Information Shared on YouTube by Individuals Affected by Long QT Syndrome: A Qualitative Study

Objectives: Little is known about the role of social media and YouTube, in people coping with serious medical diagnoses (Bane et al., 2005). Long QT Syndrome (LQTS) is an inherited cardiac condition affecting 1:2500 people that predisposes them to life threatening arrhythmias, and is often diagnosed in childhood. Few studies address the psychosocial impact of LQTS (Lane et al., 2009), though dietary, physical, and social restrictions are required (Chattha & Zelenietz, 2011), and lifelong medication and implantable devices may be needed. This study investigates what individuals share with others about LQTS via YouTube. Information may help professionals effectively use or moderate the effects of social media for patients, and identify areas for intervention for those with LQTS. Methods: Inclusion: YouTube videos from 2008 to 2013; individuals in videos have personal experience with LQTS. Exclusion: Videos without verbal or written narratives were excluded. Procedure: Of 1790 videos in a “long qt syndrome†YouTube search, 35 met inclusion criteria. Excluded videos were professionally filmed hospital testimonials, medical lectures, and videographies. LQTS patients in the included videos represent ages across the lifespan. Qualitative analysis was used to interpret the videos. Three coders used open and axial coding to determine key themes in data and achieve saturation. Grounded theory was used to explain results in a theoretical and evidence-based context. Results: Findings revealed individuals’ thoughts, feelings, and behaviors about biopsychosocial aspects of LQTS. Themes include experiences with initial diagnosis, survival stories, treatment, misdiagnoses, and mistreatment. Conclusions: YouTube offers cost-effective means to learn about patient populations’ psychological needs, experiences, and useful sources of information. Specific to LQTS, YouTube may provide an understanding of informal information communicated among patients and families that may impact questions asked of their physicians and psychosocial aspects of the condition

Translational control and the escape from translational arrest in stumpy form Trypanosoma brucei

The transmission of Trypanosoma brucei, the causative agent of human African trypanosomiasis, depends upon the development in the bloodstream of 'stumpy forms' from non-transmissible 'slender forms'. In stumpy forms many mRNAs are downregulated and translation is generally repressed. However, a small subset of genes escape this repression and are upregulated, presumably as an adaptation for transmission. To understand the basic of this, regulatory sequences within the 3'UTR of a major stumpy-enriched transcript (an ESAG9 gene) have been characterised. This identified a signal responsible for gene silencing in slender forms and gene activation when cells develop to stumpy forms. An investigation was made of upstream open reading frames (uORFs) as a mechanism for the control of stumpy form gene expression. No evidence was found of uORF control, but one gene investigated was found to produce two transcripts through trans-splicing at different sites. These transcripts, which were found to exhibit some differential abundance between life-cycle stages, would generate a long and short form (from an internal ATG) of the encoded protein. Both are predicted to contain a UBA/TS-N (ubiquitin associated) domain, however, the longer form of the protein is also predicted to contain a transmembrane helix and cleavable signal peptide, suggesting a different localisation. However, ectopic expression of either protein form with a Ty epitope tag resulted in the same protein localisation. Additionally, the transcripts of two translational protein homologues, TbeIF4E4 and TbeIF6, were identified as upregulated in stumpy forms. Radiolabelled-methionine experiments and polysome analysis showed that overexpression or RNAi-mediated ablation of TbeIF6 resulted in a decrease in protein synthesis and decrease in translation. Unlike its archaeal homologue, TbeIF6 protein was not induced by coldshock treatment. Finally, to identify which transcripts escape translational repression in stumpy forms an analysis was made of polysome-associated transcripts by RNA-sequencing. This identified potentially interesting genes for further investigation, and showed that many procyclic-enriched transcripts were also enriched in stumpy form polysomeassociated RNA, confirming these cells as preadapted for transmission. Together, this work has characterised a 3’UTR regulatory element in a stumpy-enriched transcript, examined alternative trans-splicing of another transcript, investigated two translational protein homologues and identified transcripts that escape translational repression in the transmissible life-cycle stage of T. brucei

Burden of SARS-CoV-2 infection in healthcare workers during second wave in England and impact of vaccines : prospective multicentre cohort study (SIREN) and mathematical model

Funding: The study is funded by the Department of Health and Social Care (DHSC) and UK Health Security Agency (UKHSA; formally Public Health England), with contributions from the governments of Northern Ireland, Scotland, and Wales. Funding was also provided by the National Institute for Health Research (NIHR) as an Urgent Public Health Priority Study and through the Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance (NIHR200915), a partnership between UKHSA and the University of Oxford.OBJECTIVE: To describe the incidence of, risk factors for, and impact of vaccines on primary SARS-CoV-2 infection during the second wave of the covid-19 pandemic in susceptible hospital healthcare workers in England. DESIGN: Multicentre prospective cohort study. SETTING: National Health Service secondary care health organisations (trusts) in England between 1 September 2020 and 30 April 2021. PARTICIPANTS: Clinical, support, and administrative staff enrolled in the SARS-CoV-2 Immunity and Reinfection Evaluation (SIREN) study with no evidence of previous infection. Vaccination status was obtained from national covid-19 vaccination registries and self-reported. MAIN OUTCOME MEASURE: SARS-CoV-2 infection confirmed by polymerase chain reaction. Mixed effects logistic regression was conducted to determine demographic and occupational risk factors for infection, and an individual based mathematical model was used to predict how large the burden could have been if vaccines had not been available from 8 December 2020 . RESULTS: During England's second wave, 12.9% (2353/18 284) of susceptible SIREN participants became infected with SARS-CoV-2. Infections peaked in late December 2020 and decreased from January 2021, concurrent with the cohort's rapid vaccination coverage and a national lockdown. In multivariable analysis, factors increasing the likelihood of infection in the second wave were being under 25 years old (20.3% (132/651); adjusted odds ratio 1.35, 95% confidence interval 1.07 to 1.69), living in a large household (15.8% (282/1781); 1.54, 1.23 to 1.94, for participants from households of five or more people), having frequent exposure to patients with covid-19 (19.2% (723/3762); 1.79, 1.56 to 2.06, for participants with exposure every shift), working in an emergency department or inpatient ward setting (20.8% (386/1855); 1.76, 1.45 to 2.14), and being a healthcare assistant (18.1% (267/1479); 1.43, 1.16 to 1.77). Time to first vaccination emerged as being strongly associated with infection (P<0.001), with each additional day multiplying a participant's adjusted odds ratio by 1.02. Mathematical model simulations indicated that an additional 9.9% of all patient facing hospital healthcare workers would have been infected were it not for the rapid vaccination coverage. CONCLUSIONS: The rapid covid-19 vaccine rollout from December 2020 averted infection in a large proportion of hospital healthcare workers in England: without vaccines, second wave infections could have been 69% higher. With booster vaccinations being needed for adequate protection from the omicron variant, and perhaps the need for further boosters for future variants, ensuring equitable delivery to healthcare workers is essential. The findings also highlight occupational risk factors that persisted in healthcare workers despite vaccine rollout; a greater understanding of the transmission dynamics responsible for these is needed to help to optimise the infection prevention and control policies that protect healthcare workers from infection and therefore to support staffing levels and maintain healthcare provision. TRIAL REGISTRATION: ISRCTN registry ISRCTN11041050.Publisher PDFPeer reviewe

Vocational education and training for African development: a literature review

© 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. The SDGs mark the clearest global acceptance yet that the previous approach to development was unsustainable. In VET, UNESCO has responded by developing a clear account of how a transformed VET must be part of a transformative approach to development. It argues that credible, comprehensive skills systems can be built that can support individuals, communities, and organisations to generate and maintain enhanced and just livelihood opportunities. However, the major current theoretical approaches to VET are not up to this challenge. In the context of Africa, we seek to address this problem through a presentation of literatures that contribute to the theorisation of this new vision. They agree that the world is not made up of atomised individuals guided by a “hidden hand”. Rather, reality is heavily structured within political economies that have emerged out of contestations and compromises in specific historical and geographical spaces. Thus, labour markets and education and training systems have arisen, characterised by inequalities and exclusions. These specific forms profoundly influence individuals’ and communities’ views about the value of different forms of learning and working. However, they do not fully define what individuals dream, think and do. Rather, a transformed and transformative VET for Africa is possible

Transitioning Vocational Education and Training in Africa

EPDF and EPUB available Open Access under CC-BY-NC-ND licence. This book takes an expansive view of vocational education and training. Drawing on case studies across rural and urban settings in Uganda and South Africa, the book offers a new way of seeing this through an exploration of the multiple ways in which people learn to have better livelihoods. Crucially, it explores learning that takes place informally online, within farmers’ groups and in public and private education institutions

Transitioning Vocational Education and Training in Africa

EPDF and EPUB available Open Access under CC-BY-NC-ND licence. This book takes an expansive view of vocational education and training. Drawing on case studies across rural and urban settings in Uganda and South Africa, the book offers a new way of seeing this through an exploration of the multiple ways in which people learn to have better livelihoods. Crucially, it explores learning that takes place informally online, within farmers’ groups and in public and private education institutions

Efficacy of trabectedin in metastatic solitary fibrous tumor

Solitary fibrous tumor is a rare tumor type and has an unpredictable course. Local recurrence rate varies between 9 and 19%, and rate of metastatic involvement between 0 and 36 %. It is characterized by a typical architecture and immuno-histochemistry tests. The most important prognostic factor is the complete resection of primary tumor. Treatment of recurrences is not clearly established. If a solitary fibrous tumor is too advanced to allow surgical resection, radiotherapy and chemotherapy may be used. The most often used drugs are doxorubicine and\or ifosfamide. We report the case of man with metastatic solitary fibrous tumor treated with trabectedin, administered at a dose of 1.5 mg/m² every 3 weeks. After 3 cycles, metastases had significantly decreased. Recurrence of the disease was demonstrated 8 months after the start of trabectedin. This case shows that trabectedin is a possible treatment option

A phase II evaluation of brivanib in the treatment of persistent or recurrent carcinoma of the cervix: An NRG Oncology/Gynecologic Oncology Group study

BackgroundBrivanib is an oral, tyrosine kinase inhibitor against vascular endothelial growth factor (VEGF) and fibroblast growth factor receptor (FGFR). We studied its efficacy and tolerability in persistent or recurrent cervical cancer patients.MethodsEligible patients had at least one prior cytotoxic regimen for recurrence and with measurable disease. Brivanib 800mg was administered orally every day (1cycle=28days) until disease progression or prohibitive toxicity. Primary endpoints were progression-free survival (PFS) &gt;6months and objective tumor response.ResultsOf 28 eligible and evaluable women enrolled, 11 (39%) had primary surgery and 25 (89%) had prior radiation. Eighteen (64%) received one prior cytotoxic treatment and 10 (36%) had 2 prior regimens. Twelve (43%) had &gt;2cycles of brivanib with 4 (14%) receiving &gt;10cycles (range: 1-20). Seven (25%) patients had PFS &gt;6months (90% CI: 7.3%-33.9%). Two (7%) (90% CI: 1.3%-20.8%) patients had partial tumor response with duration of 8 and 22months and 12 (43%) had stable disease. The median PFS was 3.2months (90% CI: 2.1-4.4). The median overall survival was 7.9months (90% CI: 6.1-11.7). More common grade 3 adverse events were hypertension, anemia, hyponatremia, hyperglycemia, elevated liver enzymes, nausea, headache, and colon hemorrhage. Grade 4 adverse events included sepsis and hypertension.ConclusionsBased on early results of this phase II trial, brivanib was well tolerated and demonstrated sufficient activity after first stage but trial was stopped due to lack of drug availability

Transitioning Vocational Education and Training in Africa: A Social Skills Ecosystem Perspective

The transition to more just and sustainable development requires radical change across a wide range of areas and particularly within the nexus between learning and work. This book takes an expansive view of vocational education and training that goes beyond the narrow focus of much of the current literature and policy debate. Drawing on case studies across rural and urban settings in Uganda and South Africa, the book offers a new way of seeing this issue through an exploration of the multiple ways in which people learn to have better livelihoods. Crucially, it explores learning that takes place informally online, within farmers’ groups, and in public and private educational institutions. Offering new insights and ways of thinking about this field, the book draws out clear implications for theory, policy and practice in Africa and beyond