Co‐location, an enabler for service integration? Lessons from an evaluation of integrated community care teams in East London

In an attempt to support care integration that promotes joined up service provision and patient‐centred care across care boundaries, local health and social care organisations have embarked on several initiatives and approaches. A key component of service integration is the co‐location of different professional groups. In this study, we consider the extent to which co‐location is an enabler for service integration by examining multi‐professional community care teams. The study presents findings from a qualitative evaluation of integrated care initiatives in a borough of East London, England, undertaken between 2017 and 2018. The evaluation employed a participatory approach, the Researcher‐in‐Residence model. Participant observation (n = 80 hr) and both semi‐structured individual (n = 16) and group interviews (six groups, n = 17 participants) were carried out. Thematic analysis of the data was undertaken. The findings show that co‐location can be an effective enabler for service integration providing a basis for joint working, fostering improved communication and information sharing if conditions such as shared information systems and professional cultures (shared beliefs and values) are met. Organisations must consider the potential barriers to service integration such as differing professional identity, limited understanding of roles and responsibilities and a lack of continuity in personnel. Co‐location remains an important facet in the development of multi‐professional teams and local service integration arrangements, but as yet, has not been widely acknowledged as a priority in care practice. Organisations that are committed to greying care boundaries and providing joined up patient care must ensure that sufficient focus is provided at the service delivery level and not assume that decades of silo working in health and social care and strong professional cultures will be resolved by co‐location

Observation of intrinsic inverse spin Hall effect

We report observation of intrinsic inverse spin Hall effect in un-doped GaAs multiple quantum wells with a sample temperature of 10 K. A transient ballistic pure spin current is injected by a pair of laser pulses through quantum interference. By time-resolving the dynamics of the pure spin current, the momentum relaxation time is deduced, which sets the lower limit of the scattering time between electrons and holes. The transverse charge current generated by the pure spin current via the inverse spin Hall effect is simultaneously resolved. We find that the charge current is generated well before the first electron-hole scattering event. Generation of the transverse current in the scattering-free ballistic transport regime provides unambiguous evidence for the intrinsic inverse spin Hall effect.Comment: 4 pages, 3 figure

Pharmacy Curriculum Outcomes Assessment (PCOA) as Predictor of Performance on NAPLEX

Objectives: The purpose of the study was to respond to students’ inquiry regarding the relationship between student performance on the PCOA administered in early spring of the P3 year and performance on the NAPLEX administered post-graduation. Method: PCOA scores for two of the four content areas, Pharmaceutical Sciences and Clinical Sciences, resulting from administration of the assessment for P3 students in 2012 and 2013 were compared to the same student scores for the 2013 and 2014 NAPLEX taken post-graduation. A Pearson product-moment correlation coefficient was calculated to measure the linear correlation between the two sets of exam scores. Additionally, a linear regression was used to explain the predictor, PCOA, variability on the NAPLEX Score. Results: The Pearson product-moment correlation coefficient for the combined PCOA content areas, Pharmaceutical Science and Clinical Science scores, was r=.572. A linear regression established that PCOA Pharmaceutical Science and Clinical Science scores could statistically significantly predict NAPLEX scores, p Implications: Students taking the PCOA exam in the P3 year of their PharmD program may find value in using their performance on the assessment in the areas of Pharmaceutical Science and Clinical Science to predict their performance on the NAPLEX which is blueprinted to these areas of study

Antiviral activity of silymarin in comparison with baicalein against EV-A71

Background: The hand, foot and mouth disease (HFMD) is a febrile and exanthematous childhood disease mainly caused by Enterovirus 71 (EV-A71). In severe HFMD, virulent EV-A71 strains can cause acute flaccid paralysis and cardiopulmonary edema leading to death. Currently, no FDA approved antiviral treatment or vaccine is available for EV-A71. Flavonoids such as silymarin and baicalein are known to possess in vitro antiviral properties against viruses. In this study, the cytotoxicity and antiviral activity of silymarin, baicalein and baicalin were investigated. Methods: The cytotoxic effects of three flavonoids towards rhabdomyosarcoma (RD) cells were first examined using cell proliferation MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium] assay. Compounds found to be non-cytotoxic in RD cells were evaluated for their in vitro antiviral properties against the EVA71 subgenotype B4 strain 41 (5865/SIN/000009) using antiviral assays. Viral infectivity was determined by reduction of the formation of plaques in RD cells. For the measurement of RNA copy number, the real time quantitative reverse transcription PCR (qRT-PCR) was used. The most potent compound was further evaluated to determine the mode of action of inhibition by time course, virus attachment and entry assays in Vero cells. Results: Silymarin was shown to exert direct extracellular virucidal effects against EV-A71 at 50% inhibitory concentration (IC50) of 15.2 ± 3.53 μg/mL with SI of 10.53. Similarly, baicalein exhibited direct extracellular virucidal effects against EV-A71 at a higher IC50 value of 30.88 ± 5.50 μg/mL with SI of 13.64. Besides virucidal activity, silymarin was shown to block both viral attachment and entry of EV-A71 to inhibit infection in Vero cells. Conclusions: Silymarin has a stronger inhibition activity against EV-A71 in comparison to baicalein. It could serve as a promising antiviral drug to treat EV-A71 infections

Cryo-nanoscale chromosome imaging—future prospects

The high-order structure of mitotic chromosomes remains to be fully elucidated. How nucleosomes compact at various structural levels into a condensed mitotic chromosome is unclear. Cryogenic preservation and imaging have been applied for over three decades, keeping biological structures close to the native in vivo state. Despite being extensively utilized, this field is still wide open for mitotic chromosome research. In this review, we focus specifically on cryogenic efforts for determining the mitotic nanoscale chromatin structures. We describe vitrification methods, current status, and applications of advanced cryo-microscopy including future tools required for resolving the native architecture of these fascinating structures that hold the instructions to life

Surveillance approaches to detect the quality of medicines in low-middle income countries with a focus on artemisinin combination therapies for malaria.

Introduction: Recent years have seen an increase in reports of poor quality antimalarials with estimates that up to 30% have failed chemical analysis, even though robust empirical evidence for their prevalence remains scarce. Several internal (associated with national systems) and external (not under the direct control of national authorities) risk factors may contribute to the circulation of poor quality medicines. This thesis will explore these factors with an overall aim of providing evidence to strengthen medicines quality surveillance systems (MQSS) in low-middle income countries (LMICs). Methods: Data collection was conducted in two phases in Senegal between March 2013 and April 2014. The first phase involved interviews with key stakeholders of the MQSS such as authority representatives as well as treatment providers and explored the system’s vulnerability to risk factors for poor quality medicines and their perceptions of the quality of medicines available in Senegal. The second phase comprised a series of laboratory-based studies with technicians at the national medicine quality control laboratory (MQCL) including an assessment of the practical utility, usefulness and acceptability of a specific test, to check the quality of artemisinin based medicines, namely the artemisinin derivative test (ADT). Finally, a systematic literature review assessing the study design and reporting of antimalarial medicine quality studies and surveys was conducted with the included studies assessed for quality against our newly proposed list of criteria. Findings: Overall, interviewees expressed confidence in the quality of medicines available in the public and regulated private sectors which was attributed to effective national medicines regulation and adequate technical capacity at the MQCL. In contrast, poor quality medicines were thought to be available in the unregulated (informal) sector as they were not subjected to national regulatory processes or stored appropriately, resulting in exposure to direct sunlight and high temperatures. Generic medicines were also perceived to be of inferior quality when compared to their brand versions as they were lower in cost and thought to be less effective in alleviating symptoms. The ADT demonstrated a promising level of accuracy to detect fake or grossly substandard artemisinin based medicines and laboratory technicians favoured its simplicity of use without the need for specific training. The literature review found that there is much heterogeneity in study design and inconsistency in reporting which has impacted on the generalisability of findings for antimalarial medicine quality studies. Conclusion: A major shift is required in the framing of medicine quality from a technical/legal to a clinical paradigm with evidence required to demonstrate the impact of poor quality medicines on public health. National governments need to invest in regulatory and technical capacity to strengthen MQSS to minimise the likelihood of poor quality medicines circulating in a country. Utilising simple, and portable (preferably handheld) tests like the ADT, in non-laboratory settings may enhance post-marketing surveillance, especially in resource constrained contexts. Nonetheless, comparative evaluation of all currently available screening technologies for their capability to distinguish poor quality antimalarials for confirmatory pharmacopeia testing and public health action is required. Suggestions that reduce the risk of bias and error have been proposed for conducting medicine quality studies to enable standardisation of study design and reporting, thereby increasing the reliability of findings and allowing comparison between studies

Trace element studies on Karachi populations Part V: Blood lead levels in normal healthy adults and grammar school children

Blood lead levels of healthy Karachi population were estimated. Mean levels for males, females, soldiers and school children were 34.4, 31.8, 29.9 and 38.2 micrograms/dl respectively. About 93% cases of either sex had elevated lead levels, of whom 30% males and 10% females had levels above the safety limits (40 micrograms/dl). Soldiers living in relatively pollution free area though had levels lower than the rest of the population but 91% had levels over 25 micrograms/dl and only two had acceptable levels. Ninety-two percent children showed levels above 25 micrograms/dl with a large number having levels over 40 micrograms/dl. A very small percentage had normal levels. Pollution by traffic exhaust was assumed to be the principal cause for these high levels

The Unmixing Problem: A Guide to Applying Single‐Cell RNA Sequencing to Bone

Bone is composed of a complex mixture of many dynamic cell types. Flow cytometry and in vivo lineage tracing have offered early progress toward deconvoluting this heterogeneous mixture of cells into functionally well‐defined populations suitable for further studies. Single‐cell sequencing is poised as a key complementary technique to better understand the cellular basis of bone metabolism and development. However, single‐cell sequencing approaches still have important limitations, including transcriptional effects of cell isolation and sparse sampling of the transcriptome, that must be considered during experimental design and analysis to harness the power of this approach. Accounting for these limitations requires a deep knowledge of the tissue under study. Therefore, with the emergence of accessible tools for conducting and analyzing single‐cell RNA sequencing (scRNA‐seq) experiments, bone biologists will be ideal leaders in the application of scRNA‐seq to the skeleton. Here we provide an overview of the steps involved with a single‐cell sequencing analysis of bone, focusing on practical considerations needed for a successful study. © 2019 American Society for Bone and Mineral Research.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/150567/1/jbmr3802_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/150567/2/jbmr3802.pd