Effects of targeted delivery of propionate to the human colon on appetite regulation, body weight maintenance and adiposity in overweight adults

Objective The colonic microbiota ferment dietary fibres, producing short chain fatty acids. Recent evidence suggests that the short chain fatty acid propionate may play an important role in appetite regulation. We hypothesised that colonic delivery of propionate would increase peptide YY (PYY) and glucagon like peptide-1 (GLP-1) secretion in humans, and reduce energy intake and weight gain in overweight adults. Design To investigate whether propionate promotes PYY and GLP-1 secretion, a primary cultured human colonic cell model was developed. To deliver propionate specifically to the colon, we developed a novel inulin-propionate ester. An acute randomised, controlled cross-over study was used to assess the effects of this inulin-propionate ester on energy intake and plasma PYY and GLP-1 concentrations. The long-term effects of inulin-propionate ester on weight gain were subsequently assessed in a randomised, controlled 24-week study involving 60 overweight adults. Results Propionate significantly stimulated the release of PYY and GLP-1 from human colonic cells. Acute ingestion of 10 g inulin-propionate ester significantly increased postprandial plasma PYY and GLP-1 and reduced energy intake. Over 24 weeks, 10 g/day inulin-propionate ester supplementation significantly reduced weight gain, intra-abdominal adipose tissue distribution, intrahepatocellular lipid content and prevented the deterioration in insulin sensitivity observed in the inulin-control group. Conclusions These data demonstrate for the first time that increasing colonic propionate prevents weight gain in overweight adult humans

Dual semiosis analysis model managing customer-focused service innovation

Customers will not continue to pay for a service if it is perceived to be of poor quality, and/or of no value. With a paradigm shift towards business dependence on service orientated IS solutions [1], it is critical that alignment exists between service definition, delivery, and customer expectation, businesses are to ensure customer satisfaction. Services, and micro-service development, offer businesses a flexible structure for solution innovation, however, constant changes in technology, business and societal expectations means an iterative analysis solution is required to i) determine whether provider services adequately meet customer segment needs and expectations, and ii) to help guide business service innovation and development. In this paper, by incorporating multiple models, we propose a series of steps to help identify and prioritise service gaps. Moreover, the authors propose the Dual Semiosis Analysis Model, i.e. a tool that highlights where within the symbiotic customer / provider semiosis process, requirements misinterpretation, and/or service provision deficiencies occur. This paper offers the reader a powerful customer-centric tool, designed to help business managers highlight both what services are critical to customer quality perception, and where future innovation

Using the Technology Acceptance Model to explore community dwelling older adults’ perceptions of a 3D interior design application to facilitate pre-discharge home adaptations

Background In the UK occupational therapy pre-discharge home visits are routinely carried out as a means of facilitating safe transfer from the hospital to home. Whilst they are an integral part of practice, there is little evidence to demonstrate they have a positive outcome on the discharge process. Current issues for patients are around the speed of home visits and the lack of shared decision making in the process, resulting in less than 50 % of the specialist equipment installed actually being used by patients on follow-up. To improve practice there is an urgent need to examine other ways of conducting home visits to facilitate safe discharge. We believe that Computerised 3D Interior Design Applications (CIDAs) could be a means to support more efficient, effective and collaborative practice. A previous study explored practitioners perceptions of using CIDAs; however it is important to ascertain older adult’s views about the usability of technology and to compare findings. This study explores the perceptions of community dwelling older adults with regards to adopting and using CIDAs as an assistive tool for the home adaptations process. Methods Ten community dwelling older adults participated in individual interactive task-focused usability sessions with a customised CIDA, utilising the think-aloud protocol and individual semi-structured interviews. Template analysis was used to carry out both deductive and inductive analysis of the think-aloud and interview data. Initially, a deductive stance was adopted, using the three pre-determined high-level themes of the technology acceptance model (TAM): Perceived Usefulness (PU), Perceived Ease of Use (PEOU), Actual Use (AU). Inductive template analysis was then carried out on the data within these themes, from which a number of sub-thmes emerged. Results Regarding PU, participants believed CIDAs served as a useful visual tool and saw clear potential to facilitate shared understanding and partnership in care delivery. For PEOU, participants were able to create 3D home environments however a number of usability issues must still be addressed. The AU theme revealed the most likely usage scenario would be collaborative involving both patient and practitioner, as many participants did not feel confident or see sufficient value in using the application autonomously. Conclusions This research found that older adults perceived that CIDAs were likely to serve as a valuable tool which facilitates and enhances levels of patient/practitioner collaboration and empowerment. Older adults also suggested a redesign of the interface so that less sophisticated dexterity and motor functions are required. However, older adults were not confident, or did not see sufficient value in using the application autonomously. Future research is needed to further customise the CIDA software, in line with the outcomes of this study, and to explore the potential of collaborative application patient/practitioner-based deployment.

Systemic delivery of adult stem cells improves cardiac function in spontaneously hypertensive rats

Heart regeneration after myocardial infarction (MI) can occur after cell therapy, but the mechanisms, cell types and delivery methods responsible for this improvement are still under investigation. In the present study, we evaluated the impact of systemic delivery of bone marrow cells (BMC) and cultivated mesenchymal stem cells (MSC) on cardiac morphology, function and mortality in spontaneously hypertensive rats (SHR) submitted to coronary occlusion. Female syngeneic adult SHR, submitted or not (control group; C) to MI, were treated with intravenous injection of MSC (MI + MSC) or BMC (MI + BM) from male rats and evaluated after 1, 15 and 30 days by echocardiography. Systolic blood pressure (SBP), functional capacity, histology, mortality rate and polymerase chain reaction for the Y chromosome were also analysed. Myocardial infarction induced a decrease in SBP and BMC, but not MSC, prevented this decrease. An improvement in functional capacity and ejection fraction (38 +/- 4, 39 +/- 3 and 58 +/- 2% for MI, MI + MSC and MI + BM, respectively; P < 0.05), as well as a reduction of the left ventricle infarcted area, were observed in rats from the MI + BM group compared with the other three groups. Treated animals had a significantly reduced lesion tissue score. The mortality rate in the C, MI + BM, MI + MSC and MI groups was 0, 0, 16.7 and 44.4%, respectively (P < 0.05 for the MI + MSC and MI groups compared with the C and MI + BM groups). The results of the present study suggest that systemic administration of BMC can improve left ventricular function, functional capacity and, consequently, reduce mortality in an animal model of MI associated with hypertension. We speculate that the cells transiently home to the myocardium, releasing paracrine factors that recruit host cells to repair the lesion.

Continuous and High-Level In Vivo Delivery of Endostatin From Recombinant Cells Encapsulated in TheraCyte (R) Immunoisolation Devices

Endostatin (ES) is a potent inhibitor of angiogenesis and tumor growth. Continuous ES delivery of ES improves the efficacy and potency of the antitumoral therapy. The TheraCyte (R) system is a polytetrafluoroethylene (PTFE) semipermeable membrane macroencapsulation system for implantation of genetically engineered cells specially designed for the in vivo delivery of therapeutic proteins, such as ES, which circumvents the problem of limited half-life and variation in circulating levels. In order to enable neovascularization at the tissues adjacent to the devices prior to ES secretion by the cells inside them, we designed a scheme in which empty TheraCyte (R) devices were preimplanted SC into immunodeficient mice. Only after healing (17 days later) were Chinese hamster ovary cells expressing ES injected into the preimplanted devices. In another model for device implantation, the cells expressing ES where loaded into the immunoisolation devices prior to implantation into the animals, and the TheraCyte (R) were then immediately implanted SC into the mice. Throughout the 2-month study, constant high ES levels of up to 3.7 mu g/ml were detected in the plasma of the mice preimplanted with the devices, while lower but also constant levels of ES (up to 2.1 mu g/ml plasma) were detected in the mice that had received devices preloaded with the ES-expressing cells. Immunohistochemistry using anti-ES antibody showed reaction within the device and outside it, demonstrating that ES, secreted by the confined recombinant cells, permeated through the membrane and reached the surrounding tissues.

Interaction of cationic bilayer fragments with a model oligonucleotide

The interaction between cationic bilayer fragments and a model oligonucleotide was investigated by differential scanning calorimetry, turbidimetry, determination of excimer to monomer ratio of 2-(10-(1-pyrene)-decanoyl)-phosphatidyl-choline in bilayer fragment dispersions and dynamic light scattering for sizing and zeta-potential analysis. Salt (Na(2)HPO(4)), mononucleotide (2`-deoxyadenosine-5`-monophosphate) or poly (dA) oligonucleotide (3`-AAA AAA AAA A-5`) affected structure and stability of dioctadecyldimethylammonium bromide bilayer fragments. Oligonucleotide and salt increased bilayer packing due to bilayer fragment fusion. Mononucleotide did not reduce colloid stability or did not cause bilayer fragment fusion. Charge neutralization of bilayer fragments by poly (dA) at 1:10 poly (dA):dioctadecyldimethylammonium bromide molar ratio caused extensive aggregation, maximal size and zero of zeta-potential for the assemblies. Above charge neutralization, assemblies recovered colloid stability due to charge overcompensation. For bilayer fragments/poly (dA), the nonmonotonic behavior of colloid stability as a function of poly (dA) concentration was unique for the oligonucleotide and was not observed for Na(2)HPO(4) or 2`-deoxyadenosine-5`-monophosphate. For the first time, such interactions between cationic bilayer fragments and mono- or oligonucleotide were described in the literature. Bilayer fragments/oligonucleotide assemblies may find interesting applications in drug delivery. (c) 2010 Elsevier B.V. All rights reserved.

Production and Delivery (Optimization of production system and reliability)

This thesis is done to solve two issues for Sayid Paper Mill Ltd Pakistan. Section one deals with a practical problem arise in SPM that is cutting a given set of raw paper rolls of known length and width, and a set of product paper rolls of known length (equal to the length of raw paper rolls) and width, practical cutting constraints on a single cutting machine, according to demand orders for all customers. To solve this problem requires to determine an optimal cutting schedule to maximize the overall cutting process profitability while satisfying all demands and cutting constraints. The aim of this part of thesis is to develop a mathematical model which solves this problem.Second section deals with a problem of delivering final product from warehouse to different destinations by finding shortest paths. It is an operational routing problem to decide the daily routes for sending trucks to different destination to deliver their final product. This industrial problem is difficult and includes aspect such as delivery to a single destination and multiple destinations with limited resources. The aim of this part of thesis is to develop a process which helps finding shortest path.

Rural nursing and health care reforms : building a social model

This article explores recent shifts in health-care policy and the implications for rural nursing in Australia. Health-care reforms have resulted in the implementation of a 'market forces' ideology, creating tensions between economic imperatives and the need for equity and greater access in rural service delivery. New models of health-service delivery have been developed that have significant implications for the way rural health care is defined, practised and received. The issues surrounding the context of rural nursing practice and service delivery are discussed.

Developing preparedness for flexible delivery of training in enterprises

On a basis of research and literature review, Smith, in 2001, suggested a model for the development of preparedness of learners and their workplaces to support the flexible delivery of training in enterprises. Using the model as a framework, he then developed a detailed set of strategies that may be used in operating workplaces to develop learners and workplaces for effective flexible delivery. The research reported here was designed to test that strategy set in 12 different enterprises to assess the feasibility of their implementation in operating workplaces. The research shows that a majority of suggested strategies are feasible for implementation; some are feasible with qualification; and a minority were not seen as feasible.

Interdisciplinary higher education and the Melbourne model

The so-called ‘Melbourne Model’ has recently been adopted by the Council of the University of Melbourne, Australia after a long consultation process and widespread media attention. It proposes the design of new subjects which offer what are referred to as ‘different ways of knowing’ from students’ ‘core’ disciplines, partly through ‘the delivery of breadth subjects that are interdisciplinary in character’. This paper explores interdisciplinary higher education in the light of The Melbourne Model’. Definitional issues associated with the term ‘academic discipline’, as well as the newer terms ‘interdisciplinary’, ‘pluridisciplinary’, ‘cross-disciplinary’, ‘transdisciplinary’ and ‘multidisciplinary’ are examined. Some of the pedagogical issues inherent in a move from a traditional form of educational delivery to that underlined by the Melbourne Model are outlined. Some epistemological considerations relevant to multidisciplinarity and interdisciplinarity are discussed.

Massive data delivery in unstructured peer-to-peer networks with network coding

With more and more multimedia applications on the Internet, such as IPTV, bandwidth becomes a vital bottleneck for the booming of large scale Internet based multimedia applications. Network coding is recently proposed to take advantage to use network bandwidth efficiently. In this paper, we focus on massive multimedia data, e.g. IPTV programs, transportation in peer-to-peer networks with network coding. By through study of networking coding, we pointed out that the prerequisites of bandwidth saving of network coding are: 1) one information source with a number of concurrent receivers, or 2) information pieces cached at intermediate nodes. We further proof that network coding can not gain bandwidth saving at immediate connections to a receiver end; As a result, we propose a novel model for IPTV data transportation in unstructured peer-to-peer networks with network coding. Our preliminary simulations show that the proposed architecture works very well.

Improving access to evidence-based acute stroke services: development and evaluation of a health systems model to address equity of access issues

Level 1 evidence for management of patients with stroke in a dedicated Stroke Care Unit (SCU) demonstrates improved outcomes by about 20%. It has been estimated that 21% of Australian hospitals provide an SCU and that these SCUs are mainly located in either metropolitan sites and/or in hospitals with more than 300 beds. To address equity issues related to access to SCUs, the National Stroke Foundation and the Australian Government undertook the National Stroke Units Program. One program outcome was the development of a conceptual model of acute stroke service delivery. The development process and initial evaluation of the model are described. Use of the model to increase capacity within the health care system to treat stroke is discussed.

A new model of workbased learning in the VET sector

This report provides a revised model of workbased learning for the vocational education and training (VET) sector in Australia, in response to emerging needs. The study provides a brief review of the theoretical foundations of the contemporary discussions surrounding workbased learning, drawn from literature on adult education and learning organisations. Literature on adult learning and learning organisations in the 1990's explored new dimensions of these topics and this new theorising enriched the concept of workbased learning. This examination of the literature enables the development of a model of an integrated approach to workbased learning. The model integrates compatible ideas from adult learning, learning organisations and action learning/research and facilitates new ways of thinking about workbased learning as a staff development model. This model confirms that workbased learning is an appropriate and relevant approach to staff development in contemporary times.

A rural model for delivering regional continuing nurse education by videoconference : a pilot project

Background : The South West Alliance of Rural Health (SWARH) is an alliance of 33 health care agencies scattered across South West Victoria over a total area of approximately 46 000 square kilometres. SWARH was established to develop and install information technology (IT) infrastructure, hardware and software for all acute public hospitals in the region. The Rural Intercampus Learning Environment Project (March 2003-March 2004) piloted the use of the SWARH regional area IT network to deliver a program of continuing education to Division 1 registered nurses, utilising the expertise of local health professionals. The study was funded by the Department of Human Services, Victoria.

Aims & rationale/Objectives : Establish partnerships for multi-site delivery of programs.
Develop existing educational programs and resources for video and intranet delivery (including IT training and change management).
Collaboratively deliver educational programs utilising SWARHnet to six rural sites.
Explore issues related to the use of the technology in continuing education for rural nurses and the implications for practice.

Methods : Key informant interviews, paper-based audits, and focus groups informed the development of the schedule of the program. Session participants completed a 2-page evaluation questionnaire.

Principal findings : Participants must own the process.
Videoconferencing should be considered an adjunct to traditional education programs.
Videoconferencing most suitable for short education sessions as opposed to full-day workshops.
IT problems are unpredictable and frustrating for all concerned.
IT awareness/training of staff is essential.

Implications : The project proposes a model for coordinating and delivering regional continuing education which has been shown to improve access to education programs across multiple sites. It provides a sustainable organisational framework for the program, which could be applied in continuing professional education programs of other rural health professions, such as dentistry, medicine, allied health and pharmacy.

Presentation type : Poster

Vocational education and training at a distance : transformation to flexible delivery

This chapter will explore the position that distance education has held in the past in Australian vocational education and training (VET) and how that position has developed and transformed over the past couple of decades. It is argued here that after a period of VET provision through distance education that was largely based around an earlier centralised model, VET was early to recognise the potential that new technologies in distance education had for VET learners and learning. Concurrently there was recognition of the substantial limitations a centralised model of distance education posed for new demands on VET. Economic imperatives also contributed to what became a revolution in VET and its delivery to learners.
The chapter identifies these developments and the factors that have contributed to them, and tracks the transition of Australian VET distance education as it transformed away from centralised distance education provision towards its more recent forms of locally provided flexible delivery and blended learning.