CONTINUITY OF INTEGRATED PATIENT CARE: A patient centred study of medication management

This research is about enhancing the continuity of patient care. It focuses on medication management at the time of patient discharge from a cardiology unit in an Australian acute care hospital. That is, during the time of the patients’ transition from tertiary to primary care. The philosophical concept underpinning the research is centred on continuity of patient care which is defined, and then described, in the context of each chapter study undertaken. The main aim of the overall research was to conduct an original, empirical research project to identify, characterise, and investigate a cohort of patients in need of ongoing care after discharge. Those subjects recruited into the Continuity of Care Project were 281 acute on chronic, cardiovascular patients. In this research, the individual chapter studies investigated the need for continuity of care by analysing the quality of prescribing recorded at hospital discharge and at medication review in the community

Trends and challenges for microporous polymers.

Microporous polymers are covalently bound, entirely organic materials which possess very high surface areas. These materials have been intensively studied within recent years and various interesting properties and possible applications have been discovered and described. This review article starts with the question, what makes microporous polymers special and are there certain features which differentiate them from other microporous materials? Indeed, there are some special structural and functional features found in microporous polymers which make them really unique and merit further exploration. We focus here on microporous polymers which are solution-processable, can be produced as thin films on electrodes by oxidative polymerizations, are π-conjugated organic semiconductors, or which provide the possibility to introduce and exploit distinct functional groups in an otherwise non-functional highly porous environment. Emerging applications for these microporous polymers which make explicit use of these unique features are further presented

Differentially expressed microRNAs in maternal plasma for the noninvasive prenatal diagnosis of Down syndrome (trisomy 21).

OBJECTIVES: Most developmental processes are under the control of small regulatory RNAs called microRNAs (miRNAs). We hypothesize that different fetal developmental processes might be reflected by extracellular miRNAs in maternal plasma and may be utilized as biomarkers for the noninvasive prenatal diagnosis of chromosomal aneuploidies. In this proof-of-concept study, we report on the identification of extracellular miRNAs in maternal plasma of Down syndrome (DS) pregnancies. METHODS: Using high-throughput quantitative PCR (HT-qPCR), 1043 miRNAs were investigated in maternal plasma via comparison of seven DS pregnancies with age and fetal sex matched controls. RESULTS: Six hundred and ninety-five miRNAs were identified. Thirty-six significantly differentially expressed mature miRNAs were identified as potential biomarkers. Hierarchical cluster analysis of these miRNAs resulted in the clear discrimination of DS from euploid pregnancies. Gene targets of the differentially expressed miRNAs were enriched in signaling pathways such as mucin type-O-glycans, ECM-receptor interactions, TGF-beta, and endocytosis, which have been previously associated with DS. CONCLUSIONS: miRNAs are promising and stable biomarkers for a broad range of diseases and may allow a reliable, cost-efficient diagnostic tool for the noninvasive prenatal diagnosis of DS

Inspædia: [Almost] Everything About Simplicity, Playfulness and Inspiration

The aim of this paper is to disclose the new research developments and the results from the systematization of experience and user interaction with the Inspædia (a new web knowledge “Agora”), to inspire a dynamic, collaborative, and interactive intelligence among the inspædiers. We will explain in detail and describe the design process and discuss the ultimate design interaction concept & development regarding (almost everything about) simplicity and playfulness of the inspædiers’ experience to transform relevant information (related > meanfull > useful) in productive knowledge (inspiration > insight > foresight) in a very easy and quick way (usability: learnability; understandability; operability; attractiveness...), with a smile in the face (satisfaction) and a wow in the mind (or in the soul).Inspædia is the natural consequence and development of the prototype resulting from the research in Design PhD thesis Innovation, design et cetera (FA/UTL, 2012). Therefore, it is being developed with the Science Without Borders Program (2013-2016) with a Special Visiting Researcher fellowship grant of CAPES (Brazil), and under the post-doctoral in Design at the Faculty of Architecture, University of Lisbon (FA/UL); CIAUD – Reseach Centre of Architecture, Urbanism and Design (FA/UL); Faculty of Sciences and Technology, Nova University of Lisbon (FCT/UNL); NOVA-LINCS (FCT/UNL) and CITAD - Research Centre for Territory, Architecture and Design (FAA/ULL). The Inspædia research project was ranked in first place in Design scientific area and obtained a post-doctoral fellowship by FCT – Foundation for Science and Technology (Portugal). The project has been internationally disseminated at international Design conferences with indexed publications. It was presented and published both at AHFE 2014 (Krakow) and AHFE 2015 (Las Vegas). It was part of the biennial Experimentadesign tangential events in 2013 (EXD'13), 2015 (EXD'15) and was presented, by invitation, at the International Congress DESIGN I-CON (2015). During the last year we prototyped and tested (usability testing) with some inspædiers different approaches to achieve users’ needs > desires > expectations) in a challenging way, in order to provide the most powerful and memorable user experience

Down syndrome and aberrant right subclavian artery

Down syndrome (DS) may be associated with various organ system disorders. Feeding problems are frequent in children with DS and may be caused by associated defects, including congenital heart defects, gastrointestinal defects, or endocrine disorders. In the absence of these associated conditions, feeding problems are often attributed to general hypotonia. However, an aberrant right subclavian artery (ARSA), a rare vascular anomaly and an unusual cause of problems with the passage of solid food through the esophagus, has recently been suggested to occur more frequently in patients with DS. This knowledge is of importance when evaluating feeding difficulties in patients with DS. Additional investigation for identifying an ARSA may be indicated in selected patients. Diagnostic techniques, such as transthoracic echocardiography, barium contrast esophagram, angiography, or computed tomography–angiography (CT) can be used in a diagnostic flow chart. The presence of ARSA is not synonymous to the cause of feeding problems in patients with DS and corrective surgery of this vascular anomaly should be restricted to selected cases

Transport Phenomena and Structuring in Shear Flow of Suspensions near Solid Walls

In this paper we apply the lattice-Boltzmann method and an extension to particle suspensions as introduced by Ladd et al. to study transport phenomena and structuring effects of particles suspended in a fluid near sheared solid walls. We find that a particle free region arises near walls, which has a width depending on the shear rate and the particle concentration. The wall causes the formation of parallel particle layers at low concentrations, where the number of particles per layer decreases with increasing distance to the wall.Comment: 14 pages, 14 figure

The KATRIN Pre-Spectrometer at reduced Filter Energy

The KArlsruhe TRItium Neutrino experiment, KATRIN, will determine the mass of the electron neutrino with a sensitivity of 0.2 eV (90% C.L.) via a measurement of the beta-spectrum of gaseous tritium near its endpoint of E_0 =18.57 keV. An ultra-low background of about b = 10 mHz is among the requirements to reach this sensitivity. In the KATRIN main beam-line two spectrometers of MAC-E filter type are used in a tandem configuration. This setup, however, produces a Penning trap which could lead to increased background. We have performed test measurements showing that the filter energy of the pre-spectrometer can be reduced by several keV in order to diminish this trap. These measurements were analyzed with the help of a complex computer simulation, modeling multiple electron reflections both from the detector and the photoelectric electron source used in our test setup.Comment: 22 pages, 12 figure

Prenatal hypoxia induces increased cardiac contractility on a background of decreased capillary density.

Background: Chronic hypoxia in utero (CHU) is one of the most common insults to fetal development and may be associated with poor cardiac recovery from ischaemia-reperfusion injury,yet the effects on normal cardiac mechanical performance are poorly understood. Methods: Pregnant female wistar rats were exposed to hypoxia (12% oxygen, balance nitrogen)for days 10–20 of pregnancy. Pups were born into normal room air and weaned normally. At 10 weeks of age, hearts were excised under anaesthesia and underwent retrograde 'Langendorff' perfusion. Mechanical performance was measured at constant filling pressure (100 cm H2O) with intraventricular balloon. Left ventricular free wall was dissected away and capillary density estimated following alkaline phosphatase staining. Expression of SERCA2a and Nitric Oxide Synthases (NOS) proteins were estimated by immunoblotting. Results: CHU significantly increased body mass (P < 0.001) compared with age-matched control rats but was without effect on relative cardiac mass. For incremental increases in left ventricular balloon volume, diastolic pressure was preserved. However, systolic pressure was significantly greater following CHU for balloon volume = 50 μl (P < 0.01) and up to 200 μl (P < 0.05). For higher balloon volumes systolic pressure was not significantly different from control. Developed pressures were correspondingly increased relative to controls for balloon volumes up to 250 μl (P < 0.05).Left ventricular free wall capillary density was significantly decreased in both epicardium (18%; P <0.05) and endocardium (11%; P < 0.05) despite preserved coronary flow. Western blot analysis revealed no change to the expression of SERCA2a or nNOS but immuno-detectable eNOS protein was significantly decreased (P < 0.001) in cardiac tissue following chronic hypoxia in utero. Conclusion: These data offer potential mechanisms for poor recovery following ischaemia, including decreased coronary flow reserve and impaired angiogenesis with subsequent detrimental effects of post-natal cardiac performance