RNA-sequencing highlights differential regulated pathways involved in cell cycle and inflammation in orbitofacial neurofibromas

Although most commonly benign, neurofibromas (NFs) can have devastating functional and cosmetic effects in addition to the possibility of malignant transformation. Orbitofacial NFs, in particular, may cause progressive, disfiguring tumors of the lid, brow, temple, face, and orbit, and clinical evidence suggests that they may have increased local aggressiveness compared to NFs developing at other sites. The purpose of this study was to identify biological differences between orbitofacial NFs and those occurring at other anatomic sites. We performed RNA-sequencing in orbitofacial (n = 10) and non-orbitofacial (n = 9) NFs. Differential gene expression analysis demonstrated that a variety of gene sets including genes involved in cell proliferation, interferon, and immune-related pathways were enriched in orbitofacial NF. Comparisons with publicly available databases of various Schwann cell tumors and malignant peripheral nerve sheath tumor (MPNST) revealed a significant overlap of differentially expressed genes between orbitofacial versus non-orbitofacial NF and plexiform NF versus MPNST. In summary, we identified gene expression differences between orbitofacial NF and NFs occurring at other locations. Further investigation may be warranted, given that orbitofacial NF are notoriously difficult to treat and associated with disproportionate morbidity.     

Evaluation of Safety Management and Leadership Training Using Mobile Technologies among Logging Supervisors

ABSTRACT

Background: Logging is recognized as one of the most dangerous industries in the United States (US), ranking among those with the highest occupational injury and fatality rates. Although logging operations in the Southeastern US have lower rates of injuries and fatalities compared to other regions of the US, due in part to the use of large machinery to fell timber as opposed to chainsaw felling, safety hazards continue to persist. The hazards present in the logging cut sites in which loggers operate may result in worker injury, illness, or fatality. Our objective was to develop, deliver, and evaluate a safety management and leadership training among logging contractors and supervisors using mobile tablets as a personal learning environment.

Methods: A safety leadership and management training vignette was developed based on previously collected focus group needs assessment data. A non-random sample of 31 male logging supervisors received the safety leadership and management training on a mobile tablet. Kirkpatrick Levels 1, 2, and 3 training effectiveness evaluations were performed.

Results: A statistically significant large effect size suggests safety knowledge was gained among training participants when comparing post-test scores to pre-test scores (Level-2). Participants rated their training experience favorably (Level-1), and applied knowledge gained from the training throughout their weekly work activities three months after training (Level-3).

Conclusion: Our findings suggest the utilization of mobile learning techniques can be an effective means to deliver safety management and leadership training content to logging contractors and supervisors. Future trainings should be linguistically and literacy-level appropriate, as well as comprehensive in nature, including meaningful and relevant content. Our observations support the use of mobile devices as just one component of a more comprehensive health and safety management program for workers in the logging industry.     

The Effect of Patient Education on Chinese Adolescent and Parental Beliefs About Counselors’ Breaches of Confidentiality

The Journal of Behavioral Health Services & Research - The primary aim of the present study is to explore whether brief education can change Chinese adolescents’ and parents’...     

Disparities in Tdap Vaccination and Vaccine Information Needs Among Pregnant Women in the United States

Maternal and Child Health Journal - Objectives The Advisory Committee on Immunization Practices (ACIP) and the American College of Obstetricians and Gynecologists (ACOG) recommend that pregnant...     

Comparing costs of a senior wellness care redesign in group and independent physician practices of an accountable care organization

Primary care redesign for older adult patients is currently ongoing in countries with aging populations. One of the main challenges of this type of transformations is how to estimate implementation costs in different types of health care delivery organizations. This study compares start‐up and incremental expenses of implementing a primary care redesign across 2 organization types: integrated group (n = 31) practices and independent practice association (IPA) sites (n = 213). Administrators involved with implementing the redesign completed a cost capture template to quantifying expenses. The potential impact of measurement error, recollection bias, and implementation models across sites and geographic regions was examined in sensitivity analyses. Marginal start‐up and incremental expenses were higher for Group sites ($122‐$328) compared to IPA sites ($31‐$227). Group and IPA sites, however, implemented the redesign with different intensities. According to our analyses, if IPA sites implemented the redesign with the same intensity as Group sites, marginal costs would have been $5 to $13 higher for IPA sites than for Group sites. This study shows how a flexible approach to estimate the cost of a wellness care redesign is needed when the intensity of the transformation differs across 2 different types of health care organizations.