Co-design with Integrated Care Teams: Establishing Information Needs

Introduction: Co-design has been cited as playing a major role in the future of effective integrated care, however, there is a lack of reporting and reflection on the methods used. Information sharing is fundamental when working in integrated care, however sharing across professions, service settings and localities can be complex. Through co-design, we seek to establish a shared understanding of information needs within a newly formed integrated care team. In doing so we aim to inform future practice in the understanding of co-design. Description: Co-design Workshop 1 (N = 24 participants, plus 6 facilitators), collected ‘Current Position’ understanding of service information needs. Co-design Workshop 2 (N = 18 participants, plus 6 facilitators) sought a ‘Future Position’ understanding, identifying solutions and next steps for establishing information-need solutions. Reflection on the co-design process was conducted to inform future co-design practices. Conclusion: Identified was a wide range of future service information needs under the themes of Culture Building, Health System Needs, and Processes. We conclude with 4 key learning points on co-designing. 1. Ensure simplicity in format. 2. Interdisciplinary co-design and co-facilitation of workshops are beneficial. 3. Planning and preparation are key. 4. Co-designing can enhance communication for service improvement

The Effect of Nutrient Intake on Bone Mineral Status in Young Adults: The Northern Ireland Young Hearts Project

Aunque hemos hablado de ello, no estará de más recordar que uno de los mejores blogs de historia es el de la Historical Society. Este recién empezado año lo han inaugurado con un repaso al número que su revista, Historically Speaking, publicó a principios de 2009. Ha pasado cierto tiempo, es evidente, pero conviene detenerse en su contenido, porque no es habitual: la forma en la que escribimos  la historia. En efecto, la citada publicación dedicó una mesa redonda a debatir sobre "Teaching the..

Viability analysis and apoptosis induction of breast cancer cells in a microfluidic device: effect of cytostatic drugs

Breast cancer is the leading cause of cancer deaths among non-smoking women worldwide. At the moment the treatment regime is such that patients receive different chemotherapeutic and/or hormonal treatments dependent on the hormone receptor status, the menopausal status and age. However, in vitro sensitivity testing of tumor biopsies could rationalize and improve the choice of chemo- and hormone therapy. Lab-on-a-Chip devices, using microfluidic techniques, make detailed cellular analysis possible using fewer cells, enabling working with a patients’ own cells and performing chemo- and hormone sensitivity testing in an ex vivo setting. This article describes the development of two microfluidic devices made in poly(dimethylsiloxane) (PDMS) to validate the cell culture properties and analyze the chemosensitivity of MCF-7 cells (estrogen receptor positive human breast cancer cells) in response to the drug staurosporine (SSP). In both cases, cell viability was assessed using the life-stain Calcein-AM (CAAM) and the death dye propidium iodide (PI). MCF-7 cells could be statically cultured for up to 7 days in the microfluidic chip. A 30 min flow with SSP and a subsequent 24 h static incubation in the incubator induced apoptosis in MCF-7 cells, as shown by a disappearance of the aggregate-like morphology, a decrease in CAAM staining and an increase in PI staining. This work provides valuable leads to develop a microfluidic chip to test the chemosensitivity of tumor cells in response to therapeutics and in this way improve cancer treatment towards personalized medicine

Does congenital deafness affect the structural and functional architecture of primary visual cortex?

Deafness results in greater reliance on the remaining senses. It is unknown whether the cortical architecture of the intact senses is optimized to compensate for lost input. Here we performed widefield population receptive field (pRF) mapping of primary visual cortex (V1) with functional magnetic resonance imaging (fMRI) in hearing and congenitally deaf participants, all of whom had learnt sign language after the age of 10 years. We found larger pRFs encoding the peripheral visual field of deaf compared to hearing participants. This was likely driven by larger facilitatory center zones of the pRF profile concentrated in the near and far periphery in the deaf group. pRF density was comparable between groups, indicating pRFs overlapped more in the deaf group. This could suggest that a coarse coding strategy underlies enhanced peripheral visual skills in deaf people. Cortical thickness was also decreased in V1 in the deaf group. These findings suggest deafness causes structural and functional plasticity at the earliest stages of visual cortex

Associations of autozygosity with a broad range of human phenotypes

In many species, the offspring of related parents suffer reduced reproductive success, a phenomenon known as inbreeding depression. In humans, the importance of this effect has remained unclear, partly because reproduction between close relatives is both rare and frequently associated with confounding social factors. Here, using genomic inbreeding coefficients (F-ROH) for >1.4 million individuals, we show that F-ROH is significantly associated (p <0.0005) with apparently deleterious changes in 32 out of 100 traits analysed. These changes are associated with runs of homozygosity (ROH), but not with common variant homozygosity, suggesting that genetic variants associated with inbreeding depression are predominantly rare. The effect on fertility is striking: F-ROH equivalent to the offspring of first cousins is associated with a 55% decrease [95% CI 44-66%] in the odds of having children. Finally, the effects of F-ROH are confirmed within full-sibling pairs, where the variation in F-ROH is independent of all environmental confounding.Peer reviewe

The trans-ancestral genomic architecture of glycemic traits

Glycemic traits are used to diagnose and monitor type 2 diabetes and cardiometabolic health. To date, most genetic studies of glycemic traits have focused on individuals of European ancestry. Here we aggregated genome-wide association studies comprising up to 281,416 individuals without diabetes (30% non-European ancestry) for whom fasting glucose, 2-h glucose after an oral glucose challenge, glycated hemoglobin and fasting insulin data were available. Trans-ancestry and single-ancestry meta-analyses identified 242 loci (99 novel; P < 5 x 10(-8)), 80% of which had no significant evidence of between-ancestry heterogeneity. Analyses restricted to individuals of European ancestry with equivalent sample size would have led to 24 fewer new loci. Compared with single-ancestry analyses, equivalent-sized trans-ancestry fine-mapping reduced the number of estimated variants in 99% credible sets by a median of 37.5%. Genomic-feature, gene-expression and gene-set analyses revealed distinct biological signatures for each trait, highlighting different underlying biological pathways. Our results increase our understanding of diabetes pathophysiology by using trans-ancestry studies for improved power and resolution.A trans-ancestry meta-analysis of GWAS of glycemic traits in up to 281,416 individuals identifies 99 novel loci, of which one quarter was found due to the multi-ancestry approach, which also improves fine-mapping of credible variant sets.Diabetes mellitus: pathophysiological changes and therap

Novel Loci for Adiponectin Levels and Their Influence on Type 2 Diabetes and Metabolic Traits : A Multi-Ethnic Meta-Analysis of 45,891 Individuals

J. Kaprio, S. Ripatti ja M.-L. Lokki työryhmien jäseniä.Peer reviewe

The effect of some fleece characters on the skin wax layer and fleece rot development in Merino sheep following wetting

This paper describes changes occurring on the skin surface following wetting and during the development of fleece rot and examines the effect of some fleece characters on these changes. One day of wetting reduced the average thickness of the skin wax layer from 7.82 to 4.90 ¦m, but there was little change In the proportion of the skin surface covered by wax. When hyperaemia of the skin was first noted the proportion of the skin surface covered by wax had decreased from 97.8 to 47.5% and the average thickness of skin wax had decreased to 3.64 ¦m. Cholesterol content of the skin wax increased steadily from the first day of wetting as fleece rot developed, whereas lanosterol content increased only in the early stages of fleece rot. Suint content of the fleece, measured before wetting commenced, was positively correlated with fleece rot score at all times during wetting. Suint also showed significant correlations with moisture content of the proximal portion of the staple, percentage of the skin surface covered by wax and cholesterol and lanosterol content of the wax. No relationship was observed between fleece rot score and fleece wax content, wettability, staple formation, tip formation, crimp definition or initial thickness of the skin wax layer

Block off: an examination of new control room configurations and reduced crew sizes examining engineered production blocking

Previous research has shown a potential bottleneck of communication of information between the sonar controller (SOC) and operations officer (OPSO) in submarine sound and control rooms. This research aimed to see if this bottleneck could be removed by co-locating the sound and control room teams. Further, it also looked at the effects of reducing the crew numbers. Ten teams preformed the return to periscope depth tasks during high and low demand in a simulated submarine control room. Activities and communications of the teams were recorded and compared with data from a baseline condition of contemporary operations. The findings show that the co-location of the sound room and control room teams relieved the bottleneck of communications between the SOC and OPSO. Although communications increased, this was more balanced across team members and more relative to operational demand. This was coupled with more efficient task completion, resulting in greater number of tasks being completed by the command teams. Reduced crewing led to greater communications between the remaining members of the team together with task shedding in the higher demand condition. Future research should contrast these findings with objective measures of task performance to better understand potential performance benefits.</p