Theorizing healthy settings: a critical discussion with reference to Healthy Universities

The settings approach appreciates that health determinants operate in settings of everyday life. Whilst subject to conceptual development, we argue that the approach lacks a clear and coherent theoretical framework to steer policy, practice and research. Aims: To identify what theories and conceptual models have been used in relation to the implementation and evaluation of Healthy Universities. Methods: A scoping literature review was undertaken between 2010-2013, identifying 26 papers that met inclusion criteria. Findings: Seven theoretical perspectives or conceptual frameworks were identified: the Ottawa Charter; a socio-ecological approach (which implicitly drew on sociological theories concerning structure and agency); salutogenesis; systems thinking; whole system change; organisational development; and a framework proposed by Dooris. These were used to address interrelated questions on the nature of a setting, how health is created in a setting, why the settings approach is a useful means of promoting health, and how health promotion can be introduced into and embedded within a setting. Conclusion: Although distinctive, the example of Healthy Universities drew on common theoretical perspectives that have infused the settings discourse more generally. This engagement with theory was at times well-developed and at other times a passing reference. The paper concludes by pointing to other theories that offer value to healthy settings practice and research and by arguing that theorisation has a key role to play in understanding the complexity of settings and guiding the planning, implementation and evaluation of programmes

Pythios and Pythion: The spread of a cult title

The epithet Pythios/Pythion, unequivocally denoting the cult of Apollo of Delphi, came to have a very widespread distribution throughout the Greek world, comparable only to that of Zeus Olympios. Pre-Hellenistic attestations are summarily reported, showing concentrations (e.g., Attika, Argolis, Thessaly, Aegean islands, Krete), significant vacua (e.g., Boiotia, north-western Greece), and overlaps with the epithets Delphinios and Pythaieus. Likely periods and mechanisms of its spread are sketched, as are possible explanations (colonization, oracles, purification), though without overt preference for any one model of network-formation. © 2007, Taylor & Francis Group, LLC

Network orchestration in a large inter-organizational project

Multiple organizations working jointly on shared activities in inter-organizational projects for a defined period of time are used increasingly to coordinate the supply of complex products, subsystems, and services across many industries. Despite the growth in inter-organizational networks as an organizational form, scholars have only recently begun to identify how lead organizations orchestrate the coordination of multiple parties with disparate goals, responsibilities, and capabilities. Prior work offers limited insights into the choice of network governance forms, and how coordination is undertaken by the network orchestrator to govern these networks. We conducted a longitudinal study of four networks to deliver vital services into a large project. We identified how the choice of network governance form was based on task complexity. A shared governance form was chosen for networks developed to deliver routine services, whereas a lead organization governance form was chosen for networks set up to deliver complex services. However, findings showed that the selection of an appropriate governance form was not sufficient for ensuring high performance. The network orchestrator's mode of coordination (formal or informal), the intensity of coordination (active or passive), and fit with the form of governance form (shared or lead organization governed) was important in driving performance

Reconciling and reconceptualising servitization research: drawing on modularity, platforms, ecosystems, risk and governance to develop mid-range theory

PURPOSE: This research bridges disparate research on servitization, namely product–service systems (PSS) and integrated solutions (IS), to provide valuable insights for the progression of the field. It acts as a reconciliation of these research streams and offers a reconceptualised agenda incorporating recent research on platforms, ecosystems, modularity, risk and governance as key conceptual themes to synthesise and build theory. DESIGN/METHODOLOGY/APPROACH: This is a conceptual, theory development article focused on advancing thinking on servitization by identifying systematic and theoretically informed research themes. It also proposes future research opportunities to advance theoretical contributions and practical implications for servitization research. FINDINGS: By reviewing and synthesising extant PSS and IS research, this article identified five core themes – namely modularity, platforms, ecosystems, risks and governance. The importance of these five themes and their linkages to PSS and IS are examined and a theoretical framework with a future research agenda to advance servitization is proposed. ORIGINALITY/VALUE: This paper considers the similarities and differences between PSS and IS in order to develop a theory and to reconcile formerly disparate research efforts by establishing linkages between core themes and identifying valuable synergies for scholars. The importance of the core themes and current gaps within and across these themes are shown, and a mid-range theory for servitization is positioned to bridge the servitization-related PSS and IS communities

AURKA mRNA expression is an independent predictor of poor prognosis in patients with non-small cell lung cancer

Deregulation of mitotic spindle genes has been reported to contribute to the development and progression of malignant tumours. The aim of the present study was to explore the association between the expression profiles of Aurora kinases (AURKA, AURKB and AURKC), cytoskeleton-associated protein 5 (CKAP5), discs large-associated protein 5 (DLGAP5), kinesin-like protein 11 (KIF11), microtubule nucleation factor (TPX2), monopolar spindle 1 kinase (TTK), and β-tubulins (TUBB) and (TUBB3) genes and clinicopathological characteristics in human non-small cell lung carcinoma (NSCLC). Reverse transcription-quantitative polymerase chain reaction-based RNA gene expression profiles of 132 NSCLC and 44 adjacent wild-type tissues were generated, and Cox's proportional hazard regression was used to examine associations. With the exception of AURKC, all genes exhibited increased expression in NSCLC tissues. Of the 10 genes examined, only AURKA was significantly associated with prognosis in NSCLC. Multivariate Cox's regression analysis demonstrated that AURKA mRNA expression [hazard ratio (HR), 1.81; 95% confidence interval (CI), 1.16-2.84; P=0.009], age (HR, 1.03; 95% CI, 1.00-1.06; P=0.020), pathological tumour stage 2 (HR, 2.43; 95% CI, 1.16-5.10; P=0.019) and involvement of distal nodes (pathological node stage 2) (HR, 3.14; 95% CI, 1.24-7.99; P=0.016) were independent predictors of poor prognosis in patients with NSCLC. Poor prognosis of patients with increased AURKA expression suggests that those patients may benefit from surrogate therapy with AURKA inhibitors

Biodiversity in agricultural landscapes: The effect of apple cultivar on epiphyte diversity

© 2016 The Authors. Ecology and Evolution published by John Wiley & Sons Ltd.In natural systems, extended phenotypes of trees can be important in determining the species composition and diversity of associated communities. Orchards are productive systems where trees dominate, and can be highly biodiverse, but few studies have considered the importance of tree genetic background in promoting associated biodiversity. We tested the effect of apple cultivar (plant genetic background) on the diversity and composition of the associated epiphytic bryophyte community across a total of seven cultivars in five productive East Anglian orchards where each orchard contained two cultivars. Data were collected from 617 individual trees, over 5 years. Species richness and community composition were significantly influenced by both orchard and cultivar. Differences among orchards explained 16% of the variation in bryophyte community data, while cultivar explained 4%. For 13 of the 41 bryophyte species recorded, apple cultivar was an important factor in explaining their distribution. While the effects of cultivar were small, we were able to detect them at multiple levels of analysis. We provide evidence that extended phenotypes act in productive as well as natural systems. With issues of food security ranking high on the international agenda, it is important to understand the impact of production regimes on associated biodiversity. Our results can inform mitigation of this potential conflict

Feedback from supermassive black holes transforms centrals into passive galaxies by ejecting circumgalactic gas

Davies et al. (2019) established that for L^* galaxies the fraction of baryons in the circumgalactic medium (CGM) is inversely correlated with the mass of their central supermassive black holes (BHs) in the EAGLE hydrodynamic simulation. The interpretation is that, over time, a more massive BH has provided more energy to transport baryons beyond the virial radius, which additionally reduces gas accretion and star formation. We continue this research by focusing on the relationship between the 1) BH masses, 2) physical and observational properties of the CGM, and 3) galaxy colours for Milky Way-mass systems. The ratio of the cumulative BH feedback energy over the gaseous halo binding energy is a strong predictor of the CGM gas content, with BHs injecting >~10x the binding energy resulting in gas-poor haloes. Observable tracers of the CGM, including CIV, OVI, and HI absorption line measurements, are found to be effective tracers of the total z~0 CGM halo mass. We use high-cadence simulation outputs to demonstrate that BH feedback pushes baryons beyond the virial radius within 100 Myr timescales, but that CGM metal tracers take longer (0.5-2.5 Gyr) to respond. Secular evolution of galaxies results in blue, star-forming or red, passive populations depending on the cumulative feedback from BHs. The reddest quartile of galaxies with M_*=10^{10.2-10.7} M_solar (median u-r = 2.28) has a CGM mass that is 2.5x lower than the bluest quartile (u-r=1.59). We propose strategies for observing the predicted lower CGM column densities and covering fractions around galaxies hosting more massive BHs using the Cosmic Origins Spectrograph on Hubble

Non-invasive assessment of peripheral arterial disease: Automated ankle brachial index measurement and pulse volume analysis compared to duplex scan

Objectives: This cross-sectional study aimed to individually and cumulatively compare sensitivity and specificity of the (1) ankle brachial index and (2) pulse volume waveform analysis recorded by the same automated device, with the presence or absence of peripheral arterial disease being verified by ultrasound duplex scan. Methods: Patients (n=205) referred for lower limb arterial assessment underwent ankle brachial index measurement and pulse volume waveform recording using volume plethysmography, followed by ultrasound duplex scan. The presence of peripheral arterial disease was recorded if ankle brachial index 50% was evident with ultrasound duplex scan. Outcome measure was agreement between the measured ankle brachial index and interpretation of pulse volume waveform for peripheral arterial disease diagnosis, using ultrasound duplex scan as the reference standard. Results: Sensitivity of ankle brachial index was 79%, specificity 91% and overall accuracy 88%. Pulse volume waveform sensitivity was 97%, specificity 81% and overall accuracy 85%. The combined sensitivity of ankle brachial index and pulse volume waveform was 100%, specificity 76% and overall accuracy 85%. Conclusion: Combining these two diagnostic modalities within one device provided a highly accurate method of ruling out peripheral arterial disease, which could be utilised in primary care to safely reduce unnecessary secondary care referrals

A Digital Health Solution for Child Growth Monitoring at Home: Testing the Accuracy of a Novel “GrowthMonitor” Smartphone Application to Detect Abnormal Height and Body Mass Indices

Objective: To develop and evaluate a smartphone application that accurately measures height and provides notifications when abnormalities are detected. Patients and Methods: A total of 145 (75 boys) participants with a mean age ± SD of 8.7±4.5 years (range, 1.0-17.0 years), from the Children’s Hospital at Barts Health Trust, London, United Kingdom, were enrolled in the study. “GrowthMonitor” (UCL Creatives) iPhone application (GMA) measures height using augmented reality. Using population-based (UK-WHO) references, algorithms calculated height SD score (HSDS), distance from target height (THSDSDEV), and HSDS change over time (ΔHSDS). Pre-established thresholds discriminated normal/abnormal growth. The GMA and a stadiometer (Harpenden; gold standard) measured standing heights of children at routine clinic visits. A subset of parents used GMA to measure their child’s height at home. Outcome targets were 95% of GMA measurements within ±0.5 SDS of the stadiometer and the correct identification of abnormal HSDS, THSDSDEV, and ΔHSDS. Results: Bland-Altman plots revealed no appreciable bias in differences between paired study team GMA and stadiometer height measurements, with a mean of the differences of 0.11 cm with 95% limits of agreement of −2.21 to 2.42 cm. There was no evidence of greater bias occurring for either shorter/younger children or taller/older children. The 2 methods of measurements were highly correlated (R=0.999). GrowthMonitor iPhone application measurements performed by parents in clinic and at home were slightly less accurate. The κ coefficient indicated reliable and consistent agreement of flag alerts for HSDS (κ=0.74) and THSDSDEV (κ=0.88) between 83 paired GMA and stadiometer measurements. GrowthMonitor iPhone application yielded a detection rate of 96% and 97% for HSDS-based and THSDSDEV-based red flags, respectively. Forty-two (18 boys) participants had GMA calculated ΔHSDS using an additional height measurement 6-16 months later, and no abnormal flag alerts were triggered for ΔHSDS values. Conclusion: GrowthMonitor iPhone application provides the potential for parents/carers and health care professionals to capture serial height measurements at home and without specialized equipment. Reliable interpretation and flagging of abnormal measurements indicate the potential of this technology to transform childhood growth monitoring

The pre-main sequence binary HK Ori : Spectro-astrometry and EXPORT data

In this paper we present multi-epoch observations of the pre-main sequence binary HK Ori. These data have been drawn from the EXPORT database and are complemented by high quality spectro-astrometric data of the system. The spectroscopic data appear to be very well represented by a combination of an A dwarf star spectrum superposed on a (sub-)giant G-type spectrum. The radial velocity of the system is consistent with previous determinations, and does not reveal binary motion, as expected for a wide binary. The spectral, photometric and polarimetric properties and variability of the system indicate that the active object in the system is a T Tauri star with UX Ori characteristics. The spectro-astrometry of HK Ori is sensitive down to milli-arcsecond scales and confirms the speckle interferometric results from Leinert et al. The spectro-astrometry allows with fair certainty the identification of the active star within the binary, which we suggest to be a G-type T Tauri star based on its spectral characteristics.Comment: MNRAS in press 8 pages 7 figure