2,213 research outputs found

    NHS reforms and the working lives of midwives and physiotherapists

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    From 2000 the NHS was subjected to a series of far reaching reforms, the purposes of which were to increase the role of the primary care sector in commissioning and providing services, promote healthier life styles, reduce health inequality, and improve service standards. These were seen as requiring a greater leadership role from health professionals, closer and more cooperative working between health professionals, and between health professionals, social services, and community and other service providers. The project surveyed a random sample of midwives and physiotherapists to investigate their perceptions of the effectiveness of the reforms, and their effects on working lives. The predominant perception was that NHS reforms had negatively affected the funding of their services; and had done little to improve service quality, delivery or organisation. Although the potential existed for the reforms to improve services, the necessary resources and required staffing were not made available and the objectives of the reforms were only partially secured by intensifying of work. The downside of this was a deterioration of the sociopsychological wellbeing of midwives and physiotherapists, especially the former, exacerbating the shortage of skilled and experienced. Shortage of staff and the associated increased work burdens were demoralising and demotivating; morale and job satisfaction declined, and job insecurity and labour turnover increased

    Medical and surgical management of gallbladder sludge and mucocoele development in a Miniature Schnauzer

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    The factors enhancing mucocoele development in dogs remain poorly understood. A 7-year-old female spayed Miniature Schnauzer was presented to the Massey University Veterinary Teaching Hospital for progressive lethargy, inappetance and abdominal discomfort. Initial physical examination findings revealed a moderate degree of cranial abdominal pain, with subsequent diagnostic tests confirming the patient as having diabetes mellitus, with a concurrent marked hypertriglyceridaemia. In an attempt to localise the source of pain, an ultrasound examination of the abdomen was performed, revealing a marked degree of gallbladder sludge. With appropriate medical management including ursodeoxycholic acid and insulin therapy, the patient stabilised and was discharged. With persistence of clinical signs three months later, progression of the gallbladder sludge towards mucocoele development was suspected. Exploratory laparotomy was instigated, and an emergency cholecystectomy was performed. This case report therefore entails a suspected gallbladder mucocoele that developed in a diabetic patient with previously diagnosed biliary sludge. A unique feature of this case report is the presence of diabetes mellitus, which has been suggested to be a causative factor in the development of gallbladder mucocoeles. It is also hypothesised that gallbladder sludge and mucocoeles are associated, however it is yet to be ascertained whether this association is causal or contributory. The authors examined the possible relationship between this endocrinopathy and biliary sludge, and their possible effects on mucocoele development. Specific associated factors to sludge formation are also examined. The medical and surgical management of gallbladder mucocoeles is discussed

    Human development and decent Work: Why some concepts succeed and others fail to make an impact

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    This paper examines the impact of the International Labour Office’s (ILO) concept of Decent Work on development thinking and the associated literature. We attempt to answer the question of what makes a development initiative successful by comparing the decent work approach to the United Nation Development Program's (UNDP) human development concept (in conjunction with the human development indicator). We consider that the latter has been one of the most successful development concepts ever to have been launched, while the impact of decent work by comparison has been limited. Our hypothesis relating to the question of what makes a development initiative successful has three fundamental components: first, a solid theoretical foundation has to justify the launch of a development concept. A second vital factor is the availability of sufficient national and internationally comparable data that enables researchers and policymakers alike to apply the concept, preferably by means of a synthetic indicator. Third, the political will and institutional structure of the development institution that launches a concept is a key factor, particularly if data availability is limited as countries then have to be persuaded to generate new data.The authors would like to thank the Cambridge Humanities Research Grants Scheme, the European Union (FP7 project ‘Nopoor’), and the Conicyt/Fondap Proyect number 15130009 for partial funding provided for this paper.This is the accepted manuscript. It's currently embargoed pending publication by Wiley. The final version is available at http://onlinelibrary.wiley.com/doi/10.1111/dech.12149/abstrac

    Expression of recombinant multi-coloured fluorescent antibodies in gor -/trxB- E. coli cytoplasm

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    <p>Abstract</p> <p>Background</p> <p>Antibody-fluorophore conjugates are invaluable reagents used in contemporary molecular cell biology for imaging, cell sorting and tracking intracellular events. However they suffer in some cases from batch to batch variation, partial loss of binding and susceptibility to photo-bleaching. In theory, these issues can all be addressed by using recombinant antibody fused directly to genetically encoded fluorescent reporters. However, single-chain fragment variable domains linked by long flexible linkers are themselves prone to disassociation and aggregation, and in some cases with isoelectric points incompatible with use in physiologically relevant milieu. Here we describe a general approach that permits fully functional intracellular production of a range of coloured fluorescent recombinant antibodies with optimally orientated V<sub>H</sub>/V<sub>L </sub>interfaces and isoelectric points compatible for use in physiological solutions at pH 7.4 with a binding site to fluorophore stoichiometry of 1:1.</p> <p>Results</p> <p>Here we report the design, assembly, intracellular bacterial production and purification of a panel of novel antibody fluorescent protein fusion constructs. The insertion of monomeric fluorescent protein derived from either <it>Discosoma </it>or <it>Aequorea </it>in-between the variable regions of anti-p185<sup>HER2-ECD </sup>antibody 4D5-8 resulted in optimal V<sub>H</sub>/V<sub>L </sub>interface interactions to create soluble coloured antibodies each with a single binding site, with isoelectric points of 6.5- 6. The fluorescent antibodies used in cell staining studies with SK-BR-3 cells retained the fluorophore properties and antibody specificity functions, whereas the conventional 4D5-8 single chain antibody with a (Gly<sub>4</sub>Ser)<sub>3 </sub>linker precipitated at physiological pH 7.4.</p> <p>Conclusions</p> <p>This modular monomeric recombinant fluorescent antibody platform may be used to create a range of recombinant coloured antibody molecules for quantitative <it>in situ, in vivo </it>and <it>ex vivo </it>imaging, cell sorting and cell trafficking studies. Assembling the single chain antibody with monomeric fluorescent protein linker facilitates optimal variable domain pairing and alters the isoelectric point of the recombinant 4D5-8 protein conferring solubility at physiological pH 7.4. The efficient intracellular expression of these functional molecules opens up the possibility of developing an alternative approach for tagging intracellular targets with fluorescent proteins for a range of molecular cell biology imaging studies.</p

    The quality of employment and decent work: definitions, methodologies, and ongoing debates

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    This article explores the development of concepts related to the ‘quality of employment’ in the academic literature in terms of their definition, methodological progress and ongoing policy debates. Over time, these concepts have evolved from simple studies of job satisfaction towards more comprehensive measures of job and employment quality, including the International Labour Organization’s concept of ‘Decent Work’ launched in 1999. This article compares the parallel development of quality of employment measures in the European Union with the ILO’s Decent Work agenda and concludes that the former has advanced much further due to more consistent efforts to generate internationally comparable data on labour markets, which permit detailed measurements and international comparisons. In contrast, Decent Work remains a very broadly defined concept, which is impossible to measure across countries. We conclude by proposing three important differences between these two scenarios that have lead to such diverging paths: the lack of availability of internationally comparable data, the control over the research agenda by partisan social actors, and a prematurely mandated definition of Decent Work that is extremely vague and all-encompassing
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