The health transition: the cultural inflation of morbidity during the decline of mortality

It has become commonplace to observe that as mortality falls, morbidity levels rise. The question is why? The explanation offered here stresses the multidimensional nature of morbidity, and the important role that diverse cultural forces have on the patterns of behaviour which underlie reporting behaviour during modernization. These forces involve rising health expectations on the part of ordinary people, including their ability to perceive illness and their willingness to seek professional help, and institutional pressures on medical professionals which reward them for discovering and treating an ever-growing set of non-fatal diseases. Since non-Western developing countries are training physicians to practice scientific medicine, are educating their citizens to think about disease along modern lines, and measure morbidity as developed countries do, there is every reason to suppose that as mortality falls in these countries, morbidity will rise, just as it has done in the developed world

Doing 'health' research in an unhealthy research environment

If research produces knowledge about health, and knowledge is essential for improving health, then health research improves health, particularly through policy. Health transition research is exceptionally important to the production of useful knowledge (Caldwell 1990:xiii) because it deals with the causes of improved health over time. While the logic is sound health research is not. It is a contentious field currently producing more confusion than enlightenment, in which continuing uncertainty means that it is difficult to identify and apply genuinely useful knowledge. Health research, including health transition research, is distributed over a number of fields which in themselves comprise separate academically-based disciplines and subdisciplines. These fields compete with one another to control research and funding; they do not work together to solve problems of pressing importance to health related human welfare. While there are exceptional individual social scientists, who conduct and support genuinely co-operative interdisciplinary research, their best efforts may not be able to transform a research environment which makes the production of useful knowledge difficult. In the present research environment it is generally yes that most health research is done to advance the welfare of a field and the experts in it. The competition between fields means that the overarching goal of all social science research — the improvement of human welfare — is easily lost in the struggle for disciplinary hegemony. The purpose of this paper is to explore the intellectual and institutional circumstances which create this counter-productive, welfare-negative research environment, and suggest how it might be reformed

Heterogeneity in the Speed of Adjustment to Target Leverage: A UK Study

Responding to the need to address heterogeneity in the speed of adjustment (SOA) to target leverage in a manner that reflects the fractional nature of leverage, we estimate SOAs across sub-samples of UK firms using the Dynamic Panel Fractional estimator (DPF). Using firm risk as a categorising variable, we show that riskier firms tend to adjust to target leverage at a faster rate, suggesting opportunity costs of being away from target leverage are higher for riskier firms. We also demonstrate the bias in SOAs as estimated using a model that does not account for the fractional nature of leverage, and show that this bias can result in spurious inferences being made when comparing SOAs across sub-samples. Our results cast doubt on existing evidence relating to heterogeneity in SOAs of UK firms

Structure and stereochemistry of the base excision repair glycosylase MutY reveal a mechanism similar to retaining glycosidases.

MutY adenine glycosylases prevent DNA mutations by excising adenine from promutagenic 8-oxo-7,8-dihydroguanine (OG):A mismatches. Here, we describe structural features of the MutY active site bound to an azaribose transition state analog which indicate a catalytic role for Tyr126 and approach of the water nucleophile on the same side as the departing adenine base. The idea that Tyr126 participates in catalysis, recently predicted by modeling calculations, is strongly supported by mutagenesis and by seeing close contact between the hydroxyl group of this residue and the azaribose moiety of the transition state analog. NMR analysis of MutY methanolysis products corroborates a mechanism for adenine removal with retention of stereochemistry. Based on these results, we propose a revised mechanism for MutY that involves two nucleophilic displacement steps akin to the mechanisms accepted for 'retaining' O-glycosidases. This new-for-MutY yet familiar mechanism may also be operative in related base excision repair glycosylases and provides a critical framework for analysis of human MutY (MUTYH) variants associated with inherited colorectal cancer

A Comparison of Skills Considered Important for Success as an Entry Level Manager in the Hospitality Industry vs. The Skills Recent Graduates Possess

This paper presents and discusses the findings of a study to determine if the historic gap between the skills industry and education consider important for success as an entry level manager still exists. A review of literature identified a list of skills considered important for success by both industry and higher education. Of the eighty nine skills identified, forty two showed no significant difference, six skills were considered more important by the recruiters and forty one skills were considered more important by the educators. The top 10 skills were the same for both groups; however their order is slightly different

Priorities for advancing nursing knowledge

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/88192/1/ketefian-priorities_advancing_nursing.pd

Palliative and end-of-life educational interventions for staff working in long-term care facilities: An integrative review of the literature

Background: Given the increase in the number of deaths within long-term care facilities (LTCFs), the need for palliative and end-of-life (EOL) care education among such facilities has been increasing. As such, a systematic synthesis of global palliative and EOL care educational approaches and evaluation can aid further educational development. Objective: To synthesise the current literature on palliative and EOL care educational interventions for staff working in LTCFs and identify barriers to, and facilitators of, intervention implementation. Methods: The study used an integrative review framework wherein indexed databases, namely, CINAHL, EMBASE, MEDLINE, PsycINFO, Web of Science, Cochrane Library and Japan Medical Abstract Society, were systematically searched for studies published in English and Japanese between 2007 and 2019. Search terms that are related to palliative care, LTCF, and education were combined to increase search sensitivity. The quality of the papers was assessed using Joanna Briggs Institute Critical Appraisal Tools and the Mixed-Methods Appraisal Tool. Results: A total of 52 studies were included in the review. Our results suggested that although studies in this area and setting have been evolving, suboptimal developmental research and educational practices, global variability and unstandardised approaches to education and lacking viewpoints from service users have remained. Barriers to intervention implementation were also reported due to the specific characteristics of LTCFs, which include high staff turnover and considerable variation in professional skills and experience. Conclusions: Given the different LTCF types, systems and policies across each country or region, further research on standardised educational interventions with contextual considerations using large-scale studies with robust methodology is needed to meet the increasing demand for palliative and EOL care among the global ageing population. Implications for practice: Palliative and EOL care educational intervention for LTCF staff need to include more consideration of context, organisational culture and the user involvement throughout the process of education and research to enhance the quality of care in this complex setting. © 2020 The Authors. International Journal of Older People Nursing published by John Wiley & Sons Lt

The essentiality of arachidonic acid in infant development

Arachidonic acid (ARA, 20:4n-6) is an n-6 polyunsaturated 20-carbon fatty acid formed by the biosynthesis from linoleic acid (LA, 18:2n-6). This review considers the essential role that ARA plays in infant development. ARA is always present in human milk at a relatively fixed level and is accumulated in tissues throughout the body where it serves several important functions. Without the provision of preformed ARA in human milk or infant formula the growing infant cannot maintain ARA levels from synthetic pathways alone that are sufficient to meet metabolic demand. During late infancy and early childhood the amount of dietary ARA provided by solid foods is low. ARA serves as a precursor to leukotrienes, prostaglandins, and thromboxanes, collectively known as eicosanoids which are important for immunity and immune response. There is strong evidence based on animal and human studies that ARA is critical for infant growth, brain development, and health. These studies also demonstrate the importance of balancing the amounts of ARA and DHA as too much DHA may suppress the benefits provided by ARA. Both ARA and DHA have been added to infant formulas and follow-on formulas for more than two decades. The amounts and ratios of ARA and DHA needed in infant formula are discussed based on an in depth review of the available scientific evidence