The mannose receptor is expressed by subsets of APC in non-lymphoid organs

BACKGROUND: The mannose receptor (MR) is an endocytic receptor of Mφ and endothelial cell subsets whose natural ligands include both self glycoproteins and microbial glycans. It is also expressed by immature cultured dendritic cells (DC), where it mediates high efficiency uptake of glycosylated antigens, yet its role in antigen handling in vivo is unknown. Knowledge of which APC subsets express MR will assist the design of experiments to address its immunological functions. Here the expression of MR by MHC class II positive APC in non-lymphoid organs of the mouse is described. RESULTS: MR positive APC were identified in several peripheral organs: skin, liver, cardiac and skeletal muscle and tongue. MR positive cells in salivary gland, thyroid and pancreas coexpressed MHC class II and the myeloid markers macrosialin and sialoadhesin, but not the dendritic cell markers CD11c or DEC-205. MR and MHC class II colocalised in confocal microscope images, implying that antigen capture may be the primary role of MR in these cells. Distinct ligands of MR were found in salivary gland and pancreas tissue lysates that are candidate physiological ligands of MR positive APC in these organs. CONCLUSIONS: The tissue and subcellular distribution of MR suggest it is appropriately located to serve as a high efficiency antigen uptake receptor of APC

Integrating online communities and social networks with computerised treatment for insomnia: a qualitative study of service user and multiprofessional primary health care perspectives

Purpose: We explored patient and multiprofessional health perspectives to inform the development of a computerised cognitive behavioural therapy programme for insomnia (CCBT-I) that includes social networking. Theory: We used a qualitative design and theory of planned behaviour to underpin the analysis. Methods: Interviews and focus groups were held with service users and health professionals to elicit beliefs and intentions that might facilitate or create barriers to the uptake and adherence to CCBT-I. Findings: We interviewed 23 health professionals and 28 patients. Features designed to increase confidence in CCBT-I; engender trust in professional relationships; provide online support and improve programme functionality were perceived to increase the successful uptake and adherence. Interaction with other users via integrated social networking would provide mutual support but concerns included apprehension about online ‘strangers’ and information security. Patients wanted mobile applications; access in short periods; self-assessment; more interactive, personalised information on sleep and moderated contact with other users. Discussion: Improving uptake and adherence to online programmes for insomnia requires design features which are focused on trust and functionality. Computerised therapies for insomnia would allow access treatment for more people across geographical and heath system borders

Integrating online communities and social networks with computerised treatment for insomnia: a qualitative study of service user and primary health care professional perspectives

The problem: Insomnia is the most commonly reported psychological complaint in Britain. Although hypnotic drugs are widely used for treatment of insomnia, they are only licensed short term and adverse effects are common. Cognitive Behavioural Therapy for insomnia (CBT-I), which is effective and safe long term, is recommended first line but is not widely used nor available, in part because of the lack of trained providers. In response to this, Computerised Cognitive Behavioural Therapy (CCBT) has been advocated. Existing CCBT programmes can suffer from poor rates of uptake, adherence and completion. We aimed to investigate patients and practitioners’ views on how CCBT for insomnia (CCBT-I) could be improved by incorporating features of modern technology including social networking functions. The approach: We used a qualitative design and the theory of planned behaviour to underpin the study. Interviews and focus groups were held with adult service users and health professionals using a topic guide designed to elicit participants’ beliefs, intentions and controlling factors that might facilitate or create barriers to the uptake and adherence to CCBT-I. We explored the data using thematic analysis supported by Nvivo. Findings: We interviewed 23 health professionals and 28 patients. We identified multi-faceted issues focused on meta-themes of trust and functionality which were perceived to increase likelihood of successful uptake and adherence. Trust and confidence would be increased if CCBT-I was perceived to be evidence-based and accredited; when referral was from a trusted professional within a supervised package of care; and when online support and follow-up were provided. Interaction with other users, by integrating CCBT-I with social networking, was perceived to provide mutual support but concerns from people with sleep problems included apprehension about online ‘strangers’ and concerns from practitioners included information security. Asynchronous communication such as posting a note, commenting on a forum or adding to a thread was considered safer than engaging in real-time on-line communication. To improve functionality patients wanted mobile applications; access in short periods; self-assessment of insomnia and its causes; more personalised information on sleep; an interactive approach; and contact with other users to be moderated or overseen. Consequences: Although previous qualitative studies have looked at CCBT uptake and adherence, none have looked at insomnia exclusively or explored the feasibility, advantages and drawbacks of online communication between participants. Improving uptake and adherence to online programmes for insomnia requires attention to design features which are focused on trust and functionality. Although computerised therapies for insomnia would allow more people to access treatment, some would not be suitable for online therapies because of lack of online access or poor computer literacy. The results of the study are being used the development of a novel platform for CCBT for insomnia and other health conditions

Harnessing the benefits of sanctuary scholarship: opportunities for community enhancement, widening participation and internationalisation at home

The paper focuses on the importance of Internationalisation at Home, access and support mechanisms which are provided and co-created by students and university departments to encourage sanctuary scholarship. The paper gives particular attention to activities that encourage meaningful interaction with local communities and widen international participation of marginalised groups, such as students from the global south and asylum seeker communities. The paper presents two case studies. The first case study focuses on a student-led project developed by the students and staff of Canterbury Christ Church University. The second case study projects students’ voices from the global south and refugee communities at The University of Kent and University College London (UCL). The experiences of these students highlight the importance of welcoming and supporting students from marginalised backgrounds. They also demonstrate the need for both curriculum-based and co-curricular activity and student services which provided tailored support and encouragement

Blowtooth: a provocative pervasive game for smuggling virtual drugs through real airport security

In this paper we describe a pervasive game, Blowtooth, in which players use their mobile phones to hide virtual drugs on nearby airline passengers in real airport check-in queues. After passing through airport security, the player must find and recover their drugs from the innocent bystanders, without them ever realizing they were involved in the game. The game explores the nature of pervasive game playing in environments that are not, generally, regarded as playful or “fun”. This paper describes the game’s design and implementation as well as an evaluation conducted with participants in real airports. It explores the players’ reactions to the game through questionnaire responses and in-game activity. The technologies used in Blowtooth are, intentionally, simple in order for the enjoyment of the game to be reliant more on the physical environment rather than the enabling technologies. We conclude that situating pervasive games in unexpected and challenging environments, such as international airports, may provide interesting and unique gaming experiences for players. In addition, we argue that pervasive games benefit most from using the specific features and nature of interesting real-world environments rather than focusing on the enabling technologies

‘Everyone should do it’: Client experience of a 12-week dialectical behaviour therapy group programme – An interpretative phenomenological analysis

Objective: There is a dearth of practice-based evidence of adapted or ‘DBTinformed’ transdiagnostic models, which could provide services and clinicians with information of what works and for whom, in which settings. This paper aims to bridge this gap by exploring the client experience of a 12-week transdiagnostic dialectical behaviour therapy (DBT) group programme in a private psychiatric hospital. Method: Five participants with varied clinical diagnoses and previous therapeutic experiences were interviewed following completion of one or more of the same adapted DBT programme, comprising of the standard four modules over 12 weeks, including a weekly skills group and 1:1 therapy. Interpretative phenomenological analysis (IPA) was applied to give voice to the clients’ lived experience of the group. Results: Three master themes were identified: ‘Pre DBT: Crisis & Desperation’; ‘In-session: Belonging’; and ‘The Real World: Living’, each characterised by four sub-themes, highlighting helpful and hindering factors of clients’ current and previous therapeutic experiences. Conclusion: Overall this version of DBT in a transdiagnostic setting was experienced as helpful and positive by participants; main outcomes included being able to build a life worth living, feel hope and joy, build DBT skills into a lifestyle, and develop reflective practice. Implications for clinical practice, service delivery and policy are also discussed. The article aims to provide clinicians with practice-based evidence to inform the delivery of DBT as well as supporting the case for the use of DBT with various disorders, thus paving the way for future research in this area

Naming the parts: a case-study of a gender equality initiative with academic women

YesThis paper aims to seek to contribute to current debates about the effectiveness of different types of gender equality interventions in the academic context. This paper presents an argument for the need to move beyond an individual-structural dichotomy in how such interventions are perceived. The paper draws on an action-research case-study, the Through the Glass Ceiling project, to challenge the idea that “individual”/single-actor interventions serve only to reinforce underlying inequalities by attempting to “fix the women”.It is suggested that actions that support women in their careers have the potential to achieve a degree of transformation at individual, cultural and structural levels when such actions are designed with an understanding of how individuals embody the gendered and gendering social structures and values that are constantly being produced and reproduced within society and academia. The case study highlights the benefits of supporting individuals as gendered actors in gendering institutions and of facilitating the development of critical gender awareness, suggesting that such interventions are most effective when undertaken as part of an integrated institutional equality agenda. By calling attention to the ongoing mutual construction of actors and practices in organizations, this paper seeks to make both a conceptual contribution to how we understand the (re)production and potential transformation of gender relations in academia and to influence wider policy dialogues on diversity at work.FP