The Third Way for the Third Sector: Using Design to Transfer Knowledge and Improve Service in a Voluntary Community Sector Organisation

This paper describes a two-year Knowledge Transfer Partnership that concluded in September 2011. Knowledge Transfer Partnerships (KTP) is a UK-wide activity that helps organisations to improve their competitiveness and productivity by making better use of knowledge, technology and skills within universities, colleges and research organisations. This paper details the outcome of a KTP between Age UK Newcastle and Northumbria University’s School of Design that aimed to use Design approaches to improve the charity’s services. This paper will describe the recent context for organisations operating in the Voluntary Community Sector and discuss the relevance of a Design approach to both the improvement of customer services in this circumstance, as well as the transfer of knowledge to a capacity-starved organisation. It will also document how Design was used to achieve both of these aims, and the resulting impact of this engagement on the organisation and stakeholders

Non-responsive coeliac disease : a comprehensive review from the NHS England national centre for refractory coeliac disease

Coeliac disease is a common small intestinal enteropathy which manifests following ingestion of gluten in genetically susceptible individuals. Since gluten was identified as the driving factor in coeliac disease, the gluten-free diet (GFD) has remained the mainstay of treatment. While most individuals will display improvement in symptoms and signs of coeliac disease following institution of the GFD, up to 30% will continue to experience symptoms and/or have persisting intestinal inflammation. These individuals can be classified as having non-responsive coeliac disease (NRCD), which may be associated with dietary indiscretion, slow healing, refractory coeliac disease, and/or an alternative condition. The purpose of this review is to provide an overview of the causes of NRCD in adults, highlight a systematic approach to investigate these patients, and appraise the latest management aspects of this subset of coeliac disease

Pulmonary macrophage and epithelial cells

Separate abstracts were prepared for the 41 papers presented at the conference. Abstracts of two papers have appeared in previous issues of Energy Research Abstracts. (HLW

Radiating dipoles in photonic crystals

The radiation dynamics of a dipole antenna embedded in a Photonic Crystal are modeled by an initially excited harmonic oscillator coupled to a non--Markovian bath of harmonic oscillators representing the colored electromagnetic vacuum within the crystal. Realistic coupling constants based on the natural modes of the Photonic Crystal, i.e., Bloch waves and their associated dispersion relation, are derived. For simple model systems, well-known results such as decay times and emission spectra are reproduced. This approach enables direct incorporation of realistic band structure computations into studies of radiative emission from atoms and molecules within photonic crystals. We therefore provide a predictive and interpretative tool for experiments in both the microwave and optical regimes.Comment: Phys. Rev. E, accepte

Cost-benefits and environmental impact of the no-biopsy approach for the diagnosis of coeliac disease in adults

Objective: Recent evidence suggests that adult patients with IgA tissue transglutaminase levels of ≥10× the upper limit of normal could be accurately diagnosed with coeliac disease without undergoing endoscopy and biopsy. We aimed to evaluate the cost-benefits and the environmental impact of implementing the no-biopsy approach for diagnosing coeliac disease in clinical practice. Design: We calculated the overall direct and indirect costs of the conventional serology-biopsy approach and the no-biopsy approach for the diagnosis of coeliac disease based on the national average unit costs and the Office of National Statistics data. We further estimated the environmental impact of avoiding endoscopy based on the estimated greenhouse gas emissions from endoscopy. Results: Approximately 3000 endoscopies for suspected coeliac disease could be avoided each year in the UK. Implementing the no-biopsy approach for the diagnosis of coeliac disease in adults could save the National Health Service over £2.5 million in direct and indirect costs per annum and reduce endoscopy carbon footprint by 87 tonnes of CO2 per year, equivalent to greenhouse gas emissions from driving 222 875 miles, carbon emissions from charging over 10 million smartphones and the carbon sequestrated by 1438 trees grown for 10 years. Conclusion: The implementation of this non-invasive green approach could be an essential first step in the ‘Reduce’ strategy advocated by the British Society of Gastroenterology and other international endoscopy societies for sustainable endoscopy practice

Accuracy of the no-biopsy approach for the diagnosis of coeliac disease in adults: a systematic review and meta-analysis

BACKGROUND & AIMS: Current international guidelines recommend duodenal biopsies to confirm the diagnosis of coeliac disease in adult patients. However, growing evidence suggests that IgA anti-tissue transglutaminase (tTg) antibody levels ≥10 times the upper limit of normal (ULN) can accurately predict coeliac disease, eliminating the need for biopsy. We performed a systematic review and meta-analysis to evaluate the accuracy of the no-biopsy approach to confirm the diagnosis of coeliac disease in adults. METHODS: We systematically searched MEDLINE, EMBASE, Cochrane Library and Web of Science from January 1998 to October 2023 for studies reporting the sensitivity and specificity of IgA-tTG ≥10×ULN against duodenal biopsies (Marsh grade ≥2) in adults with suspected coeliac disease. We used a bivariate random-effects model to calculate the summary estimates of sensitivity, specificity, positive and negative likelihood ratios. The positive and negative likelihood ratios were used to calculate the positive predictive value (PPV) of the no-biopsy approach across different pre-test probabilities of coeliac disease. The methodological quality of the included studies was evaluated using the QUADAS-2 tool. This study was registered with PROSPERO, number CRD42023398812. RESULTS: A total of 18 studies comprising 12,103 participants from 15 countries were included. The pooled prevalence of biopsy-proven coeliac disease in the included studies was 62% (95% CI, 40% - 83%). The proportion of patients with IgA-tTG ≥10×ULN was 32% (95% CI, 24% - 40%). The summary sensitivity of IgA-tTG ≥10×ULN was 51% (95% CI, 42% - 60%), and the summary specificity was 100% (95% CI, 98% - 100%). The area under the summary receiver operating characteristic curve was 0.83 (95% CI, 0.77 - 0.89). The PPV of the no-biopsy approach to identify patients with coeliac disease was 65%, 88%, 95%, and 99% if coeliac disease prevalence was 1%, 4%, 10% and 40%, respectively. Between-study heterogeneity was moderate (I2 =30.3%), and additional sensitivity analyses did not significantly alter our findings. Only one study had a low risk of bias across all domains. CONCLUSION: The results of this meta-analysis suggest that selected adult patients with IgA-tTG ≥10×ULN and a moderate to high pre-test probability of coeliac disease could be diagnosed without undergoing invasive endoscopy and duodenal biopsy

Generation of maximum spin entanglement induced by cavity field in quantum-dot systems

Equivalent-neighbor interactions of the conduction-band electron spins of quantum dots in the model of Imamoglu et al. [Phys. Rev. Lett. 83, 4204 (1999)] are analyzed. Analytical solution and its Schmidt decomposition are found and applied to evaluate how much the initially excited dots can be entangled to the remaining dots if all of them are initially disentangled. It is demonstrated that the perfect maximally entangled states (MES) can only be generated in the systems of up to 6 dots with a single dot initially excited. It is also shown that highly entangled states, approximating the MES with a good accuracy, can still be generated in systems of odd number of dots with almost half of them being excited. A sudden decrease of entanglement is observed by increasing the total number of dots in a system with a fixed number of excitations.Comment: 6 pages, 7 figures, to appear in Phys. Rev.