Cultivation of stable, reproducible microbial communities from different fecal donors using minibioreactor arrays (MBRAs)

Background: Continuous-flow culture models are one tool for studying complex interactions between members of human fecal microbiotas because they allow studies to be completed during an extended period of time under conditions where pH, nutrient availability, and washout of waste products and dead cells can be controlled. Because many of the existing well-validated continuous-flow models are large and complex, we were interested in developing a simpler continuous-flow system that would allow microbial community dynamics to be examined in higher throughput while still maintaining complex microbial communities. To this end, we developed minibioreactor arrays (MBRAs), small volume bioreactors (15 ml) that allow simultaneous cultivation of up to 48 microbial communities in a single anaerobic chamber. Results: We used MBRA to characterize the microbial community dynamics of replicate reactors inoculated from three different human fecal donors and reactors seeded with feces pooled from these three donors. We found that MBRA could be used to efficiently cultivate complex microbial communities that were a subset of the initial fecal inoculum (15–25 % of fecal OTUs initially observed). After an initial acclimation period of approximately 1 week, communities in each reactor stabilized and exhibited day-to-day variation similar to that observed in stable mouse fecal communities. Replicate reactors were predominately populated by shared core microbial communities; variation between replicate reactors was primarily driven by shifts in abundance of shared operational taxonomic units (OTUs). Consistent with differences between fecal donors, MBRA communities present in reactors seeded with different fecal samples had distinct composition and structure. Conclusions: From these analyses, we conclude that MBRAs can be used to cultivate communities that recapitulate key features of human fecal communities and are a useful tool to facilitate higher-throughput studies of the dynamics of these communities

The art of the possible? Supporting a patient safety culture in mental healthcare to maximise safety

Purpose The current national patient safety strategy for the National Health Service (NHS) in England states that actions need to be taken to support the development of a patient safety culture. This includes that local systems should seek to understand staff perceptions of the fairness and effectiveness of serious incident management. This study aims to explore the perspectives of patient safety professionals about what works well and what could be done better to support a patient safety culture at the level of Trust strategy and serious incident governance. Approach A total of 15 professionals with a role in serious incident management, from five mental health Trusts in England, were interviewed using a semi-structured interview guide.  Thematic analysis and qualitative description was used to analyse the data. Findings Participants felt that actions to support a patient safety culture were challenging and required long-term and clinical commitment. Broadening the scope of serious incident investigations was felt to be one way to better understand patient safety culture issues. Organisational influences during the serious incident management process were highlighted, informing approaches to maximise the fairness and objectivity of investigation findings. Originality The findings of this study offer original insights that the NHS safety system can use to facilitate progression of the patient safety culture agenda. In particular, local mental health Trusts could consider the findings in the context of their current strategic objectives related to patient safety culture and operational delivery of serious incident management frameworks

One size doesn’t always fit all:professional perspectives of serious incident management systems in mental healthcare

PurposeThe need to develop effective approaches for responding to healthcare incidents for the purpose of learning and improving patient safety has been recognised in current national policy. However, research into this topic is limited. This study aims to explore the perspectives of professionals in mental health trusts in England about what works well and what could be done better when implementing serious incident management systems.Design/methodology/approachThis was a qualitative study using semi-structured interviews. In total, 15 participants were recruited, comprising patient safety managers, serious incident investigators and executive directors, from five mental health trusts in England. The interview data were analysed using a qualitative-descriptive approach to develop meaningful themes. Quotes were selected and presented based on their representation of the data.FindingsParticipants were dissatisfied with current systems to manage serious incidents, including the root cause analysis approach, which they felt were not adequate for assisting learning and improvement. They described concerns about the capability of serious incident investigators, which was felt to impact on the quality of investigations. Processes to support people adversely affected by serious incidents were felt to be an important part of incident management systems to maximise the learning impact of investigations.Originality/valueFindings of this study provide translatable implications for mental health trusts and policymakers, informed by insights into how current approaches for learning from healthcare incidents can be transformed. Further research will build a more comprehensive understanding of mechanisms for responding to healthcare incidents

Eye See Eye Learn The Benefit of Comprehensive Eye Examinations for Preschoolers

Objective: Undetected vision problems in children can lead to permanent vision loss, a condition known as amblyopia. Early detection and treatment of the causes of amblyopia may prevent this vision loss. The objective of this paper is to look for evidence that comprehensive eye examinations upon entry to junior Kindergarten are an effective way to identify and treat vision problems early. methods: Relevant peer-reviewed publications on amblyopia and the importance of comprehensive eye examinations were reviewed. Specific areas investigated include: the prevalence and causes of amblyopia; impact of vision problems on child development and education; impact of amblyopia and/or strabismus on quality of life; and the cost effectiveness of treating amblyopia. The validity of vision screening compared to a comprehensive eye examination was also reviewed. Synthesis:The review suggests that without a complete eye examination many eye or vision problems remain undetected at school entry. Left uncorrected these problems negatively impact child development, education and quality of life. Reduced vision due to amblyopia also restricts future employment opportunities and increases the risk of bilateral visual impairment in adulthood. Examination procedures with high sensitivity and specificity are required to accurately detect these problems. Studies show that amblyopia treatment initiated at an early age is one of the most cost-effective of all health interventions. Conclusion: There is good evidence in the literature that a full eye examination is critical to detect all cases of amblyopia. This and other visual problems can be detected and managed at an early age, which leads to better visual quality of life and economical outcomes. The Eye See Eye Learn program offers the “gold standard” of eye care

Psychiatrists’ attitudes to professional boundaries concerning spirituality and religion: mixed-methods study

Aims and methodCalls for the integration of spirituality into psychiatric practice have raised concerns about boundary violations. We sought to develop a method to capture psychiatrists’ attitudes to professional boundaries and spirituality, explore consensus and understand what factors are considered. Case vignettes were developed, tested and refined. Three vignettes were presented to 80 mental health professionals (53% said they were psychiatrists; 39% did not identify their professional status). Participants recorded their reactions to the vignettes. Four researchers categorised these as identifying boundary violations or not and analysed the factors considered.ResultsIn 90% of cases, at least three of the four researchers agreed on classification (boundary violation; possible boundary violation; no boundary violation). Participants’ opinion about boundary violations was heterogeneous. There was consensus that psychiatrists should not proselytise in clinical settings. Reasoning emphasised pragmatic concerns. Few participants mentioned their religious beliefs. Equivocation was common.Clinical implicationsMental health professionals seem unsure about professional boundaries concerning religion and spirituality in psychiatric practice

The Role of Words in Cognitive Tasks: What, When, and How?

The current review focuses on how exposure to linguistic input, and count nouns in particular, affect performance on various cognitive tasks, including individuation, categorization and category learning, and inductive inference. We review two theoretical accounts of effects of words. Proponents of one account argue that words have top-down effects on cognitive tasks, and, as such, function as supervisory signals. Proponents of the other account suggest that early in development, words, just like any other perceptual feature, are first and foremost part of the stimulus input and influence cognitive tasks in a bottom-up, non-supervisory fashion. We then review evidence supporting each account. We conclude that, although much research is needed, there is a large body of evidence indicating that words start out like other perceptual features and become supervisory signals in the course of development

Infrared Diagnostics for the Extended 12 micron Sample of Seyferts

We present an analysis of Spitzer IRS spectroscopy of 83 active galaxies from the extended 12 micron sample. We find rank correlations between several tracers of star formation which suggest that (1) the PAH feature is a reliable tracer of star formation, (2) there is a significant contribution to the heating of the cool dust by stars, (3) the H$_2$ emission is also primarily excited by star formation. The 55-90 vs. 20-30 spectral index plot is also a diagnostic of the relative contribution of Starburst to AGN. We see there is a large change in spectral index across the sample. Thus, the contribution to the IR spectrum from the AGN and starburst components can be comparable in magnitude but the relative contribution also varies widely across the sample. We find rank correlations between several AGN tracers. We search for correlations between AGN and Starburst tracers and we conclude that the AGN and Starburst tracers are not correlated. This is consistent with our conclusion that the relative strength of the AGN and Starburst components varies widely across the sample. Thus, there is no simple link between AGN fueling and Black Hole Growth and star formation in these galaxies. The distribution of Sil 10 micron and 18 micron strengths is consistent with the clumpy torus models of Sirocky et al. We find a rank correlation between the [NeV] 14 micron line and the 6.7 micron continuum which may be due to an extended component of hot dust. The Sy 2s with a Hidden Broad Line Region (HBLR) have a higher ratio of AGN to Starburst contribution to the SED than Sy 2s without an HBLR. This may contribute to the detection of the HBLR in polarized light. The Sy 2s with an HBLR are more similar to the Sy 1s than they are to the Sy 2s without an HBLR

Exploring B/Ca as a pH proxy in bivalves : relationships between Mytilus californianus B/Ca and environmental data from the northeast Pacific

© The Author(s), 2011. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Biogeosciences 8 (2011): 2567-2579, doi:10.5194/bg-8-2567-2011.A distinct gap in our ability to understand changes in coastal biology that may be associated with recent ocean acidification is the paucity of directly measured ocean environmental parameters at coastal sites in recent decades. Thus, many researchers have turned to sclerochronological reconstructions of water chemistry to document the historical seawater environment. In this study, we explore the relationships between B/Ca and pH to test the feasibility of B/Ca measured on the ion probe as a pH proxy in the California mussel, Mytilus californianus. Heterogeneity in a range of ion microprobe standards is assessed, leading to reproducible B/Ca ratios at the 5% level. The B/Ca data exhibit large excursions during winter months, which are particularly pronounced during the severe winters of 2004–2005 and 2005–2006. Furthermore, B/Ca ratios are offset in different parts of the skeleton that calcified at the same time. We compare the M. californianus B/Ca record to directly measured environmental data during mussel growth from the period of 1999–2009 to examine whether seawater chemistry or temperature plays a role in controlling shell B/Ca. A suite of growth rate models based on measured temperature are compared to the B/Ca data to optimise the potential fit of B/Ca to pH. Despite sampling conditions that were well-suited to testing a pH control on B/Ca, including a close proximity to an environmental record, a distinct change in pH at the sampling locale, and a growth model designed to optimise the correlations between seawater pH and shell B/Ca, we do not see a strong correlations between pH and shell B/Ca (maximum coefficient of determination, r2, of 0.207). Instead, our data indicate a strong biological control on B/Ca as observed in some other carbonate-forming organisms.Financial support was provided by USGSWHOI Co-operative agreement and NSF-ANT award number 0902957 to L. F. Robinson, a SeaDoc Society grant to C. A. Pfister and J. T. Wootton, and a NASA Planetary Biology Internship to S. J. McCoy with L. F. Robinson and D. M. Glover