Karo Kari : the murder of honour in Sindh Pakistan : an ethnographic study

This paper aims to discuss the wider context, in which honour murders occur, the social structures which contribute to the occurrence and perpetuation of the practice of honour murders. An ethnographic fieldwork was conducted in Jacobabad Sindh, Pakistan. The study found that honour murders were not solely driven by customs and traditions, but also by a feudal culture, male-dominated social structures, the complicit role of state institutions and law enforcement agencies and a web of vested interests. Therefore, honour murders may be prevented by reducing the influence and interference of feudal lords on state institutions, in particular law enforcement agencies, and by promoting education that challenges a patriarchal and feudal mind-set in the community

The impact of COVID-19 on work, training and well-being experiences of nursing associates in England: A cross-sectional survey

Aim To explore how the COVID-19 pandemic affected nursing associate work, training and well-being experiences. Design Cross-sectional survey. Methods A survey of trainee and newly qualified nursing associates was completed in July 2020. Closed responses were analysed using descriptive statistics with inferential comparisons made between community and secondary care settings. Open questions were analysed thematically. Results Sixty-four participants responded. Over half (53.2%) experienced an increased workload with 24.2% reporting extensions in their role. One third (32.3%) were redeployed, and a quarter (24.2%) did not feel safety concerns were adequately addressed when raised. Those working in the community reported significantly more concerns about staffing (p = .03), working overtime (p = .03), missed care (p = .02) and safety (p = .04). Despite this, many (75.8%) participants felt able to provide the same standards of care. Several spoke about enhanced teamwork, and the majority (96.8%) were not looking to leave their post

Monitoring and evaluation of irrigation and drainage facilities for pilot distributaries in Sindh Province, Pakistan. Volume 2 - Bareji Distributary, Mirpurkhas District. Interim report

Irrigation management / Monitoring / Evaluation / Irrigation canals / Distributary canals / Drainage / Maintenance / Land use / Irrigation practices / Basin irrigation / Furrow irrigation / Water distribution / Equity / Flow discharge / Watercourses / Water table / Groundwater / Water quality / Pakistan / Sindh Province / Mirpurkhas District / Bareji Distributary

KARO KARI-THE MURDER OF HONOUR IN SINDH PAKISTAN: AN ETHNOGRAPHIC STUDY

ABSTRAC

Strategic Research Alliance Final Report : Review of Continuing Professional Development in Nursing

Continuing Professional Development (CPD) is important in generating and sustaining capability and in ensuring high quality, person-centred, safe and effective nursing care. In the UK, changes to models of funding for nursing CPD have raised concerns about the opportunities available for nurses to meet the requirements for revalidation of registration, their ability to provide adequate supervision of future students in relation to the new NMC standards of proficiency, and the potential impact of reductions in CPD access to nursing recruitment and retention. Contemporary evidence suggests that it is not only the opportunity to access CPD that is important to the provision of quality care, but also the ability to transform knowledge and skills learnt into practice within diverse practice settings. The purpose of CPD therefore is not only transformation of an individual’s practice but also transformation of workplace culture and context. For the purpose of this report, we follow Manley and Jackson (2020) in suggesting that transformation “implies radical ways of doing things to reflect the values aspired to; it is not about quick wins or key performance indicators.” There is then a need to understand the evidence about what factors maximise CPD impact at the individual, team, organisational and system level. Following initial scoping work, the Strategic Research Alliance (SRA) working group, in consultation with Professor Kim Manley and Carolyn Jackson, agreed to complete a rapid review to consider this evidence focusing on the specific question: "What are the factors that enable or optimise CPD impact for learning, development and improvement in the workplace at the individual, team, organisation and system level?

Malignant inflammation in cutaneous T-cell lymphoma: a hostile takeover

Cutaneous T-cell lymphomas (CTCL) are characterized by the presence of chronically inflamed skin lesions containing malignant T cells. Early disease presents as limited skin patches or plaques and exhibits an indolent behavior. For many patients, the disease never progresses beyond this stage, but in approximately one third of patients, the disease becomes progressive, and the skin lesions start to expand and evolve. Eventually, overt tumors develop and the malignant T cells may disseminate to the blood, lymph nodes, bone marrow, and visceral organs, often with a fatal outcome. The transition from early indolent to progressive and advanced disease is accompanied by a significant shift in the nature of the tumor-associated inflammation. This shift does not appear to be an epiphenomenon but rather a critical step in disease progression. Emerging evidence supports that the malignant T cells take control of the inflammatory environment, suppressing cellular immunity and anti-tumor responses while promoting a chronic inflammatory milieu that fuels their own expansion. Here, we review the inflammatory changes associated with disease progression in CTCL and point to their wider relevance in other cancer contexts. We further define the term "malignant inflammation" as a pro-tumorigenic inflammatory environment orchestrated by the tumor cells and discuss some of the mechanisms driving the development of malignant inflammation in CTCL

T-regulatory cell modulation: the future of cancer immunotherapy?

T-regulatory cells suppress anti-tumour immunity in cancer patients and in murine tumour models. Furthermore, their activity is likely to have an effect on the effectiveness of immunotherapeutic treatments for cancer. Here we describe the current status of developing clinical strategies for modulating Treg activity in cancer patients

Staphylococcal enterotoxin A (SEA) stimulates STAT3 activation and IL-17 expression in cutaneous T-cell lymphoma

Cutaneous T-cell lymphoma (CTCL) is characterized by proliferation of malignant T cells in a chronic inflammatory environment. With disease progression, bacteria colonize the compromised skin barrier and half of CTCL patients die of infection rather than from direct organ involvement by the malignancy. Clinical data indicate that bacteria play a direct role in disease progression, but little is known about the mechanisms involved. Here, we demonstrate that bacterial isolates containing staphylococcal enterotoxin A (SEA) from the affected skin of CTCL patients, as well as recombinant SEA, stimulate activation of signal transducer and activator of transcription 3 (STAT3) and upregulation of interleukin (IL)-17 in immortalized and primary patient-derived malignant and nonmalignant T cells. Importantly, SEA induces STAT3 activation and IL-17 expression in malignant T cells when cocultured with nonmalignant T cells, indicating an indirect mode of action. In accordance, malignant T cells expressing an SEA-nonresponsive T-cell receptor variable region β chain are nonresponsive to SEA in monoculture but display strong STAT3 activation and IL-17 expression in cocultures with SEA-responsive nonmalignant T cells. The response is induced via IL-2 receptor common γ chain cytokines and a Janus kinase 3 (JAK3)-dependent pathway in malignant T cells, and blocked by tofacitinib, a clinical-grade JAK3 inhibitor. In conclusion, we demonstrate that SEA induces cell cross talk-dependent activation of STAT3 and expression of IL-17 in malignant T cells, suggesting a mechanism whereby SEA-producing bacteria promote activation of an established oncogenic pathway previously implicated in carcinogenesis

Clinical and laboratory experience of vorinostat (suberoylanilide hydroxamic acid) in the treatment of cutaneous T-cell lymphoma

The most common cutaneous T-cell lymphomas (CTCLs) – mycosis fungoides (MF) and Sézary Syndrome – are characterised by the presence of clonally expanded, skin-homing helper-memory T cells exhibiting abnormal apoptotic control mechanisms. Epigenetic modulation of genes that induce apoptosis and differentiation of malignant T cells may therefore represent an attractive new strategy for targeted therapy for T-cell lymphomas. In vitro studies show that vorinostat (suberoylanilide hydroxamic acid or SAHA), an oral inhibitor of class I and II histone deacetylases, induces selective apoptosis of malignant CTCL cell lines and peripheral blood lymphocytes from CTCL patients at clinically achievable doses. In a Phase IIa clinical trial, vorinostat therapy achieved a meaningful partial response (>50% reduction in disease burden) in eight out of 33 (24%) patients with heavily pretreated, advanced refractory CTCL. The most common major toxicities of oral vorinostat therapy were fatigue and gastrointestinal symptoms (diarrhoea, altered taste, nausea, and dehydration from not eating). Thrombocytopenia was dose limiting in patients receiving oral vorinostat at the higher dose induction levels of 300 mg twice daily for 14 days. These studies suggest that vorinostat represents a promising new agent in the treatment of CTCL patients. Additional studies are underway to define the exact mechanism (s) of by which vorinostat induces selective apoptosis in CTCL cells and to further evaluate the antitumour efficacy of vorinostat in a Phase IIb study in CTCL patients