Beate Neumeier and Kay Schaffer, eds., Decolonizing the Landscape: Indigenous Cultures in Australia

Beate Neumeier and Kay Schaffer’s edited book, Decolonizing Landscape: Indigenous Cultures in Australia, examines the violence of Australia’s colonial past to engage in an intercultural dialogue and call for a renewed ethical response. The multi-disciplinary character of the topic is clearly reflected in this volume which brings together 15 innovative essays that combine philosophical, ethnographic, psychoanalytical, postmodern, and postcolonial approaches. In their introduction, Neumeier and..

Plain language communication as a priority competency for medical professionals in a globalized world

This brief report aims to highlight the impact of globalization – the international movement of goods, people, and ideas – on patient-provider communication in medical training and practice, and how the implementation of plain language communication training as a core competency for care providers can mitigate this impact. Globalization influences both patient and provider population diversity, which presents challenges with regard to patient-provider communication, particularly in cases of limited health literacy. Plain language communication - the delivery of information in a simple, succinct, and accurate manner - can help address these challenges. Training in plain language communication, however, is not a part of standard education for health care providers. Based on a synthesis of relevant literature pertaining to globalization, plain language communication, and medical education curricula, it is hoped that the information presented establishes the need for plain language communication as a core competency in medical education to enable providers to better meet the needs of an increasingly globalized health system

Perception and attitude of physicians toward local generic medicines in Saudi Arabia: A questionnaire-based study

AbstractObjectives: The current study aimed to explore the knowledge, perception, and attitude of physicians toward generic medicines in Saudi Arabia.Background: The local market of generic medicine share in Saudi Arabia is low compared to global and regional statistics. The reason for this low market share and the role of physicians has not previously been investigated. The purpose of this study was to assess health practitioner level of perceived knowledge, opinions and attitudes about local generic medication, and identify factors that influence infrequency of generic prescriptions.Methods: A random sample of 231 physicians was recruited from two hospitals in Riyadh (one government one private) and 178 (77%) responded. Information on the physicians’ perceived knowledge, opinions and attitude toward local generic medication was extracted, analyzed and interpreted. Factors that influence infrequent prescription of local generic drugs were identified.Results: Among the 178 participants in the physicians’ survey, 76% and 47% reported that they are knowledgeable about the terms “generic” and “bioequivalence” respectively, while 44% reported that they are able to explain bioequivalence to their patients. Approximately 52% of physicians reported that local generics should be substituted for brands if suitable for the case, and 21.9% reported that they believe SFDA approved local generics are therapeutically equivalent to their brands. Clinical effectiveness was reported by 71.9% of physicians as the most influential factor effecting prescription of brand over local generic medication. The three independent significant predictors for infrequent prescription of local generics among physicians: Government sector employment (OR=3.74, [95%CI 1.50–9.43]), consultant level (OR=3.94, [95%CI 1.50–10.31]) and low level of knowledge about local generics (OR=4.11, [95%CI 1.56–10.84]).Conclusion: The low market share of local generics medicines attributed to low prescription rates is significantly more among senior-level physicians working in governmental hospitals. Low level of knowledge about generic drugs among physicians was the strongest predictive factor for low prescription. Future bigger studies are needed to confirm these results

Reconstruction. Introduction

The theme of the 2017 SAES conference “(Re)construction(s)” is particularly pertinent in the area of colonial and postcolonial studies, for it captures one of its underlying preoccupations. It suggests that the ultimate purpose of postcolonial deconstruction – which represents a first step toward a transformation of critical thought that aims at overcoming Eurocentric approaches to space, place, people, and nations – is reconstruction. By incorporating other voices, postcolonial deconstructio..

Environmental isotonicity improves cold tolerance of Nile tilapia, Oreochromis niloticus, in Egypt

AbstractThe limited ability of Oreochromis niloticus to tolerate low temperatures during winter in temperate and some subtropical region, such as in Egypt, is of major economic concern. The present study was aimed to improve the cold tolerance of Nile tilapia, O. niloticus, by using the well documented phenomena of saving energy consumption for osmoregulation in isotonic medium to decrease the physiological response to cold stress at winter months and may solve the Winter Stress Syndrome (WSS) and the over-wintering problems. Fish which were either pre-acclimated to freshwater or isotonic salinity at 25°C were transferred directly to freshwater or isotonic medium (12‰) at 14°C. Fish were killed 3, 6, 24, 48, 72 and 168h after transfer. In the isotonic medium pre-acclimated fish, it is shown that the effect of cold stress on the increment of plasma glucose level was much lower than that in fresh water. From the observations of Na+, K+, Mg2+-ATPase enzyme activity we conclude that less disturbance of ionic balance caused by cold tolerance was occurred in the isotonic point water than in the fresh water. The results of the acetylcholinesterase specific activity showed that, brain enzyme was inhibited by cold stress, and that the disruption of the cholinergic function induced by cold stress was much more pronounced in fresh water pre-acclimated tilapia than in isotonic point water pre-acclimated fish. Results from this study recommend that pre-acclimation of Nile tilapia, O. niloticus, to an environmental salinity close to the isotonicity, before winter onset, may improve their cold tolerance

The combined effect of environmental thermal drop and isotonicity on metabolic stores of the teleost, Oreochromis niloticus

AbstractFour experimental regimes were designed to test the capacity of the Nile tilapia Oreochromis niloticus to make use of the energy saved form osmoregulation in an isotonic medium in overcoming the Winter Stress Syndrome (WSS). Fish either pre- acclimated to freshwater or isotonic salinity at 25°C were transferred directly to freshwater or an isotonic medium (ca. 12‰) at 14°C. Fish were killed 3, 6, 24, 48, 72 and 168h after transfer. The mobilisation and use of lipids from perivisceral and muscle fat observed in the study seem to be a direct response to cold stress as well as the associated fasting, these effects were salinity dependent being lesser at the isotonic salinity. The energy needs of fish diminish in cold conditions when the salinity of the environment approaches the isotonicity. The absence of any significant changes in muscle and water content indicated that the changes of muscle lipid are true and lipid was the sole source of energy upon thermal drop. The changes of blood haemoglobin levels throughout the four experimental regimes may indicate that the isotonic medium acclimated tilapia showed less haematological disturbance due to cold stress. Results from this experimental study recommend that the pre-acclimation of the Egyptian strain of Nile tilapia, O. niloticus, to an environmental salinity close to the isotonicity may improve fish cold tolerance

Understanding substance misuse amongst the mentally ill: an investigation of the context of, and motivations for, drug and alcohol use in an in-patient sample of individuals with psychotic illness

Background: Dual diagnosis (substance misuse and mental illness) is recognised as a significant clinical problem. However there is little evidence contributing to the understanding of what motivates people with psychotic illnesses to use drugs and alcohol, and in what social context. There is still less evidence concerning the correlates of dual diagnosis in in-patient settings including the relationship between mental health service settings and the initiation and maintenance of substance misuse. This study reports the prevalence, social context of, and motivations for substance use in a sample of in-patients with psychotic illnesses.;Methods and measures: Staff on 9 acute mental health wards and 2 psychiatric intensive care units in North London used a Clinician Drug and Alcohol Use Rating Scale to assess whether working age in-patients with psychotic illness also met the criteria for harmful alcohol or drug use, or dependence during the preceding six months. Those meeting the criteria for harmful use or dependence were then approached to participate in the study. Participants were interviewed and asked to report on the nature, extent, social context and attributions of their substance use, and whether they had continued to use whilst an in-patient. Measures used included an Inventory of Alcohol and Drug Use Situations, a Self-Medication Questionnaire, a demographic schedule and a structured set of questions concerning substance use history and it's relationship to mental health service settings.;Results: All working age adult in-patients (264) were screened for a current or recent substance use disorder. One hundred and twenty nine individuals met the study criteria (48.9%), whilst a further 39 (15%) had a substance use history, but no associated impairment of these, 102 agreed to take part in the study (response rate 79%). Those with dual diagnosis were younger on average and more likely to be male, than those with psychosis alone. The majority (76%) suffered from schizophrenia and were detained under the Mental Health Act (1983), with 19% being street homeless. A wide range of substances including opiates, stimulant substances and khat were used by participants, but alcohol, cannabis and cocaine (respectively) were the most frequently used substances. Eighty one percent of the participants reported using on the ward during their current admission, with almost half of the participants buying substances from other in-patients. Methods of using reflected the wide range of substance use reported, and included intravenous injection, chasing, and smoking. A third of participants reported feeling pressurised to buy, or use substances with other in-patients. For the majority substance use was clearly a social activity with three quarters of the participants reporting that they typically used or drank with others. Sixteen percent of the participants reported typically using with other mental health service users. Two principal components analyses of use situations and self medication data each revealed three factors, explaining 68% and 66% of the variance respectively. All factors had high mean scores, and elicited motivations for substance use. They were (use related to): negative personal and social states (48% variance), pleasant social conditions (13% variance), reward (7% variance), social interaction and boredom (41%) social acceptance (14% variance), and medication side effects (9% variance). An exploratory cluster analysis aimed at identifying sub-groups with distinctive patterns of motivations for use. Scores within clusters varied, with the membership of one cluster scoring highly on all factor items while other cluster members scored low on several items, clearly influencing their motivations for use. This exploratory analysis gives some indication that there are a number of distinctive patterns of use, including people who use in a wide range of situations with a variety of motivations, those who primarily use for relief of unpleasant feelings and social anxiety, and those whose use is predominantly social.;Conclusions: Substance misuse is a common problem in users of adult mental health services, and innovative solutions to understand and address these problems are needed. Although it was uncommon for individuals to directly medicate the symptoms of their illness with substances, their motivations for use reflected a range of social difficulties, isolation and other affective problems. Further investigation of demographic variables and substance use motivations in a larger sample may be an effective way of delineating sub groups with distinct motivations and of developing treatment strategies which take these motivations into account

The relationship between oestrogen receptor-alpha phosphorylation and the tumour microenvironment in patients with primary operable ductal breast cancer

Aims: Although the role of phosphorylation of oestrogen receptor (ER) at serines 118 (p-S118) and 167 (p-S167) has been studied, the relationship between p-S118, p-S167 and the tumour microenvironment in ER-positive primary operable ductal breast cancers have not been investigated. The aims of this study are to investigate (i) the relationship between p-S118/p-S167 and the tumour microenvironment, and (ii) the effect of p-S118/167 on survival and recurrence in ER-positive primary operable ductal breast cancers. Methods and results: Patients presenting at three Glasgow hospitals between 1995 and 1998 with invasive ductal ER-positive primary breast cancers were studied (n = 294). Immunohistochemical staining of p-S118 and p-S167 was performed and their association with clinicopathological characteristics, cancer-specific survival (CSS) and recurrence-free interval (RFI) were examined. In the whole cohort, tumour size (P < 0.05) and microvessel density (P < 0.05) were associated with high p-S118 while increased micovessel density (P < 0.05), apoptosis (P < 0.05), general inflammatory infiltrate measured using the Klintrup–Makinen score (P < 0.05) and macrophage infiltrate (P < 0.05) were found to be associated with high p-S167. Only high p-S167 was associated with shorter CSS (P < 0.005) and shorter RFI in the whole cohort (P = 0.001) and separately in the luminal A (P < 0.05) and B tumours (P < 0.05). Conclusions: This study showed that both p-S118 and p-S167 were associated with several microenvironmental factors, including increased microvessel density. In particular, p-S167 was associated with reduced RFI and CSS in the whole cohort and RFI in luminal A and B tumours and could possibly be employed to predict response to kinase inhibitors

Immunogenic cell death pathway polymorphisms for predicting oxaliplatin efficacy in metastatic colorectal cancer

Background Immunogenic cell death (ICD) is a tumor cell death involving both innate and adaptive immune responses. Given published findings that oxaliplatin, but not irinotecan, drives ICD, we investigated whether single nucleotide polymorphisms (SNPs) in the ICD pathway are associated with the efficacy of oxaliplatin-based chemotherapy in metastatic colorectal cancer (mCRC). Methods Two randomized clinical trials data were analyzed: discovery cohort, FOLFOX/bevacizumab arm (MAVERICC); validation cohort, FOLFOXIRI/bevacizumab arm (TRIBE); and two control cohorts, FOLFIRI/bevacizumab arms (both trials). Genomic DNA extracted from blood samples was genotyped. Ten SNPs in the ICD pathway were tested for associations with clinical outcomes. Results In total, 648 patients were included. In the discovery cohort, three SNPs were significantly associated with clinical outcomes in univariate analysis: CALR rs1010222 with progression-free survival (G/G vs any A, HR=0.61, 95% CI 0.43-0.88), ANXA1 rs1050305 with overall survival (OS) (A/A vs any G, HR=1.87, 95% CI 1.04-3.35), and LRP1 rs1799986 with OS (C/C vs any T, HR=1.69, 95% CI 1.07-2.70). Multivariate analysis confirmed the trend, but statistical significance was not reached. In the validation cohort, ANXA1 rs1050305, and LRP1 rs1799986 were validated to have the significant associations with clinical outcome. No significant associations of these SNPs were observed in the two control cohorts. Treatment-by-SNP interaction test confirmed the predictive values. Conclusions The predictive utility of ICD-related SNPs for the efficacy of oxaliplatin-based chemotherapy was demonstrated, warranting further validation studies to be translated into personalized treatment strategies using conventional cytotoxic agents in mCRC