Compression therapy in leg ulcer management

Led ulcer management is an important consideration for all nurses involved in the care of older people. Non-specialists in tissue viability might not always be aware of the evidence base for best practice. The authors examine the effectiveness of multi-layer and single-layer long or short stretch bandage systems in leg ulcer management.

BRCA1: mechanisms of inactivation and implications for management of patients.

The BRCA1 gene was cloned in 1994 as one of the genes that conferred genetic predisposition to early-onset breast and ovarian cancer. Since then, a genetic test for identification of high-risk individuals has been developed. Despite being implicated in many important cellular pathways, including DNA repair and regulation of transcription, the exact mechanism by which inactivation of BRCA1 might lead to malignant transformation of cells remains unknown. We examine the mechanisms that underlie inactivation of BRCA1 and assess how they affect management of patients, in terms of both primary and secondary cancer prevention strategies. Furthermore, we look at the potential usefulness of BRCA1 as a prognostic tool and as a predictive marker of response to different classes of drugs. Finally, throughout this review, we draw links between the functional consequences of BRCA1 inactivation, in terms of key cellular signalling pathways, and how they might explain specific clinical observations in individuals who carry mutations in the gene.

Lean software management case study: Timberline Inc.

This paper is believed to be the first documented account of a full adoption of lean by a software company. Lean techniques were devised by Toyota and other manufacturers over the last 50 years. The techniques are termed lean because they require less resource to produce more product and exceptional quality. Lean ideas have also been successful in service industries and product development. Applying lean to software has been advocated for over 10 years. Timberline, Inc started their lean initiative in Spring 2001 and this paper records their journey, results and lessons learned up to Fall 2003. This case study demonstrates that lean thinking can work successfully for software developers. It also indicates that the extensive lean literature is a valuable source of new ideas for software engineering.

The importance of stakeholder engagement in invasive species management: A cross-jurisdictional perspective in Ireland

The management of invasive non-native species is a frequent cause of conflict in the field of biodiversity conservation because perceptions of their costs and benefits differ among stakeholder groups. A lack of cohesion between scientific researchers, the commercial sector and policy makers lies at the root of a widespread failure to develop and implement sustainable management practices for invasive species. The crisis of this situation is intensified by drivers stemming from international conventions and directives to address invasive species issues. There are further direct conflicts between legislative instruments promoting biodiversity conservation on the one hand while liberalizing trade at the national, European and global level on the other. The island of Ireland provides graphic illustration of the importance of cross-jurisdictional approaches to biological invasions. Using primarily Irish examples in this review, we emphasize the importance of approaching risk assessment, risk reduction and control or eradication policies from a cost-efficient, highly flexible perspective, incorporating linkages between environmental, economic and social objectives. The need for consolidated policies between Northern Ireland and the Republic of Ireland is particularly acute, though few model cross-border mechanisms for such consolidation are available. The importance of engaging affected stakeholders through positive interactions is discussed with regard to reducing the currently fragmented nature of invasive species management between the two jurisdictions.