How can we develop an increased awareness of equality & diversity issues amongst our staff

This paper charts a service development initiative, which consisted of a valuing diversity pathway including awareness training days for NHS staff in one Mental Health and Learning Disability Trust. The purpose of the training days was to give staff and service users the opportunity to explore each other’s perspectives, beliefs, values, knowledge and behaviours to better prepare them to tackle inequalities and improve access to services. The main aim of a valuing diversity awareness pathway as stated in this paper is to give staff and service users the opportunity to ensure that staff working in all care services are better prepared to tackle inequalities and to improve access to services for vulnerable groups of people such as those with a learning disability and others with mental health issues requiring treatment. It is recognised that to meet diverse needs both staff and service users need to recognise the value of their differences. The South West Yorkshire Partnership NHS Foundation Trust (SWYPFT) and the University of Huddersfield worked together to produce the pathway. Both of these organisations are committed to valuing diversity and they have a strong history of partnership working. The following paper provides background information, an overview of the innovative approach taken to develop the pathway and a more detailed account of the design, delivery and evaluation of the training days

Ice nucleation at the contact line triggered by transient electrowetting fields

Supercooled water is found to have a significantly enhanced freezing temperature during transient electrowetting with electric fields of order 1 V/μm. High speed imaging reveals that the nucleation occurs randomly at the three-phase contact line (droplet perimeter) and can occur at multiple points during one freezing event. Possible nucleation mechanisms are explored by testing various substrate geometries and materials. Results demonstrate that electric field alone has no detectable effect on ice nucleation, but the moving boundary of the droplet on the substrate due to electrowetting is associated with the triggering of nucleation at a much higher temperature

Varying Alpha

We review properties of cosmological theories for the variation of the fine structure 'constant'. We highlight some general features of the cosmological models that exist in these theories with reference to recent quasar data that are consistent with time-variation in the fine structure 'constant' since a redshift of 3.5.Comment: 9 pages, Paper for the Proceedings of the Grassmann Bicentennial Conference, 'Grasscosmofun'09', Univ. Szczecin Sept. 14-19, 200

Second-trimester Maternal Serum Quadruple Test for Down Syndrome Screening: A Taiwanese Population-based Study

SummaryObjectiveTo assess the usefulness of quadruple test screening for Down syndrome in Taiwan.Materials and MethodsMaternal serum concentrations of a-fetoprotein, human chorionic gonadotropin, unconjugated estriol, and inhibin A were measured in 21,481 pregnant women from 15 to 20 weeks of gestation.ResultsOf the 21,481 women, 977 returned values greater than the high-risk cut-off value (1 in 270). Most of these women (86.2%) decided to have an invasive procedure for genetic diagnosis. Nine cases of Down syndrome and 19 cases of other chromosomal anomalies were detected prenatally. Two children with Down syndrome were diagnosed after delivery even though a low estimated risk was determined following the quadruple test. The detection rate was 81.8% (nine out of 11 cases), with a 4.4% false-positive rate. The median multiple of the median value for a-fetoprotein, human chorionic gonadotropin, unconjugated estriol and inhibin A were 0.87, 2.34, 0.77 and 2.16, respectively, in affected cases.ConclusionThis is the first study of the quadruple test for Down syndrome in a Chinese population. Our findings suggested that the second-trimester quadruple test provides an effective screening tool for Down syndrome in Taiwan

Characterisation and expression of SPLUNC2, the human orthologue of rodent parotid secretory protein

We recently described the Palate Lung Nasal Clone (PLUNC) family of proteins as an extended group of proteins expressed in the upper airways, nose and mouth. Little is known about these proteins, but they are secreted into the airway and nasal lining fluids and saliva where, due to their structural similarity with lipopolysaccharide-binding protein and bactericidal/permeability-increasing protein, they may play a role in the innate immune defence. We now describe the generation and characterisation of novel affinity-purified antibodies to SPLUNC2, and use them to determine the expression of this, the major salivary gland PLUNC. Western blotting showed that the antibodies identified a number of distinct protein bands in saliva, whilst immunohistochemical analysis demonstrated protein expression in serous cells of the major salivary glands and in the ductal lumens as well as in cells of minor mucosal glands. Antibodies directed against distinct epitopes of the protein yielded different staining patterns in both minor and major salivary glands. Using RT-PCR of tissues from the oral cavity, coupled with EST analysis, we showed that the gene undergoes alternative splicing using two 5' non-coding exons, suggesting that the gene is regulated by alternative promoters. Comprehensive RACE analysis using salivary gland RNA as template failed to identify any additional exons. Analysis of saliva showed that SPLUNC2 is subject to N-glycosylation. Thus, our study shows that multiple SPLUNC2 isoforms are found in the oral cavity and suggest that these proteins may be differentially regulated in distinct tissues where they may function in the innate immune response

Thromboprophylaxis Is Associated With Reduced Post-hospitalization Venous Thromboembolic Events in Patients With Inflammatory Bowel Diseases

Background & Aims Patients with inflammatory bowel diseases (IBDs) have increased risk for venous thromboembolism (VTE); those who require hospitalization have particularly high risk. Few hospitalized patients with IBD receive thromboprophylaxis. We analyzed the frequency of VTE after IBD-related hospitalization, risk factors for post-hospitalization VTE, and the efficacy of prophylaxis in preventing post-hospitalization VTE. Methods In a retrospective study, we analyzed data from a multi-institutional cohort of patients with Crohn's disease or ulcerative colitis and at least 1 IBD-related hospitalization. Our primary outcome was a VTE event. All patients contributed person-time from the date of the index hospitalization to development of VTE, subsequent hospitalization, or end of follow-up. Our main predictor variable was pharmacologic thromboprophylaxis. Cox proportional hazard models adjusting for potential confounders were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results From a cohort of 2788 patients with at least 1 IBD-related hospitalization, 62 patients developed VTE after discharge (2%). Incidences of VTE at 30, 60, 90, and 180 days after the index hospitalization were 3.7/1000, 4.1/1000, 5.4/1000, and 9.4/1000 person-days, respectively. Pharmacologic thromboprophylaxis during the index hospital stay was associated with a significantly lower risk of post-hospitalization VTE (HR, 0.46; 95% CI, 0.22–0.97). Increased numbers of comorbidities (HR, 1.30; 95% CI, 1.16–1.47) and need for corticosteroids before hospitalization (HR, 1.71; 95% CI, 1.02–2.87) were also independently associated with risk of VTE. Length of hospitalization or surgery during index hospitalization was not associated with post-hospitalization VTE. Conclusions Pharmacologic thromboprophylaxis during IBD-related hospitalization is associated with reduced risk of post-hospitalization VTE.National Institutes of Health (U.S.) (U54-LM008748

Human uterine and placental arteries exhibit tissue-specific acute responses to 17β-estradiol and estrogen-receptor-specific agonists

The discrete regulation of vascular tone in the human uterine and placental circulations is a key determinant of appropriate uteroplacental blood perfusion and pregnancy success. Humoral factors such as estrogen, which increases in the placenta and maternal circulation throughout human pregnancy, may regulate these vascular beds as studies of animal arteries have shown that 17β-estradiol, or agonists of estrogen receptors (ER), can exert acute vasodilatory actions. The aim of this study was to compare how acute exposure to ER-specific agonists, and 17β-estradiol, altered human placental and uterine arterial tone in vitro. Uterine and placental arteries were isolated from biopsies obtained from women with uncomplicated pregnancy delivering a singleton infant at term. Vessels were mounted on a wire myograph, exposed to the thromboxane receptor agonist U46619 (10(−6) M), and then incubated with incremental doses (5 min, 0.03–30 µM) of either 17β-estradiol or agonists specific for the ERs ERα (PPT), ERβ (DPN) or the G-protein-coupled estrogen receptor GPER-1 (G1). ERα and ERβ mRNA expression was assessed. 17β-estradiol, PPT and DPN each relaxed myometrial arteries (P < 0.05) in a manner that was partly endothelium-dependent. In contrast, 17β-estradiol or DPN relaxed placental arteries (maximum relaxation to 42 ± 1.1 or 47.6 ± 6.53% of preconstriction, respectively) to a lesser extent than myometrial arteries (to 0.03 ± 0.03 or 8.0 ± 1.0%) and in an endothelial-independent manner whereas PPT was without effect. G1 exposure did not inhibit the constriction of myometrial nor placenta arteries. mRNA expression of ERα and ERβ was greater in myometrial arteries than placental arteries. ER-specific agonists, and 17β-estradiol, differentially modulate the tone of uterine versus placental arteries highlighting that estrogen may regulate human uteroplacental blood flow in a tissue-specific manner

Using the information seeker to elicit construct models for search engine evaluation

Users’ internal representations of their interactions with systems are often termed ‘mental models’, and for successful system use, the users’ mental models and system designers’ conceptual models of the tools should be congruent. This study explores a method for non-biased determination of the user’s subconscious view of Internet search engines, in order to derive a mental model comprising those aspects of the systems of importance to the users. The investigation utilises a repertory grid approach in combination with laddering technique, the latter being based on the cause and effect style of mental model development. The detailed qualitative analysis of the data determined through use of laddering interviews is presented here in the development of a mental model comprising three strata. The main hierarchical stratum of the model conveys the interrelations between basic system description, evaluative description, and the key evaluations of ease, efficiency, effort and effectiveness. Two additional strata relating to the perceived process and the experience of emotion are also discussed. The conjunction of the procedural elements with the key evaluations is of particular significance, and further research proposes the extension of this to provide a framework for search engine evaluation