From Place to Space: A Heideggerian Analysis

In this paper, we pay attention to the impact on staff of what was a new place, Ko Awatea, within a large New Zealand hospital. The place became a space from within which a particular mood arose. This paper seeks to capture that mood and its impact. Using a Heideggerian hermeneutic approach, the study reported on drew on data from interviews with 20 staff. Philosophical notions about the nature and mood of place/space are explored. As staff claimed this space, the mood that emerged was of liveliness, buzz and comfort. It became a space where people wanted to be, where they met others, where  conversations unfolded, where thinking happened in new ways. Staff places tend to be sacrificed or poorly resourced in resource-tight environments. We argue that creating a space that feels home-like, where staff come, linger and engage in community is a priority for generating the mood and thinking of an organization. Such spaces do not happen by chance; it takes forethought and intentionality. The gift of such space is the thinking that is sparked and grown

Unaffiliated Lay Vincentians\u27 Informal Engagement with the Vincentian Mission

In winter 2013, DePaul University’s Office of Mission and Values (OMV) commissioned the Center for Applied Research in the Apostolate (CARA) at Georgetown University to conduct a survey of “unaffiliated lay Vincentians,” that is young adults between the ages of 18 to 35 who have had a formative experience in the Vincentian mission either as a student or as a post-graduate volunteer at a Vincentian institution. The central purpose of this research is to help OMV explore these unaffiliated lay Vincentians’ understanding of their experiences with the Vincentian mission, their commitment to that mission, and their desire for more formation in the Vincentian charism. In collaboration with OMV, CARA designed an online survey with 72 closed-ended and four open-ended questions. The survey asked respondents about their past and current engagement with the Vincentian mission, their understanding of the dimensions of the Vincentian mission, the importance they give to Vincentian values, their interest in learning more about the Vincentian charism, their past and current religiosity and spirituality, and their demographic characteristics. Between February 2014 and May 2014, CARA and OMV distributed a link to the survey to a total of 1,737 men and women that OVM identified as unaffiliated lay Vincentians. A total of 351 men and women (or 20 percent of those who had been sent the survey) completed the questionnaire.https://via.library.depaul.edu/vincentian_ebooks/1022/thumbnail.jp

Family history of severe cardiovascular disease in Marfan syndrome is associated with increased aortic diameter and decreased survival

Objectives.We attempted to determine whether a family history of severe cardiovascular disease in patients with the Marfan syndrome is associated with increased aortic dilation or decreased survival, or both.Background.The prognostic importance of a family history of severe cardiovascular disease in patients with the Marfan syndrome has been incompletely examined. We hypothesized that such a family history would correlate with increased aortic dilation and would be associated with decreased survival.Methods.One hundred eight affected patients and 48 unaffected family members from 33 multigenerational families with the Marfan syndrome underwent echocardiographic measurement of the aortic root, arch and mid-abdominal aorta. Date of birth and age at death ascertained from family pedigrees were used to perform life table analysis and estimate survival.Results.Aortic root and arch diameters were significantly greater in patients with a family history of severe cardiovascular disease than in patients without such a family history. Of subjects in the highest quartile for aortic size, >80% had such a family history in contrast to <10% of those in the lowest quartile (chisquare 57.37, p < 0.00001). Mean age at death and cumulative probability of survival were significantly lower in patients with such a family history.Conclusions.Among patients with the Marfan syndrome, aortic dilation is greater and life expectancy shorter in those with a family history of severe cardiovascular manifestations. These data suggest that such a family history is an important risk factor for cardiovascular events in patients with the Marfan syndrome

Developing and Implementing a Framework for System Level Measures: lessons from New Zealand

Background: Measuring performance is now the norm in health systems. System Level Measures (SLMs), implemented at New Zealand’s Counties Manukau Health (CMH) are designed to support quality improvement activities undertaken across the health system using only a small set of measures. While the healthcare and performance measurement literature contains information regarding the facilitators and barriers to quality improvement initiatives, there is an absence of studies into whether these factors are germane to the establishment and implementation of a SLM framework. Methods: A purposive sample of thirteen senior managers and clinicians involved in the construction and implementation of SLMs were invited to participate. Semi-structured telephone interviews were completed and recordings transcribed verbatim. Transcriptions were thematically analysed using a general inductive approach. Findings: In total, ten interviews took place. Six facilitative themes were identified including: dispersed and focused leadership; communication; data; alignment of the measures with organisational strategic&nbsp;data; alignment of the measures with organisational strategic plans and values; stakeholder engagement; and a dedicated project team. Conversely, five themes were identified that hindered the process. These were: reaching consensus; perfection versus pragmatism; duplication and process burden; achieving buy-in and workload. Discussion: The factors that facilitate and hinder establishing and implementing a framework of SLMs are common to other quality improvement approaches. However, this study demonstrated that these factors were also germane to SLMs. These findings are of particular relevance as researchers and policy makers elsewhere increasingly aim to adopt measurement arrangements for health systems that address equity, safety, quality, access and cost. Abbreviations: CMH – Counties Manukau Health; DHB – District Health Board; IHI – Institute for Healthcare Improvement; QI – Quality Improvement; SLM – System Level Measure

Food insecurity increases energetic efficiency, not food consumption: an exploratory study in European starlings

Food insecurity—defined as limited or unpredictable access to nutritionally adequate food—is associated with higher body mass in humans and birds. It is widely assumed that food insecurity-induced fattening is caused by increased food consumption, but there is little evidence supporting this in any species. We developed a novel technology for measuring foraging, food intake and body mass in small groups of aviary-housed European starlings (Sturnus vulgaris). Across four exploratory experiments, we demonstrate that birds responded to 1–2 weeks of food insecurity by increasing their body mass despite eating less. Food-insecure birds therefore increased their energetic efficiency, calculated as the body mass maintained per unit of food consumed. Mass gain was greater in birds that were lighter at baseline and in birds that faced greater competition for access to food. Whilst there was variation between experiments in mass gain and food consumption under food insecurity, energetic efficiency always increased. Bomb calorimetry of guano showed reduced energy density under food insecurity, suggesting that the energy assimilated from food increased. Behavioural observations of roosting showed inconsistent evidence for reduced physical activity under food insecurity. Increased energetic efficiency continued for 1–2 weeks after food security was reinstated, indicating an asymmetry in the speed of the response to food insecurity and the recovery from it. Future work to understand the mechanisms underlying food insecurity-induced mass gain should focus on the biological changes mediating increased energetic efficiency rather than increased energy consumption

Identifying future models for delivering genetic services: a nominal group study in primary care

BACKGROUND: To enable primary care medical practitioners to generate a range of possible service delivery models for genetic counselling services and critically assess their suitability. METHODS: Modified nominal group technique using in primary care professional development workshops. RESULTS: 37 general practitioners in Wales, United Kingdom too part in the nominal group process. The practitioners who attended did not believe current systems were sufficient to meet anticipated demand for genetic services. A wide range of different service models was proposed, although no single option emerged as a clear preference. No argument was put forward for genetic assessment and counselling being central to family practice, neither was there a voice for the view that the family doctor should become skilled at advising patients about predictive genetic testing and be able to counsel patients about the wider implications of genetic testing for patients and their family members, even for areas such as common cancers. Nevertheless, all the preferred models put a high priority on providing the service in the community, and often co-located in primary care, by clinicians who had developed expertise. CONCLUSION: There is a need for a wider debate about how healthcare systems address individual concerns about genetic concerns and risk, especially given the increasing commercial marketing of genetic tests

Cost-effectiveness of cognitive behavioural and personalised exercise interventions for reducing fatigue in inflammatory rheumatic diseases

Acknowledgements The authors would like to thank all the participants who supported this trial. We acknowledge the contribution of the Trial Steering Committee and Data Monitoring Committee, and Brian Taylor and Mark Forrest (Centre for Healthcare Randomised Trials [CHaRT], University of Aberdeen, Aberdeen, UK) for their technical assistance. Funding: This work was supported by Versus Arthritis (formerly Arthritis Research UK) grant number 21175.Peer reviewe

Inscuteable Regulates the Pins-Mud Spindle Orientation Pathway

During asymmetric cell division, alignment of the mitotic spindle with the cell polarity axis ensures that the cleavage furrow separates fate determinants into distinct daughter cells. The protein Inscuteable (Insc) is thought to link cell polarity and spindle positioning in diverse systems by binding the polarity protein Bazooka (Baz; aka Par-3) and the spindle orienting protein Partner of Inscuteable (Pins; mPins or LGN in mammals). Here we investigate the mechanism of spindle orientation by the Insc-Pins complex. Previously, we defined two Pins spindle orientation pathways: a complex with Mushroom body defect (Mud; NuMA in mammals) is required for full activity, whereas binding to Discs large (Dlg) is sufficient for partial activity. In the current study, we have examined the role of Inscuteable in mediating downstream Pins-mediated spindle orientation pathways. We find that the Insc-Pins complex requires Gαi for partial activity and that the complex specifically recruits Dlg but not Mud. In vitro competition experiments revealed that Insc and Mud compete for binding to the Pins TPR motifs, while Dlg can form a ternary complex with Insc-Pins. Our results suggest that Insc does not passively couple polarity and spindle orientation but preferentially inhibits the Mud pathway, while allowing the Dlg pathway to remain active. Insc-regulated complex assembly may ensure that the spindle is attached to the cortex (via Dlg) before activation of spindle pulling forces by Dynein/Dynactin (via Mud)

US Cosmic Visions: New Ideas in Dark Matter 2017: Community Report

This white paper summarizes the workshop "U.S. Cosmic Visions: New Ideas in Dark Matter" held at University of Maryland on March 23-25, 2017.Comment: 102 pages + reference