System change through collaboration for wicked problems : the framework systems thinking for social change applied in practice using action research for the system of brewers spent grain handling

This research aims to investigate the design of a framework concerning wicked problems which can successfully carry out systematic change in practice. The methods used were action-based research applying Stroh's framework: Systems Thinking for Social Change to the issue of spent grain handling. Key findings from testing the framework include (1) need for an initial system overview, (2) the importance of mapping and rating the motivation, (3) the process of using the framework should not be linear, and (4) the need for a neutral philanthropic initiator and driving actor taking over the project. The new framework System Change through Collaboration for Wicked Problems was created to provide a more general approach of addressing these specific issues related to improving wicked problems. This research shows how actions for small system changes can lead to shifts in the overall system outcome. It also emphasized that more frameworks, research and practitioners of system change are needed to improve wicked problems.M-E

A novel NR2E3 gene mutation in autosomal recessive retinitis pigmentosa with cystic maculopathy

NR2E3 is a gene that encodes for photoreceptor cell specific nuclear receptor, which is involved in cone proliferation. The splice site mutation 119-2A>C in NR2E3 (15q23) has been previously reported to underlie recessive enhanced cone S sensitivity syndrome, clumped pigmentary retinal degeneration, Goldman-Favre syndrome and also autosomal dominant and autosomal recessive retinitis pigmentosa (RP). However, the mutation c 571 + 2 T > C in NR2E3 has not been previously reported with retinal disease. We report a 44-year-old male patient who presented with night blindness since birth and acute onset decreased vision, with the compound heterozygous mutation c.119-2A>C and c.571+2T>C in the NR2E3 gene. A diagnosis of retinitis pigmentosa with cystic maculopathy was made and the patient was treated with oral carbonic anhydrase inhibitors, which lead to the partial resolution of foveal cysts and an improvement in visual acuity

Chapter 30 The role of the UN Security Council in cybersecurity

The Routledge Handbook of International Cybersecurity examines the development and use of information and communication technologies (ICTs) from the perspective of international peace and security. Acknowledging that the very notion of peace and security has become more complex, the volume seeks to determine which questions of cybersecurity are indeed of relevance for international peace and security and which, while requiring international attention, are simply issues of contemporary governance or development. The Handbook offers a variety of thematic, regional and disciplinary perspectives on the question of international cybersecurity, and the chapters contextualize cybersecurity in the broader contestation over the world order, international law, conflict, human rights, governance and development. This book will be of much interest to students of cybersecurity, computer science, sociology, international law, defence studies and International Relations in general

Kvalitetssikring av legemiddelbruk i akuttmottak

Bakgrunn: Legemiddelfeil oppstår i opptil 14% av alle legemiddeladministreringer, og er assosiert med negative konsekvenser for den enkelte pasient, men kan også ha store samfunnsøkonomiske konsekvenser (1, 2). Legemiddelfeil oppstår ofte i akuttmottak (3), og akuttmottaket er derfor et sentralt sted å undersøke kvalitet på legemiddelhåndtering og -bruk. Formål: Formålet med studien er å undersøke hvilke tanker og erfaringer helsepersonell som arbeider i akuttmottak har rundt arbeidet som gjøres omkring kvalitetssikring av legemiddelhåndtering og -bruk for å unngå legemiddelfeil. Videre skal studien forsøke å identifisere mulige forbedringspotensialer og foreslå konkrete forbedringstiltak for å unngå legemiddelfeil i akuttmottak. Studien skal også belyse hvilke tanker helsepersonell i akuttmottak har om farmasøyt i akuttmottak. Metode: Dette er en kvalitativ studie som baserer seg på 15 intervjuer med leger og sykepleiere i akuttmottaket ved Nordlandssykehuset Bodø. Dataanalyse er gjort ved Malteruds systematiske tekstkondensering (STC). Resultater: Analysen av materialet kunne kondenseres ned til fire sentrale tema: Helsepersonellet opplever en sterk følelse av ansvar ved legemiddelhåndtering. Samtidig er det heftet betydelig usikkerhet rundt oppgaven, og det foreligger stor individuell variasjon omkring hvordan legemiddelhåndtering utføres på. I tillegg oppleves oppgaven som tidkrevende. Helsepersonellet anga felles journal, elektronisk kurve, økt kunnskap og farmasøyt i akuttmottak som mulige løsninger på utfordringene beheftet ved de fire sentrale temaene. Konklusjon: Selv om helsepersonellet har en sterk ansvarsfølelse rundt legemiddelhåndtering foreligger det stor individuell variasjon og usikkerhet rundt oppgaven. Dette, i tillegg til at oppgaven er tidkrevende, er faktorer som kan føre til legemiddelfeil. Av mulige forbedringstiltak er implementering av farmasøyt i akuttmottak det enkelttiltaket i vår studie som har potensialet til å øke kvaliteten på legemiddelhåndtering, samtidig som det kan bedre pasientflyt og tidsbruk i akuttmottaket

Everyday sovereignty:International experts, brokers and local ownership in peacebuilding Liberia

publishedVersio

Poroelastic Modelling of CSF circulation via the incorporation of experimentally derived microscale water transport properties

We outline how multicompartmental poroelasticity is applied to the study of dementia. We utilize a 3D version of our poroelastic code to investigate the effects within parenchymal tissue. This system is coupled with multiple pipelines within the VPH-DARE@IT project which account for patient/subject-specific boundary conditions in the arterial compartment, in addition to both an image segmentation-mesh and integrated cardiovascular system model pipeline respectively. This consolidated template allows for the extraction of boundary conditions to run CFD simulations for the ventricles. Finally, we outline some experimental results that will help inform the MPET system

Specialized membrane domains for water transport in glial cells: high resolution immunogold cytochemistry of aquaporin-4 in rat brain

Membrane water transport is critically involved in brain volume homeostasis and in the pathogenesis of brain edema. The cDNA encoding aquaporin-4 (AQP4) water channel protein was recently isolated from rat brain. We used immunocytochemistry and high-resolution immunogold electron microscopy to identify the cells and membrane domains that mediate water flux through AQP4. The AQP4 protein is abundant in glial cells bordering the subarachnoidal space, ventricles, and blood vessels. AQP4 is also abundant in osmosensory areas, including the supraoptic nucleus and subfornical organ. Immunogold analysis demonstrated that AQP4 is restricted to glial membranes and to subpopulations of ependymal cells. AQP4 is particularly strongly expressed in glial membranes that are in direct contact with capillaries and pia. The highly polarized AQP4 expression indicates that these cells are equipped with specific membrane domains that are specialized for water transport, thereby mediating the flow of water between glial cells and the cavities filled with CSF and the intravascular space

In vivo optical imaging for evaluating the efficacy of edaravone after transient cerebral ischemia in mice

Detection and protection of apoptosis, autophagy and neurovascular unit (NVU) are essentially important in understanding and treatment for ischemic stroke patients. In this study, we have conducted an in vivo optical imaging for detecting apoptosis and activation of matrix metalloproteinases (MMPs), then evaluated the protective effect of 2 package types of free radical scavenger edaravone (A and B) on apoptosis, autophagy and NVU in mice after transient middle cerebral artery occlusion (tMCAO). As compared to vehicle treatment, edaravones A and B showed a significant improvement of clinical scores and infarct size at 48 h after 90 min of tMCAO with great reductions of in vivo fluorescent signal for MMPs and early apoptotic annexin V activations. Ex vivo imaging of MMPSense 680 or annexin V-Cy5.5 showed a fluorescent signal, while which was remarkably different between vehicle and edaravone groups, and colocalized with antibody for MMP-9 or annexin V. Edaravone A and B ameliorated the apoptotic neuronal cell death in immunohistochemistry, and activations of MMP-9 and aquaporin 4 with reducing autophagic activations of microtubule-associated protein 1 light chain 3 (LC3) in Western blot. In this study, edaravone in both packages showed a similar strong neuroprotection after cerebral ischemia, which was confirmed with in vivo and ex vivo optical imagings for MMPs and annexin V as well as reducing cerebral infarct, inhibiting apoptotic/autophagic mechanisms, and protecting a part of neurovascular unit

Aquaporin-4 water channel protein in the rat retina and optic nerve: polarized expression in Müller cells and fibrous astrocytes

The water permeability of cell membranes differs by orders of magnitude, and most of this variability reflects the differential expression of aquaporin water channels. We have recently found that the CNS contains a member of the aquaporin family, aquaporin-4 (AQP4). As a prerequisite for understanding the cellular handling of water during neuronal activity, we have investigated the cellular and subcellular expression of AQP4 in the retina and optic nerve where activity-dependent ion fluxes have been studied in detail. In situ hybridization with digoxigenin-labeled riboprobes and immunogold labeling by a sensitive postembedding procedure demonstrated that AQP4 and AQP4 mRNA were restricted to glial cells, including MHller cells in the retina and fibrous astrocytes in the optic nerve. A quantitative immunogold analysis of the MHller cells showed that these cells exhibited three distinct membrane compartments with regard to AQP4 expression. End feet membranes (facing the vitreous body or blood vessels) were 10-15 times more intensely labeled than non-end feet membranes, whereas microvilli were devoid of AQP4. These data suggest that MHller cells play a prominent role in the water handling in the retina and that they direct osmotically driven water flux to the vitreous body and vessels rather than to the subretinal space. Fibrous astrocytes in the optic nerve similarly displayed a differential compartmentation of AQP4. The highest expression of AQP4 occurred in end feet membranes, whereas the membrane domain facing the nodal axolemma was associated with a lower level of immunoreactivity than the rest of the membrane. This arrangement may allow transcellular water redistribution to occur without inducing inappropriate volume changes in the perinodal extracellular space