Stories for Change: The impact of Public Narrative on the co-production process

INTRODUCTION: Involving service users in health service design and delivery is considered important to improve the quality of healthcare because it ensures that the delivery of healthcare is adapted to the needs of the users. Co-production is a process used to involve service users, but multiple papers have highlighted the need for the mechanisms and values guiding co-production to be more clearly stated. The aim of this paper was to evaluate the mechanisms and values that guided the co-production approach of the Stories for Change project, which used Public Narrative as part of the co-design process to create change in National Health Service maternity services. METHODS: This study was conducted using a rapid feedback evaluation approach. Semistructured interviews (n = 16) were the main source of data, six of which were maternity service users, with observations (5 h) and documentary analysis also carried out in parallel. RREAL sheets were used for data analysis to organize data based on key topics of interest. RESULTS: This study identified three broad mechanisms and values underpinning the co-production approach: creating an open and safe space to share ideas, learning how to tell stories using Public Narrative and having service providers who play a key role in strengthening the health system listen to stories compelling them to action. This study identified the main areas for improvement of the Stories for Change project related to recruitment, the inclusion of participants, the co-design process, the Skills Session and the Learning Event. CONCLUSION: Our study provided a deeper understanding of the co-production approach that addresses the need to uncover the mechanism and values underlying co-production and co-design approaches. This study expands on the literature pertaining to the influence of storytelling in creating meaningful change in health care. We propose a co-design methodology that uses Public Narrative as a model for service user engagement to help inform future healthcare development processes. PATIENT OR PUBLIC CONTRIBUTION: The experiences and perceptions of maternity service users and health professionals informed this evaluation. The project organizers were involved in the manuscript preparation stage by providing feedback, and service users wrote a commentary on the project from the lived experience perspective

Comparison of gait biomechanics in patients with and without knee osteoarthritis during different phases of gait

Background: This study aimed to characterise knee adduction angles (KAA) and knee adduction moments (KAM) and compare this with foot centre of pressure (COP) in volunteers with and without knee osteoarthritis (OA). Methods: A total of 108 participants were recruited; 84 had no known pathology, 18 had medial knee OA, and six had lateral knee OA. Linear regression was used to determine correlations between the normalised COP, KAM, and KAA during each phase of gait for all participants. Results: The first phase of gait demonstrated significant differences between groups for all measures: KAA in all phases, COP in phases one and two, and KAM in phase one only. Conclusion: The largest mechanical changes are seen in the first phase of gait in osteoarthritic patients. Although COP is an easy to measure tool, it is not as sensitive as KAA and did not demonstrate a significant difference between healthy and medial OA patient

Orthodontic treatment using segmental T loop for correction of ectopically erupting canine: a case report

Most of the patients approach the orthodontist with their prime issue being their appearance. The patient expects the treatment to improve their overall appearance which in turn increases the acceptance by their peers. A 14 year old female report with a chief complain of irregularly placed teeth in upper and lower front region of jaw. After detailed diagnosis her treatment was planned wherein over retained 53 was extracted followed by correction of buccally erupting 13 and correction of crowding and improvement in airway was achieved. Titanium molybdenum (TMA) segmental T loop was used to retract 13. Post-treatment records revealed that treatment objectives were achieved and patient was satisfied with the treatment.

Socio-Economic Disparities in Access to Diagnostic Neuroimaging Services in the United Kingdom: A Systematic Review

This is the final version. Available on open access from MDPI via the DOI in this recordSocio-economic factors affecting health care can lead to delays in diagnosis of neurological conditions, consequentially affecting treatment and morbidity rates. This inequality in health care can leave patients from lower socio-economic backgrounds more vulnerable to a poorer quality of care from health care providers in the United Kingdom (U.K.). Aims: In this systematic review, we assess the impact of socio-economic status on the use of diagnostic neuroimaging in the U.K., measured by the timeliness, accessibility and appropriate use of computed tomography (CT), magnetic resonance imaging (MRI), ultrasonography, electroencephalography (EEG) and single-photon emission computed tomography (SPECT). We specifically evaluate the non-surgical use of neuroimaging techniques as this relies on the judgment of primary care-givers (e.g., doctors and radiologists), where health disparities are most common. This study includes the analysis of diagnostic imaging used for dementia, minor head injury, stroke, cancer, epilepsy, chronic inflammatory demyelinating polyneuropathy and Parkinson’s disease. With this study, we aim to assess the health inequalities at disease diagnosis. Methods: Using Medline (via Ovid), PubMed and Web of Science databases as sources of information, we critically appraise existing studies on neuroimaging use in the U.K. health care system, published between January 2010 and February 2021. Findings: A total of 18 studies were included in this research, revealing that there was an increase in patients of Black and Asian communities diagnosed with dementia and at an earlier age. There was little evidence to suggest that a lack of access to diagnostic imaging is associated with socio-economic status. However, there are data to suggest that people of a lower socio-economic background require more specialist services with diagnostic neuroimaging tools. In addition, there is evidence to suggest that diagnostic neuroimaging techniques could be utilised more effectively by health care workers to prevent unnecessary delays in diagnosis for patients in lower socio-economic areas

Versatile and scalable fabrication method for laser-generated focused ultrasound transducers

A versatile and scalable fabrication method for laser-generated focused ultrasound transducers is proposed. The method is based on stamping a coated negative mold onto polydimethylsiloxane, and it can be adapted to include different optical absorbers that are directly transferred or synthesized in situ. Transducers with a range of sizes down to 3 mm in diameter are presented, incorporating two carbonaceous (multiwalled carbon nanoparticles and candle soot nanoparticles) and one plasmonic (gold nanoparticles) optically absorbing component. The fabricated transducers operate at central frequencies in the vicinity of 10 MHz with bandwidths in the range of 15–20 MHz. A transducer with a diameter of 5 mm was found to generate a positive peak pressure greater than 35 MPa in the focal zone with a tight focal spot of 150 μm in lateral width. Ultrasound cavitation on the tip of an optical fiber was demonstrated in water for a transducer with a diameter as small as 3 mm

Cannabidiol Enhances the Passage of Lipid Nanocapsules across the Blood–Brain Barrier Both in Vitro and in Vivo

Diseases affecting the central nervous system (CNS) should be regarded as a major health challenge due to the current lack of effective treatments given the hindrance to brain drug delivery imposed by the blood–brain barrier (BBB). Since efficient brain drug delivery should not solely rely on passive targeting, active targeting of nanomedicines into the CNS is being explored. The present study is devoted to the development of lipid nanocapsules (LNCs) decorated with nonpsychotropic cannabinoids as pioneering nonimmunogenic brain-targeting molecules and to the evaluation of their brain-targeting ability both in vitro and in vivo. Noticeably, both the permeability experiments across the hCMEC/D3 cell-based in vitro BBB model and the biodistribution experiments in mice consistently demonstrated that the highest brain-targeting ability was achieved with the smallest-sized cannabinoid-decorated LNCs. Importantly, the enhancement in brain targeting achieved with the conjugation of cannabidiol to LNCs outperformed by 6-fold the enhancement observed for the G-Technology (the main brain active strategy that has already entered clinical trials for the treatment of CNS diseases). As the transport efficiency across the BBB certainly determines the efficacy of the treatments for brain disorders, small cannabinoid-decorated LNCs represent auspicious platforms for the design and development of novel therapies for CNS diseases

Effect of Plasticizer on Oxygen Permeability of Cast Polylactic Acid (PLA) Films Determined Using Dynamic Accumulation Method

Polylactic acid (PLA) is becoming an increasingly important biopolymer for packaging applications. PLA brittleness limits its applicability. This study evaluated PLA properties with increasing amounts of added polyethylene glycol (PEG) plasticizer. Oxygen transmission rate (OTR) of cast films was determined using the newly available Dynamic Accumulation (DA) method. Arrhenius temperature sensitivity of OTR and polymer Permeability was also determined. Permeability of neat PLA is 4.848 ml mm (STP)/m2 s kPa; hence, 4.84 ml mm (STP)/m2 s kPa, 4.07 ml mm (STP)/m2 s kPa and 5.42 ml mm (STP)/m2 s kPa by adding PEG 1 %, 5% and 10% respectively. The main conclusion from this work is increasing PEG will enhance the PLA permeability number but excess PEG in PLA film will decrease the permeability number