A critical ethnography of communication processes involving the management of oral chemotherapeutic agents by patients with a primary diagnosis of colorectal cancer: study protocol.

AIM: To describe the protocol used to examine the processes of communication between health professionals, patients and informal carers during the management of oral chemotherapeutic medicines to identify factors that promote or inhibit medicine concordance. BACKGROUND: Ideally communication practices about oral medicines should incorporate shared decision-making, two-way dialogue and an equality of role between practitioner and patient. While there is evidence that healthcare professionals are adopting these concordant elements in general practice there are still some patients who have a passive role during consultations. Considering oral chemotherapeutic medications, there is a paucity of research about communication practices which is surprising given the high risk of toxicity associated with chemotherapy. DESIGN: A critical ethnographic design will be used, incorporating non-participant observations, individual semi-structured and focus-group interviews as several collecting methods. METHODS: Observations will be carried out on the interactions between healthcare professionals (physicians, nurses and pharmacists) and patients in the outpatient departments where prescriptions are explained and supplied and on follow-up consultations where treatment regimens are monitored. Interviews will be conducted with patients and their informal carers. Focus-groups will be carried out with healthcare professionals at the conclusion of the study. These several will be analysed using thematic analysis. This research is funded by the Department for Employment and Learning in Northern Ireland (Awarded February 2012). DISCUSSION: Dissemination of these findings will contribute to the understanding of issues involved when communicating with people about oral chemotherapy. It is anticipated that findings will inform education, practice and policy.

Immune thrombocytopenic purpura (ITP) and breast cancer. Does adjuvant therapy for breast cancer improve platelet counts in ITP?

Although both breast cancer and immune thrombocytopenic purpura (ITP) are common conditions, the simultaneous coexistence of these two diseases is rare. ITP is an autoimmune disease in which the presence of autoantibodies against platelets results in splenic sequestration and thrombocytopenia that may be associated with lymphoid neoplasms [1]. Except for an observational case series of 10 patients [2], only a few individual case reports of ITP coinciding with breast cancer have been reported [3–8]. We are reporting two cases with simultaneous confirmed ITP and breast cancer. The platelet counts in both women have improved during adjuvant breast cancer chemotherapy.

Postchemotherapy and tumor-selective targeting with the La-specific DAB4 monoclonal antibody relates to apoptotic cell clearance

Early identification of tumor responses to treatment is crucial for devising more effective and safer cancer treatments. No widely applicable, noninvasive method currently exists for specifically detecting tumor cell death after cytotoxic treatment and thus for predicting treatment outcomes.

Controllable drug uptake and nongenomic response through estrogen-anchored cyclodextrin drug complex

Breast cancer is a leading killer of women worldwide. Cyclodextrin-based estrogen receptor-targeting drug-delivery systems represent a promising direction in cancer therapy but have rarely been investigated. To seek new targeting therapies for membrane estrogen receptor-positive breast cancer, an estrogen-anchored cyclodextrin encapsulating a doxorubicin derivative Ada-DOX (CDE1-Ada-DOX) has been synthesized and evaluated in human breast cancer MCF-7 cells. First, we synthesized estrone-conjugated cyclodextrin (CDE1), which formed the complex CDE1-Ada-DOX via molecular recognition with the derivative adamantane-doxorubicin (Ada-DOX) (Kd =1,617 M(-1)). The structure of the targeting vector CDE1 was fully characterized using (1)H- and (13)C-nuclear magnetic resonance, mass spectrometry, and electron microscopy. CDE1-Ada-DOX showed two-phase drug-release kinetics with much slower release than Ada-DOX. The fluorescence polarization analysis reveals that CDE1-Ada-DOX binds to recombinant human estrogen receptor α fragments with a Kd of 0.027 µM. Competition assay of the drug complex with estrogen ligands demonstrated that estrone and tamoxifen competed with CDE1-Ada-DOX for membrane estrogen receptor binding in MCF-7 cells. Intermolecular self-assembly of CDE1 molecules were observed, showing tail-in-bucket and wire-like structures confirmed by transmission electronic microscopy. CDE1-Ada-DOX had an unexpected lower drug uptake (when the host-guest ratio was >1) than non-targeting drugs in MCF-7 cells due to ensconced ligands in cyclodextrins cavities resulting from the intermolecular self-assembly. The uptake of CDE1-Ada-DOX was significantly increased when the host-guest ratio was adjusted to be less than half at the concentration of CDE1 over 5 µM due to the release of the estrone residues. CDE1 elicited rapid activation of mitogen-activated protein kinases (p44/42 MAPK, Erk1/2) in minutes through phosphorylation of Thr202/Tyr204 in MCF-7 cells. These results demonstrate a targeted therapeutics delivery of CDE1-Ada-DOX to breast cancer cells in a controlled manner and that the drug vector CDE1 can potentially be employed as a molecular tool to differentiate nongenomic from genomic mechanism.

`Zealotry or nostalgic regret`? women leaders in technical and further education in Australia : agents of change, entrepreneurial educators or corporate citizens?

Education has been restructured in many Western post-industrial nation states during the 1990s. The Australian Technical and Further Education sector (TAFE) has been particularly susceptible to discourses of responsiveness to the market and the new entrepreneuralism. This article explores how women have been repositioned in contradictory and ambiguous ways as the new entrepreneurial middle managers by existing and emergent discourses that circulated in and through TAFE organizations. In turn, it points to how discourses of change management and client responsiveness took on particular readings within specific institutional and professional cultures of the eight Technical and Further Education institutions (TAFEs). At the same time, the restructuring that arose from the corporatization of TAFE, in a highly gendered process, through the twin strategies of marketization and the new managerialism produced new possibilities for individual women educators who moved up into middle management. Yet these individual women were positioned within highly masculinist 'neo-corporate bureaucratic cultures' that co-opted their passion for the capacity of education to make a difference and incorporated these new entrepeneurial work identities.

Accessing database information using mobile agents

Many real-world applications on the Internet require accessing database information and typical technology employed is client/server plus Web (C/S + Web). Although past few years saw many success applications by using this technique, there are still some drawbacks that need to be overcome. One of the drawbacks is that the transaction often fails if the network connection is unstable. Another disadvantage is high bandwidth requirement and latency. This paper argues that mobile agent technology provide an easy way to overcome the shortcomings in CIS + Web in database access on the Internet. A success case study using mobile agents to admit new students to China's institutions is then presented. The mobile agent was created by using IBM's Aglets Software Development Kit (SDK). Based on the experimental results, it is evident that mobile agent technology is well suited for such applications.

Agents and stream data mining: a new perspective

Many organizations struggle with the massive amount of data they collect. Today, data does more than serve as the ingredients for churning out statistical reports. They help support efficient operations in many organizations, and to some extent, data provide the competitive intelligence organizations need to survive in today's economy. Data mining can't always deliver timely and relevant results because data are constantly changing. However, stream-data processing might be more effective, judging by the Matrix project.

Initial value generation for matchmaking in middle agents

One of the major challenges that agents used in open environments must face is that they must be able to find each other. This is because in an open environment, agents might appear and disappear unpredictably. To address this issue, middle agents have been proposed. The performance of middle agents relies heavily on the matchmaking algorithms used. Matchmaking is the process of finding an appropriate provider for a requester through a middle agent. The practical performance of service provider agents has a significant impact on the matchmaking outcomes of middle agents. Thus the track records of agents in accomplishing similar tasks in the past should be taken into account in matchmaking process. Considering that there are no track records available at the launching of an agent system, this paper discusses some ways to provide reasonable initial values for the track  records. With the agents' history and the initial vallies ofthe track records, the performance of matchmaking algorithms can be improved significantly.

An improvement to matchmaking algorithms for middle agents

A question frequently asked in multi-agent systems (MASs) concerns the efficient search for suitable agents to solve a specific problem. To answer this question, different types of middle agents are usually employed. The performance of middle agents relies heavily on the matchmaking algorithms used. Matchmaking is the process of finding an appropriate provider for a requester through a middle agent. There has been substantial work on matchmaking in different kinds of middle agents. To our knowledge, almost all currently used matchmaking algorithms missed one point when doing matchmaking -- the matchmaking is only based on the advertised capabilities of provider agents. The actual performance of provider agents in accomplishing delegated tasks is not considered at all. This results in the inaccuracy of the matchmaking outcomes as well as the random selection of provider agents with the same advertised capabilities. The quality of service of different service provider agents varies from one agent to another even though they claimed they have the same capabilities. To this end, it is argued that the practical performance of service provider agents has a significant impact on the matchmaking outcomes of middle agents. An improvement to matchmaking algorithms is proposed, which makes the algorithms have the ability to consider the track records of agents in accomplishing delegated tasks. How to represent, accumulate, and use track records as well as how to give initial values for track records in the algorithm are discussed. A prototype is also built to verify the algorithm. Based on the improved algorithm, the matchmaking outcomes are more accurate and reasonable.

Agents for invocation of web services

Web services are becoming popular and widely accepted on the Internet. UDDI is the standard for publishing and discovery of web services. In this paper, we investigate semantics description of web services based on domain ontology; based on this language, we propose an architecture for invoking agents to consume services within the UDDI registry. The semantics service description language together with agent creation
architecture provides a new way to discover and utilise published web services. This method is flexible and extendable to accomplish complex web service requests.