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Book ; Online: Ethical research in a non-orthodox way

Lane, Karen

a qualitative case study of maternity care in post-conflict Timor-Leste

2017

Abstract: The ethics process properly amplifies ethical concerns about safety, risks, autonomy, well-being of researcher and researched, and the importance of consequences. However, the regulatory function of the ethics process may fail to anticipate the limited ... ...

Author's details	Karen Lane
Abstract	The ethics process properly amplifies ethical concerns about safety, risks, autonomy, well-being of researcher and researched, and the importance of consequences. However, the regulatory function of the ethics process may fail to anticipate the limited transparency and radical uncertainty facing researchers in the field. Research in post-conflict zones magnifies these problems. In East Timor, this research study about how diverse social actors defined "a good birth" confronted a research field marked by stark memories of historical injustices, widespread abuse, and state brutality. There were also ongoing political tensions. Formal ethical clearance was not possible from the host country prior to commencement, and practical exigencies made it impossible to comply with many ethical protocols around risk assessment, transparency, and accountability. Specifically, poverty, lack of developed health infrastructure, language difficulties, and cultural variances between researcher and researched provided ongoing challenges in meeting abstract Kantian principles of universality, beneficence, and autonomy on which ethical guidelines are based. Researchers facing these challenges must proceed in an ethical way by constantly negotiating, re-negotiating, and re-defining them as practical conundrums throughout the research process. Relational ethics provides a more realistic and attainable framework-one based upon self-reflexivity, empathy, integrity, and social justice.
Keywords	Maternal health services/Research ; Research/Moral and ethical aspects ; Timor-Leste.
Language	English
Size	1 online resource
Publisher	Sage Publications Ltd
Publishing place	Place of publication not identified
Document type	Book ; Online
Note	Title from content provider.
ISBN	1526401452 ; 9781526401458
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: When is collaboration not collaboration? When it's militarized.

Lane, Karen

Women and birth : journal of the Australian College of Midwives

2012 Volume 25, Issue 1, Page(s) 29–38

Abstract: In adopting the medical lobby's preferred definition of collaboration where midwives are legally compelled to seek endorsement for their care plan from an obstetrician, Determination 2010 connotes a form of militarized collaboration and thus negates all ... ...

Abstract	In adopting the medical lobby's preferred definition of collaboration where midwives are legally compelled to seek endorsement for their care plan from an obstetrician, Determination 2010 connotes a form of militarized collaboration and thus negates all that genuine collaboration stands for--equality, mutual trust and reciprocal respect. Using Critical Discourse Analysis, the first half of this paper analyses the submissions from medical, midwifery and consumer peak organisations to the Maternity Services Review and Senate reviews held between 2008 and 2010 showing that Determination 2010 privileges the medical lobby worldview in adopting a vertical definition of collaboration. The second half of the paper responds to the principal assumption of Determination 2010--that midwives do not voluntarily collaborate. It argues by reference to a qualitative inquiry conducted into select caseload maternity units in South Australia, Victoria and New South Wales during 2009-2010 that this presupposition is erroneous. The evidence shows that genuine collaboration is possible without legislative force but it requires a coalition of the willing among senior midwives and obstetricians to institute regular interdisciplinary meetings and clinical reviews and to model respectful behaviour to new entrants.
MeSH term(s)	Continuity of Patient Care/legislation & jurisprudence ; Cooperative Behavior ; Female ; Hospital Units ; Humans ; Lobbying ; Maternal Health Services/legislation & jurisprudence ; Midwifery/legislation & jurisprudence ; Military Personnel ; New South Wales ; Obstetrics ; Organizations ; Physician-Nurse Relations ; Pregnancy
Language	English
Publishing date	2012-03
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2235085-8
ISSN	1878-1799 ; 1871-5192
ISSN (online)	1878-1799
ISSN	1871-5192
DOI	10.1016/j.wombi.2011.03.003
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Article ; Online: The role of the SWI/SNF chromatin remodelling complex in the response to DNA double strand breaks.

Harrod, Alison / Lane, Karen A / Downs, Jessica A

DNA repair

2020 Volume 93, Page(s) 102919

Abstract: Mammalian cells possess multiple closely related SWI/SNF chromatin remodelling complexes. These complexes have been implicated in the cellular response to DNA double strand breaks (DSBs). Evidence suggests that SWI/SNF complexes contribute to successful ... ...

Abstract	Mammalian cells possess multiple closely related SWI/SNF chromatin remodelling complexes. These complexes have been implicated in the cellular response to DNA double strand breaks (DSBs). Evidence suggests that SWI/SNF complexes contribute to successful repair via both the homologous recombination and non-homologous end joining pathways. In addition, repressing transcription near DSBs is dependent on SWI/SNF activity. Understanding these roles is important because SWI/SNF complexes are frequently dysregulated in cancer, and DNA DSB repair defects have the potential to be therapeutically exploited. In this graphical review, we summarise what is known about SWI/SNF contribution to DNA DSB responses in mammalian cells and provide an overview of the SWI/SNF-encoding gene alteration spectrum in human cancers.
MeSH term(s)	Animals ; Chromatin Assembly and Disassembly ; Chromosomal Proteins, Non-Histone/metabolism ; DNA/metabolism ; DNA Breaks, Double-Stranded ; DNA End-Joining Repair ; DNA Helicases/metabolism ; DNA-Binding Proteins/metabolism ; Humans ; Mammals/genetics ; Mammals/metabolism ; Nuclear Proteins/metabolism ; Recombinational DNA Repair ; Transcription Factors/metabolism
Chemical Substances	BANF1 protein, human ; Chromosomal Proteins, Non-Histone ; DNA-Binding Proteins ; Nuclear Proteins ; Transcription Factors ; DNA (9007-49-2) ; SMARCA4 protein, human (EC 3.6.1.-) ; DNA Helicases (EC 3.6.4.-)
Language	English
Publishing date	2020-10-20
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2071608-4
ISSN	1568-7856 ; 1568-7864
ISSN (online)	1568-7856
ISSN	1568-7864
DOI	10.1016/j.dnarep.2020.102919
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Article ; Online: The return of the Traditional Birth Attendant.

Lane, Karen / Garrod, Jayne

Journal of global health

2016 Volume 6, Issue 2, Page(s) 20302

MeSH term(s)	Developing Countries ; Female ; Humans ; Midwifery ; Pregnancy
Language	English
Publishing date	2016-12
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	2741629-X
ISSN	2047-2986 ; 2047-2978
ISSN (online)	2047-2986
ISSN	2047-2978
DOI	10.7189/jogh.06.020302
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Article ; Online: PBAF loss leads to DNA damage-induced inflammatory signaling through defective G2/M checkpoint maintenance.

Feng, Hugang / Lane, Karen A / Roumeliotis, Theodoros I / Jeggo, Penny A / Somaiah, Navita / Choudhary, Jyoti S / Downs, Jessica A

Genes & development

2022

Abstract: The PBRM1 subunit of the PBAF (SWI/SNF) chromatin remodeling complex is mutated in ∼40% of clear cell renal cancers. PBRM1 loss has been implicated in responses to immunotherapy in renal cancer, but the mechanism is unclear. DNA damage-induced ... ...

Abstract	The PBRM1 subunit of the PBAF (SWI/SNF) chromatin remodeling complex is mutated in ∼40% of clear cell renal cancers. PBRM1 loss has been implicated in responses to immunotherapy in renal cancer, but the mechanism is unclear. DNA damage-induced inflammatory signaling is an important factor determining immunotherapy response. This response is kept in check by the G2/M checkpoint, which prevents progression through mitosis with unrepaired damage. We found that in the absence of PBRM1, p53-dependent p21 up-regulation is delayed after DNA damage, leading to defective transcriptional repression by the DREAM complex and premature entry into mitosis. Consequently, DNA damage-induced inflammatory signaling pathways are activated by cytosolic DNA. Notably, p53 is infrequently mutated in renal cancer, so PBRM1 mutational status is critical to G2/M checkpoint maintenance. Moreover, we found that the ability of PBRM1 deficiency to predict response to immunotherapy correlates with expression of the cytosolic DNA-sensing pathway in clinical samples. These findings have implications for therapeutic responses in renal cancer.
Language	English
Publishing date	2022-07-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	806684-x
ISSN	1549-5477 ; 0890-9369
ISSN (online)	1549-5477
ISSN	0890-9369
DOI	10.1101/gad.349249.121
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Article ; Online: Incorporating Mental Health Into Lifestyle Medicine.

Abascal, Liana / Vela, Alyssa / Sugden, Steve / Kohlenberg, Samuel / Hirschberg, April / Young, Allison / Lane, Karen / Merlo, Gia

American journal of lifestyle medicine

2022 Volume 16, Issue 5, Page(s) 570–576

Abstract: The evidence-based interconnection between mental health with lifestyle medicine practice is discussed. The extent to which physical health, and mental and behavioral health overlap are significant, and their interaction is seen in many ways. These ... ...

Abstract	The evidence-based interconnection between mental health with lifestyle medicine practice is discussed. The extent to which physical health, and mental and behavioral health overlap are significant, and their interaction is seen in many ways. These bidirectional influences form a continuous thread through all lifestyle medicine pillars. The intersection of mental health and lifestyle should be considered and applied to provide optimal evidence-based lifestyle medicine for all patient populations who will benefit from the specific attention to diet, physical activity, relationships, stress, sleep, and substance use. Lifestyle medicine can be utilized to directly address and treat a range of mental health symptoms and disorders, and physical illnesses. In addition, behavior change skills and addressing the psychological factors contributing to barriers are crucial to helping patients reach their lifestyle medicine goals. Approaches to practice that attend to, and address, mental and behavioral health are relevant to and necessary for all types of providers who work within the lifestyle medicine framework.
Language	English
Publishing date	2022-06-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2265653-4
ISSN	1559-8284 ; 1559-8276
ISSN (online)	1559-8284
ISSN	1559-8276
DOI	10.1177/15598276221084250
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Article ; Online: Clinical Trial Protocol for BEACH: A Phase 2a Study of MW189 in Patients with Acute Nontraumatic Intracerebral Hemorrhage.

Avadhani, Radhika / Ziai, Wendy C / Thompson, Richard E / Mould, W Andrew / Lane, Karen / Nanni, Angeline / Iacobelli, Michael / Sharrock, Matthew F / Sansing, Lauren H / Van Eldik, Linda J / Hanley, Daniel F

Neurocritical care

2023 Volume 40, Issue 2, Page(s) 807–815

Abstract: Patients with acute spontaneous intracerebral hemorrhage (ICH) develop secondary neuroinflammation and cerebral edema that can further damage the brain and lead to increased risk of neurologic complications. Preclinical studies in animal models of acute ... ...

Abstract	Patients with acute spontaneous intracerebral hemorrhage (ICH) develop secondary neuroinflammation and cerebral edema that can further damage the brain and lead to increased risk of neurologic complications. Preclinical studies in animal models of acute brain injury have shown that a novel small-molecule drug candidate, MW01-6-189WH (MW189), decreases neuroinflammation and cerebral edema and improves functional outcomes. MW189 was also safe and well tolerated in phase 1 studies in healthy adults. The proof-of-concept phase 2a Biomarker and Edema Attenuation in IntraCerebral Hemorrhage (BEACH) clinical trial is a first-in-patient, multicenter, randomized, double-blind, placebo-controlled trial. It is designed to determine the safety and tolerability of MW189 in patients with acute ICH, identify trends in potential mitigation of neuroinflammation and cerebral edema, and assess effects on functional outcomes. A total of 120 participants with nontraumatic ICH will be randomly assigned 1:1 to receive intravenous MW189 (0.25 mg/kg) or placebo (saline) within 24 h of symptom onset and every 12 h for up to 5 days or until hospital discharge. The 120-participant sample size (60 per group) will allow testing of the null hypothesis of noninferiority with a tolerance limit of 12% and assuming a "worst-case" safety assumption of 10% rate of death in each arm with 10% significance and 80% power. The primary outcome is all-cause mortality at 7 days post randomization between treatment arms. Secondary end points include all-cause mortality at 30 days, perihematomal edema volume after symptom onset, adverse events, vital signs, pharmacokinetics of MW189, and inflammatory cytokine concentrations in plasma (and cerebrospinal fluid if available). Other exploratory end points are functional outcomes collected on days 30, 90, and 180. BEACH will provide important information about the utility of targeting neuroinflammation in ICH and will inform the design of future larger trials of acute central nervous system injury.
MeSH term(s)	Adult ; Humans ; Brain Edema/etiology ; Brain Edema/complications ; Neuroinflammatory Diseases ; Cerebral Hemorrhage/complications ; Edema/complications ; Treatment Outcome ; Randomized Controlled Trials as Topic ; Multicenter Studies as Topic ; Clinical Trials, Phase II as Topic ; Piperazines ; Pyridazines ; Pyridines
Chemical Substances	TT-301 (CY416F5NSK) ; Piperazines ; Pyridazines ; Pyridines
Language	English
Publishing date	2023-11-02
Publishing country	United States
Document type	Clinical Trial Protocol ; Journal Article
ZDB-ID	2381896-7
ISSN	1556-0961 ; 1541-6933
ISSN (online)	1556-0961
ISSN	1541-6933
DOI	10.1007/s12028-023-01867-2
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Article ; Online: Reduced time to imaging, length of stay, and hospital charges following implementation of a novel postoperative pathway for craniotomy.

Hoffman, Samantha E / Gupta, Saksham / O'Connor, Matthew / Jarvis, Casey A / Zhao, Maryann / Hauser, Blake M / Bernstock, Joshua D / Murphy, Shayna / Raftery, Siobhan M / Lane, Karen / Chiocca, E Antonio / Arnaout, Omar

Journal of neurosurgery

2023 , Page(s) 1–12

Abstract: Objective: The authors created a postoperative postanesthesia care unit (PACU) pathway to bypass routine intensive care unit (ICU) admissions of patients undergoing routine craniotomies, to improve ICU resource utilization and reduce overall hospital ... ...

Abstract	Objective: The authors created a postoperative postanesthesia care unit (PACU) pathway to bypass routine intensive care unit (ICU) admissions of patients undergoing routine craniotomies, to improve ICU resource utilization and reduce overall hospital costs and lengths of stay while maintaining quality of care and patient satisfaction. In the present study, the authors evaluated this novel PACU-to-floor clinical pathway for a subset of patients undergoing craniotomy with a case time under 5 hours and blood loss under 500 ml. Methods: A single-institution retrospective cohort study was performed to compare 202 patients enrolled in the PACU-to-floor pathway and 193 historical controls who would have met pathway inclusion criteria. The pathway cohort consisted of all adult supratentorial brain tumor cases from the second half of January 2021 to the end of January 2022 that met the study inclusion criteria. Control cases were selected from the beginning of January 2020 to halfway through January 2021. The authors also discuss common themes of similar previously published pathways and the logistical and clinical barriers overcome for successful PACU pathway implementation. Results: Pathway enrollees had a median age of 61 years (IQR 49-69 years) and 53% were female. Age, sex, pathology, and American Society of Anesthesiologists physical status distributions were similar between pathway and control patients (p > 0.05). Most of the pathway cases (96%) were performed on weekdays, and 31% had start times before noon. Nineteen percent of pathway patients had 30-day readmissions, most frequently for headache (16%) and syncope (10%), whereas 18% of control patients had 30-day readmissions (p = 0.897). The average time to MRI was 6 hours faster for pathway patients (p < 0.001) and the time to inpatient physical therapy and/or occupational therapy evaluation was 4.1 hours faster (p = 0.046). The average total length of stay was 0.7 days shorter for pathway patients (p = 0.02). A home discharge occurred in 86% of pathway cases compared to 81% of controls (p = 0.225). The average total hospitalization charges were $13,448 lower for pathway patients, representing a 7.4% decrease (p = 0.0012, adjusted model). Seven pathway cases were escalated to the ICU postoperatively because of attending physician preference (2 cases), agitation (1 case), and new postoperative neurological deficits (4 cases), resulting in a 96.5% rate of successful discharge from the pathway. In bypassing the ICU, critical care resource utilization was improved by releasing 0.95 ICU days per patient, or 185 ICU days across the cohort. Conclusions: The featured PACU-to-floor pathway reduces the stay of postoperative craniotomy patients and does not increase the risk of early hospital readmission.
Language	English
Publishing date	2023-01-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	3089-2
ISSN	1933-0693 ; 0022-3085
ISSN (online)	1933-0693
ISSN	0022-3085
DOI	10.3171/2022.12.JNS222123
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Article ; Online: 'How can we go on caring when nobody here cares about us?' Australian public maternity units as contested care sites.

Reiger, Kerreen / Lane, Karen

Women and birth : journal of the Australian College of Midwives

2013 Volume 26, Issue 2, Page(s) 133–137

Abstract: Background: Provision of personalised, continuous care focused on 'well women' is now central to midwifery identity and work ideals, but it remains difficult in hospital contexts shaped by increased demand and by neoliberal policies. Previous accounts ... ...

Abstract	Background: Provision of personalised, continuous care focused on 'well women' is now central to midwifery identity and work ideals, but it remains difficult in hospital contexts shaped by increased demand and by neoliberal policies. Previous accounts of occupational and work-family conflicts in midwifery and nursing have pointed to the 'moral distress' associated with managing conflicting expectations in health workplaces. Question: This paper examines these issues in the Australian context and considers further the ethical implications of midwives not feeling 'cared for' themselves in health care organisations. Methods: Qualitative research in several Victorian maternity units included use of interviews and observational methods to explore staff experiences of organisational and professional change. Data were coded and analysed using NVivo. Findings: Midwives reported frequent contestation as they sought to practice their ideal of themselves as caregivers in what they reported as often 'uncaring' workplaces. To interpret this data, we argue for seeing midwifery caring as embodied social practice taking place within 'organisation carescapes'. Conclusion: Theoretical analysis of the moral and ethical dimensions of the contemporary organisational structure of maternity care suggests that a practice-based and dialogical ethic should form the core principle of care both for women in childbirth and for their carers.
MeSH term(s)	Adult ; Attitude of Health Personnel ; Australia ; Caregivers/psychology ; Female ; Hospitals, Maternity ; Humans ; Interviews as Topic ; Nurse Midwives/psychology ; Occupational Health ; Pregnancy ; Qualitative Research ; Stress, Psychological ; Surveys and Questionnaires ; Workload ; Workplace
Language	English
Publishing date	2013-06
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2235085-8
ISSN	1878-1799 ; 1871-5192
ISSN (online)	1878-1799
ISSN	1871-5192
DOI	10.1016/j.wombi.2012.11.003
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Article: Benign Metastasizing Leiomyoma to the Lung and Spine: A Case Report and Literature Review.

Barber, Emily / Eapen, Ann / Mehta, Rita / Lin, Erin / Lane, Karen / Cheng, Yu / Parajuli, Ritesh

Case reports in oncology

2019 Volume 12, Issue 1, Page(s) 218–223

Abstract: Benign metastasizing leiomyomas (BML) represent a rare phenomenon consisting of the extra-uterine spread of smooth muscle cells with similar histological, immunological, and molecular patterns to those of benign uterine leiomyomas. They are considered ... ...

Abstract	Benign metastasizing leiomyomas (BML) represent a rare phenomenon consisting of the extra-uterine spread of smooth muscle cells with similar histological, immunological, and molecular patterns to those of benign uterine leiomyomas. They are considered benign based off their low mitotic activity, lack of anaplasia or necrosis, and limited vascularization. This condition represents an interesting diagnostic and treatment challenge based on their rarity and indolent nature. Our case represents a unique finding of BML in the thoracic spine in a postmenopausal woman many years after hysterectomy and partial oophorectomy. There are currently no standard guidelines for treatment of BML, given the rare nature of this condition, with most patients treated with a combination of surgical resection and radiotherapy, followed by hormonal treatment and radiological surveillance serving as the primary backbone of current management plans. Given that these patients present a unique clinical challenge in terms of diagnosis and management, it is important to delineate and further examine these rare entities.
Language	English
Publishing date	2019-02-28
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2458961-5
ISSN	1662-6575
ISSN	1662-6575
DOI	10.1159/000496333
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