Exploring practical approaches to maximising data quality in electronic healthcare records in the primary care setting and associated benefits

Exploiting the information contained within electronic healthcare records (EHR) data will be key to addressing major challenges to public health both nationally and globally, ultimately offering a means of maximising efficiency and equality in care. There are, however, significant challenges in using EHRs effectively and particularly in ensuring the quality of data recorded. Incorrect or missing data could render records as useless or indeed misleading such that conclusions drawn from the data could have a negative impact. Amongst other difficulties, recording data can be time consuming to the extent of conflicting with the GP’s primary focus of patient consultation in an already time-constrained environment. Understanding the requirements of and the demands upon GPs must be central to addressing the issue of data quality (DQ) within EHRs. As part of on-going work into DQ at the Clinical Practice Research Datalink (CPRD) and in collaboration with the University of Sussex (UoS), a workshop session was held at the SAPC (Society for Academic Primary Care) conference in 2014 with the aim of exploring issues of DQ in primary care EHRs from the perspective of different users of GP data and with particular focus on how and why data is recorded in the first instance. The intended outcome was a furthered understanding of both the challenges and the direct benefits to GPs of ensuring high quality data with a view to establishing a workable approach to recording data and maximising benefits to all users of EHRs

SDSSJ14584479+3720215: A Benchmark JHK Blazar Light Curve from the 2MASS Calibration Scans

Active galactic nuclei (AGNs) are well-known to exhibit flux variability across a wide range of wavelength regimes, but the precise origin of the variability at different wavelengths remains unclear. To investigate the relatively unexplored near-IR variability of the most luminous AGNs, we conduct a search for variability using well sampled JHKs-band light curves from the 2MASS survey calibration fields. Our sample includes 27 known quasars with an average of 924 epochs of observation over three years, as well as one spectroscopically confirmed blazar (SDSSJ14584479+3720215) with 1972 epochs of data. This is the best-sampled NIR photometric blazar light curve to date, and it exhibits correlated, stochastic variability that we characterize with continuous auto-regressive moving average (CARMA) models. None of the other 26 known quasars had detectable variability in the 2MASS bands above the photometric uncertainty. A blind search of the 2MASS calibration field light curves for AGN candidates based on fitting CARMA(1,0) models (damped-random walk) uncovered only 7 candidates. All 7 were young stellar objects within the {\rho} Ophiuchus star forming region, five with previous X-ray detections. A significant {\gamma}-ray detection (5{\sigma}) for the known blazar using 4.5 years of Fermi photon data is also found. We suggest that strong NIR variability of blazars, such as seen for SDSSJ14584479+3720215, can be used as an efficient method of identifying previously-unidentified {\gamma}-ray blazars, with low contamination from other AGN.Comment: 6 pages, 3 figures, ApJ Accepte

Young people's views about consenting to data linkage:findings from the PEARL qualitative study

Abstract Background Electronic administrative data exist in several domains which, if linked, are potentially useful for research. However, benefits from data linkage should be considered alongside risks such as the threat to privacy. Avon Longitudinal Study of Parents and Children (ALSPAC) is a birth cohort study. The Project to Enhance ALSPAC through Record Linkage (PEARL) was established to enrich the ALSPAC resource through linkage between ALSPAC participants and routine sources of health and social data. Qualitative research was incorporated in the PEARL study to examine participants’ views about data linkage and inform approaches to information sharing. This paper focusses on issues of consent. Methods Digitally recorded interviews were conducted with 55 participants aged 17–19 years. Terms and processes relating to consent, anonymization and data linkage were explained to interviewees. Scenarios were used to prompt consideration of linking different sources of data, and whether consent should be requested. Interview recordings were fully transcribed. Thematic analysis was undertaken using the Framework approach. Results Participant views on data linkage appeared to be most influenced by: considerations around the social sensitivity of the research question, and; the possibility of tangible health benefits in the public interest. Some participants appeared unsure about the effectiveness of anonymization, or did not always view effective anonymization as making consent unnecessary. This was related to notions of ownership of personal information and etiquette around asking permission for secondary use. Despite different consent procedures being explained, participants tended to equate consent with ‘opt-in’ consent through which participants are ‘asked’ if their data can be used for a specific study. Participants raising similar concerns came to differing conclusions about whether consent was needed. Views changed when presented with different scenarios, and were sometimes inconsistent. Conclusions Findings from this study question the validity of ‘informed consent’ as a cornerstone of good governance, and the extent to which potential research participants understand different types of consent and what they are consenting, or not consenting, to. Pragmatic, imaginative and flexible approaches are needed if research using data linkage is to successfully realise its potential for public good without undermining public trust in the research process

The impact of cycle proficiency training on cycle-related behaviours and accidents in adolescence:Findings from ALSPAC, a UK longitudinal cohort

Abstract Background Cycle accidents are a common cause of physical injury in children and adolescents. Education is one strategy to reduce cycle-related injuries. In the UK, some children undertake National Cycle Proficiency Scheme [NCPS] training (now known as Bikeability) in their final years of primary school. It aims to promote cycling and safe cycling behaviours but there has been little scientific evaluation of its effectiveness. Methods The sample (n = 5415) were participants in the Avon Longitudinal Study of Parents and Children who reported whether or not they had received NCPS training. Outcomes were self-reported at 14 and 16 years: cycling to school, ownership of cycle helmet, use of cycle helmet and high-visibility clothing on last cycle, and involvement in a cycle accident. An additional outcome, hospital admittance due to a cycle accident from 11 to 16 years, was also included for a subsample (n = 2222) who have been linked to Hospital Episode Statistics (HES) data. Results Approximately 40 % of the sample had received NCPS training. Trained children were more likely to cycle to school and to own a cycle helmet at both 14 and 16 years, to have worn a helmet on their last cycle at age 14, and to have worn high-visibility clothing at age 16, than those who had not attended a course. NCPS training was not associated with self-reported involvement in a cycle accident, and only six of those with HES data had been admitted to hospital due to a cycle accident. Irrespective of training, results indicate very low use of high-visibility clothing, very few girls cycling as part of their school commute, and less than half of helmet owners wearing one on their last cycle. Conclusions Our results suggest cycle training courses for children can have benefits that persist into adolescence. However, the low use of cycle helmets, very low use of high-visibility clothing, and low levels of cycling to school for girls, indicate the further potential for interventions to encourage cycling, and safe cycling behaviours, in young people

О. Олесь

О. Олесь (справж. прізв. - Олександр Іванович Кандиба; 1878-1944) - український поет

The frequency and duration of Salmonella-macrophage adhesion events determines infection efficiency.

Salmonella enterica causes a range of important diseases in humans and a in a variety of animal species. The ability of bacteria to adhere to, invade and survive within host cells plays an important role in the pathogenesis of Salmonella infections. In systemic salmonellosis, macrophages constitute a niche for the proliferation of bacteria within the host organism. Salmonella enterica serovar Typhimurium is flagellated and the frequency with which this bacterium collides with a cell is important for infection efficiency. We investigated how bacterial motility affects infection efficiency, using a combination of population-level macrophage infection experiments and direct imaging of single-cell infection events, comparing wild-type and motility mutants. Non-motile and aflagellate bacterial strains, in contrast to wild-type bacteria, collide less frequently with macrophages, are in contact with the cell for less time and infect less frequently. Run-biased Salmonella also collide less frequently with macrophages but maintain contact with macrophages for a longer period of time than wild-type strains and infect the cells more readily. Our results suggest that uptake of S. Typhimurium by macrophages is dependent upon the duration of contact time of the bacterium with the cell, in addition to the frequency with which the bacteria collide with the cell.SA was supported by an Oliver Gatty studentship, and this work was funded from EU-ITN Transpol (PC), BBSRC Research Development Fellowship BB/H021930/1 (JAW and CEB).This is the final version of the article. It first appeared from the Royal Society. via http://dx.doi.org/10.1098/rstb.2014.003

Cadherin-26 (CDH26) regulates airway epithelial cell cytoskeletal structure and polarity.

Polarization of the airway epithelial cells (AECs) in the airway lumen is critical to the proper function of the mucociliary escalator and maintenance of lung health, but the cellular requirements for polarization of AECs are poorly understood. Using human AECs and cell lines, we demonstrate that cadherin-26 (CDH26) is abundantly expressed in differentiated AECs, localizes to the cell apices near ciliary membranes, and has functional cadherin domains with homotypic binding. We find a unique and non-redundant role for CDH26, previously uncharacterized in AECs, in regulation of cell-cell contact and cell integrity through maintaining cytoskeletal structures. Overexpression of CDH26 in cells with a fibroblastoid phenotype increases contact inhibition and promotes monolayer formation and cortical actin structures. CDH26 expression is also important for localization of planar cell polarity proteins. Knockdown of CDH26 in AECs results in loss of cortical actin and disruption of CRB3 and other proteins associated with apical polarity. Together, our findings uncover previously unrecognized functions for CDH26 in the maintenance of actin cytoskeleton and apicobasal polarity of AECs