The concept of function in osteopathy and conventional medicine : a comparative study

This study compares and contrasts the uses of 'function' in osteopathy and in a closely related area of conventional medicine, viz., orthopaedic surgery. Function is a fundamental concept in both; but a survey of the literature, and an initial analysis of the language used by practitioners in a sample of case studies, suggests that while orthopaedic surgeons focus on local failures of physiological function (Fphys), osteopaths are concerned with such failures in the global context of the whole body (Fglob). This is closely related to individual patients' expectations in relation to their overall ability to function (Fpt). The musculo-skeletal system, with which osteopaths are expert, is shown to be particularly significant for understanding Fphys, Fpt and Fglob. These uses of function are further analysed by drawing on the philosophical literature. This is shown to focus, like orthopaedic surgeons, mainly on biological function (Fbiol which includes Fphys). In consequence, it is argued, the philosophical literature has under-emphasised the significance of context in defining functional norms. Certain authors have recognised the importance of context for the functioning of people (i. e. as Fpt); in this thesis, by contrast, context is shown to be important in defining functional norms at all levels, including the physiological/biological. In respect of the relationship between osteopathy and conventional medicine, it is concluded that Fglob (as employed more by osteopaths) involves explaining the clinical significance of local dysfunction in the broad context of patients' activities, and Fphys (as employed more by orthopaedic surgeons) involves categorising local dysfunction in terms of referential standards. The concept of agency, although not examined in detail, emerges as the key to linking the role of context in the meaning of function statements to the intentions and self-perception of patients in clinical practice. Because of the special role of the musculo-skeletal system in enacting agency, osteopathy offers particular insights into the contextual nature of function statements

Australian community pharmacy services: a survey of what people with chronic conditions and their carers use versus what they consider important

Objective To explore the purpose/s for which people with chronic conditions and their carers use Australian community pharmacies, and compare this to what pharmacy services they consider important, from the perspectives of both consumers and pharmacists. Design An exploratory study involving a survey, which asked participants to indicate the pharmacy services they had ever used, and rate the importance of 22 pharmacy services to them, or the person they care for, or for their consumers if a pharmacist. Setting Four regions of Australia: Logan-Beaudesert and Mt Isa/North West region, Queensland, Northern Rivers, New South Wales, and the Greater Perth area, Western Australia. Participants Surveys were undertaken with 602 consumers and 91 community pharmacists. Results Community pharmacy is predominantly used to obtain advice about medication and whether a doctor's visit is necessary, as well as for monitoring and screening services. Pharmacy services that were patient centric were important, such as individualised medication advice and respectful care, as well as tools or procedures to facilitate streamlined medication access. Less important services included adult vaccinations and health and wellness programmes. Carers identified services that assisted them with their specific role/s to be important. Overall, community pharmacists had a good understanding of the services that were important to people with chronic conditions and their carers. Conclusions People with chronic conditions and their carers not only care about what services are delivered, but how they are delivered; they sought services that generally improved their access to medication and information, but in a way that was patient centred. Ultimately, pharmacists understood the importance of patient-centred care for people with chronic conditions and their carers, perhaps indicating a greater acceptance of integrating patient-centred care into their everyday practice

Evaluation of the Accuracy of a Computer-Vision Based Crowd Monitoring System

Computer vision systems can be used to measure pedestrian flow rates, occupancy levels and queue times. It is difficult to assess the accuracy of such methods because the ground truth can be difficult to establish. Human counting is equally prone to error, even when using video recordings with no time constraints and the support of sophisticated software. In this report, we consider how errors may arise directly from the images recorded by the cameras, due to both occlusion of people and image distortion due to a fisheye lens. We also develop a statistical model of human counting errors and attempt to estimate human accuracy from data. Finally, we attempt to relate human and computer accuracy on the basis of simplifying statistical approximations

Towards detection of structurally-diverse glycated epitopes in native proteins : single-chain antibody directed to non-A1c epitope in human haemoglobin

Over 500 million people worldwide are affected by diabetes mellitus, a chronic disease that leads to high blood glucose levels and causes severe side effects. The predominant biological marker for diagnosis of diabetes is glycated haemoglobin (GHb). In human blood the predominant reducing sugar, glucose, irreversibly conjugates onto accessible amine groups within Hb. Most methods for diagnosis and monitoring of diabetes selectively detect N-terminal glycation at Val-1 on the β-globin chain, but not glycation at other sites. Detection of other glycated epitopes of GHb has the potential to provide new information on the extent, duration and timing of elevated glucose, facilitating personalised diagnosis and intelligent diabetic control. In this work, a new anti-GHb Fab antibody (Fab-1) specific for haemoglobin A1c (HbA1c) with nanomolar affinity was discovered via epitope-directed immunisation and phage display. A single chain variable fragment (scFv) antibody derived from Fab-1 retained affinity and specificity for HbA1c, and affinity was enhanced tenfold upon addition of an enhanced green fluorescent protein tag. Both the scFv and Fab-1 recognised an epitope within HbA1c that was distinct from β-Val-1, and our data suggest that this epitope may include glycation at Lys-66 in the β-globin chain. To our knowledge, this is the first report of an scFv/Fab anti-glycated epitope antibody that recognises a non-A1c epitope in GHb, and confirms that fructosamine attached to different, discrete glycation sites within the same protein can be resolved from one another by immunoassay. [Abstract copyright: Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

Genomic and Genic Deletions of the FOX Gene Cluster on 16q24.1 and Inactivating Mutations of FOXF1 Cause Alveolar Capillary Dysplasia and Other Malformations

Alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV) is a rare, neonatally lethal developmental disorder of the lung with defining histologic abnormalities typically associated with multiple congenital anomalies (MCA). Using array CGH analysis, we have identified six overlapping microdeletions encompassing the FOX transcription factor gene cluster in chromosome 16q24.1q24.2 in patients with ACD/MPV and MCA. Subsequently, we have identified four different heterozygous mutations (frameshift, nonsense, and no-stop) in the candidate FOXF1 gene in unrelated patients with sporadic ACD/MPV and MCA. Custom-designed, high-resolution microarray analysis of additional ACD/MPV samples revealed one microdeletion harboring FOXF1 and two distinct microdeletions upstream of FOXF1, implicating a position effect. DNA sequence analysis revealed that in six of nine deletions, both breakpoints occurred in the portions of Alu elements showing eight to 43 base pairs of perfect microhomology, suggesting replication error Microhomology-Mediated Break-Induced Replication (MMBIR)/Fork Stalling and Template Switching (FoSTeS) as a mechanism of their formation. In contrast to the association of point mutations in FOXF1 with bowel malrotation, microdeletions of FOXF1 were associated with hypoplastic left heart syndrome and gastrointestinal atresias, probably due to haploinsufficiency for the neighboring FOXC2 and FOXL1 genes. These differences reveal the phenotypic consequences of gene alterations in cis

Social Value at Universities: Policy and Practice Guidance

Universities globally can be major hubs of social and economic activity which drive change in society. We know that they can create multiple and diverse routes into employment, can have significant purchasing power which can inform standards across supply chains, can create learning opportunities which directly nourish and enrich local communities, and can deliver research and innovation which impact health for the better. However, the measurable difference these make to lives – and how universities and the funding bodies account for this impact - is still unknown. We created the Global Symposia for Social Value at Universities in 2022, as a way to accelerate the movement. Over 130 joined from 12 countries to contribute to the analysis, from different disciplines such as health, arts, environmental sciences, alongside private, public and third sector stakeholders. There were two symposiums. The first was related to understanding policy and practice across disciplines at universities; the second was focused on one of the biggest sectors, business and management studies. This report presents the findings from both symposiums from the perspective of different stakeholders: 1. what is currently being done that is valued 2. recommendations for improvement The Global Symposia at Universities 2022 was co-hosted between Social Value UK and Liverpool John Moores University, the British Academy of Management (Sustainable and Responsible Business SIG), Principles for Responsible Management Education (Working Group on Poverty), University Vocational Awards Council, Social Value International, The Academy of Business in Society, American International Accreditation Association for Schools and Colleges, and the National Society for Experiential Education. Maddy England and Clare Bentley at Social Value UK were also central to delivering this guidance. Supported by Liverpool John Moores University’s Quality Research Funds