269 resultados para MRC
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Acknowledgments The authors would like to thank the participants of the EPIC-Norfolk cohort. We thank the nutritionist team and data management team of the EPIC-Norfolk cohort. The EPIC-Norfolk study was supported by grants from the Medical Research Council and Cancer Research UK. Funders had no role in study design or interpretation of the findings.
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Background The growing prevalence and associated burden of diet-related non-communicable diseases is a global public health concern. The environments in which people live and work influences their dietary behaviours. Aim The focus of this thesis was on the effectiveness of complex workplace dietary interventions. The comparative effectiveness of a complex workplace environmental dietary modification intervention and an educational intervention were assessed both alone and in combination relative to a control workplace setting. Methods The systematic review was guided by the PRISMA statement. In a cluster controlled trial, four workplaces were purposively allocated to control, nutrition education alone (Education), environmental dietary modification alone (Environment) and nutrition education and environmental dietary modification (Combined intervention). The interventions were guided by the MRC framework. In the control workplace, data were collected at baseline and follow-up. In the intervention related sub-study, the relationships between nutrition knowledge, diet quality and hypertension were examined. Results The systematic review provided limited evidence. In the FCW study, 850 employees aged 18-64 years were recruited at baseline with N(response rate %) in each workplace as follows: Control: 111(72%), Education: 226(71%), Environment: 113(91%), Combined intervention: 400(61%). Complete follow-up data was obtained for 517 employees (61%). There were significant positive changes in dietary intakes of saturated fat(p=0.013), salt(p=0.010) and nutrition knowledge(p=0.034) between baseline and follow-up at 7-9 months in the combined intervention versus the control workplace in the fully adjusted multivariate analysis. Small but significant changes in BMI(-1.2kg/m2 (p=0.047) were also observed in the combined intervention. In the sub-study, nutrition knowledge was positively significantly associated with diet quality and blood pressure but no evidence of a mediation effect of the DASH score was detected between nutrition knowledge and blood pressure. Conclusion This thesis provides critical evidence on the effectiveness of complex workplace dietary interventions in a manufacturing working population.
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Purines are nitrogen-rich compounds that are widely distributed in the marine environment and are an important component of the dissolved organic nitrogen (DON) pool. Even though purines have been shown to be degraded by bacterioplankton, the identities of marine bacteria capable of purine degradation and their underlying catabolic mechanisms are currently unknown. This study shows that Ruegeria pomeroyi, a model marine bacterium and Marine Roseobacter Clade (MRC) representative, utilizes xanthine as a source of carbon and nitrogen. The R. pomeroyi genome contains putative genes that encode xanthine dehydrogenase (XDH), which is expressed during growth with xanthine. RNAseq-based analysis of the R. pomeroyi transcriptome revealed that the transcription of an XDH-initiated catabolic pathway is up-regulated during growth with xanthine, with transcription greatest when xanthine was the only available carbon source. The RNAseq-deduced pathway indicates that glyoxylate and ammonia are the key intermediates from xanthine degradation. Utilising a laboratory model, this study has identified the potential genes and catabolic pathway active during xanthine degradation. The ability of R. pomeroyi to utilize xanthine provides novel insights into the capabilities of the MRC that may contribute to their success in marine ecosystems and the potential biogeochemical importance of the group in processing DON.
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Purines are nitrogen-rich compounds that are widely distributed in the marine environment and are an important component of the dissolved organic nitrogen (DON) pool. Even though purines have been shown to be degraded by bacterioplankton, the identities of marine bacteria capable of purine degradation and their underlying catabolic mechanisms are currently unknown. This study shows that Ruegeria pomeroyi, a model marine bacterium and Marine Roseobacter Clade (MRC) representative, utilizes xanthine as a source of carbon and nitrogen. The R. pomeroyi genome contains putative genes that encode xanthine dehydrogenase (XDH), which is expressed during growth with xanthine. RNAseq-based analysis of the R. pomeroyi transcriptome revealed that the transcription of an XDH-initiated catabolic pathway is up-regulated during growth with xanthine, with transcription greatest when xanthine was the only available carbon source. The RNAseq-deduced pathway indicates that glyoxylate and ammonia are the key intermediates from xanthine degradation. Utilising a laboratory model, this study has identified the potential genes and catabolic pathway active during xanthine degradation. The ability of R. pomeroyi to utilize xanthine provides novel insights into the capabilities of the MRC that may contribute to their success in marine ecosystems and the potential biogeochemical importance of the group in processing DON.
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BACKGROUND: REAL3 (Randomised ECF for Advanced or Locally advanced oesophagogastric cancer 3) was a phase II/III trial designed to evaluate the addition of panitumumab (P) to epirubicin, oxaliplatin and capecitabine (EOC) in untreated advanced oesophagogastric adenocarcinoma, or undifferentiated carcinoma. MAGIC (MRC Adjuvant Gastric Infusional Chemotherapy) was a phase III study which demonstrated that peri-operative epirubicin, cisplatin and infused 5-fluorouracil (ECF) improved survival in early oesophagogastric adenocarcinoma. PATIENTS AND METHODS: Analysis of response rate (RR; the primary end-point of phase II) and biomarkers in the first 200 patients randomised to EOC or modified dose (m) EOC+P in REAL3 was pre-planned to determine if molecular selection for the on-going study was indicated. KRAS, BRAF and PIK3CA mutations and PTEN expression were assessed in pre-treatment biopsies and results correlated with response to mEOC+P. Association between these biomarkers and overall survival (OS) was assessed in MAGIC patients to determine any prognostic effect. RESULTS: RR was 52% to mEOC+P, 48% to EOC. Results from 175 assessable biopsies: mutations in KRAS (5.7%), BRAF (0%), PIK3CA (2.5%) and loss of PTEN expression (15.0%). None of the biomarkers evaluated predicted resistance to mEOC+P. In MAGIC, mutations in KRAS, BRAF and PIK3CA and loss of PTEN (phosphatase and tensin homolog) were found in 6.3%, 1.0%, 5.0% and 10.9%, respectively, and were not associated with survival. CONCLUSIONS: The RR of 52% in REAL3 with mEOC+P met pre-defined criteria to continue accrual to phase III. The frequency of the mutations was too low to exclude any prognostic or predictive effect.
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We investigate the secrecy performance of dualhop amplify-and-forward (AF) multi-antenna relaying systems over Rayleigh fading channels, by taking into account the direct link between the source and destination. In order to exploit the available direct link and the multiple antennas for secrecy improvement, different linear processing schemes at the relay and different diversity combining techniques at the destination are proposed, namely, 1) Zero-forcing/Maximal ratio combining (ZF/MRC), 2) ZF/Selection combining (ZF/SC), 3) Maximal ratio transmission/MRC (MRT/MRC) and 4) MRT/Selection combining (MRT/SC). For all these schemes, we present new closed-form approximations for the secrecy outage probability. Moreover, we investigate a benchmark scheme, i.e., cooperative jamming/ZF (CJ/ZF), where the secrecy outage probability is obtained in exact closed-form. In addition, we present asymptotic secrecy outage expressions for all the proposed schemes in the high signal-to-noise ratio (SNR) regime, in order to characterize key design parameters, such as secrecy diversity order and secrecy array gain. The outcomes of this paper can be summarized as follows: a) MRT/MRC and MRT/SC achieve a full diversity order of M + 1, ZF/MRC and ZF/SC achieve a diversity order of M, while CJ/ZF only achieves unit diversity order, where M is the number of antennas at the relay. b) ZF/MRC (ZF/SC) outperforms the corresponding MRT/MRC (MRT/SC) in the low SNR regime, while becomes inferior to the corresponding MRT/MRC (MRT/SC) in the high SNR. c) All of the proposed schemes tend to outperform the CJ/ZF with moderate number of antennas, and linear processing schemes with MRC attain better performance than those with SC.
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This paper investigates the achievable sum-rate of uplink massive multiple-input multiple-output (MIMO) systems considering a practical channel impairment, namely, aged channel state information (CSI). Taking into account both maximum ratio combining (MRC) and zero-forcing (ZF) receivers at the base station, we present tight closed-form lower bounds on the sum-rate for both receivers, which provide efficient means to evaluate the sum-rate of the system. More importantly, we characterize the impact of channel aging on the power scaling law. Specifically, we show that the transmit power of each user can be scaled down by 1/√(M), which indicates that aged CSI does not affect the power scaling law; instead, it causes only a reduction on the sum rate by reducing the effective signal-to-interference-and-noise ratio (SINR).
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In this paper, we consider the uplink of a single-cell massive multiple-input multiple-output (MIMO) system with inphase and quadrature-phase imbalance (IQI). This scenario is of particular importance in massive MIMO systems, where the deployment of lower-cost, lower-quality components is desirable to make massive MIMO a viable technology. Particularly, we investigate the effect of IQI on the performance of massive MIMO employing maximum-ratio combining (MRC) receivers. In order to study how IQI affects channel estimation, we derive a new channel estimator for the IQI-impaired model and show that IQI can substantially downgrade the performance of MRC receivers. Moreover, a low-complexity IQI compensation scheme, suitable for massive MIMO, is proposed which is based on the IQI coefficients' estimation and it is independent of the channel gain. The performance of the proposed compensation scheme is analytically evaluated by deriving a tractable approximation of the ergodic achievable rate and providing the asymptotic power scaling laws assuming transmission over Rayleigh fading channels with log-normal large-scale fading. Finally, we show that massive MIMO effectively suppresses the residual IQI effects, as long as, the compensation scheme is applied.
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This paper studies the impact of in-phase and quadrature-phase imbalance (IQI) in two-way amplify-and-forward (AF) relaying systems. In particular, the effective signal-to-interference-plus-noise ratio (SINR) is derived for each source node, considering four different linear detection schemes, namely, uncompensated (Uncomp) scheme, maximal-ratio-combining (MRC), zero-forcing (ZF) and minimum mean-square error (MMSE) based schemes. For each proposed scheme, the outage probability (OP) is investigated over independent, non-identically distributed Nakagami-m fading channels, and exact closed-form expressions are derived for the first three schemes. Based on the closed-form OP expressions, an adaptive detection mode switching scheme is designed for minimizing the OP of both sources. An important observation is that, regardless of the channel conditions and transmit powers, the ZF-based scheme should always be selected if the target SINR is larger than 3 (4.77dB), while the MRC-based scheme should be avoided if the target SINR is larger than 0.38 (-4.20dB).
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Massive multi-user multiple-input multiple-output (MU-MIMO) systems are cellular networks where the base stations (BSs) are equipped with hundreds of antennas, N, and communicate with tens of mobile stations (MSs), K, such that, N ≫ K ≫ 1. Contrary to most prior works, in this paper, we consider the uplink of a single-cell massive MIMO system operating in sparse channels with limited scattering. This case is of particular importance in most propagation scenarios, where the prevalent Rayleigh fading assumption becomes idealistic. We derive analytical approximations for the achievable rates of maximum-ratio combining (MRC) and zero-forcing (ZF) receivers. Furthermore, we study the asymptotic behavior of the achievable rates for both MRC and ZF receivers, when N and K go to infinity under the condition that N/K → c ≥ 1. Our results indicate that the achievable rate of MRC receivers reaches an asymptotic saturation limit, whereas the achievable rate of ZF receivers grows logarithmically with the number of MSs.
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Le développement durable et la participation citoyenne sont deux termes très en vogue actuellement. Ils sont utilisés de bien des manières et même parfois de façon détournée. Néanmoins, il est de plus en plus fréquent de voir la participation citoyenne et le développement durable être associés. Cela provient du fait que pour les tenants de cette fusion, pour qu’il y ait développement durable il doit y avoir une forme de participation citoyenne. Ce lien théorique entre les deux concepts est vrai pour ses adhérents puisque ce doit être les citoyens impliqués dans le développement qui doivent guider en partie l’élaboration de la politique de développement durable. Les politiques d’urbanismes sont parmi les politiques les plus importantes pour créer un développement durable puisqu’elle combine à la fois le transport et l’aménagement du territoire selon une perspective économique, sociale et environnementale. De plus, ce sont les politiques d’urbanismes qui gèrent les milieux naturels. Pour Gauthier et Gagnon (2013) afin qu’une politique d’urbanisme durable émerge il doit y avoir une forme spécifique de participation citoyenne soit une participation citoyenne significative. Le Schéma d’aménagement et de développement de la Ville de Sherbrooke est en fait une politique d’urbanisme tendant vers le développement durable qui a inclus une démarche de participation citoyenne. Une grille d’analyse basée sur les travaux de M. Gauthier et de Mme Gagnon a permis de savoir si l'outil de participation citoyenne utilisée par la Ville de Sherbrooke dans le cadre de l’élaboration de son schéma d’aménagement et de développement adopté en 2013 a permis une participation citoyenne significative selon les huit critères établis par Mario Gauthier et Lynda Gagnon (2013)? Deux citoyens, une élue de la Ville, une fonctionnaire responsable du Schéma et trois représentants d’associations ont donné leurs perceptions dans des entrevues semi-dirigées afin de qualifier la participation citoyenne lors de l’élaboration du Schéma d’aménagement de la Ville. Les perceptions des participants n’ont pas permis de qualifier le processus participatif de la Ville. Il est donc impossible pour le chercheur de confirmer si la démarche de participation citoyenne est significative ou non. La Loi sur l’urbanisme et l’aménagement du Québec (LAU) a influencé de façon non significative la participation citoyenne lors de l’élaboration du Schéma. Il est clair que celle-ci a une influence en instituant de façon obligatoire la participation citoyenne lors de l’élaboration de Schéma d’aménagement et de développement des MRC, mais malgré les critères obligatoires de bases ce n’est pas la LAU qui a influencé de manière significative la participation citoyenne dans la forme analysée.
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Au Québec, environ un million de résidences sont isolées des réseaux d’égouts municipaux et doivent traiter leurs eaux usées à l’aide de systèmes d’assainissement autonomes. Également nommés installations septiques, ces systèmes sont susceptibles de contaminer l’environnement lorsqu’ils sont défaillants, désuets ou non conformes. Les épisodes de cyanobactéries survenus de 2006 à 2012 dans les plans d’eau québécois ont été attribués à d’importants apports de phosphore, que libèrent notamment les installations septiques polluantes. Les municipalités, les municipalités régionales de comté et les régies intermunicipales ont des compétences et des obligations en vertu du Règlement sur l’évacuation et le traitement des eaux usées des résidences isolées et de l’article 25.1 de la Loi sur les compétences municipales portant sur une gestion adéquate des installations septiques. Une gestion optimale de celles-ci permettant de protéger l’environnement et de prévenir la contamination est possible par la mise en place d’un programme de gestion qui concerne plus spécifiquement la vidange des fosses septiques et l’inspection des systèmes. L’objectif de cet essai est de faire une analyse des éléments constituants d’un programme de gestion des installations septiques et de discuter de leur mise en oeuvre pour assurer leur fonctionnement optimal. L’essai a été rédigé de manière à présenter l’information sous forme de lignes directrices pour guider les gestionnaires de programme ainsi que les preneurs de décisions. Un programme de gestion optimal se traduit par la prise en charge de la vidange des fosses septiques d’un territoire par une des trois entités municipales qui peuvent exercer un meilleur contrôle des systèmes d’épuration autonomes par la vidange des fosses septiques et de leur inspection régulière. Les inspections prennent la forme de relevés sanitaires qui permettent de classifier les installations en fonction de leur performance et d’inspections sommaires qui visent à faire un diagnostic simple et rapide d’une installation. Plusieurs autres éléments doivent être pris en compte dans le cadre d’un programme de gestion. Soit l’application d’un règlement municipal, la fréquence et le type de vidange, le recours à des experts, la sensibilisation des propriétaires des systèmes d’épuration autonomes, une démarche d’acceptabilité sociale et l’emploi de logiciels de suivi. L’efficacité d’un programme de gestion dépendra de la rigueur avec laquelle les instances municipales appliqueront les éléments de gestion. Il est recommandé au ministère du Développement durable, de l’Environnement et de la Lutte contre les changements climatiques d’apporter des modifications au règlement provincial dans le but de le rendre plus contraignant pour les systèmes vecteurs de contamination indirecte et ceux antérieurs à 1981. Le ministère des Affaires municipales et de l’Occupation du territoire devrait offrir son soutien aux municipalités dans le cadre de leur programme de gestion en offrant de l’aide financière, de la documentation et des formations.
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G6PC3 is a widely expressed isoform of glucose-6-phosphatase, found in many foetal and adult tissues. Mutations in this gene cause developmental abnormalities and severe neutropenia due to abolition of glucose recycling between the cytoplasm and endoplasmic reticulum. Low G6PC3 expression as a result of promoter polymorphisms or dysregulation could produce similar outcomes. Here we investigated the regulation of human G6PC3 promoter activity. HeLa and H4IIE cells were transiently transfected with G6PC3 promoter coupled to the firefly luciferase gene, and promoter activity was measured by dual luciferase assay. Activity was highest in a 453 bp segment of the G6PC3 promoter, from − 455 to − 3 relative to the transcriptional start site. This promoter was unresponsive to glucostatic hormones. Its activity increased significantly between 1 and 5.5 mM glucose, and was not elevated further by glucose concentrations up to 25 mM. Pyruvate increased its activity, but β-hydroxybutyrate and sodium acetate did not. Promoter activity was reduced by inhibitors of hexokinase, glyceraldehyde phosphate dehydrogenase and the oxidative branch of the pentose phosphate pathway, but not by a transketolase inhibitor. Deletion of two adjacent Enhancer-boxes (− 274 to − 279 and − 299 to − 304) reduced promoter activity and abolished the glucose effect, suggesting they could function as a glucose response element. Deletion of an additional downstream 140 bp (− 140 to − 306) restored activity, but not the glucose response, suggesting the presence of repressor elements in this region. 5-Aminoimidazole-4-carboxamide 1-β-d-ribofuranoside (AICAR) reduced promoter activity, showing dependence on AMP-kinase. Regulation of the G6PC3 promoter is thus radically different to that of the hepatic isoform, G6PC. It is sensitive to carbohydrate, but not to fatty acid metabolites, and at much lower physiological concentrations. Based on these findings, we speculate that reduced G6PC3 expression could occur during hypoglycemic episodes in vivo, which are common in utero and in the postnatal period. If such episodes lower G6PC3 expression they could place the foetus or infant at risk of impaired immune function and development, and this possibility requires further examination both in vitro and in vivo.
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Introduction La progression de la maladie rénale chronique (MRC) augmente le risque des maladies cardiovasculaires. L’hypertension, le diabète et la dyslipidémie sont à la fois des facteurs de risque et des comorbidités de la MRC. Chez les individus souffrant de MRC, la persistance et l’observance du traitement de ces facteurs de risque, i.e. le traitement antihypertenseur (TAH), le traitement hypolipémiant (THL) et le traitement antidiabétique (TAD) contribuent à réduire le risque de mortalité et de morbidité cardiovasculaires. Néanmoins, la persistance et l’observance de ces traitements restent encore peu étudiées chez les individus ayant la MRC. Objectifs: Spécifiquement pour chacun des trois traitements (TAH, THL et TAD), une étude de cohorte a été menée dans le but : 1) d’estimer la persistance à prendre le traitement un an après le début du traitement; 2) d’estimer l’observance du traitement au cours de l’année suivant le début du traitement chez les persistants; 3) d’identifier les facteurs associés à la persistance; et 4) d’identifier les facteurs associés à l’observance. Méthodologie: Nous avons utilisé les banques de données administratives de la Régie de l’assurance maladie du Québec (RAMQ) pour mener trois études de cohorte chez les personnes âgées de 18 ans ou plus. Une étude a été conduite chez les individus qui ont commencé un TAH, l’autre conduite chez les patients ayant commencé un THL et la dernière menée chez les nouveaux utilisateurs de TAD. Les individus qui poursuivaient encore leur traitement un an après son début ont été considérés persistants. Parmi les persistants, les patients qui ont eu une proportion de jours couverts (PJC) ≥ 80 % ont été considérés observants. Les facteurs associés à la persistance et ceux associés à l’observance ont été identifiés à l’aide d’une régression de Poisson modifiée. Résultats: Parmi les 7 119 patients ayant débuté un TAH, 78,8 % ont été persistants et 87,7 % des persistants ont été observants. Les individus qui étaient plus susceptibles d’être persistants se trouvaient dans le groupe des utilisateurs de monothérapie d’inhibiteurs de l’enzyme de conversion de l’angiotensine (IECA) (Rapport de prévalences (RP) : 1,20; intervalle de confiance (IC) à 95 % : 1,13-1,27), d’antagonistes du récepteur de l’angiotensine II (ARA) (1,22; 1,14-1,31), de bloquants des canaux calciques (BCC) (1,20; 1,14-1,26), de bêta-bloquants (BB) (1,16; 1,10-1,23) et de multithérapie (1,31; 1,25-1,38) (référence : monothérapie de diurétiques (DIU)). Les individus qui étaient plus susceptibles d’être observants étaient les utilisateurs de monothérapie d’IECA (1,08; 1,03-1,04), de BB (1,10; 1,05-1,15), de BCC (1,10; 1,05-1,15) et de multithérapie. Des 14 607 individus ayant débuté un THL, 80,7 % ont persisté à le prendre; de ces derniers, 88,7 % étaient observants du THL. Les patients qui étaient plus susceptibles d’être persistants étaient ceux ayant un statut socio-économique (SSE) faible (1,03; 1,01-1,06) (référence : SSE élevé) et ceux dont le traitement initial avait été prescrit par un néphrologue (1,06; 1,04-1,09) (référence : omnipraticien). Les individus qui étaient plus susceptibles d’être observants étaient ceux âgés ≥ 66 ans (référence : 18-65) (1,04; 1,01-1,07), ceux ayant un SSE faible (1,08; 1,06-1,10) et ceux qui avaient pris plus de 12 médicaments différents (référence : <7) (1,03; 1.00-1,05). Sur un total de 6 671 individus ayant débuté un TAD, 76,9 % ont persisté à prendre le traitement. Parmi les persistants, 87,9 % étaient observants. Les individus ayant un SSE faible (1,04; 1,01-1,07) (référence : SSE élevé) ou une multithérapie (1,12; 1,08-1,16) (référence : monothérapie de metformine) étaient plus susceptibles d’être persistants, tout comme ceux ayant une comorbidité dont l’hypertension artérielle (1,04; 1,01-1,07), la dyslipidémie (1,06; 1,03-1,10), l’accident vasculaire cérébral (AVC) (1,05; 1,01-1,11) ou la maladie coronarienne (1,03; 1,01-1,06). Les individus plus susceptibles d’être observants étaient ceux ayant un SSE moyen (1,03; 1,01-1,07) ou une multithérapie (1,06; 1,03-1,09). Conclusion: Peu importe le traitement initié par les individus souffrant de MRC, environ 30% des patients ne seraient pas persistants un an après le début du traitement ou observants dans l’année suivant l’initiation. Certains facteurs sont associés de façon consistante à la persistance, par exemple l’AVC, la maladie coronarienne et le nombre de visites médicales, alors que l’âge et le SSE sont associés à l’observance peu importe que le traitement initial soit un TAH, un THL ou un TAD.
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Aim This paper will report findings from the first phase of an evaluation of a new e-health intervention designed to allow mothers to ‘see’ their baby in neonatal care (NNU) when they are not able to be with them. The intervention, MyLittleOne, involves a web-camera being placed over the incubator in NNU, which transmits a real-time video wirelessly to a coupled tablet device at the mother’s bedside. Guided by the MRC Framework for the Development and Evaluation of Healthcare Interventions (MRC, 2008), the aim was to explore parent and professional views of the technology and make recommendations for its future development, use and evaluation. Methods A qualitative approach was adopted, guided by a critical realist perspective (McEvoy and Richards, 2003). The study took place in a Level 3 NNU in Scotland. Participants were recruited purposively and included parents (n = 33) and a range of health professionals working in neonatal and postnatal care (n = 21). The data were collected during semi-structured individual, paired and small group interviews and were analysed thematically using NVivo v10. Results The majority of parents and professionals spoke positively about MyLittleOne. Perceptions were that: use of the technology assisted bonding and responsiveness; it promoted the recovery process following birth; and, for mothers who wished to breast-feed, being able to see their baby on the tablet device encouraged the ‘let-down’ reflex. An additional benefit was that siblings and others who may not be able to visit the NNU were able to see the baby. In contrast, for a small number of mothers, viewing their baby remotely appeared to increase their levels of anxiety. Switching off the camera during a medical procedure and back on after the procedure was completed was found to be problematic, at times and in different ways, for both parents and professionals. Conclusions Findings from this preliminary evaluation will guide future developments of the technology, including its use in family homes following the mother’s discharge. The findings will also inform the design of a feasibility study and subsequent RCT to assess the impact of MyLittleOne on a range of psychological indicators of postnatal adjustment.