General practitioner, specialist providers case conferences in palliative care: Lessons learned from 56 case conferences

OBJECTIVE: To describe the utility and acceptability to general practitioners and palliative care staff of case conferences in palliative care. METHOD: Research focussed on case conferences conducted between GPs and staff of three specialist palliative care units (in an inner urban, outer metropolitan and regional setting), at the time of referral of patients to the service. Telephone interviews were conducted with all GPs who participated in a case conference, and focus groups were conducted with palliative care staff. RESULTS: For most GPs, case conferences by teleconference were a time effective and immediate means of information transfer. The best instances for a conference were at time of patient referral, time of discharge to the community, or where the case was complex. General practitioners appreciated access to multiple professionals simultaneously. Workload pressures were a drawback of participation for both GPs and specialists. Palliative care team members thought case conferences gave GPs an appreciation of a team approach, and reduced professional isolation. The usefulness of the case conferences depended on the willingness of the GP to participate. General practitioners would participate again provided they did not have to organise the case conference. Specialist staff were concerned by the financial cost of organising case conferences. DISCUSSION: Case conferences provide useful information exchange between GPs and specialist staff, and are acceptable to both parties. Much depends on the individual GPs attitude toward participation, as well as the timing of the conferences in the course of the patient's illness. Organisation needs to be a task of the specialist units, who would need administrative support to organise them. (author abstract)

Chemical synthesis and biosynthesis of the cyclotide family of circular proteins

Cyclotides are a recently discovered class of proteins that have a characteristic head-to-tail cyclized backbone stabilized by a knotted arrangement of three disulfide bonds. They are exceptionally resistant to chemical, enzymatic and thermal treatments because of their unique structural scaffold. Cyclotides have a range of bio-activities, including uterotonic, anti-HIV, anti-bacterial and cytotoxic activity but their insecticidal properties suggest that their natural physiological role is in plant defense. They are genetically encoded as linear precursors and subsequently processed to produce mature cyclic peptides but the mechanism by which this occurs remains unknown. Currently most cyclotides are obtained via direct extraction from plants in the Rubiaceae and Violaceae families. To facilitate the screening of cyclotides for structure-activity studies and to exploit them in drug design or agricultural applications a convenient route for the synthesis of cyclotides is vital. In this review the current chemical, recombinant and biosynthetic routes to the production of cyclotides are discussed.

Encounter success of free-ranging marine predator movements across a dynamic prey landscape

Movements of wide-ranging top predators can now be studied effectively using satellite and archival telemetry. However, the motivations underlying movements remain difficult to determine because trajectories are seldom related to key biological gradients, such as changing prey distributions. Here, we use a dynamic prey landscape of zooplankton biomass in the north-east Atlantic Ocean to examine active habitat selection in the plankton-feeding basking shark Cetorhinus maximus. The relative success of shark searches across this landscape was examined by comparing prey biomass encountered by sharks with encounters by random-walk simulations of ‘model’ sharks. Movements of transmitter-tagged sharks monitored for 964 days (16754km estimated minimum distance) were concentrated on the European continental shelf in areas characterized by high seasonal productivity and complex prey distributions. We show movements by adult and sub-adult sharks yielded consistently higher prey encounter rates than 90% of random-walk simulations. Behavioural patterns were consistent with basking sharks using search tactics structured across multiple scales to exploit the richest prey areas available in preferred habitats. Simple behavioural rules based on learned responses to previously encountered prey distributions may explain the high performances. This study highlights how dynamic prey landscapes enable active habitat selection in large predators to be investigated from a trophic perspective, an approach that may inform conservation by identifying critical habitat of vulnerable species.

A new breed of doctor? Lessons learned and changes made to library services for the MBBS program at the University of Queensland

November 2000 saw the graduation of the first cohort from the new MBBS Program at The University of Queensland. The fully integrated problem-based curriculum has provided many challenges and opportunities for The University of Queensland Library such as servicing an extensive remote student population, information technology issues and customer demand. In October 2000 all four years of the MBBS Program completed a survey on related issues such as the library's collection, web-based resources, information skills and evidence-based medicine. This paper focuses on the results of the survey, and the future directions of the library to ensure that the new doctors graduating from this program gain the essential attributes of life-long learning, information management and evidence-based principles.

Lessons learned from INTAMAP, an interoperable web service for the real-time interpolation of environmental variables

Interpolated data are an important part of the environmental information exchange as many variables can only be measured at situate discrete sampling locations. Spatial interpolation is a complex operation that has traditionally required expert treatment, making automation a serious challenge. This paper presents a few lessons learnt from INTAMAP, a project that is developing an interoperable web processing service (WPS) for the automatic interpolation of environmental data using advanced geostatistics, adopting a Service Oriented Architecture (SOA). The “rainbow box” approach we followed provides access to the functionality at a whole range of different levels. We show here how the integration of open standards, open source and powerful statistical processing capabilities allows us to automate a complex process while offering users a level of access and control that best suits their requirements. This facilitates benchmarking exercises as well as the regular reporting of environmental information without requiring remote users to have specialized skills in geostatistics.

Capabilities and competitiveness of Chinese state owned manufacturing enterprises:what has been learned over 20 years and what remains to be learned

Technological capabilities in Chinese manufacturing have been transformed in the last three decades. However, the extent to which and how domestic market oriented state owned enterprises (SOEs) have developed their capabilities remain important questions. The East Asian latecomer model has been adapted to study six Chinese SOEs in the automotive, steel and machine tools sectors to assess capability levels attained and the role of external sources and internal efforts in developing them. All six enterprises demonstrate high competence in operating established technology, managing investment and making product and process improvements but differ in innovative capability. While the East Asian latecomer model in which linking, leveraging and learning explain technological capability development is relevant for the companies studied, it needs to be adapted for Chinese SOEs to take account of types of external links and leverage of enterprises, the role of government, enterprise level management motives and means of financing development.

Towards standardization of UV eye protection:what can be learned from photodermatology?

While knowledge about standardization of skin protection against ultraviolet radiation (UVR) has progressed over the past few decades, there is no uniform and generally accepted standardized measurement for UV eye protection. The literature provides solid evidence that UV can induce considerable damage to structures of the eye. As well as damaging the eyelids and periorbital skin, chronic UV exposure may also affect the conjunctiva and lens. Clinically, this damage can manifest as skin cancer and premature skin ageing as well as the development of pterygia and premature cortical cataracts. Modern eye protection, used daily, offers the opportunity to prevent these adverse sequelae of lifelong UV exposure. A standardized, reliable and comprehensive label for consumers and professionals is currently lacking. In this review we (i) summarize the existing literature about UV radiation-induced damage to the eye and surrounding skin; (ii) review the recent technological advances in UV protection by means of lenses; (iii) review the definition of the Eye-Sun Protection Factor (E-SPF®), which describes the intrinsic UV protection properties of lenses and lens coating materials based on their capacity to absorb or reflect UV radiation; and (iv) propose a strategy for establishing the biological relevance of the E-SPF. © 2013 John Wiley & Sons A/S.

Automatic labelling of topic models learned from Twitter by summarisation

Latent topics derived by topic models such as Latent Dirichlet Allocation (LDA) are the result of hidden thematic structures which provide further insights into the data. The automatic labelling of such topics derived from social media poses however new challenges since topics may characterise novel events happening in the real world. Existing automatic topic labelling approaches which depend on external knowledge sources become less applicable here since relevant articles/concepts of the extracted topics may not exist in external sources. In this paper we propose to address the problem of automatic labelling of latent topics learned from Twitter as a summarisation problem. We introduce a framework which apply summarisation algorithms to generate topic labels. These algorithms are independent of external sources and only rely on the identification of dominant terms in documents related to the latent topic. We compare the efficiency of existing state of the art summarisation algorithms. Our results suggest that summarisation algorithms generate better topic labels which capture event-related context compared to the top-n terms returned by LDA. © 2014 Association for Computational Linguistics.

Lessons learned from the effect of tight monetary conditions and crises on corporate capital structure

The study reviews the theoretical and empirical literature on the effect of tight monetary conditions, crisis on corporate capital structure, further creates a framework for analyzing their relation, as well as sheds light on the lessons learned and open research areas. The results highlight that the supply side of capital has an effect on corporate capital structure, though the analysis of this relation is scarce. However, the impact of tight monetary conditions on capital structure is analyzed by several studies, there is limited evidence on the financial policy and the development of financing mix during a crisis period. The impact of the 2007/08 crisis on the corporate capital structure and especially in case of firms with impaired access to external financing is scarce. The study also highlights our lack in understanding of the relation of crisis and capital structure in case of the CEE region.