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Lutein exerts the cardioprotective influence up against the trial and error style of isoprenaline-induced myocardial infarction through MIAT/miR-200a/Nrf2/TXINP path.
We also identify a unique protospacer adjacent motif (PAM) that facilitates site-specific cleavage of the NRF2 gene present only in tumor genomes. Implications Our results begin to set a scientifically meritorious foundation for the exploitation of CRISPR-directed gene editing as an augmentative therapy for lung cancer and other solid tumors. Copyright ©2020, American Association for Cancer Research.BACKGROUND Type 2 diabetes mellitus (T2DM) is a demanding condition that impacts the person living with the condition physically and psychologically. Promoting emotional support is a key strategy to improve diabetes care. AIM To explore the views and experiences of people with T2DM and healthcare professionals (HCPs) on emotional support in diabetes care, and identify barriers and facilitators to the provision of emotional support in clinical practice. DESIGN & SETTING A qualitative study in England with data collected from four focus groups. METHOD Focus group discussions were conducted with people with T2DM (n = 10) and HCPs (n = 10). The analysis was informed by the framework method and principles of the constant comparative approach. RESULTS Emotional support was lacking in diabetes primary care, and there was a need to normalise the emotional impact of T2DM. Barriers to emotional support included lack of HCP confidence to discuss emotional issues; lack of counselling training; and time constraints in consultations. Inappropriate use of the word 'depression' creates a sense of taboo for those experiencing emotions other than depression. CONCLUSION Consensus between the two target groups indicated a strong need to integrate emotional support in diabetes care, and the need to support and train HCPs in addressing psychosocial aspects of T2DM. Shared language is recommended across diabetes services to appropriately refer to wellbeing. Addressing barriers and considering ways to incorporate emotional management in diabetes consultations is recommended, includings introducing HCP training to increase confidence and enhance counselling skills. Copyright © 2020, The Authors.BACKGROUND Many countries have insufficient numbers of family doctors, and more females than males leave the workforce at a younger age or have difficulty sustaining careers. Understanding the differing attitudes, pressures, and perceptions between genders toward their medical occupation is important to minimise workforce attrition. AIM To explore factors influencing the resilience of female family doctors during lifecycle transitions. DESIGN & SETTING International qualitative study with female family doctors from all world regions. METHOD Twenty semi-structured online Skype interviews, followed by three focus groups to develop recommendations. Data were transcribed and analysed using applied framework analysis. RESULTS Interview participants described a complex interface between competing demands, expectations of their gender, and internalised expectations of themselves. Systemic barriers, such as lack of flexible working, excessive workload, and the cumulative impacts of unrealistic expectations impair likely to be of interest to all health professional staff of any gender. Copyright © 2020, The Authors.BACKGROUND Policymakers are directing attention to addressing the needs of an ageing population. Since 2017, general practices in England have been contractually required to identify and code 'frailty' as a new clinical concept and, in doing so, support targeted management for this population with the aim of improving outcomes. However, embedding frailty policies into routine practice is not without challenges and little is currently known about the success of the programme. AIM To explore the implementation of a national policy on frailty identification and management in English primary care. DESIGN & SETTING Qualitative study entailing interviews with primary care professionals in the North of England. METHOD Semi-structured interviews were conducted with GPs (n = 10), nurses (n = 6), practice managers (n = 3), and health advisors (n = 3). Normalisation process theory (NPT) and 'system thinking' provided sensitising frameworks to support data collection and analysis. RESULTS Primary care professionals were starting to use the concept of frailty to structure care within practices and across organisations; however, there was widespread concern about the challenge of providing expanded care for the identified needs with existing resources. Concerns were also expressed around how best to identify the frail subpopulation and the limitations of current tools for this, and there was a professional reticence to use the term 'frailty' with patients. CONCLUSION Findings suggests that additional, focused resources and the development of a stronger evidence base are essential to facilitate professional engagement in policies to improve the targeted coding and management of frailty in primary care. Copyright © 2020, The Authors.BACKGROUND Video consultation (VC) is an emerging consultation mode in general practice. The challenges and benefits of implementing it are not necessarily realised until it is in use, and being experienced by patients and clinicians. To date, there has been no review of the evidence about how patients and clinicians experience VC in general practice. AIM The study aimed to explore both patients' and clinicians' experiences of VCs in primary care. DESIGN & SETTING A systematic scoping review was carried out of empirical studies. METHOD All major databases were searched for empirical studies of any design, published from 1 January 2010 to 11 October 2018 in the English language. Pyrotinib order Studies were included where synchronous VCs occurred between a patient and a clinician in a primary care setting. Outcomes of interest related to experience of use. The quality of included studies were assessed. Findings were analysed using narrative synthesis. RESULTS Seven studies were included in the review. Patients reported being satisfied with VC, describing reduced waiting times and travel costs as a benefit. For patients and clinicians, VC was not deemed appropriate for all presentations and all situations, and a face-to-face consultation was seen as preferable where this was possible. CONCLUSION The findings of this scoping review show that primary care patients and clinicians report both positive and negative experiences when using VCs, and these experiences are, to a certain extent, context dependent. VC is potentially more convenient for patients, but is not considered superior to a face-to-face consultation. Accounts of experience are useful in the planning and implementation of any VC service. Copyright © 2020, The Authors.
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