The economic ecology of small businesses in Oxfordshire

Report by the Oxfordshire Economic Observatory (OEO) for the Federation of Small Businesses (FSB), Oxfordshire Branch

On a Want of Symmetry shown by Secondary X-Rays

n/

What do patients with diabetes and providers think of an innovative Australian model of remote diabetic retinopathy screening? A qualitative study

Background: Diabetic retinopathy (DR) is the commonest cause of preventable blindness in working age populations, but up to 98% of visual loss secondary to DR can be prevented with early detection and treatment. In 2012, an innovative outreach DR screening model was implemented in remote communities in a state of Australia. The aim of this study was to explore the acceptability of this unique DR screening model to patients, health professionals and other key stakeholders. Methods: This descriptive qualitative study used semi-structured interviews with patients opportunistically recruited whilst attending DR screening, and purposefully selected health care professionals either working within or impacted by the programme. Interviews were audiotaped, transcribed and analysed using NVIVO. An iterative process of thematic analysis was used following the principles of grounded theory. Results: Interviews were conducted with fourteen patients with diabetes living in three remote communities and nine health professionals or key stakeholders. Nine key themes emerged during interviews with health professionals, key stakeholders and patients: i) improved patient access to DR screening; ii) efficiency, financial implications and sustainability; iii) quality and safety; iv) multi-disciplinary diabetes care; v) training and education; vi) operational elements of service delivery; vii) communication, information sharing and linkages; viii) coordination and integration of the service and ix) suggested improvements to service delivery. Conclusions: The Remote Outreach DR Screening Service is highly acceptable to patients and health professionals. Challenges have primarily been encountered in communication and coordination of the service and further development in these areas could improve the programme's impact and sustainability in remote communities. The service is applicable to other remote communities nationally and potentially internationally

Nitisinone Arrests but Does Not Reverse Ochronosis in Alkaptonuric Mice.

Alkaptonuria (AKU) is an ultrarare autosomal recessive disorder resulting from a deficiency of homogentisate 1,2 dioxygenase (HGD), an enzyme involved in the catabolism of phenylalanine and tyrosine. Loss of HGD function prevents metabolism of homogentisic acid (HGA), leading to increased levels of plasma HGA and urinary excretion. Excess HGA becomes deposited in collagenous tissues and subsequently undergoes polymerisation, principally in the cartilages of loaded joints, in a process known as ochronosis. This results in an early-onset, devastating osteoarthropathy for which there is currently no effective treatment. We recently described the natural history of ochronosis in a murine model of AKU, demonstrating that deposition of ochronotic pigment begins very early in life and accumulates with age. Using this model, we were able to show that lifetime treatment with nitisinone, a potential therapy for AKU, was able to completely prevent deposition of ochronotic pigment. However, although nitisinone has been shown to inhibit ochronotic deposition, whether it can also facilitate removal of existing pigment has not yet been examined. We describe here that midlife administration of nitisinone to AKU mice arrests further deposition of ochronotic pigment in the tibiofemoral joint, but does not result in the clearance of existing pigment. We also demonstrate the dose-dependent response of plasma HGA to nitisinone, highlighting its efficacy for personalised medicine, where dosage can be tailored to the individual AKU patient

The moral-IT deck:A tool for ethics by design

This paper presents the design process and empirical evaluation of a new tool for enabling ethics by design: The Moral-IT Cards. Better tools are needed to support the role of technologists in addressing ethical issues during system design. These physical cards support reflection by technologists on normative aspects of technology development, specifically on emerging risks, appropriate safeguards and challenges of implementing these in the system. We discuss how the cards were developed and tested within 5 workshops with 20 participants from both research and commercial settings. We consider the role of technologists in ethics from different EU/UK policymaking initiatives and disciplinary perspectives (i.e. Science and Technology Studies (STS), IT Law, Human Computer Interaction (HCI), Computer/Engineering Ethics). We then examine existing ethics by design tools, and other cards based tools before arguing why cards can be a useful medium for addressing complex ethical issues. We present the development process for the Moral-IT cards, document key features of our card design, background on the content, the impact assessment board process for using them and how this was formulated. We discuss our study design and methodology before examining key findings which are clustered around three overarching themes. These are: the value of our cards as a tool, their impact on the technology design process and how they structure ethical reflection practices. We conclude with key lessons and concepts such as how they level the playing field for debate; enable ethical clustering, sorting and comparison; provide appropriate anchors for discussion and highlighted the intertwined nature of ethics.Comment: Governance and Regulation; Design Tools; Responsible Research and Innovation; Ethics by Design; Games; Human Computer Interaction, Card Based Tool

Intermittent applied mechanical loading induces subchondral bone thickening that may be intensified locally by contiguous articular cartilage lesions

Objectives: Changes in subchondral bone (SCB) and cross-talk with articular cartilage (AC) have been linked to osteoarthritis (OA). Using micro-computed tomography (micro-CT) this study: (1) examines changes in SCB architecture in a non-invasive loading mouse model in which focal AC lesions are induced selectively in the lateral femur, and (2) determines any modifications in the contralateral knee, linked to changes in gait, which might complicate use of this limb as an internal control. Methods: Right knee joints of CBA mice were loaded: once with 2weeks of habitual use (n=7), for 2weeks (n=8) or for 5weeks (n=5). Both left (contralateral) and right (loaded) knees were micro-CT scanned and the SCB and trabecular bone analysed. Gait analysis was also performed. Results: These analyses showed a significant increase in SCB thickness in the lateral compartments in joints loaded for 5weeks, which was most marked in the lateral femur; the contralateral non-loaded knee also showed transient SCB thickening (loaded once and repetitively). Epiphyseal trabecular bone BV/TV and trabecular thickness were also increased in the lateral compartments after 5 weeks of loading, and in all joint compartments in the contralateral knee. Gait analysis showed that applied loading only affected gait in the contralateral himd-limb in all groups of mice from the second week after the first loading episode. Conclusions: These data indicate a spatial link between SCB thickening and AC lesions following mechanical trauma, and the clear limitations associated with the use of contralateral joints as controls in such OA models, and perhaps in OA diagnosis

Benefits and risks of including the bromoform containing seaweed Asparagopsis in feed for the reduction of methane production from ruminants

The agricultural production of ruminants is responsible for 24% of global methane emissions, contributing 39% of emissions of this greenhouse gas from the agricultural sector. Strategies to mitigate ruminant methanogenesis include the use of methanogen inhibitors. For example, the seaweeds Asparagopsis taxiformis and Asparagopsis armata included at low levels in the feed of cattle and sheep inhibit methanogenesis by up to 98%, with evidence of improvements in feed utilisation efficiency. This has resulted in an increasing interest in and demand for these seaweeds globally. In response, research is progressing rapidly to facilitate Asparagopsis cultivation at large scale, and to develop aquaculture production systems to enable a high quality and consistent supply chain. In addition to developing robust strategies for sustainable production, it is important to consider and evaluate the benefits and risks associated with its production and subsequent use as an antimethanogenic feed ingredient for ruminant livestock. This review focuses on the relevant ruminal biochemical pathways, degradation, and toxicological risks associated with bromoform (CHBr3), the major active ingredient for inhibition of methanogenesis in Asparagopsis, and the effects that production of Asparagopsis and its use as a ruminant feed ingredient might have on atmospheric chemistry

Reducing green tape or rolling back IA in Australia: What are found jurisdictions up to?

EIA has been practiced in Australia and the rest of the world for over 40 years, but despite its successes, EIA may now be facing its biggest challenge since it came into being in 1970 with the US National Environmental Policy Act. As Morgan (2012, 11) notes: “As governments look to stimulate economic growth and create employment in response to the current financial crisis, many are promoting a major expansion of physical infrastructure, encouraging resource development projects, and generally seeking to speed decision-making about development projects. Both EIA and SEA should be even more important in such circumstances, yet the moves taken in some countries to speed up decision-making may weaken the provisions for environmental protection, including impact assessment.” In this political and economic environment, EIA is under scrutiny. Proposed changes to the EU directive on EIA released in October 2012 contain ten changes to the Articles of the Directive, with six of these referring to either ‘streamlining’ EIA or introducing specific timeframes for parts of the EIA process (European Commission 2012). This scrutiny has not been restricted to economies in recession, but includes those that have avoided recession because of strong resources sectors. The same appears to be happening in Australia, and this paper reports on these and other possible ‘efficiency’ changes to EIA in Australia at both national and sub-national levels. We attempt to critically examine the nature of such changes and the risks that may be associated with their implementation. Changes to three of the sub-national EIA processes are reviewed in detail, as well as the proposed changes to the national EIA process. There is always room for more timely assessments, but a critical examination of the potential consequences of these “reforms” on the conduct of EIAs is needed, including whether these efficiency changes will deliver sound environmental management and sustainability-oriented decision-making

Epidemiology of gastrostomy insertion for children and adolescents with intellectual disability

The largest group of recipients of pediatric gastrostomy have neurological impairment with intellectual disability (ID). This study investigated trends in first gastrostomy insertion according to markers of disadvantage and ID etiology. Linked administrative and health data collected over a 32-year study period (1983–2014) for children with ID born between 1983 and 2009 in Western Australia were examined. The annual incidence rate change over calendar year was calculated for all children and according to socioeconomic status, geographical remoteness, and Aboriginality. The most likely causes of ID were identified using available diagnosis codes in the linked data set. Of 11,729 children with ID, 325 (2.8%) received a first gastrostomy within the study period. The incidence rate was highest in the 0–2 age group and there was an increasing incidence trend with calendar time for each age group under 6 years of age. This rate change was greatest in children from the lowest socioeconomic status quintile, who lived in regional/remote areas or who were Aboriginal. The two largest identified groups of ID were genetically caused syndromes (15.1%) and neonatal encephalopathy (14.8%). Conclusion: Gastrostomy is increasingly used in multiple neurological conditions associated with ID, with no apparent accessibility barriers in terms of socioeconomic status, remoteness, or Aboriginality.What is Known:• The use of gastrostomy insertion in pediatrics is increasing and the most common recipients during childhood have neurological impairment, most of whom also have intellectual disability (ID).What is New:• Nearly 3% of children with ID had gastrostomy insertion performed, with the highest incidence in children under 3 years of age.• Gastrostomy use across different social groups was equitable in the Australian setting