Cenomanian/Turonian sea surface temperatures of the equatorial Atlantic reconstructed from geochemical data

Oceanic anoxic event 2 (OAE-2) occurring during the Cenomanian/Turonian (C/T) transition is evident from a globally recognized positive stable carbon isotopic excursion and is thought to represent one of the most extreme carbon cycle perturbations of the last 100 Myr. However, the impact of this major perturbation on and interaction with global climate remains unclear. Here we report new high-resolution records of sea surface temperature (SST) based on TEX86 and d 18O of excellently preserved planktic foraminifera and stable organic carbon isotopes across the C/T transition from black shales located offshore Suriname/French Guiana (Demerara Rise, Ocean Drilling Program Leg 207 Site 1260) and offshore Senegal (Cape Verde Basin, Deep Sea Drilling Project Leg 41 Site 367). At Site 1260, where both SST proxy records can be determined, a good match between conservative SST estimates from TEX86 and d 18O is observed. We find that late Cenomanian SSTs in the equatorial Atlantic Ocean (33°C) were substantially warmer than today (27°-29°C) and that the onset of OAE-2 coincided with a rapid shift to an even warmer (35°-36°C) regime. Within the early stages of the OAE a marked (4°C) cooling to temperatures lower than pre-OAE conditions is observed. However, well before the termination of OAE-2 the warm regime was reestablished and persisted into the Turonian. Our findings corroborate the view that the C/T transition represents the onset of the interval of peak Cretaceous warmth. More importantly, they are consistent with the hypotheses that mid-Cretaceous warmth can be attributed to high levels of atmospheric carbon dioxide (CO2) and that major OAEs were capable of triggering global cooling through the negative feedback effect of organic carbon-burial-led CO2 sequestration. Evidently, however, the factors that gave rise to the observed shift to a warmer climate regime at the onset of OAE-2 were sufficiently powerful that they were only briefly counterbalanced by the high rates of carbon burial attained during even the most extreme interval of organic carbon burial in the last 100 Myr.

Regime disciplinar do servidor público temporário

O presente trabalho tem por objetivo aprofundar o regime jurídico disciplinar do servidor público temporário. Analisam-se as características principais dessa espécie de agente público que o diferenciam dos demais servidores e que justificam um regime disciplinar próprio. Em uma breve investigação sobre as prováveis origens do temporário, constata-se a presença desse servidor na Administração Pública brasileira desde 1823. No direito estrangeiro (particularmente, no direito francês e no direito português), verifica-se a existência de figuras assemelhadas ao servidor público temporário brasileiro, que é uma espécie de servidor público do gênero agente público, exercendo uma função pública, mas não ocupando nem cargo, nem emprego públicos, sendo contratado por tempo determinado para atender a necessidade temporária de excepcional interesse público. A Constituição Federal, em seu artigo 37, IX, indica que a lei estabelecerá os casos de contratação por tempo determinado, mas não há uma uniformidade entre os entes da federação sobre o regime jurídico adotado para o servidor temporário. Esta análise concentra-se na Lei Federal n.º 8.745/93, que disciplina o assunto. No âmbito federal, o servidor público temporário é dotado de um regime jurídico com características mais próximas do regime jurídico administrativo, sendo recrutado por meio de contrato administrativo assemelhado ao regime estatutário. Tal contratação deve pautar-se pela observância dos princípios da continuidade do serviço público, da moralidade, da impessoalidade, da razoabilidade, da proporcionalidade e da motivação. Focaliza-se a responsabilidade do servidor público temporário no âmbito administrativo, procurando-se demonstrar que tal servidor, por um princípio de equiparação, submete-se a um processo administrativo disciplinar para apuração de suas faltas, o qual cumpre prazos especiais e condições específicas em razão do vínculo temporário com a Administração Pública, em tudo sendo respeitado o devido processo legal, a ampla defesa e o contraditório. Analisam-se as diferenças entre o processo disciplinar do servidor temporário (sindicância) e o processo do servidor público em geral, os ritos adotados, os prazos, as penalidades e os recursos, constatando-se que o servidor público temporário responde pelos atos ilícitos em todas as esferas: penal, civil, administrativa e por atos de improbidade. A transitoriedade na função não o exime de responsabilidades, por isso, com as devidas adaptações, está sujeito aos ônus e bônus do serviço público. Daí a necessidade de construir, com base nas características próprias dessa espécie de servidor público, um regime adaptado às especificações do vínculo especial a que se submete o servidor público temporário. Propõe-se aqui um miniprocesso disciplinar ou um processo disciplinar especial, ou uma minissindicância ou uma sindicância especial, sui generis.

Spatial scaling in human peripheral vision

The observation that performance in many visual tasks can be made independent of eccentricity by increasing the size of peripheral stimuli according to the cortical magnification factor has dominated studies of peripheral vision for many years. However, it has become evident that the cortical magnification factor cannot be successfully applied to all tasks. To find out why, several tasks were studied using spatial scaling, a method which requires no pre-determined scaling factors (such as those predicted from cortical magnification) to magnify the stimulus at any eccentricity. Instead, thresholds are measured at the fovea and in the periphery using a series of stimuli, all of which are simply magnified versions of one another. Analysis of the data obtained in this way reveals the value of the parameter E2, the eccentricity at which foveal stimulus size must double in order to maintain performance equivalent to that at the fovea. The tasks investigated include hyperacuities (vernier acuity, bisection acuity, spatial interval discrimination, referenced displacement detection, and orientation discrimination), unreferenced instantaneous and gradual movement, flicker sensitivity, and face discrimination. In all cases tasks obeyed the principle of spatial scaling since performance in the periphery could be equated to that at the fovea by appropriate magnification. However, E2 values found for different spatial tasks varied over a 200-fold range. In spatial tasks (e.g. bisection acuity and spatial interval discrimination) E2 values were low, reaching about 0.075 deg, whereas in movement tasks the values could be as high as 16 deg. Using a method of spatial scaling it has been possible to equate foveal and peripheral perfonnance in many diverse visual tasks. The rate at which peripheral stimulus size had to be increased as a function of eccentricity was dependent upon the stimulus conditions and the task itself. Possible reasons for these findings are discussed.

Methyl chloride purification for the silicone industry

This study experimentally investigated methyl chloride (MeCl) purification method using an inhouse designed and built volumetric adsorption/desorption rig. MeCl is an essential raw material in the manufacture of silicone however all technical grades of MeCl contain concentrations (0.2 - 1.0 % wt) of dimethyl ether (DME) which poison the process. The project industrial partner had previously exhausted numerous separation methods, which all have been deemed not suitable for various reasons. Therefore, adsorption/desorption separation was proposed in this study as a potential solution with less economic and environmental impact. Pure component adsorption/desorption was carried out for DME and MeCl on six different adsorbents namely: zeolite molecular sieves (types 4 Å and 5 Å); silica gels (35-70 mesh, amorphous precipitated, and 35-60 mesh) and granular activated carbon (type 8-12 mesh). Subsequent binary gas mixture adsorption in batch and continuous mode was carried out on both zeolites and all three silica gels following thermal pre-treatment in vacuum. The adsorbents were tested as received and after being subjected to different thermal and vacuum pre-treatment conditions. The various adsorption studies were carried out at low pressure and temperature ranges of 0.5 - 3.5 atm and 20 - 100 °C. All adsorbents were characterised using Brunauer Emmett Teller (BET), thermogravimetric analysis (TGA), scanning electron microscopy (SEM) and energy dispersive x-ray analysis (EDXA) to investigate their physical and chemical properties. The well-known helium (He) expansion method was used to determine the empty manifold and adsorption cell (AC) regions and respective void volumes for the different adsorbents. The amounts adsorbed were determined using Ideal gas laws via the differential pressure method. The heat of adsorption for the various adsorbate-adsorbent (A-S) interactions was calculated using a new calorimetric method based on direct temperature measurements inside the AC. Further adsorption analysis included use of various empirical and kinetic models to determine and understand the behaviour of the respective interactions. The gas purification behaviour was investigated using gas chromatography and mass spectroscopy (GC-MC) analysis. Binary gas mixture samples were syringed from the manifold iii and AC outlet before and after adsorption/desorption analysis through manual sample injections into the GC-MS to detect and quantify the presence of DME and ultimately observe for methyl chloride purification. Convincing gas purification behaviour was confirmed using two different GC columns, thus giving more confidence on the measurement reliability. From the single pure component adsorption of DME and MeCl on the as received zeolite 4A subjected to 1 h vacuum pre-treatment, both gases exhibited pseudo second order adsorption kinetics with DME exhibiting a rate constant nearly double that of MeCl thus suggesting a faster rate of adsorption. From the adsorption isotherm classification both DME and MeCl exhibited Type II and I adsorption isotherm classifications, respectively. The strength of bonding was confirmed by the differential heat of adsorption measurement, which was found to be 23.30 and 10.21 kJ mol-1 for DME and MeCl, respectively. The former is believed to adsorb heterogeneously through hydrogen bonding whilst MeCl adsorbs homogenously via van der Waal’s (VDW) forces. Single pure component adsorption on as received zeolite 5A, silica gels (35-70, amorphous precipitated and 35-60) resulted in similar adsorption/desorption behaviour in similar quantities (mol kg-1). The adsorption isotherms for DME and MeCl on zeolite 5A, silica gels (35-70, amorphous precipitated and 35-60) and activated carbon 8-12 exhibited Type I classifications, respectively. Experiments on zeolite 5A indicated that DME adsorbed stronger, faster and with a slightly stronger strength of interaction than MeCl but in lesser quantities. On the silica gels adsorbents, DME exhibited a slightly greater adsorption capacity whilst adsorbing at a similar rate and strength of interaction compared to MeCl. On the activated carbon adsorbent, MeCl exhibited the greater adsorption capacity at a faster rate but with similar heats of adsorption. The effect of prolonged vacuum (15 h), thermal pre-treatment (150 °C) and extended equilibrium time (15 min) were investigated for the adsorption behaviour of DME and MeCl on both zeolites 4A and 5A, respectively. Compared to adsorption on as received adsorbents subjected to 1 h vacuum the adsorption capacities for DME and MeCl were found to increase by 1.95 % and 20.37 % on zeolite 4A and by 4.52 % and 6.69 % on zeolite 5A, respectively. In addition the empirical and kinetic models and differential heats of adsorption resulted in more definitive fitting curves and trends due to the true equilibrium position of the adsorbate with the adsorbent. Batch binary mixture adsorption on thermally and vacuum pre-treated zeolite 4A demonstrated purification behaviour of all adsorbents used for MeCl streams containing DME impurities, with a concentration as low as 0.66 vol. %. The GC-MS analysis showed no DME detection for the tested concentration mixtures at the AC outlet after 15 or 30 min, whereas MeCl was detectable in measurable amounts. Similar behaviour was also observed when carrying out adsorption in continuous mode. On the other hand, similar studies on the other adsorbents did not show such favourable MeCl purification behaviour. Overall this study investigated a wide range of adsorbents (zeolites, silica gels and activated carbon) and demonstrated for the first time potential to purify MeCl streams containing DME impurities using adsorption/desorption separation under different adsorbent pre-treatment and adsorption operating conditions. The study also revealed for the first time the adsorption isotherms, empirical and kinetic models and heats of adsorption for the respective adsorbentsurface (A-S) interactions. In conclusion, this study has shown strong evidence to propose zeolite 4A for adsorptive purification of MeCl. It is believed that with a technical grade MeCl stream competitive yet simultaneous co-adsorption of DME and MeCl occurs with evidence of molecular sieiving effects whereby the larger DME molecules are unable to penetrate through the adsorbent bed whereas the smaller MeCl molecules diffuse through resulting in a purified MeCl stream at the AC outlet. Ultimately, further studies are recommended for increased adsorption capacities by considering wider operating conditions, e.g. different adsorbent thermal and vacuum pre-treatment and adsorbing at temperatures closer to the boiling point of the gases and different conditions of pressure and temperature.

Aplicação de células estaminais dentárias na Medicina e na Medicina Dentária

A temática relativa às células estaminais inicia-se na década de 60 com a descoberta da primeira fonte viável destas células: a medula óssea. Diversos estudos permitiram definir a sua função de renovação tecidular e regeneração pós-dano, assim como a sua caraterização num grupo heterogéneo de células indiferenciadas, clonogénicas, definidas pela capacidade de auto-renovação e diferenciação em células maduras. Nos últimos anos, estas células ganharam popularidade face à alternativa terapêutica que representam para muitas doenças, tais como: diabetes, anomalias congénitas, danos do tecido nervoso, Parkinson, Alzheimer e outras alterações degenerativas, exposições pulpares, defeitos periodontais e perda do órgão dentário. Apesar do seu potencial terapêutico, apresentam vários efeitos adversos, especialmente em relação ao seu envolvimento direto (via transformação maligna das MSCs) e indireto (via efeito modulatório das MSCs) no desenvolvimento do cancro. Preconiza-se o seu uso no âmbito da Engenharia Tecidular, introduzindo o processo de regeneração tecidular através da utilização combinada de biomateriais e mediadores biológicos, a fim de proporcionar novas ferramentas para a medicina regenerativa. Mais tarde, tornou-se possível identificar cinco populações de células estaminais de origem dentária (DPSCs, SHEDs, DFPCs, SCAPs e PDLCs) que, para além da sua multipotência e capacidade de diferenciação, constituem fontes acessíveis para recolha. O isolamento destas células constitui ainda uma prática relativamente recente, na qual se torna preponderante isolar células com fenótipo pré-determinado e cultivá-las em meios de cultura adequados. Estudos comprovam que o método de isolamento e as condições de cultura utilizados podem dar origem a diferentes linhas celulares. A conservação é uma prática baseada na convicção de que a medicina regenerativa é o caminho mais promissor para o desenvolvimento da medicina personalizada. Informação adicional relativa à terapia com células estaminais é ainda necessária. Esta utiliza princípios de biomimética altamente desejáveis, pelo que os resultados obtidos têm vindo a despoletar grandes expetativas e a sua implementação na Engenharia Tecidular apresenta-se promissora.

Influência das espécies ativas na absorção de intersticiais durante a carbonitretação a plasma do TI

Physical-chemical properties of Ti are sensible to the presence of interstitial elements. In the case of thermochemical treatments plasma assisted, the influence of different active species is not still understood. In order to contribute for such knowledge, this work purposes a study of the role played by the active species atmosphere into the Ar N2 CH4 carbonitriding plasma. It was carried out a plasma diagnostic by OES (Optical Emission Spectroscopy) in the z Ar y N2 x CH4 plasma mixture, in which z, y and x indexes represent gas flow variable from 0 to 4 sccm (cm3/min). The diagnostic presents abrupt variations of emission intensities associated to the species in determined conditions. Therefore, they were selected in order to carry out the chemical treatment and then to investigate their influences. Commercial pure Ti disks were submitted to plasma carbonitriding process using pre-established conditions from the OES measurements while some parameters such as pressure and temperature were maintained constant. The concentration profiles of interstitial elements (C and N atoms) were determined by Resonant Nuclear Reaction Analysis (NRA) resulting in a depth profile plots. The reactions used were 15N(ρ,αγ)12C and 12C(α,α)12C. GIXRD (Grazing Incidence X-Ray Diffraction) analysis was used in order to identify the presence of phases on the surface. Micro-Raman spectroscopy was used in order to qualitatively study the carbon into the TiCxN1 structure. It has been verified which the density species effectively influences more the diffusion of particles into the Ti lattice and characteristics of the layer formed than the gas concentration. High intensity of N2 + (391,4 nm) and CH (387,1 nm) species promotes more diffusion of C and N. It was observed that Hα (656,3 nm) species acts like a catalyzer allowing a deeper diffusion of nitrogen and carbon into the titanium lattice.

Early objective detection of lymphoedema

The aetiology of secondary lymphoedema seems to be multifactorial, with acquired abnormalities as well as pre-existing conditions being contributory factors. Many characteristics bear inconsistent relationships to lymphoedema risk, and the few that are consistently associated with an increased risk of developing the condition, do not alone distinguish the at-risk population. Further, our current prevention and management recommendations are not backed by strong evidence. Consequently, there remains much to be learned about who gets it, how can it be prevented and how can we best treat it. Nonetheless, it is clear that lymphoedema is associated with adverse side effects, which have a profound impact on daily life, and that preliminary evidence suggests that early detection may lead to more effective treatment and lack of treatment may lead to progression. These represent important reasons as to why lymphoedema deserves clinical attention. However, several pragmatic issues must be considered when discussing whether a routine objective measure of lymphoedema could be integrated among the standard clinical care of those undertaking treatment for cancers known to be associated with the development of lymphoedema.

End-of-life care pathways for improving outcomes in caring for the dying (Review)

Background In many clinical areas, integrated care pathways are utilised as structured multidisciplinary care plans which detail essential steps in caring for patients with specific clinical problems. Particularly, care pathways for the dying have been developed as a model to improve the end-of-life care of all patients. They aim to ensure that the most appropriate management occurs at the most appropriate time and that it is provided by the most appropriate health professional. Clinical pathways for end-of-life care management are used widely around the world and have been regarded as the gold standard. Therefore, there is a significant need for clinicians to be informed about the utilisation of end-of-life care pathways with a systematic review. Objectives To assess the effects of end-of-life care pathways, compared with usual care (no pathway) or with care guided by another end-of-life care pathway across all healthcare settings (e.g. hospitals, residential aged care facilities, community). Search strategy The Cochrane Register of controlled Trials (CENTRAL), the Pain, Palliative and Supportive Care Review group specialised register,MEDLINE, EMBASE, review articles and reference lists of relevant articles were searched. The search was carried out in September 2009. Selection criteria All randomised controlled trials (RCTs), quasi-randomised trial or high quality controlled before and after studies comparing use versus non-use of an end-of-life care pathway in caring for the dying. Data collection and analysis Results of searches were reviewed against the pre-determined criteria for inclusion by two review authors. Main results The search identified 920 potentially relevant titles, but no studies met criteria for inclusion in the review. Authors’ conclusions Without further available evidence, recommendations for the use of end-of-life pathways in caring for the dying cannot be made. RCTs or other well designed controlled studies are needed for evaluating the use of end-of-life care pathways in caring for dying people.

Sounds from the empty city : a practice-led case study in the confluence of music, narrative and emotion

The creative practice: the adaptation of picture book The Empty City (Megarrity/Oxlade, Hachette 2007) into an innovative, interdisciplinary performance for children which combines live performance, music, projected animation and performing objects. The researcher, in the combined roles of writer/composer proposes deliberate experiments in music, narrative and emotion in the various drafts of the adaptation, and tests them in process and performance product. A particular method of composing music for live performance is tested in against the emergent needs of a collaborative, intermedial process. The unpredictable site of research means that this project is both looking to address both pre-determined and emerging points of inquiry. This analysis (directed by audience reception) finds that critical incidents of intermediality between music, narrative, action and emotion translate directly into highlights of the performance.

Driver behaviour and decision making at railway level crossings : An exploratory on-road case study

Crashes at rail level crossings represent a significant problem, both in Australia and worldwide. Advances in driving assessment methods, such as the provision of on-road instrumented test vehicles, now provide researchers with the opportunity to further understand driver behaviour at rail level crossings in ways not previously possible. This paper gives an overview of a recent on-road pilot study of driver behaviour at rail level crossings in which 25 participants drove a pre-determined route, incorporating 4 rail level crossings, using MUARC's instrumented On-Road Test Vehicle (ORTeV). Drivers provided verbal commentary whilst driving the route, and a range of other data were collected, including eye fixations, forward, cockpit and driver video, and vehicle data (speed, braking, steering wheel angle, lane tracking etc). Participants also completed a post trial cognitive task analysis interview. Extracts from the wider analyses are used to examine in depth driver behaviour at one of the rail level crossings encountered during the study. The analysis presented, along with the overall analysis undertaken, gives insight into the driver and wider systems factors that shape behaviour at rail level crossings, and highlights the utility of using a multi-method, instrumented vehicle approach for gathering data regarding driver behaviour in different contexts.

To err (on the road) is human? An on-road study of driver errors

Human error, its causes and consequences, and the ways in which it can be prevented, remain of great interest to road safety practitioners. This paper presents the findings derived from an on-road study of driver errors in which 25 participants drove a pre-determined route using MUARC's On-Road Test Vehicle (ORTeV). In-vehicle observers recorded the different errors made, and a range of other data was collected, including driver verbal protocols, forward, cockpit and driver video, and vehicle data (speed, braking, steering wheel angle, lane tracking etc). Participants also completed a post trial cognitive task analysis interview. The drivers tested made a range of different errors, with speeding violations, both intentional and unintentional, being the most common. Further more detailed analysis of a sub-set of specific error types indicates that driver errors have various causes, including failures in the wider road 'system' such as poor roadway design, infrastructure failures and unclear road rules. In closing, a range of potential error prevention strategies, including intelligent speed adaptation and road infrastructure design, are discussed.

Development of accident modification factors on intersection crash maneuvers

In order to estimate the safety impact of roadway interventions engineers need to collect, analyze, and interpret the results of carefully implemented data collection efforts. The intent of these studies is to develop Accident Modification Factors (AMF's), which are used to predict the safety impact of various road safety features at other locations or in upon future enhancements. Models are typically estimated to estimate AMF's for total crashes, but can and should be estimated for crash outcomes as well. This paper first describes data collected with the intent estimate AMF's for rural intersections in the state of Georgia within the United Sates. Modeling results of crash prediction models for the crash outcomes: angle, head-on, rear-end, sideswipe (same direction and opposite direction) and pedestrian-involved crashes are then presented and discussed. The analysis reveals that factors such as the Annual Average Daily Traffic (AADT), the presence of turning lanes, and the number of driveways have a positive association with each type of crash, while the median width and the presence of lighting are negatively associated with crashes. The model covariates are related to crash outcome in different ways, suggesting that crash outcomes are associated with different pre-crash conditions.

The symbiosis of improvised and rehearsed elements in the creation of contemporary jazz ensemble music

This research investigates the symbiotic relationship between composition and improvisation and the notion of improvisation itself. With a specific interest in developing, extending and experimenting with the relationship of improvisation within predetermined structures, the creative work component of this research involved composing six new works with varying approaches for The Andrea Keller Quartet and guest improvisers, for performance on a National Australian tour. This is documented in the CD recording Galumphing Round the Nation - Collaborations Tour 2009. The exegesis component is intended to run alongside the creative work and discusses the central issues surrounding improvisation in an ensemble context and the subject of composing for improvisers. Specifically, it questions the notion that when music emphasises a higher ratio of spontaneous to pre-determined elements, and is exposed to the many variables of a performance context, particularly through its incorporation of visitant improvisers, the resultant music should potentially be measurably altered with each performance. This practice-led research demonstrates the effect of concepts such as individuality, variability within context, and the interactive qualities of contemporary jazz ensemble music. Through the analysis and comparison of the treatment of the six pieces over thirteen performances with varying personnel, this exegesis proposes that, despite the expected potential for spontaneity in contemporary jazz music, the presence of established patterns, the desire for familiarity and the intuitive tendency towards accepted protocols ensure that the music which emerges is not as mutable as initially anticipated.

Information interventions for orienting patients and their carers to cancer care facilities

Background: Cancer patients experience distress and anxiety related to their diagnosis, treatment and the unfamiliar cancer centre. Strategies with the aim of orienting patients to a cancer care facility may improve patient outcomes. Although meeting patients' information needs at different stages is important, there is little agreement about the type of information and the timing for information to be given. Orientation interventions aim to address information needs at the start of a person's experience with a cancer care facility. The extent of any benefit of these interventions is unknown. Objectives: To assess the effects of information interventions which orient patients and their carers/family to a cancer care facility, and to the services available in the facility. Search Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 2); MEDLINE (OvidSP) (1966 to Jun 2011), EMBASE (Ovid SP) (1966 to Jun 2011), CINAHL (EBSCO) (1982 to Jun 2011), PsycINFO (OvidSP) (1966 to Jun 2011), review articles and reference lists of relevant articles. We contacted principal investigators and experts in the field. Selection Criteria: Randomised controlled trials (RCTs), cluster RCTs and quasi-RCTs evaluating the effects of information interventions that orient patients and their carers/family to a cancer care facility. Data collection and analysis: Results of searches were reviewed against the pre-determined criteria for inclusion by two review authors. The primary outcomes were knowledge and understanding; health status and wellbeing, evaluation of care, and harms. Secondary outcomes were communication, skills acquisition, behavioural outcomes, service delivery, and health professional outcomes. We pooled results of RCTs using mean differences (MD) and 95% confidence intervals (CI). Main results: We included four RCTs involving 610 participants. All four trials aimed to investigate the effects of orientation programs for cancer patients to a cancer facility. There was high risk of bias across studies. Findings from two of the RCTs demonstrated significant benefits of the orientation intervention in relation to levels of distress (mean difference (MD) -8.96 (95% confidence interval (CI) -11.79 to -6.13), but non-significant benefits in relation to state anxiety levels (MD -9.77 (95% CI -24.96 to 5.41). Other outcomes for participants were generally positive (e.g. more knowledgeable about the cancer centre and cancer therapy, better coping abilities). No harms or adverse effects were measured or reported by any of the included studies. There were insufficient data on the other outcomes of interest. Authors conclusion: This review has demonstrated the feasibility and some potential benefits of orientation interventions. There was a low level of evidence suggesting that orientation interventions can reduce distress in patients. However, most of the other outcomes remain inconclusive (patient knowledge recall/ satisfaction). The majority of studies were subject to high risk of bias, and were likely to be insufficiently powered. Further well conducted and powered RCTs are required to provide evidence for determining the most appropriate intensity, nature, mode and resources for such interventions. Patient and carer-focused outcomes should be included.

Tampere region under the microscope : a critical analysis from the knowledge perspective

Purpose – In the context of global knowledge economy, knowledge-based urban development (KBUD) is seen as an effective development strategy for city-regions to survive, flourish and become highly competitive urban agglomerations – i.e., a knowledge city-region. This paper aims to evaluate the KBUD dynamics, capacity and potentials of a rapidly emerging knowledge city-region of Finland – Tampere region. Design/methodology/approach – The paper undertakes a review of the literature on regional development in the knowledge economy era. It adopts a qualitative analysis technique to scrutinize the dynamics, capacity and potentials of Tampere region. The semi-structured interview process starts with the pre-determined key actors of the city-region with an aim of determining the other key players. Next, with the participation of all key players to the interviews, the research reveals the principal issues, assets and mechanisms that relate to KBUD, and portrays the strengths, weaknesses, opportunities and threats of the city-region. A critical analysis of the findings along with the previous studies is undertaken to provide a clear picture of the dynamics, capacity and potentials of the emerging knowledge city-region. Originality/value – This paper reports the findings of a pioneering study focusing on the investigation of the KBUD dynamics, capacity and potentials of Tampere region. The paper critically evaluates the city-region from the knowledge perspective with the lens of KBUD, and the lessons learned and the methodological approach of the paper shed light to other city-regions seeking such development. Practical implications – The paper discusses the findings of a study from Tampere region that critically scrutinizes the KBUD experience of the city-region. The research provides an invaluable opportunity to inform the regional decision-, policy- and plan-making mechanisms by determining key issues, actors, assets, processes and potential development directions for the KBUD of Tampere region.