Mapping the “housing with care” concept with stakeholders: insights from a UK case study

Purpose - The purpose of this paper is to present the findings of an early stage, exploratory case study of a proposed housing with care initiative (the Crichton Care Campus (CCC)). This sought the perspectives of a range of key stakeholders on the proposed model and how it might be best realised. The analyses of these findings show their relevance to debates on integrated housing with care, and reflect on the methodology used and its potential relevance to similar projects. Design/methodology/approach - The study used a transactive planning approach, where grounded views are sought from a variety of stakeholders. A purposive sample identified informants from relevant health, social care and housing organisations and nine semi-structured interviews were conducted. These were transcribed and data analysis was undertaken on an “interactive” basis, relating care theory to empirical expressions. Findings - The authors identify two contrasting orientations – inclusive “community-oriented” and professional “service-oriented”. This distinction provides the basis for a rudimentary conceptual map which can continue to be used in the planning process. Two significant variables within the conceptual map were the extent to which CCC should be intergenerational and as such, the degree to which care should come from formalised and self-care/informal sources. The potential to achieve an integrated approach was high with stakeholders across all sectors fully supporting the CCC concept and agreeing on the need for it to have a mixed tenure basis and include a range of non-care amenities. Originality/value- This paper offers originality in two respects. Methodologically, it describes an attempt to undertake early stage care planning using a needs led transactive methodology. In more practical terms, it also offers an innovative environment for considering any approach to care planning that actively seeks integration – based on an acknowledgement of complexity, a variety of perspectives and possible conflicts. The authors propose that the concepts of “community-orientation” and “service-orientation” are used as a helpful basis for planning negotiations, making implicit divergences explicit and thus better delineated

Training manual for teaching working with Pacific students: engaging Pacific learners

The Centre’s vision is to “Embrace Pacific Cultures to enhance student experience through improvement of student engagement and achievement so that students become valued leaders and contributors to Pacific communities and New Zealand society”. The main function of the centre revolves firstly, around providing academic and pastoral support for Pacific students. Secondly, through the provision of advise and support for academic lecturers. Finally, through engagement and working closely with Pacific families and communities. The Nakuita, which is Fijian for octopus was developed by the Pacific Centre’s Director, Linda Aumua in 2008, to inform the work of the centre. The octopus has one central body which metaphorically refers to the centre and its tentacles as the Pacific support provided through the learning development lecturers infiltrating the departments and services. The concept started out with the centre employing learning development lecturers. The learning development lecturers are nurtured at the centre before they are placed in the departments, usually in the staff member’s area of expertise. The idea is that the staff member will be able to provide content support and learning development support for Pacific students. The flexibility of the octopus framework enabled the centre to collaborate with departments to co-employ the learning development lecturers with the aim of the departments picking up full employment of the Pacific staff. The success of the Nakuita has extended into the area of staff support. This include providing professional development workshops on understanding Pacific learners; engaging Pacific learners; providing input into curriculum development around embedding Pacific dimensions into the curricula and collaborating with staff on Pacific research. Through collaboration with the two lecturers in the Graduate Diploma in Not-For-Profit Management, Sandy Thompson and Fraser McDonald we are also able to produce this training resource. This collaboration started with the centre providing support for the Pacific students on their programme. This has extended to a co-employment of a Pacific staff member to provide focus support for students in this programme. This manual is divided into five sections. Section 1 is the introduction and includes a triangulation of a literature review on engagement of Pacific learners, students’ evaluation and tutors learning experiences. Section 2 draws on the experiences of the above Unitec staff and looks at meaningful ways to engage Pacific learners in classroom discussions and class content. Section 3 provides some example of teaching plans and Section 4 consist of a list of references used in this work. Finally, Section 5 is a resource/information section that will provide additional information and resources to support the work of teachers

What is research with children and young people?

Research with children and young people has a long history, going back at least to the end of the nineteenth century (de Landsheere 1988). However, its character has changed over time, and become more diverse. This reflects the range of different areas and disciplines involved, such as the study of health and education, of psychology, anthropology and sociology. In this chapter we will look, first of all, at the nature of research: the aim will be to give you an initial sense of the different approaches to inquiry that you will find in the literature about children and young people, the ideas underpinning them, and the debates that surround them. You will be introduced to these in more detail in later chapters. In the second half of the chapter we will look at what it means to do research with children and young people. In particular, since it has become very influential, we will pay close attention to what is referred to as ‘participatory research’. As will become clear, this kind of work highlights some important methodological, ethical and political issues

Ultrasound and Microbubbles Promote the Retention of Fluorescent Compounds in the Small Intestine

Focused ultrasound (US) is a novel means to increase the passage of medication through the wall of the small intestine. The purpose of this study was to determine whether US and microbubbles (MBs) can facilitate delivery of macromolecular therapeutic agents across the intestinal epithelium in vitro and in vivo. In vitro experiments involved delivery of compounds across a cell monolayer, namely Caco-2 cells cultured on ThinCert filters. The cells were cultured for a minimum of 3 weeks to mimic the polarised intestinal epithelium. A suspension of dextran with or without MBs, prepared in growth medium, was introduced into the apical chamber of the ThinCert with a syringe pump through a channel in the centre of a miniature focused US transducer (4 MHz, 1 MPa PNP). Each in vivo experiment involved a tethered endoscopic capsule with an US transducer and a delivery channel inserted into the small intestine of a terminally anaesthetised pig via a surgical stoma. The amount of fluorescent dextran delivered across the Caco-2 monolayer when employing US, MBs and dextran was higher than the amount delivered with dextran alone. With this approach, fluorescent marking of the wall of the small intestine was achieved in vivo by applying US and MBs. Our work indicates that US has potential for application in targeted treatment of gastrointestinal disease and oral drug delivery

Ultrasound capsule endoscopy:sounding out the future

Video capsule endoscopy (VCE) has been of immense benefit in the diagnosis and management of gastrointestinal (GI) disorders since its introduction in 2001. However, it suffers from a number of well recognized deficiencies. Amongst these is the limited capability of white light imaging, which is restricted to analysis of the mucosal surface. Current capsule endoscopes are dependent on visual manifestation of disease and limited in regards to transmural imaging and detection of deeper pathology. Ultrasound capsule endoscopy (USCE) has the potential to overcome surface only imaging and provide transmural scans of the GI tract. The integration of high frequency microultrasound (µUS) into capsule endoscopy would allow high resolution transmural images and provide a means of both qualitative and quantitative assessment of the bowel wall. Quantitative ultrasound (QUS) can provide data in an objective and measurable manner, potentially reducing lengthy interpretation times by incorporation into an automated diagnostic process. The research described here is focused on the development of USCE and other complementary diagnostic and therapeutic modalities. Presently investigations have entered a preclinical phase with laboratory investigations running concurrently

Ultrasound mediated delivery of quantum dots from a capsule endoscope to the gastrointestinal wall

Biologic drugs, defined as therapeutic agents produced from or containing components of a living organism, are of growing importance to the pharmaceutical industry. Though oral delivery of medicine is convenient, biologics require invasive injections because of their poor bioavailability via oral routes. Delivery of biologics to the small intestine using electronic delivery with devices that are similar to capsule endoscopes is a promising means of overcoming this limitation and does not require reformulation of the therapeutic agent. The efficacy of such capsule devices for drug delivery could be further improved by increasing the permeability of the intestinal tract lining with an integrated ultrasound transducer to increase uptake. This paper describes a novel proof of concept capsule device capable of electronic application of focused ultrasound and delivery of therapeutic agents. Fluorescent markers, which were chosen as a model drug, were used to demonstrate in-vivo delivery in the porcine small intestine with this capsule. We show that the fluorescent markers can penetrate the mucus layer of the small intestine at low acoustic powers when combining microbubbles with focussed ultrasound. These findings suggest that the use of focused ultrasound together with microbubbles could play a role in the oral delivery of biologic therapeutics

Ultrasound mediated delivery of quantum dots from a proof of concept capsule endoscope to the gastrointestinal wall

Biologic drugs, defined as therapeutic agents produced from or containing components of a living organism, are of growing importance to the pharmaceutical industry. Though oral delivery of medicine is convenient, biologics require invasive injections because of their poor bioavailability via oral routes. Delivery of biologics to the small intestine using electronic delivery with devices that are similar to capsule endoscopes is a promising means of overcoming this limitation and does not require reformulation of the therapeutic agent. The efficacy of such capsule devices for drug delivery could be further improved by increasing the permeability of the intestinal tract lining with an integrated ultrasound transducer to increase uptake. This paper describes a novel proof of concept capsule device capable of electronic application of focused ultrasound and delivery of therapeutic agents. Fluorescent markers, which were chosen as a model drug, were used to demonstrate in vivo delivery in the porcine small intestine with this capsule. We show that the fluorescent markers can penetrate the mucus layer of the small intestine at low acoustic powers when combining microbubbles with focused ultrasound during in vivo experiments using porcine models. This study illustrates how such a device could be potentially used for gastrointestinal drug delivery and the challenges to be overcome before focused ultrasound and microbubbles could be used with this device for the oral delivery of biologic therapeutics

Genome-wide diversity and gene expression profiling of Babesia microti isolates identify polymorphic genes that mediate host-pathogen interactions

Babesia microti, a tick-transmitted, intraerythrocytic protozoan parasite circulating mainly among small mammals, is the primary cause of human babesiosis. While most cases are transmitted by Ixodes ticks, the disease may also be transmitted through blood transfusion and perinatally. A comprehensive analysis of genome composition, genetic diversity, and gene expression profiling of seven B. microti isolates revealed that genetic variation in isolates from the Northeast United States is almost exclusively associated with genes encoding the surface proteome and secretome of the parasite. Furthermore, we found that polymorphism is restricted to a small number of genes, which are highly expressed during infection. In order to identify pathogen-encoded factors involved in host-parasite interactions, we screened a proteome array comprised of 174 B. microti proteins, including several predicted members of the parasite secretome. Using this immuno-proteomic approach we identified several novel antigens that trigger strong host immune responses during the onset of infection. The genomic and immunological data presented herein provide the first insights into the determinants of B. microti interaction with its mammalian hosts and their relevance for understanding the selective pressures acting on parasite evolution

Agreement with the internal possessor in Chimane

The paper examines a type of clausal construction in Chimane (or Tsimane’, unclassified, Bolivia) in which possessors which are apparently internal to patient- or recipient-like possessive phrases can control object agreement on the verb. Various aspects of the construction point to an analysis in which the internal possessor is doubled by an external representation or ‘proxy’ in the clause which mediates the agreement relation between the possessor and the verb. The construction bears some resemblance to external possessor constructions, albeit with the added complication that the possessor itself remains internal to the possessive phrase while its argument function is borne by the external proxy. The paper examines features of the construction and contrasts it with similar or related phenomena which have been identified in other languages