An examination of how to engage migrants in the research process: building trust through an 'insider' perspective.

Introduction: Ensuring all members of society can equally participate in research and the provision of services is a challenging goal. Increased migration has been mirrored by media narratives of social threat, leaving many migrants feeling differentiated and distrustful of mainstream society.Objectives: We explore how migrant and ethnic minority populations can be given the opportunity to participate in the research process. In this work, we iteratively and jointly developed a range of engagement strategies that adopt an 'insider' approach; seeking to eliminate feelings of differentiation and 'otherness' by establishing mutual trust.Design: Recruitment activities were carried out with 8 focus groups of first-generation South Asian migrants (the largest ethnic minority group in England). Our analysis was grounded in the broad principles of action research with reflective evaluation of our recruitment process using field observations and relevant focus group data; asking whether we tackled barriers to engagement.Results: Our findings show that 'otherness' can be reduced by establishing a trustworthy researcher-community relationship, but also that this relationship is complex, and needs to acknowledge residual mistrust. Alongside, researchers need to enable opportunities for empowered interaction, with flexible strategies to negotiate potential power divides.Conclusions: We can successfully create opportunities for engagement but there is no 'one size fits all'. Engagement requires tailored approaches that embrace flexibility, and position both engagement and non-engagement as positive and empowered choices.

Direct evidence of milk consumption from ancient human dental calculus.

Milk is a major food of global economic importance, and its consumption is regarded as a classic example of gene-culture evolution. Humans have exploited animal milk as a food resource for at least 8500 years, but the origins, spread, and scale of dairying remain poorly understood. Indirect lines of evidence, such as lipid isotopic ratios of pottery residues, faunal mortality profiles, and lactase persistence allele frequencies, provide a partial picture of this process; however, in order to understand how, where, and when humans consumed milk products, it is necessary to link evidence of consumption directly to individuals and their dairy livestock. Here we report the first direct evidence of milk consumption, the whey protein ß-lactoglobulin (BLG), preserved in human dental calculus from the Bronze Age (ca. 3000 BCE) to the present day. Using protein tandem mass spectrometry, we demonstrate that BLG is a species-specific biomarker of dairy consumption, and we identify individuals consuming cattle, sheep, and goat milk products in the archaeological record. We then apply this method to human dental calculus from Greenland's medieval Norse colonies, and report a decline of this biomarker leading up to the abandonment of the Norse Greenland colonies in the 15(th) century CE.

ATRA and the specific RARα agonist, NRX195183, have opposing effects on the clonogenicity of pre-leukemic murine AML1-ETO bone marrow cells.

All-trans retinoic acid (ATRA) is used successfully in the treatment of acute promyelocytic leukemia (APL). ATRA enhances hematopoietic stem cell self-renewal through retinoic acid receptor (RAR)γ activation while promoting differentiation of committed myeloid progenitors through RARα activation. Its lack of success in the treatment of non-APL acute myeloid leukemia (AML) may be related to ATRA's non-selectivity for the RARα and RARγ isotypes, and specific RARα activation may be more beneficial in promoting myeloid differentiation. To investigate this hypothesis, the effects of ATRA and the specific RARα agonist NRX195183 was assessed in AML1-ETO (AE)-expressing murine bone marrow (BM) progenitors. ATRA potentiated the in vitro clonogenicity of these cells while NRX195183 had the opposite effect. Morphological and flow cytometric analysis confirmed a predominantly immature myeloid population in the ATRA-treated AE cells while the NRX195183-treated cells demonstrated an increase in the mature myeloid population. Similarly, NRX195183 treatment promoted myeloid differentiation in an AE9a in vivo murine model. In the ATRA-treated AE cells, gene expression analyses revealed functional networks involving SERPINE1 and bone morphogenetic protein 2; AKT phosphorylation was upregulated. Collectively, these findings confirm the contrasting roles of specific RARα and RARγ activation in the clonogenicity and differentiation of AE cells with potential significant implications in the treatment of non-APL AML using a specific RARα agonist.

SYSTEMS: School-Years Screening Test for the Evaluation of Mental Status.

This paper introduces the School-Years Screening Test for Evaluation of Mental Status (SYSTEMS). It was designed to be used by neurologists, pediatricians, and other health professionals assessing children with suspected cognitive problems or changes. SYSTEMS was initially based on the adult Mini-Mental State Examination developed by Folstein, Folstein, and McHugh in 1975. SYSTEMS is a 7- to 12-minute, one-on-one interview test containing 46 items for use in children between 5 and 12 years of age. Although a full diagnosis cannot be made, the results do provide an indication of whether to send a child for further detailed cognitive assessment. The development of SYSTEMS comprised seven studies with a total of 1207 children involved from Sydney primary schools and neurology clinics of the New Children's Hospital, Westmead, New South Wales, Australia. All children were administered the SYSTEMS. Some of the children also were administered the Stanford-Binet Intelligence Test, 4th edition, or the Differential Ability Scales. Results showed that the SYSTEMS was internally consistent, unbiased by sex, socioeconomic indicators, or language groups; discriminated well by age; and strongly correlated (r = 0.88) with mental age. No significant differences in results obtained by two trained administrators were evident and no indication of apparent practice effect was found. The SYSTEMS was found to have desirable levels of sensitivity (83% and 92%), specificity (76% and 95%), and likelihood ratio for cognitive impairment (3.63 and 17.5) when compared with neurologic judgments and the Differential Ability Scales, respectively.

Preventation of thalassemia in Australia.

Screening for thalassemia and other hemoglobinopathies in the major maternity hospitals in Melbourne, Australia has shown that 6% of the patient population carries a clinically significant genetic abnormality. The most common of these are beta-thalassemia (3%). HbS (1.8%), HbE (0.5%) and alpha0 thalassemia (0.4%). Approximately 60 prenatal diagnoses for the clinically significant combinations of these abnormal genes are performed annually in the 2 major centers of Melbourne and Sydney. The majority of these prenatal diagnoses are for beta-thalassemia major (65%). whilst 11% are for Bart's hydrops fetalis, 8% for HbE/beta-thalassemia. 6% for HbS/beta-thalassemia, 2% for sickle cell anemia and the remaining 8% for other combinations of thalassemia/hemoglobinopathies. Of the 178 patients with beta-thalassemia major, sickle cell disease or beta-thalassemia in combination with HbE or HbS, only 5 are less than 5 years old, reflecting both the success of the screening program and the increasing acceptance by couples of 1st trimester prenatal diagnosis.

Evaluation of hemoglobin A2 quantitation assay and hemoglobin variant screening by capillary electrophoresis.

To critically assess the method of capillary electrophoresis, we examined 97 clinical samples submitted for hemoglobin electrophoresis by both conventional methods (electrophoresis on cellulose acetate and citrate agar for detection of abnormal variants, ion-exchange chromatography for quantification of HbA2, alkali denaturation for quantification of HbF, supravital stains for detection of HbH) and CE. CE was performed using a 72 cm (50 cm to detector) x 50 microns i.d. fused-silica capillary with detection of absorbance at 200 nm. Of the 97 samples examined, 34 contained a hemoglobin variant. Migration time, the difference of the variant peak to that of HbA, was used in an attempt to identify the hemoglobin variant by CE. We found the method to be suitable for the quantification of HbA2, useful as a screening technique for the presence of hemoglobin variants, but unsuitable for the quantification of HbF.

Hb Footscray or alpha 133(H16) Ser-->Arg: a new hemoglobin variant.

Hb Footscray, alpha 133(H16) Ser-->Arg, is a newly described hemoglobin variant found in an adult male of Polish-Hungarian descent. Hematological data and stability by the isopropanol stability test were normal. The abnormal hemoglobin comprised 15% of total hemoglobin and migrated as a split band in the Hb F position on cellulose acetate at pH 8.6. Like Hb Manitoba, which is also a Ser-->Arg mutation and occurs in a very similar spatial position, the split bands presumably arise from the formation of asymmetric hybrids between Hb Footscray and Hb A.

Direct detection of beta thalassemic mutations: use of biotin-labelled allele specific probes.

Mutations at positions beta IVS1-6, beta IVS1-110, and beta 39 of the beta globin gene are responsible for the three most common thalassemic genes in the Mediterranean population. The polymerase chain reaction (PCR) was employed to amplify a 536 base pair segment surrounding this region. Nonradioactive labelling of an oligonucleotide probe, specific for the beta IVS1-110 mutation, was achieved by incorporation of biotin-16-dUTP into a standard 3'-end labelling procedure. This probe was subsequently hybridized with the PCR amplification product and permitted detection of the mutant gene in a homozygous beta thalassemic child by a simple colour detection method using a streptavidin-alkaline phosphatase conjugate and NBT/BCIP (nitroblue tetrazolium/5-bromo-4-chloro-3-indolyl phosphate) substrate. A known cloned mutant gene was similarly detected. Results could be obtained within 48 hr. These findings suggest that such an approach could provide a rapid and specific means for detection of beta thalassemic mutations without the need for radioactive probes.

Recognition of abstract and concrete words in a dichotic listening paradigm.

A dichotic listening paradigm was used to examine the hypothesis that whilst concrete nouns can be processed equally well by both right and left hemispheres, the left hemisphere is superior in processing abstract nouns. Although simple main effects of word frequency, ear of presentation, sex of subject and concreteness / abstractness were significant and in the expected directions, further fine-grained analyses using in particular the laterality coefficient showed that only about a third of the subjects showed a clear right ear advantage, and that this was not related to any of the independent variables. There was no evidence supporting differential hemispheric processing of concrete and abstract words and it is suggested that methods of data analysis used in this kind of research need to be carefully examined.