Cultural aspects of primary healthcare in india: A case- based analysis

Delivering quality primary care to large populations is always challenging, and that is certainly the case in India. While the sheer magnitude of patients can create difficulties, not all challenges are about logistics. Sometimes patient health-seeking behaviour leads to delays in obtaining medical help for reasons that have more to do with culture, social practice and religious belief. When primary care is accessed via busy state-run outpatient departments there is often little time for the physician to investigate causes behind a patient's condition, and these factors can adversely affect patient outcomes. We consider the case of a woman with somatic symptoms seemingly triggered by psychological stresses associated with social norms and familial cultural expectations. These expectations conflict with her personal and professional aspirations, and although she eventually receives psychiatric help and her problems are addressed, initially, psycho-social factors underlying her condition posed a hurdle in terms of accessing appropriate medical care. While for many people culture, belief and social norms exert a stabilising, positive influence, in situations where someone's personal expectations differ significantly from accepted social norms, individual autonomy can be directly challenged, and in which case, something has to give. The result of such challenges can negatively impact on health and well-being, and for patients with immature defence mechanisms for dealing with inner conflict, such an experience can be damaging and ensuing somatic disturbances are often difficult to treat. Patients with culture-bound symptoms are not uncommon within primary care in India or in other Asian countries and communities. We argue that such cases need to be properly understood if satisfactory patient outcomes are to be achieved. While some causes are structural, having to do with how healthcare is accessed and delivered, others are about cultural values, social practices and beliefs. We note how some young adult women are adversely affected and discuss some of the ethical issues that arise

Every student counts: promoting numeracy and enhancing employability

This three-year project investigated factors that influence the development of undergraduates’ numeracy skills, with a view to identifying ways to improve them and thereby enhance student employability. Its aims and objectives were to ascertain: the generic numeracy skills in which employers expect their graduate recruits to be competent and the extent to which employers are using numeracy tests as part of graduate recruitment processes; the numeracy skills developed within a diversity of academic disciplines; the prevalence of factors that influence undergraduates’ development of their numeracy skills; how the development of numeracy skills might be better supported within undergraduate curricula; and the extra-curricular support necessary to enhance undergraduates’ numeracy skills

Evaluando el perfil de la ética, el derecho y el profesionalismo en la educación médica básica

AbstractSubstantial variation exists between schools and countries as regards the role of ethics, law and professionalism in medical curricula. Greater consistency of approach is needed between schools and countries to better safeguard standards of professional practice. From an international perspective these subjects are the focus of increasing attention as the nature of medical practice and regulation changes. This paper offers practical suggestions for raising the educational profile and integrating ethics, law and professionalism into medical curricula. Dealing with the subjects effectively during early medical training helps provide an appropriate grounding for future learning and practice

Proteolytic cleavage of pertussis toxin S1 subunit is not essential for its activity in mammalian cells

BACKGROUND: Pertussis toxin (PT) is an exotoxin virulence factor produced by Bordetella pertussis, the causative agent of whooping cough. PT consists of an active subunit (S1) that ADP-ribosylates the alpha subunit of several mammalian G proteins, and a B oligomer (S2–S5) that binds glycoconjugate receptors on cells. PT appears to enter cells by endocytosis, and retrograde transport through the Golgi apparatus may be important for its cytotoxicity. A previous study demonstrated that proteolytic processing of S1 occurs after PT enters mammalian cells. We sought to determine whether this proteolytic processing of S1 is necessary for PT cytotoxicity. RESULTS: Protease inhibitor studies suggested that S1 processing may involve a metalloprotease, and processing does not involve furin, a mammalian cell protease that cleaves several other bacterial toxins. However, inhibitor studies showed a general lack of correlation of S1 processing with PT cellular activity. A combination of replacement, insertion and deletion mutations in the C-terminal region of S1, as well as mass spectrometry data, suggested that the cleavage site is located around residue 203–204, but that cleavage is not strongly sequence-dependent. Processing of S1 was abolished by each of 3 overlapping 8 residue deletions just downstream of the putative cleavage site, but not by smaller deletions in the same region. Processing of the various mutant forms of PT did not correlate with cellular activity of the toxin, nor with the ability of the bacteria producing them to infect the mouse respiratory tract. In addition, S1 processing was not detected in transfected cells expressing S1, even though S1 was fully active in these cells. CONCLUSIONS: S1 processing is not essential for the cellular activity of PT. This distinguishes it from the processing of various other bacterial toxins, which has been shown to be important for their cytotoxicity. S1 processing may be mediated primarily by a metalloprotease, but the cleavage site on S1 is not sequence-dependent and processing appears to depend on the general topology of the protein in that region, indicating that multiple proteases may contribute to this cleavage

Response to The Department of the Prime Minister and Cabinet's discussion paper "Connecting with Confidence"

The ACS has prepared this response to the discussion paper to assist with the design of the cyber whitepaper expected in 2012. The ACS also welcomes the opportunity to promote discussion and support of our digital economy to position Australia for the future. Drawing from its membership of ICT professionals, and academics - particularly in areas of cyber resilience and security - the ACS established a Cyber Taskforce for this purpose. The ACS recommends: greater focus on education - noting that ICT education in primary and secondary schooling is essential - to developing ICT skills of the future and that school level educational activity forms the base on which appropriate tertiary level education programs can function for the education and training of ICT professionals; greater assistance to small and medium sized business as this is the engine room of the Australian economy; policy coordination on trusted identities; better coordination of cyber related education and research; providing consumers and businesses with resources directed to the everyday real-life challenges they face; global Internet governance changes designed to underpin and deliver trustworthy people, processes and systems including, where appropriate, a legislated mandatory baseline of trustworthiness attributes analogous to the non-excludable warranties implied in consumer contacts

Immunochip analysis identifies multiple susceptibility loci for systemic sclerosis

In this study, 1,833 systemic sclerosis (SSc) cases and 3,466 controls were genotyped with the Immunochip array. Classical alleles, amino acid residues, and SNPs across the human leukocyte antigen (HLA) region were imputed and tested. These analyses resulted in a model composed of six polymorphic amino acid positions and seven SNPs that explained the observed significant associations in the region. In addition, a replication step comprising 4,017 SSc cases and 5,935 controls was carried out for several selected non-HLA variants, reaching a total of 5,850 cases and 9,401 controls of European ancestry. Following this strategy, we identified and validated three SSc risk loci, including DNASE1L3 at 3p14, the SCHIP1-IL12A locus at 3q25, and ATG5 at 6q21, as well as a suggested association of the TREH-DDX6 locus at 11q23. The associations of several previously reported SSc risk loci were validated and further refined, and the observed peak of association in PXK was related to DNASE1L3. Our study has increased the number of known genetic associations with SSc, provided further insight into the pleiotropic effects of shared autoimmune risk factors, and highlighted the power of dense mapping for detecting previously overlooked susceptibility loci

A rare polymorphism in Toll Like Receptor 2 is associated with systemic sclerosis phenotype and increases production of inflammatory mediators

T.R. was sponsored by the Dutch association of Research (NWO). J.M. was sponsored by grants SAF2009-1110, cts-4977 T.R. and J.M. were sponsored by the Orphan Disease program grant from the European League Againts Rheumatism (EULAR)Peer Reviewe