ALBERT

Description: Sustainability, Vol. 10, Pages 398: Sustainable Urban Homecare Delivery with Different Means of Transport Sustainability doi: 10.3390/su10020398 Authors: Norina Szander Lorenzo Ros-McDonnell María de-la-Fuente-Aragón Robert Vodopivec Due to the increasing number of requests for homecare services, care institutions struggle to perform in urban traffic, which eventually makes travel times longer and less predictable and, therefore, leads to a declining service quality. Homecare delivery scheduling and planning tools must lead to efficient reliable routes that allow the nursing crew to make the least efforts and use the fewest institutional resources, and that consider urban sustainability goals. For the case study, a European city was selected with 58,000 people of whom 73 patients received long-term care at homes provided by 11 homecare nurses. While maximising patient satisfaction, a homecare planning algorithm considered many means of transport and minimised travel times. The study reduced the total nurses’ working hours/day by a bus and walking combination, and by comparing if nurses ride e-bikes, which respectively reduced ~35–44% of the total time that nurses spent travelling. This result is applicable to an urban environment where the public transport network is sufficient and biking is allowed on a reasonable number of roads. Better homecare management can support the efficient use of resources of health care institutions, high-quality home care and aspirations towards livable communities and sustainable development.

Description: The essential characteristics that distinguish homecare services from other routing and scheduling problems are relatively few patients being spread out over a large urban area, long transport times and several different services being provided. The approach that the authors present herein was developed to solve planning homecare services according to the criterion of increasing social sustainability and incorporating environmentally sustainable transport systems. The objective of this paper is to present a tool to plan the daily work carried out by a homecare service with assigned patients with specific care requirements. It relies on the resources of nurses with different qualifications by assuming costs that depend on both offering the service and the different chosen transport modes. The algorithm manages several priority rules by ensuring that homecare provider goals and standards are met. The developed algorithm was tested according to the weekly homecare schedule of a group of nurses in a medium-sized European city and was successfully used during validation to improve homecare planning decisions. The results, therefore, are not generalisable but its modular structure ensures its applicability to different cases. The algorithm provides a patient-centred visiting plan and improves transport allocation by offering nurses a better route assignment by considering the required variables and each nurse’s daily workload.

Description: Background RASSF1A and RASSF1C are two major isoforms encoded by the Ras association domain family 1 (RASSF1) gene through alternative promoter selection and mRNA splicing. RASSF1A is a well established tumor suppressor gene. Unlike RASSF1A, RASSF1C appears to have growth promoting actions in lung cancer. In this article, we report on the identification of novel RASSF1C target genes in non small cell lung cancer (NSCLC). Methods Over-expression and siRNA techniques were used to alter RASSF1C expression in human lung cancer cells, and Affymetrix-microarray study was conducted using NCI-H1299 cells over-expressing RASSF1C to identify RASSF1C target genes. Results The microarray study intriguingly shows that RASSF1C modulates the expression of a number of genes that are involved in cancer development, cell growth and proliferation, cell death, and cell cycle. We have validated the expression of some target genes using qRT-PCR. We demonstrate that RASSF1C over-expression increases, and silencing of RASSF1C decreases, the expression of PIWIL1 gene in NSCLC cells using qRT-PCR, immunostaining, and Western blot analysis. We also show that RASSF1C over-expression induces phosphorylation of ERK1/2 in lung cancer cells, and inhibition of the MEK-ERK1/2 pathway suppresses the expression of PIWIL1 gene expression, suggesting that RASSF1C may exert its activities on some target genes such as PIWIL1 through the activation of the MEK-ERK1/2 pathway. Also, PIWIL1 expression is elevated in lung cancer cell lines compared to normal lung epithelial cells. Conclusions Taken together, our findings provide significant data to propose a model for investigating the role of RASSF1C/PIWIL1 proteins in initiation and progression of lung cancer.