Hepatitis C, mental health and equity of access to antiviral therapy : a systematic narrative review

Introduction Access to hepatitis C (hereafter HCV) antiviral therapy has commonly excluded populations with mental health and substance use disorders because they were considered as having contraindications to treatment, particularly due to the neuropsychiatric effects of interferon that can occur in some patients. In this review we examined access to HCV interferon antiviral therapy by populations with mental health and substance use problems to identify the evidence and reasons for exclusion. Methods We searched the following major electronic databases for relevant articles: PsycINFO, Medline, CINAHL, Scopus, Google Scholar. The inclusion criteria comprised studies of adults aged 18 years and older, peer-reviewed articles, date range of (2002--2012) to include articles since the introduction of pegylated interferon with ribarvirin, and English language. The exclusion criteria included articles about HCV populations with medical co-morbidities, such as hepatitis B (hereafter HBV) and human immunodeficiency virus (hereafter HIV), because the clinical treatment, pathways and psychosocial morbidity differ from populations with only HCV. We identified 182 articles, and of these 13 met the eligibility criteria. Using an approach of systematic narrative review we identified major themes in the literature. Results Three main themes were identified including: (1) pre-treatment and preparation for antiviral therapy, (2) adherence and treatment completion, and (3) clinical outcomes. Each of these themes was critically discussed in terms of access by patients with mental health and substance use co-morbidities demonstrating that current research evidence clearly demonstrates that people with HCV, mental health and substance use co-morbidities have similar clinical outcomes to those without these co-morbidities. Conclusions While research evidence is largely supportive of increased access to interferon by people with HCV, mental health and substance use co-morbidities, there is substantial further work required to translate evidence into clinical practice. Further to this, we conclude that a reconsideration of the appropriateness of the tertiary health service model of care for interferon management is required and exploration of the potential for increased HCV care in primary health care settings.

A role for IGF-1R-targeted therapies in small-cell lung cancer?

Background: Small-cell lung cancer (SCLC) is an aggressive disease with a poor prognosis. The insulin-like growth factor-1 receptor (IGF-1R) is an autocrine growth factor and an attractive therapeutic target in many solid tumors, but particularly in lung cancer. Patients and Methods: This study examined tumor samples from 23 patients diagnosed with SCLC, 11 resected specimens and 12 nodal biopsies obtained by mediastinoscopy, for expression of IGF-1R using the monoclonal rabbit anti-IGF-1R (clone G11, Ventana Medical Systems, Tucson, AZ) and standard immunohistochemistry (IHC). Results: All 23 tumor samples expressed IGF-1R with a range of stain intensity from weak (1+) to strong (3+). Ten tumors had a score of 3+, 7 tumors 2+, and 6 tumors 1+. Patient survival data were available for all 23 patients. Two patients died < 30 days post biopsy, therefore, the intensity of anti-IGF-1R immunostaining for 21 patients was correlated to survival. Patients with 3+ immunostaining had a poorer prognosis (P = .003). The overall survival of patients who underwent surgical resection was significantly better (median survival not reached) than patients who were not resected (median survival, 7.4 months) (P = .006). Conclusion: IGF-1R targeted therapies may have a role in the treatment of SCLC in combination with chemotherapy or as maintenance therapy. Further studies on the clinical benefit of targeting IGF-1R in SCLC are needed.

Expression of thrombospondin-1 in resected colorectal liver metastases predicts poor prognosis

Purpose The aim of this study was to examine the expression and prognostic relevance of thrombospondin-1 (TSP-1) in tumor biopsies taken from a consecutive series of liver resections done at the University Hospitals of Leicester and the Royal Liverpool Hospital. Experimental Design Patients having undergone a liver resection for colorectal liver metastases at our institutions between 1993 and 1999 inclusive were eligible. Inclusion criteria were curative intent, sufficient tumor biopsy, and patient follow-up data. One hundred eighty-two patients were considered in this study. Standard immunohistochemical techniques were used to study the expression of TSP-1 in 5-μm tumor sections from paraffin-embedded tissue blocks. TSP-1 was correlated with survival using the Kaplan-Meier method and log-rank test for univariate analysis and the Cox proportional hazard model for multivariate analysis. Results One hundred eighty-two patients (male, n = 122 and female, n = 60) ages between 25 and 81 years (mean, 61 years) were included. TSP-1 was expressed around blood vessels (n = 45, 25%) or in the stroma (n = 59, 33%). No expression was detected in the remaining tumors. TSP-1 significantly correlated with poor survival on univariate (P = 0.01 for perivascular expression and P = 0.03 for stromal expression) and multivariate analysis (P = 0.01 for perivascular expression). Conclusion TSP-1 is a negatively prognostic factor for survival in resected colorectal liver metastases. © 2005 American Association for Cancer Research.

Cross-cultural learning experiences in architectural education

This qualitative study looks at the joint output of 20 architecture students from 2 different countries during their short respective Study Tours to each other’s country to discern the effect of cross-cultural experiences on their learning. This paper uses the students’ joint design efforts and reflective writings to investigate the outcome of this cross-cultural educational exchange. Their joint design efforts resulted in the making of small built structures, drawings and collaborative design proposals for an urban setting. In addition, a short questionnaire and personal interviews were also used as methods to gain insight into their experience and to use as a comparative study. The question is also raised in this paper of whether spontaneous friendship among students is integral to long term learning in a cross-cultural context in comparison to pre-designed learning objectives on the part of the educators. This paper also initiates the dialogue of the extent of cultural influences and universal ideas on collaborative architectural design. With increasing joint design ventures between architectural firms in different countries, there is interest in how collaborative design can be understood in a cross-cultural context. This paper examines short term cross cultural experiences and its contribution to architectural education.

Evoking gesture in interactive art

In this paper, we describe an interactive artwork that uses large body gestures as its primary interactive mode. The artist intends the work to provoke active reflection in the audience by way of gesture and content. The technology is not the focus, rather the aim is to provoke memory, to elicit feelings of connective human experiences in a required-to-participate audience. We find the work provokes a diverse and contradictory set of responses. The methods used to understand this include qualitative methods common to evaluating interactive art works, as well as in-depth discussions with the artist herself. This paper is relevant to the Human - Centered Computing track because in all stages of the design of the work - as well as the evaluation - the focus is on the human aspect; the computing is designed to enable all-too-human responses.

The lily, client and measure of Bruno Taut’s Glashaus

The Glashaus is considered a significant exemplar of early modernist architecture and is generally accepted as having had Expressionist origins. However, current research has revealed that the design origins of this important building are not fully understood. While the historical record acknowledges the contributions of the bohemian poet Paul Scheerbart and the art critic Adolf Behne, the role of the Glashaus’ architect, Bruno Taut, has been moderated. In an attempt to rectify this situation this article proposes that the design origins of the Glashaus can be found in a strong architect-client interaction. It is argued that the Glashaus’ client, the Deutsche Luxfer Prismen Syndikat under the directorship of Frederick Keppler, exerted a significant influence on its design. In order to showcase the glazed products of Luxfer in the best manner possible, Keppler insisted that the design feature a glazed dome, electric lighting, a fountain as well as a cascade. Given the detailed stipulations of this brief, Taut had few options other than to offer interpretations of precedent that derived from the Victoria regia lily and Gothic proportioning. By expounding this architect-client relationship, this article expands our understanding of the Glashaus, and reinvigorates our understanding of this important early example of modern architecture.

With budget cuts coming, ABC and SBS stand divided

Did SBS chief executive Michael Ebeid score a well-timed free kick or an own goal in his attack on the ABC this week? The ABC recently secured the free-to-air television rights for the Asian Cup football tournament to be held in Australia early next year, together with tonight’s match between the Socceroos and Japan. A lower bid by SBS – still in some circles fondly known as the “Soccer Broadcasting Service” – was rejected, dealing a significant blow to the smaller public broadcaster. The ABC was reportedly asked to make a bid by Football Federation Australia. The FFA presumably believes the ABC’s coverage will attract larger audiences to the game. This is despite SBS’s long-term success with the sport. It should not be forgotten, however, that while SBS has largely been defined by its long connection with the world game, ABC was the home of football from the late 1950s until the 1980s. But the stoush is only partly about football. It was surely no coincidence that it comes on the eve of the government’s formal announcement of the size of the cuts to public broadcasting...

Improved nutritional status is related to improved quality of life in Parkinson’s disease

Background: Quality of life is poorer in Parkinson’s disease than in other conditions and in the general population without Parkinson’s disease. Malnutrition also results in poorer quality of life. This study aimed at determining the relationship between quality of life and nutritional status. Methods: Community-dwelling people with Parkinson’s disease >18 years old were recruited. The Patient-Generated Subjective Global Assessment (PG-SGA) assessed nutritional status. The Parkinson’s Disease Questionnaire 39 (PDQ-39) measured quality of life. Phase I was cross-sectional. The malnourished in Phase I were eligible for a nutrition intervention phase, randomised into 2 groups: standard care (SC) with provision of nutrition education materials only and intervention (INT) with individualised dietetic advice and regular weekly follow-up. Data were collected at baseline, 6 weeks, and 12 weeks. Results: Phase I consisted of 120 people who completed the PDQ-39. Phase II consisted of 9 in the SC group and 10 in the INT group. In Phase I, quality of life was poorer in the malnourished, particularly for mobility and activities of daily living domains. There was a significant correlation between PG-SGA and PDQ-39 scores (Phase I, rs = 0.445, p = .000; Phase II, rs = .426, p = .002). In Phase II, no significant difference in the PDQ-39 total or sub-scores was observed between the INT and SC groups; however, there was significant improvement in the emotional well-being domain for the entire group, X2(2) = 8.84, p = .012. Conclusions: Malnourished people with Parkinson’s disease had poorer quality of life than the well-nourished, and improvements in nutritional status resulted in quality of life improvements. Attention to nutritional status is an important component of quality of life and therefore the total care of people with Parkinson’s disease.

The US’ trade secrets demands and what they mean for journos

Leaked Trans-Pacific Partnership documents show the US is pushing for unprecedented penalties for those (like journalists) who expose trade secrets. Will Australia go along with the proposal?

It's all in the Team: Collaborations driving success in learning – a first year case

First year medical laboratory science students (up to 120) undertake a group e-poster project, based in a blended learning model Google Drive, encompassing Google’s cloud computing software, provides a readily accessible, transparent online space for students to collaborate with each other and realise tangible outcomes from their learning The Cube provides an inspiring digital learning display space for student ‘conference style’ presentations

“Success in (Surviving) Bioscience and Pharmacology” – an eBook to improve the retention of diploma nurses transitioning to a Bachelor of Nursing course

Diploma students transitioning into the NS40 BNursing (BN) course at QUT withdraw from the bioscience and pharmacology units, and leave the university at higher rates than traditional students. The diploma students, entering in second year, have missed out on 2 units of bioscience taught to the traditional students in their first year, and miss out on a 3rd unit of bioscience taught to the traditional students in their 2nd year. Instead the diploma students receive one specialized unit in bioscience only i.e. a bridging unit. As a consequence, the diploma students may not have the depth of bioscience knowledge to be able to successfully study the bridging unit (LSB111) or the pharmacology unit (LSB384). Our plan was to write an eBook which refreshed and reinforced diploma students’ knowledge of bioscience aiming to prepare them with the concepts and terminology, and to build a level of confidence to support their transition to the BN. We have previously developed an intervention associated with reduced attrition of diploma nursing students, and this was our starting point. The study skills part of the initial intervention was addressed in the eBook, by links to the specialist services and resources available from our liaison librarian and academic skills adviser. The introductory bioscience/pharmacology information provided by the previous intervention involved material from standard textbooks. However, we considered this material too difficult for diploma students. Thus, we created simplified diagrams to go with text as part of our eBook. The outcome is an eBook, created and made available to the diploma students via the Community Website: “Surviving Bioscience and Pharmacology”. Using simplified diagrams to illustrate the concise text, definition to explain the concepts, the focus has been on encouraging self-awareness and help-seeking strategies and building students who take responsibility for their learning. All the nursing students in the second semester LSB384 Pharmacology Unit have been surveyed face-to-face to get feedback on their engagement with the eBook resource. The data has not been analysed to date. An important consideration is that the website be evaluated by the diploma students as they come into bioscience in first semester (LSB111), the student population for whom the eBook is primarily intended. To get a good response rate we need to do a face-to-face survey. However, we have not been able to do this, as the co-ordinator of the unit has changed since we started the project, and the present co-ordinator will not allow us access to these students.

4th International Workshop on Theory and Application of Visualizations and Human-centric Aspects in Processes

This is the fourth TAProViz workshop being run at the 13th International Conference on Business Process Management (BPM). The intention this year is to consolidate on the results of the previous successful workshops by further developing this important topic, identifying the key research topics of interest to the BPM visualization community. Towards this goal, the workshop topics were extended to human computer interaction and related domains. Submitted papers were evaluated by at least three program committee members, in a double blind manner, on the basis of significance, originality, technical quality and exposition. Three full and one position papers were accepted for presentation at the workshop. In addition, we invited a keynote speaker, Jakob Pinggera, a postdoctoral researcher at the Business Process Management Research Cluster at the University of Innsbruck, Austria.

The biochemistry of blister fluid from pediatric burn injuries: proteomics and metabolomics aspects

Burn injury is a prevalent and traumatic event for pediatric patients. At present, the diagnosis of burn injury severity is subjective and lacks a clinically relevant quantitative measure. This is due in part to a lack of knowledge surrounding the biochemistry of burn injuries and that of blister fluid. A more complete understanding of the blister fluid biochemistry may open new avenues for diagnostic and prognostic development. Burn insult induces a highly complex network of signaling processes and numerous changes within various biochemical systems, which can ultimately be examined using proteome and metabolome measurements. This review reports on the current understanding of burn wound biochemistry and outlines a technical approach for ‘omics’ profiling of blister fluid from burn wounds of differing severity.

Copper Diffusion Barrier Deposition on Integrated Circuit Devices by Atomic Layer Deposition Technique

Transfer from aluminum to copper metallization and decreasing feature size of integrated circuit devices generated a need for new diffusion barrier process. Copper metallization comprised entirely new process flow with new materials such as low-k insulators and etch stoppers, which made the diffusion barrier integration demanding. Atomic Layer Deposition technique was seen as one of the most promising techniques to deposit copper diffusion barrier for future devices. Atomic Layer Deposition technique was utilized to deposit titanium nitride, tungsten nitride, and tungsten nitride carbide diffusion barriers. Titanium nitride was deposited with a conventional process, and also with new in situ reduction process where titanium metal was used as a reducing agent. Tungsten nitride was deposited with a well-known process from tungsten hexafluoride and ammonia, but tungsten nitride carbide as a new material required a new process chemistry. In addition to material properties, the process integration for the copper metallization was studied making compatibility experiments on different surface materials. Based on these studies, titanium nitride and tungsten nitride processes were found to be incompatible with copper metal. However, tungsten nitride carbide film was compatible with copper and exhibited the most promising properties to be integrated for the copper metallization scheme. The process scale-up on 300 mm wafer comprised extensive film uniformity studies, which improved understanding of non-uniformity sources of the ALD growth and the process-specific requirements for the ALD reactor design. Based on these studies, it was discovered that the TiN process from titanium tetrachloride and ammonia required the reactor design of perpendicular flow for successful scale-up. The copper metallization scheme also includes process steps of the copper oxide reduction prior to the barrier deposition and the copper seed deposition prior to the copper metal deposition. Easy and simple copper oxide reduction process was developed, where the substrate was exposed gaseous reducing agent under vacuum and at elevated temperature. Because the reduction was observed efficient enough to reduce thick copper oxide film, the process was considered also as an alternative method to make the copper seed film via copper oxide reduction.