Interleukin-17 Pathophysiology and Therapeutic Intervention in Cystic Fibrosis Lung Infection and Inflammation.

Cystic fibrosis (CF) is characterized by an excessive neutrophilic inflammatory response within the airway as a result of defective cystic fibrosis transmembrane receptor (CFTR) expression and function. Interleukin-17A induces airway neutrophilia and mucin production associated with Pseudomonas aeruginosa colonization, which is associated with the pathophysiology of cystic fibrosis. The objectives of this study were to use the preclinical murine model of cystic fibrosis lung infection and inflammation to investigate the role of IL-17 in CF lung pathophysiology and explore therapeutic intervention with a focus on IL-17. Cftr-deficient mice (CF mice) and wild-type mice (WT mice) infected with P. aeruginosa had robust IL-17 production early in the infection associated with a persistent elevated inflammatory response. Intratracheal administration of IL-17 provoked a neutrophilic response in the airways of WT and CF animals which was similar to that observed with P. aeruginosa infection. The neutralization of IL-17 prior to infection significantly improved the outcomes in the CF mice, suggesting that IL-17 may be a therapeutic target. We demonstrate in this report that the pathophysiological contribution of IL-17 may be due to the induction of chemokines from the epithelium which is augmented by a deficiency of Cftr and ongoing inflammation. These studies demonstrate the in vivo contribution of IL-17 in cystic fibrosis lung disease and the therapeutic validity of attenuating IL-17 activity in cystic fibrosis.

myPace: an integrative health platform for supporting weight loss and maintenance behaviors.

Obesity is a major health concern caused by unhealthy eating behaviors. Digital weight loss interventions have adopted mobile technology primarily in order to support self-monitoring. However, many available apps are not designed as a part of dietetic practice; therefore, a distinct gap in the research exists relating to technology that supports the patient-practitioner relationship. This paper presents myPace, which is a complete weight loss and management system that is deployed via a smartphone and a PC. It connects dietitians and patients between face-to-face consultations and extends the relationship through patients' regular progress updates and dietitians' tailored and timely advice, for sustained behavior change. The prototype was developed from research into behavior change for weight loss, which furthermore was underpinned by theory and tenets of human support models, such as the supportive accountability framework. We report on an early-phase system design goals via a formative research process, which aimed to implement theoretical principles and match practical dietetic practice. To that end, only the clinical end user's perspective was sought through a coaching think-aloud protocol on the first iteration of the prototype and interviews with dietitians. Findings show that the system has many positive design features, but which require further development in order for the system to be fully acceptable within dietetic practice and motivate patient engagement.

'Would you eat cultured meat?': Consumers' reactions and attitude formation in Belgium, Portugal and the United Kingdom.

Cultured meat has evolved from an idea and concept into a reality with the August 2013 cultured hamburger tasting in London. Still, how consumers conceive cultured meat is largely an open question. This study addresses consumers' reactions and attitude formation towards cultured meat through analyzing focus group discussions and online deliberations with 179 meat consumers from Belgium, Portugal and the United Kingdom. Initial reactions when learning about cultured meat were underpinned by feelings of disgust and considerations of unnaturalness. Consumers saw few direct personal benefits but they were more open to perceiving global societal benefits relating to the environment and global food security. Both personal and societal risks were framed in terms of uncertainties about safety and health, and possible adverse societal consequences dealing with loss of farming and eating traditions and rural livelihoods. Further reflection pertained to skepticism about 'the inevitable' scientific progress, concern about risk governance and control, and need for regulation and proper labeling.

Choosing and using: patient choice in 'Choose and Book'.

Seventy six percent of people feel that the main healthcare priority should be to involve people in decisions over the treatment of their illness. One group of users in primary care that are likely to have diminished choice are the heaviest users: the elderly. Modernization of the NHS has placed the user as a consumer, thus creating a more user-friendly service that not only takes into account the role of the consumer, but actively engages with them. Increased patient choice provides a context for meeting patient expectations. Patient choice and patient centred care are evident within the NHS Plan, which outlines a vision of health services designed around the patient. This article will review the extent to which elderly patients have real and meaningful choices in the 'Choose and Book' system which operates within the primary care setting.