1,042 research outputs found
Stress, Motivation and Professional Satisfaction among Health Care Workers in HIV/AIDS Care and Treatment Centers in Urban Tanzania: A Cross-Sectional Study.
Shortages of health care workers (HCWs) represents a serious challenge to ensuring effective HIV care in resource-limited settings (RLS). Stress, motivation, and job satisfaction have been linked with HCW retention and are important in addressing HCW shortages. In this cross-sectional study HCW stress, motivation and perceived ability to meet patient needs were assessed in PEPFAR-supported urban HIV care and treatment clinics (CTCs) in Tanzania. A self-administered questionnaire measuring motivation, stress, and perceived ability to and meet patient needs was given to HCWs at 16 CTCs. Scales measuring HCW satisfaction, motivation, and stress were developed using principle components analysis. Hierarchical linear models were used to explore the association of HCW and site characteristics with reported satisfaction, stress, motivation, and ability to meet patients' needs.\ud
Seventy-three percent (279) of HCWs completed the questionnaire. Most (73%) HCWs reported minimal/no work-related stress, with 48% reporting good/excellent motivation, but 41% also reporting feeling emotionally drained. Almost all (98%) reported feeling able to help their patients, with 68% reporting work as rewarding. Most reported receipt of training and supervision, with good availability of resources. In the multivariate model, direct clinical providers reported lower motivation than management (p < 0.05) and HCWs at medium-sized sites reported higher motivation than HCWs at larger sites (p < 0.05). HCWs at small and medium sites were more likely to feel able to help patients than those from larger sites (p < 0.05 and p < 0.001 respectively). Despite significant patient loads, HCWs in these PEPFAR-supported CTCs reported high levels of motivation, job satisfaction, ability to meet patients' needs, low levels of stress but significant emotional toll. Understanding the relationship between support systems such as strong supervision and training and these outcomes is critical in designing interventions to improve motivation, reduce stress and increase retention of HCWs
Modeling early haematologic adverse events in conformal and intensity-modulated pelvic radiotherapy in anal cancer
AbstractBackground and purposeTo determine if there are differences between dose to pelvic bone marrow (PBM) using intensity modulated radiotherapy (IMRT) under UK guidance versus conformal radiotherapy (CRT) per ACT II protocol and if differences translate to rates of early haematological adverse events grade 3 or greater (HT3+).Methods and materialsTwo groups of 20+ patients, treated under IMRT and CRT regimes respectively, were identified. All patients underwent weekly blood cell count: haemoglobin (HgB), white cell count (WCC), absolute neutrophil count (ANC) and platelets (plats).Percent volume of PBM and sub structures receiving 5–25Gy were tested for statistical significance. Regression models were used to test for correlation to blood counts. NTCP modeling was also performed.ResultsPMB dose metrics showed a significant increase in the IMRT group. Regression analysis showed iliac and lumbosacral PBM dose metrics to associate with reduced nadir ANC and WCC. NTCP at HT3+ was 0.13 using IMRT relative to 0.07 using CRT (p<0.05).ConclusionWhilst this is a relatively small retrospective study and lacks information on the distribution of active PBM, IMRT treatment has been shown to significantly increase PMB irradiation. PBM dose metrics have been shown to be predictive of WCC and ANC suppression. NTCP modeling predicts much high risk of HT3+. Paradoxically, actual rates of HT3+ were comparable suggesting that differences in the distributions of dose metrics maybe a significant factor and/or that there are insufficiency in the NTCP modeling
Sigma-2 receptor agonist derivatives of 1-Cyclohexyl-4-[3-(5-methoxy-1,2,3,4-tetrahydronaphthalen-1-yl)propyl]piperazine (PB28) induce cell death via mitochondrial superoxide production and caspase activation in pancreatic cancer
Abstract
Background
Despite considerable efforts by scientific research, pancreatic cancer is the fourth leading cause of cancer related mortalities. Sigma-2 receptors, which are overexpressed in several tumors, represent promising targets for triggering selective pancreatic cancer cells death.
Methods
We selected five differently structured high-affinity sigma-2 ligands (PB28, PB183, PB221, F281 and PB282) to study how they affect the viability of diverse pancreatic cancer cells (human cell lines BxPC3, AsPC1, Mia PaCa-2, and Panc1 and mouse Panc-02, KCKO and KP-02) and how this is reflected in vivo in a tumor model.
Results
Important cytotoxicity was shown by the compounds in the aggressive Panc02 cells, where cytotoxic activity was caspase-3 independent for four of the five compounds. However, both cytotoxicity and caspase-3 activation involved generation of Reactive Oxygen Species (ROS), which could be partially reverted by the lipid antioxidant \u3b1-tocopherol, but not by the hydrophilic N-acetylcysteine (NAC) indicating crucial differences in the intracellular sites exposed to oxidative stress induced by sigma-2 receptor ligands. Importantly, all the compounds strongly increased the production of mitochondrial superoxide radicals except for PB282. Despite a poor match between in vitro and the in vivo efficacy, daily treatment of C57BL/6 mice bearing Panc02 tumors resulted in promising effects with PB28 and PB282 which were similar compared to the current standard-of-care chemotherapeutic gemcitabine without showing signs of systemic toxicities.
Conclusions
Overall, this study identified differential sensitivities of pancreatic cancer cells to structurally diverse sigma-2 receptor ligands. Of note, we identified the mitochondrial superoxide pathway as a previously unrecognized sigma-2 receptor-activated process, which encourages further studies on sigma-2 ligand-mediated cancer cell death for the targeted treatment of pancreatic tumors
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Thunderstorm occurrence at ten sites across Great Britain over 1884–1993
The UK Met Office's Daily Weather Reports (DWR) contain extensive logs of UK thunderstorm activity. To date, only a very small fraction of these data have been digitized as part of the MIDAS dataset, and exclusively after 1950. Using the recently‐scanned UK Met Office Monthly Weather Reports (MWR), which are based on a subset of the observations that form the DWR, we here provide digitized data and a summary of thunderdays from 10 long‐running British stations over the period 1884–1993. The data are presented ‘as is’, with no attempt to provide any corrections or calibration. For 4 of the 10 stations, thunderday observations were discontinued at various times between 1949 and 1964, and it is necessary to switch to a neighbouring station in order to continue the series. Approximately half the series exhibit sharp drops in thunderdays at various points between 1960 and 1990, although none are coincident with known station changes. Comparison with nearby MIDAS stations suggests the low thunderdays are the result of changes in observing practice, rather than genuine changes in thunderstorm occurrence. These potential data issues limit interpretation of the long‐term trends. However, it can nevertheless be concluded that none of the stations show the expected increase in thunderdays as a result of the rise in surface temperature over the 20th century. In order to provide more quantitative determination of the long‐term trends in thunderstorm occurrence, we advocate further digitization efforts to recover the data from the numerous stations in the MWRs, and subsequent analysis of the common signals across neighbouring stations
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A taxonomic revision of the myrmecophilous species of the rattan genus Korthalsia (Arecaceae)
The rattan genus Korthalsia Blume (Arecaceae: Calamoideae: Calameae) is
widespread in the Malesian region. Among the 28 accepted species are 10 species
that form intimate associations with ants. The ants inhabit the conspicuous ocreas that
are produced by these species, using them as domatia to care for their young and to
husband scale insects. As a foundation for future work, we present here a taxonomic
treatment of the myrmecophilous Korthalsia species, based on extensive research both
in the herbarium and the field. In addition, we conduct detailed morphological
characterisation of the structure and development of ocrea using light and scanning
electron microscopy. Descriptions, illustrations, keys and distribution maps are
presented for all 10 species, along with microscopic images of ocrea morphology and
development for selected species
Patient-reported outcomes in PROSPECT trial (Alliance N1048) – FOLFOX is not a panacea
The PROSPECT was a randomized phase III trial that included patients with resectable rectal cancer (clinical stage cT2-3N+ or cT3N0). The trial aimed to test the hypothesis that pre-operative chemotherapy consisting of 6 cycles of FOLFOX given over a 12-week period, followed by total mesorectal excision (TME) surgery, was non-inferior to pre-operative long-course chemoradiotherapy (CRT). The primary endpoint of the study was disease-free survival (DFS), and patients were also monitored for other relevant oncological outcomes such and health-related quality of life (HRQoL) using patient-reported outcome (PRO) tools [1, 2]
Stereotactic Body Radiotherapy re-irradiation for locally recurrent rectal cancer: outcomes and toxicity
Background:
Stereotactic body radiotherapy (SBRT) has emerged as a potential therapeutic option for locally recurrent rectal cancer (LRRC) but contemporaneous clinical data is limited. We aimed to evaluate the local control, toxicity and survival outcomes in a cohort of patients previously treated with neoadjuvant pelvic radiotherapy for non-metastatic LRRC, now treated with SBRT.
Methods:
Inoperable rectal cancer patients with ≤ 3 sites of pelvic recurrence and > 6 months since prior pelvic radiotherapy were identified from a prospective registry over 4 years. SBRT dose was 30Gy in 5 fractions, daily or alternate days, using cumulative organ at risk dose constraints. Primary outcome was local control (LC). Secondary outcomes were progression free survival (PFS), overall survival (OS), toxicity and patient reported Quality of Life scores (QoL) using EQ-VAS tool.
Results:
30 patients (35 targets) were included. Median GTV size was 14.3cm3. 27/30 (90%) previously received 45-50.4Gy in 25/28 fractions, with 10% receiving an alternative prescription. All patients received the planned re-irradiation SBRT dose. The median FU was 24.5 months (IQR 17.8 – 28.8). The 1-year LC was 84.9% (95% CI 70.6 – 99) and a 2-year LC was 69% (95% CI 51.8 – 91.9). The median PFS was 12.1 months (95% 8.6 – 17.66) and median OS was 28.3 months (95% CI 17.88 – 39.5 months). No patient experienced >G2 acute toxicity and only 1 patient experienced late G3 toxicity. Patient reported QoL outcomes were improved at 3 months following SBRT (Δ EQ-VAS, +10 points, Wilcoxon signed rank, p=0.009).
Conclusion:
Our study demonstrates that, for small volume pelvic disease relapses from rectal cancer, re-irradiation with 30Gy in 5 fractions is well tolerated and achieves an excellent balance between high local control rates with limited toxicity
Influences on the Illusory Truth Effect in Consumer Judgment
The Illusory Truth Effect: Exploring Implicit and Explicit Memory Influences on Consumer JudgmentsMaria L. CronleyMiami UniversityFrank R. KardesUniversity of CincinnatiScott A. HawkinsUniversity of TorontoRepetition does not seem like a sound basis for determining truth, but researchers have consistently found that people rate repeated statements as more true than non-repeated statements. This effect is known as the illusory truth effect and appears to be quite persistent. Following on previous work in memory and judgment, additional moderators of attention, exclusion, and subliminal exposure are investigated in two experiments to assess their effects on repetition-induced beliefs of validity for product claims. Results provide new insights into the processes of incidental learning and implicit memory use by which consumers form judgments based on repetitive persuasive messages
Ontogeny of acoustic and feeding behaviour in the grey gurnard, Eutrigla gurnardus
Although sound production in teleost fish is often associated with territorial
behaviour, little is known of fish acoustic behaviour in other agonistic contexts
such as competitive feeding and how it changes during ontogeny. The grey
gurnard, Eutrigla gurnardus, frequently emits knock and grunt sounds during
competitive feeding and seems to adopt both contest and scramble tactics under
defensible resource conditions. Here we examine, for the first time, the effect of
fish size on sound production and agonistic behaviour during competitive feeding.
We have made sound (alone) and video (synchronized image and sound)
recordings of grey gurnards during competitive feeding interactions. Experimental
fish ranged from small juveniles to large adults and were grouped in four size
classes: 10–15, 15–20, 25–30 and 30–40 cm in total length. We show that, in this
species, both sound production and feeding behaviour change with fish size.
Sound production rate decreased in larger fish. Sound duration, pulse duration
and the number of pulses increased whereas the peak frequency decreased with
fish size, in both sound types (knocks and grunts). Interaction rate and the
frequency of agonistic behaviour decreased with increasing fish size during
competitive feeding sessions. The proportion of feeding interactions accompanied
by sound production was similar in all size classes. However, the proportion of
interactions accompanied by knocks (less aggressive sounds) and by grunts (more
aggressive) increased and decreased with fish size, respectively. Taken together,
these results suggest that smaller grey gurnards compete for food by contest
tactics whereas larger specimens predominantly scramble for food, probably
because body size gives an advantage in locating, capturing and handling prey.
We further suggest that sounds emitted during feeding may potentially give
information on the motivation and ability of the individual to compete for food
resources
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