346 research outputs found

    Adaptation requires attuning to shifting temporal patterns

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    Communal life is characterized by the shared timing of human and environmental events. Climate change is disrupting these timings, creating mismatches in these coordinated temporal patterns and requiring adaptive governance

    The Malaysian Workplace Bullying Index (MWBI): A new measure of workplace bullying in Eastern countries

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    Workplace bullying is a significant cause of stress at work. Existing studies, primarily based on Western-oriented frameworks and instruments, have largely overlooked the role of culture. This oversight questions whether understandings generated from those studies can be generalised to employees working in Eastern countries, which differ on important cultural dimensions. To date, there is no Eastern-based instrument for measuring workplace bullying. In two studies, we developed and validated such a measure: the Malaysian Workplace Bullying Index (MWBI). Study 1 entailed a content validation of bullying behaviours via written records (diaries) completed by Malaysian bullying victims. The 19 validated behaviours formed the basis of Study 2, with additions from the wider literature. Study 2 used survey data collected at three time-points from Malaysian employees exposed to bullying at work. The final result was an 18-item scale with two nine-item factors: work-related bullying and person-related bullying. Overall, the MWBI is a psychometrically sound measure of workplace bullying in Eastern workplaces

    Professional Interpreter Services and the Impact on Hospital Care Outcomes: An Integrative Review of Literature

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    Migration patterns have rapidly changed in Australia and elsewhere, which have contributed to increasingly culturally and linguistically diverse societies. This requires healthcare sectors to provide professional interpreter services for patients with a language barrier to eliminate healthcare disparities. This integrative review aimed to investigate the impact of professional interpreter services on hospital care outcomes and the associated cost of service provision. A systematic search of five databases was conducted for peer-reviewed articles from January 1996 to December 2020. Data were extracted for the hospital setting, intervention, population, study design, outcomes and key findings. Following the PRISMA guidelines, full-text screening identified 37 articles that were analysed and included. Communication quality, hospital care outcomes and hospital costs were the three main themes identified. Closing the language gap should be a primary consideration to prevent adverse events that affect patient safety and the standard of care in hospitals. The findings of this review indicate the provision of professional interpreter services can enhance hospital care for linguistically diverse patients by improving patient–provider communication. To gain insight into the changing patterns on the outcomes of medical care, further research requires efforts by the hospital administrative system to document complete records of service usage

    Interpreter Services in a General Health Setting in Western Australia: A Retrospective Study

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    Migration patterns have rapidly changed in Australia which have contributed to an increasingly culturally and linguistically diverse society. This has brought new opportunities and challenges in the healthcare sector to address the different language needs of the culturally and linguistically diverse (CaLD) populations. A key strategy is the provision of interpreter services to bridge the language gap and assist patients and healthcare providers in clinical encounters. This research project explored interpreter service usage at a Western Australian (WA) hospital, a general hospital located in Perth, providing hospital and community care to meet broader health needs of the population. In relation to the current COVID situation, the WA Language Service Policy has been updated to provide guidance to all public services to ensure that all information can be accessible to CaLD populations. The findings of this project aimed to inform current hospital practices, health policies and to support financial funding for hospital interpreter services

    A Pilot Study Comparing HPV-Positive and HPV-Negative Head and Neck Squamous Cell Carcinomas by Whole Exome Sequencing.

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    Background. Next-generation sequencing of cancers has identified important therapeutic targets and biomarkers. The goal of this pilot study was to compare the genetic changes in a human papillomavirus- (HPV-)positive and an HPV-negative head and neck tumor. Methods. DNA was extracted from the blood and primary tumor of a patient with an HPV-positive tonsillar cancer and those of a patient with an HPV-negative oral tongue tumor. Exome enrichment was performed using the Agilent SureSelect All Exon Kit, followed by sequencing on the ABI SOLiD platform. Results. Exome sequencing revealed slightly more mutations in the HPV-negative tumor (73) in contrast to the HPV-positive tumor (58). Multiple mutations were noted in zinc finger genes (ZNF3, 10, 229, 470, 543, 616, 664, 638, 716, and 799) and mucin genes (MUC4, 6, 12, and 16). Mutations were noted in MUC12 in both tumors. Conclusions. HPV-positive HNSCC is distinct from HPV-negative disease in terms of evidence of viral infection, p16 status, and frequency of mutations. Next-generation sequencing has the potential to identify novel therapeutic targets and biomarkers in HNSCC

    Hypermethylation of SOX2 Promoter in Endometrial Carcinogenesis

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    This paper aimed at investigating the expression and methylation profiles of SOX2, a gene coding for the stem cell-related transcription factor SOX2, in endometrial carcinomas. By methylation-specific polymerase chain reaction (MS-PCR), the methylation status of SOX2 promoter region in 72 endometrial carcinomas and 12 normal endometrial samples was examined. Methylated allele was found in 37.5% (27/72) of endometrial carcinomas but only in 8.3% (1/12) of normal endometrial, significantly more frequent in cancers (P = .0472). SOX2 mRNA level was significantly reduced in endometrial carcinoma compared with nonneoplastic endometrium (P = .045). A significant correlation between SOX2 mRNA expression and hypermethylation of SOX2 was found (P = .024). Hypermethylation of SOX2 tended to be more frequently found in type II serous or clear cell adenocarcinoma. SOX2 methylation was also significantly correlated with shorter survival of patients (P = .046). In conclusion, epigenetic mechanisms may play a crucial role on the transcriptional regulation of SOX2 and loss of SOX2 expression may be related to endometrial carcinogenesis

    The Relationship between AKI and CKD in Patients with Type 2 Diabetes:An Observational Cohort Study

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    Background There are few observational studies evaluating the risk of AKI in people with type 2 diabetes, and even fewer simultaneously investigating AKI and CKD in this population. This limits understanding of the interplay between AKI and CKD in people with type 2 diabetes compared with the nondiabetic population. Methods In this retrospective, cohort study of participants with or without type 2 diabetes, we used electronic healthcare records to evaluate rates of AKI and various statistical methods to determine their relationship to CKD status and further renal function decline. Results We followed the cohort of 16,700 participants (9417 with type 2 diabetes and 7283 controls without diabetes) for a median of 8.2 years. Those with diabetes were more likely than controls to develop AKI (48.6% versus 17.2%, respectively) and have preexisting CKD or CKD that developed during follow-up (46.3% versus 17.2%, respectively). In the absence of CKD, the AKI rate among people with diabetes was nearly five times that of controls (121.5 versus 24.6 per 1000 person-years). Among participants with CKD, AKI rate in people with diabetes was more than twice that of controls (384.8 versus 180.0 per 1000 person-years after CKD diagnostic date, and 109.3 versus 47.4 per 1000 person-years before CKD onset in those developing CKD after recruitment). Decline in eGFR slope before AKI episodes was steeper in people with diabetes versus controls. After AKI episodes, decline in eGFR slope became steeper in people without diabetes, but not among those with diabetes and preexisting CKD. Conclusions Patients with diabetes have significantly higher rates of AKI compared with patients without diabetes, and this remains true for individuals with preexisting CKD.on behalf of the BEAt-DKD Consortiu

    Digital interventions in alcohol and drug prevention, treatment and recovery: Systematic maps of international research and interventions available in England

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    Executive Summary Background Digital interventions in alcohol and drug prevention, treatment and recovery have the potential to overcome barriers faced by non-digital interventions. However, we lack a clear understanding of the types of digital interventions that have been evaluated and where gaps in the evidence base exist. We also need to understand the effectiveness of different types of digital alcohol and drug interventions for various population groups. Further, we do not know which digital alcohol and drug interventions are being used in England, and whether the interventions in use align with those that have been evaluated. Research questions To address the above concerns, we sought to address the following questions: • RQ1: What is the possible range of digital alcohol and drug interventions? • RQ2: Which types of digital alcohol and drug interventions are currently available for use in England? • RQ3: What systematic reviews provide findings for digital alcohol and drug intervention strategies within a prevention/treatment/recovery pathway? • RQ4: Which types of digital alcohol and drug interventions have been evaluated in primary research? • RQ5: To what extent does the evaluation evidence overlap with digital alcohol and drug interventions that are currently available for use in England? • RQ6: What evidence is there that certain types of digital alcohol and drug interventions are (cost-) effective or ineffective for specific population groups or in particular contexts? This report covers our findings in relation to questions RQ1 - RQ5. Based on these findings we also provide suggestions as to what could be the focus of further work to answer RQ6. Methods To address RQ1 an initial typology was drafted, adapting and building on existing typologies of digital interventions. Through this process it became clear to OHID/PHE that a pathway, presenting a route through services, with different types of interventions recommended for use at different times would be more helpful than a typology of intervention characteristics. This pathway was then developed by OHID/PHE and trialled by the research team, with refinements made over time with discussions between the study team and PHE. To address RQ2 we contacted people in England in 2019, who were involved in developing, commissioning, prescribing, recommending or evaluating digital alcohol/drug interventions. Using an online survey, we asked them to describe the interventions they were involved with. To address RQ3, RQ4 and RQ5 we conducted systematic searching and screening to identify and describe existing systematic reviews (RQ3) and primary studies (RQ4). Included systematic reviews were appraised for quality and detailed information was extracted from full reports. For primary studies we extracted basic details using the information contained within the title and abstract. The pathway developed for RQ1 was employed to code and describe the nature of available interventions (RQ2), systematic reviews (RQ3) and primary studies (RQ4). EPPI-Mapper software was used to produce online interactive maps to visually display the findings
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