Setting priorities to inform assessment of care homes’ readiness to participate in healthcare innovation: a systematic mapping review and consensus process

© 2020 The Author(s). This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedOrganisational context is known to impact on the successful implementation of healthcare initiatives in care homes. We undertook a systematic mapping review to examine whether researchers have considered organisational context when planning, conducting, and reporting the implementation of healthcare innovations in care homes. Review data were mapped against the Alberta Context Tool, which was designed to assess organizational context in care homes. The review included 56 papers. No studies involved a systematic assessment of organisational context prior to implementation, but many provided post hoc explanations of how organisational context affected the success or otherwise of the innovation. Factors identified to explain a lack of success included poor senior staff engagement, non-alignment with care home culture, limited staff capacity to engage, and low levels of participation from health professionals such as general practitioners (GPs). Thirty-five stakeholders participated in workshops to discuss findings and develop questions for assessing care home readiness to participate in innovations. Ten questions were developed to initiate conversations between innovators and care home staff to support research and implementation. This framework can help researchers initiate discussions about health-related innovation. This will begin to address the gap between implementation theory and practice.Peer reviewe

Depth profiling of the elemental surface composition of the oral microorganism S. salivarius HB and fibrillar mutants by X-ray photoelectron spectroscopy

X-ray photoelectron spectroscopy (XPS) on microbial cell surfaces requires freeze-drying of cells, and as a result, the cell surface appendages flatten out on the cell surface and form a collapsed fibrillar mass. At present, it is unclear how the density, length and composition of these fibrils influence the elemental surface composition as probed by XPS. The sampling depth of XPS can be varied by changing the electron take-off angle. In this article, we made a depth profiling of the collapsed fibrillar mass of Streptococcus salivarius HB and fibril-deficient mutants by angle-dependent XPS. Methylamine tungstate negative staining and ruthenium red staining followed by sectioning revealed distinct classes of fibrils with various lengths on each of the strains. Interpretation of the angle dependence of the oxygen/carbon (O/C) and phosphorus/carbon (P/C) surface concentration ratios of these strains was difficult. However, the angle dependence of the nitrogen/carbon (N/C) surface concentration ratio could be fully interpreted: N/C did not vary with sampling depth on a bald strain, S. salivarius HBC12 and on S. salivarius HB7, a strain with a dense array of fibrils of uniform length. N/C decreased with sampling depth in case of a sparsely fibrillated strain, S. salivarius HBV51 and eventually reached the value observed for the bald strain, HBC12. A high N/C at small sampling depth was observed for S. salivarius HB with protruding, protein rich fibrils. We conclude that elemental depth profiling of microbial cell surfaces by XPS can be interpreted to coincide with structural and biochemical information on the cell surface as obtained by electron microscopy and can therefore be considered as a useful technique to study structural features of cell surfaces in combination with electron microscopy.</p

The Digital Sky Project: Prototyping Virtual Observatory Technologies

Astronomy is entering a new era as multiple, large area, digital sky surveys are in production. The resulting datasets are truly remarkable in their own right; however, a revolutionary step arises in the aggregation of complimentary multi-wavelength surveys (i.e., the cross-identification of a billion sources). The federation of these large datasets is already underway, and is producing a major paradigm shift as Astronomy has suddenly become an immensely data-rich field. This new paradigm will enable quantitatively and qualitatively new science, from statistical studies of our Galaxy and the large-scale structure in the universe, to discoveries of rare, unusual, or even completely new types of astronomical objects and phenomena. Federating and then exploring these large datasets, however, is an extremely challenging task. The Digital Sky project was initiated with this task in mind and is working to develop the techniques and technologies necessary to solve the problems inherent in federating these large databases, as well as the mining of the resultant aggregate data.Comment: 8 pages, 3 Figures, uses newpasp.sty (included). To be published in the proceedings of the conference "Virtual Observatories of the Future," editors R.J. Brunner, S.G. Djorgovski, and Alex S. Szala

Dependence of Ice-Core Relative Trace-Element Concentration on Acidification

To assess the role of methodological differences on measured trace-element concentrations in ice cores, we developed an experiment to test the effects of acidification strength and time on dust dissolution using snow samples collected in West Antarctica and Alaska. We leached Antarctic samples for 3 months at room temperature using nitric acid at concentrations of 0.1, 1.0 and 10.0% (v/v). At selected intervals (20 min, 24 hours, 5 days, 14 days, 28 days, 56 days, 91 days) we analyzed 23 trace elements using inductively coupled plasma mass spectrometry. Concentrations of lithogenic elements scaled with acid strength and increased by 100–1380% in 3 months. Incongruent elemental dissolution caused significant variability in calculated crustal enrichment factors through time (factor of 1.3 (Pb) to 8.0 (Cs)). Using snow samples collected in Alaska and acidified at 1% (v/v) for 383 days, we found that the increase in lithogenic element concentration with time depends strongly on initial concentration, and varies by element (e.g. Fe linear regression slope =1.66; r = 0.98). Our results demonstrate that relative trace-element concentrations measured in ice cores depend on the acidification method used

Theorising Disability: Beyond Common Sense

This article seeks to introduce the topic of disability to political theory via a discussion of some of the literature produced by disability theorists. The author argues that these more radical approaches conceptualise disability in ways that conflict with ‘common-sense’ notions of disability that tend to underpin political theoretical considerations of the topic. Furthermore, the author suggests that these more radical conceptualisations have profound implications for current debates on social justice, equality and citizenship that highlight the extent to which these notions are also currently underpinned by ‘common-sense’ notions of ‘normality’

ELN and FBN2 gene variants as risk factors for two sports-related musculoskeletal injuries

The proteins ELN and FBN2 are important in extracellular matrix function. The ELN rs2071307 and FBN2 rs331079 gene variants have been associated with soft tissue pathologies. We aimed to determine whether these variants were predisposing factors for both Achilles tendinopathy (AT) and anterior cruciate ligament (ACL) ruptures. For the AT study, 135 cases (TEN group) and 239 asymptomatic controls were recruited. For the ACL rupture study our cohort consisted of 141 cases (ACL group) and 219 controls. Samples were genotyped for both the ELN rs2071307 and FBN2 rs331079 variants using TaqMan assays. Analysis of variance and chi-squared tests were used to determine whether either variant was associated with AT or ACL rupture with significance set at p<0.05. The GG genotype of the FBN2 variant was significantly over-represented within the TEN group (p=0.035; OR=1.83; 95% CI 1.04–3.25) compared to the CON group. We also found that the frequency of the G allele was significantly different between the TEN (p=0.017; OR=1.90; 95% CI 1.11–3.27) and ACL groups (p=0.047; OR=1.76; 95% CI 1.00–3.10) compared to controls. The ELN rs207137 variant was not associated with either AT or ACL rupture. In conclusion, DNA sequence variation within the FBN2 gene is associated with both AT and ACL rupture

A novel, high-sensitivity, bacteriophage-based assay identifies low level Mycobacterium tuberculosis bacteraemia in immunocompetent patients with active and incipient tuberculosis

Haematogenous dissemination of M. tuberculosis (Mtb) is critical to pathogenesis of progressive tuberculous infection in animal models. Using a novel phage-based blood assay, we report the first concordant evidence in well-characterised immunocompetent human cohorts, demonstrating associations of Mtb bacteraemia with progressive phenotypes of latent infection and active pulmonary TB respectively

Limited dispersion and quick degradation of environmental DNA in fish ponds inferred by metabarcoding

Background Environmental DNA (eDNA) metabarcoding is a promising tool for rapid, non‐invasive biodiversity monitoring. Aims In this study, eDNA metabarcoding is applied to explore the spatial and temporal distribution of fish communities in two aquaculture ponds and to evaluate the detection sensitivity of this tool for low‐density species alongside highly abundant species. Materials & Methods This study was carried out at two artificially stocked ponds with a high fish density following the introduction and removal of two rare fish species. Results & Discussion When two rare species were introduced and kept at a fixed location in the ponds, eDNA concentration (i.e., proportional read counts abundance) of the introduced species typically peaked after two days. The increase in eDNA concentration of the introduced fish after 43 hrs may have been caused by increased eDNA shedding rates as a result of fish being stressed by handling, as observed in other studies. Thereafter, it gradually declined and stabilised after six days. These findings are supported by the highest community dissimilarity of different sampling positions being observed on the second day after introduction, which then gradually decreased over time. On the sixth day, there was no longer a significant difference in community dissimilarity between sampling days. The introduced species were no longer detected at any sampling positions on 48 hrs after removal from the ponds. eDNA is found to decay faster in the field than in controlled conditions, which can be attributed to the complex effects of environmental conditions on eDNA persistence or resulting in the vertical transport of intracellular DNA and the extracellular DNA absorbed by particles in the sediment. The eDNA signal and detection probability of the introduced species were strongest near the keepnets, resulting in the highest community variance of different sampling events at this position. Thereafter, the eDNA signal significantly decreased with increasing distance, although the signal increased slightly again at 85 m position away from the keepnets. Conclusions Collectively, these findings reveal that eDNA distribution in lentic ecosystems is highly localised in space and time, which adds to the growing weight of evidence that eDNA signal provides a good approximation of the presence and distribution of species in ponds. Moreover, eDNA metabarcoding is a powerful tool for detection of rare species alongside more abundant species due to the use of generic PCR primers, and can enable monitoring of spatial and temporal community variance