Healthcare workers' attitudes to working during pandemic influenza: a qualitative study

Background  

Healthcare workers (HCWs) will play a key role in any response to pandemic influenza, and the UK healthcare system's ability to cope during an influenza pandemic will depend, to a large extent, on the number of HCWs who are able and willing to work through the crisis. UK emergency planning will be improved if planners have a better understanding of the reasons UK HCWs may have for their absenteeism, and what might motivate them to work during an influenza pandemic.     

School Injury Among Ottawa-Area Children: A Population-Based Study

BACKGROUND:  Injuries are the leading cause of death among Canadian children and are responsible for a substantial proportion of hospitalizations and emergency department visits. This investigation sought to identify the factors associated with the likelihood of sustaining an injury at school among Ottawa-area children.
METHODS:  Children presenting to Ottawa-area hospitals and urgent care clinics from January to December 2002 (n = 24,074) were included for analysis. The frequency of school injuries by sex, age group, type of injury, and hospitalization was analyzed. Multivariate logistic regression was used to assess the factors associated with sustaining an injury at school. The school activities most associated with injury and the most frequent types of school injuries were assessed.
RESULTS:  A total of 4287 Ottawa-area children were injured at school in 2002, representing 18% of all injuries. Children aged 5-9 years and 10-14 years were more likely to have school injuries than older children (aged 15-19 years) (OR = 3.07, 95% CI = 2.77-3.40 and OR = 3.10, 95% CI = 2.83-3.37, respectively). The most frequently encountered school injuries were fractures (n = 1132) and musculoskeletal injury (n = 907). The most frequent mechanisms of school injuries were "playing" (n = 1004) and "informal sports" (n = 1503).
CONCLUSIONS:  Many children get hurt at school, particularly during informal recreation activities. Environmental modification and increased supervision are strategies that may reduce school injuries.     

Substance abuse, treatment needs and access among female sex workers and non-sex workers in Pretoria, South Africa

Background  

This study examined cross-sectional data collected from substance-using female sex workers (FSW) and non-sex workers (non-SW) in Pretoria, South Africa, who entered a randomized controlled trial.     

Combined treatment with Denbinobin and Fas ligand has a synergistic cytotoxic effect in human pancreatic adenocarcinoma BxPC-3 cells

Background and purpose:

Human pancreatic carcinoma is a highly malignant cancer. Previous studies have shown that the decoy receptor 3 (DcR3) for Fas ligand (FasL) plays significant roles in tumour progression and immune suppression. In the present study, we evaluated the anti-cancer activity of a natural compound, denbinobin (5-hydroxy-3,7-dimethoxy-1,4-phenanthraquinone), through decreasing DcR3 levels in human pancreatic adenocarcinoma cell lines.

Experimental approach:

We used immunoprecipitation and ELISA assays to examine DcR3 levels, and used FACS to determine the percentage of cells with a sub-G1 DNA content.

Key results:

AsPC-1 and BxPC-3 human pancreatic cancer cells express high levels of DcR3. Denbinobin concentration-dependently decreased DcR3 levels in BxPC-3 cells. MTT and flow cytometry assays indicated that BxPC-3 was FasL-resistant because high concentrations (100 ng·mL⁻¹) of soluble FasL did not inhibit cell growth. However, combinations of denbinobin (3 µmol·L⁻¹) with lower concentrations of soluble FasL (10, 30 and 50 ng·mL⁻¹) or membrane-bound FasL, were synergistic on cell growth inhibition and apoptosis. Exogenous excess DcR3 reversed this synergistic effect. We observed no significant increase in the levels of surface Fas, cleaved forms of caspase-8, -3, -9, Bax, Bid, Bcl-xL, cytochrome c or mitochondrial membrane potentials following denbinobin treatment. However, denbinobin treatment increased the levels of apoptosis-inducing factor.

Conclusions and implications:

Denbinobin and FasL trigger a synergistic cytotoxic effect in human pancreatic adenocarcinoma cells. Denbinobin mediated a decrease in levels of DcR3, which played a major role in this synergistic effect, and also increased caspase-independent apoptosis, via apoptosis-inducing factor.     

"You're too young for this": adolescent and young adults' perspectives on cancer survivorship

Adolescent and young adult cancer survivors face unique challenges not systematically addressed by cancer clinicians. Four focus groups and two individual interviews were conducted with 19 survivors to profile experiences and identify key concerns for future interventions. The resultant themes reflect cancer care continuum challenges (such as delays in diagnosis, problems with adherence), psychosocial concerns (such as infertility and reproductive concerns, changing social relationships, financial burden), and the paradox of being diagnosed with cancer as a young adult. Future intervention development for adolescent and young adult survivors should involve patient voices at each stage of the research process.     

Evolution of transcatheter closure of perimembranous ventricular septal defects in a single centre

Objectives : To describe the evolution of transcatheter closure of perimembranous ventricular septal defects (PMVSD) using either the Amplatzer membranous or muscular occluders in a single centre. Methods : Retrospective analysis of all patients referred for transcatheter PMVSD closure from December 2003 to December 2007. All patients met unit criteria for surgical closure. Results : There were 27 procedures on 25 patients (11 male) with a preprocedure diagnosis of a PMVSD. Median age was 9.6 years (1.8–32.8). Median weight was 28 kg (10.2–86). Defect size on TOE ranged from 5 to 12 mm. Median Qp:Qs was 1.6:1. A muscular occluder was used in six patients. Median procedure time was 93.5 min (51–214). Implantation was ultimately successful in 23 patients (92%). Acute aortic incompetence resulting in occluder removal occurred in two cases, one requiring surgical removal. Another patient had an aborted attempt but had subsequent successful closure in another unit. Median follow‐up is 19.5 months (1–42). Five patients (22%) have trivial/mild residual leak across the occluder at their latest assessment, the majority of which had an aneurysmal perimembranous septum (n = 4). Two patients (8%) developed new trivial to mild aortic incompetence. To date, none of the patients in our group have developed complete heart block. Conclusions : Transcatheter closure of PMVSD is evolving and should be considered an acceptable alternative to surgery in selected subgroups. Avoidance of oversized occluders and use of muscular occluders in those with aneurysmal defects may help to avoid heart block and aortic regurgitation. Muscular occluders may however interfere with tricuspid valve function. © 2009 Wiley‐Liss, Inc.