A pragmatic 2 × 2 × 2 factorial cluster randomized controlled trial of educational outreach visiting and case conferencing in palliative care—methodology of the Palliative Care Trial [ISRCTN 81117481]

The demand for palliative care is increasing, yet there are few data on the best models of care nor well-validated interventions that translate current evidence into clinical practice. Supporting multidisciplinary patient-centered palliative care while successfully conducting a large clinical trial is a challenge. The Palliative Care Trial (PCT) is a pragmatic 2 x 2 x 2 factorial cluster randomized controlled trial that tests the ability of educational outreach visiting and case conferencing to improve patient-based outcomes such as performance status and pain intensity. Four hundred sixty-one consenting patients and their general practitioners (GPs) were randomized to the following: (1) GP educational outreach visiting versus usual care, (2) Structured patient and caregiver educational outreach visiting versus usual care and (3) A coordinated palliative care model of case conferencing versus the standard model of palliative care in Adelaide, South Australia (3:1 randomization). Main outcome measures included patient functional status over time, pain intensity, and resource utilization. Participants were followed longitudinally until death or November 30, 2004. The interventions are aimed at translating current evidence into clinical practice and there was particular attention in the trial's design to addressing common pitfalls for clinical studies in palliative care. Given the need for evidence about optimal interventions and service delivery models that improve the care of people with life-limiting illness, the results of this rigorous, high quality clinical trial will inform practice. Initial results are expected in mid 2005. (c) 2005 Elsevier Inc. All rights reserved.

Applying network analysis to the conservation of habitat trees in urban environments: a case study from Brisbane, Australia

In Australia more than 300 vertebrates, including 43 insectivorous bat species, depend on hollows in habitat trees for shelter, with many species using a network of multiple trees as roosts, We used roost-switching data on white-striped freetail bats (Tadarida australis; Microchiroptera: Molossidae) to construct a network representation of day roosts in suburban Brisbane, Australia. Bats were caught from a communal roost tree with a roosting group of several hundred individuals and released with transmitters. Each roost used by the bats represented a node in the network, and the movements of bats between roosts formed the links between nodes. Despite differences in gender and reproductive stages, the bats exhibited the same behavior throughout three radiotelemetry periods and over 500 bat days of radio tracking: each roosted in separate roosts, switched roosts very infrequently, and associated with other bats only at the communal roost This network resembled a scale-free network in which the distribution of the number of links from each roost followed a power law. Despite being spread over a large geographic area (> 200 km(2)), each roost was connected to others by less than three links. One roost (the hub or communal roost) defined the architecture of the network because it had the most links. That the network showed scale-free properties has profound implications for the management of the habitat trees of this roosting group. Scale-free networks provide high tolerance against stochastic events such as random roost removals but are susceptible to the selective removal of hub nodes. Network analysis is a useful tool for understanding the structural organization of habitat tree usage and allows the informed judgment of the relative importance of individual trees and hence the derivation of appropriate management decisions, Conservation planners and managers should emphasize the differential importance of habitat trees and think of them as being analogous to vital service centers in human societies.

Effect of sequence variation in Plasmodium falciparum Histidine-Rich protein 2 on binding of specific monoclonal antibodies: Implications for rapid diagnostic tests for malaria

This Article Right arrow Full Text Right arrow Full Text (PDF) Right arrow Supplemental material Right arrow Alert me when this article is cited Right arrow Alert me if a correction is posted Services Right arrow Similar articles in this journal Right arrow Similar articles in PubMed Right arrow Alert me to new issues of the journal Right arrow Download to citation manager Right arrow Reprints and Permissions Right arrow Copyright Information Right arrow Books from ASM Press Right arrow MicrobeWorld Citing Articles Right arrow Citing Articles via HighWire Right arrow Citing Articles via Google Scholar Google Scholar Right arrow Articles by Lee, N. Right arrow Articles by McCarthy, J. Right arrow Search for Related Content PubMed Right arrow PubMed Citation Right arrow Articles by Lee, N. Right arrow Articles by McCarthy, J. Right arrow Pubmed/NCBI databases * Substance via MeSH Previous Article | Next Article Journal of Clinical Microbiology, August 2006, p. 2773-2778, Vol. 44, No. 8 0095-1137/06/$08.00+0 doi:10.1128/JCM.02557-05 Copyright © 2006, American Society for Microbiology. All Rights Reserved. Effect of Sequence Variation in Plasmodium falciparum Histidine- Rich Protein 2 on Binding of Specific Monoclonal Antibodies: Implications for Rapid Diagnostic Tests for Malaria{dagger} Nelson Lee,1,2 Joanne Baker,2 Kathy T. Andrews,1 Michelle L. Gatton,1,3 David Bell,4 Qin Cheng,2,3 and James McCarthy1* Australian Centre for International and Tropical Health and Nutrition, Queensland Institute of Medical Research and School of Population Health, University of Queensland, Queensland, Australia,1 Department of Drug Resistance and Diagnostics, Australian Army Malaria Institute, Brisbane, Australia,2 Malaria Drug Resistance and Chemotherapy, Queensland Institute of Medical Research, Queensland, Australia,3 World Health Organization, Regional Office for the Western Pacific, Manila, Philippines4 Received 8 December 2005/ Returned for modification 23 February 2006/ Accepted 26 May 2006 The ability to accurately diagnose malaria infections, particularly in settings where laboratory facilities are not well developed, is of key importance in the control of this disease. Rapid diagnostic tests (RDTs) offer great potential to address this need. Reports of significant variation in the field performance of RDTs based on the detection of Plasmodium falciparum histidine-rich protein 2 (HRP2) (PfHRP2) and of significant sequence polymorphism in PfHRP2 led us to evaluate the binding of four HRP2-specific monoclonal antibodies (MABs) to parasite proteins from geographically distinct P. falciparum isolates, define the epitopes recognized by these MABs, and relate the copy number of the epitopes to MAB reactivity. We observed a significant difference in the reactivity of the same MAB to different isolates and between different MABs tested with single isolates. When the target epitopes of three of the MABs were determined and mapped onto the peptide sequences of the field isolates, significant variability in the frequency of these epitopes was observed. These findings support the role of sequence variation as an explanation for variations in the performance of HRP2-based RDTs and point toward possible approaches to improve their diagnostic sensitivities

Ross River virus disease clusters and spatial relationship with mosquito biting exposure in Redland Shire, southern Queensland, Australia

The spatial heterogeneity in the risk of Ross River virus (family Togaviridae, genus Alphavirus, RRV) disease, the most common mosquito-borne disease in Australia, was examined in Redland Shire in southern Queensland, Australia. Disease cases, complaints from residents of intense mosquito biting exposure, and human population data were mapped using a geographic information system. Surface maps of RRV disease age-sex standardized morbidity ratios and mosquito biting complaint morbidity ratios were created. To determine whether there was significant spatial variation in disease and complaint patterns, a spatial scan analysis method was used to test whether the number of cases and complaints was distributed according to underlying population at risk. Several noncontiguous areas in proximity to productive saline water habitats of Aedes vigilax (Skuse), a recognized vector of RRV, had higher than expected numbers of RRV disease cases and complaints. Disease rates in human populations in areas which had high numbers of adult Ae. vigilax in carbon dioxide- and octenol-baited light traps were up to 2.9 times those in areas that rarely had high numbers of mosquitoes. It was estimated that targeted control of adult Ae. vigilax in these high-risk areas could potentially reduce the RRV disease incidence by an average of 13.6%. Spatial correlation was found between RRV disease risk and complaints from residents of mosquito biting. Based on historical patterns of RRV transmission throughout Redland Shire and estimated future human population growth in areas with higher than average RRV disease incidence, it was estimated that RRV incidence rates will increase by 8% between 2001 and 2021. The use of arbitrary administrative areas that ranged in size from 4.6 to 318.3 km2, has the potential to mask any small scale heterogeneity in disease patterns. With the availability of georeferenced data sets and high-resolution imagery, it is becoming more feasible to undertake spatial analyses at relatively small scales.

Roost tree characteristics determine use by the white-striped freetail bat (Tadarida australis, Chiroptera : Molossidae) in suburban subtropical Brisbane, Australia

We examined factors affecting roost tree selection by the white-striped freetail bat Tadarida australis (Chiroptera: Molossidae), a large insectivorous bat in suburban Brisbane, Australia. We compared biophysical characteristics associated with 34 roost trees and 170 control trees of similar diameter, height and tree senescence characters. Roost trees used by the white-striped freetail bat had significantly higher numbers of hollows in the trunk and branches (P < 0.003) and were more likely to contain a large trunk cavity with an internal diameter of > 30 cm (P < 0.001) than control trees. These trees also accommodated more species of hollow-using fauna (P = 0.005). When comparing roost trees with control trees of similar diameters and heights, roost trees were on average at a later stage of tree senescence (P < 0.001). None of the roost trees were found in the large forest reserves fringing the Brisbane metropolitan area despite these areas being used for foraging by the white-striped freetail bat. Although all tree locations in this study were in modified landscapes, roost trees tended to be surrounded by groups of trees and undergrowth. Roost trees provide important habitat requirements for hollow-using fauna in suburban, rural and forested environments.

Geochemical changes recorded in Lynch's Crater, Northeastern Australia, over the past 50 ka

There are many geochemical reconstructions of environmental change in the mid and high latitudes but relatively few in the tropical latitudes, despite their considerable potential for reconstructing environmental processes that cannot be identified using more traditional proxies. Here we present one reconstruction of environmental change for the tropics. This reconstruction covers the past 50 ka using a suite of geochemical data from the high-resolution sequence of Lynch's Crater in northeast Queensland, Australia, a region highly sensitive to El Nino-Southern Oscillation (ENSO) activity. The 23 major oxides and trace elements measured Could be summarised by extracting three axes using principal components analysis (accounting for 72% of the variability). The data indicate that the greatest variability in the geochemical data accounted for erosional activity within the catchment that was associated with past changes in the frequency of ENSO activity (though this was less sensitive during wetter periods, probably as a result of buffering by high vegetation cover). The remaining variability was largely explained by elements that form complexes with organic compounds (e.g., humic acids) and those that are important nutrients for specific vegetation types (and therefore a measure of vegetation distribution). For more detailed reconstructions, further work is required to disentangle the complex controls of clements within sedimentary sequences. (c) 2005 Elsevier B.V. All rights reserved.

The importance of forest area and configuration relative to local habitat factors for conserving forest mammals: A case study of koalas in Queensland, Australia

The loss and fragmentation of forest habitats by human land use are recognised as important factors influencing the decline of forest-dependent fauna. Mammal species that are dependent upon forest habitats are particularly sensitive to habitat loss and fragmentation because they have highly specific habitat requirements, and in many cases have limited ability to move through and utilise the land use matrix. We addressed this problem using a case study of the koala (Phascolarctos cinereus) surveyed in a fragmented rural-urban landscape in southeast Queensland, Australia. We applied a logistic modelling and hierarchical partitioning analysis to determine the importance of forest area and its configuration relative to site (local) and patch-level habitat variables. After taking into account spatial auto-correlation and the year of survey, we found koala occurrence increased with the area of all forest habitats, habitat patch size and the proportion of primary Eucalyptus tree species; and decreased with mean nearest neighbour distance between forest patches, the density of forest patches, and the density of sealed roads. The difference between the effect of habitat area and configuration was not as strong as theory predicts, with the configuration of remnant forest becoming increasingly important as the area of forest habitat declines. We conclude that the area of forest, its configuration across the landscape, as well as the land use matrix, are important determinants of koala occurrence, and that habitat configuration should not be overlooked in the conservation of forest-dependent mammals, such as the koala. We highlight the implications of these findings for koala conservation. (c) 2006 Elsevier Ltd. All rights reserved.

The effect of organic mulch amendments on the physical and chemical properties and revegetation success of a saline-sodic minespoil from central Queensland, Australia

Saline-sodic clay minespoil materials excavated during open-cut coal mining in central Queensland, Australia, pose significant challenges for revegetation, particularly where suitable topsoil capping is not available. We examined the ability of sawdust or straw mulch amendments to ameliorate the adverse properties of these minespoils and improve the success of revegetation efforts. In laboratory studies, mulch application improved infiltration, increased soil moisture retention and reduced surface crust strength. In the field, mulches incorporated to a depth of 0.15 m at application rates of at least 20 t/ha straw or 80 t/ha sawdust were needed to mitigate against capillary rise of salts during drying cycles and support satisfactory vegetation cover. Further research is needed to determine whether improvements are maintained beyond the 4-year trial period reported here.

Multiple paradigms and organisational research: an analysis of work behaviour in the fire service

The thesis examines Kuhn's (1962, 1970) concept of paradigm, assesses how it is employed for mapping intellectual terrain in the social sciences, and evaluates it's use in research based on multiple theory positions. In so doing it rejects both the theses of total paradigm 'incommensurability' (Kuhn, 1962), and also of liberal 'translation' (Popper, 1970), in favour of a middle ground through the 'language-game of everyday life' (Wittgenstein, 1953). The thesis ultimately argues for the possibility of being 'trained-into' new paradigms, given the premise that 'unorganised experience cannot order perception' (Phillips, 1977). In conducting multiple paradigm research the analysis uses the Burrell and Morgan (1979) model for examining the work organisation of a large provincial fire Service. This analysis accounts for firstly, a 'functionalist' assessment of work design, demonstrating inter alia the decrease in reported motivation with length of service; secondly, an 'interpretive' portrayal of the daily accomplishment of task routines, highlighting the discretionary and negotiated nature of the day's events; thirdly, a 'radical humanist' analysis of workplace ideology, demonstrating the hegemonic role of officer training practices; and finally, a 'radical structuralist' description of the labour process, focusing on the establishment of a 'normal working day'. Although the argument is made for the possibility of conducting multiple paradigm research, the conclusion stresses the many institutional pressures serving to offset development.

Research cultures and the pragmatic functions of humor in academic research presentations:A corpus-assisted analysis

Based on a corpus of English, German, and Polish spoken academic discourse, this article analyzes the distribution and function of humor in academic research presentations. The corpus is the result of a European research cooperation project consisting of 300,000 tokens of spoken academic language, focusing on the genres research presentation, student presentation, and oral examination. The article investigates difference between the German and English research cultures as expressed in the genre of specialist research presentations, and the role of humor as a pragmatic device in their respective contexts. The data is analyzed according to the paradigms of corpus-assisted discourse studies (CADS). The findings show that humor is used in research presentations as an expression of discourse reflexivity. They also reveal a considerable difference in the quantitative distribution of humor in research presentations depending on the educational, linguistic, and cultural background of the presenters, thus confirming the notion of different research cultures. Such research cultures nurture distinct attitudes to genres of academic language: whereas in one of the cultures identified researchers conform with the constraints and structures of the genre, those working in another attempt to subvert them, for example by the application of humor. © 2012 Elsevier B.V.

Review of progress in implementing the recommendations of Sir Gareth Roberts regarding employability and career development of PhD students and research staff:A report for Research Councils UK by an independent review panel October 2010

The need for improvement in the development of research careers and researchers’ training in transferable skills was highlighted in two particular recommendations (numbers 4.2 and 5.3) in the 2002 report ‘SET for success: the report of Sir Gareth Roberts’ Review - the supply of people with science, technology, engineering and mathematics skills’ (Roberts, 2002). As a consequence of that review, Research Councils UK (RCUK)1 have invested about £120 million, usually referred to as ’Roberts’ Money’, in research organisations to address this concern in all research disciplines. The last ‘Roberts’ Money’ payment will be for the period up to March 2011; it was therefore proposed to assess the progress made with taking forward these specific recommendations. An independent panel was formed by RCUK to undertake this review in 2010. The terms of reference for the panel are in Annex A. In summary, the panel was asked to review progress made and to advise RCUK and the higher education (HE) sector about future requirements for the development and training of researchers. In the course of their review, the panel considered a wide range of existing reports, interviewed key stakeholders in the HE sector and elsewhere, as well as drawing on their own knowledge and expertise. This report presents the findings of the panel’s review.

Disconnected brains:what is the role of fMRI in connectivity research?

In this paper we consider how functional Magnetic Resonance Imaging (fMRI) has been used to study cortical connectivity in autism and autistic spectrum disorders (ASD). We discuss those studies that have contributed to the evidence supporting a model of disordered cortical connectivity in autism and (ASD), with a focusing emphasis on the application to research into the underconnectivity model. We note that the analytical techniques employed are limited and do not allow interpretation in terms of effective, or directional connectivity, nor do they provide information about the temporal or spectral characteristics of the functional networks being studied. We highlight how currently the features of neural generators that are being assessed by functional connectivity in fMRI are unclear. In addition, we note the importance in clinical studies of considering the consequences of task choice for the nature of the imaging data that can be collected and also of individual differences in participant state and trait characteristics for the accurate interpretation of imaging data. We discuss how alternative techniques such as EEG/MEG may address the limitations of fMRI in assessing brain connectivity, and additionally consider the potential of multimodal approaches. We conclude that fMRI has made significant contributions towards our understanding of the brain in terms of neural systems but that the conclusions drawn from its application in the sphere of autism research need to be approached with caution. It is important in research of this kind that we are aware of the need to examine the methodological and analytical techniques closely when applying findings in clinical populations, not only when they are used to support the development of theoretical models but also to inform diagnostic or treatment decisions.

State-of-the-art in integrated vehicle health management

Cranfield University in collaboration with The Boeing Company have set up a Centre of Excellence in IVHM on the University?s technology park. Sponsored by the East of England Development Agency (EEDA), the Centre carries out pre-competitive research and development of IVHM technologies for the benefit of industrial partners. In addition, the dedicated facilities and university staff provide an unparalleled educational environment for learning and applying IVHM technologies. Boeing is actively involved in the creation and work of the Centre through its enterprise-wide Phantom Works technology organization. This paper will describe the organisation and operation of the Centre and will illustrate its activities by describing a research project being carried out in the Centre. This project is a demonstration of an end to end IVHM system beginning with cost/benefit analysis and extending to maintenance, logistics and operations decision support.

Integrated logistics and supply chain management:the state of practice in Ireland

The Republic of Ireland and Northern Ireland were provided with aid to offset locational disadvantages in the run up to the Single European Market. Since then the Republic has emerged as the fastest growing member of the E.U. Success has not been underpinned by the transport system, suggesting that business has had to overcome locational disadvantages by strong performance elsewhere in the supply chain. The evidence indicates that there are Irish firms operating supply chain management techniques at a truly international standard. The problem is that there are so few in that category Meeting Ireland’s competitiveness challenge means closing the gap between the small group of large and foreign-owned firms, which display excellence in SCM, and the larger group of indigenous small and medium size businesses, which do not.

Outsourcing in Ireland:a literature review, survey and case study perspective

Outsourcing, or offshoring as it is now known, has been around for many decades. In the beginning it was only the very peripheral activities that were blue-collar (lower skilled) work outsourced, but this is now all changing with the outsourcing of white-collar jobs. Historically outsourcing was used when organisation could not perform to world-class excellence in all sectors of the organisation due to incompetence of staff and/or management, lack of capacity, financial pressures, and/or technological pressures. The research currently underway is initially focusing on a literature review of current outsourcing applications in the market place and what impact outsourcing has on business performance. This paper will present the findings of the initial literature review. It will also discuss the methodology being followed to explore the Irish Industrial Sector.