Who’s at the Bottom of the Hiring List? Exploring the Compounding Effects of Applicant Race and Offense History on Employability

Justice-involved persons, especially people of color and those convicted of a sexual offense, experience bias and other barriers when seeking employment. However, there is no research on the synergistic effects of race and sexual criminal offense on employment-related outcomes. This study examined whether a hypothetical job applicant’s race (Black vs. White) and/or sexual criminal offense history (sexual, non-sexual, or no history) impacted hiring decisions and related employment-related outcomes among 476 volunteers recruited from Amazon Mechanical Turk. Participants were randomly assigned to one of six conditions in which they read mock job application materials that varied based on the applicant’s identified race and criminal history. Results revealed no significant main effects of applicant race and no interaction between applicant race and offense history across all employment-related outcomes. However, participants were least likely to endorse hiring the applicant and desired greater social distance (a measure of stigmatizing attitudes) from the applicant if he had a prior sexual offense, even though participants expected him to perform similarly at the job relative to applicants described as having a non-sexual offense. This finding suggests applicants with a known sexual offense history may be more frequently passed up for jobs than other justice-involved applicants for reasons unrelated to the job itself

Democracy promotion in reverse? An evaluation of the UK and the US’s democracy promotion programmes (2005-2017).

This thesis provides an original contribution to knowledge by arguing that UK and US democracy promotion is in reverse. In order to fully understand democracy promotion in an era of democratic decline, this thesis draws upon two dominant theories: democratisation and foreign policy analysis. This thesis critically evaluates applied democracy promotion, thereby transitioning theoretical research into practical democracy promotion and arguing it is in reverse. Democracy promotion as democratisation can be explained as the process by which developing, or undemocratic nations, use to transition towards democracy. Democracy promotion as a foreign policy has developed from the UK and the US’s motives to build relationships with developing nations in order to achieve necessary foreign policy goals. The UK and the US are the two most prominent promotors of democracy, thus have been chosen as donor nations as they use democratisation and foreign policy as a channel to facilitate this. An unequal relationship between donor states and recipient states has occurred due to a misunderstanding of democracy promotion aims and objectives. This shows democracy promotion is in reverse as donors promote democracy in their own interests and not for the needs of the recipients. More importantly, although democracy promotion is becoming more prevalent than ever, the misalignment of aims and objectives from donors has led to the argument that democracy promotion is in reverse. The purpose of this research is twofold. Firstly, in order to argue democracy promotion is in reverse, it is necessary to understand what democracy promotion is and who is promoting it. Secondly, it is crucial to evaluate how democracy is promoted. By positing a holistic picture of democracy promotion, this thesis asserts that democracy promotion is in reverse. Alongside the usage of secondary data sources, (including a literature review and document analysis), data was collected through interviews to generate primary data. This thesis offers a comparative analysis of the UK and the US’s democracy promotion programmes from 2005-2017, with the timeframe chosen in order to capture the period of decline in the number of democracies worldwide. The central argument for democracy promotion in reverse is that the UK and the US’s, as donors of democracy promotion, reinforce their self-image of democracy at home, into recipient nations, rather than strengthening permanent outcomes of democracy in a form that is best s uited to the recipient. This lack of permanent change within recipient states is further enhanced by the lack of universal application of guidelines to UK and US democracy promotion programmes. Consequently, with no universal methodology enforced by the UK and the US to programmes, it has become unclear as to whether it is a successful endeavour and allows space for donors to benefit more from programmes. This thesis is unique in its exploration of this topic as previous scholarship has concentrated on acknowledging that democratisation has stagnated in the past decade, yet has failed to develop a deeper rationale for this. This thesis presents the evidence for this decline in democracy, as democracy promotion in reverse

The role of the non-canonical NF-κB pathway in colorectal cancer

Colorectal cancer (CRC) is the fourth most common cancer in the UK and despite earlier detection and improved treatments, it remains the second most common cause of cancer death. Currently, TNM staging is widely used to determine patient prognosis and the need for adjuvant therapies however, it is well recognised that CRC is a heterogeneous disease and patients with the same stage of disease can have very different survival outcomes. The molecular mechanisms underpinning these differences, and difficulties associated with treatment resistance have yet to be fully elucidated. This requires attention. Understanding molecular signalling pathways allows the discovery of new therapeutic targets and identification of biomarkers to enable treatments to be directed towards those patients who will benefit the most. Nuclear Factor kappa B (NF-κB) has key roles in tumourigenic processes described as the hallmarks of cancer. However, the majority of this evidence is based on investigation of the canonical NF-κB pathway. The aims of the present study were to understand the role of the non-canonical NF-κB pathway in the development and progression of CRC, establish if expression of non-canonical pathway members could be employed as prognostic biomarkers and assess the viability of inhibiting key non-canonical kinase IKKα as a potential therapeutic strategy in CRC. Using a tissue microarray (TMA), immunohistochemistry was used to assess expression of key members of the non-canonical NF-κB pathway in patients who had undergone surgery for stage I-III CRC. High cytoplasmic expression of IKKα was associated with adverse pathological tumour features including increasing T stage, poor tumour differentiation, tumour necrosis and low proliferation status. Key pathway members were also investigated in a cohort of patients who underwent treatment for screen-detected T1/2 CRC. Even in this cohort of early-stage disease, IKKα was associated with a more invasive phenotype. An unfamiliar ‘punctate’ pattern of IKKα expression was observed and this was associated with significantly inferior survival outcome in patients who had undergone surgery for stage I-III CRC, this was potentiated in patients with BRAF wild-type status. Using immunochemistry the present study was able to demonstrate the pattern of punctate IKKα expression was not associated with two IKKα phosphorylation sites. To investigate the distribution and localisation of IKKα further, markers of cellular transport were investigated using immunofluorescence. IKKα was co-located with a marker of the Golgi apparatus. This observation raises a number of possible hypotheses that require further investigation. Expression of the non-canonical NF-κB pathway was investigated in two colon cancer cell lines with contrasting mutational landscapes. Using western blot the present study was able to demonstrate the non-canonical NF-κB pathway can be inhibited with first-in-class IKKα inhibitors. This data, together with results from tissue studies suggest investigation of IKKα in CRC should be pursued further. Additional studies are required to investigate the predictive capacity of IKKα in the context of existing therapies used in the treatment of CRC

Delayed Manifestation of Transurethral Syndrome as a Complication of Transurethral Prostatic Resection

Metabolic encephalopathy as a part of ‘transurethral syndrome’ is an immediate complication following transurethral resection of prostate. It occurs during or few hours after the surgery. However, delayed manifestation of this complication is rare. It is also possible that pretreatment with diuretics can exaggerate this problem by predisposing the patient to electrolyte abnormalities. Here we present a report of such a patient who manifested with neurological complications six days after the prostate surger

Physical comorbidity and its impact on symptom profile of depression in Indian setting 2 (COSPO-DEP-2 study)

Background: The objective of the study was to determine the symptom profile and prevalence of comorbidities and to understand the prescription patterns of antidepressants among depression patients in India.Methods: The real-world, retrospective, observational COSPO-DEP-2 study was conducted at various centres across India between April 2021 and March 2022.Results: Data of 7288 patients with depression was analyzed. The mean (SD) age of the patients was 45.1 (11.9) years. Majority of the patients were males (54.2%) and literate (92.7%); 53.1% were unemployed; 14.5% were unmarried and other 8.8% patients were divorced or separated. Almost equal proportion of patients were from urban and rural areas. A family history of psychiatric disorder was present in 14.9% patients. More than half (57.3%) of the patients presented with first episode of depression. Mild depression was present in 38.87% patients, moderate depression in 38.06% patients and severe depression in 23.07% patients. Diabetes was the most common comorbid condition (31.5%) followed by hypertension (26.6%), migraine (24.6%), and chronic pain (16.6%). Majority (54%) of patients were prescribed combination of pharmacotherapy with psychotherapy. The most commonly prescribed drug for depression management was escitalopram (57.5%) followed by benzodiazepines (38.7%). Escitalopram was also the most commonly prescribed drug in patients with depression having comorbidities.Conclusions: Depression is common among both genders and more commonly seen among unemployed people and in those with family history of depression. The commonly reported comorbidities include diabetes, hypertension, migraine and chronic pain. Escitalopram is the most commonly used agent followed by benzodiazepines among patients of depression with or without comorbidities

NF-κB pathways in the development and progression of colorectal cancer

Nuclear factor-κB (NF-κB) has been widely implicated in the development and progression of cancer. In colorectal cancer (CRC), NF-κB has a key role in cancer-related processes such as cell proliferation, apoptosis, angiogenesis, and metastasis. The role of NF-κB in CRC is complex, owed to the cross talk with other signaling pathways. Although there is sufficient evidence gained from cell lines and animal models that NF-κB is involved in cancer-related processes, because of a lack of studies in human tissue, the clinical evidence of its importance is limited in patients with CRC. This review summarizes evidence relating to how NF-κB is involved in the development and progression of CRC and comments on future work to be carried out

Non-specialist health worker interventions for the care of mental, neurological and substance-abuse disorders in low- and middle-income countries.

BACKGROUND: Many people with mental, neurological and substance-use disorders (MNS) do not receive health care. Non-specialist health workers (NSHWs) and other professionals with health roles (OPHRs) are a key strategy for closing the treatment gap. OBJECTIVES: To assess the effect of NSHWs and OPHRs delivering MNS interventions in primary and community health care in low- and middle-income countries. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register) (searched 21 June 2012); MEDLINE, OvidSP; MEDLINE In Process & Other Non-Indexed Citations, OvidSP; EMBASE, OvidSP (searched 15 June 2012); CINAHL, EBSCOhost; PsycINFO, OvidSP (searched 18 and 19 June 2012); World Health Organization (WHO) Global Health Library (searched 29 June 2012); LILACS; the International Clinical Trials Registry Platform (WHO); OpenGrey; the metaRegister of Controlled Trials (searched 8 and 9 August 2012); Science Citation Index and Social Sciences Citation Index (ISI Web of Knowledge) (searched 2 October 2012) and reference lists, without language or date restrictions. We contacted authors for additional studies. SELECTION CRITERIA: Randomised and non-randomised controlled trials, controlled before-and-after studies and interrupted-time-series studies of NSHWs/OPHR-delivered interventions in primary/community health care in low- and middle-income countries, and intended to improve outcomes in people with MNS disorders and in their carers. We defined an NSHW as any professional health worker (e.g. doctors, nurses and social workers) or lay health worker without specialised training in MNS disorders. OPHRs included people outside the health sector (only teachers in this review). DATA COLLECTION AND ANALYSIS: Review authors double screened, double data-extracted and assessed risk of bias using standard formats. We grouped studies with similar interventions together. Where feasible, we combined data to obtain an overall estimate of effect. MAIN RESULTS: The 38 included studies were from seven low- and 15 middle-income countries. Twenty-two studies used lay health workers, and most addressed depression or post-traumatic stress disorder (PTSD). The review shows that the use of NSHWs, compared with usual healthcare services: 1. may increase the number of adults who recover from depression or anxiety, or both, two to six months after treatment (prevalence of depression: risk ratio (RR) 0.30, 95% confidence interval (CI) 0.14 to 0.64; low-quality evidence); 2. may slightly reduce symptoms for mothers with perinatal depression (severity of depressive symptoms: standardised mean difference (SMD) -0.42, 95% CI -0.58 to -0.26; low-quality evidence); 3. may slightly reduce the symptoms of adults with PTSD (severity of PTSD symptoms: SMD -0.36, 95% CI -0.67 to -0.05; low-quality evidence); 4. probably slightly improves the symptoms of people with dementia (severity of behavioural symptoms: SMD -0.26, 95% CI -0.60 to 0.08; moderate-quality evidence); 5. probably improves/slightly improves the mental well-being, burden and distress of carers of people with dementia (carer burden: SMD -0.50, 95% CI -0.84 to -0.15; moderate-quality evidence); 6. may decrease the amount of alcohol consumed by people with alcohol-use disorders (drinks/drinking day in last 7 to 30 days: mean difference -1.68, 95% CI -2.79 to -0.57); low-quality evidence).It is uncertain whether lay health workers or teachers reduce PTSD symptoms among children. There were insufficient data to draw conclusions about the cost-effectiveness of using NSHWs or teachers, or about their impact on people with other MNS conditions. In addition, very few studies measured adverse effects of NSHW-led care - such effects could impact on the appropriateness and quality of care. AUTHORS' CONCLUSIONS: Overall, NSHWs and teachers have some promising benefits in improving people's outcomes for general and perinatal depression, PTSD and alcohol-use disorders, and patient- and carer-outcomes for dementia. However, this evidence is mostly low or very low quality, and for some issues no evidence is available. Therefore, we cannot make conclusions about which specific NSHW-led interventions are more effective

Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Women: Evidence Report and Systematic Review for the US Preventive Services Task Force

Importance: Postmenopausal status coincides with increased risks for chronic conditions such as heart disease, osteoporosis, cognitive impairment, or some types of cancers. Previously, hormone therapy was used for the primary prevention of these chronic conditions. Objective: To update evidence for the US Preventive Services Task Force on the benefits and harms of hormone therapy in reducing risks for chronic conditions. Data Sources: MEDLINE, Cochrane Library, EMBASE, and trial registries from June 1, 2011, through August 1, 2016. Surveillance for new evidence in targeted publications was conducted through July 1, 2017. Study Selection: English-language randomized clinical trials reporting health outcomes. Data Extraction and Synthesis: Dual review of abstracts, full-text articles, and study quality; meta-analyses when at least 3 similar studies were available. Main Outcomes and Measures: Beneficial or harmful changes in risks for various chronic conditions. Results: Eighteen trials (n = 40 058; range, 142-16 608; mean age, 53-79 years) were included. Women using estrogen-only therapy compared with placebo had significantly lower risks, per 10 000 person-years, for diabetes (-19 cases [95% CI, -34 to -3]) and fractures (-53 cases [95% CI, -69 to -39]). Risks were statistically significantly increased, per 10 000 person-years, for gallbladder disease (30 more cases [95% CI, 16 to 48]), stroke (11 more cases [95% CI, 2 to 23]), venous thromboembolism (11 more cases [95% CI, 3 to 22]), and urinary incontinence (1261 more cases [95% CI, 880 to 1689]). Women using estrogen plus progestin compared with placebo experienced significantly lower risks, per 10 000 person-years, for colorectal cancer (-6 cases [95% CI, -9 to -1]), diabetes (-14 cases [95% CI, -24 to -3), and fractures (-44 cases [95% CI, -71 to -13). Risks, per 10 000 person-years, were significantly increased for invasive breast cancer (9 more cases [95% CI, 1 to 19]), probable dementia (22 more cases [95% CI, 4 to 53]), gallbladder disease (21 more cases [95% CI, 10 to 34]), stroke (9 more cases [95% CI, 2 to 19]), urinary incontinence (876 more cases [95% CI, 606 to 1168]), and venous thromboembolism (21 more cases [95% CI, 12 to 33]). Conclusions and Relevance: Hormone therapy for the primary prevention of chronic conditions in menopausal women is associated with some beneficial effects but also with a substantial increase of risks for harms. The available evidence regarding benefits and harms of early initiation of hormone therapy is inconclusive

Associations between inflammation, coagulation, cardiac strain and injury, and subclinical vascular disease with frailty in older men: a cross-sectional study

BACKGROUND: Inflammation, coagulation activation, endothelial dysfunction and subclinical vascular disease are cross-sectionally associated with frailty. Cardiac-specific biomarkers are less-well characterised. We assessed associations between these and frailty, in men with, and without, cardiovascular disease (CVD). METHODS: Cross-sectional analysis of 1096 men without, and 303 with, CVD, aged 71–92, from the British Regional Heart Study. Multinominal logistic regression was performed to examine the associations between frailty status (robust/pre-frail/frail) and, separately, C-reactive protein (CRP), interleukin-6 (IL-6), tissue plasminogen activator (tPA), D-dimer, von Willebrand factor (vWF), high-sensitivity cardiac troponin-T (hs-cTnT), N-terminal pro B-type natriuretic peptide (NT-proBNP) (all natural log-transformed), and, in men without CVD, carotid intima-media thickness (CIMT), carotid-femoral pulse wave velocity (cfPWV), carotid distensibility coefficient (DC), and ankle-brachial pressure index (ABPI), adjusted for age, renal function, BMI, social class, smoking, polypharmacy, cognition, multimorbidity and systolic blood pressure. Explanatory variables with p < 0.05 were carried forward into mutually-adjusted analysis. RESULTS: In men without CVD, higher CRP, IL-6, vWF, tPA, hs-cTnT, NT-proBNP, cfPWV, and lower DC were significantly associated with frailty; mutually-adjusted, log IL-6 (OR for frailty = 2.02, 95%CI 1.38–2.95), log hs-cTnT (OR = 1.95, 95%CI 1.24–3.05) and DC (OR = 0.92, 95%CI 0.86–0.99) retained associations. In men with CVD, higher CRP, IL-6, and hs-cTnT, but not vWF, tPA, NT-proBNP or D-dimer, were significantly associated with frailty; mutually-adjusted, log hs-cTnT (OR 3.82, 95%CI 1.84–7.95) retained a significant association. CONCLUSIONS: In older men, biomarkers of myocardial injury are associated with frailty. Inflammation is associated with frailty in men without CVD. Carotid artery stiffness is associated with frailty in men without CVD, independently of these biomarkers

Pharmacological and non-pharmacological treatments for major depressive disorder: review of systematic reviews

This study aims to summarise the evidence on more than 140 pharmacological and non-pharmacological treatment options for major depressive disorder (MDD) and to evaluate the confidence that patients and clinicians can have in the underlying science about their effects