Poots launches £18m state-of-the-art Telemonitoring NI service

Health Minister Edwin Poots today marked the roll-out of a ground-breaking hi-tech scheme which will enable more patients to monitor their health in their own homes. Following funding of £18m from the Department of Health, the newly named Centre for Connected Health and Social Care (CCHSC), part of the Public Health Agency, worked in partnership with business consortium TF3to establish the innovative Telemonitoring NI service. The service is now being delivered by the TF3 consortium in partnership with the Health and Social Care Trusts.Remote telemonitoring combines technology and services that enable patients with chronic diseases to test their vital signs such as pulse, blood pressure, body weight, temperature, blood glucose and oxygen levels at home on a daily basis. The service will now be rolled out to 3,500 patients across Northern Ireland per annum for a period of six years.Mr Poots today visited the home of Larne pensioner Michael Howard who has Chronic Pulmonary Obstructive Disorder (COPD) to hear how Telemonitoring NI has changed his life.During the visit Mr Poots said: "Chronic diseases such as heart disease, diabetes and COPD affect around three quarters of people over the age of 75. This is the generation from whom transport and mobility pose the biggest problems. The Telemonitoring NI service will allow thousands to monitor their vital signs without having to leave their own homes."It means that patients are able to understand and manage their condition better. Many say it has improved their confidence and given them peace of mind. With a health professional monitoring each patient's health on a daily basis, there is less need for hospital admission. Carers are also better informed with the pro-active support provided. It means earlier intervention in, and the prevention of, deterioration of condition, acute illness and hospital admissions."Telemonitoring NI is an excellent example of how the Health Service can innovateusing modern technology to deliver a better service for our patients."Eddie Ritson, Programme Director of CCHSC, PHA, said: "The roll-out of Telemonitoring NI represents a significant step towards providing quality care for the growing number of people with heart disease, stroke, some respiratory conditions and diabetes who want to live at home while having their conditions safely managed."This new service will give people more information which combined with timely advice will enable patients to gain more control over their health while supporting them to live independently in their own homes for longer."A patient will take their vital sign measurements at home, usually on a daily basis. and these will automatically be transmited to the Tf3 system. The resulting readings are monitored centrally by a healthcare professional working in the Tf3 triage team. If the patient's readings show signs of deterioration to an unacceptable level, they will be contacted by phone by a nurse working in a central team and if appropriate a healthcare professional in the patient's local Trust will be alerted to enable them to take appropriate action."Families and carers will also benefit from the reassurance that chronic health conditions are being closely monitored on an ongoing basis. The information collected through the service can also be used by doctors, nurses and patients in making decisions on how individual cases should be managed. "Using the service, Mr Howard, 71, who has emphysema - a long-term, progressive disease of the lungs that primarily causes shortness of breath - monitors his vital signs using the new technology every weekday morning. The information is monitored centrally and if readings show signs of deterioration to an unacceptable level, Mr Howard's local healthcare professional is alerted."Taking my readings is such a simple process but one that gives me huge benefits as it is an early warning system to me and also for the specialist nurses in charge of my care. Without the remote telemonitoring I would be running back and forward to the GPs' surgery all the time to have things checked out," he explained."Having my signs monitored by a nurse means any changes in my condition are dealt with immediately and this has prevented me from being admitted to hospital - in the past I've had to spend six days in hospital any time I'm admitted with a chest infection."The telemonitoring is not only reassuring for me, it also gives me more control over managing my own condition and as a result I have less upheaval in my life, and I'm less of a cost to the health care system. Most importantly, it gives me peace of mind and one less thing to worry about at my age."Patients seeking further information about the new telemonitoring service should contact their healthcare professional.

Social inequalities in health. New evidence and policy implications

Health inequalities according to people's social standing are persisting, or even growing, in modern societies. Recent decades have revealed evidence of strong variations in life expectancy, both between countries and within them. This widening of social inequalities has developed despite considerable progress in medical science and an increase in health care spending. The reasons behind this are complex, and the implications considerable.   This book provides a summary of the major achievements of a five-year European Science Foundation (ESF) Programme on 'Social Variations in Health Expectancy in Europe'. The contributors are major figures in their subjects, and combine state of the art reviews with the latest results from interdisciplinary research in epidemiology, sociology, psychology and biomedicine.   Three conceptual frameworks of life course influences, health effects of stressful environments, and macro social determinants of health, are unified, while each chapter addresses the policy implications and recommendations derived from currently available evidence. The major topics covered include the role of family in early life, social integration and health, work stress and job security, successful ways of facing adversity, and the impact of the larger environment on health. Epidemiologists, public health research and policy makers, and students of related public health and sociology courses wlll find the results of this research fascinating.This resource was contributed by The National Documentation Centre on Drug Use.

What new cell biology findings could bring to therapeutics: is it time for a phenome-project in Toxoplasma gondii?

"If you know the enemy and know yourself, you need not fear the result of a hundred battles. If you know yourself but not the enemy, for every victory gained you will also suffer a defeat" (SunTzu the Art of War, 544-496 BC). Although written for the managing of conflicts and winning clear victories, this basic guideline can be directly transferred to our battle against apicomplexan parasites and how to focus future basic research in order to transfer the gained knowledge to a therapeutic intervention stratey. Over the last two decades the establishment of several key-technologies, by different groups working on Toxoplasma gondii, made this important human pathogen accessible to modern approaches in molecular cell biology. In fact more and more researchers get attracted to this easy accessible model organism to study specific biological questions, unique to apicomplexans. This fascinating, unique biology might provide us with new therapeutic options in our battle against apicomplexan parasites by finding its Achilles' heel. In this article we argue that in the absence of a powerful high throughput technology for the characterisation of essential gene of interests a coordinated effort should be undertaken to convert our knowledge of the genome into one of the phenome.

Biomarkers of therapeutic responses in chronic Chagas disease: state of the art and future perspectives

The definition of a biomarker provided by the World Health Organization is any substance, structure, or process that can be measured in the body, or its products and influence, or predict the incidence or outcome of disease. Currently, the lack of prognosis and progression markers for chronic Chagas disease has posed limitations for testing new drugs to treat this neglected disease. Several molecules and techniques to detect biomarkers inTrypanosoma cruzi-infected patients have been proposed to assess whether specific treatment with benznidazole or nifurtimox is effective. Isolated proteins or protein groups from different T. cruzistages and parasite-derived glycoproteins and synthetic neoglycoconjugates have been demonstrated to be useful for this purpose, as have nucleic acid amplification techniques. The amplification of T. cruziDNA using the real-time polymerase chain reaction method is the leading test for assessing responses to treatment in a short period of time. Biochemical biomarkers have been tested early after specific treatment. Cytokines and surface markers represent promising molecules for the characterisation of host cellular responses, but need to be further assessed.

A new factor stimulating peptidoglycan hydrolysis to separate daughter cells in Caulobacter crescentus.

Cell division in Gram-negative bacteria involves the co-ordinated invagination of the three cell envelope layers to form two new daughter cell poles. This complex process starts with the polymerization of the tubulin-like protein FtsZ into a Z-ring at mid-cell, which drives cytokinesis and recruits numerous other proteins to the division site. These proteins are involved in Z-ring constriction, inner- and outer-membrane invagination, peptidoglycan remodelling and daughter cell separation. Three papers in this issue of Molecular Microbiology, from the teams of Lucy Shapiro, Martin Thanbichler and Christine Jacobs-Wagner, describe a novel protein, called DipM for Division Involved Protein with LysM domains, that is required for cell division in Caulobacter crescentus. DipM localizes to the mid-cell during cell division, where it is necessary for the hydrolysis of the septal peptidoglycan to remodel the cell wall. Loss of DipM results in severe defects in cell envelope constriction, which is deleterious under fast-growth conditions. State-of-the-art microscopy experiments reveal that the peptidoglycan is thicker and that the cell wall is incorrectly organized in DipM-depleted cells compared with wild-type cells, demonstrating that DipM is essential for reorganizing the cell wall at the division site, for envelope invagination and cell separation in Caulobacter.

Open minded and open access: introducing NeoBiota, a new peer-reviewed journal of biological invasions

The Editorial presents the focus, scope, policies, and the inaugural issue of NeoBiota, a new open access peer-reviewed journal of biological invasions. The new journal NeoBiota is a continuation of the former NEOBIOTA publication series. The journal will deal with all aspects of invasion biology and impose no restrictions on manuscript size neither on use of color. NeoBiota implies an XML-based editorial workflow and several cutting-edge innovations in publishing and dissemination, such as semantic markup of and enhancements to published texts, data publication, and extensive cross-linking within the journal and to external sources

Development and validation of AMANDA, a new algorithm for selecting highly relevant regions in Molecular Interaction Fields

Descriptors based on Molecular Interaction Fields (MIF) are highly suitable for drug discovery, but their size (thousands of variables) often limits their application in practice. Here we describe a simple and fast computational method that extracts from a MIF a handful of highly informative points (hot spots) which summarize the most relevant information. The method was specifically developed for drug discovery, is fast, and does not require human supervision, being suitable for its application on very large series of compounds. The quality of the results has been tested by running the method on the ligand structure of a large number of ligand-receptor complexes and then comparing the position of the selected hot spots with actual atoms of the receptor. As an additional test, the hot spots obtained with the novel method were used to obtain GRIND-like molecular descriptors which were compared with the original GRIND. In both cases the results show that the novel method is highly suitable for describing ligand-receptor interactions and compares favorably with other state-of-the-art methods.

A two-stage approach for tonic identification in indian art music

In this paper we propose a new approach for tonic identification in Indian art music and present a proposal for acomplete iterative system for the same. Our method splits the task of tonic pitch identification into two stages. In the first stage, which is applicable to both vocal and instrumental music, we perform a multi-pitch analysis of the audio signal to identify the tonic pitch-class. Multi-pitch analysisallows us to take advantage of the drone sound, which constantlyreinforces the tonic. In the second stage we estimate the octave in which the tonic of the singer lies and is thusneeded only for the vocal performances. We analyse the predominant melody sung by the lead performer in order to establish the tonic octave. Both stages are individually evaluated on a sizable music collection and are shown toobtain a good accuracy. We also discuss the types of errors made by the method.Further, we present a proposal for a system that aims to incrementally utilize all the available data, both audio and metadata in order to identify the tonic pitch. It produces a tonic estimate and a confidence value, and is iterative in nature. At each iteration, more data is fed into the systemuntil the confidence value for the identified tonic is above a defined threshold. Rather than obtain high overall accuracy for our complete database, ultimately our goal is to develop a system which obtains very high accuracy on a subset of the database with maximum confidence.

Opportunities for a cultural specific approach in the computational description of music

The current research in Music Information Retrieval (MIR) is showing the potential that the Information Technologies can have in music related applications. Amajor research challenge in that direction is how to automaticallydescribe/annotate audio recordings and how to use the resulting descriptions to discover and appreciate music in new ways. But music is a complex phenomenonand the description of an audio recording has to deal with this complexity. For example, each musicculture has specificities and emphasizes different musicaland communication aspects, thus the musical recordings of each culture should be described differently. At the same time these cultural specificities give us the opportunity to pay attention to musical concepts andfacets that, despite being present in most world musics, are not easily noticed by listeners. In this paper we present some of the work done in the CompMusic project, including ideas and specific examples on how to take advantage of the cultural specificities of differentmusical repertoires. We will use examples from the art music traditions of India, Turkey and China.

L'erreur en médecine ambulatoire: comment l'aborder. [Error in ambulatory medicine: how to deal with it?]

Medical errors compromise patient safety in ambulatory practice. These errors must be faced in a framework that reduces to a minimum their consequences for the patients. This approach relies on the implementation of a new culture without stigmatization and where errors are disclosed to the patients; this culture implies the build up of a system for reporting errors associated to an in-depth analysis of the system, looking for root causes and insufficient barriers with the aim to fix them. A useful education tool is the "critical situations" meeting during which physicians are encouraged to openly present adverse events and "near misses". Their analysis, with supportive attitude towards involved staff members, allows to reveal systems failures within the institution or the private practice.

Transcatheter aortic valve implantation (TAVI): state of the art techniques and future perspectives.

Transcatheter aortic valve therapies are the newest established techniques for the treatment of high risk patients affected by severe symptomatic aortic valve stenosis. The transapical approach requires a left anterolateral mini-thoracotomy, whereas the transfemoral method requires an adequate peripheral vascular access and can be performed fully percutaneously. Alternatively, the trans-subclavian access has been recently proposed as a third promising approach. Depending on the technique, the fine stent-valve positioning can be performed with or without contrast injections. The transapical echo-guided stent-valve implantation without angiography (the Lausanne technique) relies entirely on transoesophageal echocardiogramme imaging for the fine stent-valve positioning and it has been proved that this technique prevents the onset of postoperative contrast-related acute kidney failure. Recent published reports have shown good hospital outcomes and short-term results after transcatheter aortic valve implantation, but there are no proven advantages in using the transfemoral or the transapical technique. In particular, the transapical series have a higher mean logistic Euroscore of 27-35%, a procedural success rate above 95% and a mean 30-day mortality between 7.5 and 17.5%, whereas the transfemoral results show a lower logistic Euroscore of 23-25.5%, a procedural success rate above 90% and a 30-day mortality of 7-10.8%. Nevertheless, further clinical trials and long-term results are mandatory to confirm this positive trend. Future perspectives in transcatheter aortic valve therapies would be the development of intravascular devices for the ablation of the diseased valve leaflets and the launch of new stent-valves with improved haemodynamic, different sizes and smaller delivery systems.

You’re the COACH!: A Guide for Parents of New Drivers, June 23, 2008

This publication is a guide for parents and guardians of teenagers learning to drive. It should be used with the Iowa Driver’s Manual to aid you in instructing your new driver about how to safely and responsibly operate a motor vehicle. Since the task of driving is affected by changing conditions, this manual does not attempt to cover all situations that may arise. Under Iowa’s graduated driver licensing system young drivers must complete 20 hours of supervised drive time with their parents or guardians during the instruction permit stage and 10 hours during the intermediate license stage. Even though your teenager is taking or has completed driver education in school, there is a great deal of benefit to be obtained from you providing this additional practice time. Learning from your experience and under your guidance, your teenager will apply the rules of the road and more fully understand the risks involved in driving. This will require time and patience on your part, but the effort will result in you knowing that your teenager will be better able to cope with the demands of safe driving. In the back of this manual you will find several pages of diagrams. Use these diagrams to illustrate different driving situations for your teenage driver. Consider taking a notepad and pencil along during your practice sessions for additional drawings. This manual also contains a chart to log your supervised drive time. As your new driver advances through the graduated system you will be required to certify to an Iowa driver’s license examiner that you completed the minimum number of hours of supervised drive time. By becoming involved in the learning driver’s educational process, you are contributing to Iowa’s overall highway safety effort and helping your teenager develop safe driving habits that will last a lifetime.

Dense deformation field estimation for atlas-based segmentation of pathological MR brain images.

Atlas registration is a recognized paradigm for the automatic segmentation of normal MR brain images. Unfortunately, atlas-based segmentation has been of limited use in presence of large space-occupying lesions. In fact, brain deformations induced by such lesions are added to normal anatomical variability and they may dramatically shift and deform anatomically or functionally important brain structures. In this work, we chose to focus on the problem of inter-subject registration of MR images with large tumors, inducing a significant shift of surrounding anatomical structures. First, a brief survey of the existing methods that have been proposed to deal with this problem is presented. This introduces the discussion about the requirements and desirable properties that we consider necessary to be fulfilled by a registration method in this context: To have a dense and smooth deformation field and a model of lesion growth, to model different deformability for some structures, to introduce more prior knowledge, and to use voxel-based features with a similarity measure robust to intensity differences. In a second part of this work, we propose a new approach that overcomes some of the main limitations of the existing techniques while complying with most of the desired requirements above. Our algorithm combines the mathematical framework for computing a variational flow proposed by Hermosillo et al. [G. Hermosillo, C. Chefd'Hotel, O. Faugeras, A variational approach to multi-modal image matching, Tech. Rep., INRIA (February 2001).] with the radial lesion growth pattern presented by Bach et al. [M. Bach Cuadra, C. Pollo, A. Bardera, O. Cuisenaire, J.-G. Villemure, J.-Ph. Thiran, Atlas-based segmentation of pathological MR brain images using a model of lesion growth, IEEE Trans. Med. Imag. 23 (10) (2004) 1301-1314.]. Results on patients with a meningioma are visually assessed and compared to those obtained with the most similar method from the state-of-the-art.

Intel·ligència competitiva en la gestió de recursos de talent (RRT)

Les organitzacions afronten una nova era industrial, la era de la Societat del Coneixement. Als recursos clàssics necessaris per mantenir-se competitiu en un mercat cada cop més exigent (RRHH, recursos naturals, recursos financers, etc.), s'hi ha afegit el recurs del coneixement, associat a les persones que tenen la capacitat d'aportar un elevat valor afegit a les organitzacions. Aquestes persones amb aptitud, actitud i sensibilitat per actuar amb intel·ligència són recursos de talent (RRT) i han de considerar-se un factor clau per qualsevol organització. L'estudi dut a terme sobre l'estat de l'art de la gestió de RRT evidencia la manca d'estratègies en aquest sentit. A més a més, s'han detectat alguns aspectes millorables en l'actual percepció entre informació-empresa. Per tots aquests motius, s'ha dut a terme una nova proposta per entendre la relació informacióempresa i s'ha desenvolupat un model de vigilància de RRT, que hauria de quedar integrat en l'estratègia de Gestió del Coneixement de qualsevol organització. L'estudi inclou també la presentació d'algunes eines de vigilància d'informació, fent incís en les eines de cerca d'informació a Internet, per la seva creixent rellevància. Aquesta nova situació industrial presentarà noves oportunitats de negoci relacionades amb la gestió de RRT, així com obrirà possiblement nous debats ètics sobre la conveniència o no, d'entendre les persones com a un recurs més per a les organitzacions.