Conserved roles of Osiris genes in insect development, polymorphism, and protection

Much of the variation among insects is derived from the different ways that chitin has been moulded to form rigid structures, both internal and external. In this study, we identify a highly conserved expression pattern in an insect-only gene family, the Osiris genes, that is essential for development, but also plays a significant role in phenotypic plasticity and in immunity/toxicity responses. The majority of Osiris genes exist in a highly syntenic cluster, and the cluster itself appears to have arisen very early in the evolution of insects. We used developmental gene expression in the fruit fly, Drosophila melanogaster, the bumble bee, Bombus terrestris, the harvester ant, Pogonomyrmex barbatus, and the wood ant, Formica exsecta, to compare patterns of Osiris gene expression both during development and between alternate caste phenotypes in the polymorphic social insects. Developmental gene expression of Osiris genes is highly conserved across species and correlated with gene location and evolutionary history. The social insect castes are highly divergent in pupal Osiris gene expression. Sets of co-expressed genes that include Osiris genes are enriched in gene ontology terms related to chitin/cuticle and peptidase activity. Osiris genes are essential for cuticle formation in both embryos and pupae, and genes co-expressed with Osiris genes affect wing development. Additionally, Osiris genes and those co-expressed seem to play a conserved role in insect toxicology defences and digestion. Given their role in development, plasticity, and protection, we propose that the Osiris genes play a central role in insect adaptive evolution.Peer reviewe

Deploying a clinical innovation in the context of actor-patient consultations in general practice: A prelude to a formal clinical trial

<p>Abstract</p> <p>Background</p> <p>Innovations to be deployed during consultations with patients may influence the clinical performance of the medical practitioner. This study examined the impact on General Practitioners' (GPs) consultation performance of novel computer software, designed for use while consulting the patient.</p> <p>Methods</p> <p>Six GPs were video recorded consulting six actor-patients in a simulated clinical environment. Two sessions were recorded with six consultations per GP. Five cases presented cancer symptoms which warranted a referral for specialist investigation. Practitioners were invited to use a novel software package to process referrals made during the consultations in the second session. Two assessors independently reviewed the consultation performance using the Leicester Assessment Package (LAP). Inter-rater agreement was assessed by a Bland-Altman plot of the difference in score against the average score.</p> <p>Results</p> <p>Sixty of the seventy two consultations were successfully recorded. Each video consultation was scored twice by two assessors leaving 120 LAP scores available for analysis. There was no evidence of a difference in the variance with increasing score (Pitmans test p = 0.09). There was also no difference in the mean differences between assessor scores whether using the software or not (T-test, P = 0.49)</p> <p>Conclusion</p> <p>The actor-patient consultation can be used to test clinical innovations as a prelude to a formal clinical trial. However the logistics of the study may impact on the validity of the results and need careful planning. Ideally innovations should be tested within the context of a laboratory designed for the purpose, incorporating a pool of practitioners whose competencies have been established and assessors who can be blinded to the aims of the study.</p

Voronoi Growth Model of Sheet Nacre.

The aim of this work was to study the tiling mode of nacre tablets in the 'brick and mortar' array of sheet nacre. For that purpose, incipient shell nacre (Pinctada margaritifera) was analysed by electron microscopy (SEM) and Raman spectroscopy. Experimental observations pointed out the key role of the stairs-like growing front in sheet-like nacre not only for its long range ordering but also as controlling the hierarchy of local mechanisms. A morphogenesis sequence is proposed taking into account the dynamics of the environment. First, the mantel cells are organised to synthesise and discharge alternatively the extrapallial fluid as batches. Because of the stairs-like feature of the growth front, the extrapallial fluid organizes as successive 'biological films', each of them delayed from the underlying one by 10 to 15µm. Each film is a compartment to prefigure a nacre layer. Then, after individualisation, this film undergoes nucleation and crystallisation of tablets. Finally, the biological film transforms progressively as mature nacre following self assembly mechanisms. The resulting tablets have a shape which responds to a Voronoi growth model, this is shown for the first time: aggregation at the same speed in all directions around single growth centers. This is an efficient model to understand the growth mechanism and rationalise all the experimental observations we have obtained

Factors Influencing Speed of Cancer Diagnosis in Rural WA

Introduction: The speed of diagnosis impacts on prognosis and survival in all types of cancer. In most cases survival and prognosis are significantly worse in rural and remote Australian populations who have less access to diagnostic and therapeutic services than metropolitan communities in this country. Research suggests that in general delays in diagnosis were a factor of misdiagnosis, the confounding effect of existing conditions and delayed or misleading investigation of symptoms. The aim of this study is to further explore the factors that impact on the speed of diagnosis in rural Western Australia with direct reference to General Practitioners (GPs) working in this setting. Methods: The methodology consisted of a structured discussion of specific cases. GPs based in two rural locations in Western Australia were asked to identify up to eight clinical cases for discussion. A diversity of cases was requested encompassing those with timely and delayed diagnosis of cancer. Focus groups were held with the practitioners to identify which factors under six headings delayed or facilitated the diagnosis in each case. A structured summary of the discussion was relayed to a wider group of GPs to seek additional views or comments on specific factors that impact on the speed of cancer diagnosis in rural and remote locations in Australia. Results: A number of factors affecting the speed of diagnosis were identified: the demographic shift towards a frailer and older population, presenting with multiple and complex diseases, increases the challenge to identify early cancer symptoms; seasonal and demanding work patterns leading to procrastination in presenting for medical are; unhelpful scheduling of specialist appointments; and the varying impact of informal networks and social relationships. Conclusion: Within the limitations of this study we have generated a number of hypotheses that require formal evaluation: (1) GPs working within informal professional and social networks are better informed about their patients\u27 health needs and have an advantage in making early diagnosis; (2) Despite the other differences in the population characteristics decentralising services would improve the prospect for timely diagnosis; and (3) Careful coordination of specialist appointments would improve the speed of diagnosis for rural patients. . would improve the speed of diagnosis for rural patients. procrastination in presenting for medical care; unhelpful scheduling of specialist appointments; and the varying impact of informal networks and social relationships. Conclusion: Within the limitations of this study we have generated a number of hypotheses that require formal evaluation: (1) GPs working within informal professional and social networks are better informed about their patients\u27 health needs and have an advantage in making early diagnosis; (2) Despite the other differences in the population characteristics decentralising services would improve the prospect for timely diagnosis; and (3) Careful coordination of specialist appointments would improve the speed of diagnosis for rural patients. procrastination in presenting for medical care; unhelpful scheduling of specialist appointments; and the varying impact of informal networks and social relationships. Conclusion: Within the limitations of this study we have generated a number of hypotheses that require formal evaluation: (1) GPs working within informal professional and social networks are better informed about their patients\u27 health needs and have an advantage in making early diagnosis; (2) Despite the other differences in the population characteristics decentralising services would improve the prospect for timely diagnosis; and (3) Careful coordination of specialist appointments would improve the speed of diagnosis for rural patients. most cases survival and prognosis are significantly worse in rural and remote Australian populations who have less access to diagnostic and therapeutic services than metropolitan communities in this country. Research suggests that in general delays in diagnosis were a factor of misdiagnosis, the confounding effect of existing conditions and delayed or misleading investigation of symptoms. The aim of this study is to further explore the factors that impact on the speed of diagnosis in rural Western Australia with direct reference to General Practitioners (GPs) working in this setting. Methods: The methodology consisted of a structured discussion of specific cases. GPs based in two rural locations in Western Australia were asked to identify up to eight clinical cases for discussion. A diversity of cases was requested encompassing those with timely and delayed diagnosis of cancer. Focus groups were held with the practitioners to identify which factors under six headings delayed or facilitated the diagnosis in each case. A structured summary of the discussion was relayed to a wider group of GPs to seek additional views or comments on specific factors that impact on the speed of cancer diagnosis in rural and remote locations in Australia. Results: A number of factors affecting the speed of diagnosis were identified: the demographic shift towards a frailer and older population, presenting with multiple and complex diseases, increases the challenge to identify early cancer symptoms; seasonal and demanding work patterns leading to procrastination in presenting for medical care; unhelpful scheduling of specialist appointments; and the varying impact of informal networks and social relationships. Conclusion: Within the limitations of this study we have generated a number of hypotheses that require formal evaluation: (1) GPs working within informal professional and social networks are better informed about their patients\u27 health needs and have an advantage in making early diagnosis; (2) Despite the other differences in the population characteristics decentralising services wouldimprove the prospect for timely diagnosis; and (3) Careful coordination of specialist appointments would improve the speed of diagnosis for rural patients

Sheet nacre growth mechanism: a Voronoi model.

Xavier Bourrat is in ISTO's lab since January 2005International audienceShell nacre (mother of pearl) of Pinctada margaritifera was analyzed by scanning electron microscopy. The originality of this work concerns the sampling performed to observe incipient nacre on the mantle side. The whole animal is embedded in methyl methacrylate followed by separation of the shell from the hardened mantle. It is revealed this way how each future nacre layer pre-exists as a film or compartment. Experimental observations also show for the first time, the progressive lateral crystallization inside this film, finishing under the form of a non-periodic pattern of polygonal tablets of bio-aragonite. It is evidenced that nuclei appear in the film in the vicinity of the zone where aragonite tablets of the underlying layer get in contact to each other. A possible explanation is given to show how nucleation is probably launched in time and space by a signal coming from the underlying layer. Finally, it is evidenced that tablets form a Voronoi tiling of the space: this suggests that their growth is controlled by an "aggregation-like" process of "crystallites" and not directly by the aragonite lattice growth

Does smoking status affect the likelihood of consulting a doctor about respiratory symptoms? A pilot survey in Western Australia

<p>Abstract</p> <p>Background</p> <p>Smokers attribute respiratory symptoms, even when severe, to everyday causes and not as indicative of ill-health warranting medical attention. The aim of this pilot study was to conduct a structured vignette survey of people attending general practice to determine when they would advise a person with respiratory symptoms to consult a medical practitioner. Particular reference was made to smoking status and lung cancer.</p> <p>Methods</p> <p>Participants were recruited from two general practices in Western Australia. Respondents were invited to complete self-administered questionnaires containing nine vignettes chosen at random from a pool of sixty four vignettes, based on six clinical variables. Twenty eight vignettes described cases with at least 5% risk of cancer. For analysis these were dubbed 'cancer vignettes'. Respondents were asked if they would advise a significant other to consult a doctor with their respiratory symptoms. Logistic regression and non-parametric tests were used to analyse the data.</p> <p>Results</p> <p>Three hundred questionnaires were distributed and one hundred and forty completed responses were collected over six weeks. The majority (70.3%) of respondents were female aged forty and older. A history of six weeks' of symptoms, weight loss, cough and breathlessness independently increased the odds of recommending a consultation with a medical practitioner by a factor of 11.8, 2.11, 1.40 and 4.77 respectively. A history of smoking independently increased the odds of the person being thought 'likely' or 'very likely' to have cancer by a factor of 2.46. However only 32% of cancer vignettes with a history of cigarette smoking were recognised as presentations of possible cancer.</p> <p>Conclusion</p> <p>Even though a history of cigarette smoking was more likely to lead to the suggestion that a symptomatic person may have cancer we did not confirm that smokers would be more likely to be advised to consult a doctor, even when presenting with common symptoms of lung cancer.</p

Likestilling i lekebutikken - En kartlegging av småbarnsmødres holdninger til kjønnsrettet markedsføring mot barn og likestilling i arbeidslivet.

Denne oppgaven har som hensikt å kartlegge småbarnsmødres holdninger til kjønnsrettet markedsføring mot barn og likestilling i arbeidslivet. Holdningene vil knyttes opp mot holdningsteori, samt teori som virker forklarende på hvorfor de ulike holdningene oppstår. Debatten tilknyttet de respektive fenomenene i media inspirerte oss til å velge dette temaet, da det både er interessant og aktuelt. Det teoretiske rammeverket er delt inn i to ulike kategorier henholdsvis holdningsteori og teori for å forklare hvorfor holdningene eksisterer. Holdningsteoridelen tar for seg holdningsmodeller, stereotypier, fordommer og persepsjon. Den forklarende teorien fokuserer på Bourdieus habitus samt Berger og Luckmanns teori om den samfunnsskapte virkelighet. Oppgaven benytter seg av kvalitativ metode, herunder en kombinasjon av dybdeintervju og projektive teknikker. De projektive teknikkene består av bildevisning og setningsutfylling. Da dette gir grunnlag for et dypere innblikk i informantens holdninger, ble spørsmålene underveis i intervjuet tilpasset de projektive teknikkene. Funn fra undersøkelsen viser at småbarnsmødrene har delte meninger om kjønnsrettet markedsføring mot barn. De kjønnsdelte barnebøkene som ble fremvist skapte provokasjon, mens kjønnsdelingen i lekebutikken ble ansett som praktisk. Informantene er enige om at media i stor grad styrer hva deres barn interesserer seg for, noe som bidrar til å forsterke kjønnsdelingen. Barna søker avstand fra leker som var stereotypiske for det motsatte kjønn. For å få en naturlig overgang til spørsmålene om arbeidslivet forklarte informantene hva de la i ordet kjønnsroller, og hvilke forventinger som forelå til de respektive rollene. Forventningene til de ulike kjønnsrollene viser å gjenspeile seg både i hjemmet og på arbeidsplassen. Informantene forklarer at det var forskjell på kvinnelige og mannlige yrker, og at de maskuline egenskapene egner seg best i en lederstilling. Stereotypiene tilknyttet det enkelte kjønn står sterkt hos informantene, noe som vitner om inkongruens i holdningene tilknyttet kjønnsdeling og likestilling

Effectiveness of the International Child Development Programme: Results from a randomized controlled trial

This study aimed to evaluate the effectiveness of the International Child Development Programme (ICDP), a group-based parenting programme used internationally and implemented nationally in Norway. We used a cluster randomized controlled trial in which 81 groups were randomly assigned to either the intervention or waitlist control condition after the baseline data collection. A total of 590 parents completed at least one of three questionnaires (administrated before and after ICDP and 4 months after completing the intervention). Primary outcomes included parental self-efficacy, parental emotion sensitivity and positive involvement with their child. Secondary outcomes included parents' perceptions of their relationship with the child, child-rearing conflicts and the child's psychosocial health. We found significant effects favouring the intervention arm following the intervention and at follow-up on two primary outcomes (parental self-efficacy and emotion sensitivity). For the secondary outcomes, we found a significant reduction in child-rearing conflict at the 4-month follow-up, increased closeness to the child, reduced child internalizing difficulties and increased prosocial behaviour immediately following the intervention. However, ICDP seems to have limited effects on parent-reported changes in children. We conclude that ICDP as a universal preventive programme offered to parents in groups can be effective in strengthening parental self-efficacy and improving parental emotion sensitivity.publishedVersio

Past, present and future challenges in health care priority setting:findings from an international expert survey

Purpose Current conditions have intensified the need for health systems to engage in the difficult task of priority setting. As the search for a “magic bullet” is replaced by an appreciation for the interplay between evidence, interests, culture, and outcomes, progress in relation to these dimensions requires assessment of achievements to date and identification of areas where knowledge and practice require attention most urgently. The paper aims to discuss these issues. Design/methodology/approach An international survey was administered to experts in the area of priority setting. The survey consisted of open-ended questions focusing on notable achievements, policy and practice challenges, and areas for future research in the discipline of priority setting. It was administered online between February and March of 2015. Findings “Decision-making frameworks” and “Engagement” were the two most frequently mentioned notable achievements. “Priority setting in practice” and “Awareness and education” were the two most frequently mentioned policy and practical challenges. “Priority setting in practice” and “Engagement” were the two most frequently mentioned areas in need of future research. Research limitations/implications Sampling bias toward more developed countries. Future study could use findings to create a more concise version to distribute more broadly. Practical implications Globally, these findings could be used as a platform for discussion and decision making related to policy, practice, and research in this area. Originality/value Whilst this study reaffirmed the continued importance of many longstanding themes in the priority setting literature, it is possible to also discern clear shifts in emphasis as the discipline progresses in response to new challenges. </jats:sec

Investigating the impact of extraneous distractions on consultations in general practice: Lessons learned

<p>Abstract</p> <p>Background</p> <p>Extraneous distractions may influence the flow of general practice consultations. This study piloted a methodology to examine the impact of interrupting general practitioners (GPs) while consulting actor-patients.</p> <p>Methods</p> <p>Six GPs were video recorded consulting six actor-patients each presenting a different clinical scenario in a simulated surgery. Five cases presented red flag cancer symptoms. Half the consultations were interrupted. Two independent assessors, blinded to the occurrence of interruptions, assessed consultation performance using the Leicester Assessment Package (LAP) for clinical competence.</p> <p>Results</p> <p>24 of 36 consultations were video recorded with sufficient audio-visual clarity to allow scoring. The association between LAP score and three variables could be studied: a variety of interruptions, different GPs and various scenarios. Agreement between assessors on GP performance was poor and showed an increased bias with increasing LAP score. Despite this, the interruption did not significantly impact on assessor LAP scores (Mean difference: 0.22, P = 0.83) even after controlling for assessor, different GPs and scenarios.</p> <p>Conclusion</p> <p>Extraneous distractions had no impact on GP performance in this underpowered pilot study, a conclusion which needs to be confirmed in a larger study. However several important lessons were learned. Recorded actor-patient clinical sessions are logistically challenging. GPs whose skills were not previously assessed were working in unfamiliar surroundings dealing with relatively straight forward diagnostic challenges and may have anticipated the interruptions. In a redesign of this experiment it may be possible to eliminate some of these limitations.</p