Organizations in the making: Learning and intervening at the science-policy interface

This paper synthesizes recent insights from geography, science and technology studies and related disciplines concerning organizations and organizational learning at the science-policy interface. The paper argues that organizations do not exist and evolve in isolation, but are co-produced through networked connections to other spaces, bodies and practices. Furthermore, organizations should not be studied as stable entities, but are constantly in-the-making. This co-productionist perspective on organizations and organizing has implications for how geographers theorize, study and intervene in organizations at the science-policy interface with respect to encouraging learning and change and in the roles we adopt within and around such organizations

Public Participation Organizations and Open Policy:A Constitutional Moment for British Democracy?

This article builds on work in Science and Technology Studies and cognate disciplines concerning the institutionalization of public engagement and participation practices. It describes and analyses ethnographic qualitative research into one “organization of participation,” the UK government–funded Sciencewise program. Sciencewise’s interactions with broader political developments are explored, including the emergence of “open policy” as a key policy object in the UK context. The article considers what the new imaginary of openness means for institutionalized forms of public participation in science policymaking, asking whether this is illustrative of a “constitutional moment” in relations between society and science policymaking

The interaction of human microbial pathogens, particulate material and nutrients in estuarine environments and their impacts on recreational and shellfish waters

Anthropogenic activities have increased the load of faecal bacteria, pathogenic viruses and nutrients in rivers, estuaries and coastal areas through point and diffuse sources such as sewage discharges and agricultural runoff. These areas are used by humans for both commercial and recreational activities and are therefore protected by a range of European Directives. If water quality declines in these zones, significant economic losses can occur. Identifying the sources of pollution, however, is notoriously difficult due to the ephemeral nature of discharges, their diffuse source, and uncertainties associated with transport and transformation of the pollutants through the freshwater–marine interface. Further, significant interaction between nutrients, microorganisms and particulates can occur in the water column making prediction of the fate and potential infectivity of human pathogenic organisms difficult to ascertain. This interaction is most prevalent in estuarine environments due to the formation of flocs (suspended sediment) at the marine-freshwater interface. A range of physical, chemical and biological processes can induce the co-flocculation of microorganisms, organic matter and mineral particles resulting in pathogenic organisms becoming potentially protected from a range of biotic (e.g. predation) and abiotic stresses (e.g. UV, salinity). These flocs contain and retain macro- and micro- nutrients allowing the potential survival, growth and transfer of pathogenic organisms to commercially sensitive areas (e.g. beaches, shellfish harvesting waters). The flocs can either be transported directly to the coastal environment or can become deposited in the estuary forming cohesive sediments where pathogens can survive for long periods. Especially in response to storms, these sediments can be subsequently remobilised releasing pulses of potential pathogenic organisms back into the water column leading to contamination of marine waters long after the initial contamination event occurred. Further work, however, is still required to understand and predict the potential human infectivity of pathogenic organisms alongside the better design of early warning systems and surveillance measures for risk assessment purposes

UK Environmental Change Network stakeholder consultation

During the Environmental Change Network (ECN) site mangers meeting feedback on the role of UK-SCAPE funding was sought. Representatives from collaborating institutions did not restrict their comments to only the period of UK-SCAPE, as this program is a continuation of previous national capability funding. The stakeholders present appreciated the role of UKCEH through the processes of co-design, co-delivery and co-development in shaping the ECN. They further commented on the co-dependency conferred by the network for their institutions and sites. While several stakeholders noted that they could not benefit directly from UK-SCAPE funding they recognised that funding was required for coordination of the network in addition to collecting monitoring data. They highlighted the risk of failure of the network and the lost opportunities in terms of collaborative working and data delivery to the research community if funding is not maintained in the network

Therapeutic potential of TLR8 agonist GS-9688 (selgantolimod) in chronic hepatitis B: re-modelling of antiviral and regulatory mediators

Background & Aims: GS‐9688 (selgantolimod) is a toll‐like receptor 8 (TLR8) agonist in clinical development for the treatment of chronic hepatitis B (CHB). Antiviral activity of GS‐9688 has previously been evaluated in vitro in hepatitis B virus (HBV)‐infected hepatocytes and in vivo in the woodchuck model of CHB. Here we evaluated the potential of GS‐9688 to boost responses contributing to viral control and to modulate regulatory mediators. Approach & Results: We characterised the effect of GS‐9688 on immune cell subsets in vitro in PBMC of healthy controls and CHB patients. GS‐9688 activated dendritic cells and mononuclear phagocytes to produce IL‐12 and other immunomodulatory mediators, inducing a comparable cytokine profile in healthy controls and CHB patients. GS‐9688 increased the frequency of activated natural killer (NK) cells, mucosal‐associated invariant T‐cells (MAITs), CD4+ follicular helper T‐cells (TFH) and, in ~50% of patients, HBV‐specific CD8+T‐cells expressing interferon‐γ (IFNγ). Moreover, in vitro stimulation with GS‐9688 induced NK cell expression of IFNγ and TNFα and promoted hepatocyte lysis. We also assessed whether GS‐9688 inhibited immunosuppressive cell subsets that might enhance antiviral efficacy. Stimulation with GS‐9688 reduced the frequency of CD4+ regulatory T‐cells and monocytic myeloid‐derived suppressor cells (MDSC). Residual MDSC expressed higher levels of negative immune regulators, galectin‐9 and PD‐L1. Conversely, GS‐9688 induced an expansion of immunoregulatory TNF‐related apoptosis‐inducing ligand+ (TRAIL) regulatory NK cells and degranulation of arginase‐I+ polymorphonuclear‐MDSC (PMN‐MDSC). Conclusions: GS‐9688 induces cytokines in human PBMC that are able to activate antiviral effector function by multiple immune mediators (HBV‐specific CD8+T‐cells, TFH, NK cells and MAITs). Whilst reducing the frequency of some immunoregulatory subsets, it enhances the immunosuppressive potential of others, highlighting potential biomarkers and immunotherapeutic targets to optimise the antiviral efficacy of GS‐9688

The UK Environmental Change Network datasets – integrated and co-located data for long-term environmental research (1993–2015)

Long-term datasets of integrated environmental variables, co-located together, are relatively rare. The UK Environmental Change Network (ECN) was launched in 1992 and provides the UK with its only long-term integrated environmental monitoring and research network for the assessment of the causes and consequences of environmental change. Measurements, covering a wide range of physical, chemical, and biological “driver” and “response” variables are made in close proximity at ECN terrestrial sites using protocols incorporating standard quality control procedures. This paper describes the datasets (there are 19 published ECN datasets) for these co-located measurements, containing over 20 years of data (1993–2015). The data and supporting documentation are freely available from the NERC Environmental Information Data Centre under the terms of the Open Government Licence (see paper for DOIs)

Invasive Propionibacterium acnes infections in a non-selective patient cohort: clinical manifestations, management and outcome

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Purpose An increasing number of reports suggest that Propionibacterium acnes can cause serious invasive infections. Currently only limited data exist regarding the spectrum of invasive P. acnes infections. Methods Non-selective cohort study at a tertiary hospital in the UK over a nine-year-period (2003-2012) investigating clinical manifestations, risk factors, management and outcome of invasive P. acnes infections. Results Forty-nine cases were identified; the majority were neurosurgical infections and orthopaedic infections (n=28 and n=15, respectively). Only two cases had no predisposing factors; all neurosurgical and 93.3% of orthopaedic cases had a history of previous surgery and/or trauma. Foreign material was in situ at the infection site in 59.3% and 80.0% of neurosurgical and orthopaedic cases, respectively. All neurosurgical and orthopaedic cases required one or more surgical interventions to treat P. acnes infection, with or without concomitant antibiotic therapy; the duration of antibiotic therapy was significantly longer in the group of orthopaedic cases (median 53 versus 19 days; p=0.0025). All tested P. acnes isolates were susceptible to penicillin, ampicillin and chloramphenicol; only one was clindamycin-resistant. Conclusions Neurosurgical and orthopaedic infections account for the majority of invasive P. acnes infections. The majority of cases have predisposing factors, including previous surgery and/or trauma; spontaneous infections are rare. Foreign material is commonly present at the site of infection, indicating that the pathogenesis of invasive P. acnes infections likely involves biofilm formation. Since invasive P. acnes infections are associated with considerable morbidity, further studies are needed to establish effective prevention and optimal treatment strategies

Duration of intravenous antibiotic therapy for children with acute osteomyelitis or septic arthritis: a feasibility study.

BACKGROUND: There is little current consensus regarding the route or duration of antibiotic treatment for acute osteomyelitis (OM) and septic arthritis (SA) in children. OBJECTIVE: To assess the overall feasibility and inform the design of a future randomised controlled trial (RCT) to reduce the duration of intravenous (i.v.) antibiotic use in paediatric OM and SA. DESIGN: (1) A prospective service evaluation (cohort study) to determine the current disease spectrum and UK clinical practice in paediatric OM/SA; (2) a prospective cohort substudy to assess the use of targeted polymerase chain reaction (PCR) in diagnosing paediatric OM/SA; (3) a qualitative study to explore families' views and experiences of OM/SA; and (4) the development of a core outcome set via a systematic review of literature, Delphi clinician survey and stakeholder consensus meeting. SETTING: Forty-four UK secondary and tertiary UK centres (service evaluation). PARTICIPANTS: Children with OM/SA. INTERVENTIONS: PCR diagnostics were compared with culture as standard of care. Semistructured interviews were used in the qualitative study. RESULTS: Data were obtained on 313 cases of OM/SA, of which 218 (61.2%) were defined as simple disease and 95 (26.7%) were defined as complex disease. The epidemiology of paediatric OM/SA in this study was consistent with existing European data. Children who met oral switch criteria less than 7 days from starting i.v. antibiotics were less likely to experience treatment failure (9.6%) than children who met oral switch criteria after 7 days of i.v. therapy (16.1% when switch was between 1 and 2 weeks; 18.2% when switch was > 2 weeks). In 24 out of 32 simple cases (75%) and 8 out of 12 complex cases (67%) in which the targeted PCR was used, a pathogen was detected. The qualitative study demonstrated the importance to parents and children of consideration of short- and long-term outcomes meaningful to families themselves. The consensus meeting agreed on the following outcomes: rehospitalisation or recurrence of symptoms while on oral antibiotics, recurrence of infection, disability at follow-up, symptom free at 1 year, limb shortening or deformity, chronic OM or arthritis, amputation or fasciotomy, death, need for paediatric intensive care, and line infection. Oral switch criteria were identified, including resolution of fever for ≥ 48 hours, tolerating oral food and medicines, and pain improvement. LIMITATIONS: Data were collected in a 6-month period, which might not have been representative, and follow-up data for long-term complications are limited. CONCLUSIONS: A future RCT would need to recruit from all tertiary and most secondary UK hospitals. Clinicians have implemented early oral switch for selected patients with simple disease without formal clinical trial evidence of safety. However, the current criteria by which decisions to make the oral switch are made are not clearly established or evidence based. FUTURE WORK: A RCT in simple OM and SA comparing shorter- or longer-course i.v. therapy is feasible in children randomised after oral switch criteria are met after 7 days of i.v. therapy, excluding children meeting oral switch criteria in the first week of i.v. therapy. This study design meets clinician preferences and addresses parental concerns not to randomise prior to oral switch criteria being met. FUNDING: The National Institute for Health Research Health Technology Assessment programme

Evaluation of a training programme for foster carers in an independent fostering agency

The aim of this study was to evaluate a parenting programme designed for foster carers from an independent fostering agency. The programme (Park’s Parenting Approach) adapted existing parenting programmes to be more specific to the needs of looked-after children. Sixty-one carers consented to take part in the evaluation of the training, and 55 (90%) completed the programme. The training was delivered over 9 weeks, once a week for 2 h, and pre- and post-course evaluations were carried out at the first and last sessions of the course. The evaluation included carers’ ratings of their fosterchild’s most challenging problems, parenting style, carer efficacy and a survey of carer satisfaction with training. Results showed a decrease in foster children’s problem behaviours and an increase in carer confidence. Carers expressed a high level of satisfaction with the programme, and 100% felt that they would be able to retain the information and skills they had acquired on the course. The implications of providing training within an independent foster care context are discussed