Diversity in interprofessional education: disciplines and topics.

This paper challenges the notion that interprofessional education is only about health and social care, and examines perspectives on diversity in relation to inclusivity and relevance in university education. It draws on evidence from the implementation of an interdisciplinary event titled "Strictly Come Dining" and a module titled "The Arts and Humanities in Health and Social Care Contexts" - both are within undergraduate curricula. Diversifying the disciplines and topics involved in interprofessional education brings holism to staff and student development, both personally and professionally. It develops graduate attributes for students and promotes employability

Quality and safety of medication use in primary care: consensus validation of a new set of explicit medication assessment criteria and prioritisation of topics for improvement.

Background: Addressing the problem of preventable drug related morbidity (PDRM) in primary care is a challenge for health care systems internationally. The increasing implementation of clinical information systems in the UK and internationally provide new opportunities to systematically identify patients at risk of PDRM for targeted medication review. The objectives of this study were (1) to develop a set of explicit medication assessment criteria to identify patients with sub-optimally effective or high-risk medication use from electronic medical records and (2) to identify medication use topics that are perceived by UK primary care clinicians to be priorities for quality and safety improvement initiatives. Methods: For objective (1), a 2-round consensus process based on the RAND/UCLA Appropriateness Method (RAM) was conducted, in which candidate criteria were identified from the literature and scored by a panel of 10 experts for 'appropriateness' and 'necessity'. A set of final criteria was generated from candidates accepted at each level. For objective (2), thematically related final criteria were clustered into 'topics', from which a panel of 26 UK primary care clinicians identified priorities for quality improvement in a 2-round Delphi exercise. Results: (1) The RAM process yielded a final set of 176 medication assessment criteria organised under the domains 'quality' and 'safety', each classified as targeting 'appropriate/necessary to do' (quality) or 'inappropriate/ necessary to avoid' (safety) medication use. Fifty-two final 'quality' assessment criteria target patients with unmet indications, sub-optimal selection or intensity of beneficial drug treatments. A total of 124 'safety' assessment criteria target patients with unmet needs for risk-mitigating agents, high-risk drug selection, excessive dose or duration, inconsistent monitoring or dosing instructions. (2) The UK Delphi panel identified 11 (23%) of 47 scored topics as 'high priority' for quality improvement initiatives in primary care. Conclusions: The developed criteria set complements existing medication assessment instruments in that it is not limited to the elderly, can be implemented in electronic data sets and focuses on drug groups and conditions implicated in common and/or severe PDRM in primary care. Identified priorities for quality and safety improvement can guide the selection of targets for initiatives to address the PDRM problem in primary care

An artificially-intelligent biomeasurement system for total hip arthroplasty patient rehabilitation.

This study concerned the development and validation of a hardware and software biomeasurement system, which was designed to be used by physiotherapists, general practitioners and other healthcare professionals. The purpose of the system is to detect and assess gait deviation in the form of reduced post-operative range of movement (ROM) of the replacement hip joint in total hip arthroplasty (THA) patients. In so doing, the following original work is presented: Production of a wearable, microcontroller-equipped system which was able to wirelessly relay accelerometer sensor data of the subjects key hip-position parameters to a host computer, which logs the data for later analysis. Development of an artificial neural network is also reported, which was produced to process the sensor data and output assessment of the subjects hip ROM in the flexion/extension and abduction/adduction rotations (forward and backward swing and outward and inward movement of the hip respectively). The review of literature in the area of biomeasurement devices is also presented. A major data collection was carried out using twenty-one THA patients, where the device output was compared to the output of a Vicon motion analysis system which is considered the gold standard in clinical gait analysis. The Vicon system was used to show that the device developed did not itself affect the patients hip, knee or ankle gait cycle parameters when in use, and produced measurement of hip flexion/extension and abduction/adduction closely approximating those of the Vicon system. In patients who had gait deviations manifesting in reduced ROM of these hip parameters, it was demonstrated that the device was able to detect and assess the severity of these excursions accurately. The results of the study substantiate that the system developed could be used as an aid for healthcare professionals in the following ways: 1) To objectively assess gait deviation in the form of reduced flexion/extension and abduction/adduction in the human hip, after replacement; 2) Monitoring of patient hip ROM post-operatively; 3) Assist in the planning of gait rehabilitation strategies related to these hip parameters

Future textile visions: smart textiles for health and wellness.

A report prepared for the Scottish Government on behalf of the Scottish Academy of Fashion, which examines the potential of new textiles solutions for health applications. Following a Sandpit event hosted by the Scottish Academy of Fashion on 13th and 14th January 2011, a number of projects emerged one of which was Molecular Imprinted Textiles (MIT). The interest of this group was to apply nano-technology to extend the value of textiles by making it possible to add or extract information over the lifetime of garments. A workshop was held on 19th October 2011 by the MIT Group at Edinburgh College of Art to explore concepts based on related technologies. An emerging conversation was focused on the potential of technologies that could be incorporated into textiles specifically for medical applications. The Future Textiles Project (FTV) developed as a result of the earlier dialogue, with the aim of exploring the potential for developing new textiles products designed to address specific medical conditions. The report details some of the most prominent areas of medical need and some of the technologies that may be applied. It does not suggest specific concepts, but rather examines the methodologies that could be profitably adopted for developing new concepts in this field based on a cross-disciplinary user-focused approach. The premise for this project is based on the identification of human needs that provide the focus for subsequent technology development. The report focuses on the potential of Scottish businesses, making use of current research across a number of fields in order to develop new products, which have life-changing implications. Smart (or technologically enhanced) textiles have the potential to control temperature, incorporate antimicrobial properties, provide insulation, breathability, compression, re-shaping, moisture absorption, articulation enabling mobility, constrain movement and improve circulation. They can be used as a diagnostic tool to deliver drugs and respond to changing body states. This project considers new methodologies for rapid product development looking for synergies between business and academic research

Engaging with the Scottish Government's agenda on health and social care.

Outside of SF circles, SF remains relatively unknown. The Scottish Solution Focused Network (SSFN) is an organisation of SF practitioners established to support and promote SF practice in Scotland. In this paper, the authors discuss their recent thinking, derived from a series of conversations within the SSFN, on how their organisation can engage with one aspect of the Scottish Government's (formerly known as the Scottish Executive) strategy for health and wellbeing. They argue that SF practitioners in this field have a moral obligation to engage in political discourse, and that in Scotland, the Government are actively promoting SF methodologies in practice

North-east transport survey 2012.

The aim of this survey is to highlight the importance of transport and deliver a general overview of the services provided. Our conclusion is that transport providers in North-east Scotland are generally positive and satisfied with their current business performance. In the past 12 months, the sector has witnessed an increase in productivity and reported turnover, and this has led to net positive increase in profitability. However, the level of profit increase that may have been possible was negatively affected by costs. Not surprisingly, the main cost component affecting transport providers has been fuel. As a result, the pressure on profitability arising from costs appears to be the underlying theme of this report. There is a high level of satisfaction with the local business environment and its clear that providers find a highly conducive environment for doing business in the North-east and consider this the most satisfying factor. However this level of satisfaction is countered by the high dissatisfaction expressed in the local infrastructure. It would appear that while the North-east may provide an enabling environment in many forms, such as business opportunities, wealth and skills, the same cant be said about the level of infrastructural availability and quality but providers expect a significant improvement in infrastructure in the next three years. They also expect significant improvements in technology and further improvements in the local environment. We conclude that transport in North-east Scoland, in terms of providers, is stable and continues to show signs of growth in spite of tough times in the wider econom

The politics of destination marketing: assessing stakeholder interaction choice orientations toward a DMO formation, using the Thomas-Kilmann Conflict Mode Instrument.

Purpose: Destination Management Organisations (DMOs) are very much a part of the Scottish tourism landscape in 2011. Some regional tourism stakeholders have created DMOs to manage their respective regional attractions, but until now, this has not been the case with north-east Scotland. As a prelude to the potential creation of a regional DMO, the purpose of this paper is to empirically evaluate tourism business leaders' attitudes and likely acceptance of the DMO's structure and functions. Design/methodology/approach: The Thomas-Kilmann Conflict Mode (TKCM) was utilised to provide an evaluative framework, with discussion of the assertiveness versus cooperativeness needs of tourism business stakeholders in the region. The TKCM's measurement instrument was utilised along with a purpose-built questionnaire to gather information about tourism leaders' interaction orientations and their level of support for the formation of a DMO, its structure and functions. Findings: Tourism leaders in north-east Scotland are collaboration-oriented. Initial findings indicate that on balance, tourism businesses (as expressed by their managers/owners) are persuaded by the attractiveness of collaboration at an integrated regional level, but would nevertheless prefer a certain degree of competition. In addition, organisational size and membership of existing destination management networks appear to moderate the interaction choice preference. Research limitations/implications: First, the scale and questionnaire instrument developed to test attitudes toward a DMO formation have not been exhaustively evaluated, nor have the potential moderating factors been comprehensively assessed. A more robust and validated scale should be developed and moderators clearly modelled. Second, current sample size is limited and may not provide an adequate basis for generalisation. In future, a larger sample should be employed. Finally, this research is exploratory in scope, and future research, designed along an evaluative and analytical basis, is encouraged. Practical implications: Collaboration within a new DMO in marketing to new markets and the support for this is not challenged, but some competition among tourism providers will continue. It is likely that the disparity between tourism performance in the city and rural areas will continue in the near future. The role of the DMO will therefore involve enlarging the customer base and raising the tourism profiles of both city and rural locations, in order to create a level playing field. Originality/value: This research is the first to utilise the TKCM and Instrument to assess tourism business leaders' assertiveness versus cooperativeness orientations, prior to the initiation of an alliance in a region. The paper shows that this approach holds viability for future research in this direction, especially the potential of TKCM as a predictive framework for interorganisational interaction and collaboration

An investigation into the biodegradation of peptide cyanotoxins (microcystins and nodularin) by novel gram-positive bacteria.

Cyanobacterial secondary metabolites, microcystins (MC) and nodularin (NOD) have become common contaminants in most aquatic ecosystems over recent years presenting a hazard to animal and human health. Unfortunately, these chemically diverse peptide hepatotoxins remain a challenge to most conventional water treatments due to their stable cyclic structures. Over recent years, bioremediation of MC and NOD has become one of the most exciting areas that holds promise for a successful and cost effective solution for water treatment process. The current work presents the biodegradation of MCs and NOD by bacterial isolates from three different bacteria genus Arthrobacter, Brevibacterium and Rhodococcus belonging to Actinobacteria. A total of five isolates representing the three genera have demonstrated an overall metabolism of MC-LR, -LF, -LY, -LW, -RR and NOD in a Biolog MT2 assay. Subsequently, these bacteria were reported to degrade the range of toxins in a separate batch experiment. The bacterial degradation rate of the above cyanobacterial peptides were found to decrease with the multiple subculturing of the bacteria. However, a rapid degradation was discovered when the bacteria were re-exposed to MC or other prokaryotic peptides demonstrating an inducible bacterial biodegradation. Utilising latest molecular biology techniques, the gene responsible for production of MC degrading enzymes was successfully elucidated and its activity was evaluated. Analysis of the degradation products of MC-LR revealed a glutathione conjugate detoxification mechanism involved during the degradation of MC-LR by Rhodococcus sp. (C1). A novel MC degradation pathway was proposed. Further studies were suggested to fully characterise the degradation pathway and to evaluate the MC detoxification mechanism in bacteria

Energy absorption characteristics of nano-composite conical structures.

The effect of the filler material on the energy absorption capabilities of polyamide 6 composite structures is studied in details in the present paper. The axial dynamic and quasi-static collapse of conical structures was conducted using a high energy drop tower, as well as Instron 5500R electro-mechanical testing machine. The impact event was recorded using a high-speed camera and the fracture surface was investigated using scanning electron microscopy (SEM). The obtained results indicate an important influence of filler material on the energy absorption capabilities of the polymer composites. A significant increase in specific energy absorption (SEA) is observed in polyamide 6 (PA6) reinforced with nano-silica particles (SiO2) and glass-spheres (GS), whereas addition of montmorillonite (MMT) did not change the SEA parameter

Assessment of nanoparticle release and associated health effect of polymer-silicon composites.

Little information is currently available on possible release of nanomaterials or/and nanoparticles (NP) from conventional and novel products and associated health effect. This study aimed to assess the possible release of NP during the application stage of conventional and nanoproducts. NP release was monitored during physical processing of polymer-silicon composites, and the toxicity of both the released NP and the raw silica nanomaterials that were used as fillers in the nanocomposites was assessed in vitro using human lung epithelial A549 cells. This study suggests that 1) NP can be released from the conventional and novel polymer-silicon composites under certain application scenario; 2) the level of NP release from polymer composites could be altered by different reinforcement materials; e.g. nanostructured MMT could reduce the release while SiO2 NP could increase the release; 3) working with polymer composites under certain conditions could risk inhalation of high level of polymer NP; 4) raw nanomaterials appeared to be toxic in the chosen in vitro system. Further study of the effect of novel filler materials on NP release from final polymer products and the effect of released NP on environment and human health will inform design of safe materials and minimization of negative impact on the environment and human health