Patient perspectives of a diagnosis of myeloproliferative neoplasm in a case control study

Background: Myeloproliferative neoplasms (MPNs) including the classic entities; polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis are rare diseases with unknown aetiology. The MOSAICC study, is an exploratory case–control study in which information was collected through telephone questionnaires and medical records. Methods: As part of the study, 106 patients with MPN were asked about their perceived diagnosis and replies correlated with their haematologist’s diagnosis. For the first time, a patient perspective on their MPN diagnosis and classification was obtained. Logistic regression analyses were utilised to evaluate the role of variables in whether or not a patient reported their diagnosis during interview with co-adjustment for these variables. Chi square tests were used to investigate the association between MPN subtype and patient reported categorisation of MPN. Results: Overall, 77.4 % of patients reported a diagnosis of MPN. Of those, 39.6 % recognised MPN as a ‘blood condition’,23.6 % recognised MPN as a ‘cancer’ and 13.2 % acknowledged MPN as an ‘other medical condition’. There was minimal overlap between the categories. Patients with PV were more likely than those with ET to report their disease as a ‘blood condition’. ET patients were significantly more likely than PV patients not to report their condition at all.Patients from a single centre were more likely to report their diagnosis as MPN while age, educational status, and WHO re-classification had no effect. Conclusions: The discrepancy between concepts of MPN in patients could result from differing patient interest in their condition, varying information conveyed by treating hematologists, concealment due to denial or financial concerns. Explanations for the differences in patient perception of the nature of their disease, requires further, larger scale investigation.

MicroRNAs in Parasitic Helminthiases: Current Status and Future Perspectives

MicroRNAs (miRNAs) play a variety of roles in diverse biological processes at the post-transcriptional regulatory level. Although numerous miRNAs have been identified in parasitic helminths, we still know little about their biological functions. As molecular signatures that can be stably detectable in serum and plasma, worm-derived miRNAs have shown promise as markers for the early detection of particular helminth infections. In addition, host miRNAs are dysregulated during the development of pathology associated with helminthiases and show potential as therapeutic intervention targets. This review discusses the possible biological roles of helminth miRNAs, the prediction of their specific targets, their application in diagnosis and anti-pathology therapy interventions, and the potential functions of miRNAs in extracellular vesicle cargo, such as exosomes, in helminth-host interplay.

Primary Health Care Providers' Perspectives: Facilitating Older Patients' Access to Community Support Services

The purpose of the study examined in this article was to understand how non-physician health care professionals working in Canadian primary health care settings facilitate older persons’ access to community support services (CSSs). The use of CSSs has positive impacts for clients, yet they are underused from lack of awareness. Using a qualitative description approach, we interviewed 20 health care professionals from various disciplines and primary health care models about the processes they use to link older patients to CSSs. Participants collaborated extensively with interprofessional colleagues within and outside their organizations to fi nd relevant CSSs. They actively engaged patients and families in making these linkages and ensured follow-up. It was troubling to fi nd that they relied on out-of-date resources and ineffi cient search strategies to fi nd CSSs. Our fi ndings can be used to develop resources and approaches to better support primary health care providers in linking older adults to relevant CSSs. 

Community Perspectives On Public Order Policing in Northern Ireland

In 2011 the Chief Constable of the PSNI commissioned a review of public order policing in Northern Ireland, following closely behind a review of public order policing in Britain undertaken by Her Majesty’s Inspectorate of Constabulary (HMIC) (2011). As part of the review, the PSNI decided to adopt a ‘twin-track’ approach, with an internal review of organisational practice, experiences and roles/responsibilities; and an independent external review of community experiences of public order policing across the country. The external strand to the review was publically tendered during the first half of 2012 and was awarded to a joint bid by the University of Ulster and the Institute for Conflict Research. The overall aim of the research was to inform the PSNI’s review of public order policing in the widest possible sense so that community experiences and attitudes may be considered by the PSNI as part of decisions taken about future changes in police strategy and tactics on public order issues, with full cognisance of their community impact. In regard to the specific objectives, the research was tasked with the following:

• Provide qualitative information on community experiences and attitudes to public order policing;
• Identify critical issues, dilemmas and debates resulting from public order policing as delivered by the PSNI – both in terms of communities directly and indirectly affected;
• Highlight issues for the PSNI consideration in terms of carrying out its task of maintaining public order while upholding the human rights of all; and
• Explore the above issues in respect of both the PSNI’s style and tactics, along with community attitudes and approaches.