In cervical screening programmes, Papanicolaou test (Pap test) is the key screening tool. However Pap test is difficult to implement in low-resource region. Introduction of an economic, cost-effective and less skill demanding equipment is hence a potential direction of advance in cervical screening methodology. 　　Cervical carcinogenesis involves genetic instability which leads to chromosomal aneuploidy. Evaluation of aneuploidy may hence provide information for identifying cancer and precursor cells. An automated DNA-image-cytometry system (DNA-imager) capable of quantitating the DNA content of cells has recently been developed. 　　To evaluate the efficacy of DNA-imager in cervical cancer screening, a total of 483 residual ThinPrep liquid-based cytology (LBC) samples after diagnosis were retrieved and evaluated by the DNA-imager. The high risk human papillomavirus (HPV) status of the atypical squamous cells of undetermined significance (ASC-US) samples has been tested as a parallel study. According to established criteria, 423 out of the 483 samples were satisfactory for downstream analysis. The samples were designated “Normal”, “Suspicious” or “Abnormal” according to their DNA aneuploidy and proliferation activity. 　　Significantly more high grade lesion samples (HSIL and SCC) were designated as “Abnormal” by DNA-imager than were lower grade lesion samples (Negative, ASC-US, AGC, ASC-H, and LSIL) (94.19% vs 51.04%, p<0.0001). For detecting ≥HSIL, DNA-imager achieved high sensitivity and specificity (94.19% and 48.96%) using “Abnormal” as cut off. Adopting a more stringent definition of “Suspicious” or “Abnormal” would increase the sensitivity to 100% but decreased the specificity to 24.33%. 　　 　　Regarding ASC-US triage, DNA-imager achieved a sensitivity and specificity of 80.00% and 71.29% respectively when “Abnormal” was used as test positive to predict cases with ≥HSIL follow-up in the next two year. The sensitivity increased but the specificity decreased to 90.00% and 34.65% respectively if “Suspicious or above” was used as indicator of undesirable follow-up. HR-HPV test, on the other hand, was able to identify all cases with ≥HSIL upon follow-up (sensitivity = 100%) but the specificity was only 15.84%. Among these ASC-US sample, test positivity of the two tests showed poor concordance with each other (Cohen’s κ = 0.062 and 0.074 respectively for “Suspicious or above” or “Abnormal”, respectively). 　　Our findings suggested that DNA-imager may be a useful tool for automated primary screening of cervical cancer 3 / published_or_final_version / Pathology / Master / Master of Medical Sciences

Hållbarhet och etik är ett högst aktuellt ämne i dagens samhälle som även påverkar den finansiella sektorn. Ämnen som CSR och hållbarhetsfrågor har tidigare haft fokus på företagsvärlden men under de senaste åren har även finansvärlden uppmärksammat ämnet, i och med uppkomsten av sociala och etiska investeringar.Tidigare forskning inom området etiska fonder har framförallt handlat om avkastningen och urvalsprocessen av bolag, få studier har gjorts av fondernas etiska prestanda. Den här studien syftar till att fördjupa diskussionen kring de etiska fonderna. Detta görs genom att studera hur fondbolagen bedriver urvalsprocessen och förvaltningen av dessa fonder.I studien används en abduktiv ansats. Det har inneburit att vi har fått komplettera den ursprungliga teoridelen utifrån de svar vi fick under den empiriska insamlingen. Studien är kvalitativ och empirin samlades in genom semi-strukturerade intervjuer. Vi valde att kontakta de fyra storbankernas fondbolag, två AP-fonder samt ytterligare ett fondbolag. Respondenterna som intervjuades bestod av fondförvaltare eller specialister inom hållbarhetsområdet.Resultatet av studien visar att benämningen etiska fonder är på väg bort. Branschen vill inte definiera etik istället talar man om efterträdarna, hållbara och ansvarsfulla fonder. Trots förnekelsen av etiska fonder används en liknande urvalprocess för de hållbara fonderna, därmed kvarstår den problematiken som funnits för de etiska fonderna. Den stora skillnaden idag är att fondbolagen vill agera hållbart och ansvarsfullt på alla plan, både gällande sociala- och miljömässiga aspekter.Studies resultat skiljer sig från tidigare forskning genom att den fokuserar på den etiska prestandan. Undersökningen konstaterar att etikfonderna håller på att försvinna, men ur dem har hållbara fonder fötts. Den här studien har gett ökad kunskap inom ett område som är relativt outforskat. Studien kan därför lämpligtvis användas för framtida forskning. / Sustainability and ethics are discussed all over the world. Subjects as CSR and sustainability related questions were earlier only highlighted by companies. Nowadays even the financial industry has started to focus on those questions, with the emergence of social and ethical investments.Previous research have focused on return or the selection process, very few have studied the ethical performance. This study aims to deepen the discussion about ethical funds. This is done by studying how the fund companies conduct the management of ethical funds.This study is using an abductive approach, which means that we have completed the original theory with more theory after we had done the research on the field. We have used a qualitative method and collected the empirical data by semi-structured interviews. The four largest banks fund companies of Sweden, two pension funds and one additional fund company were interviewed. The respondents were either fund managers or specialists in the area of sustainability.The results of the study show that the term ethical fund is slowly disappearing. No one of the respondents were willing to define ethics, they would rather discuss the successors sustainable- and responsible funds. Despite the denial of ethical funds, similar selection processes for sustainable funds are used as for ethical funds. The problems that have existed for the ethical funds are moving to the sustainable funds. The big difference today is that fund companies have a vision of acting responsible and sustainable at all levels, both in terms of social and environmental aspects.The results differ from previous research, since it focuses on the ethical performance. The study finds that ethical funds are disappearing as time goes by, but out of them have sustainable funds developed. This research has provided increased knowledge in an area that is relatively unexplored. The study can therefore be suitable for future research.

The Saint Louis University Mental Status (SLUMS) Examination is a relatively new brief cognitive screening measure developed for use with veterans. To date, there has been a paucity of research on its psychometric properties. Using a sample of 148 male veterans referred to a VA Mild Cognitive Impairment (MCI) Clinic for evaluation, the SLUMS’ ability to discriminate between MCI versus other diagnoses or no diagnosis was compared to results from a more comprehensive neuropsychological battery. Approximately 51% of the sample was diagnosed with MCI, 16% with Major Depressive Disorder (MDD), 17% did not meet criteria for a diagnosis, and 16% were given some other DSM-IV-TR diagnosis. The SLUMS demonstrated poor internal consistency (Cronbach’s alpha = .57), but scores were significantly correlated with scores on every neuropsychological measure, except for Trails B. Diagnostic discriminability was comparable to that of the more time intensive neuropsychological battery for discriminating between MCI and no diagnosis, and MCI and MDD. In the current sample, a cutoff score of 25 was optimal for discriminating between MCI and no diagnosis, whereas a slightly lower cutoff score of 24 is recommended for discriminating between MCI and those with MDD. Diagnostic indicators were poor for the SLUMS and the battery when discriminating between MCI and a heterogeneous group of other disorders. Possible reasons for low reliability in such a screening measure in the context of convergent validity are discussed. It is concluded that the SLUMS may be a viable brief cognitive screening measure in such veteran populations, particularly when discriminating between MCI and MDD; however, additional studies should be completed to evaluate other forms of consistency, such as test-retest reliability.

Background: Becoming a parent can elicit many emotions. For some parents, it can be a time of anxiety and depression. Fathers are not exempt from this type of depression. Paternal depression (PD) is a serious health issue with long lasting consequences for both the father and child. Unfortunately, little research has been done on PD. The research that has been done recommends routine PD screening. Methods: A cross-sectional descriptive study design was used to determine the current PD screening practices and screening tools of providers in the Tucson area. The study sample consisted of randomly selected healthcare providers. The total number of possible participants was eighty two. Participants were provided a 20 question survey to assess screening practices as well as the beliefs, attitudes, norms, and confidence of providers regarding PD screening. Results: The study found many providers routinely screen for maternal depression but few screen for PD. While providers did recognize the impact PD has on children, this belief was not enough to implement screening. Most providers were unsure if PD was serious or if PD screening and therapy were effective. Few providers had any training or education regarding PD and few were confident in their ability to screen for PD. Providers who felt confident in their ability to screen, acknowledge the USPTF recommendation for screening all adults for depression, and had positive beliefs/attitudes regarding PD screening were more likely to have incorporated screening into practice. Of those who do screen, the majority do not use a validated screening. Conclusions: Although research recommends PD screening, it has not been implemented into practice. Training and education regarding PD is also lacking. The next step in research is to implement interventions that improve screening practices among providers, increase provider confidence in screening, and increase provider's awareness about PD.

The American Academy of Pediatrics (AAP) released a statement recommending that primary care providers perform developmental screening with a standardized instrument for all 9-, 18-, 24-, or 30-month well-child visits. Despite evidence-based recommendations by the AAP, numerous pediatric practices do not currently use a standardized instrument for well-child visits. This quality improvement project aimed to determine the feasibility of implementing the Ages and Stages Questionnaire (ASQ), a validated developmental screening tool, at a pediatric primary care practice. In order to accurately assess implementation barriers and benefits, this feasibility study would have determined if the ASQ was the right fit for this pediatric practice. The first phase of implementation would have begun with the 9-month well-child visits and using the same process, later expanded to include the 18- and 24-month visits. The Plan-Do-Study-Act (PDSA) method would have provided the implementation framework for this project and the project would have been written utilizing the SQUIRE (Standards for Quality Improvement Reporting Excellence) guidelines. However, due to unforeseen complications, this project was unable to be completed as planned. Instead, this project discusses outcomes of the DNP project without data, and provides guidance and points of consideration for future implementation in pediatric primary care settings.

No description available.

No description available.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Purpose: compare the Southwestern Indigenous Cognitive Assessment (SWICA), a novel tool for screening AI older adults in Arizona, with The Montreal Cognitive Assessment (MoCA), a commonly used memory screening tool, for comparison of cultural bias. Methods: Cultural bias was assessed by retrospectively comparing coded participant responses to 16 questions about their cultural context. Intrasample variation on MoCA and SWICA tests was controlled by using the participants as their own controls. Data were analyzed using a multiple regression general linear model on SPSS software. Results: Scores on the SWICA test were independently associated with English use in the home (Beta = .396, p = .026), years of education (Beta = 335, p = .027), and ease of learning (Beta = .361, p = .029), but not age (Beta = .366, p = .054). Scores on the MoCA test were independently associated with age (Beta = ‐.491, p = .001), English use in the home (Beta = ‐.320, p = .039) , and years of education (Beta = ‐.284. p = .030), but not ease of learning (Beta = ‐.267, p = .067). Conclusions: Scores were similar on both tests (t=3.934, p=.001), and were independently associated with English use in the home and years of education. SWICA was uniquely associated with ease of learning and MoCA was uniquely associated with age. This preliminary comparison demonstrates the usefulness of SWICA, and validation of this tool is recommended.

As a barrier to metastases, cells normally undergo apoptosis after they lose contact with their extra cellular matrix or their neighbouring cells. This cell death process has been termed “anoikis”. Tumour cells that acquire malignant potential have developed mechanisms to resist anoikis and thereby survive after detachment from their primary site and while travelling through the lymphatic and circulatory systems. The understanding of the molecular regulators of anoikis resistance will allow for a better understanding of the metastatic process and the development of novel anti-metastatic therapeutics. To better determine the molecular underpinnings of anoikis resistance, we have used both chemical biology and genetic approaches. Using chemical biological approaches such as small molecule screens, we determined that both FLIP and Na+/K+ ATPase could modulate a cell’s response to anoikis. Through the use of a shRNA genome wide lentiviral screen we determined that ABHD4 was able to inhibit a cell’s response to anoikis. We also showed the importance of anoikis resistance in the ability of malignant cancer cells to survive in circulation. By decreasing a cell’s ability to resist anoikis, one is able to decrease the ability of a cancer cell to survive in circulation and form tumours in distant organs. Taken together, we have identified novel regulators of anoikis resistance and demonstrated the importance of anoikis in metastatic progression, which may lead to the development of novel treatments for metastatic cancers.

Human assessors are currently the best instruments for evaluating the sensory properties of both food and non-food consumer products. In the early stages of descriptive sensory panel training, a lexicon is still undergoing refinement and assessors are only beginning to understand the identities of sensory attributes and how to use the scale to communicate the intensity of sensations. To expedite training, the panel leader provides structure and feedback. Several statistical approaches have been proposed that indicate training status. In this thesis several approaches are reviewed, and a multistage process that involves scrubbing data, estimating parameters, reviewing fit, and exploring multivariate relationships is developed. The process reveals attribute misunderstandings, considers candidate training targets for subsequent training sessions, and explores data to better understand product properties.