Group singing for couples where one partner has a diagnosis of dementia

There is an emerging interest in the literature base around the use of group singing in dementia care. Although studies indicate positive outcomes, limited research has been carried out from a relational perspective. Additionally, theoretical underpinnings of the reported benefits have yet to be explored. This study aims to investigate the key theoretical mechanisms underlying the experience of group singing. Interview data from seventeen couples who sing together in a group is analysed using grounded theory method. Several key aspects of group singing are presented, namely that the positive experience of the act of singing combined with effective group facilitation enables equal participation and a powerful group effect. A further benefit of new learning and creativity is explored. Implications for clinical practice and possible directions for future research are outlined

“The major obstacle which women need to overcome is the public perception about their leadership abilities” – Kalpana Unadkat

According to a new report entitled Women on Boards, women make up only 4% of the directors of publicly listed Indian companies. But this is due to change as a result of legislation introduced last year. Sonali Campion talks to Kalpana Unadkat, solicitor and co-author of the report, about the implications of the new law and the challenges facing women who aspire to senior positions in Indian businesses

After the deadline, women remain underrepresented in India Inc. boardrooms. What happens next?

On 1 April 2015, the deadline passed for public companies in India to appoint at least one female director. Kalpana Unadkat analyses the slow progress so far, and outlines the penalties that have been introduced for non-compliance

Knowledge, attitudes, practices and barriers in use of evidence-based medicine among resident physicians in Aga Khan University Hospital, Nairobi.

Background: Evidence based medicine (EBM) helps clinicians to integrate latest research evidence into their daily clinical practice. There is a need for all healthcare professions to adopt it in order to provide scientific, safe, efficient and most cost-effective care. Postgraduate residents are at the frontline of healthcare delivery and all medical institutions should strive to produce practitioners of EBM. Studies have shown that physicians are still struggling to adapt to this paradigm shift in the practice of medicine, especially in Sub Saharan Africa (SSA). However, very few studies have been done in SSA and none in East Africa to explore the knowledge, attitudes, practices and barriers of evidence-based practice among resident physicians. Objectives: This study was conducted to determine the knowledge, attitudes, and practices towards EBM among resident physicians at Aga Khan University Hospital Nairobi (AKUHN) and barriers that impede application of EBM in practice. Methods: A convergent parallel mixed methods study was conducted. The quantitative tool was developed and initially piloted on recently graduated residents from AKUHN. From this, a final questionnaire was developed and sent to all current AKUHN residents via an online survey application. In addition, purposive sampling was used to identify 18 participants for the qualitative study. In-depth interviews (IDIs) were conducted to gain an understanding of the knowledge, attitude and practice of residents towards EBM and their perceived barriers. Quantitative data were analyzed using descriptive statistics for continuous variables and linear regression analysis for testing associations between variables. Qualitative data were analyzed using thematic framework analysis. Results: A total of 101 residents participated in the quantitative study. The mean scores for knowledge, attitude and practice of EBM among residents were 73.88, 66.96 and 63.19 respectively, which were generally higher than in comparable studies. There was no significant association between knowledge/attitude of EBM and sex, age, department and year of residency but there was a significant association between department (p-value = 0.00) and year of residency (p-value= 0.01) with practice of EBM. The most common barriers faced by residents were lack of time (mean score of 3.35), lack of EBM skills (mean score of 2.97) and patients’ unawareness about EBM (mean score 2.83). Several key themes were identified from the qualitative findings and were merged with the quantitative findings where appropriate. From the IDIs, residents again demonstrated good knowledge and support of EBM but practice was low (only 20-30% of clinical practice is evidence based on a daily basis). Main themes that characterized the barriers to practicing EBM were: lack of motivation, lack of time, lack of skills, patient overload, lack of resources, intimidation from patients and fear of challenging the consultants. Conclusion: Residents are at the frontline of health care delivery and although there is a good understanding and support of EBM among residents at AKUHN both from the quantitative and qualitative studies, the practice of EBM among residents which rated quite high in the quantitative study was reported to be low in the qualitative study. Major barriers identified were lack of time and lack of skills to practice EBM. Residents reported high practice of EBM in the survey but this was not supported by qualitative findings. Therefore, enhancing the use of EBM concepts in a timely and accurate manner is highly recommended at both institutional and national level

Materiomics: deciphering topographic cues for cell-surface interactions

The technological advances in the field of material science coupled with the improved understanding of cell behaviour have brought us to the era of smart or instructive biomaterials. In contrast to the bioinert materials this new generation of materials rely on the technological advances from the evolving field of Nanotechnology. It has long been known that the surface topography of a biomedical implant is able to dictate the response of tissue surrounding it. The increasing trend of using stem cells in combination with biomaterials requires materials with predictable instructive properties. Surface topography of an implant can provide such instructions to stem cells in a reliable manner. However, the endless possibilities for the creation of surface topographies make it difficult to choose the best one for a given implant.\ud \ud The field of Materiomics, which deals with high throughput screening of natural and synthetic materials and their properties, provides us with tools to better understand cell behaviour on a library of surface topographies. This thesis describes the TopoChip platform, a high‐throughput screening system for studying the interaction of cells with surface topographies

Growth by stretch: an interdisciplinary approach

Tissue expansion is a technique used by plastic and restorative surgeons to cause the body to grow additional skin, bone or other tissues. Distraction osteogenesis (DO) is an example of tissue expansion which has been widely applied in lower limb surgery (trauma/congenital), and congenital upper limb reconstruction (e.g. radial dysplasia). This complex and tightly regulated expansion process has resulted in adverse effects such as severe soft-tissue contractures and loss of nerve function as well as microtrauma and micro-haematoma formation (Natu et al., 2014). Thus far, the procedure can only be optimised by long-term animal or human experimentation. This thesis explains the development of an in vitro model that will allow extension regimes (µm/h, continuous/ intermittent) and molecular pathways involved in soft tissue damage related to DO to be explored. Cells cultured onto polycaprolactone (PCL) polymer films can be stretched at very low, adjustable speeds, using a stepper motor and various 3D printed and laser cut designs. The idea here is that plastic flow of PCL can be utilised to enable the material to stay extended upon strain being released, to represent permanent stretching of soft tissue. PCL film for the purposes of this project was made using a solvent in conjunction with a spin-coating process; A semi-crystalline and amorphous derivative of the polymer was made (C-PCL and A-PCL respectively). Testing the two polymer sheets indicated that C-PCL is a more rigid material and that strain occurs in more localised regions when it is stretched in comparison to A-PCL. The profile of the stress-strain curve for both C-PCL and A-PCL closely resemble that of a typical soft tissue after it has passed its yield point (33% strain). Due to the known involvement of fibroblasts in mechanical loading of tissue (B. Hinz, 2004), they were used as an initial cell line to develop an in vitro model for growth by stretch. Both A-PCL and C-PCL were used as substrates and were stretched passed their yield point (33% strain) before cells were cultured on. Following fibroblast proliferation to confluency substrates were further stretched by 1mm (2.5% strain) over 24 hours (stepped stretching at 0.04mm per hour). Orientation analysis indicated that cells grown on C-PCL initially elongate and orient to the direction of pre-stretch (when substrates are initially stretched passed their yield point), then contract upon being further stretched by 1mm over 24 hours. Cells cultured on A-PCL, under the same stretching regime initially align to the direction of pre-stretch; after being further stretched by 1mm the majority of cells remain aligned, but also elongate in the direction of stretch. Initial alignment on both materials was deemed a result of tension in the material and/or or topographical features which formed during stretching of substrates before cells were cultured on. The alignment was more pronounced on the C-PCL substrate and cell nuclei were analysed to be more elongated indicating the topography caused the fibroblasts to reside in a stressed state. This aligned cell effect was lost on C-PCL during further 1mm stretching due to; stress relaxation after each step of stretching; and/or localised strain regions causing cells to round during the stepped 1mm stretch. A-PCL was further investigated as a substrate to model soft tissue expansion in relation to DO where MRTF-A nuclear translocation was shown to increase in response to stretch (by 3-fold). F-actin texture analysis further implied cytoskeletal involvement in the stretching regime utilised for this project. Based on the results obtained, it was concluded that A-PCL with the stretching regime detailed (where plastic flow is utilised), provides the basis for a representative in vitro model of stretching soft tissue in relation to DO. Future work outlined to build on this model would be to: further investigate the relation between strain and cell response at the cell level for both materials using live imaging (in conjunction with fiducial markers in the substrate) and atomic force microscopy methods; and to develop understanding of extracellular matrix (ECM) interactions with cells in response to the stretching in the plastic flow region by again using live imaging methods (fluorescently tagging ECM components)

Investigation of turbulence modulation in solid-liquid suspensions using FPIV and micromixing experiments

The focus of this thesis is the study of turbulent solid-liquid stirred suspensions, which are involved in many common unit operations in the chemical, pharmaceutical and food industries. The studies of two-phase flows present a big challenge to researchers due to the complexity of experiments; hence there is a lack of quantitative solid and liquid hydrodynamic measurements. Therefore, an investigation of turbulence modulation by dispersed particles on the surrounding fluid in stirred vessels has been carried out, via two-phase fluorescent Particle Image Velocimetry (FPIV) and micromixing experiments. The main property of interest has been the local dissipation rate, as well as root-mean-square (rms) velocities and turbulent kinetic energy (TKE) of the fluid. Initially a single-phase PIV study was conducted to investigate the flow field generated by a sawtooth (EkatoMizer) impeller. The purpose of this study was to gain insight into various PIV techniques before moving on to more complex two-phase flows. Subsequently stereo-, highspeed and angle-resolved measurements were obtained. The EkatoMizer formed a good case study as information regarding its hydrodynamics is not readily available in literature, hence knowledge has been extended in this area. An analysis of the mean flow field elucidated the general structure of fluid drawn into the impeller region axially and discharged radially; the latter characterised the impeller stream. The radial rms velocity was considered to represent best the system turbulence, even though the tangential rms velocity was greater close to the blade; however the radial component was more prevalent in the discharge stream. Due to differences in rms velocities, TKE estimates obtained from two and three velocity components deviated, being greater in the latter case. Integral (1-D and 2-D) length scales were overestimated by the quantity W / 2 in the impeller region. Ratios of longitudinal-to-lateral length scales also indicated flow anisotropy (as they deviated from 2:1). The anisotropy tensor showed that the flow was anisotropic close to the blade, and returned to isotropy further away from the impeller. Instantaneous vector plots revealed vortices in the discharge stream, but these were not associated with flow periodicity. Alternatively, the vortex structures were interpreted as low frequency phenomena between 0-200 Hz; macro-instabilities were found to have a high probability of occurrence in the discharge stream. Dissipation is the turbulent property of most interest as it directly influences micromixing processes, and its calculation is also the most difficult to achieve. Its direct determination from definition requires highly resolved data. Alternative methods have been proposed in the literature, namely dimensional analysis, large eddy simulation (LES) analogy and deduction from the TKE balance. All methods were employed using 2-D and 3-D approximations from stereo-PIV data. The LES analogy was deemed to provide the best estimate, since it accounts for three-dimensionality of the flow and models turbulence at the smallest scales using a subgrid scale model. (Continues...)

Editorial: Conversation is essential in publishing

In this editorial, the journal's Correspondence Section Editors discuss the importance of the section to the scientific process

Unexpected predicted length variation for the coding sequence of the sleep related gene, \u3ci\u3eBHLHE41\u3c/i\u3e in gorilla amidst strong purifying selection across mammals

There is a molecular basis for many sleep patterns and disorders involving circadian clock genes. In humans, “short-sleeper” behavior has been linked to specific amino acid substitutions in BHLHE41 (DEC2), yet little is known about variation at these sites and across this gene in mammals. We compare BHLHE41 coding sequences for 27 mammals. Approximately half of the coding sequence was invariable at the nucleotide level and close to three-quarters of the amino acid alignment was identical. No other mammals had the same “short-sleeper” amino acid substitutions previously described from humans. Phylogenetic analyses based on the nucleotides of the coding sequence alignment are consistent with established mammalian relationships confirming orthology among the sampled sequences. Significant purifying selection was detected in about two-thirds of the variable codons and no codons exhibited significant signs of positive selection. Unexpectedly, the gorilla BHLHE41 sequence has a 318 bp insertion at the 5’ end of the coding sequence and a deletion of 195 bp near the 3’ end of the coding sequence (including the two short sleeper variable sites). Given the strong signal of purifying selection across this gene, phylogenetic congruence with expected relationships and generally conserved function among mammals investigated thus far, we suggest the indels predicted in the gorilla BHLHE41 may represent an annotation error and warrant experimental validation

Simulation of Beam Dynamics for MEMS Devices

Microelectromechanical Systems (MEMS) are systems made up of small components to complete a bigger goal. Some of these components can be modeled as small beams, which are anchored at both sides, or as cantilever beams. These beams can be subjected to various forces such as Knudsen Forces, Electrostatic Forces as well as G-loading. These devices have many applications such as sensors, actuators and even as accelerometers for airbags, smart phones and game controllers. Modeling the dynamics of these beams is an important task for the MEMS community, consisting of researchers, fabricators, and designers working on one of the many applications of MEMS, and they will benefit from having a tool that can model this. These beam dynamics were simulated on naohub.org by using the RAPPTURE tool, created by Michael Mclennan et. al. to help create graphical user interfaces with different codes to perform analyses, in order to design the graphical user interface for the modeling program. This tool uses a nondimensional, explicit solver to analyze the dynamics of the beams. The results of this are a tool that has been incorporated onto nanoHub.org that is able to simulate the dynamics of microbeams that are subjected to one of many forces. This tool is able to simulate the dynamics of cantilever microbeams with acceleration, electrostatic and Knudsen Forces acting on it, and some more work needs to be done in order to include the effects of these forces on microbeams that are anchored at both sides