Collaborative and partnership research for improvement of health and social services: researcher's experiences from 20 projects

BACKGROUND

Getting research into policy and practice in healthcare is a recognised, world-wide concern. As an attempt to bridge the gap between research and practice, research funders are requesting more interdisciplinary and collaborative research, while actual experiences of such processes have been less studied. Accordingly, the purpose of this study was to gain more knowledge on the interdisciplinary, collaborative and partnership research process by investigating researchers' experiences of and approaches to the process, based on their participation in an inventive national research programme. The programme aimed to boost collaborative and partnership research and build learning structures, while improving ways to lead, manage and develop practices in Swedish health and social services.

METHODS

Interviews conducted with project leaders and/or lead researchers and documentation from 20 projects were analysed using directed and conventional content analysis.

RESULTS

Collaborative approaches were achieved by design, e.g. action research, or by involving practitioners from several levels of the healthcare system in various parts of the research process. The use of dual roles as researcher/clinician or practitioner/PhD student or the use of education designed especially for practitioners or 'student researchers' were other approaches. The collaborative process constituted the area for the main lessons learned as well as the main problems. Difficulties concerned handling complexity and conflicts between different expectations and demands in the practitioner's and researcher's contexts, and dealing with human resource issues and group interactions when forming collaborative and interdisciplinary research teams. The handling of such challenges required time, resources, knowledge, interactive learning and skilled project management.

CONCLUSIONS

Collaborative approaches are important in the study of complex phenomena. Results from this study show that allocated time, arenas for interactions and skills in project management and communication are needed during research collaboration to ensure support and build trust and understanding with involved practitioners at several levels in the healthcare system. For researchers, dealing with this complexity takes time and energy from the scientific process. For practitioners, this puts demands on understanding a research process and how it fits with on-going organisational agendas and activities and allocating time. Some of the identified factors may be overlooked by funders and involved stakeholders when designing, performing and evaluating interdisciplinary, collaborative and partnership research.

Prevalence of Pediatric Functional Gastrointestinal Disorders Utilizing the Rome IV Criteria

OBJECTIVE

To assess the prevalence of functional gastrointestinal (GI) disorders in children 0-18 years old according to the newly established Rome IV diagnostic criteria as reported by parents in a representative community sample.

STUDY DESIGN

A cross-sectional study in which mothers (n = 1255) of children aged 0-18 years old in the US were recruited to complete an online survey about their child's GI symptoms, quality of life (QoL), and other health conditions.

RESULTS

Based on the Rome IV criteria, 24.7% of infants and toddlers aged 0-3 years and 25.0% of children and adolescents aged 4-18 years fulfilled symptom-based criteria for a functional GI disorder. The most common functional GI disorders were infant regurgitation among infants (24.1%) and functional constipation among both toddlers (18.5%) and children and adolescents (14.1%). QoL was diminished in pediatric patients with functional GI disorders (median = 71.69 vs median = 87.60; z = -11.41; P  < .001). Children were more likely to qualify for a functional GI disorder if their parent qualified for a functional GI disorder (35.4% vs 23.0%; P < .001).

CONCLUSIONS

Based on Rome IV criteria, functional GI disorders are common in pediatric populations of all ages and are associated with decreased QoL.

Effect of phytoliths for mitigating water stress in durum wheat

The role of silicon (Si) in alleviating biotic and abiotic stresses in crops is well evidenced by empirical studies; however, the mechanisms by which it works are still poorly known. The aim of this study is to determine whether or not phytolith composition and distribution in wheat are affected by drought and, if so, why. Durum wheat was grown using hydroponics in the presence of polyethylene glycol (PEG)-6000 to perform a water-stress simulation. We developed an original method for in situ analysis of phytoliths in leaves via X-ray imaging. PEG was efficient in inhibiting water uptake by roots and creating stress, and prevented a small fraction of Si from being accumulated in the shoots. The application of Si with PEG maintained shoot and root fresh weights (FW) and relative water content at higher values than for plants without Si, especially at PEG 12%. Our data show that, under water stress in the presence of Si, accumulation of phytoliths over the veins provides better support to the leaf, thus allowing for a better development of the whole plant than in the absence of Si. The development of silicified trichomes in durum wheat depends primarily on the availability of Si in soil and is not an adaptation to water stress.

Diurnal evolution of the temperature sensitivity of CO2 efflux in permafrost soils under control and warm conditions

Cryosols contain ~33% of the global soil organic carbon. Cryosol warming and permafrost degradation may enhance the CO₂ release to the atmosphere through the microbial decomposition. Despite the large carbon pool, the permafrost carbon feedback on the climate remains uncertain. In this study, we aimed at better understanding the diurnal evolution of the temperature sensitivity of CO₂ efflux in Cryosols. A Histic Cryosol and a Turbic Cryosol were instrumented in tussock tundra ecosystems near Salluit (Nunavik, Canada). Open top chambers were installed during summer 2011 and the ground temperature, the soil moisture and meteorological variables were recorded hourly while the ecosystem respiration was measured three times per day every second day with opaque and closed dynamic chambers in control and warm stations. Despite warmer conditions, the average CO₂ efflux at the control stations at the Histic site (1.29±0.45μmolCO₂m^-2s^-1) was lower than at the Turbic site (2.30±0.74μmolCO₂m^-2s^-1). The increase in CO₂ efflux with warming was greater in the Histic Cryosol (~39%) than in the Turbic Cryosol (~16%). Our study showed that the temperature sensitivity of the ecosystem respiration evolved during the day and decreased with the experimental warming. Both sites exhibited diurnal hysteresis loops between CO₂ efflux and the soil surface temperature. The width of hysteresis loops increased with the solar radiation and decreased along the growing season. We developed simple linear models that took into account the diurnal evolution of the temperature sensitivity of CO₂ efflux and we estimated the seasonal cumulative carbon release to the atmosphere. The calculation using solely diurnal measurements significantly differed from the seasonal carbon release modelled hourly. Our study highlighted that the time of the day when measurements are performed should be taken into account to accurately estimate the seasonal carbon release from tundra ecosystems.

The PRECOS framework: Measuring the impacts of the global changes on soils, water, agriculture on territories to better anticipate the future

In a context of increased land and natural resources scarcity, the possibilities for local authorities and stakeholders of anticipating evolutions or testing the impact of envisaged developments through scenario simulation are new challenges. PRECOS's approach integrates data pertaining to the fields of water and soil resources, agronomy, urbanization, land use and infrastructure etc. It is complemented by a socio-economic and regulatory analysis of the territory illustrating its constraints and stakes. A modular architecture articulates modeling software and spatial and temporal representations tools. It produces indicators in three core domains: soil degradation, water and soil resources and agricultural production. As a territory representative of numerous situations of the Mediterranean Basin (urban pressures, overconsumption of spaces, degradation of the milieus), a demonstration in the Crau's area (Southeast of France) has allowed to validate a prototype of the approach and to test its feasibility in a real life situation. Results on the Crau area have shown that, since the beginning of the 16th century, irrigated grasslands are the cornerstones of the anthropic-system, illustrating how successfully men's multi-secular efforts have maintained a balance between environment and local development. But today the ecosystem services are jeopardized firstly by urban sprawl and secondly by climate change. Pre-diagnosis in regions of Emilia-Romagna (Italy) and Valencia (Spain) show that local end-users and policy-makers are interested by this approach. The modularity of indicator calculations and the availability of geo-databases indicate that PRECOS may be up scaled in other socio-economic contexts.

Cadmium minimization in wheat: A critical review

Cadmium (Cd) accumulation in wheat (Triticum aestivum L.) and its subsequent transfer to food chain is a major environmental issue worldwide. Understanding wheat response to Cd stress and its management for aiming to reduce Cd uptake and accumulation in wheat may help to improve wheat growth and grain quality. This paper reviewed the toxic effects, tolerance mechanisms, and management of Cd stress in wheat. It was concluded that Cd decreased germination, growth, mineral nutrients, photosynthesis and grain yield of wheat and plant response to Cd toxicity varies with cultivars, growth conditions and duration of stress applied. Cadmium caused oxidative stress and genotoxicity in wheat plants. Stimulation of antioxidant defense system, osmoregulation, ion homeostasis and over production of signalling molecules are important adaptive strategies of wheat under Cd stress. Exogenous application of plant growth regulators, inorganic amendments, proper fertilization, silicon, and organic, manures and biochar, amendments are commonly used for the reduction of Cd uptake in wheat. Selection of low Cd-accumulating wheat cultivars, crop rotation, soil type, and exogenous application of microbes are among the other agronomic practices successfully employed in reducing Cd uptake by wheat. These management practices could enhance wheat tolerance to Cd stress and reduce the transfer of Cd to the food chain. However, their long-term sustainability in reducing Cd uptake by wheat needs further assessment.

Silicon alleviates Cd stress of wheat seedlings (Triticum turgidum L. cv. Claudio) grown in hydroponics

We investigated the potential role of silicon in improving tolerance and decreasing cadmium (Cd) toxicity in durum wheat (Triticum turgidum L. durum) either through a reduced Cd uptake or exclusion/sequestration in non-metabolic tissues. For this, plants were grown in hydroponic conditions for 10 days either in presence or absence of 1 mM Si and for 11 additional days in various Cd concentrations (0, 0.5, 5.0 and 50 μM). After harvesting, morphological and physiological parameters as well as elemental concentrations were recorded. Cadmium caused reduction in growth parameters, photosynthetic pigments and mineral nutrient concentrations both in shoots and roots. Shoot and root contents of malate, citrate and aconitate increased, while contents of phosphate, nitrate and sulphate decreased with increasing Cd concentrations in plants. Addition of Si to the nutrient solution mitigated these adverse effects: Cd concentration in shoots decreased while concentration of Cd adsorbed at the root cell apoplasmic level increased together with Zn uptake by roots. Overall, total Cd uptake decreased in presence of Si. There was no co-localisation of Cd and Si either at the shoot or at the root levels. No Cd was detected in leaf phytoliths. In roots, Cd was mainly detected in the cortical parenchyma and Si at the endodermis level, while analysis of the outer thin root surface of the plants grown in the 50 μM Cd + 1 mM Si treatment highlighted non-homogeneous Cd and Si enrichments. These data strongly suggest the existence of a root localised protection mechanism consisting in armoring the root surface by Si- and Cd-bearing compounds and in limiting root-shoot translocation.

Effect of silicon on wheat seedlings (Triticum turgidum L.) grown in hydroponics and exposed to 0 to 30 µM Cu

Aqueous Si limits Cu uptake by a Si-accumulating plant via physicochemical mechanisms occurring at the root level. Sufficient Si supply may alleviate Cu toxicity in Cu-contaminated soils. Little information is available on the role of silicon (Si) in copper (Cu) tolerance while Cu toxicity is widespread in crops grown on Cu-contaminated soils. A hydroponic study was set up to investigate the influence of Si on Cu tolerance in durum wheat (Triticum turgidum L.) grown in 0, 0.7, 7.0 and 30 µM Cu without and with 1.0 mM Si, and to identify the mechanisms involved in mitigation of Cu toxicity. Si supply alleviated Cu toxicity in durum wheat at 30 µM Cu, while Cu significantly increased Si concentration in roots. Root length, photosynthetic pigments concentrations, macroelements, and organic anions (malate, acetate and aconitate) in roots, were also increased. Desorption experiments, XPS analysis of the outer thin root surface (≤100 Å) and µXRF analyses showed that Si increased adsorption of Cu at the root surface as well as Cu accumulation in the epidermis while Cu was localised in the central cylinder when Si was not applied. Copper was not detected in phytoliths. This study provides evidences for Si-mediated alleviation of Cu toxicity in durum wheat. It also shows that Si supplementation to plants exposed to increasing levels of Cu in solution induces non-simultaneous changes in physiological parameters. We propose a three-step mechanism occurring mainly at the root level and limiting Cu uptake and translocation to shoots: (i) increased Cu adsorption onto the outer thin layer root surface and immobilisation in the vicinity of root epidermis, (ii) increased Cu complexation by both inorganic and organic anions such as aconitate and, (iii) limitation of translocation through an enhanced thickening of a Si-loaded endodermis.

Comparison of soil solution sampling techniques to assess metal fluxes from contaminated soil to groundwater

The unsaturated zone plays a major role in elemental fluxes in terrestrial ecosystems. A representative chemical analysis of soil pore water is required for the interpretation of soil chemical phenomena and particularly to assess Trace Elements (TEs) mobility. This requires an optimal sampling system to avoid modification of the extracted soil water chemistry and allow for an accurate estimation of solute fluxes. In this paper, the chemical composition of soil solutions sampled by Rhizon® samplers connected to a standard syringe was compared to two other types of suction probes (Rhizon® + vacuum tube and Rhizon® + diverted flow system). We investigated the effects of different vacuum application procedures on concentrations of spiked elements (Cr, As, Zn) mixed as powder into the first 20 cm of 100-cm columns and non-spiked elements (Ca, Na, Mg) concentrations in two types of columns (SiO2 sand and a mixture of kaolinite + SiO2 sand substrates). Rhizon® was installed at different depths. The metals concentrations showed that (i) in sand, peak concentrations cannot be correctly sampled, thus the flux cannot be estimated, and the errors can easily reach a factor 2; (ii) in sand + clay columns, peak concentrations were larger, indicating that they could be sampled but, due to sorption on clay, it was not possible to compare fluxes at different depths. The different samplers tested were not able to reflect the elemental flux to groundwater and, although the Rhizon® + syringe device was more accurate, the best solution remains to be the use of a lysimeter, whose bottom is kept continuously at a suction close to the one existing in the soil.

[Two forms of familial hypercholesterolemia: differences in cardiovascular risk factors, cardiac and extracardiac atherosclerosis]

BACKGROUND AND AIM

The monogenetic hypercholesterolemias (HC) are associated with a very high risk of premature coronary heart disease (CHD). We sought to assess the influence of the genetic defect and the cardiovascular risk factors on the manifestation of atherosclerotic complications in two forms of genetic HC.

PATIENTS AND METHODS

Data of patients with genetically defined HC (54 LDL-receptor defective familial hypercholesterolemia (FH) and 54 familial defective apolipoprotein B (FDB)) were analysed retrospectively for cardiac and extracardiac atherosclerosis.

RESULTS

Total and LDL-cholesterol were significantly higher in FH men than in FDB men, but not so in women. 41.8% of FH patients had CHD (mean age 41 years), 5.6% of FDB (mean age 52 years). Stenoses (>50% narrowing) of the internal carotid artery were verified in 15% of FH and 4% of FDB patients. Peripheral arterial disease was found in 3 FH and 2 FDB patients. Hypertension and active smoking were allotted almost equally, body weight was normal in most of the patients (BMI ≤ 25 kg/m(2)). Conlusion: Patients with genetic HC suffer from early manifestation of cardiac disease. Patients with FH seem to be affected more often than patients with FDB. Early diagnosis and early and lifelong treatment are essential and, according to the literature, lead to a delay of disease manifestation.

Zum Einbau von einigen Lanthaniden in Gd2Cl3 / Incorporation of Some Lanthanides into Gd2Cl3

Co-crystallization experiments with radioactive isotopes of lanthanides (Ce, Nd, Eu, Gd, Tb, Dy, Tm, Yb) show that only Tb is incorporated by Gd2Cl3 in a significant amount. The results are discussed in terms of the electronic configuration of Ln2+ ions as well as redox potentials E°(Ln3+/Ln2+).