11237 research outputs found
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Understanding professional curiosity in everyday child safeguarding practice through the lens of narrative inquiry
No full textThe phrase professional curiosity stems from child safeguarding practice reviews as a recurring omission of safeguarding practice. This study examines what local authority workers define professional curiosity to be and what enables or restricts them in being curious about the lived experiences of the child. Understanding how to improve this area of practice protects children, keeping them safe from harm.Using a narrative inquiry approach, a purposive sample of thirteen participants were engaged in an online conversation through semi-structured interview. NVivo was used to thematically analyse their narratives to ascertain what professional curiosity in everyday practice looked like and what were the facilitators and barriers to being curious about the child. Labov’s (1972) structural analysis of selected stories provided deeper insight and evaluation as to why practitioners chose to be curious.Work skills, experiences and attitudes were the three domains which reflected what professional curiosity meant to practitioners, providing an understanding of the phrase for future policies, practice and learning. The four domains of service users, safeguarding practice, professional development and service factors were the enablers and barriers to being curious. Vignettes illustrating the enablers of curiosity serve as evidence of good safeguarding practice.From a constructivist point of view the key process that emerged behind a practitioner’s curiosity stemmed from positioning theory. How practitioners positioned themselves in response to their conversations with children and parents influenced whether or not they were able to be curious about the child. A service user’s risk factors also impacted upon a professional’s curiosity. Those factors that were constructed as something that could be worked with positioned professionals as wanting to work with the child to find out more about them. This knowledge supports practitioners to consciously consider their own positionalities when interacting with families for being curious to protect the child.</p
CRISPR screens in 3D tumourspheres identified miR-4787-3p as a transcriptional start site miRNA essential for breast tumour-initiating cell growth
No full textOur study employs pooled CRISPR screens, integrating 2D and 3D culture models, to identify miRNAs critical in Breast Cancer (BC) tumoursphere formation. These screens combine with RNA-seq experiments allowing identification of miRNA signatures and targets essential for tumoursphere growth. miR-4787-3p exhibits significant up-regulation in BC, particularly in basal-like BCs, suggesting its association with aggressive disease. Surprisingly, despite its location within the 5’UTR of a protein coding gene, which defines DROSHA-independent transcription start site (TSS)-miRNAs, we find it dependant on both DROSHA and DICER1 for maturation. Inhibition of miR-4787-3p hinders tumoursphere formation, highlighting its potential as a therapeutic target in BC. Our study proposes elevated miR-4787-3p expression as a potential prognostic biomarker for adverse outcomes in BC. We find that protein-coding genes positively selected in the CRISPR screens are enriched of miR-4787-3p targets. Of these targets, we select ARHGAP17, FOXO3A, and PDCD4 as known tumour suppressors in cancer and experimentally validate the interaction of miR-4787-3p with their 3’UTRs. Our work illuminates the molecular mechanisms underpinning miR-4787-3p’s oncogenic role in BC. These findings advocate for clinical investigations targeting miR-4787-3p and underscore its prognostic significance, offering promising avenues for tailored therapeutic interventions and prognostic assessments in BC.</p
Fractional flow reserve and instantaneous wave-free ratio as predictors of the placebo-controlled response to percutaneous coronary intervention in stable coronary artery disease
No full textBackground: ORBITA-2 (the Placebo-Controlled Trial of Percutaneous Coronary Intervention for the Relief of Stable Angina) provided evidence for the role of percutaneous coronary intervention (PCI) for angina relief in stable coronary artery disease. Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are often used to guide PCI; however, their ability to predict placebo-controlled angina improvement is unknown. Methods: Participants with angina, ischemia, and stable coronary artery disease were enrolled, and anti-anginal medications were stopped. Participants reported angina episodes daily for 2 weeks using the ORBITA smartphone symptom application (ORBITA-app). At the research angiogram, FFR and iFR were measured. After sedation and auditory isolation, participants were randomized to PCI or placebo before entering a 12-week blinded follow-up phase with daily angina reporting. The ability of FFR and iFR, analyzed as continuous variables, to predict the placebo-controlled effect of PCI was tested using Bayesian proportional odds modeling. Results: Invasive physiology data were available for 279 patients (140 PCI and 139 placebo). The median (interquartile range) age was 65 years (59.0–70.5), and 223 (79.9%) were male. Median FFR was 0.60 (0.46–0.73), and median iFR was 0.76 (0.50–0.86). The lower the FFR or iFR, the greater the placebo-controlled improvement with PCI across all end points. There was strong evidence that a patient with an FFR at the lower quartile would have a greater placebo-controlled improvement in angina symptom score with PCI than a patient at the upper quartile (FFR, 0.46 versus 0.73: odds ratio, 2.01; 95% credible interval, 1.79–2.26; probability of interaction, >99.9%). Similarly, there was strong evidence that a patient with an iFR at the lower quartile would have greater placebo-controlled improvement in angina symptom score with PCI than a patient with an iFR at the upper quartile (iFR, 0.50 versus 0.86: odds ratio, 2.13; 95% credible interval, 1.87–2.45; probability of interaction, >99.9%). The relationship between benefit and physiology was seen in both Rose angina and Rose nonangina. Conclusions: Physiological stenosis severity, as measured by FFR and iFR, predicts placebo-controlled angina relief from PCI. Invasive coronary physiology can be used to target PCI to those patients who are most likely to experience benefit. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03742050.</p
2024 UK and Ireland modified Delphi consensus on myopia management in children and young people
No full textAbstractIntroductionThis work aimed to establish the largest UK and Ireland consensus on myopia management in children and young people (CYP).MethodsA modified Delphi consensus was conducted with a panel of 34 optometrists and ophthalmologists with expertise in myopia management.ResultsTwo rounds of voting took place and 131 statements were agreed, including that interventions should be discussed with parents/carers of all CYP who develop myopia before the age of 13 years, a recommendation for interventions to be publicly funded for those at risk of fast progression and high myopia, that intervention selection should take into account the CYP's hobbies and lifestyle and that additional training for eye care professionals should be available from non‐commercial sources. Topics for which published evidence is limited or lacking were areas of weaker or no consensus. Modern myopia management contact and spectacles are suitable first‐line treatments. The role and provision of low‐concentration atropine needs to be reviewed once marketing authorisations and funding decisions are in place. There is some evidence that a combination of low‐concentration atropine with an optical intervention can have an additive effect; further research is needed. Once an intervention is started, best practice is to monitor non‐cycloplegic axial length 6 monthly.ConclusionResearch is needed to identify those at risk of progression, the long‐term effectiveness of individual and combined interventions, and when to discontinue treatment when myopia has stabilised. As further evidence continues to emerge, this consensus work will be repeated to ensure it remains relevant.</p
RT-qPCR Testing and Performance Metrics in the COVID-19 Era
No full textThe COVID-19 pandemic highlighted the crucial role of diagnostic testing in managing infectious diseases, particularly through the use of reverse transcription-quantitative polymerase chain reaction (RT-qPCR) tests. RT-qPCR has been pivotal in detecting and quantifying viral RNA, enabling the identification and management of SARS-CoV-2 infections. However, despite its widespread use, there remains a notable gap in understanding fundamental diagnostic metrics such as sensitivity and specificity among many scientists and healthcare practitioners. This gap is not merely academic; it has profound implications for interpreting test results, making public health decisions, and affecting patient outcomes. This review aims to clarify the distinctions between laboratory- and field-based metrics in the context of RT-qPCR testing for SARS-CoV-2 and summarise the global efforts that led to the development and optimisation of these tests during the pandemic. It is intended to enhance the understanding of these fundamental concepts among scientists and healthcare professionals who may not be familiar with the nuances of diagnostic test evaluation. Such knowledge is crucial for accurately interpreting test results, making informed public health decisions, and ultimately managing infectious disease outbreaks more effectively.</p
Enhancing the resilience of cancer services in terms of hospital built environment reconfiguration in case of pandemics
No full textThe provision of cancer care is complex due to its heavy reliance on hospital-intertwined departments and services. However, with hospital care severely disrupted during COVID-19, cancer services were affected. This research aims to extract lessons from the experience of COVID-19 at the cancer service delivered across three hospitals in an NHS Trust in England and provide recommendations to enhance the resilience of the built environment for cancer service in future pandemics. The study employed a qualitative approach, including a literature review on the impact of COVID-19 on cancer services and their built environment. Seven staff interviews were conducted to gather insights, followed by a focus group with eight participants to discuss findings and potential environmental reconfigurations. In evaluating the cancer service infrastructure pre- and peri-COVID-19, the research found a correlation between the pre- and peri-pandemic challenges and strategies to cope with them during the pandemic. The complexity of the cancer service and its hospital location posed risks for staff moving between offices and departments, increasing their chances of contracting the virus. While hospital zoning was implemented, it resulted in longer travel times for staff and failed to ease patients' fears about visiting hospitals. Local makeshift solutions also proved ineffective. Findings established the need for ‘lasting solutions’ to improve the resilience of the cancer service to future pandemics, such as developing independent, purpose-built buildings for cancer services, integrated with remote consultation and work to enhance staff and patient safety and needs.</p
An Exploration Of The Current State Of Equality And Diversity In The UK Construction Industry
No full textMany industries in the UK have embraced the Equality and Diversity agenda, including the UK construction industry, with a commitment to ensure broader representation. Despite the acknowledged commitments to improve diversity by many stakeholders in the construction industry, systemic inequalities in the representation of women and Blacks persist. This paper explores the current state of equality and diversity within the UK construction industry. The paper explores diversity in thirty-nine of some of the leading contractors in the UK. The paper is based on a detailed review of extant literature, with data collected through interviews, questionnaires, and publicly available information from major industry institutions and leading construction firms. The study shows that women and people from Black ethnic groups are grossly underrepresented within the UK construction industry both at the site level on projects and at the corporate leadership level. The paper confirms the UK construction industry’s reputation as a predominantly white-male-dominated sector. This extends to the corporate leadership and board levels with females making up less than a third of senior management, with only two Black females but no Black male representatives at this level. The paper provides compelling evidence about both the urgency and scale of the need for action. It is recommended that the construction industry must have a clear programme of action and execution plan, with commitment at the highest levels to ensure equality and diversity within the UK construction industry.</p
Application of plane wave imaging and processing for measurement of reflectors in concrete
No full textMeasurement and quantification of detected subsurface features is an important step toward the evaluation of concrete structures. A model-based evaluation relies on better spatial measurement and updating of internal features, apart from detection. In this work, we aim for precise measurement and tracing in the spatial domain of features like internal multilinear crack patterns and embedded circular and polygonal ducts, with the data from a limited angle of view of one-sided inspection on concrete. Plane wave imaging (PWI) - which is rather completely new in concrete - is used for subsurface image reconstruction, due to which better and more feasible tracing has been achieved, compared to images of the total focusing method (TFM). The dependence of measurements on scanning frequency has been removed with image segmentation and morphological erosion in the reconstructed images. With one-sided inspection of general features, the part facing the inspection surface has been traced with considerable accuracy, but for circular embedments, the complete spatial trace is marked after ensuring that it is indeed a circular object. The estimation errors in both the spatial location of the center and the radius measurement of circular features have been found to be under the 5% limit. For multilinear cracks, the error in measurement of the length of crack segments is within 4%.</p
Is coloniality shaping patterns of intimate partner violence within the Nigerian migrant community in the UK?
No full textHow do colonial legacies influence patterns and experiences of intimate partner violence (IPV) among those from previously colonised countries? Dr Yemisi Sloane examines the impact of colonial history on IPV within the British Nigerian diaspora, challenging simplistic cultural explanations and advocating a decolonial approach to understand and address diverse IPV experiences in the UK.</p
Current nursing and midwifery leadership contribution to leading digital health policy and practice: An integrative review.
No full textAim: To review the current nursing and midwifery contribution to leading digital health policy and practice and what facilitates and/or challenges this.
Design: Integrative literature review
Methods: Pre-defined inclusion criteria were used. Study selection and quality assessment using the appropriate critical appraisal tools were undertaken by two authors, followed by narratives synthesis.
Data sources: Six databases and hand searching for papers published 2012 to February 2024.
Findings: Four themes were identified from twenty-four included papers. These are discussed according to the World Health Organisation’s Global Strategic Directions for Nursing and Midwifery; and indicate nurses/midwives are leading digital health policy and practice, but this is not widespread or systematically enabled.
Conclusion: Nurses and midwives are ideally placed to help improve health outcomes through digital healthcare transformation, but their policy leadership potential is underused.</p
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