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Repetitive elements (REs) compose ∼50% of the human genome and are normally transcriptionally silenced, although the mechanism has remained elusive. Through an RNAi screen, we identified FBXO44 as an essential repressor of REs in cancer cells. FBXO44 bound H3K9me3-modified nucleosomes at the replication fork and recruited SUV39H1, CRL4, and Mi-2/NuRD to transcriptionally silence REs post-DNA replication. FBXO44/SUV39H1 inhibition reactivated REs, leading to DNA replication stress and stimulation of MAVS/STING antiviral pathways and interferon (IFN) signaling in cancer cells to promote decreased tumorigenicity, increased immunogenicity, and enhanced immunotherapy response. FBXO44 expression inversely correlated with replication stress, antiviral pathways, IFN signaling, and cytotoxic T cell infiltration in human cancers, while a FBXO44-immune gene signature correlated with improved immunotherapy response in cancer patients. FBXO44/SUV39H1 were dispensable in normal cells. Collectively, FBXO44/SUV39H1 are crucial repressors of RE transcription, and their inhibition selectively induces DNA replication stress and viral mimicry in cancer cells.

Research indicates that parenting has important effects on adolescent substance use. However, the indirect effect of parenting on adolescent substance use via self-control is less understood. Gottfredson and Hirschi's General Theory of Crime has been extensively tested by researchers in the field of criminology, but the theory rarely has been used to predict adolescent substance use. Although Goffredson and Hirschi clearly assume that self-control is predicated on parenting, its mediating effect is rarely assessed. We find direct effects of self-control and maternal marijuana use on substance use and also find that self-control mediates the relationship between other parenting variables and adolescent substance use.

Examines the cross-situational patterns in rural and urban communities at school entry. Results show child behavior at school was heavily influenced by exposure to aggressive models and deviant peer support experienced by children in urban as compared to rural schools. This leads to higher rates of school conduct problems for children in urban settings. (MKA)

Competency-based pharmacist education develops robust professional identities and prepares graduates for future practice to ensure optimal patient outcomes. An extended gamified simulation was developed as a capstone activity for a new Australian Bachelor of Pharmacy (BPharm) program. The simulation was designed to consolidate students' knowledge, skills, and behaviors from prior learning. This research aimed to explore whether participation in an extended gamified simulation could influence pharmacy students' perceptions of their professional competencies. Data were collected over three years to compare a superseded Master of Pharmacy (MPharm) program with an incoming BPharm program. Final year students were invited to self-assess their professional competencies at the start and end of their final semester of study, using a digital self-assessment tool which replicated Australia's National Competency Standards Framework for Pharmacists. Participants rated their own competency against the 26 competency standards across five domains on a five-point Likert scale (not at all competent to very competent). This provided pre- and post-data to compare the simulation (BPharm intervention) and a traditional semester (MPharm comparison), in addition to final course grades. From 2016 to 2019, 85 (90.4%) of 94 intervention and 50 (83.3%) of 60 comparison students completed the self-assessment of professional competencies. Participation in the gamified simulation significantly improved students' pharmacotherapeutics grades and pre-post change scores for seven of the 26 competency standards, two of the five domains, and all domains combined of the National Competency Standards. An extended, gamified simulation enhances the development of pharmacy students' self-assessed professional competencies. [ABSTRACT FROM AUTHOR]

Digitization of learning and teaching resources allows for paper-free, digitally-enabled approaches to learning. While PebblePad is well recognized as an electronic portfolio platform, this study aimed to evaluate PebblePad for delivery of foundational workshop materials to provide sustainable and ongoing student access. From 2017, all workshops in a foundational pharmacy practice course were transferred from a paper-based manual to a modular digitized format hosted in PebblePad. An electronic survey tool assessed students' experiences with the platform. The voluntary and anonymous survey sought participant opinions on use, usability, ways of using, and reflection on using PebblePad on a five-point Likert-type scale (strongly disagree to strongly agree). Participants were asked to identify techniques they used to become familiar with PebblePad and the ways in which they used the platform. From 2017 to 2019, 81 (45.3%) of 179 second-year pharmacy students participated in the research. Students most strongly agreed with statements related to comfort with online technologies for learning (n = 46/80, 57.5%), ease of use of PebblePad (n = 41/80, 51.3%), and having sufficient support from teaching staff (n = 39/78, 50%). The primary technique for becoming familiar with PebblePad was individual guidance from the teacher. The main use was to complete required workbook templates. Free-text comments demonstrated overwhelming support for PebblePad used in this teaching context. PebblePad provided a valuable and sustainable platform for hosting digitized foundational pharmacy practice workshop resources. [ABSTRACT FROM AUTHOR]

Abstract Background Cancer is a major cause of mortality and morbidity in patients with chronic kidney disease (CKD). In patients without kidney disease, screening is a major strategy for reducing the risk of cancer and improving the health outcomes for those who developed cancers by detecting treatable cancers at an early stage. Among those with CKD, the effectiveness, the efficacy and patients' preferences for cancer screening are unknown. Methods/Design This work describes the protocol for the DETECT study examining the effectiveness, efficiency and patient's perspectives of colorectal cancer screening using immunochemical faecal occult blood testing (iFOBT) for people with CKD. The aims of the DETECT study are 1) to determine the test performance characteristics of iFOBT screening in individuals with CKD, 2) to estimate the incremental costs and health benefits of iFOBT screening in CKD compared to no screening and 3) to elicit patients' perspective for colorectal cancer screening in the CKD population. Three different study designs will be used to explore the uncertainties surrounding colorectal cancer screening in CKD. A diagnostic test accuracy study of iFOBT screening will be conducted across all stages of CKD in patients ages 35-70. Using individually collected direct healthcare costs and outcomes from the diagnostic test accuracy study, cost-utility and cost-effective analyses will be performed to estimate the costs and health benefits of iFOBT screening in CKD. Qualitative in-depth interviews will be undertaken in a subset of participants from the diagnostic test accuracy study to investigate the perspectives, experiences, attitudes and beliefs about colorectal cancer screening among individuals with CKD. Discussion The DETECT study will target the three major unknowns about early cancer detection in CKD. Findings from our study will provide accurate and definitive estimates of screening efficacy and efficiency for colorectal cancer, and will allow better service planning and budgeting for early cancer detection in this at-risk population. The DETECT study is also registered with the Australia New Zealand Clinical Trials Registry ACTRN12611000538943

Background: Studies have explored community pharmacy ethical dilemmas; however, limited research exists on hospital pharmacy ethical issues and pharmacists' ethical decision-making processes. Research exploring this is timely, considering developments in hospital pharmacy practices, new hospital pharmacist roles, and evolving responsibilities.Aim/objectives: To explore hospital pharmacists' ethical decision-making and processes for managing ethical challenges in the context of evolving Australian hospital pharmacy practices.Methods: Face-to-face semi-structured interviews with 20 purposively-selected hospital pharmacists from four Queensland Health hospitals. An interview guide with 11 open-ended questions and prompts was developed, validated, and trialed. Pharmacists who consented received the guide prior to interviews. Interviews were audio recorded, transcribed verbatim, and compared with field notes. Transcribed data were imported into NVivo 12 to facilitate coding and thematic analysis.Results: Participants were interviewed January to April 2019; median interview duration was 17.45 min. Data saturation was reached. Participants' experiences ranged from junior level pharmacists to senior management positions, in clinical and non-clinical roles. Emerging themes were: 1) influences on the development of ethical decision-making skills, 2) ethical decision-making is an integral part of the hospital pharmacist's role, and 3) institutional requirements and settings impact on ethical exposure. A wide range of contemporary ethical issues unique to hospital pharmacy practice, mostly involving complex medication management safety, supply, and cost scenarios, were identified. Junior pharmacists indicated they would benefit from additional training, mentorship, and availability of hospital-specific targeted ethics resources.Conclusion: The findings highlighted that hospital pharmacists are regularly faced with ethical issues unique to the hospital pharmacy practice context. Application of sound and structured ethical reasoning and decision-making is, therefore, required in this setting. Participants identified many interrelated factors that impacted their ethical reasoning and behaviour. This study identified gaps that, once addressed, will better support ethical reasoning in hospital pharmacy settings. [ABSTRACT FROM AUTHOR]

Using in-depth, face-to-face personal interviews of 25 formerly incarcerated participants, this study examines former inmates' perceptions of prison gang affiliation, factors that shaped their decision to join, associate, and disengage from prison gangs, as well as the impact of gang involvement on their imprisonment adaptation. Overall, we found that inmates' decisions about gang affiliation were linked to a variety of considerations – from personal safety, a sense of pride/belonging, to the consequences of gang affiliation for the prospect of release. Based on the narratives from our participants, two key themes emerge – contextual effects and individual selection effects, each with different policy implications. Findings from this study can be used to develop and improve research instruments for larger scale quantitative and qualitative studies to further understand the experiences of gang affiliated inmates. [ABSTRACT FROM AUTHOR]

A review of anesthetic procedures used in Andean bears (Tremarctos ornatus), sloth bears (Melursus ursinus), and giant pandas (Ailuropoda melanoleuca) housed at the Smithsonian Institution's National Zoological Park (NZP) from 1995 to 2016 was performed. A total of 146 anesthetic procedures (55 procedures on 12 Andean bears, 38 procedures on nine sloth bears, and 53 procedures on five giant pandas) occurred at NZP during this time frame. Induction protocols involved some combination of ketamine (K; n = 121), tiletamine--zolazepam (TZ; n=91), medetomidine (M; n=67), xylazine (X; n=42), midazolam (Mid; n=9), and butorphanol (B; n = 1). The most commonly used protocols were TZKM for both Andean bears (n = 29) and sloth bears (n = 12), and KX in giant pandas (n = 17). Supplemental injections of K, TZ, Mid, or M were required to complete inductions in 66 cases (45%). Anesthetic maintenance was most often completed with isoflurane, ketamine, or propofol. The most commonly reported complications included perianesthetic emesis (n=47), ptyalism (n=16), and seizure-like activity (n=11). The most frequent physiologic findings included low pulse oximetry values (n= 95), bradycardia (n=95), hypothermia (n=74), and hypertension (n=55). Dose ranges, induction, and recovery times, supplementation and complication rates, and physiologic values are reported for each protocol by species. [ABSTRACT FROM AUTHOR]

Background: Consumer awareness of emergency contraception is generally poor. School leavers (schoolies) engage in risky behaviours, including casual sex and alcohol and drug consumption. Aim: The aim of this study was to explore the awareness of an at‐risk population of schoolies regarding the use and availability of emergency contraception. Methods: An electronic survey was self‐administered by participants using Wi‐Fi‐connected iPads at the Schoolies Wristband Distribution Centre, Surfers Paradise, on the first day of Queensland Schoolies Week, November 2017. Outcomes measured were awareness of the availability of emergency contraception from a pharmacy, maximum time for effective use following unprotected intercourse and whether emergency contraception is harmful to the health of the user. Results: Schoolies completed 498 valid surveys. Most (83.5%) were aged 17 years and 50.8% were aware that emergency contraception is available from community pharmacies with prescription and 36.7% were aware that it is available without prescription; 18.5% were aware of the 72‐ or 120‐h effectiveness window and 38.0% agreed that it is not harmful. All questions were associated with considerable uncertainty. Females were 1.8‐ to 3.2‐fold more likely than males to provide an appropriate response to any emergency contraception statement. Conclusion: Schoolies' awareness of emergency contraception availability, effectiveness window and safety was low. At‐risk schoolies may not access emergency contraception when indicated due to fear of harm, uncertainty about its effectiveness window or a lack of knowledge about timely non‐prescription access from community pharmacies. Targeted education may improve current knowledge gaps. The misnomer 'morning‐after pill' should be abandoned for the clinically appropriate term 'emergency contraception'. [ABSTRACT FROM AUTHOR]

The article offers information on the introduction of new Appendix M category to the Standard for Uniform Scheduling of Medicines and Poisons (SUSMP) which allows pharmacists to prescribe medicine that down-scheduling from S4 to S3 Appendix M. Pharmacists are confident in supplying various medications including S3 nausea treatments for migraine, trimethoprim for treatment of uncomplicated urinary tract infection (UTI) and steroid inhalers for asthma management.

The article discusses the Australian Health Practitioner Regulation Agency allows medical practitioners to prescribe medicines to themselves and their families. Topics discussed include lack of objectivity for self-treatment, the risks of self-prescribing and self-medication are listed, and the legality of self-prescribing.

Background Medicare and the Pharmaceutical Benefits Scheme may suggest to patients that medicines supply is the same everywhere in Australia. National Registration of Health Practitioners removed barriers to practitioners working interstate. Aim To identify variations in state and territory medicines legislation with potential to negatively impact patients or practitioners. Method Australian state and territory Acts and Regulations related to medicines prescribing and provision were compared. Legislative variations with potential to either harm patients, or increase health practitioners' legal or ethical risk, were identified. Results Potential patient harm may occur due to inconsistent requirements for prescription particulars, retention of prescription repeats by pharmacies in some states, or variation in age restriction on medicines provision.Potential practitioner risk may arise due to inconsistencies in practitioners' prescribing rights or variable requirements to prescribe or dispense medicines. Conclusion Ideally, all Australian states and territories should adopt uniform medicines legislation. [ABSTRACT FROM AUTHOR]

The Tasmanian devil ( Sarcophilus harrisii) population has decreased by estimates of 80% in the past 20 yr due to the effects of devil facial tumor disease (DFTD). In the process of creating a DFTD-free insurance population, the captive population and the number of institutions housing devils worldwide has increased tremendously. In order to provide the best husbandry and veterinary care for these captive animals, it is essential to know normal hematology and biochemistry values for the species. Baseline reference intervals (RIs) were determined for hematology and biochemistry variables for 170 healthy anesthetized captive Tasmanian devils and significant sex and age differences were determined. Higher relative neutrophil counts, hemoglobin, mean corpuscular hemoglobin (MCH), creatinine, creatine phosphokinase, and cholesterol were seen in males compared to females, whereas higher white cell counts (WBC) and lymphocyte counts (absolute and relative) were seen in females. Subadults have higher red blood cell counts, WBC, lymphocytes (absolute and relative), calcium and phosphorus, alkaline phosphatase, glutamate dehydrogenase, glucose, and albumin than adults; whereas, adults have higher relative neutrophils, relative eosinophils, mean corpuscular volume, MCH, platelets, total solids, total plasma proteins, globulins, and chloride than subadults. This study provides a comprehensive report of hematology and serum biochemistry RIs for healthy captive anesthetized Tasmanian devils and offers invaluable diagnostic information to care for the growing captive population of this endangered marsupial. [ABSTRACT FROM AUTHOR]

An exploratory mixed methods study was conducted to investigate potential differences in the pro-environmental values and beliefs of people from the UK Christian, Muslim and secular (non-religious) communities. The study explored how religion might shape perspectives on themes within the New Ecological Paradigm (NEP) scale, including the relationship between humans and the environment (Dunlap, Kent, Mertig, & Jones, 2000). This study also explored how religious beliefs and values might influence perspectives on: (a) climate change; and (b) the acceptability of Carbon Capture and Storage (CCS) technologies. Muslim and Christian participants' opinions about climate change and CCS technologies were shaped by the importance of environmental stewardship and intergenerational justice. Both groups had relatively low perceptions of urgency for environmental issues, particularly climate change, due to beliefs in an afterlife and divine intervention. Acceptance of CCS for Muslim participants was considered problematic due to teachings on stewardship, harmony values and the intrinsic value of nature. CCS was considered less problematic for Christian participants, who demonstrated anthropocentric values and evaluated environmental issues and technological solutions in relation to the extent to which they supported human welfare. Secular participants expressed anxiety in relation to environmental issues, especially climate change. Lack of belief in an afterlife or divine intervention led secular participants to focus on human responsibility and the need for action, bolstering the perceived necessity of a range of technologies including CCS. [ABSTRACT FROM AUTHOR]