A qualitative study analysing the journey towards an embedded approach to service user involvement

Service user involvement in the design and delivery of education programmes for professionals is a key tenet of current policy. This study used a qualitative approach to explore the experiences of young mothers, students and academics who participated in an initiative aimed to coproduce and deliver a teaching resource focusing on becoming a mother and receiving services. The findings from the focus group interviews suggested that involving service users in student learning can provide an opportunity for open and honest dialogue, where assumptions and stereotypes can be challenged and better understood. It can also encourage users who are often seen as ‘hard to reach’ to be more actively involved in shaping the development of professionals

Introduction: doing rural cultural studies

The guest editors of the Rural Cultural Studies section introduce the articles

Can on-line discussion sites generate quality data for research purposes?

We have recently presented orally the preliminary findings of some research where we derived our data from online discussion sites. Our research described parents’ and caregivers’ experiences of administering medications to young children (1, 2). Different aspects of these data have been presented at four different conferences (each in a different country, and across two continents). On each occasion, our audience of clinicians and researchers have been divided about the credibility and quality of our results. In response to these divergent opinions encountered, we have reflected on whether online discussion sites can contribute to quality research in the arena of health

Increased diastolic blood pressure is associated with MRI biomarkers of dementia-related brain pathology in normative ageing

Background hypertension is a risk for brain ageing, but the mechanisms underlying this effect remain unclear. Magnetic resonance imaging (MRI) detected biomarkers of brain ageing include white matter hyperintensities (WMHs), a marker of cerebrovascular disease, and hippocampal volume, a marker of Alzheimer’s disease pathology. Objective to examine relationships between blood pressure (BP) components and brain pathology in older adults. Subjects two hundred and twenty-seven members of the Aberdeen 1936 Birth Cohort between ages 64 and 68 years. Methods BP was assessed biennially between 64 and 68 years and brain MRI performed at 68 years. The risk factors of interest were diastolic and systolic BP and their visit-to-visit variability. Outcomes were WMH abundance and hippocampal volume. Regression models, controlling for confounding factors, examined their relationships. Results higher diastolic BP predicted increased WMH (β = 0.13, P = 0.044) and smaller hippocampi (β = −0.25, P = 0.006). In contrast, increased systolic BP predicted larger hippocampi (β = 0.22, P = 0.013). Variability of diastolic BP predicted lower hippocampal volume (β = −0.15, P = 0.033). These relationships were independent of confounding life-course risk factors. Anti-hypertensive medication did not modify these relationships, but was independently associated with increased WMH (β = 0.17, P = 0.011). Conclusion increased diastolic BP is associated with biomarkers of both cerebrovascular and Alzheimer’s diseases, whereas the role of systolic BP is less clear, with evidence for a protective effect on hippocampal volume. These differing relationships emphasise the importance of considering individual BP components with regard to brain ageing and pathology. Interventions targeting diastolic hypertension and its chronic variability may provide new strategies able to slow the accumulation of these harmful pathologies

Post-operative monitoring of intestinal tissue oxygenation using an implantable microfabricated oxygen sensor

Anastomotic leakage (AL) is a common and dangerous post-operative complication following intestinal resection, causing substantial morbidity and mortality. Ischaemia in the tissue surrounding the anastomosis is a major risk-factor for AL development. Continuous tissue oxygenation monitoring during the post-operative recovery period would provide early and accurate early identification of AL risk. We describe the construction and testing of a miniature implantable electrochemical oxygen sensor that addresses this need. It consisted of an array of platinum microelectrodes, microfabricated on a silicon substrate, with a poly(2-hydroxyethyl methacrylate) hydrogel membrane to protect the sensor surface. The sensor was encapsulated in a biocompatible package with a wired connection to external instrumentation. It gave a sensitive and highly linear response to variations in oxygen partial pressure in vitro, although over time its sensitivity was partially decreased by protein biofouling. Using a pre-clinical in vivo pig model, acute intestinal ischaemia was robustly and accurately detected by the sensor. Graded changes in tissue oxygenation were also measurable, with relative differences detected more accurately than absolute differences. Finally, we demonstrated its suitability for continuous monitoring of tissue oxygenation at a colorectal anastomosis over a period of at least 45 h. This study provides evidence to support the development and use of implantable electrochemical oxygen sensors for post-operative monitoring of anastomosis oxygenation

A Diffusion-Based Approach to Geminate Recombination of Heme Proteins with Small Ligands

A model of postphotodissociative monomolecular (geminate) recombination of heme proteins with small ligands (NO, O2 or CO) is represented. The non-exponential decay with time for the probability to find a heme in unbound state is interpreted in terms of diffusion-like migration of ligabs physics/0212040 and between protein cavities. The temporal behavior for the probability is obtained from numerical simulation and specified by two parameters: the time \tau_{reb} of heme-ligand rebinding for the ligand localized inside the heme pocket and the time \tau_{esc} of ligand escape from the pocket. The model is applied in the analysis of available experimental data for geminate reoxygenation of human hemoglobin HbA. Our simulation is in good agreement with the measurements. The analysis shows that the variation in pH of the solution (6.0<pH<9.4) results in considerable changes for \tau_{reb} from 0.36 ns (at pH=8.5) up to 0.5 ns (pH=6.0) but effects slightly on the time \tau_{esc} (\tau_{esc} ~ 0.88 ns).Comment: 8 pages with 4 figures, submitted to Chem. Phy

Stepwise Observation and Quantification and Mixed Matrix Membrane Separation of CO2 within a Hydroxy-Decorated Porous Host

The identification of preferred binding domains within a host structure provides important insights into the function of materials. State-of-the-art reports mostly focus on crystallographic studies of empty and single component guest-loaded host structures to determine the location of guests. However, measurements of material properties (e.g., adsorption and breakthrough of substrates) are usually performed for a wide range of pressure (guest coverage) and/or using multi-component gas mixtures. Here we report the development of a multifunctional gas dosing system for use in X-ray powder diffraction studies on Beamline I11 at Diamond Light Source. This facility is fully automated and enables in situ crystallographic studies of host structures under (i) unlimited target gas loadings and (ii) loading of multi-component gas mixtures. A proof-of-concept study was conducted on a hydroxyl-decorated porous material MFM-300(V-III) under (i) five different CO2 pressures covering the isotherm range and (ii) the loading of equimolar mixtures of CO2/N-2. The study has successfully captured the structural dynamics underpinning CO2 uptake as a function of surface coverage. Moreover, MFM-300(V-III) was incorporated in a mixed matrix membrane (MMM) with PIM-1 in order to evaluate the CO2/N-2 separation potential of this material. Gas permeation measurements on the MMM show a great improvement over the bare PIM-1 polymer for CO2/N-2 separation based on the ideal selectivity

In vivo validation of a miniaturized electrochemical oxygen sensor for measuring intestinal oxygen tension

Recent advances in the fields of electronics and microfabrication techniques have led to the development of implantable medical devices for use within the field of precision medicine. Monitoring visceral surface tissue O2 tension (ptO2) by means of an implantable sensor is potentially useful in many clinical situations including the peri-operative management of patients undergoing intestinal resection and anastomosis. This concept could provide a means by which treatment could be tailored to individual patients. This study describes the in vivo validation of a novel miniaturised electrochemical O2 sensor to provide real-time data on intestinal ptO2. A single O2 sensor was placed onto the serosal surface of the small intestine of anaesthetised rats that were exposed to ischaemic (superior mesenteric artery occlusion) and hypoxaemic (alterations in inspired fractional O2 concentrations) insults. Control experiments demonstrated that the sensors function and remain stable in an in vivo environment. Intestinal ptO2 decreased following superior mesenteric artery occlusion and with reductions in inspired O2 concentrations. These results were reversible after reinstating blood flow or increasing inspired O2 concentrations. We have successfully developed an anaesthetised rat intestinal ischaemic and hypoxic model for validation of a miniaturised O2 sensor to provide real-time measurement of intestinal ptO2. Our results support further validation of the sensors in physiological conditions using a large animal model to provide evidence of their use in clinical applications where monitoring visceral surface tissue O2 tension is important

Fundamental differences between SPH and grid methods

We have carried out a hydrodynamical code comparison study of interacting multiphase fluids. The two commonly used techniques of grid and smoothed particle hydrodynamics (SPH) show striking differences in their ability to model processes that are fundamentally important across many areas of astrophysics. Whilst Eulerian grid based methods are able to resolve and treat important dynamical instabilities, such as Kelvin-Helmholtz or Rayleigh-Taylor, these processes are poorly or not at all resolved by existing SPH techniques. We show that the reason for this is that SPH, at least in its standard implementation, introduces spurious pressure forces on particles in regions where there are steep density gradients. This results in a boundary gap of the size of the SPH smoothing kernel over which information is not transferred.Comment: 15 pages, 13 figures, to be submitted to MNRAS. For high-resolution figures, please see http://www-theorie.physik.unizh.ch/~agertz