Impact of Implementing New ICF-Based Practices on Staff Valence of Disability Practitioners: An Experience in Hong Kong

The International Classification of Functioning, Disability, and Health (ICF) was endorsed by The World Health Organization (WHO) in 2001. However, Hong Kong is at the beginning stage of implementing and testing ICF-based practices. This study examines any changes in the valences of disability practitioners in an organization under the newly introduced ICF-based practices. It was hypothesized that the involved staff members’ self-perceived valences in relation to the ICF would be enhanced. A pretest-posttest design was adopted. The 27-item Scale on Staff Valence under ICF-based practice (SSV-ICF) was used to measure the impact on staff valence of a pilot scheme in which ICF-based practice was implemented. Self-report questionnaires were completed by the involved staff members at the beginning of the pilot scheme and 12 months later. Analyses used paired samples t-tests and one-way repeated measures ANOVAs, performed by SPSS software, version 25. In total, 91 participants took part in the study. Results showed that participants achieved positive changes in all domains of valences, while participants’ level of involvement in the new ICF-based intervention had significant effects on their score differences in the “Competence” domain (r = 0.262, p p p < 0.05). The study demonstrated that disability practitioners who implemented ICF-based practices developed higher staff valences, which, in turn, benefited service users. Implementation of ICF-based practices also contributed to a more positive organizational culture

Sociodemographic and psychosocial factors associated with vaccine hesitancy – results from a longitudinal study in Singapore

Singapore has one of the highest COVID-19 vaccination rates, however identifying vaccine-hesitant sub-groups and their concerns is vital given the need for future boosters in vulnerable populations. Furthermore, vaccine hesitancy remains a concern in the event of an emergence of a newer strain that necessitates the rolling out of a new vaccination programme. The aims of this study were to establish the extent of COVID-19 vaccine hesitancy and the factors influencing it among adults in Singapore using the Vaccine Hesitancy Scale (VHS). The study used a longitudinal methodology and participants were recruited in two waves from May 2020 to Sep 2022. In all 858 participants agreed to participate in both waves of the study. The two-factor structure of the VHS scale as established in earlier studies was tested using confirmatory factor analysis. The results revealed a two-factor structure of VHS comprising “lack of confidence” and “risks”. Those who had higher stress, resilience, and concerns that they might be infected with COVID-19 at wave 1 were significantly associated with lower ‘lack of confidence’ scores i.e. lower vaccine hesitancy. In comparison, those with higher concerns about inadequate government preventive measures and unemployment at wave 1 were significantly associated with higher ‘lack of confidence’ scores. Those with higher concerns about inadequate government preventive measures in wave 1 were significantly associated with higher ‘risks’ scores i.e. higher vaccine hesitancy. The findings point toward the need for a nuanced messaging that considers the fears expressed by the populace and addresses them directly using clear simple language

CD44+ Cancer Stem-Like Cells in EBV-Associated Nasopharyngeal Carcinoma

<div><p>Nasopharyngeal carcinoma (NPC) is a unique EBV-associated epithelial malignancy, showing highly invasive and metastatic phenotype. Despite increasing evidence demonstrating the critical role of cancer stem-like cells (CSCs) in the maintenance and progression of tumors in a variety of malignancies, the existence and properties of CSC in EBV-associated NPC are largely unknown. Our study aims to elucidate the presence and role of CSCs in the pathogenesis of this malignant disease. Sphere-forming cells were isolated from an EBV-positive NPC cell line C666-1 and its tumor-initiating properties were confirmed by <em>in vitro</em> and <em>in vivo</em> assays. In these spheroids, up-regulation of multiple stem cell markers were found. By flow cytometry, we demonstrated that both CD44 and SOX2 were overexpressed in a majority of sphere-forming C666-1 cells. The CD44+SOX2+ cells was detected in a minor population in EBV-positive xenografts and primary tumors and considered as potential CSC in NPC. Notably, the isolated CD44+ NPC cells were resistant to chemotherapeutic agents and with higher spheroid formation efficiency, showing CSC properties. On the other hand, microarray analysis has revealed a number of differentially expressed genes involved in transcription regulation (e.g. <em>FOXN4</em>, <em>GLI1</em>), immune response (<em>CCR7</em>, <em>IL8</em>) and transmembrane transport (e.g. <em>ABCC3</em>, <em>ABCC11</em>) in the spheroids. Among these genes, increased expression of CCR7 in CD44+ CSCs was confirmed in NPC xenografts and primary tumors. Importantly, blocking of CCR7 abolished the sphere-forming ability of C666-1 <em>in vitro</em>. Expression of CCR7 was associated with recurrent disease and distant metastasis. The current study defined the specific properties of a CSC subpopulation in EBV-associated NPC. Our findings provided new insights into developing effective therapies targeting on CSCs, thereby potentiating treatment efficacy for NPC patients.</p> </div

In vivo tumorigenic capacity of sphere-forming cells and unselected parental cells of C666-1 in nude mice.

<p>N/A – data not available.</p

Overexpression of multiple EBV and cellular genes in sphere-forming NPC cells.

<p>(A) By qRT-PCR, multiple EBV genes (EBER, BARF1, LMP1, LMP2A, EBNA1 and BZLF1) were found to be overexpressed in spheroids when compared to monolayer C666-1 cells. EBV copy number in these cells was determined by qPCR. (B) Selected genes aberrantly expressed in spheroids were confirmed by qRT-PCR. The significantly upregulated genes include chemokines and receptors (CCR7, CCL4, CX3CL1 and IL-8), cell adhesion molecule SELE, signaling molecules (GLI1, FOXN4) and ABC transporters (ABCC3, ABCC11). (C) Cell surface-expressed CCR7 was found to be frequently expressed in sphere-forming cells (>60%) by flow cytometry. The CCR7+ cell subpopulation was also detected in NPC lines and primary tumors (<5%). (D) CD44+CCR7+cells were also found to be enriched in spheroids. Histograms denoting mean ± SE (n≥3) with statistical significance calculated by t-test (*<i>P</i><0.05, **<i>P</i><0.01, *** <i>P</i><0.001).</p

Immunohistochemical analysis of CCR7 and CD44 expression in primary NPC.

<p>Representative primary NPC cases with high (A), medium (B), low (C) expression of CCR7. (D) Primary NPC with absence of CCR7 expression was shown. CCR7 staining were detected in few infiltrating lymphocytes, but not in the tumor cells. Primary tumors with high (E) and medium (F) CD44 expression were shown. In (G) and (H), weak CD44 expression was detected in the tumor cells while strong CD44 staining in infiltrating lymphocytes was commonly found.</p

Selection of aberrantly expressed genes in sphere-forming cells compared to monolayer C666-1 cells.

<p>Selection of aberrantly expressed genes in sphere-forming cells compared to monolayer C666-1 cells.</p