UK community health visiting: challenges faced during lean implementation

This paper presents an overview of the challenges and potential of lean implementation for the health visiting service in England and examines the rhetoric and the reality of the situation. It is coauthored by academic researchers and senior service providers so as to embrace the multidimensional issues impacting on this subject. If lean thinking is to be implemented in relation to health visiting, it is important to understand how it is likely to be viewed by practitioners and line managers in settings where it is used. In order to contextualize the discussion, an introduction to the roles, systems, and structures of health visiting are provided. The literature on what lean implementation is, what it means, and in particular the application and potential of the approach to primary care and public health services is reviewed. The process and findings from a focus group convened within a large primary care organization in the National Health Service during their lean implementation is reported. The paper concludes that it is important for staff at all levels to see a clear link between strategic aims and objectives and the planning processes operated by providers and commissioners. It appears that the successful introduction of lean thinking should focus more on productive working and thereby reducing waste. This has the potential to refresh workforce models to ensure that health visiting and other practitioners liberate the use of their specialist knowledge and skills. In a context of enhanced partnership working, the stage is then set for providers to add value to the whole system and together improve service user outcomes

The liturgical element in the Autos sacramentales of Calderon

Thesis (Ph.D.)--Boston Universit

Epstein-Barr Virus Infection of CR2-Transfected Epithelial Cells Reveals the Presence of MHC Class II on the Virion

AbstractEpithelial cell lines transfected with the Epstein-Barr virus (EBV) receptor CR2 are susceptible to infection by EBV. Following infection with certain EBV strains we found that these cells became positive for MHC class II. The class II was confirmed as being of viral and not target cell origin by immunostaining with HLA-specific monoclonal antibodies. Electron microscopic immunogold staining confirmed the presence of MHC class II on the surface of the virion. While some MHC class I was also found on the EB virion, other cell surface molecules were absent. Dual color immunofluorescence and confocal microscopy analysis demonstrated colocalization of class II with EBV-encoded structural proteins (MA and VCA) in infected epithelial cells. However, preincubation of EBV with antibodies against either MHC class I or MHC class II failed to affect either EBV binding or EBV infection. The presence of MHC on the surface of the EB virion may be a consequence of the intracellular pathways through which productive virus exits from the cell and may influence the target cell tropism of EBV

Corporate Social Responsibility in the U.S. Travel Industry

As the travel industry consists of various sectors, which often depend on environmental and cultural resources, socially responsible business policies, programs and practices are essential to achieve sustainable tourism at the local as well as the global level. nonetheless, it has yet to be known how the industry perceives and practices corporate social responsibility (CSR) activities. Thus, this study aims to better understand the opinions about and engagementin (CSR) by the the U.S. travel industry. Results of a survey conducted to the members of Travel Industry Association of America can provide travel companies with an important reference point about the concept of and practices of CSR by the industry members. Moreover, results of this study will reveal areas for further research

Clothing Retail Channel Use and Digital Behavior: Generation and Gender Differences

This study examined whether selecting certain retail channels to purchase clothing reflects generational and gender preferences as well as their digital behavior. Based on 1000 consumer cases from a Cornell National Social Survey conducted in 2012, this study employed correspondence analysis to segment clothing retail channel groups and relate the segments to generational cohorts and gender. Overall, the majority of Gen Y, Gen X, and Baby Boomer male consumers preferred the store-only channel, while the majority of female consumers of these generations liked the digital-only or digital-store channel for purchasing clothing. On the other hand, both male and female seniors liked catalogs (either digital-catalog or catalog only) for purchasing clothing. In addition, ANOVA was run with generation and gender as the independent variables and digital behaviors as the dependent variables. Results provided strategic information on how to target each clothing channel segment using the digital behavior of different generations and gender

Generalized software requirements to access thesauri and classification schemes for user-based image collections

This paper describes proposed schemes for describing and indexing two image collections and equirements for the software that would give the end-user access to thesaurus terms and a graphical display of the faceted classification structures of indexing records. Editorial cartoons comprise one collection, dance videos the other

DPY-17 and MUA-3 Interact for Connective Tissue-Like Tissue Integrity in Caenorhabditis elegans: A Model for Marfan Syndrome

mua-3 is a Caenorhabditis elegans homolog of the mammalian fibrillin1, a monogenic cause of Marfan syndrome. We identified a new mutation of mua-3 that carries an in-frame deletion of 131 amino acids in the extracellular domain, which allows the mutants to survive in a temperature-dependent manner; at the permissive temperature, the mutants grow normally without obvious phenotypes, but at the nonpermissive temperature, more than 90% die during the L4 molt due to internal organ detachment. Using the temperature-sensitive lethality, we performed unbiased genetic screens to isolate suppressors to find genetic interactors of MUA-3. From two independent screens, we isolated mutations in dpy-17 as a suppressor. RNAi of dpy-17 in mua-3 rescued the lethality, confirming dpy-17 is a suppressor. dpy-17 encodes a collagen known to genetically interact with dpy-31, a BMP-1/Tolloid-like metalloprotease required for TGFβ activation in mammals. Human fibrillin1 mutants fail to sequester TGFβ2 leading to excess TGFβ signaling, which in turn contributes to Marfan syndrome or Marfan-related syndrome. Consistent with that, RNAi of dbl-1, a TGFβ homolog, modestly rescued the lethality of mua-3 mutants, suggesting a potentially conserved interaction between MUA-3 and a TGFβ pathway in C. elegans. Our work provides genetic evidence of the interaction between TGFβ and a fibrillin homolog, and thus provides a simple yet powerful genetic model to study TGFβ function in development of Marfan pathology

The 'Matters' of Science Diplomacy:Transversal Analysis of the S4D4C Case Studies

What matters in science diplomacy? That is the question that the publication of the S4D4C project (see www.s4d4c.eu) “The 'Matters' of Science Diplomacy: Transversal Analysis of the S4D4C Case Studies” aims to answer. To do so, the transversal analysis critically analyses the content of the project's nine case studies and identifies insights to foster and advance the understanding and the practice of science diplomacy. Each matter addresses a piece from the larger picture; together they form a mosaic depicting the complex and wide-ranging concept of science diplomacy. The 10 “matters” are the result of the collaborative work between 11 S4D4C team members, coordinated by Mitchell Young, S4D4C lead for empirical work

A novel class of CoA-transferase involved in short-chain fatty acid metabolism in butyrate-producing human colonic bacteria

Peer reviewedPublisher PD