The applicability of the decisional conflict scale in nursing home placement decision among Chinese family caregivers: A mixed methods approach

This study aimed to 1) examine relationships between uncertainty, perceived information, personal values, social support, and filial obligation among Chinese family caregivers faced with nursing home placement of an older adult family member with dementia; and 2) describe the applicability of the Decisional Conflict Scale in nursing home placement decision making among Chinese family caregivers through the integration of quantitative and qualitative data. We used a mixed-methods approach. Quantitative data analysis consisted of descriptive and correlational statistics. We utilized a thematic analysis for the qualitative data. Data transformation and data comparison techniques were used to combine qualitative and quantitative data. Thirty Chinese family caregivers living in Taiwan caring for an older adult with dementia participated in this study. We found a significant association among the quantitative findings, which indicated that perceived information, personal values, social support, and filial obligation, and nursing home placement decisional conflict. Mixed-method data analysis additionally revealed that conflicting differences existed between the traditional role of Chinese family collective decision making and the contemporary role of single family member surrogate decision making. Although the Decisional Conflict Scale can be utilized when exploring nursing home placement for an older adult with dementia among Chinese family caregivers, applicability issues existed regarding cultural beliefs and values related to filial piety and family collectivism. Findings strongly support the need for researchers to consider cultural beliefs and values when selecting tools that assess health-related decision making across cultures. Further research is needed to explore the role culture plays in nursing home decision making

Multistage carcinogenesis and the incidence of thyroid cancer in the US by sex, race, stage and histology

Abstract Background Thyroid cancer has the fastest growing incidence in the US. However, the underlying causes are still under debate. Methods We analyzed thyroid cancer incidence in the SEER-9 registry from 1973-2010 using multistage carcinogenesis and age-period-cohort models. Multistage models were used to investigate differences in initiation, promotion and malignant conversion rates of thyroid tumors by sex, race, stage, and histology. Models were adjusted for period and cohort trends to investigate the contributions of each factor, and determine whether birth- or diagnosis-year better correlate with observed incidence patterns. Results Significant increases in thyroid cancer incidence by period or calendar-year were found for all sex, race, stage and histology combinations, particularly for localized cases (a 3- and 4-fold increase from 1973-2010 for females and males, respectively). Multistage analyses suggest that the 3-fold higher incidence in women could be explained by 1.5-fold higher initiation and promotion rates. Analyses by race suggest that the lower incidence in blacks can be attributed to lower promotion rates versus whites. Analysis by histology showed considerable decreases in follicular cancer incidence by birth-cohort since the early 1900s. Conclusions Multistage modeling suggests that variations in thyroid cancer initiation and promotion can explain the observed differences in incidence by sex, race and histology. The consistent increases in incidence by calendar-year for all sex-race-histology-stage combinations suggest that the rise may be predominantly due to more intensive screening-diagnostics, although an environmental factor may be also at play. Our analyses constitute a first step towards the development of thyroid cancer natural history models.http://deepblue.lib.umich.edu/bitstream/2027.42/113073/1/12889_2015_Article_2108.pd

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Best practices for venture philanthropy collaborations between disease-focused foundations and for-profit life science companies by Joanne Chang.

Thesis (S.M.)--Harvard-MIT Division of Health Sciences and Technology, 2010.Cataloged from PDF version of thesis.Includes bibliographical references (p. 69-71).The history of private philanthropy in the US has been dominated by family foundations with arms-length philanthropy practices that largely existed in separation from commercial enterprise and business operations. This paper looks at emerging organizational and funding models being used in a wide range of disease areas in which philanthropy has shifted towards a more "venture-oriented" model sometimes referred to as disease foundation venture philanthropy (DFVP) as practiced by disease focused foundations (DFFs). More specifically, this research seeks to understand how these models map onto the range of translational challenges confronted by those engaged in bringing ideas from the bench to the bedside and it explores our current understanding of DFVP best practices. It concludes by raising questions and addressing issues designed to assist those who seek to setup successful collaborations between DFFs and industry partners.S.M

A Loophole In Financial Accounting: A Detailed Analysis Of Repo 105

From 2000 to 2008, Lehman used repo transactions to hide billions of dollars on their statements. They alsomisrepresented the repo transactions as secured borrowings even though they actually recorded the transactions as sales. Valukas report in 2010 stimulated an extensive coverage of the repo transactions and spurred an array of studies addressing issues related to the collapse of financial institutions. Since the Repo 105 maneuver of Lehman provides a good example on how regulatory deficiencies can induce companies to obscure financial reporting and the importance of ethics in deterring these abuses, our study intends to examine repo transactions related accounting standards, illustrate how repo transactions can enhance a banks financial statements, and discuss the importance of business ethics in curtailing accounting irregularities

Transcriptional landscape of epithelial and immune cell populations revealed through FACS-seq of healthy human skin.

Human skin consists of multiple cell types, including epithelial, immune, and stromal cells. Transcriptomic analyses have previously been performed from bulk skin samples or from epithelial and immune cells expanded in cell culture. However, transcriptomic analysis of bulk skin tends to drown out expression signals from relatively rare cells while cell culture methods may significantly alter cellular phenotypes and gene expression profiles. To identify distinct transcriptomic profiles of multiple cell populations without substantially altering cell phenotypes, we employed a fluorescence activated cell sorting method to isolate keratinocytes, dendritic cells, CD4+ T effector cells, and CD8+ T effector cells from healthy skin samples, followed by RNA-seq of each cell population. Principal components analysis revealed distinct clustering of cell types across samples, while differential expression and coexpression network analyses revealed transcriptional profiles of individual cell populations distinct from bulk skin, most strikingly in the least abundant CD8+ T effector population. Our work provides a high resolution view of cutaneous cellular gene expression and suggests that transcriptomic profiling of bulk skin may inadequately capture the contribution of less abundant cell types