Evidence for the Positive Impact of Centralization in Esophageal Cancer Surgery.

Objective: To analyze the impact of centralization on key metrics, outcomes, and patterns of care at the Irish National Center.

Background: Overall survival rates for esophageal cancer in the West have doubled in the last 25 years. An international trend towards centralization may be relevant; however, this model remains controversial, with Ireland centralizing esophageal cancer surgery in 2011.

Nutrient deprivation and hypoxia alter T cell immune checkpoint expression: potential impact for immunotherapy.

Aim: Use of immune checkpoint blockade to enhance T cell-mediated immunity within the hostile tumour microenvironment (TME) is an attractive approach in oesophageal adenocarcinoma (OAC). This study explored the effects of the hostile TME, including nutrient deprivation and hypoxia, on immune checkpoint (IC) expression and T cell phenotypes, and the potential use of nivolumab to enhance T cell function under such conditions.

Methods And Results: ICs were upregulated on stromal immune cells within the tumour including PD-L2, CTLA-4 and TIGIT.

Acidosis significantly alters immune checkpoint expression profiles of T cells from oesophageal adenocarcinoma patients.

Tumour acidosis contributes to cancer progression by inhibiting anti-tumour immunity. However, the effect of acidosis on anti-tumour T cell phenotypes in oesophageal adenocarcinoma (OAC) is unknown. Therefore, this study investigated the effect of acidosis on anti-tumour T cell profiles and if immune checkpoint blockade (ICB) could enhance anti-tumour T cell immunity under acidosis.

Cooperation between chemotherapy and immune checkpoint blockade to enhance anti-tumour T cell immunity in oesophageal adenocarcinoma.

Response rates to immune checkpoint blockade (ICB) remain low in oesophageal adenocarcinoma (OAC). Combining ICB with immunostimulatory chemotherapies to boost response rates is an attractive approach for converting 'cold' tumours into 'hot' tumours. This study profiled immune checkpoint (IC) expression on circulating and tumour-infiltrating T cells in OAC patients and correlated these findings with clinical characteristics.

Flavonoid-based inhibitors of the Phi-class glutathione transferase from black-grass to combat multiple herbicide resistance.

The evolution and growth of multiple-herbicide resistance (MHR) in grass weeds continues to threaten global cereal production. While various processes can contribute to resistance, earlier work has identified the phi class glutathione--transferase (GSTF1) as a functional biomarker of MHR in black-grass (). This study provides further insights into the role of GSTF1 in MHR using a combination of chemical and structural biology.

Confronting the opioid crisis with consumer health information: a look at East Tennessee.

Background: Starting in the 1990s, health care providers began prescribing opioids to patients as pain relievers, believing they were safe. However, many patients became addicted to these pills. In 2017, the US Department of Health and Human Services declared a public health emergency to fight the opioid epidemic.

Modern oncological and operative outcomes in oesophageal cancer: the St. James's hospital experience.

Background: Oesophageal cancer has a reputation for poor survival, and a relatively high risk of major postoperative morbidity and mortality. Encouragingly, a recent international cancer registry study reports a doubling of survival outcomes in Ireland over the last 20 years. This study focused on both oncologic and operative outcomes in patients treated with curative intent requiring surgery at a high-volume center.

Making sense of concept analysis.

Background: Concept analysis is frequently the first step novice nurse researchers take when beginning their work. However, the value of concept analysis in generating theory is debated, and although there are many models researchers can use, few provide guidance for applying them or overviews of their philosophical underpinnings.

Aim: To share learning about challenges encountered when undertaking concept analysis and to present an adaptation of Rodgers ( 1989 ) model created to overcome these.

Prospective Study of Malabsorption and Malnutrition After Esophageal and Gastric Cancer Surgery.

Objective: To study malabsorption and malnutrition after curative resection of esophageal and gastric cancer.

Design: Prospective cohort study.

Background: Improved cure rates for esophageal and gastric cancer have increased focus on health-related quality of life (HR-QL) in survivorship.

Standards for midwife practitioners of external cephalic version: A Delphi study.

Introduction: expansion of advanced and specialist midwifery practitioner roles across professional boundaries requires an evidence-based framework to evaluate achievement and maintenance of competency. In order to develop the role of Breech Specialist Midwife to include the autonomous performance of external cephalic version within one hospital, guidance was required on standards of training and skill development, particularly in the use of ultrasound.

Methods: a three-round Delphi survey was used to determine consensus among an expert panel, including highly experienced obstetric and midwife practitioners, as well as sonographers.

Living with hepatitis C: a phenomenological study.

Aims And Objectives: To explore the experience of adults living with hepatitis C over time.

Background: Hepatitis C virus is a growing problem affecting thousands of people worldwide. The majority of individuals infected develop chronic liver disease, but treatment is not always successful, leaving many to live with the virus indefinitely.

Patient- and family-centred care on an acute adult cardiac ward.

This paper outlines a service improvement project undertaken in one acute cardiac ward within a regional NHS trust in the east of England that explored the impact of advancing patient- and family-centred care within an acute adult setting. The project was implemented and evaluated over a 9-month period between March and December 2012 and data collected via a pre and post-intervention survey. The results demonstrated that the majority of family carers wanted to be involved in patient care.

A personal insight into researcher positionality.

Aim: To highlight observations on the dilemmas of insider research.

Background: Researchers in qualitative research have traditionally been thought of as positioned inside or outside the social group being studied. However, there is recognition of the blurring of the apparent Separation between these two positions.

Innovations and action research to develop research skills for nursing and midwifery practice: the Innovations in Nursing and Midwifery Practice Project study.

Aims And Objectives: To develop sustainable resources and activity in one hospital to encourage, support and build research activity and innovation among nurses and midwives.

Background: Much resource is spent internationally to enable nurses and midwives to critique and quote research papers. The evidence suggests that little resource is focussed on enabling staff to conduct structured interventions that implement research as a service improvement activity, or enable nurses and midwives to undertake research in their clinical areas.

An action research approach for developing research and innovation in nursing and midwifery practice: building research capacity in one NHS foundation trust.

The National Health Service in the United Kingdom is committed to a process of reform centred on quality care and innovative practice. Central to this process is the need for research capacity building within the workforce. The aim of this study was to develop an infrastructure for research capacity building within one National Health Service Foundation Trust.

An exploration of lecturer as facilitator within the context of problem-based learning.

Although the concept and practice of problem-based learning (PBL) has been explored extensively in different arenas, the perspective of the lecturer as facilitator has not featured prominently in these discussions. There has been relatively little attention focused on lecturers' personal pedagogical values and beliefs and how these interact with the discourse and rhetoric of problem-based learning. The aim of this study therefore was to explore the role of lecturer as facilitator within a PBL context.

Binary nanoparticle superlattices in the semiconductor-semiconductor system: CdTe and CdSe.

We report binary nanoparticle superlattices obtained by self-assembly of two different semiconductor quantum dots. Such a system is a means to include two discretized, quantum-confined, and complimentary semiconductor units in close proximity, for purposes of band gap matching and/or energy transfer. From a range of possible structures predicted, we observe an exclusive preference for the formation of Cuboctahedral AB13 and AB5 (isostructural with CaCu5) obtained in the system of 8.

Social networks: a profile of the elderly who self-neglect.

Background: Self-neglect is an independent risk factor for early mortality in older people and has been linked to depression and the occurrence of mental and physical decline. Sound social networks have been shown to slow the process of decline in the elderly, and currently little is known about the social networks associated with elder self-neglect. The aim of this study was to explore the social networks associated with elder self-neglect compared with a matched-control group.