Violence in health care: institutional strategies to cope with the phenomenon

Violence permeates every aspect of society, including the health care organization. Appropriate health care organizational response to the phenomenon of violence requires recognition that the emergence of violence is associated with patient, staff, situational, and environmental variables, and it is predictable in most instances. Effective management of violent patients requires comprehensive organizational policies, procedures, and protocols, combined with periodic staff training and retraining. Health care organizations and their personnel need to be knowledgeable about pre-assaultive clinical symptomatology, modification of staff behaviors and environmental factors with the goal of reducing the potential for violence, therapeutic interventions during both pre-assaultive and violent phases of patient behavior, and quality assurance and risk management issues implicit in managing violent patients.     

MIR29B regulates expression of MLLT11 (AF1Q), an MLL fusion partner, and low MIR29B expression associates with adverse cytogenetics and poor overall survival in AML

MLLT11, an MLL fusion partner, is a poor prognostic biomarker for paediatric acute myeloid leukaemia (AML), adult normal cytogenetics AML, and adult myelodysplastic syndrome. MLLT11 is highly regulated during haematopoietic progenitor differentiation and development but its regulatory mechanisms have not been defined. In this study, we demonstrate by transfection experiments that MIR29B directly regulates MLLT11 expression in vitro. MIR29B expression level was also inversely related to MLLT11 expression in a cohort of 56 AML patients (P<0·05). AML patients with low MIR29B/elevated MLLT11 expression had poor overall survival (P=0·038). Therefore, MIR29B may be a potential prognostic biomarker for AML patients.