Remote consultations in mental health: collaborative evaluation applying learning health systems thinking.

Aims And Method: A collaborative evaluation of remote consultations in mental health services was undertaken by mental health service providers, experts by experience, academic institutions and a Health Innovation Network in south London, UK. 'Learning healthcare systems' thinking was applied. Workstream 1 reviewed international published evidence; workstream 2 synthesised findings from three health provider surveys of the perceptions and experiences of staff, patients and carers; and workstream 3 comprised an electronic survey on local projects.

The Relation of Diabetes Complications to a New Interpretation of Glycaemic Variability from Continuous Glucose Monitoring in People with Type 1 Diabetes.

Introduction: Microvascular and macrovascular complications in type 1 diabetes (T1D) may be linked to endothelial stress due to glycaemic variability. Continuous glucose monitoring systems (CGMs) provide new opportunities to quantify this variability, utilising the amplitude of glucose change summated over time. The aim of this study was to examine whether this determination of glucose variability (GV) is associated with microvascular clinical sequelae.

Father and mother harsh parenting and adult romantic relationships over time: Individual behavior during adolescence.

The present study examined how father and mother harsh parenting as experienced in middle adolescence impacted individual behavior during late adolescence and subsequent harsh couple interaction with their romantic partner in adulthood using a prospective longitudinal design ( = 117 males, 239 females). Data were collected during home visits by a trained interviewer in which family members completed questionnaires and participated in videotaped structured interaction tasks that were coded by trained observers. We assessed the influence of harsh parenting in adolescence (ages 15 and 16, Time 1) on individual processes (e.

Enhancing type 2 diabetes treatment through digital plans of care - a randomized controlled trial: evaluation of change in patient reported outcome measures.

Background: We investigated how a personalized care-planning software and linked mobile-app may aid people to self-manage their type 2 diabetes (T2D) more effectively.

Research Design And Methods: People with T2D and glycated hemoglobin (HbA1c) greater than 58 mmol/mol (7.5%) were randomized to either an intervention group receiving a personalized care plan, or the control group receiving usual care.

Bacterial communities of the threatened Western Pond Turtle may be impacted by land use.

As semi-aquatic species that use both terrestrial and aquatic habitats, freshwater turtles and their microbial communities are especially sensitive to the impacts of habitat disturbance. In this study, we use 16S rRNA amplicon sequencing to characterize the shell and cloacal bacterial communities of turtles in the San Francisco Bay Area. We captured western pond turtles (Actinemys/Emys marmorata) across eight sites located in urban and rural environments, along with invasive red-eared sliders (Trachemys scripta elegans).

Real World Experience of Change in Psycho-Existential Symptoms in Palliative Care.

Context: Psycho-existential symptoms in palliative care are addressed insufficiently. Routine screening, ongoing monitoring and meaningful treatment of psycho-existential symptoms may contribute to the relief of suffering in palliative care.

Objectives: We sought to explore longitudinal change in psycho-existential symptoms following the routine implementation of the Psycho-existential Symptom Assessment Scale (PeSAS) in Australian palliative care services.

Making the transition from student to newly qualified vascular sonographer: An exploration of the domains of professionalism.

Introduction: Rapid increases in the utility of vascular ultrasound combined with increasing expectations from reporting physicians have required a shift to a more defined professional role for the vascular sonographer in Australia. This has created increasing pressure on newly qualified sonographers to be more job-ready and better able to navigate the challenges of the clinical workplace early in their career.

Topic Description: There is a distinct lack of structured strategies that newly qualified sonographers can utilise to assist their transition from student to employee.

A Randomised Control Trial to Explore the Impact and Efficacy of the Healum Collaborative Care Planning Software and App on Condition Management in the Type 2 Diabetes Mellitus Population in NHS Primary Care.

Introduction: Effective and scalable solutions to support management of Type 2 Diabetes (T2D) at a distance are a priority for health systems worldwide. The use of personalised care planning has been shown to be effective at improving the health outcomes and the experience of care amongst people with T2D and other long-term health conditions. Here we describe a specific example of such an intervention.

Controlling adsorption density of polymer-stabilised metal nanoparticles at the oil-water interface.

Emulsion droplets offer an alternative to solid supports as templates for the deposition of metallic nanoparticles. An emulsion interface provides the opportunity to exploit both sides of the nanoparticles and to utilise the liquid core as a microreactor in addition to forming a scaffold for encapsulation. However, despite the extensive literature studying a very broad range of factors influencing the characteristics of particle-stabilised (Pickering) emulsions, most reports focus on particles of diameters >100 nm and a very small proportions consider particles of diameters <10 nm.

Enhancing type 2 diabetes treatment through digital plans of care. First results from the East Cheshire Study of an App to support people in the management of type 2 diabetes.

Introduction: The use of personalised care planning has been effective at improving health outcomes for people with long-term health conditions.

Methods: We analysed data in relation to changes in BMI/HbA1c. The sample was made up of ( = 36) participants randomised to either the active intervention group (App+usual care) or the control group (usual care).

Ancient surgeons: A characterization of Mesopotamian surgical practices.

Background: The Ancient Mesopotamian civilization, the earliest known, emerged in the fourth millennium BCE. While the advent of medicine is established, there is little understanding of surgery's origins. We sought to describe the characteristics and medical acumen of the surgeons of the first civilization.

Integrating Arts with STEM to Foster Systems Thinking.

Interest is growing among out-of-school time (OST) educators in integrating the arts into STEM (science, technology, engineering, and mathematics) programming (e.g., Kelton & Saraniero, 2018).

Applying the Digital Health Social Justice Guide.

Introduction: Digital health, the use of apps, text-messaging, and online interventions, can revolutionize healthcare and make care more equitable. Currently, digital health interventions are often not designed for those who could benefit most and may have unintended consequences. In this paper, we explain how privacy vulnerabilities and power imbalances, including racism and sexism, continue to influence health app design and research.

Facilitating Systems Thinking Through Arts-Based STEM Integration.

Engaging with socio-scientific issues often involves making sense of how - and for whom - actions, choices, and policies might affect aspects of daily life. Understanding the complexity of socio-scientific issues also requires recognizing the interconnectedness of - and working across - multiple communities and professions. We suggest that art, whether musical composition, illustrations, or sculpture / collage across materials would promote the synthesis of different types of knowledge across different scales and systems.

Deposition of non-porous calcium phosphate shells onto liquid filled microcapsules.

The efficient encapsulation of small molecule active ingredients has been a challenge for many decades across many commercial applications. Recently, successful attempts to address this issue have included deposition of thin metal shells onto liquid filled polymer microcapsules or emulsion droplets to provide an impermeable barrier to diffusion. In this work we have developed a novel method to protect small molecule active ingredients by deposition of thin mineral shells.

Virus-encoded histone doublets are essential and form nucleosome-like structures.

The organization of genomic DNA into defined nucleosomes has long been viewed as a hallmark of eukaryotes. This paradigm has been challenged by the identification of "minimalist" histones in archaea and more recently by the discovery of genes that encode fused remote homologs of the four eukaryotic histones in Marseilleviridae, a subfamily of giant viruses that infect amoebae. We demonstrate that viral doublet histones are essential for viral infectivity, localize to cytoplasmic viral factories after virus infection, and ultimately are found in the mature virions.

Capecitabine for hormone receptor-positive versus hormone receptor-negative breast cancer.

Background: Retrospective analyses suggest that capecitabine may carry superior activity in hormone receptor-positive relative to hormone receptor-negative metastatic breast cancer. This review examined the veracity of that finding and explored whether this differential activity extends to early breast cancer.

Objectives: To assess effects of chemotherapy regimens containing capecitabine compared with regimens not containing capecitabine for women with hormone receptor-positive versus hormone receptor-negative breast cancer across the three major treatment scenarios: neoadjuvant, adjuvant, metastatic.

Treating Women with Recurrent Stress Urinary Incontinence: A Hornet's Nest Still Needing Proper Clinical Evidence.

Evidence is lacking on the best treatment for women presenting with recurrent stress urinary incontinence. PURSUIT is a randomised trial of urethral bulking agent injection versus surgical intervention. It will provide high-quality evidence to aid counselling and inform choice.

MR-guided focused ultrasound increases antibody delivery to nonenhancing high-grade glioma.

Background: High-grade glioma (HGG) remains a recalcitrant clinical problem despite many decades of research. A major challenge in improving prognosis is the inability of current therapeutic strategies to address a clinically significant burden of infiltrating tumor cells that extend beyond the margins of the primary tumor mass. Such cells cannot be surgically excised nor efficiently targeted by radiation therapy.

Comparative study of preclinical mouse models of high-grade glioma for nanomedicine research: the importance of reproducing blood-brain barrier heterogeneity.

The clinical translation of new nanoparticle-based therapies for high-grade glioma (HGG) remains extremely poor. This has partly been due to the lack of suitable preclinical mouse models capable of replicating the complex characteristics of recurrent HGG (rHGG), namely the heterogeneous structural and functional characteristics of the blood-brain barrier (BBB). The goal of this study is to compare the characteristics of the tumor BBB of rHGG with two different mouse models of HGG, the ubiquitously used U87 cell line xenograft model and a patient-derived cell line WK1 xenograft model, in order to assess their suitability for nanomedicine research.

Metal-shell nanocapsules for the delivery of cancer drugs.

Cytotoxic drugs tend to have substantial side effects on healthy tissues leading to systemic toxicity, limited tolerated doses and reduced drug efficacy. A prominent research area focuses on encapsulating cytotoxic drugs for targeted delivery to cancer tissues. However, existing carriers suffer from low drug loading levels and high drug leaching both when circulating systemically and when accumulating in non-target organs.

Ultrasound-triggered release from metal shell microcapsules.

Metal shell microcapsules have been shown to completely retain their core until its release is triggered, making them a promising candidate for use as a controllable drug delivery vehicle due to their superior retention properties as compared to polymer shell microcapsules. Focused ultrasound (FUS) has been successfully utilised to trigger release of lipophilic drugs from polymer microcapsules, and in this work the response of gold shell microcapsules with and without an inner polymeric shell, to FUS and standard ultrasound is explored. The results show that gold shell microcapsules with an inner polymer shell rupture when exposed to standard ultrasound and that there is a linear correlation between the gold shell thickness and the extent of shell rupture.

Wildfire severity reduces richness and alters composition of soil fungal communities in boreal forests of western Canada.

Wildfire is the dominant disturbance in boreal forests and fire activity is increasing in these regions. Soil fungal communities are important for plant growth and nutrient cycling postfire but there is little understanding of how fires impact fungal communities across landscapes, fire severity gradients, and stand types in boreal forests. Understanding relationships between fungal community composition, particularly mycorrhizas, and understory plant composition is therefore important in predicting how future fire regimes may affect vegetation.