International nursing students and clinical learning environments: A convergent mixed-methods study.

AIM: To acquire a comprehensive understanding of the international nursing students' clinical learning environments, comparing and contrasting qualitative and quantitative insights. BACKGROUND: The influx of international nursing students has increased in Italy and across Europe. These students, diverse in culture and language, encounter significant challenges to their education in clinical learning environments. DESIGN: convergent mixed-methods research. METHODS: Qualitative and quantitative data were collected concurrently and independently, with equal emphasis, following a QUAL-QUANT structure. Qualitative analysis used descriptive content analysis, while quantitative data were based on descriptive and correlation analyses on surveys using the CALD scale. RESULTS: Overall 96 international nursing students participated in 24 focus groups. The CALD scale mean scores ranged from 2.7 to 4.5. The qualitative analysis presented two overarching themes: factors that promote a successful clinical learning environment and factors that inhibit a successful clinical learning environment in international students. The integration of qualitative and quantitative data generated four concordant and one discordant meta-inferences about the learning environment. CONCLUSIONS: Culturally sensitive clinical learning environments are imperative for the holistic development of international nursing students. Nurse educators must cultivate transcultural competencies and pedagogical skills to enhance the competencies and skills of this student population effectively.

Barriers and enablers of women carers from culturally and linguistically diverse communities participating in physical activities.

Introduction: This research article presents a phenomenological evaluation of an organization working within disability and with CALD communities of a project that was supporting women carers who are newly arrived to Australia to be happier and healthier. The initiative aimed to alleviate social isolation, enhance wellbeing, and boost confidence among women from Culturally and Linguistically Diverse (CALD) backgrounds in Metropolitan Melbourne, Victoria. Methods: Through a qualitative exploration of the lived experiences of participants, findings were categorized into enablers and barriers, shedding light on the outcomes of physical activity participation for these women. Results and discussion: Enablers included improvements in health, skill development, achievement, and enhanced social interaction and support, while barriers encompassed challenges related to access, socio-cultural factors, resource availability, interpersonal dynamics, and physiological constraints. Based on these findings, recommendations are proposed to empower CALD community members in the co-development and co-delivery of future programs, fostering sustainability and community-driven engagement.

Emergency Department Use Following Self-Harm and Suicide Ideation: An Analysis of the Influence of Cultural and/or Linguistic Diversity Using Data From the Self-Harm Monitoring System for Victoria (2012-2019).

Self-harm and suicide ideation are global health concerns, significantly impacting culturally and linguistically diverse (CALD) populations. Emergency departments (EDs) play a role in intervening following such presentations, yet there is limited research focusing on the CALD population's use of these services in Australia. This study aimed to explore patterns in ED use for self-harm and suicide ideation, comparing CALD and non-CALD persons in terms of service use, presentation themes and likelihood of repeat presentations. This was a cross-sectional analysis of data from presentations for self-harm and suicide ideation to the ED of a major metropolitan hospital in Victoria, Australia, from 2012 to 2019. The study used thematic analysis of triage notes, recurrent event analysis and logistic and linear regressions to compare CALD and non-CALD presentations. CALD presentations comprised 1.3% (n = 202) of the total (n = 15 606). CALD presentations were more likely to occur during business hours, less likely to be triaged as urgent and more likely to result in ward admission. Occupation stressors were more common in CALD presentations. A lower likelihood of repeat presentations was observed among CALD persons. The study also highlighted the limitations of current data collection practices in capturing the full spectrum of CALD presentations. This study found variability in the recording of CALD status, warranting further investigation into how data collection in EDs may be improved. Increased ward admission rate and lower likelihood of repeat presentation by CALD persons also indicate that further research is required to understand help-seeking and clinical decision-making in the CALD population.

Comprehensive analysis to identify the relationship between CALD1 and immune infiltration in glioma.

Background: An accumulating number of studies show that CALD1 is associated with a variety of tumor microenvironments (TME) and is closely related to patients' survival. However, to the best of our knowledge, few studies examined the role of CALD1 in the immune microenvironment of glioma. The aim of this study is to investigate the potential correlation between CALD1 and the pathogenesis and progression of glioma, aiming to identify a novel therapeutic target. Methods: We assessed the role of CALD1 in pan-cancer and investigated the correlation between CALD1 and TME of glioma by bioinformatic analysis and experimental verification. Results: We found that CALD1 expression in glioma was associated with a variety of infiltrating immune cells. CALD1 can promote the development of glioma by affecting M2 macrophage infiltration. Also, we found that CALD1 was closely associated with tumor mutation burden, microsatellite instability, copy number variation, methylation, and stem cell index. Our clinical correlation study demonstrated that CALD1 was associated with overall survival, progression-free interval, and disease-specific survival in a variety of tumors. We verified the significantly high expression of CALD1 in glioma using quantitative real-time polymerase chain reaction (PCR) and Western blotting. Meanwhile, we also conducted relevant cell experiments to prove that CALD1 can affect the proliferation and migration ability of glioma cells in vitro. Conclusions: Our results confirmed that CALD1 may be a prognostic marker for glioma and a potential target for immunotherapy in the future.

Starting conversations about mental health and wellbeing in Australian culturally and linguistically diverse communities.

Australia is a multicultural nation with nearly 30% of the population born overseas. Migrants' mental health can be impacted by discrimination, racism and experiences relating to asylum and immigration. These can be compounded by low help-seeking caused by stigmatized beliefs and poor mental health literacy. My Mind, My Voice (MMMV) is a co-designed program aiming to promote awareness of mental health and wellbeing for people with a culturally and linguistically diverse (CALD) background. This research project explored the perceived impacts and value of MMMV and processes leading to those impacts. A mixture of internal quantitative and qualitative evaluation surveys (n = 32) and researcher-conducted semi-structured interviews (n = 9) were conducted with CALD organization and community members who attended training workshops, presented MMMV events or attended an event. Data were analysed using a reflexive thematic analysis approach. Five themes were developed: culturally relevant and respectful, cross-cultural connections, the importance of language, increasing confidence and literacy and the potential to change attitudes. Being involved with a co-produced program that was culturally relevant and respectful was a positive experience that enhanced people's confidence and literacy. Feeling respected, valued and validated helped participants feel empowered to develop and deliver mental health and wellbeing education in their community. Open, honest conversations are an important way to break down stigma and start conversations about mental health and wellbeing in CALD communities. Evaluation outcomes demonstrate the success of MMMV's collaborative approach, which can inform the development and evaluation of CALD mental health promotion interventions.

Searching for choice and control: Western Australian service provider experiences of health, housing and migration.

This research aimed to inform approaches to increase access to secure housing and improve mental health outcomes for migrants from culturally and linguistically diverse backgrounds (hereafter migrants) who are generally invisible in health and social policy and service provision in Western Australia. We used semi-structured, in-depth interviews (n = 11) and interpretative phenomenological analysis to explore service provider experiences and perspectives of issues impacting service provision and the needs of migrants in this context. Five superordinate themes reveal complex experiences for both service providers and the migrants with whom they work. Findings reflect tensions between contemporary notions of choice and control and a social service system that is difficult to navigate, reflects systemic racism and appears to rely heavily on the non-government sector. Insights have important and practical implications for health promotion policy, practice and research. Recommendations include improvements to housing access, provision, funding and policies; addressing service barriers via staff training and more accessible community resources; and co-design and community outreach approaches.

Suicidal Behavior of Australian Males, From an Ethnicity Perspective.

BACKGROUND: Suicide is the 10th leading cause of death among Australian males. Despite the cultural diversity in Australia, there is a significant research gap in knowledge of suicidal behavior among Australian males from ethnically and culturally diverse backgrounds. The study aimed to estimate the prevalence and risk of suicidal behaviors among Australian males based on ethnicity, with an emphasis on those from ethnic-minority backgrounds. METHODS: We used data from the first wave of the Australian Longitudinal Study on Male Health. Multiple logistic regression models were used to determine the risk of suicidal behavior (lifetime suicide attempt, lifetime suicidal ideation, recent suicidal ideation) by ethnicity. RESULTS: Among ethnic minority males, Pacific Islander males also had the highest prevalence of lifetime suicide attempts (12.2%), while Middle Eastern (2.3%) and South-/North-East Asian males (2.9%) had the lowest rates. South American males had the highest recent suicidal ideation (18.2%), followed by Pacific Islanders (14.2%). The highest prevalence of lifetime suicidal thoughts was reported among males of mixed ethnicity (23.0%), followed by South American (14.6%) and Pacific Islander (13.5%) males. Most ethnic-minority groups had a lower risk of lifetime suicidal ideation compared with Australian males. Evidence regarding differences in recent suicidal ideation and lifetime suicide attempts between ethnic-minority and Australian-background males was inconclusive. CONCLUSION: Evidence was found of differences in suicidal behaviors among Australian males based on ethnicity. Future research should use inclusive methodologies to confirm these associations and explore the underlying factors contributing to higher rates of suicidal behavior in specific populations.

Addressing disparities in health outcomes for patients with advanced pancreatic cancer and limited English proficiency.

INTRODUCTION: There are significant challenges and a lack of data related to culturally and linguistically diverse (CALD) cancer patients. We compared patient characteristics, treatment patterns, and outcomes of patients with advanced pancreatic cancer that required an interpreter. METHODS: Registry data was extracted for advanced pancreatic cancer patients from a single health institution with a comprehensive Transcultural and Language Service (TALS). Demographic and clinicopathologic characteristics were compared. Kaplan-Meier survival estimates with log-rank testing, and univariate and multivariable regression analysis were performed to compare the group with limited English proficiency (LEP) to the English proficient (EP) group. RESULTS: Of 155 patients, 32.9% (n = 51) required the TALS. The LEP group had a higher mean age (71.2 vs. 76.8 years; p = 0.005) and received less chemotherapy (42.3% vs. 31.4%, p = 0.220). Univariate analysis revealed a shorter median overall survival (OS) in the LEP group (3.6 vs. 5.0 months), with a hazard ratio [HR] of 1.51 (95% confidence interval [CI]: 1.03-2.21, p = 0.033). Upon multivariable analysis, adjusting for Eastern Cooperative Oncology Group (ECOG) performance scale, the number of sites of metastatic disease and chemotherapy use, the strength of association between LEP and OS reduced marginally (HR 1.42, 95% CI: 0.93-2.16), and was no longer statistically significant (p = 0.103). CONCLUSIONS: In patients with advanced pancreatic cancer utilizing a comprehensive TALS, there was a trend to poorer survival with limited English proficiency, although this association was not statistically significant. An ongoing research commitment to the CALD experience is necessary to build a granular understanding of this population and ensure equitable outcomes.

XTP8 Promotes Ovarian Cancer Progression by Activating AKT/AMPK/mTOR Pathway to Regulate EMT.

Ovarian cancer (OC) ranks as the fifth leading cause of cancer-related death in women. The main contributors to the poor prognosis of ovarian cancer are the high rates of recurrence and metastasis. Studies have indicated a crucial role for hepatitis B virus X Ag-Transactivated Protein 8 (XTP8), a protein containing the DEP domain, in various cellular processes, including cell growth, movement, and differentiation, across several types of cancers. However, the role of XTP8 in ovarian cancer remains unclear. We observed elevated expression of XTP8 in ovarian cancer. Silencing XTP8 inhibited cell proliferation, promoted apoptosis, and yielded contrasting results in cells overexpressing XTP8. Furthermore, XTP8 facilitated ovarian cancer invasion and migration, triggering epithelial-mesenchymal transition (EMT). Mechanistically, XTP8 silencing led to reduced phosphorylation levels of AKT, increased p-AMPK levels, and decreased p-mTOR levels, while XTP8 overexpression exerted the opposite effects. Additionally, the activation of p-AMPK rescued the promoting effect of XTP8 on EMT in ovarian cancer cell lines, indicating that XTP8 acts as an oncogene by modulating the AKT/AMPK/mTOR pathway. Through transcriptome sequencing to identify downstream targets of XTP8, we found that XTP8 influences the expression of Caldesmon (CALD1) at both transcriptional and translational levels. CALD1 can be considered a downstream target of XTP8. The collaborative action of XTP8 and CALD1 activates the AKT/AMPK/mTOR pathway, regulating EMT to promote ovarian cancer progression. Inhibiting this signaling axis might represent a potential therapeutic target for ovarian cancer.

Suicide and mortality following self-harm in Culturally and Linguistically Diverse communities in Victoria, Australia: insights from a data linkage study.

Background: While cultural backgrounds are well-documented to be relevant to intentional self-harm, little is known about how cultural and linguistically diverse (CALD) backgrounds affect mortality outcomes following self-harm. Aim: This study aimed to compare the risk of all-cause mortality and suicide after intentional hospital admissions for self-harm among people from CALD (vs. non-CALD) backgrounds. Method: Linked hospital and mortality data in Victoria, Australia, was used to assess suicide and all-cause death after hospital admissions for self-harm among patients aged 15+ years. All-cause death was identified by following up on 42,122 self-harm patients (hospitalized between 01 July 2007 and 30 June 2019) until death or 15 February 2021. Suicide death was evaluated in 16,928 self-harm inpatients (01 January 2013 and 31 December 2017) until death or 28 March 2018. Cox regression models were fitted to compare mortality outcomes in self-harm patients from CALD vs. non-CALD backgrounds. Outcomes: During the follow-up periods, 3,716 of 42,122 (8.8%) participants died by any cause (by 15 February 2021), and 304 of 16,928 (1.8%) people died by suicide (by 28 March 2018). Compared to the non-CALD group, CALD intentional self-harm inpatients had a 20% lower risk of all-cause mortality (HR: 0.8, 95% CI: 0.7-0.9) and a 30% lower risk of suicide (HR: 0.7, 95% CI: 049-0.97). Specifically, being from North Africa/Middle East and Asian backgrounds lowered the all-cause mortality risk; however, the suicide risk in Asians was as high as in non-CALD people. Conclusion: Overall, people from CALD backgrounds exhibited lower risks of all-cause mortality and suicide following hospital admission for self-harm compared to the non-CALD group. However, when comparing risks based on regions of birth, significant variations were observed. These findings underscore the importance of implementing culturally tailored background-specific suicide preventive actions. The study focussed on outcomes following hospital admission for self-harm and did not capture outcomes for cases of self-harm that did not result in hospital admission. This limits generalisability, as some CALD people might avoid accessing healthcare after self-harm due to cultural factors. Future research that not limited to hospital data is suggested to build on the results.

CALD1 facilitates epithelial-mesenchymal transition progression in gastric cancer cells by modulating the PI3K-Akt pathway.

BACKGROUND: CALD1 has been discovered to be abnormally expressed in a variety of malignant tumors, including gastric cancer (GC), and is associated with tumor progression and immune infiltration; however, the roles and mechanisms of CALD1 in epithelial-mesenchymal transition (EMT) in GC are unknown. AIM: To investigate the role and mechanism of CALD1 in GC progression, invasion, and migration. METHODS: In this study, the relationship between CALD1 and GC, as well as the possible network regulatory mechanisms of CALD1, was investigated by bioinformatics and validated by experiments. CALD1-siRNA was synthesized and used to transfect GC cells. Cell activity was measured using the CCK-8 method, cell migration and invasive ability were measured using wound healing assay and Transwell assay, and the expression levels of relevant genes and proteins in each group of cells were measured using qRT-PCR and Western blot. A GC cell xenograft model was established to verify the results of in vitro experiments. RESULTS: Bioinformatics results showed that CALD1 was highly expressed in GC tissues, and CALD1 was significantly higher in EMT-type GC tissues than in tissues of other types of GC. The prognosis of patients with high expression of CALD1 was worse than that of patients with low expression, and a prognostic model was constructed and evaluated. The experimental results were consistent with the results of the bioinformatics analysis. The expression level of CALD1 in GC cell lines was all higher than that in gastric epithelial cell line GES-1, with the strongest expression found in AGS and MKN45 cells. Cell activity was significantly reduced after CALD1-siRNA transfection of AGS and MKN45 cells. The ability of AGS and MKN45 cells to migrate and invade was reduced after CALD1-siRNA transfection, and the related mRNA and protein expression was altered. According to bioinformatics findings in GC samples, the CALD1 gene was significantly associated with the expression of members of the PI3K-AKT-mTOR signaling pathway as well as the EMT signaling pathway, and was closely related to the PI3K-Akt signaling pathway. Experimental validation revealed that upregulation of CALD1 increased the expression of PI3K, p-AKT, and p-mTOR, members of the PI3K-Akt pathway,while decreasing the expression of PTEN; PI3K-Akt inhibitor treatment decreased the expression of PI3K, p-AKT, and p-mTOR in cells overexpressing CALD1 (still higher than that in the normal group), but increased the expression of PTEN (still lower than that in the normal group). CCK-8 results revealed that the effect of CALD1 on tumor cell activity was decreased by the addition of the inhibitor. Scratch and Transwell experiments showed that the effect of CALD1 on tumor cell migration and invasion was weakened by the addition of the PI3K-Akt inhibitor. The mRNA and protein levels of EMT-related genes in AGS and MKN45 cells were greatly altered by the overexpression of CALD1, whereas the effect of overexpression of CALD1 was significantly weakened by the addition of the PI3K-Akt inhibitor. Animal experiments showed that tumour growth was slow after inhibition of CALD1, and the expression of some PI3K-Akt and EMT pathway proteins was altered. CONCLUSION: Increased expression of CALD1 is a key factor in the progression, invasion, and metastasis of GC, which may be associated with regulating the PI3K-Akt pathway to promote EMT.

Unraveling the mechanism in l-Caldesmon regulating the osteogenic differentiation of PDLSCs: An innovative perspective.

Maxillofacial bone defect is one of the common symptoms in maxillofacial, which affects the function and aesthetics of maxillofacial region. Periodontal ligament stem cells (PDLSCs) are extensively used in bone tissue engineering. The mechanism that regulates the osteogenic differentiation of PDLSCs remains not fully elucidated. Previous studies demonstrated that l-Caldesmon (l-CALD, or CALD1) might be involved in the osteogenic differentiation of PDLSCs. Here, the mechanism by which CALD1 regulates the osteogenic differentiation of PDLSCs is investigated. The osteogenic differentiation of PDLSCs is enhanced with Cald1 knockdown. Whole transcriptome sequencing (RNA-seq) analysis shows that bone morphogenetic proteins (BMP) signaling pathway and Wingless type (Wnt) pathway have significant change with Cald1 knockdown, and the expressions of Wnt-induced secreted protein 1 (WISP1), BMP2, Smad1/5/9, and p-Smad1/5/9 are significantly upregulated, while Glycogen synthase kinase 3ß (GSK3ß) and p-GSK3ß are downregulated. In addition, subcutaneous implantation in nude mice shows that knockdown of Cald1 enhances the osteogenic differentiation of PDLSCs in vivo. Taken together, this study demonstrates that knockdown of Cald1 enhances the osteogenic differentiation of PDLSCs by BMP and Wnt signaling pathways, and provides a novel approach for subsequent clinical treatment.

Piloting a language translation device for Mandarin-speaking patients presenting for radiotherapy treatment-assessing patient and radiation therapist perspectives.

PURPOSE: Culturally and linguistically diverse (CALD) cancer patients report unmet informational and emotional needs when receiving radiotherapy (RT). This feasibility study aimed to evaluate the clinical use of an instant translation device (ITD) to facilitate communication between Mandarin-speaking patients and radiation therapists (RTTs) within the Australian public RT setting. The primary aim was to assess the ability to convey information relating to daily patient care and build rapport using the device. METHODS: A single-arm prospective interventional trial was employed with patient and RTT participants. Eligible patient participants were aged 18 years or older, diagnosed with cancer, referred for RT with self-reported Mandarin as the primary language spoken at home. Patients who had previously received RT were excluded. Consenting patient participants completed a baseline assessment of health literacy (REALM-SF) and English proficiency (LexTALE). Surveys were administered to patients and consenting RTTs at the cessation of treatment, forming two distinct participant groups. Descriptive statistics were used to compare participant groups. RESULTS: Eleven patients and 36 RTTs were recruited to the study. Descriptive statistics demonstrated participant group agreement in conveying treatment instructions, though differing experiences were reported against general conversation. Although the reporting of technical difficulties was inconsistent, both groups recommended the application of the ITD within the RT domain. CONCLUSION: This feasibility study demonstrated encouraging accounts of patients and RTTs with regard to ITD use in the context of RT treatment. Expanded, multi-institutional recruitment is required to yield statistical significance, inform the impact of the device, and determine requisite training requirements. TRIAL REGISTRATION: HREC reference number: LNR/18/PMCC/115 (18/100L). HREC approval date: 10 July 2018.

Upregulation of CALD1 predicted a poor prognosis for platinum-treated ovarian cancer and revealed it as a potential therapeutic resistance target.

BACKGROUND: Ovarian cancer (OC) has the worst prognosis among gynecological malignancies, most of which are found to be in advanced stage. Cell reduction surgery based on platinum-based chemotherapy is the current standard of treatment for OC, but patients are prone to relapse and develop drug resistance. The objective of this study was to identify a specific molecular target responsible for platinum chemotherapy resistance in OC. RESULTS: We screened the protein-coding gene Caldesmon (CALD1), expressed in cisplatin-resistant OC cells in vitro. The prognostic value of CALD1 was evaluated using survival curve analysis in OC patients treated with platinum therapy. The diagnostic value of CALD1 was verified by drawing a Receiver Operating Characteristic (ROC) curve using clinical samples from OC patients. This study analyzed data from various databases including Gene Expression Omnibus (GEO), Human Protein Atlas (HPA), The Cancer Cell Line Encyclopedia (CCLE), The Cancer Genome Atlas (TCGA), GEPIA 2, UALCAN, Kaplan-Meier (KM) plotter, LinkedOmics database, and String. Different expression genes (DEGs) between cisplatin-sensitive and cisplatin-resistant cells were acquired respectively from 5 different datasets of GEO. CALD1 was selected as a common gene from 5 groups DEGs. Online data analysis of HPA and CCLE showed that CALD1 was highly expressed in both normal ovarian tissue and OC. In TCGA database, high expression of CALD1 was associated with disease stage and venous invasion in OC. Patients with high CALD1 expression levels had a worse prognosis under platinum drug intervention, according to Kaplan-Meier (KM) plotter analysis. Analysis of clinical sample data from GEO showed that CALD1 had superior diagnostic value in distinguishing patients with platinum "resistant" and platinum "sensitive" (AUC = 0.816), as well as patients with worse progression-free survival (AUC = 0.741), and those with primary and omental metastases (AUC = 0.811) in ovarian tumor. At last, CYR61 was identified as a potential predictive molecule that may play an important role alongside CALD1 in the development of platinum resistance in OC. CONCLUSIONS: CALD1, as a member of cytoskeletal protein, was associated with poor prognosis of platinum resistance in OC, and could be used as a target protein for mechanism study of platinum resistance in OC.

Identifying Longer-Term Health Events and Outcomes and Health Service Use of Low Birthweight CALD Infants in Australia.

INTRODUCTION: Approximately one-third of all births in Australia each year are by culturally and linguistically diverse (CALD) women. CALD women are at an increased risk of adverse pregnancy and birth outcomes including prematurity and low birthweight. Infants born weighing less than 2500 g are susceptible to increased risk of ill health and morbidities such as cognitive defects including cerebral palsy, and neuro-motor functioning. METHODS: An existing linked administrative dataset, Maternity 1000 was utilized for this study which has identified all children born in Queensland (QLD), Australia, between 1st July 2012 to 30th June 2018 from the QLD Perinatal Data Collection. This has then been linked to the QLD Hospital Admitted Patient Data Collection, QLD Hospital Non-Admitted Patient Data Collection, QLD Emergency Department Data Collection, and Medicare Benefits Schedule and Pharmaceutical Benefits Scheme Claims Records between 1 and 2012 to 30th June 2019. RESULTS: Culturally and linguistically diverse infants born with low birthweight had higher mean and standard deviation of all health events and outcomes; potentially preventable hospitalisations, hospital re-admissions, ED presentations without admissions, and development of chronic diseases compared to non-CALD infants born with low birthweight. DISCUSSION: Results from this study highlight the disparities in health service use and health events and outcomes associated with low birthweight infants, between both CALD and Australian born women. This study has responded to the knowledge gap of low birthweight on the Australian economy by identifying that there are significant inequalities in access to health services for CALD women in Australia, as well as increased health events and poor birth outcomes for these infants when compared to those of mothers born in Australia.

Examination of Physical Activity, Organized Sport, and Sitting Time Among Women and Mothers From Culturally and Linguistically Diverse Backgrounds.

BACKGROUND: Little evidence is available from culturally and linguistically diverse (CALD) communities on the association between motherhood and physical activity (PA). This study aimed to examine independent and joint associations of cultural background and motherhood with meeting PA guidelines, participation in organized sports, and high sitting time (>8 h/d). METHODS: We used self-reported cross-sectional data from survey 8 of the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health. PA was measured using the Active Australia Survey while organized sport and sitting time were measured using single items. CALD was defined as being born in a non-English speaking country or primarily speaking a non-English language at home. Multivariable-adjusted logistic regression analyses were used to examine independent and joint associations. RESULTS: Data from 5967 women (mean age 42.4 [SD 1.5] y, 6.9% CALD, 81.2% mothers) were analyzed. Women of CALD background had lower odds of meeting PA guidelines (odds ratio; 95% confidence interval: 0.80; 0.64-0.98) and participation in organized sports (0.68; 0.54-0.86), but no statistically significant association with sitting time (0.90; 0.72-1.14). Mothers had lower odds of meeting PA guidelines (0.75; 0.64-0.87) and high sitting time (0.42; 0.36-0.49). Compared with non-CALD women without children, mothers (irrespective of cultural background) were less likely to meet PA guidelines and have high sitting time. The association of "cultural background and motherhood" with organized sports participation was only significant for CALD mothers. CONCLUSIONS: Increased efforts and investments are needed to ensure that sports and other PA promotion interventions are culturally sensitive and engaging for CALD women and those with children.

How do universities support communication skills for clinical placements with culturally and linguistically diverse students? A scoping review.

AIM: The aim of this scoping review was to examine and synthesise contemporary research on clinical communication interventions for tertiary students from a culturally and linguistically diverse background enrolled in a health professional qualification. BACKGROUND: Clinical communication competence is essential to high quality healthcare and thus is a critical component of all health professional education. The rise in tertiary students from non-English speaking backgrounds in Australia and many other countries has escalated concern over the communication skills required for success in clinical placements and future practice as a health professional. DESIGN: A scoping review was conducted using Arskey and O'Malley's methodological framework. METHODS: The search targeted journal articles published in English between 2010 and 2022 in the databases Medline, CINAHL, ProQuest, Scopus, and Google Scholar. A total of 105 full texts were independently reviewed by the team of researchers, and hand-searching of the references in these studies was conducted. Eighteen articles were eligible for inclusion. RESULTS: The majority of studies involved a small scale (<30 participants) intervention with nursing students in Australian universities. A small number of studies involved medical, physiotherapy and dentistry students. Most interventions were a voluntary face-to-face workshop(s) focused on experiential learning of either literacy-based skills (reading and writing) or communication skills for specific clinical procedures. Self-reported outcomes were the most commonly cited outcome measure. CONCLUSIONS: While a critical appraisal was not conducted, concerns over the quality of the research were highlighted, and most interventions were not replicable due to the lack of detail provided. Further research to address the gaps in current knowledge identified in this review is warranted.

IPSC-Derived Astrocytes to Model Neuroinflammatory and Metabolic Responses in X-linked Adrenoleukodystrophy.

X-linked adrenoleukodystrophy (X-ALD) is an inherited metabolic disorder caused by pathogenic variants in the ABCD1 gene, leading to accumulation of saturated very long chain fatty acids (VLCFA) in body fluids and tissues including brain and spinal cord. In the absence of a clear genotype-phenotype correlation the molecular mechanisms of the fatal cerebral adrenoleukodystrophy (cALD) and the milder adrenomyeloneuropathy (AMN) phenotypes remain unknown. Given our previous evidence of role of astrocytes in the neuroinflammatory response in X-ALD we investigated the metabolic and molecular profiles of astrocytes derived from induced pluripotent stem cells (iPSC). The iPSCs were in turn generated from skin fibroblasts of healthy controls and patients with AMN or cALD. AMN and cALD astrocytes exhibited lack of ABCD1 and accumulation of VLCFA, a biochemical hallmark of X-ALD disease. Accumulation of VLCFA was significantly higher in cALD astrocytes. Mitochondrial function analysis by Seahorse extracellular flux identified increased oxygen consumption and extracellular acidification rates in cALD astrocytes, yet the ATP levels were decreased. Molecular signaling identified increased phosphorylation of STAT3 in cALD astrocytes, and higher proinflammatory cytokine and Toll like receptor (TLR) expression. CRISPR-Cas9 knock-in of functional ABCD1 gene expression differentially affected the expression of key molecular and metabolic targets in AMN and cALD astrocytes. AMN and cALD iPSC-derived astrocytes and their isogenic controls demonstrate differential aspects of X-ALD metabolic and inflammatory response to ABCD1 mutation and can be further utilized for exploring the contribution of iPSC-derived astrocytes to differential X-ALD disease pathology.

Does the requirement for an interpreter impact experience with telehealth modalities, acceptability and trust in telehealth? Results from a national survey including people requiring interpreter services.

We aimed to assess if experience with telehealth modalities, acceptability and levels of trust in telehealth vary with the need for an interpreter using a cross-sectional survey of telehealth consumers in Australia. Non-parametric tests were used to compare the means and percentages between those who required an interpreter and those who did not. A total of N = 1,116 completed the survey; 5% (n = 56) represented people needing an interpreter for telehealth services. Of those needing interpreters, 14.29% had experienced only phone consultations whereas 63.21% of those who did not need interpreters had experienced only phone consultations. Trust in telehealth with allied health professionals was significantly higher among people needing interpreters (mean 4.12 ± 1.02) than those with no interpreter required (mean 3.70 ± 1.30), p = 0.03. People requiring interpreters had non-significantly higher acceptability towards video consultation than those who did not (mean 3.60 ± 0.61 vs mean 3.51 ± 0.80, p = 0.42), similar to telephone consultations (mean 3.71 ± 0.95 vs mean 3.48 ± 0.79, p = 0.38). The need for interpreters does not appear to impact acceptability or trust in telehealth with doctors. However, experience with telehealth modalities and trust in telehealth with allied health varied significantly among groups. Increasing exposure to telehealth modalities, trust and acceptability is crucial to promote equitable access to telehealth.

MiR-1278 targets CALD1 and suppresses the progression of gastric cancer via the MAPK pathway.

This study aimed to investigate the interaction between miR-1278 and Caldesmon (CALD1) in gastric cancer (GC) and the regulatory mechanism. In both GC cells and tissues, the levels of CALD1, miR-1278, migration-related markers (E-cadherin, N-cadherin, and Snail), and MAPK signaling pathway-related proteins were clarified using quantitative real-time PCR and western blotting analyses. The effects of miR-1278 and CALD1 on GC cell viability and migration were analyzed using CCK-8 and Transwell assays, respectively. The targeting effect of miR-1278 on CALD1 was investigated using bioinformatics prediction and a dual luciferase reporter assay. The effect of miR-1278 on tumor growth was estimated in vivo using a tumor xenograft assay. In GC, miR-1278 expression decreased, whereas CALD1 was highly expressed. Transfecting an miR-1278 mimic into cells inhibited the viability as well as migration of GC cells, and suppressed Ras, phosphorylated (p)-P38, and p-ERK1/2 protein levels. Moreover, miR-1278 targeted and negatively regulated CALD1 expression. CALD1 overexpression promoted GC cell survival and migration and activated the MAPK pathway. Treatment with an miR-1278 mimic partially rescued the changes caused by CALD1 overexpression. Overall, our study revealed that miR-1278 suppresses the malignant behavior of GC cells by targeting CALD1 and regulating the MAPK pathway.