Highlights • Sweden lacks models of care that offer continuity of care. • More than half of the women would prefer continuity from the same midwife during antenatal, intrapartum and postpartum care. ...• Women with childbirth fear could benefit from continuity with midwife.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Highlights • 30% of the fathers agreed that they had concerns about difficulties of parenthood • Experienced and new fathers expressed similar concerns about parenthood • Financial worry was a key ...concern especially for experienced fathers • Feeling less positive about expecting a baby was associated with having concerns • Those concerned about parenthood were more likely to have poor emotional health
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Abstract Background and purpose The existence of a hypersensitive radiation response to doses below 0.5 Gy is well established for many normal and tumour cell lines. There is also evidence for ...hypersensitive tissue responses in acute skin damage and kidney function in mice. Recently, we have identified that a hypersensitive γH2AX response exists in human epidermis. The aim of this study was to investigate the dose–response of basal clonogenic keratinocytes in normal skin to fractionated radiotherapy with low dose fractions. Materials Skin punch biopsies were taken before and during radiotherapy from prostate cancer patients undergoing radiotherapy with a curative intent. Areas of epidermis receiving daily fractions of approximately 0.1, 0.2, 0.45 and 1.1 Gy were biopsied on the same occasion to determine dose–response for each individual patient. In total, 89 cases were assessed either at 1, 2.5, 3, 4, 5 or 6.5 weeks in the treatment course. Biopsy sampling of another 25 patients was performed from areas receiving 0.45 and 1.1 Gy per fraction at regular intervals throughout the 7-week treatment period. The number of basal keratinocytes per mm of the interfollicular epidermis was determined. The DNA damage response of the basal keratinocytes was investigated by immunohistochemical staining for molecular markers of growth arrest, mitosis and cell death, using p21, phospho-H3 and γH2AX, respectively. The number of stained keratinocytes in the basal layer was counted manually. The p21 staining was also quantified by digital image analysis. Results The individual dose–response relationships revealed a low-dose hypersensitivity for reduction of basal keratinocytes throughout 7 weeks of radiotherapy ( p < 0.01). Growth arrest and cell proliferation assessed at 1 week and 6.5 weeks showed, in both cases, hypersensitive increase of p21 ( p < 0.01) and hypersensitive depression of mitosis ( p < 0.01). Manual counting and digital image analysis of p21 showed good agreement. Cell death was infrequent but increased significantly between 1 and 6.5 weeks and displayed a hypersensitive dose–response at the end of the treatment period. Conclusions A low-dose hypersensitivity in basal skin keratinocyte reduction is present throughout 7 weeks of radiotherapy. A persistent hypersensitive growth arrest response and cell killing mediate this effect.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Ultraviolet (UV)-induced DNA damage causes an efficient block of elongating replication forks. The checkpoint kinase, CHK1 has been shown to stabilize replication forks following hydroxyurea ...treatment. Therefore, we wanted to test if the increased UV sensitivity caused by the unspecific kinase inhibitor caffeine--inhibiting ATM and ATR amongst other kinases--is explained by inability to activate the CHK1 kinase to stabilize replicative structures. For this, we used cells deficient in polymerase η (Polη), a translesion synthesis polymerase capable of properly bypassing the UV-induced cis-syn TT pyrimidine dimer, which blocks replication. These cells accumulate gaps behind progressing replication forks after UV exposure. We demonstrate that both caffeine and CHK1 inhibition, equally retards continuous replication fork elongation after UV treatment. Interestingly, we found more pronounced UV-sensitization by caffeine than with the CHK1 inhibitor in clonogenic survival experiments. Furthermore, we demonstrate an increased collapse of replicative structures after caffeine treatment, but not after CHK1 inhibition, in UV-irradiated cells. This demonstrates that CHK1 activity is not required for stabilization of gaps induced during replication of UV-damaged DNA. These data suggest that elongation and stabilization of replicative structures at UV-induced DNA damage are distinct mechanisms, and that CHK1 is only involved in replication elongation.
Aim
To evaluate student nurses' perceptions of the effects of process‐oriented group supervision provided during their undergraduate education.
Background
Supervision is an important ability and part ...of a nurse's leadership role. Student nurses need to learn competence in clinical practice.
Method
A descriptive‐correlational study comparing three groups of student nurses (n = 151) who attended process‐oriented group supervision during their education.
Findings
The effects of process‐oriented group supervision were increased awareness of interpersonal, professional and communication skills. There was a moderate relation between the three factors. The strongest correlation was found between the factors professional and communication skills (r = 0.81). The correlations between the factors in group 3, the mandatory group, were identical.
Conclusions
By correlating the factors, we concluded that the student nurses' perceptions of the effects of process‐oriented group supervision strengthened their professional identity, which may have a bearing on patient safety, nursing leadership and collaboration with the patient, her/his family members and other professionals.
Implication for nursing leadership
There is potential for improving the links between nursing leadership, supervision and patient safety.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
The contents of flavonoids in onions, green beans, and peas have been analysed in relation to the effect of different heat treatments. Two major flavonoids were studied, quercetin and kaempferol. The ...identification and quantification of the flavonoids were performed with high performance liquid chromatography and UV detection. The greatest loss of flavonoids in onion took place during the pre-processing step where the onion was peeled, trimmed, and chopped before blanching. Blanched onion contained 25 mg quercetin and 0.35 mg kaempferol per 100 g edible part. Blanched green beans contained 1.3 mg quercetin and 0.24 mg kaempferol per 100 g, and blanched peas only 0.15 mg quercetin per 100 g. No kaempferol was detected in peas. Further cooking, frying or warm-holding for up to 2 h of the blanched vegetables, did not influence the flavonoid content. Onions in ready-made dishes and home-cooked food as well as green beans may be good dietary sources of flavonoids.
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IJS, IMTLJ, KILJ, KISLJ, NUK, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Rose hips and sea buckthorn berries contain high amounts of beneficial bioactive compounds. In this study the content and stability of natural vitamins and antioxidants were investigated in two fruit ...beverages made from rose hip powder, sea buckthorn berry purée and white grape juice concentrate, and wheat germ oil in one of the beverages. Beverages were formulated, pasteurised and filled aseptically in Tetra Brik packages and stored up to 35 days at 4 °C or 22 °C. Samples were analysed for the content of ascorbic acid, carotenoids, major phenolics, tocochromanols, total phenols and total antioxidant capacity as ferric reducing ability. The largest changes occurred during the first 5 days of storage, thereafter mainly ascorbic acid decreased. In the wheat germ oil supplemented beverage, α-tocopherol was more rapidly degraded. Negative correlations between the decrease of some carotenoids and tocochromanols, and the increase of some phenolics, suggest relationships of redox reactions specific to the amount of oil supplemented. From the present study we can conclude that additions of oil to beverages should be carefully selected to avoid oxidations of bioactive compounds. Furthermore, packaging of the beverages should be carried out at higher temperatures and thereafter it should be stored at low temperatures (4 °C), which decreased oxidation of all bioactive compounds except ascorbic acid.
Assessments of the epidemiology of malaria over time are needed to understand changes in transmission and guide control and elimination strategies.
A longitudinal population study was established in ...1985 in Nyamisati village in the Rufiji River Delta, Tanzania. A physician and research team lived in the village 1984-2000. Parasite prevalence by microscopy and two PCR methods, spleen rates and haemoglobin levels were measured in repeated cross-sectional surveys between 1985 and 2010. Passive surveillance of malaria cases was maintained until end 1999. Bed nets were distributed after the surveys 1993, 1999 and 2010.
In 1985, overall parasite prevalence by microscopy was 70% (90% in children ages two to nine years). The prevalence decreased gradually by microscopy (38.9% 1994, 26.7% 1999) and msp2-PCR (58.7% 1994, 44.8% 1999), whereas real-time PCR prevalence remained higher throughout the 1990s (69.4% 1994, 64.8% 1999). In 2010, parasite prevalence was 17.8% by real-time PCR and 16.3% by msp2-PCR, and estimated to 4.8% by microscopy. Spleen rates in children ages two to nine years decreased earlier than parasite prevalence, from >75 to 42% in the 1980s, to nil during the 1990s. The prevalence of severe and moderate anaemia decreased from 41.1 to 13.1%. No deaths at the time of acute malaria were recorded when the research team lived in the village.
A marked decline in malaria transmission was observed over 25 years. The decrease was detected after the arrival of the research team and continued gradually both before and after distribution of bed nets. Spleen rates and microscopy identified early changes when transmission was still intense, whereas real-time PCR was a more sensitive metric when transmission was reduced. The study provides historical data on malaria within a closely monitored rural village and contributes to the understanding of changing epidemiology in sub-Saharan Africa.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Summary
Paediatric B‐cell precursor acute lymphoblastic leukaemias (
BCP ALL
) with
IKZF
1
deletions (∆
IKZF
1
) are associated with a poor outcome. However, there are conflicting data as to whether ...∆
IKZF
1
is an independent risk factor if minimal residual disease (
MRD
) and other copy number alterations also are taken into account. We investigated 334 paediatric
BCP ALL
, diagnosed 1992–2013 and treated according to Nordic Society for Paediatric Haematology and Oncology
ALL
protocols, with known
IKZF
1
status based on either single nucleotide polymorphism array (
N
=
218) or multiplex ligation‐dependent probe amplification (
N
=
116) analyses. ∆
IKZF
1
, found in 15%, was associated with inferior 10‐year probabilities of event‐free (60% vs. 83%;
P
<
0·001) and overall survival (
pOS
; 73% vs. 89%;
P
=
0·001). Adjusting for known risk factors, including white blood cell (
WBC
) count and
MRD
, ∆
IKZF
1
was the strongest independent factor for relapse and death. ∆
IKZF
1
was present in 27% of cases with non‐informative cytogenetics (‘
BCP
‐other’) and a poor 10‐year
pOS
was particularly pronounced in this group (58% vs. 90%;
P
<
0·001). Importantly, neither
MRD
nor
WBC
count predicted events in the ∆
IKZF
1
‐positive cases. Co‐occurrence of pseudoautosomal region 1 (
PAR
1) deletions in Xp22.33/Yp11.32 (
P2
RY
8
‐
CRLF
2
) and ∆
IKZF
1
increased the risk of relapse (75% vs. 30% for cases with only ∆
IKZF
1
;
P
=
0·045), indicating that
BCP
‐other
ALL
with both
P2
RY
8
‐
CRLF
2
and ∆
IKZF
1
constitutes a particularly high‐risk group.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
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