Cultural Competency in Hospice Care: A Case Study of Hospice Toronto

The population demographics of the greater Toronto Area are rapidly changing, with visible minorities comprising 43% of the GTA, and 10% of the total adult population of Canada. It is incumbent upon the health care sector to accommodate these changes in a culturally competent manner. Health care and culture intersect in the most delicate of ways during the last stages of life. The health care system must ensure that minorities have an equal access to end-of-life health care services and that their individual cultural beliefs and values are respected by culturally competent health care providers. Hence, this thesis examines the current state of cultural competence in hospice and palliative care in the Greater Toronto Area. This study will show the strengths and limitations of the current hospice care in terms of providing culturally competent care. To explore this topic in greater detail, my research is guided by the following questions: 1) What is the current state of culturally competent care in a hospice setting? 2) What are the challenges to providing culturally competent care in a hospice in the Greater Toronto Area? 3) What are some possible strategies for increasing competency within a hospice setting? To explore my research questions fully, I provide a critical analysis of six cultural competency theories, while integrating a social determinants of health framework, focusing on the theory of social exclusion and minority health care. This case study analysis is enhanced by the 14 in-depth interviews of hospice volunteer participants and 1 administrator. There are six major findings in this research. First, volunteer participants encountered cultural clashes when their levels of cultural competency were weak. Second, volunteer participants revealed there was a lack of adequate cultural competency training with the hospice. Third, volunteer participants gave abundant suggestions for improving cultural competency training. Fourth, volunteer participants perceived the hospice to be unsupportive of some of their needs. Fifth, the lack of ethnic, cultural and linguistic diversity of the hospice volunteer participants was noted. Last, the lack of religiosity amongst the volunteer participants was surprising. This research is significant for its Canadian hospice volunteer focus and the findings will be beneficial in practice for patients, their families, volunteers, and other health care providers, by providing the knowledge and tools necessary to enhance their level of cultural competency

Myeloid Sarcoma of the Skin in a Patient with Myelodysplastic Syndrome

ABSTRACT We report the case of a 76-year-old woman who presented with asymptomatic extensive erythematous. Firm plaques were noted over the right cheek. Complete blood count was normal, as was a peripheral smear. An excision biopsy taken from the cheek showed infiltration of the dermis and hypodermis with atypical cells which were strongly positive for human leukocyte antigen (HLA-DR) and lysozyme and were moderately myeloperoxidase (MPO) enzyme. The results of immunohistochemical staining for CD34, CD117, CD3, CD4, CD8, CD20, CD23, CD56, and ALK-1 were negative. Bone marrow analysis indicated myelodysplastic syndrome RAEB 1 while cytogenetic finding showed tetrasomy 8. It was recommended that the patient undergo local radiotherapy of skin lesions, but she refused and was lost to follow-up. KEY WORDS: skin; myeloid sarcoma; myelodysplastic syndrome </p

Myeloid Sarcoma of the Skin in a Patient with Myelodysplastic Syndrome

ABSTRACT We report the case of a 76-year-old woman who presented with asymptomatic extensive erythematous. Firm plaques were noted over the right cheek. Complete blood count was normal, as was a peripheral smear. An excision biopsy taken from the cheek showed infiltration of the dermis and hypodermis with atypical cells which were strongly positive for human leukocyte antigen (HLA-DR) and lysozyme and were moderately myeloperoxidase (MPO) enzyme. The results of immunohistochemical staining for CD34, CD117, CD3, CD4, CD8, CD20, CD23, CD56, and ALK-1 were negative. Bone marrow analysis indicated myelodysplastic syndrome RAEB 1 while cytogenetic finding showed tetrasomy 8. It was recommended that the patient undergo local radiotherapy of skin lesions, but she refused and was lost to follow-up. KEY WORDS: skin; myeloid sarcoma; myelodysplastic syndrome </p

Post-Covidowy zrównoważony rozwój ekonomiczny

Crises show all the vulnerability and unsustainability of modern economic systems, imposing the need to ask ourselves what really is important, what wealth actually is. At the same time, they are an opportunity to critically review economic systems, ideologies, economic indicators of quality of life&nbsp;and dogmatically set ideas which have negative impacts on society, culture and the environment. In this sense, the current pandemic is an opportunity to take action and make a change, to shift the focus to socio-economic models focused on people, environment and strengthening of global partnership for sustainable development.Kryzysy ukazują wszystkie wady i niezrównoważoność współczesnych systemów ekonomicznych, narzucając potrzebę zadawania pytań o to, co jest naprawdę ważne, czym właściwie jest bogactwo. Jednocześnie kryzysy są okazją do krytycznego przeglądu systemów ekonomicznych, ideologii, ekonomicznych wskaźników jakości życia oraz dogmatycznie ustalonych idei, które mają negatywny wpływ na społeczeństwo, kulturę i środowisko. W tym kontekście obecna pandemia jest okazją do podjęcia działań i wprowadzenia zmian, przesunięcia punktu ciężkości na modele społeczno-gospodarcze skupione na ludziach, środowisku i wzmocnieniu globalnego partnerstwa na rzecz zrównoważonego rozwoju

Functional analysis of B and C class floral organ genes in spinach demonstrates their role in sexual dimorphism

<p>Abstract</p> <p>Background</p> <p>Evolution of unisexual flowers entails one of the most extreme changes in plant development. Cultivated spinach, <it>Spinacia oleracea </it>L., is uniquely suited for the study of unisexual flower development as it is dioecious and it achieves unisexually by the absence of organ development, rather than by organ abortion or suppression. Male staminate flowers lack fourth whorl primordia and female pistillate flowers lack third whorl primordia. Based on theoretical considerations, early inflorescence or floral organ identity genes would likely be directly involved in sex-determination in those species in which organ initiation rather than organ maturation is regulated. In this study, we tested the hypothesis that sexual dimorphism occurs through the regulation of B class floral organ gene expression by experimentally knocking down gene expression by viral induced gene silencing.</p> <p>Results</p> <p>Suppression of B class genes in spinach resulted in the expected homeotic transformation of stamens into carpels but also affected the number of perianth parts and the presence of fourth whorl. Phenotypically normal female flowers developed on <it>SpPI</it>-silenced male plants. Suppression of the spinach C class floral organ identity gene, <it>SpAG</it>, resulted in loss of reproductive organ identity, and indeterminate flowers, but did not result in additional sex-specific characteristics or structures. Analysis of the genomic sequences of both <it>SpAP3 </it>and <it>SpPI </it>did not reveal any allelic differences between males and females.</p> <p>Conclusion</p> <p>Sexual dimorphism in spinach is not the result of homeotic transformation of established organs, but rather is the result of differential initiation and development of the third and fourth whorl primordia. <it>SpAG </it>is inferred to have organ identity and meristem termination functions similar to other angiosperm C class genes. In contrast, while <it>SpPI </it>and <it>SpAP3 </it>resemble other angiosperms in their essential functions in establishing stamen identity, they also appear to have an additional function in regulating organ number and identity outside of the third whorl. We present a model for the evolution of dioecy in spinach based on the regulation of B class expression.</p

The blues of Romuliana

The paper presents a set of glass fragments excavated at several different locations within and outside the late Roman fortified imperial residence Felix Romuliana (Gamzigrad, Serbia). This small group of eighteen fragments and mosaic glass tesserae are distinguished by their cobalt blue colour. The majority of the finds are mosaic tesserae (six pcs) and sheets of glass (five pcs), which could be related to architectural decoration (sectilia panels). Others are pieces left behind from secondary glass working (four pcs). There are also two fragments tentatively identified as window pane pieces, and only one find is a vessel sherd. The materials are dated to the 4th century. Significantly, some of the production debris and the two “window pane” fragments were found inside the destruction of a glass furnace. The analyses of the chemical glass composition of the finds confirmed that the blue colourant in all samples is cobalt, and antimony is also present at notable levels (except for one sample), likely to produce opacification of the glass. Regarding the origin of the raw glass, the data on almost all pieces suggests a Syro-Palestinian provenance, and a single sample could be related to Egyptian primary glass production. Importantly, the concentrations of the oxides added to the base glasses in order to modify the colour are positively correlated in certain samples, hinting at the makeup of the cobalt bearing ingredient and at a likely existence of particular production practices of the late Roman period

Acute effects of nandrolone decanoate on oxidative stress in isolated rat heart

Abuse of anabolic-androgenic steroids (AAS) produces side effects in different tissues, with oxidative stress linked to their pathophysiology, being involved in fibrosis, cellular proliferation, and tumorigenesis. The aim of this study was to examine the acute effects of nandrolone decanoate (ND) on oxidative stress in isolated rat heart. The hearts of male Wistar albino were excised and perfused according to the Langendorff technique at gradually increasing coronary perfusion pressures (40-120 cm H2O). The hearts were perfused with ND at doses of 1, 10 and 100 μM. Oxidative stress markers, including the index of lipid peroxidation (thiobarbituric acid reactive substances (TBARS)), nitric oxide (nitrites; NO2-), the superoxide anion radical (O2-) and hydrogen peroxide (H2O2) were measured in the coronary venous effluent. Our results showed that acute effects of ND do not promote the production of reactive oxygen species (ROS). Our finding pointed out that the highest concentration of ND may even possess some anti-oxidative potential, which should be examined further

Measuring the Potential for Technology Entrepreneurship Development: Serbian Case

Research Question: This paper explores the potential for technology entrepreneurship development at the country level through the creation of a new composite index. Motivation: Motivation for this paper arises from the fact there is a lack of the composite indices used exclusively for technology management as identified by Jovanovic et al. (2017). Technology indices are mostly used as important components of other composite indices used for tracking a country performance from the perspective of other global phenomena (e.g. competitiveness and innovativeness). The novelty of this paper reflects in the proposed Technology Entrepreneurship Development Potential (TED-pot) index which has multiple significances. It could serve as a help for policy makers in creating national policies; other companies and countries looking for the adequate environment to invest in technology entrepreneurship projects; academics who benefit from a new country-level view on technology entrepreneurship, especially ICT entrepreneurship. Idea: The idea of the paper was to create the TED-pot index to enable the cross-countries comparisons and examine whether the potential of Serbia lies in its entrepreneurial ICT sector. Data: Four indicators included in the created index are measured by the World Bank. The index is applied on six ex-Yugoslav countries and the EU for the period 2009-2014. All the data is collected from the World Bank database. Tools: The final index value is obtained by using the simple weighted function with equal weights. The overall TED-pot has been built upon the equal weighting of the two created pillars: ICT potential (ICT-pot) and Entrepreneurial potential (E-pot). The values for each pillar are calculated by the same procedure, through the simple mean of certain indicators. Findings: According to the calculated TED-pot values, Serbia stands out as a country with the greatest potential for technology entrepreneurship development in the region. Analysing individual pillars, ICT-pot indicates Serbia has very strong ICT sector, far ahead of other countries in the region, while the E-pot values show there is a space for administration to ease and speed up the process of starting new businesses in Serbia. This is a pilot research and the first presentation of the created index, which calls for further investigation. Contribution: This paper expands exiting research related to the country-level measurement in the field of technology management and entrepreneurship, especially focusing on ICT entrepreneurship development

Nasal morphological characteristics of the serbian population

The aim of this study was to determine the nasal parameters in the population of central Serbia and to compare them with those determined in earlier studies in different populations. The research was conducted on 496 randomly selected persons (262 males and 234 females), aged 18-65 years. The measured parameters were nasal height and nasal breadth and the standard spreading caliper with scale was used for measurements. There were significant differences in the nasal parameters between male and female subjects. The nasal breadth was 34.72 mm in females, and in the male population it was 36.7 mm. The mean values of nasal height were 52.6 mm and 54.32 mm in females and males, respectively. The nasal index in females and males was 66.01 and 67.56, respectively, and the mean value of the nasal index of all respondents was 66.78. After conducting the research it was concluded that the dominant nasal type in the population of the central part of Serbia is leptorrhine. The present study showed the existence of sexual dimorphism in nasal morphology. The data obtained in our study may be useful in anthropological and forensic research, as well as in cosmetic planning and reconstructive surgery

SERUM LEVELS OF INTERLEUKIN-6 AND TUMOR NECROSIS FACTOR-ALPHA IN EXACERBATION AND REMISSION PHASE OF SCHIZOPHRENIA

Background: The variations in proinflamatory cytokine levels have been associated with schizophrenia (SCH), duration of illness, psychopathology and treatment. The aim of the study was to investigate serum levels of interleukin-6 (IL-6) and tumor necrosis factoralpha (TNF-α) in schizophrenic patients during exacerbation and remission, and its association with course of illness and therapy. Subjects and methods: We measured serum levels of IL-6 and TNF-α in 43 schizophrenic patients in exacerbation and remission and compared them to 29 healthy controls, matched by sex, age, body mass index (BMI) and smoking habits. The severity of psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS). Results: There was no difference in levels of IL-6 and TNF-α in exacerbation compared to remission in schizophrenic patients. IL-6 was higher and TNF-α was lower in schizophrenic patients in both exacerbation and remission in comparison with healthy controls. TNF-α in exacerbation was in negative correlation with IL-6 in remission. No statistical significance was found between levels of cytokines and sex, age, BMI, smoking habits, antipsychotic medication, duration of treatment and duration of illness. IL-6 levels were in positive correlation with the age of onset and the duration of untreated psychosis. In schizophrenic patients on adjunctive treatment with mood stabilizers, TNF-α levels increased in remission. Conclusion: Our results suggest that the connection between schizophrenia, cytokines and medication is multifaceted, and not necessarily linear. Adjunct mood stabilizers not only ameliorate psychopathology, but might convey immunomodulatory effects as well. Further longitudinal studies could elucidate potential beneficial effect of combined therapy in treatment of SCH