Myopia : why study the mechanisms of myopia? Novel approaches to risk factors Signaling eye growth- how could basic biology be translated into clinical insights? Where are genetic and proteomic approaches leading? How does visual function contribute to an

On July 26–29, 2010 the 13th International Myopia Conference was held in Tübingen, Germany and included 17 separate symposia, each with 3–5 presentations. Here, in a single paper, the chairs of those Symposia describe the scientific advances noted at the conference and include the full abstracts of the individual myopia papers presented in each symposium along with the authors and their institutions. The 17 Symposia covered 7 topics: Why Study the Mechanisms of Myopia?; Novel Approaches to Risk Factors; Signaling Eye Growth- How Could Basic Biology Be Translated into Clinical Insights?; Where Are Genetic and Proteomic Approaches Leading?; How Does Visual Function Contribute to and Interact with Ametropia?; Does Eye Shape Matter?; Why Ametropia at All?

Application of the gradient boosted method in randomised clinical trials: participant variables that contribute to depression treatment efficacy of duloxetine, SSRIs or placebo

Randomised, placebo-controlled trials of treatments for depression typically collect outcomes data but traditionally only analyse data to demonstrate efficacy and safety. Additional post-hoc statistical techniques may reveal important insights about treatment variables useful when considering inter-individual differences amongst depressed patients. This paper aims to examine the Gradient Boosted Model (GBM), a statistical technique that uses regression tree analyses and can be applied to clinical trial data to identify and measure variables that may influence treatment outcomes.

Urbanisation, climate change and health equity: how can health promotion contribute?

We live in a world that is constantly changing and is challenging established approaches to managing human and ecological health. Two key drivers of change are urbanisation and global climate change. This commentary is concerned with the interrelationship of these drivers with human and ecological health, proposing that health promotion practitioners need to actively seek a new role in the process of creating urban environments that support social and ecological well-being. It provides practitioners with an up-to-date synthesis of climate change science and future projections, the literature around the health impacts of climate change and potential health challenges to urban communities. We argue that health promotion cannot respond to the challenges created by climate change and urbanisation, nor can it meet its own mandate without shifting from an anthropogenic-focussed approach toward embracing a multi-scale, collaborative approach outside the health sector. We suggest that the underlying principles of health promotion, which include equity and community engagement at all scales, are critical to the evolution of thriving urban environments. Food security is given as an example to demonstrate the proposed shift away from an anthropogenic and urban focus toward a socio-ecological approach (i.e. resilience thinking) that provides a framework for collaboration between sectors working with unpredictable global systems. In so doing, the commentary provides practitioners with guidance on the complex science of climate change and its impact on health in urban settings, as well as highlighting the skills that they can bring to creating resilient urban settlements in these times of change.

Can macroalgae contribute to blue carbon? An Australian perspective

Macroalgal communities in Australia and around the world store vast quantities of carbon in their living biomass, but their prevalence of growing on hard substrata means that they have limited capacity to act as long-term carbon sinks. Unlike other coastal blue carbon habitats such as seagrasses, saltmarshes and mangroves, they do not develop their own organic-rich sediments, but may instead act as a rich carbon source and make significant contributions in the form of detritus to sedimentary habitats by acting as a “carbon donor” to “receiver sites” where organic material accumulates. The potential for storage of this donated carbon however, is dependent on the decay rate during transport and the burial efficiency at receiver sites. To better understand the potential contribution of macroalgal communities to coastal blue carbon budgets, a comprehensive literature search was conducted using key words, including carbon sequestration, macroalgal distribution, abundance and productivity to provide an estimation of the total amount of carbon stored in temperate Australian macroalgae. Our most conservative calculations estimate 109.9 Tg C is stored in living macroalgal biomass of temperate Australia, using a coastal area covering 249,697 km2. Estimates derived for tropical and subtropical regions contributed an additional 23.2 Tg C. By extending the search to include global studies we provide a broader context and rationale for the study, contributing to the global aspects of the review. In addition, we discuss the potential role of calcium carbonate-containing macroalgae, consider the dynamic nature of macroalgal populations in the context of climate change, and identify the knowledge gaps that once addressed will enable robust quantification of macroalgae in marine biogeochemical cycling of carbon. We conclude that macroalgal communities have the potential to make ecologically meaningful contributions toward global blue carbon sequestration, as donors, but given that the fate of detached macroalgal biomass remains unclear, further research is needed to quantify this contribution.

Patient and carer identified factors which contribute to safety incidents in primary care: a qualitative study

BACKGROUND: Patients can have an important role in reducing harm in primary-care settings. Learning from patient experience and feedback could improve patient safety. Evidence that captures patients' views of the various contributory factors to creating safe primary care is largely absent. The aim of this study was to address this evidence gap. METHODS: Four focus groups and eight semistructured interviews were conducted with 34 patients and carers from south-east Australia. Participants were asked to describe their experiences of primary care. Audio recordings were transcribed verbatim and specific factors that contribute to safety incidents were identified in the analysis using the Yorkshire Contributory Factors Framework (YCFF). Other factors emerging from the data were also ascertained and added to the analytical framework. RESULTS: Thirteen factors that contribute to safety incidents in primary care were ascertained. Five unique factors for the primary-care setting were discovered in conjunction with eight factors present in the YCFF from hospital settings. The five unique primary care contributing factors to safety incidents represented a range of levels within the primary-care system from local working conditions to the upstream organisational level and the external policy context. The 13 factors included communication, access, patient factors, external policy context, dignity and respect, primary-secondary interface, continuity of care, task performance, task characteristics, time in the consultation, safety culture, team factors and the physical environment. DISCUSSION: Patient and carer feedback of this type could help primary-care professionals better understand and identify potential safety concerns and make appropriate service improvements. The comprehensive range of factors identified provides the groundwork for developing tools that systematically capture the multiple contributory factors to patient safety.

How social work can contribute in the shift to personalised, recovery-oriented psycho-social disability support services

This paper presents the findings from an Australian study in which forty-one people, who self-identified as having a psycho-social disability as a result of mental health problems, spoke about their priorities for treatment, care and support within a personalised funding context. The research enabled an improved understanding of the choices about support that people with psycho-social disabilities would make if offered individualised funding packages. Participants prioritised specific supports to improve their health, financial situation, social connection, housing and personal relationships. A relationship with a support worker with a range of skills was identified as a key facilitator of these life goals, but people with psycho-social disabilities also valued opportunities to have discretionary funds to directly address the major problems they face, including stigma, discrimination and poverty. The paper argues that social workers can potentially fill a range of roles and are well placed to work in partnership with people with psycho-social disabilities. Particularly, they have skills in co-production of services, negotiation and advocacy that are required if individual funding is to be maximised for user control, social justice and personal recovery outcomes.

What factors contribute to failure of fieldwork placement? Perspectives of supervisors and university fieldwork educators

Failing a fieldwork placement can be a challenging and emotional experience. This study aimed to explore the perspectives of placement supervisors and university fieldwork educators (UFEs) of the factors that contribute to occupational therapy students failing placement. Twenty placement supervisors and four UFEs participated, and completed single instance surveys and interviews. Failure of a placement was noted to be a stressful experience for all stakeholders. Reasons identified for student failure included poor communication and reflection skills; non-disclosure of health issues and an inability to accept feedback. Placement supervisors highlighted that although failing a student was difficult, there was a need to uphold the values and standards of the profession. Strategies to facilitate placement success were identified.