Naresuan University Journal
Not a member yet
39887 research outputs found
Sort by
Resource allocation priorities in social care for adults with a learning disability: an analysis and comparison of different stakeholder perspectives
No full textPurpose – How resources for social care are allocated to individual service users has long been a concern. There are debates regarding the priority given to certain needs in Resource Allocation Systems (RASs). The purpose of this paper is to compare the views of adults with a learning disability and Directors of Adult Social Care regarding their priorities for resource allocation with priorities arising from observed resource allocation decisions. Design/methodology/approach – In a consultation workshop, 12 adults with learning disabilities were asked to rank the perceived importance of eight needs-related outcomes. Directors of Adult Social Care completed an online questionnaire concerning the distribution of resources across the same eight outcomes. Actual resource allocation data from 11 local authorities were also modelled against these outcomes. A variable importance metric (the percentage contribution of each outcome to predicting costs) was used to rank the importance of these outcomes in terms of determining actual resource allocation. Findings from these data collections were compared. Findings – There were discrepancies between the views of adults with a learning disability, the perspectives of Directors and actual resource allocation data. Whereas adults with a learning disability perceived psychological well-being as most important, Directors and actual resource allocation data stressed the importance of activities of daily living and carer burden. Originality/value – This analysis will prove useful in understanding the concerns of adults with a learning disability and whether these are adequately addressed by current RASs
A comparative policy analysis of healthcare PPPs: examining evidence from two Spanish regions from an international perspective
No full textAs demand for public healthcare grows and government budgets are squeezed, many countries find policies involving private sector delivery of clinical services increasingly attractive. This article takes a critical analysis approach to examine the organisational and financial arrangements of healthcare PPPs from two regions in Spain. The comparative policy analysis shows that competent learning from cross-national experience is complex because in practice it is difficult to identify specific institutional factors, evaluate operational costs, and determine whether risks have transferred. Care is needed to avoid unwarranted inferences that this policy will deliver the claimed benefits of lower costs whilst maintaining sustainable quality
Mitochondrial biogenesis is required for the anchorage-independent survival and propagation of stem-like cancer cells.
No full textHere, we show that new mitochondrial biogenesis is required for the anchorage independent survival and propagation of cancer stem-like cells (CSCs). More specifically, we used the drug XCT790 as an investigational tool, as it functions as a specific inhibitor of the ERRα-PGC1 signaling pathway, which governs mitochondrial biogenesis. Interestingly, our results directly demonstrate that XCT790 efficiently blocks both the survival and propagation of tumor initiating stem-like cells (TICs), using the MCF7 cell line as a model system. Mechanistically, we show that XCT790 suppresses the activity of several independent signaling pathways that are normally required for the survival of CSCs, such as Sonic hedgehog, TGFβ-SMAD, STAT3, and Wnt signaling. We also show that XCT790 markedly reduces oxidative mitochondrial metabolism (OXPHOS) and that XCT790-mediated inhibition of CSC propagation can be prevented or reversed by Acetyl-L-Carnitine (ALCAR), a mitochondrial fuel. Consistent with our findings, over-expression of ERRα significantly enhances the efficiency of mammosphere formation, which can be blocked by treatment with mitochondrial inhibitors. Similarly, mammosphere formation augmented by FOXM1, a downstream target of Wnt/β-catenin signaling, can also be blocked by treatment with three different classes of mitochondrial inhibitors (XCT790, oligomycin A, or doxycycline). In this context, our unbiased proteomics analysis reveals that FOXM1 drives the expression of >90 protein targets associated with mitochondrial biogenesis, glycolysis, the EMT and protein synthesis in MCF7 cells, processes which are characteristic of an anabolic CSC phenotype. Finally, doxycycline is an FDA-approved antibiotic, which is very well-tolerated in patients. As such, doxycycline could be re-purposed clinically as a 'safe' mitochondrial inhibitor, to target FOXM1 and mitochondrial biogenesis in CSCs, to prevent tumor recurrence and distant metastasis, thereby avoiding patient relapse
Equivalence closure in the two-variable guarded fragment
No full textWe consider the satisfiability and finite satisfiability problems for the extension of the two-variable guarded fragment in which an equivalence closure operator can be applied to two distinguished binary predicates. We show that the satisfiability and finite satisfiability problems for this logic are 2-ExpTime-complete. This contrasts with an earlier result that the corresponding problems for the full two-variable logic with equivalence closures of two binary predicates are 2-NExpTime-complete
Nano-curcumin prepared via supercritical: Improved anti-bacterial, anti-oxidant and anti-cancer efficacy
No full textCopper(II)-mediated self-assembly of hairpin peptides and templated synthesis of CuS nanowires
No full textAppendiceal Goblet Cell Carcinoids: Management Considerations from a Reference Peritoneal Tumour Service Centre and ENETS Centre of Excellence
No full textBACKGROUND: Appendix goblet cell carcinoids (GCCs) are known to share histological features of adenocarcinoma and neuroendocrine tumours. Due to their low incidence, quality evidence is lacking for management of these patients. METHODS: We performed a single-centre retrospective study of patients with confirmed diagnosis of appendiceal GCC (1996-2014). Patients were divided into curative intent (CI) and palliative intent (PI) cohorts. Our primary end-point was overall survival (OS). RESULTS: Seventy-four patients were eligible; 76% were treated with CI (surgery only (36%), Cytoreductive Surgery (CRS) and Hyperthermic Intra-peritoneal Chemotherapy (HIPEC) (36%), adjuvant chemotherapy (20%) and combination of CRS and HIPEC followed by adjuvant chemotherapy (9%)); 23% had advanced stage-disease amenable to palliative treatment (chemotherapy or supportive care) only. Completion right hemicolectomy, performed in 64% of the CI cohort, did not impact on relapse rate or disease-free survival. FOLFOX chemotherapy was used in both adjuvant and palliative settings; safety was as expected and we observed a high rate (60%) of disease control in the palliative cohort. The estimated median OS (all patients), disease-free (CI patients) and progression-free survivals (PI patients) were 52.1 (95% CI 29.4-90.3), 75.9 (26.6-not reached) and 5.3 (0.6-5.7) months, respectively. Age and stage were independent factors associated with OS in the multivariable analysis. Tang classification showed a trend for impact on OS. No benefit from specific adjuvant approach was identified; however selection bias for treatment approach was observed. CONCLUSION: Prospective trials are needed to define optimal approaches in GCC. All GCC patients should be managed by specialized centres due to their esoteric behaviour; we provide management considerations based on our experience and conclusions
Pathways through the Landscape in a Changing Climate: The Role of Landscape Structure in Facilitating Species Range Expansion through an Urbanised Region
No full textUnder climate change many species may need to shift polewards to track suitable bioclimatic conditions. This movement is likely to be impeded by intensively modified landscapes, but little is known in practice about how species undergo range expansion in these conditions. Using biological record data, this paper explores the occurrence of five butterfly species undertaking range expansion in the UK through an urbanised landscape to better understand the ‘pathways’ or landscape features used to expand their distributions. The findings demonstrate that the two most adaptable species were able to navigate well through the urban matrix. Significantly, the remaining three species used more rural pathways, with two using stepping stones of habitat patches and landscape corridors and the final, most specialised species using near-connected chains of woodland habitat. These findings emphasise the importance of retaining corridors of open land around hostile matrices and in this instance, a planning designation ‘Green Belt’ proved to be particularly effective in providing broad pathways of open land for range expansion through a heavily urbanised landscape
