350 research outputs found

    The Meaningful Involvement of Service Users in Social Work Education: Examples from Belgium and The Netherlands

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    Β© 2016 Informa UK Limited, trading as Taylor & Francis Group.This article links the development of service user involvement championed in the United Kingdom to two examples in Dutch-speaking qualifying social work programmes: one from Belgium and one from the Netherlands. In both projects, a longer lasting cooperation with more marginalised service users was established. The Belgium project highlights social work lecturers and service users living in poverty, working in tandem to deliver a module to social work and socio-educational care work students. The example from the Netherlands involves young people from a homeless shelter as peer-researchers, working together with social work students. Both projects, one focusing on social work education and on social work research, highlight striking similarities in the positives and challenges of working with service users including how this challenges both groups preconceptions of the other, deepens learning but also creates greater potential for confrontations which need to be managed creatively. The article also identifies the pre-requisites for this to be effective including appropriate resourcing, training, facilitative skills and acknowledges that collaborations can be extremely fragile. However, such projects need further investment, experimentation and implementation on an international scale to share learning and promote creative approaches for the development and learning of social work students

    First validation study of the living with long term conditions scale (LwLTCs) among English-speaking population living with Parkinson's disease

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    INTRODUCTION: Parkinson's disease is the second most prevalent neurodegenerative disease, affecting 10Β million people worldwide. Health and social care professionals need to have personalised tools to evaluate the process of living with Parkinson's disease and consequently, plan individualised and targeted interventions. Recently, the English version of the Living with Long term conditions (LwLTCs) scale has been developed filling an important gap related to person-centred tools to evaluate the process of living with long term conditions among English-speaking population. However, no validation studies for testing its psychometric properties have been conducted. AIM: To analyse the psychometric properties of the LwLTCs scale in a wide English-speaking population living with Parkinson's disease. METHODS: Validation study, with an observational and cross-sectional design. The sample was composed of individuals living with Parkinson's disease from non-NHS services in the community. Psychometric properties including feasibility and acceptability, internal consistency, reproducibility, and construct, internal and known-groups validity were tested. RESULTS: A total sample of 241 people living with Parkinson's disease were included. 6 individuals did not complete 1 or 2 items on the scale. Ordinal alpha was 0.89 for the total scale. The intraclass correlation coefficient for the total scale was 0.88. The LwLTCs scale is strongly correlated with scales measuring satisfaction with life (rs=0.67), quality of life (rs=0.54), and moderately correlated with social support (rs=0.45). Statistically significant difference just for therapy and co-morbidity, yet no for gender, employment situation, or lifestyle changes. CONCLUSIONS: The LwLTCs scale is a valid scale to evaluate how the person is living with Parkinson's disease. Future validation studies to prove the repeatability of the total scale and particularly, domains 3-Self-management, and 4-Integration and internal consistency will be needed. Developing further studies on the English version of the LwLTC in people with other long term conditions is also proposed

    Maternal and neonatal bleeding complications in relation to peripartum management in hemophilia carriers:A systematic review

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    Currently, there is no consensus on the optimal management to prevent postpartum hemorrhage (PPH) in hemophilia carriers. We aimed to evaluate peripartum management strategies in relation to maternal and neonatal bleeding outcomes by performing an extensive database search up to August 2020. Seventeen case-reports/series and 11 cohort studies were identified of overall 'poor' quality describing 502 deliveries. The PPH incidence in the individual patient data was 63%; 44% for those women receiving prophylaxis to correct coagulation and 77% for those without (OR 0.23, CI 0.09-0.58) and in cohort data 20.3% (26.8% (11/41) vs. 19.4% (55/284) (OR: 1.53, 95% CI: 0.72-3.24), respectively. Peripartum management strategies mostly consisted of clotting factor concentrates, rarely of desmopressin or plasma. Tranexamic acid appears promising in preventing secondary PPH, but was not used consistently. Neonatal bleeding was described in 6 affected male neonates, mostly after instrumental delivery or emergency CS, but insufficient information was provided to reliably investigate neonatal outcome in relation to management. The high PPH risk seems apparent, at most mildly attenuated by prophylactic treatment. Prospective cohort studies are needed to determine the optimal perinatal management in hemophilia.Thrombosis and Hemostasi

    Robustness of optimal channel reservation using handover prediction in multiservice wireless networks

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    The aim of our study is to obtain theoretical limits for the gain that can be expected when using handover prediction and to determine the sensitivity of the system performance against different parameters. We apply an average-reward reinforcement learning approach based on afterstates to the design of optimal admission control policies in mobile multimedia cellular networks where predictive information related to the occurrence of future handovers is available. We consider a type of predictor that labels active mobile terminals in the cell neighborhood a fixed amount of time before handovers are predicted to occur, which we call the anticipation time. The admission controller exploits this information to reserve resources efficiently. We show that there exists an optimum value for the anticipation time at which the highest performance gain is obtained. 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    Plexin-B2 Negatively Regulates Macrophage Motility, Rac, and Cdc42 Activation

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    Plexins are cell surface receptors widely studied in the nervous system, where they mediate migration and morphogenesis though the Rho family of small GTPases. More recently, plexins have been implicated in immune processes including cell-cell interaction, immune activation, migration, and cytokine production. Plexin-B2 facilitates ligand induced cell guidance and migration in the nervous system, and induces cytoskeletal changes in overexpression assays through RhoGTPase. The function of Plexin-B2 in the immune system is unknown. This report shows that Plexin-B2 is highly expressed on cells of the innate immune system in the mouse, including macrophages, conventional dendritic cells, and plasmacytoid dendritic cells. However, Plexin-B2 does not appear to regulate the production of proinflammatory cytokines, phagocytosis of a variety of targets, or directional migration towards chemoattractants or extracellular matrix in mouse macrophages. Instead, Plxnb2βˆ’/βˆ’ macrophages have greater cellular motility than wild type in the unstimulated state that is accompanied by more active, GTP-bound Rac and Cdc42. Additionally, Plxnb2βˆ’/βˆ’ macrophages demonstrate faster in vitro wound closure activity. Studies have shown that a closely related family member, Plexin-B1, binds to active Rac and sequesters it from downstream signaling. The interaction of Plexin-B2 with Rac has only been previously confirmed in yeast and bacterial overexpression assays. The data presented here show that Plexin-B2 functions in mouse macrophages as a negative regulator of the GTPases Rac and Cdc42 and as a negative regulator of basal cell motility and wound healing

    Population pharmacokinetics of factor IX in hemophilia B patients undergoing surgery

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    Essentials Factor IX (FIX) dosing using body weight frequently results in under and overdosing during surgery. We aimed to establish a population pharmacokinetic (PK) model describing the perioperative FIX levels. Population PK parameter values for clearance and V1 were 284 mL hβˆ’170 kgβˆ’1 and 5450 mL70 kgβˆ’1. Perioperative PK parameters differ from those during non-surgical prophylactic treatment. Summary: Background Hemophilia B is a bleeding disorder characterized by a deficiency of coagulation factor IX (FIX). In the perioperative setting, patients receive FIX concentrates to ensure hemostasis. Although FIX is usually dosed according to bodyweight, under- and overdosing occurs frequently during surgery. Aim The objective was to quantify and explain the interpatient variability of perioperatively administered plasma-derived (pd) and recombinant (r) FIX concentrates. Methods Data were collected from 118 patients (median age, 40 years [range, 0.2–90]; weight, 79 kg [range, 5.3–132]) with moderate (28%) or severe hemophilia B (72%), undergoing 255 surgical procedures. Population pharmacokinetic (PK) parameters were estimated using nonlinear mixed-effect modeling in NONMEM. Results Measured perioperative FIX level vs. time profiles were adequately described using a three-compartment PK model. For a typical 34-year-old patient receiving rFIX, clearance (CL), intercompartmental clearance (Q2, Q3), distribution volume of the central compartment (V1) and peripheral compartments (V2, V3) plus interpatient variability (%CV) were: CL, 284 mL hβˆ’170 kgβˆ’1 (18%); V1, 5450 mL70 kgβˆ’1 (19%); Q2, 110 mL hβˆ’170 kgβˆ’1; V2, 4800 mL70 kgβˆ’1; Q3, 1610 mL hβˆ’170 kgβˆ’1; V3, 2040 mL70 kgβˆ’1. From 0.2 years, CL and V1 decreased 0.89% and 1.15% per year, respectively, until the age of 34 years. Patients receiving pdFIX exhibited a lower CL (11%) and V1 (17%) than patients receiving rFIX. Interpatient variability was successfully quantified and explained. Conclusions The estimated perioperative PK parameters of both pdFIX and rFIX are different from those reported for prophylactic treatment. The developed model may be used to apply PK-guided dosing of FIX concentrates during surgery
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