Lost in translation: a multi-level case study of the metamorphosis of meanings and action in public sector organisational innovation

This paper explores the early implementation of an organisational innovation in the UK National Health Service (NHS) - Treatment Centres (TCs) - designed to dramatically reduce waiting lists for elective care. The paper draws on case studies of eight TCs (each at varying stages of their development) and aims to explore how meanings about TCs are created and evolve, and how these meanings impact upon the development of the organisational innovation. Research on organisational meanings needs to take greater account of the fact that modern organisations like the NHS are complex multi-level phenomena, comprising layers of interlacing networks. To understand the pace, direction and impact of organisational innovation and change we need to study the interconnections between meanings across different organisational levels. The data presented in this paper show how the apparently simple, relatively unformed, concept of a TC framed by central government, is translated and transmuted by subsequent layers in the health service administration, and by players in local health economies and, ultimately in the TCs themselves, picking up new rationales, meanings, and significance as it goes. The developmental histories of TCs reveal a range of significant re-workings of macro policy with the result that there is considerable diversity and variation between local TC schemes. The picture is of important disconnections between meanings, that in many ways mirror Weick’s (1976) ‘loosely coupled systems’. The emergent meanings and the direction of micro-level development of TCs appear more strongly determined by interactions within the local TC environment, notably between what we identify as groups of ‘idealists’, ‘pragmatists’, ‘opportunists’ and ‘sceptics’ than by the framing (Goffman 1974) provided by macro and meso organisational levels. While this illustrates the limitations of top down and policy-driven attempts at change, and highlights the crucial importance of the front-line local ‘micro-systems’ (Donaldson & Mohr, 2000) in the overall scheme of implementing organisational innovations, the space or headroom provided by frames at the macro and meso levels can enable local change, albeit at variable speed and with uncertain outcomes

Scanning Electron Microscopic Study of Pulp Stones in Human Permanent Teeth

Scanning electron microscopy was used to examine pulp stones which are small calcified formations found in the coronal and/or radicular part of the dental pulp. Pulp stones range considerably in size and shape. Most are round or oval but others can be irregular and may correspond to a reduced duplicate of the pulp chamber anatany. Both free and attached pulp stones were observed. The surface aspect was variable and frequently exhibited large resorption zones. Three characteristic features were observed on fractures a) no characteristic organization where the mineralized mass is compact and hanogeneous, b) a concentric architecture around an initiating central core, and c) a linear orientation along the pulp axis showing mineralized fibres and vessels. The findings suggest that the presence or absence of tubules should not be the sole factor for denticle classification since tubules can be also observed in false pulp stones. Cellular oval lacunae connected by long extensions were also found. Various stages of mineralization were seen, in particular, a deposition of fine needle shaped crystals on a collagenous matrix, and the fusion of numerous small calcospherules to the mineralized mass

Electron Probe Micro-Analysis of Human Dental Pulp Stones

The mineral composition of ten human dental pulp stones presenting various morphological aspects has been studied by electron probe micro-analysis. The denticles were composed of two major chemical elements Ca and P with mean concentrations 32.12% and 14.69% respectively giving a Ca/P weight ratio of 2.19 which is very close to the weight ratio of pure stoichiometric hydroxyapatite (2.15). The concentration of some other elements was much lower (0.88% for F ; 0.75% for Na ; 0.51% for Mg). The other analysed constituents (K, Cl, Mn, Zn, Fe) were present at trace concentrations. The mineral composition of sound human dentine from one tooth containing a pulpal calcification was also analysed for comparative purpose

PPARγ Modulates Long Chain Fatty Acid Processing in the Intestinal Epithelium.

Nuclear receptor PPARγ affects lipid metabolism in several tissues, but its role in intestinal lipid metabolism has not been explored. As alterations have been observed in the plasma lipid profile of ad libitum fed intestinal epithelium-specific PPARγ knockout mice (iePPARγKO), we submitted these mice to lipid gavage challenges. Within hours after gavage with long chain unsaturated fatty acid (FA)-rich canola oil, the iePPARγKO mice had higher plasma free FA levels and lower gastric inhibitory polypeptide levels than their wild-type (WT) littermates, and altered expression of incretin genes and lipid metabolism-associated genes in the intestinal epithelium. Gavage with the medium chain saturated FA-rich coconut oil did not result in differences between the two genotypes. Furthermore, the iePPARγKO mice did not exhibit defective lipid uptake and stomach emptying; however, their intestinal transit was more rapid than in WT mice. When fed a canola oil-rich diet for 4.5 months, iePPARγKO mice had higher body lean mass than the WT mice. We conclude that intestinal epithelium PPARγ is activated preferentially by long chain unsaturated FAs compared to medium chain saturated FAs. Furthermore, we hypothesize that the iePPARγKO phenotype originates from altered lipid metabolism and release in epithelial cells, as well as changes in intestinal motility

Early compaction at day 3 may be a useful additional criterion for embryo transfer

PURPOSE: The reduction of the number of embryos transferred while maintaining a satisfactory rate of pregnancy (PR) with in vitro fertilization calls for a refined technique of embryonic selection. This prospective study investigates the significance of early embryonic compaction at day 3 as a marker of the chances of implantation. METHODS: We examined 317 transfers and their outcome involving 509 embryos including 91 compacted embryos. RESULTS: Early compaction seems linked with the ovarian response to stimulation and embryonic quality. The PR is significantly increased when the embryonic cohort contains at least one compacted embryo (44% versus 29.5%, p = 0.01), and when at least one compacted embryo is transferred (44% versus 31%, p < 0.05). The analysis of our single embryo transfers shows that the implantation rates are significantly better for compacted embryos (50% versus 30%, p < 0.05) (OR 2.98; CI 1.02-5.28). CONCLUSION: Thus, early compaction, sometimes observed at day 3, may serve as a useful additional criterion for selecting the embryos transferred

First Report of Ascochyta Blight on Field Pea (Pisum sativum) Caused by Didymella pisi in Bosnia and Herzegovina

International audienceThe areas under the field pea are constantly increasing in Bosnia and Herzegovina. However, pea is susceptible to a large number of diseases, especially to Ascochyta blight, which is considered as one of the most economically important diseases of legume crops throughout the world (Le May et al. 2014; Rubiales et al. 2018). In May 2016, characteristic Ascochyta blight symptoms were observed on stems and flowers of field pea plants (Pisum sativum L.) grown at Velika Ilova (northern Bosnia and Herzegovina)

Hsp90 governs dispersion and drug resistance of fungal biofilms

Fungal biofilms are a major cause of human mortality and are recalcitrant to most treatments due to intrinsic drug resistance. These complex communities of multiple cell types form on indwelling medical devices and their eradication often requires surgical removal of infected devices. Here we implicate the molecular chaperone Hsp90 as a key regulator of biofilm dispersion and drug resistance. We previously established that in the leading human fungal pathogen, Candida albicans, Hsp90 enables the emergence and maintenance of drug resistance in planktonic conditions by stabilizing the protein phosphatase calcineurin and MAPK Mkc1. Hsp90 also regulates temperature-dependent C. albicans morphogenesis through repression of cAMP-PKA signalling. Here we demonstrate that genetic depletion of Hsp90 reduced C. albicans biofilm growth and maturation in vitro and impaired dispersal of biofilm cells. Further, compromising Hsp90 function in vitro abrogated resistance of C. albicans biofilms to the most widely deployed class of antifungal drugs, the azoles. Depletion of Hsp90 led to reduction of calcineurin and Mkc1 in planktonic but not biofilm conditions, suggesting that Hsp90 regulates drug resistance through different mechanisms in these distinct cellular states. Reduction of Hsp90 levels led to a marked decrease in matrix glucan levels, providing a compelling mechanism through which Hsp90 might regulate biofilm azole resistance. Impairment of Hsp90 function genetically or pharmacologically transformed fluconazole from ineffectual to highly effective in eradicating biofilms in a rat venous catheter infection model. Finally, inhibition of Hsp90 reduced resistance of biofilms of the most lethal mould, Aspergillus fumigatus, to the newest class of antifungals to reach the clinic, the echinocandins. Thus, we establish a novel mechanism regulating biofilm drug resistance and dispersion and that targeting Hsp90 provides a much-needed strategy for improving clinical outcome in the treatment of biofilm infections

Nuclear structure and reaction studies at SPIRAL

The SPIRAL facility at GANIL, operational since 2001, is described briefly. The diverse physics program using the re-accelerated (1.2 to 25 MeV/u) beams ranging from He to Kr and the instrumentation specially developed for their exploitation are presented. Results of these studies, using both direct and compound processes, addressing various questions related to the existence of exotic states of nuclear matter, evolution of new "magic numbers", tunnelling of exotic nuclei, neutron correlations, exotic pathways in astrophysical sites and characterization of the continuum are discussed. The future prospects for the facility and the path towards SPIRAL2, a next generation ISOL facility, are also briefly presented.Comment: 48 pages, 27 figures. Accepted for publication in Journal of Physics

Interstellar OH+, H2O+ and H3O+ along the sight-line to G10.6-0.4

We report the detection of absorption lines by the reactive ions OH+, H2O+ and H3O+ along the line of sight to the submillimeter continuum source G10.6$-$0.4 (W31C). We used the Herschel HIFI instrument in dual beam switch mode to observe the ground state rotational transitions of OH+ at 971 GHz, H2O+ at 1115 and 607 GHz, and H3O+ at 984 GHz. The resultant spectra show deep absorption over a broad velocity range that originates in the interstellar matter along the line of sight to G10.6$-$0.4 as well as in the molecular gas directly associated with that source. The OH+ spectrum reaches saturation over most velocities corresponding to the foreground gas, while the opacity of the H2O+ lines remains lower than 1 in the same velocity range, and the H3O+ line shows only weak absorption. For LSR velocities between 7 and 50 kms$^{-1}$ we estimate total column densities of $N$(OH+) $> 2.5 \times 10^{14}$ cm$^{-2}$, $N$(H2O+) $\sim 6 \times 10^{13}$ cm$^{-2}$ and $N$(H3O+) $\sim 4.0 \times 10^{13}$ cm$^{-2}$. These detections confirm the role of O$^+$ and OH$^+$ in initiating the oxygen chemistry in diffuse molecular gas and strengthen our understanding of the gas phase production of water. The high ratio of the OH+ by the H2O+ column density implies that these species predominantly trace low-density gas with a small fraction of hydrogen in molecular form