Teaching and learning interventions designed to improve cultural competence in health profession students : a systematic review

Purpose: Developing healthcare profession students’ cultural competency knowledge, skills and attributes is critical to meet the needs of culturally and linguistically diverse healthcare service consumers. The purpose of this systematic review was to identify effective cultural competence interventions for healthcare profession students. Methods: A systematic review of peer reviewed articles published from 2010-2021 using PRISMA guidelines was conducted by searching CINAHL, EMBASE, ERIC, PubMed, and Psych INFO databases. Article quality was assessed using the Evaluation Tool for Quantitative Research and Mixed Method Appraisal Tool. Results: The initial search identified 2,261 potentially relevant studies, 41 studies met the inclusion criteria in which intervention effectiveness was evaluated using a validated outcome measure pre- and post- intervention. Only one study used a non-self-report outcome measure. Out of the 41 studies, only eight studies employed randomisation in the method. Conclusion/Recommendations: This review evaluated effectiveness of cultural competence interventions and evaluation of the intervention using either self-report or non-self-report validated outcome measures at pre- and post-intervention exposure. Combining cultural competence teaching methods such as lectures with simulations, role-playing and community engagement with diverse populations enhanced cultural competence. Further studies are required to compare effective cultural competence teaching models and identify reliable non-self-report outcome measures to assess the effectiveness of interventions post-exposure. Comparing effective cultural competence teaching models that utilise reliable non-self-report outcome measures will be valuable for guiding the design of teaching and learning interventions directed towards cultural competence. Further research is also required to examine the duration of intervention efficacy and how to maintain efficacy post-intervention exposure. Findings from this review are important for designing and structuring of cultural competence curriculum for healthcare profession students and informing future research on cultural competence teaching. This review has identified that most evaluation tools and studies have been designed for the nursing discipline. There is need to design more cultural competence evaluation tools and studies for other healthcare disciplines such as pharmacy and physical therapy

Reducing health inequities for asylum seekers with chronic non-communicable diseases : Australian context

Asylum seekers are susceptible to chronic non-communicable diseases pre- and post-arrival due to poor living conditions, unhealthy lifestyles and restrictive and poor access to health services. Despite their need for constant and continuous health care access due to poor health, they face healthcare services access restrictions dependent on their visa conditions in Australia. Some visas only allow access to hospital services with restrictions on primary health services access such as GPs and free or discounted pharmaceutical products. In comparison, disadvantaged host populations have access to free/discounted pharmaceutical products and unrestricted access to primary and secondary health care. Ten professionals who constantly engage with asylum seekers in three large asylum seeker centres in Melbourne were interviewed either face-to-face or over the phone. The interviews were essential to understand how health inequities may be addressed for asylum seekers. Interviews were audio-recorded, transcribed verbatim and analysed using a thematic analysis framework. Their recommendations, based mainly on their experience and evaluation of programs, were: (1) cultural competence training (2) use of interpreters (3) free access to health services and medications (4) use of English learning to promote health literacy and community integration (5) robust chronic non-communicable diseases screening and (6) health promotion and accessible food programs. © 2021 La Trobe University

Multiple extradigital glomus tumors of the ankle and foot with limb hypoplasia in a child: a case report

Glomus tumors are rare tumors, and mostly occur in the fingertips and/ or subungual location. Multiple extradigital glomus tumors are extremely rare. We hereby described a rare case of multiple extradigital glomus tumor of the ankle and foot in a 11 year old girl with hypoplasia of the affected limb. The patient presented with swellings over her right ankle and foot for the past 5 years. The swellings were initially painless but became painful for the past 15 months. On examination, patient’s right leg and foot appeared to be smaller when compared to the left side. There were multiple vague swellings over the dorsum of right food and lateral aspect of right ankle, which were very tender to touch. There was no overlying skin changes observed. Magnetic resonance imaging showed multiple well defined, encapsulated lesions of varying sizes at the level of distal third right fibula and foot. The lesions appeared isointense to muscle in T1-weighted image, hyperintense in T2-weighted image with enhancement post-contrast. Excision biopsy of the right lateral distal leg swelling was performed. Histopathological examination of the excised mass confirmed the diagnosis of glomus tumor. In view of her parents were not keen for any further surgical intervention, the patient will be evaluated regularly, and any enlarging painful lesions will be excised as required. The clinical diagnosis of multiple extradigital glomus tumors is much more problematic due to its rarity. The physicians must be aware of this differential diagnosis so that early diagnosis and treatment could be administered to the patients

A non-canonical Raf function is required for dorsal–ventral patterning during Drosophila embryogenesis

Proper embryonic development requires directional axes to pattern cells into embryonic structures. In Drosophila, spatially discrete expression of transcription factors determines the anterior to posterior organization of the early embryo, while the Toll and TGFβ signalling pathways determine the early dorsal to ventral pattern. Embryonic MAPK/ERK signaling contributes to both anterior to posterior patterning in the terminal regions and to dorsal to ventral patterning during oogenesis and embryonic stages. Here we describe a novel loss of function mutation in the Raf kinase gene, which leads to loss of ventral cell fates as seen through the loss of the ventral furrow, the absence of Dorsal/NFκB nuclear localization, the absence of mesoderm determinants Twist and Snail, and the expansion of TGFβ. Gene expression analysis showed cells adopting ectodermal fates much like loss of Toll signaling. Our results combine novel mutants, live imaging, optogenetics and transcriptomics to establish a novel role for Raf, that appears to be independent of the MAPK cascade, in embryonic patterning

Investigation of attentional bias in obsessive compulsive disorder with and without depression in visual search

Copyright: © 2013 Morein-Zamir et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are creditedWhether Obsessive Compulsive Disorder (OCD) is associated with an increased attentional bias to emotive stimuli remains controversial. Additionally, it is unclear whether comorbid depression modulates abnormal emotional processing in OCD. This study examined attentional bias to OC-relevant scenes using a visual search task. Controls, non-depressed and depressed OCD patients searched for their personally selected positive images amongst their negative distractors, and vice versa. Whilst the OCD groups were slower than healthy individuals in rating the images, there were no group differences in the magnitude of negative bias to concern-related scenes. A second experiment employing a common set of images replicated the results on an additional sample of OCD patients. Although there was a larger bias to negative OC-related images without pre-exposure overall, no group differences in attentional bias were observed. However, OCD patients subsequently rated the images more slowly and more negatively, again suggesting post-attentional processing abnormalities. The results argue against a robust attentional bias in OCD patients, regardless of their depression status and speak to generalized difficulties disengaging from negative valence stimuli. Rather, post-attentional processing abnormalities may account for differences in emotional processing in OCD.Peer reviewedFinal Published versio

Nuclear Export Signal Mutation of Epidermal Growth Factor Receptor Enhances Malignant Phenotypes of Cancer Cells

Nuclear epidermal growth factor receptor (EGFR) has been shown to be correlated with drug resistance and a poor prognosis in patients with cancer. Previously, we have identified a tripartite nuclear localization signal (NLS) within EGFR. To comprehensively determine the functions and underlying mechanism of nuclear EGFR and its clinical implications, we aimed to explore the nuclear export signal (NES) sequence of EGFR that is responsible for interacting with the exportins. We combined in silico prediction with site-directed mutagenesis approaches and identified a putative NES motif of EGFR, which is located in amino acid residues 736-749. Mutation at leucine 747 (L747) in the EGFR NES led to increased nuclear accumulation of the protein via a less efficient release of the exportin CRM1. Interestingly, L747 with serine (L747S) and with proline (L747P) mutations were found in both tyrosine kinase inhibitor (TKI)-treated and -naïve patients with lung cancer who had acquired or de novo TKI resistance and a poor outcome. Reconstituted expression of the single NES mutant EGF

Antiproliferation effect of sulforaphene isolated from radish (Raphanus sativus L.) seeds on A549 cells

Sulforaphene (SFE), a major isothiocyanate in radish seeds, is a close chemical relative of sulforaphane (SFA) isolated from broccoli seeds and florets. The anti-proliferative mechanisms of SFA against cancer cells have been well investigated, but little is known about the potential anti-proliferative effects of SFE. In this study, we showed that SFE purified from radish seeds inhibited the growth of six cancer cell lines (A549, CHO, HeLa, Hepa1c1c7, HT-29, and LnCaP), with relative half maximal inhibitory concentration values ranging from 1.37 to 3.31 μg/mL. Among the six cancer cell lines, SFE showed the greatest growth inhibition against A549 lung cancer cells, where it induced apoptosis by changing the levels of poly(ADP-ribose) polymerase and caspase-3, -8, and -9. Our results indicate that SFE from radish seeds may have significant anti-proliferative potency against a broad range of human cancer cells via induction of apoptosis