Menopause at work—An organisation-based case study

Aim: The aim of the study was to explore and understand the organizational culture of a workplace in terms of support and well- being for staff experiencing perimenopausal and menopausal symptoms at work. Design: It is widely acknowledged that perimenopause and menopause symptoms are experienced by a large percentage of the female workforce. There is a lack of research into how nurses are supported through menopause (Cronin et al. Issues in Mental Health Nursing, 42, 2021, 541–548). The perimenopause and menopause transition can be a challenging time where many may require symptom management and support (RCN, The Menopause and Work: Guidance for RCN Representatives, 2020). This paper presents a case study research (CSR) approach to examine one healthcare organization. Methods: CSR design was used: A survey distributed to all staff employed, a review of the available documentation on menopause and interviews with managers from different levels of the organization. The COREQ consolidated criteria was used for reporting the qualitative research reported this study. Results: The case study generated both quantitative and qualitative data using sur-veys, interviews and documentation. Data from the organization (n= 6905) showed a majority female workforce of 81.9% with 40.6% aged between 41 and 55 years old, meaning a third of the organization working through perimenopause and menopause. Survey responses (n= 167) collected biographical and psychometric data on the prevalence of perimenopausal and menopausal symptoms. Seven managers were interviewed highlighting two themes: Access to support and culture of menopause and 13 documents from the organization on menopause were analysed for content. The study design permitted an iterative approach to data collection and providing an in-depth understanding of the needs and support for those experiencing perimenopause and menopause. The findings help healthcare organizations to understand their workforce and take in to account the larger numbers of female employees particularly nurses with the need to provide person-centred support mechanisms and an organizational approach for all employees

Inclusive education in progress: policy evolution in four European countries

This paper seeks to compare the evolution of inclusive education policy in the four countries of an EU-funded research project (QualiTYDES) operating under the shared policy environment of the UN, EU and European Commission. A shared policy cannot of course be assumed to result in common legislative or provisional outcomes at national level. The different sociocultural, political, historical and economic contexts in each country shape its journey towards ‘compliance’ with an international convention (both pre- and post-ratification), and neither the route nor the destination can be assumed to be shared, given the scope for different interpretations of the same texts. This paper places the implementation trajectories of four European countries side by side as they attempt to move towards ‘inclusive’ education systems. Following a brief overview of the international education policy environment relating to the education of people with disabilities, we describe the national education policy responses in Ireland, Austria, Spain and Czech Republic in recent decades, including both legislation pertaining to special educational need and implementation of policies in practice. The comparison highlights the different manifestations of inclusive education current in each country, and also explores the challenges which have arisen as individual countries attempt to align international policy with provision in existing education systems, each with their own legacy interests, pressures and priorities. Examples of ‘gaps’ in this alignment are where learners with disabilities/SEN are likely to be failed, and represent the critical points at which barriers to fully inclusive education arise and negatively impact opportunity over the life course.The QualiTYDES research project was supported by the European Science Foundation [grant number 09-ECRP-032]; Austrian Science Fund (FWF) [grant number I343]; Irish Research Council (IRC, formerly IRCHSS) [grant number IRCHSS 09-ECRP-032]; Ministerio de Economía y Competitividad (MINECO) [grant number EUI-2010-04,213]; and Czech Science Foundation [grant number P407/11/2009].Peer reviewe

Overcoming Ostrea edulis seed production limitations to meet ecosystem restoration demands in the UN decade on restoration

The European flat oyster, Ostrea edulis, is a habitat-forming bivalve which was historically widespread throughout Europe. Following its decline due to overfishing, pollution, sedimentation, invasive species, and disease, O. edulis and its beds are now listed as a threatened and/or declining species and habitat by OSPAR. Increasing recognition of the plight of the oyster, alongside rapidly developing restoration techniques and growing interest in marine restoration, has resulted in a recent and rapid growth in habitat restoration efforts. O. edulis seed supply is currently a major bottleneck in scaling up habitat restoration efforts in Europe. O. edulis has been cultured for centuries, however, research into its culture declined following the introduction of the Pacific oyster, Crassostrea gigas to Europe in the early 1970 s. Recent efforts to renew both hatchery and pond production of O. edulis seed for habitat restoration purposes are hampered by restoration project timelines and funding typically being short, or projects not planning appropriately for the timescales required for investment, research-and-development and delivery of oyster seed by commercial producers. Furthermore, funding for restoration is intermittent, making long-term commitments between producers and restoration practitioners difficult. Long-term, strategic investment in research and production are needed to overcome these bottlenecks and meet current ambitious restoration targets across Europe

Bone marrow transplantation generates T cell–dependent control of myeloma in mice

Transplantation with autologous hematopoietic progenitors remains an important consolidation treatment for patients with multiple myeloma (MM) and is thought to prolong the disease plateau phase by providing intensive cytoreduction. However, transplantation induces inflammation in the context of profound lymphodepletion that may cause hitherto unexpected immunological effects. We developed preclinical models of bone marrow transplantation (BMT) for MM using Vk*MYC myeloma-bearing recipient mice and donor mice that were myeloma naive or myeloma experienced to simulate autologous transplantation. Surprisingly, we demonstrated broad induction of T cell-dependent myeloma control, most efficiently from memory T cells within myeloma-experienced grafts, but also through priming of naive T cells after BMT. CD8+ T cells from mice with controlled myeloma had a distinct T cell receptor (TCR) repertoire and higher clonotype overlap relative to myeloma-free BMT recipients. Furthermore, T cell-dependent myeloma control could be adoptively transferred to secondary recipients and was myeloma cell clone specific. Interestingly, donor-derived IL-17A acted directly on myeloma cells expressing the IL-17 receptor to induce a transcriptional landscape that promoted tumor growth and immune escape. Conversely, donor IFN-γ secretion and signaling were critical to protective immunity and were profoundly augmented by CD137 agonists. These data provide new insights into the mechanisms of action of transplantation in myeloma and provide rational approaches to improving clinical outcomes

Time to Switch to Second-line Antiretroviral Therapy in Children With Human Immunodeficiency Virus in Europe and Thailand.

Background: Data on durability of first-line antiretroviral therapy (ART) in children with human immunodeficiency virus (HIV) are limited. We assessed time to switch to second-line therapy in 16 European countries and Thailand. Methods: Children aged <18 years initiating combination ART (≥2 nucleoside reverse transcriptase inhibitors [NRTIs] plus nonnucleoside reverse transcriptase inhibitor [NNRTI] or boosted protease inhibitor [PI]) were included. Switch to second-line was defined as (i) change across drug class (PI to NNRTI or vice versa) or within PI class plus change of ≥1 NRTI; (ii) change from single to dual PI; or (iii) addition of a new drug class. Cumulative incidence of switch was calculated with death and loss to follow-up as competing risks. Results: Of 3668 children included, median age at ART initiation was 6.1 (interquartile range (IQR), 1.7-10.5) years. Initial regimens were 32% PI based, 34% nevirapine (NVP) based, and 33% efavirenz based. Median duration of follow-up was 5.4 (IQR, 2.9-8.3) years. Cumulative incidence of switch at 5 years was 21% (95% confidence interval, 20%-23%), with significant regional variations. Median time to switch was 30 (IQR, 16-58) months; two-thirds of switches were related to treatment failure. In multivariable analysis, older age, severe immunosuppression and higher viral load (VL) at ART start, and NVP-based initial regimens were associated with increased risk of switch. Conclusions: One in 5 children switched to a second-line regimen by 5 years of ART, with two-thirds failure related. Advanced HIV, older age, and NVP-based regimens were associated with increased risk of switch

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Facilitating Innovation in Agricultural Biotechnology : An Examination of the Ag-West Biotech Model, 1989-2004

Innovation is more than just science. Innovation encompasses a diversity of disciplines, such as law (patents and freedom to operate), economics (spill-over benefits and returns to investment), political science (government policy and international trade barriers), and psychology (consumer responses). Clearly, the multiple disciplines that can -- and have -- investigated aspects of cycles of innovation or innovation systems indicate that the concept of innovation is extremely broad. This article examines Ag-West Biotech, a non-profit venture funded by the Saskatchewan government. Ag-West Biotech has delivered a wide range of services to the Saskatchewan biotechnology industry by acting as a mediator between business and government, as project facilitator and financier, and by offering visible leadership and direction for the biotechnology sector

Economic Implications of Low-level Presence in a Zero-Tolerance European Import Market : The Case of Canadian Triffid Flax

Triffid is the name given to a genetically modified (GM) variety of flaxseed that was developed in the late 1980s at the University of Saskatchewan's Crop Development Centre. The variety was designed to thrive in soil containing residues from sulfonylurea-type herbicides and offered greater weed control options to flax growers. In 1998, Triffid received Canadian and American feed and food regulatory approvals and entered a seed multiplication program. The following year, Europe threatened to stop importing Canadian flax should GM flax enter into commercial production. By April 2001, Triffid was deregistered and all remaining seed was supposedly destroyed. However, in late 2009, Triffid flax was unexpectedly detected in EU food products and in subsequent flax imports into Europe from Canada. In response to this, the EU immediately halted Canadian flax imports. This article documents Canadian costs of the Triffid flax issue as an example of low level presence (LLP) of an unapproved transformation event in a zero-tolerance European market. It explores/evaluates the impacts (economic and social costs) on the Canadian industry -- including the development of a stewardship program and testing protocols, the engagement and relationship strategies utilized in negotiations with the EU to resolve market access, and the overall industry response to the issue (from producers to exporters). The article presents survey responses from more than 270 Western Canadian flax farmers. This survey data provides new insights as to how farmers manage LLP on-farm. The production attributes that are examined range from field agronomics to ability to export. Specifically, it examines how farmers have dealt with flax, in terms of production and sale, since the Fall of 2009. Detailed analysis is provided for the following supply chain components: on-farm testing, carryover costs, and opportunity costs. Finally, the article provides some insights as to who farmers trust in terms of communicating information to them on how to best manage this situation

Cytokine-driven role of Srebps in killer cell metabolism

A new and unexpected role is identified for Srebps in controlling NK cell activity that is independent of their role in lipid biosynthesis

Exploring the Influence of International Agreements on the Development of Science-based Regulatory Systems in Developing Economies

This article examines three developing countries to identify capacities for innovative science policy: Brazil, South Africa and the Philippines. Using membership in regional trading agreements, we assess whether these three nations have aligned their science/innovation policy with the partners of their trading agreements. This assessment provides insights into the potential trade-offs that other developing nations will need to consider as they contemplate the adoption of genetically modified crops