The effect on melanoma risk of genes previously associated with telomere length.

Telomere length has been associated with risk of many cancers, but results are inconsistent. Seven single nucleotide polymorphisms (SNPs) previously associated with mean leukocyte telomere length were either genotyped or well-imputed in 11108 case patients and 13933 control patients from Europe, Israel, the United States and Australia, four of the seven SNPs reached a P value under .05 (two-sided). A genetic score that predicts telomere length, derived from these seven SNPs, is strongly associated (P = 8.92x10(-9), two-sided) with melanoma risk. This demonstrates that the previously observed association between longer telomere length and increased melanoma risk is not attributable to confounding via shared environmental effects (such as ultraviolet exposure) or reverse causality. We provide the first proof that multiple germline genetic determinants of telomere length influence cancer risk.This is the final version of the article. It first appeared from Oxford University Press via http://dx.doi.org/10.1093/jnci/dju26

Fine mapping of genetic susceptibility loci for melanoma reveals a mixture of single variant and multiple variant regions.

Dermatology-oncolog

Nurses' perception of senior managers at the front line: people working with clipboards.

AIM: To provide an original perspective on front-line nurses' perception of senior managers who are not nurses.BACKGROUND: A key element of new public management had been the drive for 'hands-on' professional management within the UK National Health Service, meaning the employment of mangers with managerial experience but little or no healthcare experience.DESIGN: An interpretive qualitative study, based on a single case study design with semi-structured interviews.METHODS: Semi-structured interviews were carried out with 31 front-line Scottish National Health Service nurses exploring their perceptions of the role of managers between July-September 2010.RESULTS/FINDINGS: Nursing staff were often unsure of the responsibilities of managers and perceived that there were an unnecessarily high number of managers within the National Health Service. Nursing staff raised concerns over the non-clinical background of managers, including their ability to understand the pressures faced at the front line.CONCLUSIONS: The main reason for conflict between managers and nursing staff was their differing foci. Managers were seen to concentrate on decisions surrounding targets, audits and budgets with little consideration given to the impact of these decisions on patient car

Causality in qualitative and quantitative research

Causality, Explanation versus understanding (quantitative research versus qualitative research, positivism versus hermeneutics), INUS-causation, Causal realism, Experimental logic, Counterfactual conditional,