The Ethics of Human Intervention on Behalf of ‘Others’

I regularly pass several homeless persons surviving on the streets even in winter. One sits on a folded scrap of a blanket leaning against a wall looking thin, pale and resigned, doing some calligraphy of messages on card for those who want them. Almost everyone walks quickly past, some manoeuvring to the opposite side of the wide pavement, others almost treading on some of their sparse belongings. Hardly anyone makes eye contact. The harsh reality of living on the street is some days without enough food and basic provisions

Healthcare disparities and models for change.

With Healthy People 2010 making the goal of eliminating health disparities a national priority, policymakers, researchers, medical centers, managed care organizations (MCOs), and advocacy organizations have been called on to move beyond the historic documentation of health disparities and proceed with an agenda to translate policy recommendations into practice. Working models that have successfully reduced health disparities in managed care settings were presented at the National Managed Health Care Congress Inaugural Forum on Reducing Racial and Ethnic Disparities in Health Care on March 10-11, 2003, in Washington, DC. These models are being used by federal, state, and municipal governments, as well as private, commercial, and Medicaid MCOs. Successful models and programs at all levels reduce health disparities by forming partnerships based on common goals to provide care, to educate, and to rebuild healthcare systems. Municipal models work in collaboration with state and federal agencies to integrate patient care with technology. Several basic elements of MCOs help to reduce disparities through emphasis on preventive care, community and member health education, case management and disease management tracking, centralized data collection, and use of sophisticated technology to analyze data and coordinate services. At the community level, there are leveraged funds from the Health Resources and Services Administration's Bureau of Primary Health Care. Well-designed models provide seamless monitoring of patient care and outcomes by integrating human and information system resources

Is there a feudal hierarchy amongst regulatory immune cells? More than just Tregs

Nature has provided the developing immune system with several checkpoints important for the maintenance of tolerance and the prevention of autoimmunity. The regulatory mechanisms operating in the periphery of the system are mediated by subsets of regulatory cells, now considered principal contributors to peripheral tolerance. Regulatory T cells (Tregs) have received titanic interest in the past decade, placing them at the centre of immuno-suppressive reactions. However, it has become clearer that other immune suppressive cells inhibit auto-reactivity as effectively as Tregs. The function of Tregs and other regulatory cells in rheumatoid arthritis will be discussed in this review

What can planners do to climate-proof development and aid multi-functionality?

In this guest editorial, I argue that reducing negative impacts of climate change sits firmly in the realm of planning. Urban development visions, negotiations, recommendations and decision-making by planners directly or indirectly contribute to climate change

Climate and environmental change are happening fast – but will the political climate facilitate transformative planning?

As planners we may identify ourselves or be described as ‘change-makers’. Planning and planners often get bad press about specific planning decisions or being too slow in coming forward with, and approving, new housing, for example. These labels and press coverage may however be more like rose-tinted glasses or a smoke screen than reality. So let’s consider some facts, figures and recent events from the local to the national to the global

The use of design thinking in non-design contexts – a journey and experience

Design thinking is gaining momentum for developing solutions to issues in many areas, eg, health, education and business management. It is seen as a tool for improving creativity, addressing complex or wicked problems and a method for promoting interdisciplinary working among students and professionals. In this paper, we focus on the experiences of four academics on their design thinking journey as part of a European project. This aimed to share design thinking skills and processes for peer training and application with non-design student cohorts. Important is the fact that none of the participants are trained designers. The four have been participants, facilitators and teachers and been subject to and used design thinking tools and techniques in a variety of contexts, together and individually. By reflecting on these experiences and drawing out lessons learned the paper argues that design thinking is useful in a non-design context and has become well enough defined to be applied by people whose background is not design. The paper concludes with some key factors in delivering design thinking workshops for the future as well as identifying areas for further research

Are you game for Climate Action? Lessons for STEAM education from developing the built environment climate literacy board game CLIMANIA through youth-led co-design

The Climate Action Game project used a co-design method to develop a board game – CLIMANIA, focusing on climate research/action in the built environment. Climate change adaptation and mitigation in the built environment, while being researched, are not yet at the forefront of policy, public awareness or action (Harrop, 2018); for example, public awareness about the amount of carbon that buildings use and produce appears low. The aim was to co-design an action research game using a transdisciplinary STEAM-like approach. The output focused on climate education in the built environment which can be used as a teaching tool and as a community game by young people to understand how their local built environment can adapt and help achieve the climate targets set by the Paris Climate Agreement/COPs. In the process of co-design, the project tested the awareness of young people regarding the impact of built environment on the climate crisis. It also explored young people’s preferences in built environment climate related issues and explored critical and creative approaches to public education

Growth and development of the placenta in the capybara (Hydrochaeris hydrochaeris)

<p>Abstract</p> <p>Background</p> <p>The guinea pig is an attractive model for human pregnancy and placentation, mainly because of its haemomonochorial placental type, but is rather small in size. Therefore, to better understand the impact of body mass, we studied placental development in the capybara which has a body mass around 50 kg and a gestation period of around 150 days. We paid attention to the development of the lobulated arrangement of the placenta, the growth of the labyrinth in the course of gestation, the differentiation of the subplacenta, and the pattern of invasion by extraplacental trophoblast.</p> <p>Methods</p> <p>Material was collected from six animals at pregnancy stages ranging from the late limb bud stage to mid gestation. Methods included latex casts, standard histology, immunohistochemistry for cytokeratin, vimentin, alpha-smooth muscle actin, and proliferating cell nuclear antigen as well as transmission electron microscopy.</p> <p>Results</p> <p>At the limb bud stage, the placenta was a pad of trophoblast covered by a layer of mesoderm from which fetal vessels were beginning to penetrate at folds in the surface. By 70 days, the placenta comprised areas of labyrinth (lobes) separated by interlobular areas. Placental growth resulted predominantly from proliferation of cellular trophoblast situated in nests at the fetal side of the placenta and along internally directed projections on fetal mesenchyme. Additional proliferation was demonstrated for cellular trophoblast within the labyrinth.</p> <p>Already at the limb bud stage, there was a prominent subplacenta comprising cellular and syncytial trophoblast with mesenchyme and associated blood vessels. At 90 days, differentiation was complete and similar to that seen in other hystricognath rodents. Overlap of fetal vessels and maternal blood lacunae was confirmed by latex injection of the vessels. At all stages extraplacental trophoblast was associated with the maternal arterial supply and consisted of cellular trophoblast and syncytial streamers derived from the subplacenta.</p> <p>Conclusion</p> <p>All important characteristics of placental development and organization in the capybara resembled those found in smaller hystricognath rodents including the guinea pig. These features apparently do not dependent on body size. Clearly, placentation in hystricognaths adheres to an extraordinarily stable pattern suggesting they can be used interchangeably as models of human placenta.</p