel van WaterSense was: - het onderzoeken en ontwikkelen van het concept van een beslissingsondersteunend systeem voor waterbeheer met behulp van sensortechnologie; - validatie van het concept aan de hand van een demonstratiesysteem. In WaterSense zijn diverse aspecten van meten, modelleren en sturen met betrekking tot waterkwantiteit, waterkwaliteit en landbouw onderzocht

Educating health and social care practitioners on the experiences and needs of older LGBT+ adults: Findings from a systematic review

Aim(s): To report review findings into interventions used to educate the health and social care workforce on the experiences and needs of LGBT+ older adults. Background: Research demonstrates that inequalities in outcomes on health and social well-being for LGBT+ older adults are perpetuated by the cumulative disadvantages from discrimination and social exclusion throughout the life course and a lack of culturally competent workforce. Methods: A systematic search of peer-reviewed papers published before February 2020 was conducted in electronic databases. The search resulted in a screening of 2,509 papers with nine matching the inclusion criteria, which were rated using the MERSQI quality measure. Results: Studies demonstrated some positive outcomes of interventions, especially an increase in knowledge, but less so in skills and attitudes. Discussion: More robust designs such as randomized controlled trials, the use of standardized measures and a focus more on the longitudinal impact of educational interventions could improve the quality of study designs. Conclusion(s): Diversification of intervention content and patient and public involvement in the design, delivery and evaluation of educational interventions could improve efforts and have a more sustained impact on LGBT+ ageing inequalities. Implications for Nursing Management: Nurse managers have important roles in supporting staff education and ensuring LGBT+ inclusive practice

"Teta, s kom si ti lezbijka?" Z izobraževanjem proti nevidnosti LGBT+ starih ljudi v socialni in zdravstveni oskrbi [Slovenian] / "Auntie, with whom are you lesbian?": with education against the invisibility of LGBT+ old people in social and health care [English]

socialni in zdravstveni oskrbi Specifične značilnosti življenjskih potekov in preteklih izkušenj LGBT+ starih ljudi zahtevajo znanje in ozaveščenost zaposlenih v skrbstvenih poklicih. V članku s pomočjo mednarodne perspektive osvetlimo temeljne teme področja vključujoče oskrbe LGBT+ starih ljudi, s posebnim poudarkom na slovenskem kontekstu, in pri tem izčrpno uporabimo spoznanja evropskega projekta »Being me« (2018–2020). V projektu smo raziskovali dobre prakse na področju izobraževanja in razvili spletna učna gradiva ter pripomočke za zaposlene v socialni in zdravstveni oskrbi. Med načeli in pristopi, ki so nas vodili pri raziskovanju, so bili v ospredju poudarek na medpresečnosti, odpornosti, perspektivi moči, življenjskih zgodbah in sodelovanju z LGBT+ starimi ljudmi v vseh fazah projekta. (English) The specific characteristics of life course and past experiences of LGBT+ old people require knowledge and awareness on the part of carers. In this paper, an international perspective to shed light on key issues in the field of inclusive care for LGBT+ older people is used, with a particular focus on the Slovenian context, drawing extensively on the findings of the European project “Being me” (2018–2020). In the project, we aimed to explore best practice in the area of education and to develop online learning materials and tools for social and health care workers. Among the principles and approaches that guided our research, the focus was put on intersectionality, resilience, strengths perspective, life stories, and collaboration with LGBT+ old people in all phases of the project

"Teta, s kom si ti lezbijka?" : z izobraževanjem proti nevidnosti LGBT+ starih ljudi v socialni in zdravstveni oskrbi

The specific characteristics of life course and past experiences of LGBT+ old people require knowledge and awareness on the part of carers. In this paper, an international perspective to shed light on key issues in the field of inclusive care for LGBT+ older people is used, with a particular focus on the Slovenian context, drawing extensively on the findings of the European project “Being me” (2018–2020). In the project, we aimed to explore best practice in the area of education and to develop online learning materials and tools for social and health care workers. Among the principles and approaches that guided our research, the focus was put on intersectionality, resilience, strengths perspective, life stories, and collaboration with LGBT+ old people in all phases of the project

Profile of down syndrome–associated malignancies: Epidemiology, clinical features and therapeutic aspects

Down syndrome (DS) is a congenital chromosomal abnormality caused by the presence of all or part of a third copy of chromosome 21 (+21). DS is frequently complicated by congenital heart or digestive tract diseases at birth. DS patients are prone to infections and have mental retardation, with dementia such as Alzheimer's disease showing in later life. Furthermore, malignancies with specific characteristics are also highly reported in DS patients compared with non-DS patients. Therefore, DS is believed to be a cancer predisposition syndrome due to the chromosomal instability. Acute myeloid leukemia (AML) and especially acute megakaryoblastic leukemia (AMKL) by French-American-British (FAB) classification are the most frequent hematological malignancies in DS patients, occurring at a rate that is 500 times higher than that in non-DS patients. Interestingly, transient abnormal myelopoiesis (TAM) is observed in approximately 10% of DS neonates with GATA1 mutations, and most TAM patients are asymptomatic and show spontaneous regression; however, about 10%–20% of TAM cases are fatal because of complications such as fetal effusion, liver fibrosis, and other complications.Acute lymphoblastic leukemia (ALL) is also associated with DS, occurring at a rate that is 20 times higher than that in non-DS patients. Furthermore, the prognosis of DS-ALL patients is poorer than that of non-DS-ALL patients. A recent genetic analysis revealed that more than half of DS-ALL cases have a mutation in the CRLF2–JAK pathway, indicating that JAK inhibitors might have a limited effect for DS-ALL patients.Notably, solid tumors such as neuroblastoma, Wilms tumor, and brain tumor, which are frequently observed in non-DS children, are rarely reported in DS children. The reason remains unknown, but it may be because of the triplication of the Down syndrome critical region 1 (DSCR1) gene on chromosome 21. In adult patients with DS, the expected age-adjusted incidence rates of solid tumors are low compared with age-matched euploid cohorts for most cancers except for testicular cancer. Although the average life expectancy of patients with DS will increase with advances in healthcare, the detailed health problems including cancer rates in older DS patients remain unknown. Therefore, these issues will be needed to be addressed in future studies