A tsunami of unmet needs: Pancreatic and ampullary cancer patients’ supportive care needs and use of community and allied health services

Objective People diagnosed with pancreatic cancer have the worst survival prognosis of any cancer. No previous research has documented the supportive care needs of this population. Our objective was to describe people’s needs and use of support services and to examine whether these differed according to whether or not patients had undergone surgical resection. Methods Queensland pancreatic or ampullary cancer patients (n=136, 54% of those eligible) completed a survey which assessed 34 needs across 5 domains (SCNS-SF34) and use of health services. Differences by resection were compared with Chi-squared tests. Results Overall, 96% of participants reported having some needs. More than half reported moderate-to-high unmet physical (54%) or psychological (52%) needs whereas, health system/information (32%), patient care (21%) and sexuality needs (16%) were described less frequently. The three most frequently reported moderate-to-high needs included ‘not being able to do things they used to do’ (41%), ‘concerns about the worries of those close’ (37%), and ‘uncertainty about the future’ (30%). Patients with non-resectable disease reported greater individual information needs but their needs were otherwise similar to patients with resectable disease. Self-reported use of support was low; only 35% accessed information, 28%, 18% and 15% consulted a dietician, complementary medicine practitioner or mental health practitioner, respectively. Palliative care access was greater (59% vs 27%) among those with non-resectable disease. Conclusion Very high levels of needs were reported by people with pancreatic or ampullary cancer. Future work needs to elucidate why uptake of appropriate supportive care is low and which services are required.

In the Solanaceae, a hierarchy of bHLHs confer distinct target specificity to the anthocyanin regulatory complex

The anthocyanin biosynthetic pathway is regulated by a transcription factor complex consisting of an R2R3 MYB, a bHLH, and a WD40. Although R2R3 MYBs belonging to the anthocyanin-activating class have been identified in many plants, and their role well elucidated, the subgroups of bHLH implicated in anthocyanin regulation seem to be more complex. It is not clear whether these potential bHLH partners are biologically interchangeable with redundant functions, or even if heterodimers are involved. In this study, AcMYB110, an R2R3 MYB isolated from kiwifruit (Actinidia sp.) showing a strong activation of the anthocyanin pathway in tobacco (Nicotiana tabacum) was used to examine the function of interacting endogenous bHLH partners. Constitutive expression of AcMYB110 in tobacco leaves revealed different roles for two bHLHs, NtAN1 and NtJAF13. A hierarchical mechanism is shown to control the regulation of transcription factors and consequently of the anthocyanin biosynthetic pathway. Here, a model is proposed for the regulation of the anthocyanin pathway in Solanaceous plants in which AN1 is directly involved in the activation of the biosynthetic genes, whereas JAF13 is involved in the regulation of AN1 transcription.

Understanding the effects of complex seasonality on suburban daily transit ridership

Fluctuations in transit ridership pattern over the year have always concerned transport planners, operators and researchers. Predominantly, metrological elements have been specified to explain variability in ridership volume. However, the outcome of this research points to new direction to explain ridership fluctuation in Brisbane. It explored the relationship between daily bus ridership, seasonality and weather variables for a one-year period, 2012. Rather than segregating the entire year’s ridership into the four calendar seasons (summer, autumn, spring, and winter), this analysis distributed the yearly ridership into nine complex seasonality blocks. These represent calendar season, school/university (academic) period and their corresponding holidays, as well as other observant holidays such as Christmas. The dominance of complex seasonality over typical calendar season was established through analysis and using Multiple Linear Regression (MLR). This research identified a very strong association between complex seasonality and bus ridership. Furthermore, an expectation that Brisbane’s subtropical summer is unfavourable to transit usage was not supported by the findings of this study. A nil association of precipitation and temperature was observed in this region. Finally, this research developed a ridership estimation model, capable of predicting daily ridership within very limited error range. Following the application of this developed model, the estimated annual time series data of each suburb was analysed using Fourier Transformation to appreciate whether any cyclical effects remained, compared with the original data.

The structures of the isomorphous potassium and rubidium salts of 4-nitrobenzoic acid and an overview of the metal complex stereochemistries of the alkali metal salt series with this ligand

The structures of the isomorphous potassium and rubidium polymeric coordination complexes with 4-nitrobenzoic acid, poly[mu2-aqua-aqua-mu3-(4-nitrobenzoato)-potassium], [K(C7H4N2O2)(H2O)2]n, (I) and poly[mu3-aqua-aqua-mu5-(4-nitrobenzoato)-rubidium], [Rb(C7H4N2O2)(H2O)2]n, (II) have been determined. In (I) the very distorted KO6 coordination sphere about the K+ centres in the repeat unit comprise two bridging nitro O-atom donors, a single bridging carboxyl O-atom donor and two water molecules, one of which is bridging. In the the Rb complex (II), the same basic MO6 coordination is found in the repeat unit but is expanded to RbO9 through a slight increase in the accepted Rb-O bond length range and includes an additional Rb-O(carboxyl) bond, completing a bidentate O,O'-chelate interaction, and additional bridging Rb-Onitro) and Rb-O(water) bonds. The comparative K-O and Rb-O bond length ranges are 2.738(3)-3.002(3)Ang. (I) and 2.884(2)-3.182(2)Ang. (II). The structure of (II) is also isomorphous as well as isostructural with the known structure of the nine-coordinate caesium 4-nitrobenzoate analogue, [Cs(C7H4N2O~2~)(H~2~O)2]n, (III) in which the Cs---O range is 3.047(4)-3.338(4)Ang. In all three complexes, common basic polymeric extensions are found, including two different centrosymmetric bridging interactions through both water and nitro groups as well as extensions along c through the p-related carboxyl group, giving a two-dimensional structure in (I). In (II) and (III), three-dimensional structures are generated through additional bridges through the nitro and water O-atoms. In all structures, both water molecules are involved in similar intra-polymer O-H...O hydrogen-bonding interactions to both carboxyl as well as water O-atom acceptors. A comparison of the varied coordination behaviour of the full set of Li-Cs salts with 4-nitrobenzoic acid is also made.

Identification of a BRCA1-mRNA splicing complex required for efficient DNA repair and maintenance of genomic stability

Mutations within BRCA1 predispose carriers to a high risk of breast and ovarian cancers. BRCA1 functions to maintain genomic stability through the assembly of multiple protein complexes involved in DNA repair, cell-cycle arrest, and transcriptional regulation. Here, we report the identification of a DNA damage-induced BRCA1 protein complex containing BCLAF1 and other key components of the mRNA-splicing machinery. In response to DNA damage, this complex regulates pre-mRNA splicing of a number of genes involved in DNA damage signaling and repair, thereby promoting the stability of these transcripts/proteins. Further, we show that abrogation of this complex results in sensitivity to DNA damage, defective DNA repair, and genomic instability. Interestingly, mutations in a number of proteins found within this complex have been identified in numerous cancer types. These data suggest that regulation of splicing by the BRCA1-mRNA splicing complex plays an important role in the cellular response to DNA damage.

Investigating teachers' concerns and experiences in teaching children with special educational needs in Bhutan

This study investigated Bhutanese teachers' concerns and experiences in teaching children with Special Educational Needs in both inclusive and special schools. A mixed method design, combining quantitative and qualitative methods was used to answer the research questions. The aim of collecting quantitative data was to identify the key concerns. The aim of collecting qualitative data was to find out how teachers were experiencing including students with SEN in the classrooms. In doing so, three major issues were highlighted from this study: lack of classroom and human resources, lack of policy and lack of professional development for teachers.

Infrastructure, investment and development evaluation: A Complex Stakeholder Perception Mapping approach for improving local and regional economic development outcomes

Partial evaluation of infrastructure investments have resulted in expensive mistakes, unsatisfactory outcomes and increased uncertainties for too many stakeholders, communities and economies in both developing and developed nations. "Complex Stakeholder Perception Mapping" (CSPM), is a novel approach that can address existing limitations by inclusively framing, capturing and mapping the spectrum of insights and perceptions using extended Geographic Information Systems. Maps generated in CSPM offer presentations of flexibly combined, complex perceptions of stakeholders on multiple aspects of development. CSPM extends the applications of GIS software in non-spatial mapping and of Multi-Criteria Analysis with a multidimensional evaluation platform and augments decision science capabilities in addressing complexities. Application of CSPM can improve local and regional economic gains from infrastructure projects and aid any multi-objective and multi-stakeholder decision situations.

Small firm training: Just meeting the day-to-day needs of the business

Purpose The purpose of this paper is to explore what the attitudes of small firm owner-managers are to developing the skills of their key resources and then examine how these and other factors affect owner-managers’ preferences for training these employees. Design/methodology/approach This study of training in small road transport firms in West Australia is cast in light of the literature on human resource management in small firms underpinned by insights drawn using the resource based view of the firm. Small firms (less than 20 people) dominate this industry, while the increasing freight task, and extreme distances between West Australian ports, towns and mines highlight this sectors’ importance. Survey results from 39 small road transport firms and interviews with nine owner-managers are analysed. Findings Legislative, regulatory and licensing requirements were shown to be a key determinant of skills development. Employers ensured that basic standards for employee certification and qualification were met, as the penalty for not doing so would be too high. Regulations drove the need for certain types of training – licenses, fatigue management, occupational health and safety, handling dangerous goods, the Maritime Security Identification Card card, forklift license, mine site inductions – while owner-managers knew where to get the training their staff needed. Although regulation appeared most visible in prescribing what happened in relation to training for drivers, the relevance of owner-managers’ attitudes could not be ignored, nor could conditions in the firms external environment as this shaped how these requirements were met. Research limitations/implications The RBV is useful in showing how skill development enabled similarity in skills across firms, while the attitudes owner-managers and economic and social conditions meant what happened in firms around skill development varied. The importance of small firm owner-managers’ attitudes are clearly highlighted and shown to influence organizational decisions and choices around training, but these were not independent of the regulatory framework and the economic and social conditions within which the firm operated. The small firms in this study did engage workers in formal training when necessary but it was put in the context of the idiosyncratic approach of the owner-manager and the day-to-day needs of the firm. “Training” was essentially about ensuring certain types of skills were held by employees and then passing on knowledge to ensure the behavior of employees was consistent with the owner-manager’s vision for the firm in its current environment. Originality/value Ways industry and government can encourage training activity that goes beyond the day-to-day firm needs are suggested.

A feasibility and pilot randomized controlled trial of the "Timing it Right Stroke Family Support Program"

- Objective Examine feasibility of conducting a randomized controlled trial of the Timing it Right Stroke Family Support Program (TIRSFSP) and collect pilot data. - Design Multi-site mixed method randomized controlled trial. - Setting Acute and community care in three Canadian cities. - Subjects Caregivers were family members or friends providing care to individuals who experienced their first stroke. - Intervention The TIRSFSP offered in two formats, self-directed by the caregiver or stroke support person-directed over time, were compared to standard care. - Main Measures Caregivers completed baseline and follow-up measures 1, 3 and 6 months post-stroke including Centre for Epidemiological Studies Depression, Positive Affect, Social Support, and Mastery Scales. We completed in-depth qualitative interviews with caregivers and maintained intervention records describing support provided to each caregiver. - Results Thirty-one caregivers received standard care (n=10), self-directed (n=10), or stroke support person-directed (n=11) interventions. We retained 77% of the sample through 6-months. Key areas of support derived from intervention records (n=11) related to caregiver wellbeing, caregiving strategies, patient wellbeing, community re-integration, and service delivery. Compared to standard care, caregivers receiving the stroke support person-directed intervention reported improvements in perceived support (estimate 3.1, P=.04) and mastery (estimate .35, P=.06). Qualitative caregiver interviews (n=19) reflected the complex interaction between caregiver needs, preferences and available options when reporting on level of satisfaction. - Conclusions Preliminary findings suggest the research design is feasible, caregivers’ needs are complex, and the support intervention may enhance caregivers’ perceived support and mastery. The intervention will be tested further in a large scale trial.

Identifying the molecular mediators of VN and the IGF:VN complex-stimulated breast cancer cell survival

This project has identified a molecular signature involved in functions critical to breast cancer progression and metastasis mediated by vitronectin, an abundant protein in human plasma and victornectin:insulin-like growth factor complexes. This may have significant implications in designing future therapeutic targets for patient with tumours overexpressing vitronectin and/or the components of the insulin-like growth factor system:vitronectin axis. In particular, the findings from this project have identified Cyr61 and CTGF as key mediators involved in vitroncetin- and insulin-like growth factor I: Insulin-like growth factor-binding protein:vitronectin-induced breast cancer cell survival and migration.

Fatigue and sleepiness: Complex bedfellows

Do you know how to drive a train? If you don’t you probably believe that you have a fair idea of what it’s all about. Forget what you know, or think you know. Trains are heavy and fast but they feel and handle like driving on ice so they take a long time to stop. The braking distances for a typical piece of track are unlike anything you will have experienced before. With that in mind, imagine you were driving with a bit of dew, or grease, or millipede over the track. You would lose traction and slip everywhere. To avoid this, you would need a compensatory driving strategy. You could drive more slowly, or brake sooner, or change how you brake. Your experience and intuition would lead the way. Folks, this is why it’s called “driving by the seat of your pants”...

Disruptive innovations in complex product systems industries: A case study

We propose that disruptive changes pertaining to complex product systems (CoPS) will yield a different set of characteristics than those traditionally observed for commodity products, and seek evidence for this proposition in a case study of the Flash Converting technology, a disruptive CoPS innovation in the copper production industry. Our results show that unlike disruptions in commodity product industries, the incumbent CoPS technology does not overshoot mainstream market performance demand. Also, the disruptive CoPS innovation: (i) is not nurtured in low-end niche markets; (ii) initially satisfies mainstream market performance demand, and; (iii) has higher unit price than the incumbent technology.

Measuring sustainability performance within the Australian energy industry

Sustainability has become crucial for the energy industry as projects in this industry are extensively large and complex and have significant impacts on the environment, community and economy. It demands the energy industry to proactively incorporate sustainability ideas and commit to sustainable project development. This study aims to investigate how the Australian energy industry responds to sustainability requirements and in particular what indicators used to measure sustainability performance. To achieve this, content analysis of sustainability reports, vision statements and policy statements of Australian energy companies listed in the 2013 PLATTS Top 250 Global Energy Company Rankings and government reports relating to sustainability has been conducted. The findings show that the energy companies extensively discuss sustainability aspects within three dimensions, i.e. community, environment, and economy. Their primary goals in sustainability are supplying cleaner energy for future, and doing business in a way that improves outcomes for shareholders, employees, business partners and the communities. In particular, energy companies have valued the employees of the business as a one of the key area that needs to be considered. Furthermore, the energy industry has become increasingly aware of the importance of measuring sustainability performance to achieve sustainability goals. A number of sustainability indicators have been developed on the basis of the key themes beyond economic measures. It is envisaged that findings from this research will help stakeholders in the energy industry to adopt different indicators to evaluate and ultimately achieve sustainability performance.

Acting, accidents and performativity: Challenging the hegemonic good student in secondary schools

Current educational practice tends to ascribe a limiting vision of the good student as one who is well behaved, performs well in assessments and demonstrates values in keeping with dominant expectations. This paper argues that this vision of the good student is antithetical to the lived experience of students as they negotiate their positionality within complex power games in secondary schools. Student voices in focus group research nominate six rationales of the good student that inform their ‘performances’ of the good student. Understanding the multiplicity and dynamism of the good student is an educational imperative as schools seek to meet the changing needs of society in the new millennium.