Motivators and deterrents to blood donation among Black South Africans: a qualitative analysis of focus group data

BACKGROUND AND OBJECTIVES

South Africa has a markedly skewed representation where the majority of blood (62%) is presently collected from an ethnically White minority. This study seeks to identify culturally specific factors affecting motivation of donors in South Africa.

MATERIALS AND METHODS

We performed a qualitative study to evaluate motivators and deterrents to blood donation among Black South Africans. A total of 13 focus groups, comprising a total of 97 Black South Africans, stratified by age and geographic location were conducted. Transcripts of the interviews were analysed using a coding framework by Bednall & Bove.

RESULTS

Participants made 463 unique comments about motivators focusing primarily on promotional communications (28%), incentives (20%) and prosocial motivation (16%). Participants made 376 comments about deterrents which focused primarily on fear (41%), negative attitudes (14%) and lack of knowledge (10%).

CONCLUSION

Although prosocial motivation (altruism) was the most frequently mentioned individual motivator, promotional communication elicited more overall comments by participants. As reported by many authors, fear and lack of awareness were strong deterrents, but scepticism engendered by perceived racial discrimination in blood collection were unique to the South African environment.

The pro-apoptotic role of autophagy in breast cancer

BACKGROUND

Autophagy is a catabolic process that has a vital role in cancer progression and treatment. Current chemotherapeutic agents, which target autophagy, result in growth inhibition in many cancer types. In this study, we examined the role of autophagy in breast cancer (BCa) patients as well as BCa cell lines.

METHODS

Tissue microarray was used to detect the expression of an autophagy marker, LC3B in BCa patients (normal/hyperplasia=8; grade-I=15, grade-II=84, and grade-III=27) and BCa cell lines. To modulate the activation of autophagy, we used novel herbal compound nimocinol acetate (NA) in BCa cell lines and the anticancer activity was measured by phenotypic and molecular analysis.

RESULTS

LC3B is highly expressed in tumours as compared with normal tissues. Activation of LC3B in NA-treated BCa (MCF-7 and MDA-MB-231) cells was evident as compared with other autophagy makers. Further, our results confirmed that NA-transcriptionally regulates LC3B (as confirmed by mRNA levels and reporter assay), which resulted in the formation of acidic autophagy vesicles and autolysosomes in BCa cells. Nimocinol acetate inhibited mTOR-mediated pro-survival signalling that resulted in inhibition of growth in BCa cells without affecting normal breast epithelial cells. Downregulation of LC3B expression by siRNA significantly inhibited the anticancer effects of NA in BCa cells.

CONCLUSIONS

Together, our results suggest that LC3B is highly expressed in BCa tissues and increasing the threshold of LC3B activation dictates the pro-apoptotic function, which in turn, suppresses the growth of BCa cells. Nimocinol acetate could be a potential agent for treatment of BCa.

Development of the hearing protection assessment (HPA-2) questionnaire

BACKGROUND

Noise-induced hearing loss (NIHL) remains an important occupational health issue as the second most commonly self-reported occupational injury or illness. The incorrect and inconsistent use of hearing protection devices (HPDs) compromises their effectiveness in preventing NIHL.

AIMS

To describe the development of an easily administered yet robust questionnaire to investigate factors that influence HPD use.

METHODS

A hearing protection assessment (HPA-2) questionnaire was developed using items based on themes identified in our previous research. These fell into two classes: supports and barriers to wearing HPD, which formed two scales within the questionnaire. The questionnaire, which also included demographic items, was administered to workers from 34 manufacturing companies. The internal consistency of the scales was tested, and factor analysis was conducted to investigate the underlying structure of the scales.

RESULTS

Of the 1053 questionnaires distributed, 555 completed questionnaires were received giving a response rate of 53%. The Cronbach's alpha for the barriers scale (α = 0.740) and supports scale (α = 0.771) indicated strong internal reliability of the questionnaire. The supports and barriers were further described as five key factors (risk justification, HPD constraints, hazard recognition, behaviour motivation and safety culture) that influence hearing protection behaviour. Workers who reported always using HPDs had more supports across these factors, while those who did not always wear HPDs reported more barriers.

CONCLUSIONS

The HPA-2 questionnaire may be useful in both research and interventions to understand and motivate hearing protection behaviour by identifying and targeting supports and barriers to HPD use at different levels of the ecological model.

Exome and whole-genome sequencing of esophageal adenocarcinoma identifies recurrent driver events and mutational complexity

The incidence of esophageal adenocarcinoma (EAC) has risen 600% over the last 30 years. With a 5-year survival rate of ~15%, the identification of new therapeutic targets for EAC is greatly important. We analyze the mutation spectra from whole-exome sequencing of 149 EAC tumor-normal pairs, 15 of which have also been subjected to whole-genome sequencing. We identify a mutational signature defined by a high prevalence of A>C transversions at AA dinucleotides. Statistical analysis of exome data identified 26 significantly mutated genes. Of these genes, five (TP53, CDKN2A, SMAD4, ARID1A and PIK3CA) have previously been implicated in EAC. The new significantly mutated genes include chromatin-modifying factors and candidate contributors SPG20, TLR4, ELMO1 and DOCK2. Functional analyses of EAC-derived mutations in ELMO1 identifies increased cellular invasion. Therefore, we suggest the potential activation of the RAC1 pathway as a contributor to EAC tumorigenesis.

Workplace injuries in Fiji: a population-based study (TRIP 7)

BACKGROUND

Workplace injury rates in low and middle-income countries are known to be high. Contemporary data on this topic from Pacific Island countries and territories are scant.

AIMS

To describe the epidemiology of fatal and hospitalized workplace injuries in Fiji using a population-based trauma registry.

METHODS

An analysis of data from a prospective population-based surveillance registry investigated the characteristics associated with workplace injuries resulting in death or hospital admission among people aged 15 years and older in Viti Levu, the largest island in the Republic of Fiji, from October 2005 to September 2006. Incidence rates were calculated using denominator data from the 2004-05 Fiji Employment Survey.

RESULTS

One hundred and eighty-nine individuals met the study eligibility criteria (including nine deaths). This corresponded to annual injury-related hospitalization and death rates of 73.4 and 3.7 per 100 000 workers, respectively. Males accounted for 95% of injuries, and hospitalization rates were highest among those aged 15-29 years (33 per 100 000 workers). Fijian and Indian workers had similar rates of admission to hospital (38.3 and 31.8 per 100 000 workers, respectively). Fractures (40%) and 'cuts/bites/open wounds' (32%) were the commonest types of injury while 'being hit by a person or object' (34%), falls (27%) and 'cutting or piercing' injuries (27%) were the commonest mechanisms. Overall, 7% of injuries were deemed intentional.

CONCLUSIONS

Acknowledging the likely underestimation of the overall burden of workplace injuries, these findings support the need to identify context-specific risk factors and effective approaches to preventing workplace injuries in Fiji.

Clinical profile of diabetic ketoacidosis in adults

Introduction: Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Recent epidemiological studies indicate that hospitalizations for DKA in the U.S. are increasing. Epidemiological studies from India are limited. We undertook this observational study to analyse the clinical profiles of DKA in adults in south India.Methods: This study was conducted in at a tertiary care center in Andhra Pradesh for one year from Aug 2010 to July 2011. Diagnosis of DKA was made by the presence of (1) Plasma glucose level of 250mg/dl or higher (2) Serum bicarbonate level of 15mEq/lt or lower (3) Arterial blood pH of 7.3 or lower or a venous blood pH of 7.25 or lower (4) Presence of moderate or large urine ketones. All the patients were treated with institutional treatment protocol.Results: Of 27 patients, 22(81%) had type2 diabetes and 5(19%) had type 1 DM .10 were females and 17 males. Age of the patients ranged between 18 to 70 years, with an average of 45.3 years. Precipitating factors were present in 60% of the admissions. Non-compliance or discontinuation of drug therapy was seen in fifty per cent of patients. Average length of hospital stay was slightly longer in type 1 than type 2 DM patientsConclusion: A significant proportion of DKA occurs in patients with type 2 diabetes and many of these cases can be prevented with proper patient education and effective communication with a health care provider during an inter-current illness.DOI: http://dx.doi.org/10.3126/hren.v10i2.6569 Health Renaissance 2012; Vol 10 (No.2); 80-86 

Abstract 4147: Ratio of miR-146b/miR-191 in serum predicts prognosis in surgically resected lung squamous cell carcinomas

Background: We profiled 61 lung squamous cell carcinomas (SCC) and 10 matched adjacent normal lung tissue using the Ambion mirVana Bioarray that contains 328 human micro-RNA (miR) probes (Raponi et al. Cancer Research 2009). MiR-146b and miR-191 showed the strongest prediction accuracy for stratifying the prognostic groups. We hypothesize that these miRs can be detectable in serum and its expression in serum might be prognostic. Methods: Using the mirVana PARIS kit (Ambion), total RNA was isolated from 0.5 ml serum samples from 60 resected lung SCC patients, 30 healthy controls and 17 patients with benign lung disease. Reverse transcription reaction using Megaplex RT primers (Applied Biosystems) and preamplification using Megaplex PreAmp primers (Applied Biosystems) were performed. Expression of mature miRs, miR-146b and miR-191, were examined by real-time quantitative polymerase chain reaction using the comparative cycle threshold (Ct) method. Since the normalization of miRNA data in blood samples is still controversial, the ratio between the expression values of miR-146b and miR-191 was calculated and data log transformed. Results: miR-146b and miR-191 expression was detectable in the serum from all lung SCC patients and the serum miR-146b/miR-191 ratio was significantly higher in lung SCC patients (0.29±0.25) than in cancer-free subjects (0.16±0.11) (p-value=0.001). The miR-146b/miR-191 ratio showed a modest discriminative receiver-operator characteristic (ROC) curve, distinguishing cancer patients from cancer-free subjects with areas under the ROC curve at 0.69 (95% CI 0.59-0.79). In 20 SCC patients, the primary tumor miR-146b/miR-191 ratio (calculated using our microarray data) was compared with the miR ratio in serum and a significant correlation was observed (Pearson coefficient=0.455; p-value<0.001). Median overall survival of patients with high miR-146b/miR-191 ratio was significantly shorter (2.25 years ±0.32) than in patients with low miR ratio (5 years ±0.23, log-rank p-value=0.020). After adjusting by clinical covariates (sex, age and stage), miR-146b/miR-191 ratio remained as independent prognostic markers individually. Using the median of miR-146b/miR-191 ratio as a cutoff, the adjusted hazard ratio (HR) for death in those patients with higher miR ratio was 2.24 (95% CI 1.18-4.23). A validation of this miR-146b/miR-191 ratio as a prognostic marker in an independent cohort of resected lung SCC is warranted. Conclusions: Serum miR-146b/miR-191 ratio was significantly higher in lung SCC patients than in cancer-free subjects, but its accuracy to detect lung cancer is limited. Serum miR-146b/miR-191 ratio was significantly correlated with the primary tumor expression and the serum expression has a potential utility as independent prognostic marker in resected lung SCC.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4147. doi:1538-7445.AM2012-4147