Clinical Significance of NOTCH1 and NOTCH2 Expression in Gastric Carcinomas: An Immunohistochemical Study.

BACKGROUND NOTCH signaling can exert oncogenic or tumor suppressive functions and can contribute to chemotherapy resistance in cancer. In this study, we aimed to clarify the clinicopathological significance and the prognostic and predictive value of NOTCH1 and NOTCH2 expression in gastric cancer (GC). METHODS NOTCH1 and NOTCH2 expression was determined immunohistochemically in 142 primarily resected GCs using tissue microarrays and in 84 pretherapeutic biopsies from patients treated by neoadjuvant chemotherapy. The results were correlated with survival, response to therapy, and clinico-pathological features. RESULTS Primarily resected patients with NOTCH1-negative tumors demonstrated worse survival. High NOTCH1 expression was associated with early-stage tumors and with significantly increased survival in this subgroup. Higher NOTCH2 expression was associated with early-stage and intestinal-type tumors and with better survival in the subgroup of intestinal-type tumors. In pretherapeutic biopsies, higher NOTCH1 and NOTCH2 expression was more frequent in non-responding patients, but these differences were statistically not significant. CONCLUSION Our findings suggested that, in particular, NOTCH1 expression indicated good prognosis in GC. The close relationship of high NOTCH1 and NOTCH2 expression with early tumor stages may indicate a tumor-suppressive role of NOTCH signaling in GC. The role of NOTCH1 and NOTCH2 in neoadjuvantly treated GC is limited.

Maternal health during pregnancy and perinatal mortality in Bangladesh: evidence form a large-scale community-based clinical trial

Perinatal mortality is very high in Bangladesh. In this setting, few community-level studies have assessed the influence of underlying maternal health factors on perinatal outcomes. We used the data from a community-based clinical controlled trial conducted between 1994 and 1997 in the catchment areas of a large MCH/FP hospital located in Mirpur, a suburban area of Dhaka in Bangladesh, to investigate the levels of perinatal mortality and its associated maternal health factors during pregnancy. A total of 2007 women were followed after recruitment up to delivery, maternal death, or until they dropped out of the study. Of these, 1584 who gave birth formed our study subjects. The stillbirth rate was 39.1 per 1000 births [95% confidence interval (CI) 39.0, 39.3] and the perinatal mortality rate (up to 3 days) was 54.3 per 1000 births [95% CI 54.0, 54.6] among the study population. In the fully adjusted logistic regression model, the risk of perinatal mortality was as high as 2.7 times [95% CI 1.5, 4.9] more likely for women with hypertensive disorders, 5.0 times [95% CI 2.3, 10.8] as high for women who had antepartum haemorrhage and 2.6 times [95% CI 1.2, 5.8] as high for women who had higher haemoglobin levels in pregnancy when compared with their counterparts. The inclusion of potential confounding variables such as poor obstetric history, sociodemographic characteristics and preterm delivery influenced only marginally the net effect of important maternal health factors associated with perinatal mortality. Perinatal mortality in the study setting was significantly associated with poor maternal health conditions during pregnancy. The results of this study point towards the urgent need for monitoring complications in high-risk pregnancies, calling for the specific components of the safe motherhood programme interventions that are designed to manage these complications of pregnancy.

Becoming a psychology undergraduate:integrating study skills and integrating students

Three years of action research into a study skills and transition programme for psychology undergraduates are reported. The programme began as a ‘bolt-on’ response to perceptions of student deficit and developed to focus on transition to university. Data from three cohorts and over 600 students show attendance to be associated with higher academic grades and progression rates. The programme has also helped to establish relationships with peers and staff, prepare students for assessments, set expectations about study, and provided an opportunity to ask questions, to work collaboratively and to learn about referencing and plagiarism. Concerns with study skills highlighted by Wingate (2006) and others are discussed.

Heteronormativity and teaching: A phenomenological study of lesbian teachers

The purpose of this phenomenological study was to understand what impact “heteronormativity” has on a lesbian teacher's perception of her instructional style, content, and context of curriculum taught. Through taped interviews with lesbian educators, this research examined the lived experience of the lesbian teacher. The framework for this study included theories related to historical, sociocultural, and psychosocial development while the methodology included a qualitative design using primary elements of a phenomenological study outlined without ignoring the influence associated with contextualism. Due to the sensitive nature of the study nine women who were the focus of this research were volunteers with the first serving as a “gatekeeper” to assist in the pilot study. The subsequent group evolved as a result of “snowballing” to gain more participants. ^ The data in the form of narrative derived from the interviews was transcribed, color-coded, and organized into four themes and associated sub-themes, based upon the perceptions of these educators. These themes characterized the coming out process of a lesbian, which directly paralleled the personal and professional development of the lesbian educator, emerged as a result of the analysis. They included: (a) self-acknowledgement; (b) self-indentification; (c) coming out to other lesbians by overcoming fear and establishing relationships; (d) coming out to others by overcoming heteronormativity by using support groups in defining a lesbian's role as a teacher. ^ The results of this study showed that the acceptance of the lesbian culture, shared with the acknowledgement, rather than compliance or defiance, of cultural hegemony can allow the lesbian educator to develop a curriculum and a classroom climate that will foster understanding and even generate social change among colleagues, parents, and students, one person at a time. ^

Education and Training in Occupational Health Psychology: The Case for E-Learning

For the discipline of occupational health psychology (OHP) to continue to evolve and to serve workers effectively it is imperative that education and training provision is available that enables students to acquire knowledge and skills, free of geographical and temporal constraints. This chapter begins with a brief introduction to the historical development of education and training in OHP in Europe. The review culminates with the assertion that higher education institutions are now required to act innovatively in regard to the expansion of provision. One such initiative involves the introduction of e-learning. A case study concerning the implementation of a Masters degree in OHP by e-learning is presented. On the outcomes of the case study, recommendations are offered for the design and implementation of such courses. The chapter concludes by raising some further questions that need to be addressed for education and training provision in OHP to continue to expand.

The Definition of Curriculum Areas in Occupational Health Psychology

Across the international educational landscape, numerous higher education institutions (HEIs) offer postgraduate programmes in occupational health psychology (OHP). These seek to empower the next generation of OHP practitioners with the knowledge and skills necessary to advance the understanding and prevention of workplace illness and injury, improve working life and promote healthy work through the application of psychological principles and practices. Among the OHP curricula operated within these programmes there exists considerable variability in the topics addressed. This is due, inter alia, to the youthfulness of the discipline and the fact that the development of educational provision has been managed at the level of the HEI where it has remained undirected by external forces such as the discipline’s representative bodies. Such variability makes it difficult to discern the key characteristics of a curriculum which is important for programme accreditation purposes, the professional development and regulation of practitioners and, ultimately, the long-term sustainability of the discipline. This chapter has as its focus the imperative for and development of consensus surrounding OHP curriculum areas. It begins by examining the factors that are currently driving curriculum developments and explores some of the barriers to such. It then reviews the limited body of previous research that has attempted to discern key OHP curriculum areas. This provides a foundation upon which to describe a study conducted by the current authors that involved the elicitation of subject matter expert opinion from an international sample of academics involved in OHP-related teaching and research on the question of which topic areas might be considered important for inclusion within an OHP curriculum. The chapter closes by drawing conclusions on steps that could be taken by the discipline’s representative bodies towards the consolidation and accreditation of a core curriculum.

A longitudinal study of the relationship between lifestyle and mental health among midlife and older women in Australia : findings from the Healthy Aging of Women Study

We investigated the temporal relationship between lifestyle and mental health among 564 midlife women. The mental health measured included anxiety, depression, and mental well-being; the lifestyle measures included body mass index (BMI), exercise, smoking, alcohol use, and caffeine consumption. We found that BMI was positively related with mental well-being (r = .316, p = .009); smokers had lower mental well-being than nonsmokers (β = 6.725, p = .006), and noncaffeine drinkers had higher mental well-being (β = 5, p = .023). Past alcohol-drinkers had less anxiety than nondrinkers (β = 1.135, p = .04). Therefore, lifestyle is predictive of mental health among midlife and older women.

Research and/or learning and teaching : a study of Australian professors' priorities, beliefs and behaviours

This paper presents findings from an empirical study of key aspects of the teaching and research priorities, beliefs and behaviours of 72 professorial and associate professorial academics in Science, Information Technology and Engineering across four faculties in three Australian universities. The academics ranked 16 research activities and 16 matched learning and teaching (L&T) activities from three perspectives: job satisfaction, role model behaviour and perceptions of professional importance. The findings were unequivocally in favour of research in all three areas and remarkably consistent across the universities. The only L&T activity that was ranked consistently well was 'improving student satisfaction ratings for teaching', an area in which academics are increasingly held accountable. Respondents also indicated that their seniors encourage research efforts more than L&T efforts. Recommendations include that higher education rewards for quality L&T are maintained or improved and that recognition of L&T research domains is further strengthened.

From policy borrowing to implementation : an illuminative evaluation of learning and teaching in higher education in Australia (2002 to 2008)

This study documents and theorises the consequences of the 2003 Australian Government Reform Package focussed on learning and teaching in Higher Education during the period 2002 to 2008. This is achieved through the perspective of program evaluation and the methodology of illuminative evaluation. The findings suggest that the three national initiatives of that time, Learning and Teaching Performance Fund (LTPF), Australian Learning and Teaching Council (ALTC), and Australian Universities Quality Agency (AUQA), were successful in repositioning learning and teaching as a core activity in universities. However, there were unintended consequences brought about by international policy borrowing, when the short-lived nature of LTPF suggests a legacy of quality compliance rather than one of quality enrichment.

Psychological health of medical and dental students in Saudi Arabia : a longitudinal study

Introduction: Many studies have indicated the poor psychological health of medical and dental students. However, few studies have assessed the longitudinal trajectory of that psychological health at different times in an academic year. Aim: To evaluate the positive and negative aspects of psychological health among preclinical medical and dental students in Saudi Arabia prospectively. Methods: A total of 317 preclinical medical and dental students were recruited for a longitudinal study design from second and third-year students at Umm Al-Qura University in the 2012-2013 academic year. The students were assessed at the middle of the first term and followed up after 3-monthes at the beginning of the second term. Questionnaires included assessment of depression, anxiety, stress, self-efficacy, and satisfaction with life. Results: Depression, anxiety, stress, and satisfaction with life were improved significantly at the beginning of the second term, whereas self-efficacy did not change significantly. The medical, female, and third-year student subgroups had the most significant changes. Depression and stress were significantly changed at the beginning of the second term in most demographic subgroups. Conclusion: Preclinical medical and dental students have different psychological health levels at different times of the same academic year. It is recommended to consider time of data collection when analyzing the results of such studies.

Incidence and fatality of serious suicide attempts in a predominantly rural population in Shandong, China : a public health surveillance study

Objectives To estimate the incidence of serious suicide attempts (SSAs, defined as suicide attempts resulting in either death or hospitalisation) and to examine factors associated with fatality among these attempters. Design A surveillance study of incidence and mortality. Linked data from two public health surveillance systems were analysed. Setting Three selected counties in Shandong, China. Participants All residents in the three selected counties. Outcome measures Incidence rate ( per 100 000 person-years) and case fatality rate (%). Methods Records of suicide deaths and hospitalisations that occurred among residents in selected counties during 2009–2011 (5 623 323 person-years) were extracted from electronic databases of the Disease Surveillance Points (DSP) system and the Injury Surveillance System (ISS) and were linked by name, sex, residence and time of suicide attempt. A multiple logistic regression model was developed to examine the factors associated with a higher or lower fatality rate. Results The incidence of SSAs was estimated to be 46 (95% CI 44 to 48) per 100 000 person-years, which was 1.5 times higher in rural versus urban areas, slightly higher among females, and increased with age. Among all SSAs, 51% were hospitalised and survived, 9% were hospitalised but later died and 40% died with no hospitalisation. Most suicide deaths (81%) were not hospitalised and most hospitalised SSAs (85%) survived. The fatality rate was 49% overall, but was significantly higher among attempters living in rural areas, who were male, older, with lower education or with a farming occupation. With regard to the method of suicide, fatality was lowest for non-pesticide poisons (7%) and highest for hanging (97%). Conclusions The incidence of serious suicide attempts is substantially higher in rural areas than in urban areas of China. The risk of death is influenced by the attempter’s sex, age, education level, occupation, method used and season of year.

The WIL (Work Integrated Learning) Report : A national scoping study [Australian Learning and Teaching Council (ALTC) Final report]

This report provides an account of the first large-scale scoping study of work integrated learning (WIL) in contemporary Australian higher education. The explicit aim of the project was to identify issues and map a broad and growing picture of WIL across Australia and to identify ways of improving the student learning experience in relation to WIL. The project was undertaken in response to high levels of interest in WIL, which is seen by universities both as a valid pedagogy and as a means to respond to demands by employers for work-ready graduates, and demands by students for employable knowledge and skills. Over a period of eight months of rapid data collection, 35 universities and almost 600 participants contributed to the project. Participants consistently reported the positive benefits of WIL and provided evidence of commitment and innovative practice in relation to enhancing student learning experiences. Participants provided evidence of strong partnerships between stakeholders and highlighted the importance of these relationships in facilitating effective learning outcomes for students. They also identified a range of issues and challenges that face the sector in growing WIL opportunities; these issues and challenges will shape the quality of WIL experiences. While the majority of comments focused on issues involved in ensuring quality placements, it was recognised that placements are just one way to ensure the integration of work with learning. Also, the WIL experience is highly contextualised and impacted by the expectations of students, employers, the professions, the university and government policy.

Caught in the headlights: Designing for creative learning and teaching in higher education

This study was an exploration of the different ways that educators conceptualise and approach creative learning and teaching. The research revealed theoretical and practice-based insights, demonstrating that exemplary teachers adopt an ecological approach to designing for student creativity; this approach acknowledges and works with the complexity of the higher education environment and the dynamic relationships between students, peers and teachers. The inquiry confirmed the value of using learning design patterns to uncover hidden creative processes.

Temporomandibular disorders and related psychosocial factors in non-patients : A survey and a clinical follow-up study based on the RDC/TMD

Temporomandibular disorders (TMD) and psychosocial factors reportedly associate. The underlying factors remain partially obscure, however, and further studies are required to clarify the relationships. The aims of this study were thus to assess in a non-patient working population the prevalence of TMD and related symptoms, and to clinically diagnose and follow the natural courses of TMD over a one-year period. In addition, possible comorbidity of temporomandibular and/or neck muscle pain and perceived stress and their impact on work performance were investigated, as well as how various psychosocial aspects relate to TMD. A questionnaire was mailed to all 30- to 55-year-old employees of the Finnish Broadcasting Company Ltd. whose employment in the Helsinki area had lasted at least five years (n = 1784). Of the 1339 subjects, who returned the questionnaire, 241 were examined according to the RDC/TMD and standard neck muscle palpation methods. Clinical signs of temporomandibular and/or neck muscle pain were found in 118 subjects. One-year follow-up TMD examinations were conducted on 211 subjects. The prevalence of frequent painless TMJ-related symptoms was 10%, orofacial pain 7%, neck pain 38%, and headache 15%. TMD diagnoses were: myofascial pain (13%), disc displacements (16%), and arthralgia, osteoarthritis, osteoarthrosis (4%). Chronic myofascial pain was present in 7% and chronic disc displacement with reduction in 11% of the subjects. Symptoms were significantly associated with almost all the studied psychosocial symptoms. Reduced work performance was significantly positively associated with continuous pain, severity of pain, and health stress perception, and according to logistic regression, somatization with the probability of having chronic myofascial pain. It could be concluded based on the results of this study among a non-patient working population that TMD and related symptoms are common and associated with psychosocial factors. Moreover, myofascial pain and disc displacement with reduction are the most common diagnoses of TMD. In addition, self-reported health related stress, and continuous pain in temporomandibular and/or neck muscles are associated with reduced work performance, and somatization is significantly associated with chronic myofascial pain.