From waste product to blood, brains and narratives : developing a pluralist sociology of contributions to health research

Funded by National Institute for Health Research (NIHR) Oxford Biomedical Research CentrePeer reviewedPublisher PD

Sustainable workplaces: the impact of workplace learning

The Wales Institute for Work Based Learning provides modular courses for learners in employment. For the last two years the Institute has been running two ESF projects under the pan-Wales Work-Based Learning (WIWBL) programme 2007-2014. WIWBL developed a suite of courses aimed at raising awareness of sustainability and the environment among the workforce and the corporate responsibilities for managers. As part of each course, the learners were required to examine an issue at their workplace, and in many cases this has led to the company changing its working practices to reduce waste. The legacy of the learners within their organisations is having a direct impact on the environmental effects of their activities. On the other hand, there were some disappointing lessons learned. Many companies saw sustainability as a ‘nice to have’ part of Corporate Social Responsibility, and were not thinking strategically about the future. The ability of learners embedded within organisations to initiate change with direct practical results in the short term is an area where the University is having a visible positive effect on the Welsh economy for the future. Mae Athrofa Cymru ar gyfer Dysgu Seiliedig ar Waith yn darparu cyrsiau modiwlaidd ar gyfer dysgwyr sydd mewn cyflogaeth. Dros y ddwy flynedd ddiwethaf mae’r Athrofa wedi bod yn cynnal dau brosiect Cronfa Gymdeithasol Ewrop dan raglen Dysgu Seiliedig ar waith Cymru Gyfan 2007-2014. Datblygodd yr Athrofa gyfres o gyrsiau a anelai at godi ymwybyddiaeth ynghylch cynaliadwyedd a’r amgylchedd ymhlith y gweithlu a’r cyfrifoldebau corfforaethol i reolwyr. Yn rhan o bob cwrs, roedd yn ofynnol i’r dysgwyr archwilio mater yn eu gweithle, ac mewn nifer o achosion mae hyn wedi arwain y cwmni i newid ei arferion gwaith er mwyn lleihau gwastraff. Mae gwaddol y dysgwyr o fewn eu sefydliadau’n cael effaith uniongyrchol ar effeithiau amgylcheddol eu gweithgareddau. Ar y llaw arall, dysgwyd rhai gwersi siomedig. Ystyriai llawer o gwmnïoedd gynaliadwyedd yn rhan ‘hyfryd ei chael’ o Gyfrifoldeb Cymdeithasol Corfforaethol, ac nid oeddynt yn meddwl yn strategol am y dyfodol. Mae gallu dysgwyr o fewn sefydliadau i gychwyn newid gyda chanlyniadau ymarferol uniongyrchol yn y tymor byr yn faes lle mae’r Brifysgol yn cael effaith gadarnhaol weladwy ar economi Cymru i’r dyfodol

Overcoming potential barriers to investigating and treating myxomatous mitral valve disease

Achieving a diagnosis of mitral valve disease (MMVD) can be relatively straightforward. Persuading owners to investigate and treat, and then maintaining adherence to a therapeutic regimen can be significantly more challenging. While heart murmurs are most likely to be detected during the annual health check or booster consultation, recent evidence suggests this might not be an ideal time to discuss MMVD. This article reviews some of the potential barriers to owners following practitioners’ recommendations, and suggests some solutions

Antimicrobial polymers : mimicking amino acid functionality, sequence control and three-dimensional structure of host-defense peptides

Peptides and proteins control and direct all aspects of cellular function and communication. Having been honed by nature for millions of years, they also typically display an unsurpassed specificity for their biological targets. This underlies the continued focus on peptides as promising drug candidates. However, the development of peptides into viable drugs is hampered by their lack of chemical and pharmacokinetic stability and the cost of large scale production. One method to overcome such hindrances is to develop polymer systems that are able to retain the important structural features of these biologically active peptides, while being cheaper and easier to produce and manipulate chemically. This review illustrates these principles using examples of polymers designed to mimic antimicrobial host-defence peptides. The host-defence peptides have been identified as some of the most important leads for the next generation of antibiotics as they typically exhibit broad spectrum antimicrobial ability, low toxicity toward human cells and little susceptibility to currently known mechanisms of bacterial resistance. Their movement from the bench to clinic is yet to be realised, however, due to the limitations of these peptides as drugs. The literature provides a number of examples of polymers that have been able to mimic these peptides through all levels of structure, starting from specific amino acid sidechains, through to more global features such as overall charge, molecular weight and three-dimensional structure (e.g. α-helical). The resulting optimised polymers are able retain the activity profile of the peptides, but within a synthetic macromolecular construct that may be better suited to the development of a new generation of antimicrobial therapeutics. Such work has not only produced important new leads to combat the growing threat of antibiotic resistance, but may also open up new ways for polymers to mimic other important classes of biologically active peptides

Life interrupted and life regained? Coping with stroke at a young age

Stroke is a leading cause of disability across the developed world, affecting an increasing number of younger people. In this article, we seek to understand the experience of stroke as a disabling life situation among young people and the strategies that they use to recover and cope. Directed content analysis was conducted from interviews with 17 community-dwelling stroke survivors aged 55 years and younger across the United Kingdom. The sample was drawn from a larger maximum variation sample of stroke survivors. Using the sociological concepts of biographical disruption and biographical repair as a guide, excerpts from the interviews pertaining to aspects of the patients’ life that were interrupted, in addition to how they coped with the changes, were selected and analysed. All individuals described an ‘‘altered sense of self,’’ a theme that included loss of identity, family disruption, and/or loss of valued activities. Individuals sought to adapt their sense of self by seeking external support, by restoring normality, and/or through positive reflection. Despite the adapted self that emerged, most individuals continued to experience impairments. While young stroke survivors adapt to their illness over time, they continue to experience impairments and disruptions in their personal and work lives.Aholistic model of rehabilitation that helps individuals regain the capacity for everyday activities related to work, family life, and leisure can begin to address the emotional ramifications of diseases such as stroke, restore wellness, and work towards minimizing the burden felt by family caregivers and children

Looped flow RAFT polymerization for multiblock copolymer synthesis

A looped flow process was designed for the synthesis of well-defined multiblock copolymers using reversible addition–fragmentation chain transfer (RAFT) polymerization. The reaction conditions were optimized to reach high conversions whilst maintaining a high end-group fidelity. The loop set-up proved to be a flexible, robust and time-efficient process for scaling-up multiblock copolymers

Multi-scale investigation of uranium attenuation by arsenic at an abandoned uranium mine, South Terras

Detailed mineralogical analysis of soils from the UK’s historical key uranium mine, South Terras, was performed to elucidate the mechanisms of uranium degradation and migration in the 86 years since abandonment. Soils were sampled from the surface (0 – 2 cm) and near-surface (25 cm) in two distinct areas of ore processing activities. Bulk soil analysis revealed the presence of high concentrations of uranium (<1690 ppm), arsenic (1830 ppm) and beryllium (~250 ppm), suggesting pedogenic weathering of the country rock and ore extraction processes to be the mechanisms of uranium ore degradation. Micro-focus XRF analysis indicated the association of uranium with arsenic, phosphate and copper; µ-XRD data confirmed the presence of the uranyl-arsenate minerals metazeunerite (Cu(UO2)2(AsO4)2·8H2O) and metatorbernite (Cu(UO2)2(PO4)2·8H2O) to be ubiquitous. Our data are consistent with the solid solution of these two uranyl-mica minerals, not previously observed at uranium-contaminated sites. Crystallites of uranyl-mica minerals were observed to coat particles of jarosite and muscovite, suggesting that the mobility of uranium from degraded ores is attenuated by co-precipitation with arsenic and phosphate, which was not previously considered at this site

Reciprocal relationships and the importance of feedback in patient and public involvement: A mixed methods study

Background: Reciprocal relationships between researchers and patient and public involvement (PPI) contributors can enable successful PPI in research. However, research and anecdotal evidence suggest that researchers do not commonly provide feedback to PPI contributors thus preventing them from knowing whether, how or where their contributions were useful to researchers and research overall. Aims: The aim of this study was to explore the variation, types, importance of, and satisfaction with feedback given by researchers to PPI contributors in six PPI groups in England, and identify the barriers to the process of feedback. Methods: An explanatory mixed methods sequential study design with a questionnaire survey followed by semi‐structured interviews with researchers and PPI contributors in six PPI groups. PPI contributors were involved in all stages of the research process. Results: Researchers do not routinely give feedback to PPI contributors. Feedback was found to have different meanings: an acknowledgement, impact and study success and progress. PPI contributors who receive feedback are motivated for further involvement; it supports their learning and development and prompts researchers to reflect on PPI impact. The importance of the role of a PPI lead or coordinator to facilitate the process of providing feedback was also highlighted. Conclusion: This study found no generic way to give feedback indicating that mutual feedback expectations should be discussed at the outset. PPI feedback needs to become integral to the research process with appropriate time and resources allocated. PPI feedback can be seen as a key indicator of mature, embedded PPI in research

Biosamples as gifts? How participants in biobanking projects talk about donation.

Funded by National Institute for Health Research (NIHR) Oxford Biomedical Research Centre based at Oxford University Hospitals NHS Trust University of Oxford Oxford Biomedical Research Centre FellowshipPeer reviewedPublisher PD

A pragmatic cluster randomised trial evaluating three implementation interventions

Background Implementation research is concerned with bridging the gap between evidence and practice through the study of methods to promote the uptake of research into routine practice. Good quality evidence has been summarised into guideline recommendations to show that peri-operative fasting times could be considerably shorter than patients currently experience. The objective of this trial was to evaluate the effectiveness of three strategies for the implementation of recommendations about peri-operative fasting. Methods A pragmatic cluster randomised trial underpinned by the PARIHS framework was conducted during 2006 to 2009 with a national sample of UK hospitals using time series with mixed methods process evaluation and cost analysis. Hospitals were randomised to one of three interventions: standard dissemination (SD) of a guideline package, SD plus a web-based resource championed by an opinion leader, and SD plus plan-do-study-act (PDSA). The primary outcome was duration of fluid fast prior to induction of anaesthesia. Secondary outcomes included duration of food fast, patients' experiences, and stakeholders' experiences of implementation, including influences. ANOVA was used to test differences over time and interventions. Results Nineteen acute NHS hospitals participated. Across timepoints, 3,505 duration of fasting observations were recorded. No significant effect of the interventions was observed for either fluid or food fasting times. The effect size was 0.33 for the web-based intervention compared to SD alone for the change in fluid fasting and was 0.12 for PDSA compared to SD alone. The process evaluation showed different types of impact, including changes to practices, policies, and attitudes. A rich picture of the implementation challenges emerged, including inter-professional tensions and a lack of clarity for decision-making authority and responsibility. Conclusions This was a large, complex study and one of the first national randomised controlled trials conducted within acute care in implementation research. The evidence base for fasting practice was accepted by those participating in this study and the messages from it simple; however, implementation and practical challenges influenced the interventions' impact. A set of conditions for implementation emerges from the findings of this study, which are presented as theoretically transferable propositions that have international relevance. Trial registration ISRCTN18046709 - Peri-operative Implementation Study Evaluation (POISE