Professional misconduct in healthcare : setting out a research agenda for work sociology

In the light of its surprising absence in extant literature in the domain of the sociology of work, specifically within the journal Work, Employment and Society, this article represents a ‘call to arms’ for research focused upon professional misconduct in healthcare. Specifically, interrogation of four dimensions of professional misconduct in healthcare is called for: a broader definition of professional misconduct; antecedents of professional misconduct that recognise the effect of context; professional response to regulation of misconduct; and the hierarchical and affective challenge to frontline professionals blowing the whistle on professional misconduct

Real-time cell analysis by xCELLigence®: a new method for dynamic, quantitative measurement of adhesion and proliferation of cell lines

Objectives. In this study, we report the use of a real-time cell analysis (RTCA) test system, the xCELLigence® RTCA, as efficient tool for a fast growth kinetics analysis of cell lines. This new dynamic real-time monitoring and impedance-based assay allows for a combined measurement of cell adhesion, spreading and proliferation. Methods. We used four representative human OSCC derived cell lines, PE49, HSC2, HSC3 and PE15 cells. The measured impedance values could be correlated to characteristic cell culture behaviours. In parallel, were evaluated proliferation and cell viability of the cell lines by the 3-[4,5-dimethylthizol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay. Results. Through the analysis we were able to quantitatively characterize the growth kinetics of the cell lines. The results are in agreement with the analysis MTT and for us will be the basis for future studies with respect to these lines.Conclusions. The advantage of impedance-based measurements is mainly based on these continuous monitoring of cell responses for a broad range of different cells and with different parameters of culture. Therefore, the xCELLigence system can be used as a rapid monitoring tool for cellular viability and used for multiple applications, such as toxicity testing of xenobiotics, biocompatibility of dental materials, tests of invasion and migration using in vitro cell cultures

Oral squamous cell carcinoma as a complication of chronic graft-versus-host disease: a case report

Objectives. Chronic Graft-Versus-Host Disease (cGVHD) is an immunoregulatory disorder which occurs after allogeneic hematopoietic-cell transplantation (HCT) and often shares features of autoimmunity and immunodeficiency. GVHD related oral manifestations include severe oral pain, xerostemia, ulcerative lesions, and mucositis. Furthermore,a major late suggested complication of HSCT is the dramatically increased risk of secondary malignancies including oral cancer and oral cGVHD-releted inflammation may be considered a potential risk factor. Case report. A 51-year-old male patient referred in 1994 to our surgery for cGVHD oral lesions secondary to HCT for acute myelogenous leukemia developed in 1992. In 2010, an incisional biopsy in left retrocommissural region for an erosive lesion was performed and microscopic analysis revealed an intense lymphoplasmacytic inflammatory infiltrate. In 2011, clinical intraoral examination revealed white verrucous plaque lesion associated with ulcerations on the gingiva of the V sextant and on the lower labial mucosa; two incisional biopsies of oral mucosa and an incisional skin biopsy were performed. Microscopic analysis revealed a well differentiated SCC, a moderately differentiated SCC and a skin high grade dysplasia. Patient was surgically treated and is currently in follow up. Conclusions. Several authors suggest that cGVHD-related inflammation could be an important risk factor for carcinogenesis, also for oral cavity. Then it is recommended close follow-up to all patients treated with HCT, particularly when they develop graft-versus-host disease, and any suspicious oral lesions should be biopsied to rule out dysplasia or malignancy

A rapid review of time management strategies among nurse managers

Background: Time management practice is the act of influencing one's behavioural dimensions to complete as many tasks as possible within a specified amount of time. These behavioural dimensions include work organization and the continued application of time management techniques. Good time management, such as setting goals and priorities, as well as planning and delegating tasks, can facilitate productivity and success, contributing to work effectiveness, maintaining balance and job satisfaction. Conversely, poor time management has been associated with poor quality of work, low productivity, negative influence on the career path, and high levels of stress. Aim: The study aims to identify the strategies used by middle nurse managers in time management. Methods: A rapid review of biomedical databases was undertaken during the month of June 2021. The included studies were published in English and in Italian. Results: Findings reveal that the most used and effective time management strategies for nurse managers are setting goals, and priorities and delegating tasks. Other useful strategies also found to be fundamental are discussed in detail. Conclusion: A manager should prioritize the concept of planning, which can be counted as an efficient time management technique and educate himself on delegating. Time management has an impact not only on productivity and organizational success, but also on the balance between private and working life of managers

ENDOCANNABINOIDS CB1 AND CB2: A POSSIBLE ROLE IN ORAL SQUAMOUS CELL CARCINOMA PATHOGENESIS

Aim. Cancer of the oral cavity is the eighth most common malignancy in the world. The disease is diagnosed after a considerable delay and predict the individual progression is difficult. The improvements of the therapy did not increased the rate of survival at 5 years, that is still about 50%. The identification of the possible markers that indicates the progression of the tumor is therefore necessary. Endocannabinoids may play an important role in the process of carcinogenesis in the oral mucosa. They are able to bind and activate specific membrane receptors coupled to G proteins, cannabinoid receptors CB1 and CB2. The purpose of this study is to evaluate the expression of CB1 and CB2 receptors in the development of oral cancer through the immunohistochemical study on samples of OSCC. Materials and methods. We selected 44 cases of patients with the primary tumor in the oral cavity. The stage of the tumor was classified according to the TNM system. The tumors grading was divided into I, II and III grade. The paraffin sections were analyzed by immunohistochemistry. The assessment of the immunoreactivity for CB1 and CB2 receptors was weak or strong. For quantitative analysis the expression of CB1 and CB2 receptors was evaluated in percentage with scale of values ??ranging from 0 to 100%. Results. The immunohistochemical examination of the samples analyzed showed the absence of expression of CB1 and CB2 receptors in normal mucosa, while peritumoral mucosa showed a weak expression in the vicinity of cancer and tumor mucosa showed an overexpression of receptors. Furthermore, the intensity of staining increased with the increase of the grading. It can be concluded that the strong immunoreactivity of CB1 and CB2 receptors is related to aggressive behavior of oral carcinoma. Conclusions. The analysis of endocannabinoids and their receptors on tissue biopsies taken from carcinoma of the oral cavity may therefore indicate future therapeutic targets and new prognostic biomarkers in these patients, especially in the early stages of the disease. The ultimate goal of this work is to indicate the possible role of CB1 and CB2 receptors such as tumor biomarker that may help in the early diagnosis of oral cancer and therefore contribute to reduce drastically the mortality of this disease

Interleukin-13 induces expression and release of interleukin-1 decoy receptor in human polymorphonuclear cells.

The aim of this study was to examine whether interleukin-13 (IL-13), a cytokine with anti-inflammatory activities, affected expression of interleukin-1 (IL-1) receptors (R) in human polymorphonuclear cells (PMN). Treatment with IL-13 augmented both type I and type II (decoy) R transcripts, with the latter being by far the most represented. The transcriptional inhibitor actinomycin D blocked the induction of IL-1 R mRNAs by IL-13. Nuclear run-off experiments demonstrated an augmented transcriptional rate of IL-1 decoy R in IL-13-treated B lymphoblastoid cells. The protein synthesis inhibitor cycloheximide blocked type I R expression but superinduced decoy R expression. IL-13 augmented the binding of radiolabeled IL-1 beta on the PMN surface with an increased number of IL-1 receptors and no change in Kd values. IL-13 induced the surface expression of IL-1 decoy R and the release by PMN of an IL-1-binding protein identified as a soluble version of the IL-1 decoy R. These results show that PMN is an important target for IL-13 and that induction of expression and release of the IL-1 decoy R, in concert with inhibition of cytokine synthesis, may represent an important mechanism by which IL-13 blocks IL-1, a central mediator of inflammatory reactions

Oral health status and periodontitis in Alzheimer's disease patients: A case control Study in a Sicilian rural community

Aim. Dementia is a common disorder among the elderly. Alzheimer’s disease (AD) is the most common cause of dementia. In addition to known risk factors (e.g. age and familiarity) of AD, recently it has been suggested a possible promoting role for chronic inflammatory infective diseases. Periodontal disease (PD) is a frequent chronic multi-bacterial infection involving the tissues supporting the teeth; in addition to promoting inflammation locally, the periodontal pathogens possess mechanisms able to influence the systemic balance of inflammatory mediators. Similarly to other systemic diseases (e.g. cardiovascular disease, diabetes, renal diseases and low birth weight), a possible link has been proposed between PD and the development and progression of AD. Aim of the present study was to evaluate the oral health status and the prevalence/severity of PD in a group of patients affected by AD compared to a control group of healthy subjects. Materials and methods. A case-controlled clinical trial was designed to compare patients with AD (Test group - T; n = 16; M: 8; F: 8, range age 64-93 yrs) with healthy controls (Control group - C; n = 16; M: 8; F:8; range age 64-92 yrs). The population study was named ZAP (Zabut Aging Project) and all participants, enrolled in a Sicilian rural community (Sambuca di Sicilia, AG, Italy), were matched for age and sex. Following variables were recorded: smoking and drinking habits, number of teeth, Decayed Missed Filled Teeth scoring (DMFT), measurement of the probing depth (CPI and PSR index). The association between AD and PD, socio-demographic and behavioural-clinical variables was assessed using the χ2 test or Fisher’s exact test, as appropriate. To measure the association level, crude OR and the 95% Confidence Interval (CI) were calculated. Statistical significance of the difference in the average DMFT between cases and controls was assessed using the Student’s t-test. A p value ≤0.05 was considered statistically significant. Results. One patient of T group was a smoker versus four of C group; four T patients were drinker versus two of C group. Seven of T group (43.7%) were totally edentulous, conversely only 2 (12.5%) of controls have the same condition (p=0.04). With respect to oral status, DMFT index was 23.7 ±9.0 in T patients versus 25.2±7.8 in controls (p=0.633). There were no significant differences between T and C groups regarding periodontal index: high PSR and CPI scores (>3) were recorded in 77.8% of AD patients and 46.1% of health cases (p >0.05). A similar distribution among two groups was observed regarding the other investigated variables (e.g. smoking and drinking habits). Conclusions. In this rural Sicilian adult/elderly community, poor oral health is frequent with a DMFT score higher than general population. The obtained data do not support the hypothesis of a major prevalence and severity of PD among AD patients. However, to confirm these preliminary results the recruitment of a wider sample size and further data, regarding proteomic salivary profiles and RT PCR-based microbiological investigation on sub-gingival plaque samples, still need in order to better clarify the role of PD and periodontal pathogens in the AD natural history