Transcriptomic Analysis of Alzheimer's Disease Pathways in a Pakistani Population.

Background: Alzheimer's disease (AD) is a multifactorial neurodegenerative disorder that is most prevalent in elderly individuals, especially in developed countries, and its prevalence is now increasing in developing countries like Pakistan. Objective: Our goal was to characterize key genes and their levels of expression and related molecular transcriptome networks associated with AD pathogenesis in a pilot case-control study in a Pakistani population. Methods: To obtain the spectrum of molecular networks associated with pathogenesis in AD patients in Pakistan (comparing cases and controls), we used high-throughput qRT-PCR (TaqMan Low-Density Array; n = 33 subjects) coupled with Affymetrix Arrays (n = 8) and Ingenuity Pathway Analysis (IPA) to identify signature genes associated with Amyloid processing and disease pathways. Results: We confirmed 16 differentially expressed AD-related genes, including maximum fold changes observed in CAPNS2 and CAPN1. The global gene expression study observed that 61% and 39% of genes were significantly (p-value 0.05) up- and downregulated, respectively, in AD patients compared to healthy controls. The key pathways include, e.g., Amyloid Processing, Neuroinflammation Signaling, and ErbB4 Signaling. The top-scoring networks in Diseases and Disorders Development were Neurological Disease, Organismal Injury and Abnormalities, and Psychological Disorders. Conclusions: Our pilot study offers a non-invasive and efficient way of investigating gene expression patterns by combining TLDA and global gene expression method in AD patients by utilizing whole blood. This provides valuable insights into the expression status of genes related to Amyloid Processing, which could play potential role in future studies to identify sensitive, early biomarkers of AD in general.

Sociocultural and patient-health care professional related factors influencing self-management of multiethnic patients with multimorbidities: A thematic synthesis.

Self-management is critical for the general well-being and disease management of individuals with multimorbidities. A better understanding of sociocultural and patient-professional level factors affecting self-management can be valuable for designing individual and community-based strategies to promote optimal self-management. The purpose of this review was to explore sociocultural and patient-health care professional related factors affecting self-management among patients with multimorbidities. A metasynthesis was conducted. Literature was searched in PubMed, CINAHL, Scopus, Web of Science, and OVID databases. In total, 21 qualitative studies published from January 2010-March 2023 were critically appraised and reviewed. Thematic synthesis was used for analysis and eight descriptive and three analytical themes were generated. The analytical themes illustrated that personal and structural vulnerabilities, social and family struggles, and fragmented interpersonal relationships with health care professionals affect health care access, navigation, and self-management of individuals with multimorbidities. Engagement in self-management for individuals with multiple chronic conditions is hampered by under-resourced community and health care environments, structural vulnerabilities, familial and interpersonal conflicts, and disjointed relationships. There is a dire need to ensure optimal community resources to support individuals to address and navigate complexities associated with accessing care and effectively managing their illnesses.

BioClay nanosheets infused with GA3 ameliorate the combined stress of hexachlorobenzene and temperature extremes in Brassica alboglabra plants.

Environmental pollutants and climate change are the major cause of abiotic stresses. Hexachlorobenzene (HCB) is an airborne and aero-disseminated persistent organic pollutants (POP) molecule causing severe health issues in humans, and temperature extremes and HCB in combination severely affect the growth and yield of crop plants around the globe. The higher HCB uptake and accumulation by edible plants ultimately damage human health through the contaminated food chain. Hence, confining the passive absorbance of POPs is a big challenge for researchers to keep the plant products safer for human consumption. BioClay functional layered double hydroxide is an effective tool for the stable delivery of acidic molecules on plant surfaces. The current study utilized gibberellic acid (GA3) impregnated BioClay (BioClay GA ) to alleviate abiotic stress in Brassica alboglabra plants. Application of BioClay GA mitigated the deleterious effects of HCB besides extreme temperature stress in B. alboglabra plants. BioClay GA significantly restricted HCB uptake and accumulation in applied plants through increasing the avoidance efficacy (AE) up to 377.61%. Moreover, the exogenously applied GA3 and BioClay GA successfully improved the antioxidative system, physiochemical parameters and growth of stressed B. alboglabra plants. Consequently, the combined application of BioClay and GA3 can efficiently alleviate low-temperature stress, heat stress, and HCB toxicity.

Social justice education in nursing: An integrative review of teaching and learning approaches and students' and educators' experiences.

OBJECTIVES: To synthesize literature about teaching social justice to nursing students and identify approaches for effective teaching of social justice issues in nursing education. DESIGN: An integrative review. DATA SOURCES: Literature was searched in CINAHL, PubMed, Scopus, Science Direct, and OVID databases. In total, 32 articles were assessed for full-text eligibility, and 18 articles published from January 2011 until August 2021 were critically appraised and reviewed. REVIEW METHODS: Articles were appraised using Mixed Methods Appraisal Tool. Data analysis and synthesis were completed using literature summary tables, constant comparative analysis, and thematic synthesis. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines were followed for reporting. RESULTS: Two themes: Teaching Approaches Fostering Student Learning of Social Justice and Capabilities Promoting Effective Teaching and Learning about Social Justice were generated. The teaching and learning approaches included experiential, reflective and case based. The necessary capabilities to foster social justice education were intrapersonal assessment and collaboration of educators and students. CONCLUSIONS: Participating in interactive, group, and relational simulations and service-learning, interpersonal dialogues, and collaborative work in critical community-based pedagogies has the potential to develop students' competencies to practice social justice in their everyday practice. Nurse educators should be mindful of personal biases and competencies concerning social justice and take proactive steps to develop competencies for effectively teaching students. Nurse educators can implement teaching strategies integrating real clinical cases to improve students learning of social justice and impartial care for vulnerable populations.

Data Analysis and Presentation in Integrative Reviews: A Narrative Review.

Integrative reviews are invaluable for synthesizing literature to guide practice. This review examined the nature and range of data analysis approaches and the methods used for data presentation in integrative reviews. We reviewed 151 integrative reviews published from January to December 2019 in nursing journals listed in Journal Citation Report 2020. Summary tables were used for data extraction and researcher-developed questions-based process for synthesis. Data analysis and synthesis methods were categorized as non-specific, inductive, deductive, and framework-based. Majority of reviews did not explicitly delineate data analysis and synthesis methods (n = 67) or used inductive methods (n = 55). Limited reviews used deductive (n = 13) and framework-based methods (n = 13). Most of the reviews used narrative descriptions for presentations of findings, but some reviews also used innovative tables, concept maps, frameworks, and word clouds to enhance data presentation. The findings provide a comprehensive overview of the diversity of methods for data analysis and presentation in integrative reviews.

Challenges and approaches to transcultural care: An integrative review of nurses' and nursing students' experiences.

BACKGROUND: Provision of transcultural care is an essential nursing competency. It is important to comprehensively understand the challenges nurses and nursing students face while striving to provide transcultural care in clinical settings. PURPOSE: The purpose of this review was to develop a comprehensive understanding of nurses' and nursing students' challenges and approaches to the provision of transcultural care to people with diverse ethnicities. METHODS: An integrative review was conducted. Literature was searched within five databases, and 30 studies published from January 2010 to January 2021 were reviewed and appraised using mixed methods critical appraisal tool. Literature summary tables and inductive approaches were used for data extraction and synthesis. RESULTS: The challenges to the provision of transcultural care were intrapersonal struggle, cultural conflicts, varied expressions of pain and suffering, and navigation of personal and organizational constraints. Addressing these challenges required nurses and students to practice self-criticism and tolerate differences, develop interpersonal and psychological skills, and collaborate with peers and patients' families. CONCLUSIONS: Provision of transcultural care is a complex task for nurses and students because of different interpretation of personal and organizational factors. Health care institutions should proactively provide resources to nurses and students to strengthen their interpersonal and psychological skills to provide effective transcultural care.

Emphasizing the need to integrate and teach sociocultural determinants of health in undergraduate nursing curricula.

Sociocultural determinants affect health and illness experiences, care choices, and preferences of patients. Nursing curricula include limited content about sociocultural determinants of health in clinical courses. Nevertheless, nursing students must be prepared to understand the complexities of nursing practice beyond acute care and to examine the influence of sociocultural determinants and their linkages to health behaviors of various patient populations. The purpose of this discussion is to emphasize the need for greater integration and teaching of social determinants of health in undergraduate nursing curricula.

Ethical and culturally competent care of transgender patients: A scoping review.

BACKGROUND: Transgender individuals experience discrimination, stigmatization, and unethical and insensitive attitudes in healthcare settings. Therefore, healthcare professionals must be knowledgeable about the ways to deliver ethical and culturally competent care. ETHICAL CONSIDERATIONS: No formal ethical approval was required. AIM: To synthesize the literature and identify gaps about approaches to the provision of ethical and culturally competent care to transgender populations. DESIGN: A Scoping Review. LITERATURE SEARCH: Literature was searched within CINAHL, Science Direct, PubMed, Google Scholar, EMBASE, and Scopus databases using indexed keywords such as "transgender," "gender non-conforming," "ethically sensitive care," and "culturally sensitive care." In total, 30 articles, which included transgender patients and their families and nurses, doctors, and health professionals who provided care to transgender patients, were selected for review. Data were extracted and synthesized using tabular and narrative summaries and thematic synthesis. FINDINGS: Of 30 articles, 23 were discussion papers, 5 research articles, and 1 each case study and an integrative review. This indicates an apparent dearth of literature about ethical and culturally sensitive care of transgender individuals. The review identified that healthcare professionals should educate themselves about sensitive issues, become more self-aware, put transgender individual in charge during care interactions, and adhere to the principles of advocacy, confidentiality, autonomy, respect, and disclosure. CONCLUSIONS: The review identified broad approaches for the provision of ethical and culturally competent care. The identified approaches could be used as the baseline, and further research is warranted to develop and assess organizational and individual-level approaches.