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Nina Fudge Charles D A Wolfe Christopher McKevitt 《BMJ (Clinical research ed.)》2008,336(7639):313-317
Objectives To understand how the policy of user involvement is interpreted in health service organisations and to identify factors that influence how user involvement is put into practice.Design Ethnographic study using participant observation, interviews, and collection of documentary evidence.Setting A multiagency modernisation programme to improve stroke services in two London boroughs.Participants Service users, National Health Service managers, and clinicians.Results User involvement in the programme was initiated and led by professionals. Professionals determined the areas of service improvement service users could participate in. A wide range of activities were considered “user involvement,” from patient satisfaction surveys to service users delivering peer support. Involvement tended to be most active in the least technical areas and areas with least input from clinicians. Factors that might explain this included organisational structure, the vagueness of the concept of user involvement, the value attributed to service users’ experiential knowledge, and variations in professional and service user understandings of and commitment to involvement. The gains of involvement were harder to identify in terms of impact on services. More evident were the personal gains for those involved: satisfaction of feeling listened to by professionals, social opportunities of meeting others in a similar situation, and increased knowledge about stroke and services available.Conclusions User involvement may not automatically lead to improved service quality. Healthcare professionals and service users understand and practise user involvement in different ways according to individual ideologies, circumstances, and needs. Given the resource implications of undertaking user involvement in service development there is a need for critical debate on the purpose of such involvement as well as better evidence of the benefits claimed for it. 相似文献
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The biocontrol properties of Trichoderma species are well documented, but their effectiveness in antagonism of the problematic Sclerotium cepivorum, the causal agent of white rot in Allium species, appears limited with reports of significant control only relating to deliberately-mutated strains of Trichoderma. Our previous studies have indicated the possibility of using selected naturally-occurring strains of the antagonist in the suppression of other diseases; now in vitro and controlled environment in vivo studies have indicated that a degree of control of Onion White Rot is possible, and that the selected antagonist strains can be used in integrated treatments with Iprodione to good effect. The possible value of such treatments is considered in light of other approaches to the suppression of this continuing problem. 相似文献
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Leblanc DM Wood CM Fudge DS Wright PA 《Physiological and biochemical zoology : PBZ》2010,83(6):932-949
The euryhaline, amphibious mangrove killifish Kryptolebias marmoratus is known to survive weeks out of water in moist environments. We tested the hypothesis that the skin is a site of osmo- and ionoregulation in K. marmoratus. We predicted that under terrestrial conditions, gill and skin remodeling would result in an enhanced role for skin and a diminished role for the gills in osmo- and ionoregulation. Fish were exposed to water-either freshwater (FW, 1‰) or hypersaline water (saltwater [SW], 45‰)-or air over a moist surface of FW or SW for 9 d and then recovered in water. When fish were emersed for 9 d, (22)Na and (3)H-H(2)O were exchanged across the cutaneous surface. Homeostasis of whole-body Cl(-) and water levels but not of Na(+) levels was maintained over 9 d in air. In air-exposed fish, there was a significant increase in the size of skin ionocytes (in SW), a decrease in the number of skin mucous cells (in SW), and an increase in the gill interlamellar cell mass relative to those of fish in water. Gill ionocytes were mostly embedded away from the external surface in air-exposed fish, but the number and size of ionocytes increased (in FW). Interestingly, skin ionocytes formed distinct clusters of 20-30 cells. The estimated number of ionocytes over the whole skin surface was comparable to that in the gills. Overall, the findings support the hypothesis that the skin is a site of osmo- and ionoregulation in K. marmoratus in aquatic and terrestrial environments. Reversible cellular and morphological changes to the skin and gills during air exposure probably enhanced the cutaneous contribution to ion and water balance. 相似文献
4.
Kovacs CS Woodland ML Fudge NJ Friel JK 《American journal of physiology. Endocrinology and metabolism》2005,289(1):E133-E144
We utilized a vitamin D receptor (VDR) gene knockout model to study the effects of maternal and fetal absence of VDR on maternal fertility, fetal-placental calcium transfer, and fetal mineral homoeostasis. Vdr null mice were profoundly hypocalcemic, conceived infrequently, and had significantly fewer viable fetuses in utero that were also of lower body weight. Supplementation of a calcium-enriched diet increased the rate of conception in Vdr nulls but did not normalize the number or weight of viable fetuses. Among offspring of heterozygous (Vdr(+/-)) mothers (wild type, Vdr(+/-), and Vdr null fetuses), there was no alteration in serum Ca, P, or Mg, parathyroid hormone, placental (45)Ca transfer, Ca and Mg content of the fetal skeleton, and morphology and gene expression in the fetal growth plates. Vdr null fetuses did have threefold increased 1,25-dihydroxyvitamin D levels accompanied by increased 1alpha-hydroxylase mRNA in kidney but not placenta; a small increase was also noted in placental expression of parathyroid hormone-related protein (PTHrP). Among offspring of Vdr null mothers, Vdr(+/-) and Vdr null fetuses had normal ionized calcium levels and a skeletal ash weight that was appropriate to the lower body weight. Thus our findings indicate that VDR is not required by fetal mice to regulate placental calcium transfer, circulating mineral levels, and skeletal mineralization. Absence of maternal VDR has global effects on fetal growth that were partly dependent on maternal calcium intake, but absence of maternal VDR did not specifically affect fetal mineral homeostasis. 相似文献
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The prevailing model of the mechanical function of intermediate filaments in cells assumes that these 10 nm diameter filaments make up networks that behave as entropic gels, with individual intermediate filaments never experiencing direct loading in tension. However, recent work has shown that single intermediate filaments and bundles are remarkably extensible and elastic in vitro, and therefore well-suited to bearing tensional loads. Here we tested the hypothesis that the intermediate filament network in keratinocytes is extensible and elastic as predicted by the available in vitro data. To do this, we monitored the morphology of fluorescently-tagged intermediate filament networks in cultured human keratinocytes as they were subjected to uniaxial cell strains as high as 133%. We found that keratinocytes not only survived these high strains, but their intermediate filament networks sustained only minor damage at cell strains as high as 100%. Electron microscopy of stretched cells suggests that intermediate filaments are straightened at high cell strains, and therefore likely to be loaded in tension. Furthermore, the buckling behavior of intermediate filament bundles in cells after stretching is consistent with the emerging view that intermediate filaments are far less stiff than the two other major cytoskeletal components F-actin and microtubules. These insights into the mechanical behavior of keratinocytes and the cytokeratin network provide important baseline information for current attempts to understand the biophysical basis of genetic diseases caused by mutations in intermediate filament genes. 相似文献
7.
Melissa A. Fudge Martin Kavaliers John-Paul Baird Klaus-Peter Ossenkopp 《Life sciences》2009,84(9-10):282-289
AimsEstrogen receptor activation has been shown to reduce body weight and produce conditioned taste avoidance (CTA) when estradiol administration is paired with a novel tastant. This study determined if the selective estrogen receptor modulators tamoxifen and raloxifene, which effectively prevent and treat breast cancer, can induce a CTA and alter body weight in ovariectomized (OVX)-female rats.Main methodsDuring conditioning, OVX-female rats were injected with tamoxifen, raloxifene, 17β-estradiol or vehicle, or were uninjected, prior to drinking 0.3 M sucrose in a lickometer. Immediately following sucrose access, alterations in locomotor activity and thigmotaxis (anxiety) were assessed in an open field apparatus. Conditioned drug effects on drinking, locomotor activity and anxiety were examined on a separate test day.Key findingsOur results suggest that both tamoxifen and raloxifene produce CTA that is similar to that produced by estradiol. Both the number and size of bursts of licking were significantly reduced, as well as body weight gain, in OVX-female rats treated with tamoxifen or raloxifene.SignificanceThe results of the present study suggest that tamoxifen and raloxifene may have the potential to produce CTA in breast cancer patients receiving chemoprevention care. 相似文献
8.
Pasquier CM; Promponas VI; Varvayannis NJ; Hamodrakas SJ 《Bioinformatics (Oxford, England)》1998,14(8):749-750
Summary : FT is a tool written in C++, which implements the Fourier
analysis method to locate periodicities in aminoacid or DNA sequences. It
is provided for free public use on a WWW server with a Java interface.
Availability : The server address is http://o2.db. uoa.gr/FT Contact :
shamodr@atlas.uoa.gr
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Utility of the white gene in estimating phylogenetic relationships among mosquitoes (Diptera: Culicidae) 总被引:2,自引:0,他引:2
The utility of a nuclear protein-coding gene for reconstructing
phylogenetic relationships within the family Culicidae was explored.
Relationships among 13 species representing three subfamilies and nine
genera of Culicidae were analyzed using a 762-bp fragment of coding
sequence from the eye color gene, white. Outgroups for the study were two
species from the sister group Chaoboridae. Sequences were determined from
clone PCR products amplified from genomic DNA, and aligned following
conceptual intron splicing and amino acid translation. Third codon
positions were characterized by high levels of divergence and biased
nucleotide composition, the intensity and direction of which varied among
taxa. Equal weighting of all characters resulted in parsimony and
neighboring-joining trees at odds with the generally accepted phylogenetic
hypothesis based on morphology and rDNA sequences. The application of
differential weighting schemes recovered the traditional hypothesis, in
which the subfamily Anophelinae formed the basal clade. The subfamily
Toxorhynchitinae occupied an intermediate position, and was a sister group
to the subfamily Culicinae. Within Culicinae, the genera Sabethes and
Tripteroides formed an ancestral clade, while the Culex-Deinocerites and
Aedes- Haemagogus clades occupied increasingly derived positions in the
molecular phylogeny. An intron present in the Culicinae- Toxorhynchitinae
lineage and one outgroup taxon was absent in the basal Anophelinae lineage
and the second outgroup taxon, suggesting that intron insertions or
deletions may not always be reliable systematic characters.
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