Risk and Reward: Safer systems of work practice.

To develop and implement a risk assessment process for all unlicenced medicinal products in use within the Belfast City Hospital.
Over half 65% of the unlicenced medicinal products currently in use were rated low or minor risk and therefore required no recording upon supply.
This has greatly improved the way unlicensed medicines are prescribed, procured, supplied and administered within the Belfast City Hospital.

Technology, work organisation and job quality in the service sector: an introduction’

This special issue volume is concerned with how technology is changing the nature of work and working conditions while generating new products and new forms of service delivery. The five articles included in this volume cover service work, from the routine and clerical through to highly credentialed and professional work. Although some of the established challenges concerning the impact of Information and Communication Technology (ICT) on work and workplaces are evident in the articles, it is also clear that new service delivery processes demand new skills and training to some extent. Overall findings indicate that while ICT competencies are important, they need to be supplemented by the soft skills that are crucial for effective customer interactions and more open work systems with greater autonomy and participation whereby flexible work teams can have a positive impact on job quality outcomes. This introductory article examines technology and the changing nature of work through three strands of interpretation, prior to introducing the five articles in this special issue.

New technology and new workplaces: call centre careers – a growing reality?

Research to date suggests that career advancement in call centres (CCs) is relatively uncommon with employees often viewing such employment as a stopgap measure before moving on to something better. This study set out to determine whether such scenarios have changed over time since CCs have become more established in their work organisation, information and communication technology (ICT) and management processes. This study particularly focused on training and development initiatives, how employees access training and development, and whether CCs support career development. Using both qualitative and quantitative methods, these issues are examined within 10 Australian CCs of varying size from various sectors. Two-thirds of respondents stated that they intended to develop a career in the industry and 7 in 10 reported that they believed there were promotional opportunities emerging in their current organisation. Despite these findings, the evidence also suggests that more needs to be done both to create coherent career paths and to establish structured, accredited training programmes for CC employees.

Anti-TNF antibody-induced psoriasiform skin lesions in patients with inflammatory bowel disease are characterised by interferon-γ-expressing Th1 cells and IL-17A/IL-22-expressing Th17 cells and respond to anti-IL-12/IL-23 antibody treatment

Background We analysed incidence, predictors, histological features and specific treatment options of anti-tumour necrosis factor alpha (TNF-alpha) antibody-induced psoriasiform skin lesions in patients with inflammatory bowel diseases (IBD).

Design Patients with IBD were prospectively screened for anti-TNF-induced psoriasiform skin lesions. Patients were genotyped for IL23R and IL12B variants. Skin lesions were examined for infiltrating Th1 and Th17 cells. Patients with severe lesions were treated with the anti-interleukin (IL)-12/IL-23 p40 antibody ustekinumab.

Results Among 434 anti-TNF-treated patients with IBD, 21 (4.8%) developed psoriasiform skin lesions. Multiple logistic regression revealed smoking (p=0.007; OR 4.24, 95% CI 1.55 to 13.60) and an increased body mass index (p=0.029; OR 1.12, 95% CI 1.01 to 1.24) as main predictors for these lesions. Nine patients with Crohn's disease and with severe psoriasiform lesions and/or anti-TNF antibody-induced alopecia were successfully treated with the anti-p40-IL-12/IL-23 antibody ustekinumab (response rate 100%). Skin lesions were histologically characterised by infiltrates of IL-17A/IL-22-secreting T helper 17 (Th17) cells and interferon (IFN)-gamma-secreting Th1 cells and IFN-alpha-expressing cells. IL-17A expression was significantly stronger in patients requiring ustekinumab than in patients responding to topical therapy (p=0.001). IL23R genotyping suggests disease-modifying effects of rs11209026 (p.Arg381Gln) and rs7530511 (p.Leu310Pro) in patients requiring ustekinumab.

Conclusions New onset psoriasiform skin lesions develop in nearly 5% of anti-TNF-treated patients with IBD. We identified smoking as a main risk factor for developing these lesions. Anti-TNF-induced psoriasiform skin lesions are characterised by Th17 and Th1 cell infiltrates. The number of IL-17A-expressing T cells correlates with the severity of skin lesions. Anti-IL-12/IL23 antibody therapy is a highly effective therapy for these lesions.

Determining optimal duration of seed translocation periods for benthic mussel (Mytilus edulis) cultivation using physiological and behavioural measures of stress

During the benthic cultivation process of Mytilus edulis (blue mussels), wild mussel seed is often transplanted from naturally occurring subtidal beds to sheltered in-shore waters to be grown to a commercial size. The survival of these relaid mussels is ultimately a function of their quality and physiological condition upon relaying and it has been recognised that mussels can suffer from a loss in condition following transportation. We investigated whether the process of being transported to ongrowing plots had a negative effect on the physiological health and resultant behaviour of mussels by simulating transportation conditions in a controlled experiment. Mussels were kept, out of water, in plastic piping to recreate translocation conditions and further, we tested if depth held in a ship hold (0, 1.5 and 3 m) and length of time emersed (12, 24 and 48 h) affected mussel condition and behaviour. Physiological condition was assessed by quantifying mussel tissue pH and whole tissue glucose, glycogen, succinate and propionate concentrations. The rate of byssogenesis was also quantified to estimate recovery following a period of re-immersion. The depth at which mussels were held did not affect any of the physiological indicators of mussel stress but short-term byssus production was affected. Mussels held at 3 m produced fewer byssus threads during the first 72 h following re-immersion compared with mussels at 0 m (i.e. not buried) suggesting that depth held can impede recovery following transportation. Duration of emersion affected all stress indicators. Specifically, mussels held out of water for 48 h had a reduced physiological condition compared with those emersed for just 12 h. This work has practical implications for the benthic cultivation industry and based on these results we recommend that mussels are held out of water for less than 24 h prior to relaying to ensure physiological health and resultant condition is preserved.

A genome-wide association study of anorexia nervosa

Anorexia nervosa (AN) is a complex and heritable eating disorder characterized by dangerously low body weight. Neither candidate gene studies nor an initial genome-wide association study (GWAS) have yielded significant and replicated results. We performed a GWAS in 2907 cases with AN from 14 countries (15 sites) and 14 860 ancestrally matched controls as part of the Genetic Consortium for AN (GCAN) and the Wellcome Trust Case Control Consortium 3 (WTCCC3). Individual association analyses were conducted in each stratum and meta-analyzed across all 15 discovery data sets. Seventy-six (72 independent) single nucleotide polymorphisms were taken forward for in silico (two data sets) or de novo (13 data sets) replication genotyping in 2677 independent AN cases and 8629 European ancestry controls along with 458 AN cases and 421 controls from Japan. The final global meta-analysis across discovery and replication data sets comprised 5551 AN cases and 21 080 controls. AN subtype analyses (1606 AN restricting; 1445 AN binge-purge) were performed. No findings reached genome-wide significance. Two intronic variants were suggestively associated: rs9839776 (P=3.01 × 10(-7)) in SOX2OT and rs17030795 (P=5.84 × 10(-6)) in PPP3CA. Two additional signals were specific to Europeans: rs1523921 (P=5.76 × 10(-)(6)) between CUL3 and FAM124B and rs1886797 (P=8.05 × 10(-)(6)) near SPATA13. Comparing discovery with replication results, 76% of the effects were in the same direction, an observation highly unlikely to be due to chance (P=4 × 10(^-6)), strongly suggesting that true findings exist but our sample, the largest yet reported, was underpowered for their detection. The accrual of large genotyped AN case-control samples should be an immediate priority for the field.

Herschel key program HERITAGE:A far-infrared source catalog for the Magellanic Clouds

Observations from the HERschel Inventory of the Agents of Galaxy Evolution (HERITAGE ) have been used to identify dusty populations of sources in the Large and Small Magellanic Clouds (LMC and SMC). We conducted the study using the HERITAGE catalogs of point sources available from the Herschel Science Center from both the Photodetector Array Camera and Spectrometer (PACS; 100 and 160 μm) and Spectral and Photometric Imaging Receiver (SPIRE; 250, 350, and 500 μm) cameras. These catalogs are matched to each other to create a Herschel band-merged catalog and then further matched to archival Spitzer IRAC and MIPS catalogs from the Spitzer Surveying the Agents of Galaxy Evolution (SAGE) and SAGE-SMC surveys to create single mid- to far-infrared (far-IR) point source catalogs that span the wavelength range from 3.6 to 500 μm. There are 35,322 unique sources in the LMC and 7503 in the SMC. To be bright in the FIR, a source must be very dusty, and so the sources in the HERITAGE catalogs represent the dustiest populations of sources. The brightest HERITAGE sources are dominated by young stellar objects (YSOs), and the dimmest by background galaxies. We identify the sources most likely to be background galaxies by first considering their morphology (distant galaxies are point-like at the resolution of Herschel) and then comparing the flux distribution to that of the Herschel Astrophysical Terahertz Large Area Survey (ATLAS ) survey of galaxies. We find a total of 9745 background galaxy candidates in the LMC HERITAGE images and 5111 in the SMC images, in agreement with the number predicted by extrapolating from the ATLAS flux distribution. The majority of the Magellanic Cloud-residing sources are either very young, embedded forming stars or dusty clumps of the interstellar medium. Using the presence of 24 μm emission as a tracer of star formation, we identify 3518 YSO candidates in the LMC and 663 in the SMC. There are far fewer far-IR bright YSOs in the SMC than the LMC due to both the SMC's smaller size and its lower dust content. The YSO candidate lists may be contaminated at low flux levels by background galaxies, and so we differentiate between sources with a high ("probable") and moderate ("possible ") likelihood of being a YSO. There are 2493/425 probable YSO candidates in the LMC/SMC. Approximately 73% of the Herschel YSO candidates are newly identified in the LMC, and 35% in the SMC. We further identify a small population of dusty objects in the late stages of stellar evolution including extreme and post-asymptotic giant branch, planetary nebulae, and supernova remnants. These populations are identified by matching the HERITAGE catalogs to lists of previously identified objects in the literature. Approximately half of the LMC sources and one quarter of the SMC sources are too faint to obtain accurate ample FIR photometry and are unclassified.

The Host Defence Peptide LL-37 is Susceptible to Proteolytic Degradation by Wound Fluid Isolated from Foot Ulcers of Diabetic Patients

The pleiotropic effects of host defence peptides (HDPs), including the ability to kill microorganisms, enhance re-epithelialisation and increase angiogenesis, indicates a role for these important peptides as potential therapeutic agents in the treatment of chronic, non-healing wounds. However, the maintenance of peptide integrity, through resistance to degradation by the array of proteinases present at the wound site, is a prerequisite for clinical success. In this study we explored the degradation of exogenous LL-37, one such HDP, by wound fluid from diabetic foot ulcers to determine its susceptibility to proteolytic degradation. Our results suggest that LL-37 is unstable in the diabetic foot ulcer microenvironment. Following overnight treatment with wound fluid, LL-37 was completely degraded. Analysis of cleavage sites suggested potential involvement of both host- and bacterial-derived proteinases. The degradation products were shown to retain some antibacterial activity against Pseudomonas aeruginosa but were inactive against Staphylococcus aureus. In conclusion, our data suggest that stabilising selected peptide bonds within the sequence of LL-37 would represent an avenue for future research prior to clinical studies to address its potential as an exogenously-applied therapeutic in diabetic wounds. 

Strangers in a strange land: How Afghanistan changed our lives:How Afghanistan changed our lives

This half hour audio documentary for BBC Northern Ireland examined the connections between the different people in Northern Ireland who have forged links with Afghanistan.

The effects of transportation stress and barnacle fouling on predation rates of starfish (Asterias rubens) on mussels (Mytilus edulis).

The starfish, Asterias rubens, is widely distributed throughout the northern hemisphere and is an important predator on benthic mussel (Mytilus edulis) beds. Whilst several studies have examined how the size of individuals determines this predator–prey relationship, less is known about how the physiological condition of the prey (mussels) and the extent of their fouling may alter these relationships. Such issues are of particular interest to those working within the benthic mussel cultivation industry to inform best management practice and to help minimise losses during the aquaculture process. The potential role of starfish in the removal of epibiotic barnacles from mussels, the presence of which increases processing costs within the industry, is also of interest. We tested whether stressing mussels by aerial exposure for 48 h and whether the extent of barnacle fouling on mussels affected the feeding rates of three different size classes of starfish feeding on two different size classes of mussels. Feeding rates on stressed and unstressed mussels were similar for each starfish–mussel size combination. Barnacle fouling reduced the feeding rate of medium-sized starfish on larger-sized mussels. We also observed starfish, of all size classes, preying directly on the epibiotic barnacles on mussels, however, feeding rates were low and considered unlikely to reduce the extent of fouling on mussels. Our findings show that the predator–prey relationship between starfish and mussels does not differ between unstressed mussels and those experimentally stressed by aerial exposure for 48 h so that this level of stress is unlikely to affect predation rates by A. rubens following relaying in commercial operations. Whilst barnacle fouling suppressed predation rates in one of our experimental treatments, it does not appear that fouling by barnacles would provide a significant refuge from predation for the majority of mussels in benthic aquaculture stocks. Instead we found the size relationship between starfish and mussels was more important in determining predation rates. Starfish are also unlikely to help reduce barnacle fouling on cultured mussels by preying solely on fouling barnacles and the need to control starfish predation during culture remains.