The role of champions in the implementation of technology in healthcare services: a systematic mixed studies review.

BACKGROUND: Champions play a critical role in implementing technology within healthcare services. While prior studies have explored the presence and characteristics of champions, this review delves into the experiences of healthcare personnel holding champion roles, as well as the experiences of healthcare personnel interacting with them. By synthesizing existing knowledge, this review aims to inform decisions regarding the inclusion of champions as a strategy in technology implementation and guide healthcare personnel in these roles. METHODS: A systematic mixed studies review, covering qualitative, quantitative, or mixed designs, was conducted from September 2022 to March 2023. The search spanned Medline, Embase, CINAHL, and Scopus, focusing on studies published from 2012 onwards. The review centered on health personnel serving as champions in technology implementation within healthcare services. Quality assessments utilized the Mixed Methods Appraisal Tool (MMAT). RESULTS: From 1629 screened studies, 23 were included. The champion role was often examined within the broader context of technology implementation. Limited studies explicitly explored experiences related to the champion role from both champions' and health personnel's perspectives. Champions emerged as promoters of technology, supporting its adoption. Success factors included anchoring and selection processes, champions' expertise, and effective role performance. DISCUSSION: The specific tasks and responsibilities assigned to champions differed across reviewed studies, highlighting that the role of champion is a broad one, dependent on the technology being implemented and the site implementing it. Findings indicated a correlation between champion experiences and organizational characteristics. The role's firm anchoring within the organization is crucial. Limited evidence suggests that volunteering, hiring newly graduated health personnel, and having multiple champions can facilitate technology implementation. Existing studies predominantly focused on client health records and hospitals, emphasizing the need for broader research across healthcare services. CONCLUSIONS: With a clear mandate, dedicated time, and proper training, health personnel in champion roles can significantly contribute professional, technological, and personal competencies to facilitate technology adoption within healthcare services. The review finds that the concept of champions is a broad one and finds varied definitions of the champion role concept. This underscores the importance of describing organizational characteristics, and highlights areas for future research to enhance technology implementation strategies in different healthcare settings with support of a champion.

Tensions between closure of the digital divide and acts of care in residential settings for persons with disabilities. A study of adopting customised information and communication technology.

PURPOSE: In contemporary society, being unable to take advantage of information and communication technology (ICT) can create barriers to maintaining social relations and, thus, can increase the risk of social exclusion and loneliness. Prior studies have revealed that, among persons with disabilities, customised ICT can contribute to the maintenance and improvement of personal social networks. Nevertheless, there is still a need for knowledge regarding the adaption of ICT of those involved when customized ICT are set up in the residents for persons with disabilities. METHODS: Through conducting interviews with four residents, as well as their relatives and members of staff this article explores how KOMP, a customised ICT product designed to enhance digital contact among people who are unable to use ICT independently, was applied in four different municipal residences in Norway. Collective qualitative analysis was utilised to perform this investigation. RESULTS: The analysis show that KOMP can help strengthen relationships, interferes with interactional practices, and underscores the institutionalised lives in the residences. These findings emphasise that applying customised ICT/KOMP in such settings highlights the underlying tensions regarding residents' rights to self-determination and privacy. CONCLUSIONS: This study provides insights into how formal and informal regulations developed by relatives and staff, with the purpose of both protecting residents and protecting oneself from digital exposure, impacts the residents' ability to take advantage of customised ICT and overcome the digital disability divide.

The present findings underscore the need for enhancing residential staff's competence regarding the use of information and communication technology and their knowledge of the associated rights of persons with disabilities.These findings represent the need to improving residential staff's awareness of their role in providing services that enable persons with disabilities to benefit from technological advancements offering distance communication.

We all care just as much about the child: stakeholders' experiences of parenting support in a Norwegian school context.

Purpose: Despite increased focus on parenting support internationally, there is a lack of agreement in what constitutes parenting support. This paper explores the experiences of parenting support activities from the perspective of stakeholders in Norwegian basic schools.Methods: Five focus group interviews were conducted with representatives from the schools' parent work committee, class teachers, health nurses, and social workers from nine schools. The data were interpreted using an inductive thematic analysis.Results: Three main themes emerged from the data: (1) A community for the best of the child, (2) uniting through relations, and (3) sharing knowledge and language. Parenting support was experienced as universal, relational, and multidimensional. It was related to everyday life interactions between the home, school, and the parenting community with the best interest of the child as a goal.Conclusion: To avoid reducing parents to passive recipients of expert advice, parenting support activities should be an integral part of everyday school-home-parenting community collaborations.Abbreviation: EU-The European Union; UN-The Unition Nations; CoE-The Council of Europe; NSD-The Norwegian Centre for Research Data; CTP-Class teachers in primary school; CTJS-Class teachers in junior secondary school; P-Parents; H-Health nurses; SW-Social workers.

Untold stories of living with a bariatric body: long-term experiences of weight-loss surgery.

This article explores patients' long-term experiences after undergoing bariatric surgery (BS) by individual interviews and the interplay between biographical disruption and biographical flow when the body's normal physiology and anatomy are intentionally altered. Based on interpretative phenomenological analysis the findings show that the bariatric body is still prominent in daily life, positively by displacing the overweight body and negatively due to the development of unexpected health problems after surgery. Due to individual informed consent to the treatment, the negative consequences are perceived as self-inflicted. The feelings of responsibility and shame make it difficult to seek help and to be open about undesirable long-term effects and other health problems after surgery. The study argues that undergoing BS is a disruptive event with uncertain long-term outcomes and living with a bariatric body as a vulnerable life continuously at the intersection of biographical disruption, flow and reinforcement. This study reinforces the importance of doing critical sociological studies of standardised medical interventions which aim to improve patients health problems. Included in these types of studies should be the patients' long-term experiences and the awareness not to uncritically present their experiences as universal and the treatment result solely as the patients' own responsibility.

AtMBD8 is involved in control of flowering time in the C24 ecotype of Arabidopsis thaliana.

The Arabidopsis thaliana accession C24 is a vernalization-responsive, moderately late flowering ecotype. We report that a mutation in AtMBD8, which encodes a protein with a putative Methyl-CpG-Binding Domain (MBD), in C24 background, results in a delay in flowering time during both long and short days. The atmbd8-1 mutant responded to vernalization as wild type (wt) plants. Consistent with a role in modulation of flowering time, an AtMBD8::GUS-reporter construct was expressed in the shoot meristem region and developing leaves. Full-genome transcriptional profiling revealed very few changes in gene expression between atmbd8-1 and wt plants. The expression level of FLC, the major repressor of transition to flowering, was unchanged in atmbd8-1, and in accordance with that, genes upstream of FLC were unaffected by the mutation. The expression level of CONSTANS, involved in photoperiodic control of flowering, was very similar in atmbd8-1 and wt plants. In contrast, the major promoters of flowering, FT and SOC1, were both downregulated. As FT is a regulator of SOC1, we conclude that AtMBD8 is a novel promoter of flowering that acts upstream of FT in the C24 accession. In contrast to atmbd8-1, the Colombia (Col) SALK T-DNA insertion line, atmbd8-2, did not display a delayed transition to flowering. Transcriptional profiling revealed that a substantial number of genes were differentially expressed between C24 and Col wt seedlings. Several of these genes are also differentially expressed in late flowering mutants. We suggest that these differences contribute to the contrasting effect of a mutation in AtMBD8 in the two ecotypes.

Molecular analysis of Arabidopsis endosperm and embryo promoter trap lines: reporter-gene expression can result from T-DNA insertions in antisense orientation, in introns and in intergenic regions, in addition to sense insertion at the 5' end of genes.

Random insertions of promoterless reporter genes in genomes are a common tool for identifying marker lines with tissue-specific expression patterns. Such lines are assumed to reflect the activity of endogenous promoters and should facilitate the cloning of genes expressed in the corresponding tissues. To identify genes active in seed organs, plant DNA flanking T-DNA insertions (T-DNAs) have been cloned in 16 Arabidopsis thaliana GUS-reporter lines. T-DNAs were found in proximal promoter regions, 5' UTR or intron with GUS in the same (sense) orientation as the tagged gene, but contrary to expectations also in inverted orientation in the 5' end of genes or in intergenic regions. RT-PCR, northern analysis, and data on expression patterns of tagged genes, compared with the expression pattern of the reporter lines, suggest that the expression pattern of a reporter gene will reflect the pattern of a tagged gene when inserted in sense orientation in the 5' UTR or intron. When inserted in the promoter region, the reporter-gene expression patterns may be restricted compared with the endogenous gene. Among the trapped genes, the previously described nitrate transporter gene AtNRT1.1, the cyclophilin gene ROC3, and the histone deacetylase gene AtHD2C were found. Reporter-gene expression when positioned in antisense orientation, for example, in the SLEEPY1 gene, is indicative of antisense expression of the tagged gene. For T-DNAs found in intergenic regions, it is suggested that the reporter gene is transcribed from cryptic promoters or promoters of as yet unannotated genes.

Ten members of the Arabidopsis gene family encoding methyl-CpG-binding domain proteins are transcriptionally active and at least one, AtMBD11, is crucial for normal development.

Animal proteins that contain a methyl-CpG-binding domain (MBD) are suggested to provide a link between DNA methylation, chromatin remodelling and gene silencing. However, some MBD proteins reside in chromatin remodelling complexes, but do not have specific affinity for methylated DNA. It has recently been shown that the Arabidopsis genome contains 12 putative genes encoding proteins with domains similar to MBD, of which at least three bind symmetrically methylated DNA. Using a bioinformatics approach, we have identified additional domains in a number of these proteins and, on this basis and extended sequence similarity, divided the proteins into subgroups. Using RT-PCR we show that 10 of the AtMBD genes are active and differentially expressed in diverse tissues. To investigate the biological significance of AtMBD proteins, we have transformed Arabidopsis with a construct aimed at RNA interference with expression of the AtMBD11 gene, normally active in most tissues. The resulting 35S::AtMBD11-RNAi plants displayed a variety of phenotypic effects, including aerial rosettes, serrated leaves, abnormal position of flowers, fertility problems and late flowering. Arabidopsis lines with reduced expression of genes involved in chromatin remodelling and transgene silencing show similar phenotypes. Our results suggest an important role for AtMBD proteins in plant development.

Analyses of single-copy Arabidopsis T-DNA-transformed lines show that the presence of vector backbone sequences, short inverted repeats and DNA methylation is not sufficient or necessary for the induction of transgene silencing.

In genetically transformed plants, transgene silencing has been correlated with multiple and complex insertions of foreign DNA, e.g. T-DNA and vector backbone sequences. Occasionally, single-copy transgenes also suffer transgene silencing. We have compared integration patterns and T-DNA/plant DNA junctions in a collection of 37 single-copy T-DNA-transformed Arabidopsis lines, of which 13 displayed silencing. Vector sequences were found integrated in five lines, but only one of these displayed silencing. Truncated T-DNA copies, positioned in inverse orientation to an intact T-DNA copy, were discovered in three lines. The whole nptII gene with pnos promoter was present in the truncated copy of one such line in which heavy silencing has been observed. In the two other lines no silencing has been observed over five generations. Thus, vector sequences and short additional T-DNA sequences are not sufficient or necessary to induce transgene silencing. DNA methylation of selected restriction endonuclease sites could not be correlated with silencing. Our collection of T-DNA/plant DNA junctions has also been used to evaluate current models of T-DNA integration. Data for some of our lines are compatible with T-DNA integration in double-strand breaks, while for others initial invasion of plant DNA by the left or by the right T-DNA end seem important.

Characterization of Carnobacterium divergens strain 6251 isolated from intestine of Arctic charr (Salvelinus alpinus L.).

An atypical strain of Carnobacterium divergens, strain 6251, was isolated from the small intestine of Arctic charr (Salvelinus alpinus L.), fed high dietary carbohydrate. This strain showed marked growth inhibitory effects in vitro against the fish pathogens Aeromonas salmonicida subsp. salmonicida (furunculosis), Vibrio anguillarum (vibriosis) and Vibrio viscocus (winter ulcer). The strain is a non-motile Gram-positive psychrotrophic rod that lacks both catalase and oxidase, grows at pH 9.1 (CTAS agar), but not on acetate containing media (pH < or = 5.4), on TCBS or at < or =6% sodium chloride content. Strain 6251 is facultatively anaerobic and utilises tryptone as a sole source of nutrient. Further characterisation showed the most abundant cellular fatty acid of strain 6251 to be oleic acid (18:1) (n-9) (36.0%). Sequencing of a 16S rDNA region of 578 nucleotides and AFLP microbial fingerprinting suggested that strain 6251 is not closely related to any carnobacteria known, however, DNA-DNA similarity determinations showed high similarity (96.2%) with the type strain of Carnobacterium divergens. The unique phenotypic attributes of this strain represent new information on the biodiversity and ecology of carnobacteria and especially of the species C. divergens.