Turning the gaze:Digital patient feedback and the silent pathology of the NHS

Online review and rating sites, where patients can leave feedback on their experience of the health-care encounter, are becoming an increasing feature of primary care in the NHS. Previous research has analysed how digital surveillance is re-shaping the clinical gaze, as health-care professionals are subject to increased public monitoring. Here, we draw on an empirical study of 41 GP practice staff to show how the gaze is turning, not simply from the patient to the health-care provider, but additionally to the body politic of the NHS. Drawing on focus group and interview data conducted in five UK practices, we show how discourses of online reviews and ratings are producing new professional subjectivities among health-care professionals and the extent to which the gaze extends not only to individual health-care interactions but to the health-care service writ large. We identify three counter-discourses characterising the evolving ways in which online reviews and ratings are creating new subjects in primary care practices: victimhood, prosumption versus traditional values and taking control. We show how the ways in which staff speak about online feedback are patterned by the social environment in which they work and the constraints of the NHS they encounter on a day-to-day basis

Electrochemical assessment of water|ionic liquid biphasic systems towards cesium extraction from nuclear waste

A room temperature ionic liquid (IL) composed of a quaternary alkylphosphonium (trihexyltetradecylphosphonium, P66614(+)) and tetrakis(pentafluorophenyl) borate anion (TB) was employed within a water| P66614TB (w|P66614TB or w|IL) biphasic system to evaluate cesium ion extraction in comparison to that with a traditional water|organic solvent (w|o) combination. Cs-137 is a major contributor to the radioactivity of spent nuclear fuel as it leaves the reactor, and its extraction efficiency is therefore of considerable importance. The extraction was facilitated by the ligand octyl(phenyl)-N, N'-diisobutylcarbamoylphosphine oxide (CMPO) used in TRans- Uranium EXtraction processes and investigated through well established liquid| liquid electrochemistry. This study gave access to the metal ion to ligand (1: n) stoichiometry and overall complexation constant, beta, of the interfacial complexation reaction which were determined to be 1: 3 and 1.6 x 10(11) at the w| P66614TB interface while the study at w|o elicited an n equal to 1 with beta equal to 86.5. Through a straightforward relationship, these complexation constant values were converted to distribution coefficients, da, with the ligand concentrations studied for comparison to other studies present in the literature; the w|o and w|IL systems gave delta(alpha) of 2 and 8.2 x 10(7), respectively, indicating a higher overall extraction efficiency for the latter. For the w|o system, the metal ion-ligand stoichiometries were confirmed through isotopic distribution analysis of mass spectra obtained by the direct injection of an emulsified water-organic solvent mixture into an electron spray ionization mass spectrometer. (c) 2014 Elsevier B.V. All rights reserved

Association of distinct fine specificities of anti-citrullinated peptide antibodies with elevated immune responses to Prevotella intermedia in a subgroup of patients with rheumatoid arthritis and periodontitis

Objective In addition to the long-established link with smoking, periodontitis (PD) is also a risk factor for rheumatoid arthritis (RA). To elucidate the mechanism by which PD could induce antibodies to citrullinated peptides (ACPA), we examine the antibody response to a novel citrullinated peptide from cytokeratin type I 13 identified in gingival crevicular fluid (GCF), and compare the response to 4 other citrullinated peptides in patients with RA, well-characterized for PD and smoking. Methods The citrullinomes of GCF and periodontal tissue from people with PD were mapped by mass spectrometry. Antibodies to citrullinated peptides from cytokeratin type I 13 (cCK13), tenascin-C (cTNC5), vimentin (cVIM), enolase (CEP-1) and fibrinogen β (cFIBβ) were examined by ELISA in patients with RA (n=287) and osteoarthritis (OA) (n=330), and cross-reactivity assessed by inhibition assays. Results A novel citrullinated peptide cCK13-1 (444TSNASGR-cit-TSDV-cit-RP458) identified in GCF, exhibited elevated antibody responses in RA patients (24%). Anti-cCK13-1 antibodies correlated with anti-cTNC5 antibodies, and absorption experiments confirmed this was not due to cross-reactivity. Only anti-cCK13-1 and anti-cTNC5 were associated with antibodies to the periodontal pathogen Prevotella intermedia (p=0.05 and p =0.001 respectively), but not with antibodies to Porphyromonas gingivalis arginine gingipains. Antibodies to CEP-1, cFIBβ and cVIM correlated with each other, and with smoking and shared epitope risk factors in RA. Conclusion This study identifies two groups of ACPA fine specificities associated with different RA risk factors; one predominantly linked to smoking and shared epitope, the other linking anti- cTNC5 and cCK13-1 to infection with the periodontal pathogen P. intermedia

Gender and Administration

Summary Public administration in development has been a poor instrument for implementing gender policies. Rural development administration in particular has tended to be indifferently accountable to female ‘publics’ in agrarian economies. Conventionally, this particular feature of institutional failure is explained by the suggestion that public administrations reflect gender relations in society. This paper, however, argues that the role of public administration in the organization of gender provokes questions about the gender of organization. It sketches out the conceptual premises for a theory of the gender of organization, looking at the way organizational structures, cultures, and purposes institutionalize male dominance. This perspective may help illuminate the processes and relationships through which other inequalities, such as those of class, race, and the North?South divide, are reproduced in public administration. Résumé Le Genre et l'insuccès des institutions dans le développement: l'organisation du Genre et le Genre dans l'organisation Au sein du développement, les administrations publiques ont constitué un outil peu utile pour la mise en oeuvre des politiques relatives au genre. Les administrations de développement rural notamment ont eu tendance à comptabiliser de manière indifférente les ‘publics’ féminins dans les économies agraires. Classiquement, et notoirement, cette caractéristique de l'insuccès des institutions est expliquée par la suggestion que les administrations publiques reflètent les rapports entre les genres dans la société. Le présent article, par contre, revendique que le rôle des administrations publiques dans l'organisation des genres soulève certaines questions le genre dans l'organisation même. L'auteur ébauche les prémisses d'une éventuelle théorie du genre dans l'organisation, et examine comment les structures, les cultures et les objectifs mêmes de ces organisations tendent à institutionnaliser la dominance masculine. Cette perspective veut aider à mettre en lumière des procédés et des rapports par l'influence desquels d'autres inégalités, par exemples celles des classes, des races et du partage nord?sud, viennent à se reproduire dans les administrations publiques. Resumen El Género y las fallas institucionales en el desarrollo: la organización del género y el género de la organización La administración pública en el desarrollo ha sido un instrumento muy pobre para la implementación de criterios relativos al género. En las economías agrarias en particular la administración del desarrollo rural tiende a ser poco responsable para con el ‘público’ femenino. Tradicionalmente, este rasgo característico del fracaso institucional se explica sugiriendo que la administración pública refleja las relaciones entre los sexos en la sociedad. Este artículo, sin embargo, argumenta que el papel de la administración pública en la organización del género suscita interrogantes sobre el género de la organización. Se bosquejan las premisas conceptuales para una teoría del género en la organización, analizando la forma en que las culturas, estructuras organizativas y objetivos institucionalizan la dominación masculina. Esta perspectiva puede arrojar luz sobre los procesos y relaciones a través de los cuales otras desigualdades — clase, raza, la división Norte?Sur — se reproducen en la administración pública

Reflections on the Formation and Growth of the SURE Network: a National Disciplinary Network to Enhance Undergraduate Research in the Sciences

The Science Undergraduate Research Experience (SURE) Network is an academic network comprised of nine Higher Education Institutions (HEI) in Ireland that seeks to enhance the profile of, and practices in, undergraduate research in the Sciences within the Technological Higher Education Sector. This paper presents the reflections of the network\u27s leaders on the formation and growth of the network over the period from 2015, just prior to its establishment, to 2020 when the network hosted its seventh undergraduate research conference, published its second undergraduate journal issue, and initiated a coordinated community of practice in response to the Covid-19 crisis. The paper presents the motivations of the leaders for establishing and joining the SURE network, their interpretation of how involvement in the network enhances practice in their own HEI, their reflections on how their own personal development was enhanced, their interpretation of the factors that have contributed to the success of the network, and the direction in which they see the network going in the future. The collective reflections of the leaders of the SURE Network, as presented in this paper, provide importance guidance for those seeking to establish similar academic networks, both in the area of undergraduate research and elsewhere

Il sito web dell'Osservatorio Vesuviano

L'Osservatorio Vesuviano ha di recente realizzato una radicale ristrutturazione del proprio sito Web, attivo dalla seconda metà del 1997, al fine di adeguarlo alla sua nuova configurazione giuridica. Infatti, dal 10 gennaio 2001 è entrato a far parte dell'Istituto Nazionale di Geofisica e Vulcanologia (INGV), un ente nazionale di nuova formazione in cui sono confluiti i maggiori enti ed istituzioni di ricerca operanti nel campo della geofisica e della vulcanologia in Italia. Con la nascita dell'INGV si è posta un'esigenza di coordinamento tra i siti web di dette istituzioni, che si configurano attualmente come sezioni del nuovo ente nazionale. Inoltre, è sorta la necessità di creare delle pagine comuni, relative all'ente nella sua totalità, che introducessero i visitatori alle pagine delle singole sezioni ed eventualmente a specifici tematismi riguardanti le attività dell'ente. A tal fine, è stato istituito un gruppo di Coordinamento Nazionale per il Web che comprende personale afferente alle diverse sezioni. Parallelamente sono stati istituiti gruppi di lavoro locali per la ristrutturazione dei siti delle sezioni. Nell'ambito di questa riorganizzazione, presso l'Osservatorio Vesuviano, con Decreto Direttoriale N. 6, del 30 gennaio 2002, è stato istituito un gruppo di lavoro con il compito di curare la progettazione e lo sviluppo del nuovo sito web della sezione. Nello svolgimento di questa attività il gruppo di lavoro si è posto come obbiettivi prioritari l'usabilità e l'accessibilità del sito, in ottemperanza alle indicazioni espresse dalla più recente normativa apparsa in materia. Per perseguire a pieno questi obbiettivi e garantire la massima fruibilità delle informazioni è stata prevista, fin dalla fase progettuale, la realizzazione del sito anche in versione inglese, che attualmente è in allestimento. Il nuovo sito web dell'Osservatorio Vesuviano è stato messo in linea il 22 maggio 2002 ed è visitabile all'indirizzo http://www.ov.ingv.it. Nel seguito del presente rapporto sono introdotte sinteticamente le finalità istituzionali e le principali attività dell'Osservatorio Vesuviano e sono descritte le fasi di progettazione e sviluppo del sito, con particolare dettaglio sulla strutturazione dei contenuti, definita nell'ambito delle linee dettate dal decreto di istituzione del gruppo di lavoro, e sulle scelte tecnologiche adottate

Childhood in Sociology and Society: The US Perspective

The field of childhood studies in the US is comprised of cross-disciplinary researchers who theorize and conduct research on both children and youth. US sociologists who study childhood largely draw on the childhood literature published in English. This article focuses on American sociological contributions, but notes relevant contributions from non-American scholars published in English that have shaped and fueled American research. This article also profiles the institutional support of childhood research in the US, specifically outlining the activities of the ‘Children and Youth’ Section of the American Sociological Association (ASA), and assesses the contributions of this area of study for sociology as well as the implications for an interdisciplinary field.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

GWAS and meta-analysis identifies 49 genetic variants underlying critical COVID-19

Critical illness in COVID-19 is an extreme and clinically homogeneous disease phenotype that we have previously shown1 to be highly efficient for discovery of genetic associations2. Despite the advanced stage of illness at presentation, we have shown that host genetics in patients who are critically ill with COVID-19 can identify immunomodulatory therapies with strong beneficial effects in this group3. Here we analyse 24,202 cases of COVID-19 with critical illness comprising a combination of microarray genotype and whole-genome sequencing data from cases of critical illness in the international GenOMICC (11,440 cases) study, combined with other studies recruiting hospitalized patients with a strong focus on severe and critical disease: ISARIC4C (676 cases) and the SCOURGE consortium (5,934 cases). To put these results in the context of existing work, we conduct a meta-analysis of the new GenOMICC genome-wide association study (GWAS) results with previously published data. We find 49 genome-wide significant associations, of which 16 have not been reported previously. To investigate the therapeutic implications of these findings, we infer the structural consequences of protein-coding variants, and combine our GWAS results with gene expression data using a monocyte transcriptome-wide association study (TWAS) model, as well as gene and protein expression using Mendelian randomization. We identify potentially druggable targets in multiple systems, including inflammatory signalling (JAK1), monocyte-macrophage activation and endothelial permeability (PDE4A), immunometabolism (SLC2A5 and AK5), and host factors required for viral entry and replication (TMPRSS2 and RAB2A)