ALBERT

Description: IJERPH, Vol. 15, Pages 1545: Implementing Supported Employment. Lessons from the Making IPS Work Project International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15071545 Authors: Jan Hutchinson David Gilbert Rachel Papworth Jed Boardman Individual Placement and Support (IPS) is an internationally accepted and effective form of supported employment for people with severe mental health conditions. Despite its strong evidence base, the implementation of IPS has been slow and inconsistent. In England, a demonstration project, Making IPS Work, was developed to offer support for the implementation of IPS in six local sites National Health Service Mental Health trusts. The project aimed to: Establish Individual Placement and Support services within clinical teams; develop high fidelity practice and leave a sustainable IPS service beyond the project. The number of people gaining open employment in each site was monitored. Fidelity checks were carried out at three sites by independent assessors. Stakeholders were interviewed over the 18-month lifetime of the implementation period to examine the experience of developing the services in the six sites. A total of 421 jobs were found for people with mental health conditions over 18 months with a large variation between the highest and lowest performing sites. The sites assessed for fidelity all attained the threshold for a ‘Good Fidelity’ service. The new services were readily accepted by mental health service users, clinical staff and managers across the trust sites. Maintaining the funding for the Individual Placement and Support services beyond the project period proved to be problematic for many sites. Placing the services within a broader strategy of improving psychosocial services and bringing together decision making at the corporate, commissioning and clinical management level were helpful in achieving success. The growth and maintenance of these services is difficult to achieve whilst the current cost pressures on the NHS continue.

Description: While it has been shown that decades of astronauts and cosmonauts suffer from immune disorders both during and after spaceflight, the underlying causes are still poorly understood, due in part to the fact that there are so many variables to consider when investigating the human immune system in a complex environment. Invertebrates have become popular models for studying human disease because they are cheap, highly amenable to experimental manipulation, and have innate immune systems with a high genetic similarity to humans. Fruit flies (Drosophila melanogaster) have been shown to experience a dramatic shift in immune gene expression following spaceflight, but are still able to fight off infections when exposed to bacteria. Furthermore, a recent spaceflight mission showed that flies are more susceptible to infection following exposure to microgravity conditions, compared to ground-reared flies from the same population. Additionally, the common bacterial pathogen Serratia marcescens was shown to become more lethal to fruit flies (both space- and ground-reared) after being cultured in space, suggesting that not only do we need to consider host changes in susceptibility, but also changes in the pathogen itself after spaceflight conditions. Being able to simulate spaceflight conditions in a controlled environment on the ground gives us the ability to not only evaluate the effects of microgravity on the host immune system, but also how the microorganisms that cause immune disorders are being affected by these drastic environmental shifts. In this study, I use both spaceflight and ground-based (simulated microgravity) environments to examine the genetic changes associated with increased S. marcescens virulence in order to understand how microgravity is affecting this pathogen, as well as to evaluate how these genetic changes influence and interact with the host immune system. This study will provide us with more directed approaches to studying the effects of spaceflight on human beings, with the ultimate goal of being able to ameliorate human immune dysfunction in future space exploration.

Description: Extended exposure to radiation and microgravity in space has been linked to astronauts developing chronic diseases upon returning to Earth. The Gram-negative pathogen Serratia marcescens has been shown to potentially cause significant infections in humans and in insect models on Earth. Our recent findings also showed that S. marcescens shows an increase in virulence after a short period of growth in the spaceflight environment, which raises initiatives to find the correlation between space environment and the increased virulence. Because we know that the health of astronauts is immunocompromised in space, it is possible that the combination of increased bacterial virulence and the weakened immune system will cause astronauts to be more susceptible to chronic diseases in extended spaceflight. With 75% of human disease genes being conserved in the fruit fly Drosophila melanogaster, these insects act as an ideal model organism to study the human immune system. The high accessibility, low cost, high rate of reproductivity, and short lifespans of D. melanogaster facilitate efficient, high-quality research that seeks to understand altered virulence of this opportunistic pathogen. In this ground-based study, we will use a rotating wall vessel apparatus to simulate microgravity and determine how pathogenicity changes by evaluating differences in gene expression for S. marcescens between bacteria grown in simulated microgravity conditions and controls. We will compare the results of our findings to gene expression patterns in actual spaceflight samples of S. marcescens grown on the ISS (International Space Station) during a recent validation mission, to see if there are common mechanisms across our simulated microgravity and actual spaceflight microgravity samples that both show increased virulence in the fruit fly. With extended space travel in the foreseeable future, understanding how human physiology will be affected by these different factors will help mitigate risks and deaths.

Description: While it has been shown that decades of astronauts and cosmonauts can suffer from illnesses both during and after spaceflight, the underlying causes are still poorly understood, due in part to the fact that there are so many variables to consider when investigating the human immune system in a complex environment. Invertebrates have become popular models for studying human disease because they are cheap, highly amenable to experimental manipulation, and have innate immune systems with a high genetic similarity to humans. Fruit flies (Drosophila melanogaster) have been shown to experience a dramatic shift in immune gene expression following spaceflight, but are still able to fight off infections when exposed to bacteria. However, the common bacterial pathogen Serratia marcescens was shown to become more lethal to fruit flies after being cultured in space, suggesting that not only do we need to consider host changes in susceptibility, but also changes in the pathogen itself after spaceflight conditions. Being able to simulate spaceflight conditions in a controlled environment on the ground gives us the ability to not only evaluate the effects of microgravity on the host immune system, but also how the microorganisms that cause immune disorders are being affected by these drastic environmental shifts. In this study, I use a ground-based simulated microgravity environment to examine the genetic changes associated with increased S. marcescens virulence in order to understand how microgravity is affecting this pathogen, as well as how these genetic changes influence and interact with the host immune system. This study will provide us with more directed approaches to studying the effects of spaceflight on human beings, with the ultimate goal of being able to counteract immune dysfunction in future space exploration.

Description: While it has been shown that decades of astronauts and cosmonauts can suffer from illnesses both during and after spaceflight, the underlying causes are still poorly understood, due in part to the fact that there are so many variables to consider when investigating the human immune system in a complex environment. Invertebrates have become popular models for studying human disease because they are cheap, highly amenable to experimental manipulation, and have innate immune systems with a high genetic similarity to humans. Fruit flies (Drosophila melanogaster) have been shown to experience a dramatic shift in immune gene expression following spaceflight, but are still able to fight off infections when exposed to bacteria. However, the common bacterial pathogen Serratia marcescens was shown to become more lethal to fruit flies after being cultured in space, suggesting that not only do we need to consider host changes in susceptibility, but also changes in the pathogen itself after spaceflight conditions. Being able to simulate spaceflight conditions in a controlled environment on the ground gives us the ability to not only evaluate the effects of microgravity on the host immune system, but also how the microorganisms that cause immune disorders are being affected by these drastic environmental shifts. In this study, I use a ground-based simulated microgravity environment to examine the genetic changes associated with increased S. marcescens virulence in order to understand how microgravity is affecting this pathogen, as well as how these genetic changes influence and interact with the host immune system. This study will provide us with more directed approaches to studying the effects of spaceflight on human beings, with the ultimate goal of being able to counteract immune dysfunction in future space exploration.

Description: While evidence suggests that astronauts and cosmonauts suffer from immune disorders both during and after spaceflight, the underlying causes are still poorly understood, due in part to the fact that there are so many variables to consider when investigating the human immune system in a complex environment. Furthermore, research has shown that common human pathogens also become more virulent after experiencing spaceflight, which can be especially concerning in the context of potentially immunocompromised astronauts. Invertebrates have become popular models for studying human disease because they have immune systems with a high genetic similarity to humans. Recently, the common bacterial pathogen Serratia marcescens was shown to become more lethal to the fruit fly, Drosophila melanogaster, after being cultured in space, suggesting that not only do we need to consider host changes in susceptibility, but also changes in the pathogen itself after exposure to spaceflight conditions. Being able to simulate spaceflight conditions in a controlled environment on the ground gives us the ability to understand how the microorganisms that cause immune disorders are being affected by these drastic environmental shifts. In this study, I use both spaceflight and Low-shear modeled microgravity (LSMMG) environments to examine the genetic changes associated with increased S. marcescens virulence in order to understand how microgravity is affecting this pathogen, as well as how these genetic changes influence and interact with the host immune system. I also examined the effects of nutrient composition and altered growth conditions on the LSMMG-induced increase in virulence, as well as changes in gene expression mediated by both nutrient composition and exposure to LSMMG. This study will provide us with more directed approaches to studying the effects of spaceflight on human beings, with the ultimate goal of being able to prevent human immune dysfunction in future space exploration.