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Biomedical subjects

Philip Shields

Publications and source records attributed to Philip Shields.

2 recordsLinked to original sources

Recruitment of lymphocytes to the human liver.

This review discusses the function and localisation of lymphocytes resident within the human liver, under both physiological and pathological conditions. Through description of the mechanisms that mediate lymphocyte recruitment into tissues, this article explains how hepatic endothelial and epithelial cells regulate the recruitment of specific lymphocyte subpopulations. We illustrate that the expression of adhesion molecules and chemokines is crucial to the control of lymphocyte adhesion. Thus, in the normal liver, adhesion molecules such as vascular adhesion protein-1 (VAP-1), intercellular adhesion molecule-1 (ICAM-1) and intercellular adhesion molecule-2 (ICAM-2), and chemokines such as regulated on activation, normal T cell expressed and secreted (RANTES), monocyte chemoattractant protein-1 (MCP-1), macrophage inflammatory protein-1alpha (MIP-1alpha), interferon gamma inducible protein-10 (IP-10), MIG and interferon inducible T-cell alpha chemoattractant (ITAC) are involved in lymphocyte binding to different endothelial compartments. However, in response to inflammation or injury, additional expression of adhesion molecules such as VCAM-1, p-selectin and e-selectin, as well as higher levels of chemokines, permits the attraction and retention of specific effector populations of lymphocytes. We also discuss the expression and function of a newly defined adhesion protein, (VAP-1), and suggest that the unique functions of this protein may provide therapeutic potential for the treatment of liver disease.

Animals↗

Commissioning post-registration education programmes for health professionals.

Many of the post-registration education programmes provided by the universities for health professionals are commissioned on behalf of NHS employers by the Workforce Development Confederations. (Workforce Development Confederations were formed from their predecessor organizations, Education Consortia, from 1 April 2001.) This study describes a review of the post-registration education contracts held by the North and East Yorkshire Confederation, together with a survey of post-registration contracting across England. A recurrent theme was that contracting arrangements did not easily allow the purchasers of education to measure value for money. Other key issues were found to be the relevance of courses to clinical practice and their accessibility in view of difficulties in releasing staff. A new form of contract will be introduced by this Confederation, basing payment on the academic credit of courses, which will facilitate cost comparisons with other providers. At the same time a greater level of partnership with providers will be fostered and the risks inherent in the contracting mechanism will be shared between the commissioner and the providers. The review also highlighted issues that must be addressed by NHS employers if Confederations are to be able to commission effectively on their behalf.

Allied Health Personnel↗