CANDOR: The Antidote to Deny and Defend?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134840/1/hesr12626_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/134840/2/hesr12626.pd

A qualitative study to explore factors that influence the vocabulary used by Cancer Nurse Specialists in a District General Hospital

There are 1.6 million people living with a diagnosis of cancer. A plethora of reports and studies have demonstrated that effective communication between health professionals and patients forms the foundation for caring for people with cancer. Effective communication has been shown to reduce levels of depression and anxiety, improve levels of self-esteem and well-being, reduce psychological morbidity and increase survival. Despite this there are ongoing concerns regarding the language used by health professions and the impacts on people with cancer. The literature search reveals there is research available concerning the language used by professionals and the effect upon people with cancer however there does not appear to be any research on factors that have influenced the vocabulary and language used. The sample population consists of 14 CNS’s across a range of cancer specialities. All 14 CNS’s were invited to participate; the eight respondents form the study sample. The setting is a DGH in the North West of England. Qualitative data was collected via digitally recorded semi-structured interviews using an interview guide. The recordings were transcribed verbatim and analysed using the framework of Cohen, Kahn and Steeves. Four broad themes representing four key factors that influence CNS’s vocabulary emerged; people with cancer, personal, process and publicity. Each of the four themes encompasses sub themes. ‘People with cancer’ includes the vocabulary of people with cancer, non-verbal language, narrative and the influence of relatives. The ‘personal experience’ of the CNS includes level of experience in the role, knowledge of speciality, confidence, personal experience of cancer, reflection and listening and learning. The third theme ‘process’ includes themes concerning consultants, stage of the patient journey, training courses, cancer type, environment, terminology, policy and team working. The fourth theme ‘publicity’ includes the influence media awareness, the internet and literature. The study reveals multiple factors influence the vocabulary CNS’s in a DGH use when communicating with people with cancer. The study provides new insight into how CNS’s form and choose their vocabulary in response to the stimuli and influences of the people they care for and work with. The findings reveal new data on the interaction and interconnectedness of the experience, knowledge and confidence of the CNS and how these factors influence vocabulary and communications with people with cancer

Whatever happened to Canadian big business?

This paper reappraises shifts in the composition of the largest Canadian-owned corporations. It highlights the patterns of size, industrial mix, and turnover across the twentieth-century. The logic of the turnover of the leading domestic firms is surveyed and the implications are explored

Retargeted adenoviruses for radiation-guided gene delivery

The combination of radiation with radiosensitizing gene delivery or oncolytic viruses promises to provide an advantage that could improve the therapeutic results for glioblastoma. X-rays can induce significant molecular changes in cancer cells. We isolated the GIRLRG peptide that binds to radiation-inducible 78 kDa glucose-regulated protein (GRP78), which is overexpressed on the plasma membranes of irradiated cancer cells and tumor-associated microvascular endothelial cells. The goal of our study was to improve tumor-specific adenovirus-mediated gene delivery by selectively targeting the adenovirus binding to this radiation-inducible protein. We employed an adenoviral fiber replacement approach to conduct a study of the targeting utility of GRP78-binding peptide. We have developed fiber-modified adenoviruses encoding the GRP78-binding peptide inserted into the fiber-fibritin. We have evaluated the reporter gene expression of fiber-modified adenoviruses in vitro using a panel of glioma cells and a human D54MG tumor xenograft model. The obtained results demonstrated that employment of the GRP78-binding peptide resulted in increased gene expression in irradiated tumors following infection with fiber-modified adenoviruses, compared with untreated tumor cells. These studies demonstrate the feasibility of adenoviral retargeting using the GRP78-binding peptide that selectively recognizes tumor cells responding to radiation treatment

Performance and bacterial community shifts during phosphogypsum biotransformation

Phosphogypsum (PG) is an industrial waste composed mainly by sulfate, turning it a suitable sulfate source for sulfate-reducing bacteria (SRB). In the present work, the capability of two SRB communities, one enriched from Portuguese PG (culture PG) and the other from sludge from a wastewater treatment plant (culture WWT-1), to use sulfate from PG was compared. In addition, the impact of this sulfate-rich waste in the microbial community was assessed. The highest efficiency in terms of sulfate reduction was observed with culture WWT-1. The bacterial composition of this culture was not significantly affected when sodium sulfate from the nutrient medium was replaced by PG as a sulfate source. Next generation sequencing (NGS) showed that this community was phylogenetically diverse, composed by bacteria affiliated to Clostridium, Arcobacter, and Sulfurospirillum genera and by SRB belonging to Desulfovibrio, Desulfomicrobium, and Desulfobulbus genera. In contrast, the bacterial structure of the community enriched from PG was modified when sodium sulfate was replaced by PG as the sulfate source. This culture, which showed the poorest performance in the use of sulfate from PG, was mainly composed by SRB related to Desulfosporosinus genus. The present work provides new information regarding the phylogenetic characterization of anaerobic bacterial communities with the ability to use PG as sulfate donor, thus, contributing to improve the knowledge of microorganisms suitable to be used in PG bioremediation. Additionally, this paper demonstrates that an alternative to lactate and low-cost carbon source (wine wastes) can be used efficiently for that purpose

Communication and resolution programs expose hard-to-hear truths

Communication and Resolution Programs' (CRP) favorable impact on professional liability claims continues to draw attention, but because they are deliberately aligned to advance the health system's mission rather than amelioration of litigation exposure, CRPs stand a better chance of delivering durable healthcare improvements than traditional responses to patient harm. CRP adherents employ focused investigations overseen by their own patient safety leader in order to engage patients with a principled response following unintended clinical outcomes. Focused on safety and unencumbered by litigation delays, CRP investigations are more apt than traditional responses to lay bare patient safety risks including professionalism challenges. Leaders, however, must be prepared to embrace and address hard-to-hear truths about dysfunctional systems or disruptive humans that threaten outcomes of care or clinical staff wellbeing

Salinity Controls on Steel Biocorrosion relevant to the Disposal of High-level Radioactive Waste

In a geological disposal facility (GDF) for spent fuel and high-level radioactive waste, the canister serves as one of the main engineered barriers. The resistance of the canister to degradation processes such as microbially influenced corrosion (MIC) needs be characterised to support GDF environmental safety cases. Here the impacts of salinity on sulfate-reducing bacterial (SRB) activity and associated MIC were explored in 84-day batch incubations at 30 ◦C. A 5 % standard bentonite slurry (MX80) in a low-salinity (0.1 g l− 1 NaCl) artificial groundwater containing lactate added as an electron donor provided suitable conditions for the proliferation of SRB. Corrosion rates of carbon steel (080-A15) coupon surfaces in microcosms amended with lactate were > 2.5 times greater than those absent of lactate, and sterile controls. At an increased salinity of 12.4 g l− 1, adding lactate resulted in 2 times the corrosion depth of sterile conditions, but at 50 g l− 1 there was no detected microbial activity, and no pronounced increase in corrosion by adding lactate compared to sterile controls. Here, microbial activity and subsequent MIC was suppressed at high salinity (50 g l− 1) suggesting that groundwater composition played a controlling role in SRB biocorrosion. The relevance to geodisposal scenarios, where bentonite is used to protect and support the waste canister, is discussed