Epidemiology of protozoan and helminthic parasites in wild passerine birds of Britain and Ireland.

Avian endoparasites play important roles in conservation, biodiversity and host evolution. Currently, little is known about the epidemiology of intestinal helminths and protozoans infecting wild birds of Britain and Ireland. This study aimed to determine the rates of parasite prevalence, abundance and infection intensity in wild passerines. Fecal samples (n = 755) from 18 bird families were collected from 13 sites across England, Wales and Ireland from March 2020 to June 2021. A conventional sodium nitrate flotation method allowed morphological identification and abundance estimation of eggs/oocysts. Associations with host family and age were examined alongside spatiotemporal and ecological factors using Bayesian phylogenetically controlled models. Parasites were detected in 20.0% of samples, with corvids and finches having the highest prevalences and intensities, respectively. Syngamus (33%) and Isospora (32%) were the most prevalent genera observed. Parasite prevalence and abundance differed amongst avian families and seasons, while infection intensity varied between families and regions. Prevalence was affected by diet diversity, while abundance differed by host age and habitat diversity. Infection intensity was higher in birds using a wider range of habitats, and doubled in areas with feeders present. The elucidation of these patterns will increase the understanding of parasite fauna in British and Irish birds.

Monoclonal tobacco cell lines with enhanced recombinant protein yields can be generated from heterogeneous cell suspension cultures by flow sorting.

Plant cell suspension cultures can be used for the production of recombinant pharmaceutical proteins, but their potential is limited by modest production levels that may be unstable over long culture periods, reflecting initial culture heterogeneity and subsequent genetic and epigenetic changes. We used flow sorting to generate highly productive monoclonal cell lines from a heterogeneous population of tobacco BY-2 cells expressing the human antibody M12 by selecting the co-expressed fluorescent marker protein DsRed located on the same T-DNA. Separation yielded ∼35% wells containing single protoplasts and ∼15% wells with monoclonal microcolonies that formed within 2 weeks. Thus, enriching the population of fluorescent cells from initially 24% to 90-96% in the six monoclonal lines resulted in an up to 13-fold increase in M12 production that remained stable for 10-12 months. This is the first straightforward procedure allowing the generation of monoclonal plant cell suspension cultures by flow sorting, greatly increasing the potential of plant cells as an economical platform for the manufacture of recombinant pharmaceutical proteins.

Comprehensive characterization of two different Nicotiana tabacum cell lines leads to doubled GFP and HA protein production by media optimization.

For over two decades, plant cell cultures have been a promising research platform to express recombinant and therapeutic proteins such as hormones, growth factors, full-size antibodies and antigens. Chosen as a good host for manufacturing recombinant proteins, the Nicotiana tabacum L. cv. Bright Yellow 2 (BY-2) cell line has been studied in shake flasks by offline analysis of only a few growth parameters. The objective of this study is to comprehensively characterize the growth of a transgenic BY-2 cell line and to investigate the expression profile of the model protein GFP. Based on the correlations between nutrient consumption, cell growth and product formation, the intention is to improve the standard MS-medium. Hereby, multiple growth parameters were analyzed offline and online by using a respiration activity monitoring system (RAMOS). A reproducibly observed shift of the oxygen transfer rate (OTR) could be identified to indicate ammonium depletion in the medium. Concurrent with this ammonium depletion, the total protein concentration began to decrease. After the MS-medium was improved, the GFP concentration nearly doubled. When this improved ammonium enriched medium was applied to another transgenic tobacco cell line similar improvements to the amount of the glycoprotein influenza hemagglutinin (HA) produced by Nicotiana tabacum NT-1 cells could be achieved. Ultimately, this combined offline and online analysis can be successfully used for further cell line characterization and media optimization to improve growth and boost target product formation.

eHealth informatics workforce challenges for Europe.

There is an increasing demand for informatics human resources from major ehealth developments aimed at supporting more effective healthcare in many countries. Focus to date has been on the standards required to describe ehealth applications and solutions; with sporadic attention to the workforce necessary to deliver them. There are challenges to ensuring that the ehealth informatics staff involved in production and operation of such ehealth systems are 'fit to practice' professionals and their competences can be clearly defined. There are currently different levels of understanding, quantification and definition of the existing and projected workforce requirements across Europe and in the USA. This paper highlights some of the issues to be considered across Europe in moving towards a situation where the limitations to appropriately skilled staff being deployed wherever necessary are reduced and free mobility of the workforce can be enabled.

Personal electronic health records: from biomedical research to people's health.

Access to web technologies and the increased bandwidth and capacity of these systems has facilitated the development of personal electronic health records (PEHRs). This conference reports the key messages from the Friends of the National Library of Medicine (FNLM) meeting on PEHRs 'From Biomedical Research to People's Health' in May 2009. The conference provided a comprehensive overview of issues and best practice for PEHR. The key messages of the conference were: PEHR have the potential to ensure equity, continuity and healthcare quality. Electronic records may allow individuals to contribute to disease surveillance, public health and research in ways that were not previously possible. We need to prepare carefully for a 'brave new world' in which a small number of commercial organisations may become trusted custodians of the planet's medical information. Ethical dilemmas are already emerging from the use of PEHRs - largely stemming from our experiences within the UK. This report links the findings of this conference with key UK and European innovations. Informaticians, in conjunction with clinicians and solution providers, should both prepare for the realities of PEHR and more formally articulate their potential benefits and risks.

Recognising e-health as part of a cohesive professional community.

This paper identifies a mechanism for specific professional registration in order to sustain a holistic community fit to practice in informatics to support the health domain. It considers risks and opportunities that have an international resonance, and comments on the areas where multi-national activity could provide additional impetus to improvement of the quality of the profession of health informatics overall. It puts the case for the over-arching term health informatics to be used to maximize synergy and drive up quality, whilst still recognising the specificity and place for more focused descriptive terms. Whilst grounded in the contemporary UK environment, the principles explored in this paper are currently being considered for adoption internationally.

Establishing a national resource: a health informatics collection to maintain the legacy of health informatics development.

This case study report of the establishment of a national repository of multi-media materials describes the creation process, the challenges faced in putting it into operation and the opportunities for the future. The initial resource has been incorporated under standard library and knowledge management practices. A collaborative action research method was used with active experts in the domain to determine the requirements and priorities for further development. The National Health Informatics Collection (NatHIC) is now accessible and the further issues are being addressed by inclusion in future University and NHS strategic plans. Ultimately the Collection will link with other facilities that contribute to the description and maintenance of effective informatics in support of health globally. The issues raised about the National Health Informatics Collection as established in the UK have resonance with the challenges of capturing the overall historic development of an emerging discipline in any country.

Progressing professional maturity in health informatics.

This paper looks at ways in which the profession of health informatics is gaining definition, through the actions of both the BCS Health Informatics Forum and the UK Council for Health Informatics Professions. It explores the some of the ways the current situation was achieved, how the lessons can be applied internationally and the challenges yet to be met. Opportunities for further progress within the existing landscape of technology and health care delivery and management are outlined. The paper documents actions taken and planned and the rationale of why, with supporting evidence of similar contributory work to date. It concludes by stating that the profession must remain flexible and dynamic, and nurture its professional members if it is to continue to develop within an ever-changing scenario.

Developing health informatics as a recognised professional domain supporting clinical and health management activity.

This paper puts forward a case for use of the term "health informatics" to be deployed as a catalyst to collective recognition of the contribution that technology, information handling and decision support can provide to effective health care internationally. It cautions against disregarding the impact that the collective 'health informatics' may have on cohesion and recognition across the specialist clinical areas, management sectors and diverse professions involved in specialist areas. It also recognises that commonality of standards and consistency of protocols can be identified in many of the technical and clinical specialist areas, confirming the basis for a collective term. Having looked at potentially generic factors in the development of both a learned society and professional regulation body in the UK, the paper concludes that without recognition of the collective term "health informatics" there will be an grossy extended time frame before any of those working in this area gain the recognition and respect of a formal discipline.

What is eHealth (5): a research agenda for eHealth through stakeholder consultation and policy context review.

BACKGROUND: In 2003, the National Health Service in England and Wales, despite its large investment in information and communication technology, had not set a national research agenda. The National Health Service has three main research and development programs: one is the Service Delivery and Organisation program, commissioned in 2003, and the others are two parallel "scoping exercises" to help set a research agenda. This paper reports on one of those projects. A parallel literature review was carried out by others and has been reported elsewhere. OBJECTIVE: The objective was to explore the concerns of stakeholders and to review relevant policy in order to produce recommendations and a conceptual map of eHealth research. METHODS: There were two parallel strands. For the stakeholder consultation, 37 professionals representing 12 "stakeholder" groups participated in focus groups or interviews. Discussion was prompted by eHealth "scenarios" and analyzed using thematic content analysis. Subsequently, 17 lay participants, in three focus groups, discussed and prioritized these themes. For the policy review, 26 policy makers were interviewed, and 95 policy documents were reviewed. Recommendations were subsequently reviewed in a conference workshop. Recommendations for research from both strands were combined into a conceptual map. RESULTS: Themes from stakeholder consultation and policy review were combined as 43 recommendations under six headings. Four of these headings (using, processing, sharing, and controlling information) describe the scope of eHealth research. The other two relate to how research should be carried out (ensuring best practice is first identified and disseminated) and to the values considered important by stakeholders (in particular, measuring improvement in health). CONCLUSIONS: The scope of eHealth research (using, processing, sharing, controlling information) derived empirically from this study corresponds with "textbook" descriptions of informatics. Stakeholders would like eHealth research to include outcomes such as improved health or quality of life, but such research may be long term while changes in information technology are rapid. Longer-term research questions need to be concerned with human behavior and our use of information, rather than particular technologies. In some cases, "modelling" longer-term costs and benefits (in terms of health) may be desirable.

Validating national informatics policy--the importance of operational consensus to influence positive developments.

The National Health Service in England faces reorganisation of services on a very regular basis. In 2002 a 'Long Term Review of Health Trends', commissioned by the Chancellor of the Exchequer indicated the need for a substantially larger investment in informatics to support the delivery of better healthcare overall. Subsequent to the issue of this report, the Spending Review confirmed an investment of pound 2.3 Billion (approximately $3.7 Bn) for the period to 2005 for NHS informatics, subject to performance. This paper describes the actions taken by the national representative society (the British Computer Society Health Informatics Committee) to ensure that the views of those in the field were taken into account in facilitating the best possible outcomes from this investment. In addition, the initiative established has confirmed the ongoing priorities for involvement in health informatics, regardless of professional role, in support of healthcare. The outputs and insights gained from two years of this initiative provide useful points for thought about health informatics and health management in other countries and under different models of care to that of the NHS in England.

Student and teacher exchanges--criteria for access.

Student and teacher exchanges between countries and within the domain of informatics to support health are considered. The availability of guidance appears to be institution-wide not country-specific. It is also not related to the discipline within which the exchange will occur. Concerns and issues are considered here in order for potential participants to prepare better for such exchanges. The observations made will be of interest to the administration of the organisations within which exchanges may occur. The investigation of this topic was delphic and pragmatic rather then exhaustive. The author bears no liability for situations that occur in specific locations.

Health informatics needs regulation and registration to add value recognition.

Education is only one step towards being recognised as 'fit' to carry out an operational role in informatics to support health at any level. For many years there has been little real 'brand image'. Although significant bodies like IMIA and the BCS welcome a wide range of professionals, there is still confusion over what the discipline really means and does. In order to become a mature profession in the health domain, particularly in the UK, it is necessary to operate a registration process that recognises both qualification and competency, and the responsibility to keep skills and knowledge contemporary. This paper describes the steps taken to establish a registration and regulatory body to maintain high quality professionalism in operational care delivery, academic and commercial organisations in the health domain. The concepts described have resonance internationally.