Advance care planning in 21st century Australia: a systematic review and appraisal of online advance care directive templates against national framework criteria

Objectives A drive to promote advance care planning at a population level has led to a proliferation of online advance care directive (ACD) templates but little information to guide consumer choice. The current study aimed to appraise the quality of online ACD templates promoted for use in Australia. Methods A systematic review of online Australian ACD templates was conducted in February 2014. ACD templates were identified via Google searches, and quality was independently appraised by two reviewers against criteria from the 2011 report A National Framework for Advance Care Directives. Bias either towards or against future medical treatment was assessed using criteria designed to limit subjectivity. Results Fourteen online ACD templates were included, all of which were available only in English. Templates developed by Southern Cross University best met the framework criteria. One ACD template was found to be biased against medical treatment – the Dying with Dignity Victoria Advance Healthcare Directive. Conclusions More research is needed to understand how online resources can optimally elicit and record consumers’ individual preferences for future care. Future iterations of the framework should address online availability and provide a simple rating system to inform choice and drive quality improvement

Determinants of Capital Flight: New Panel Evidence from Sub-Saharan Africa (SSA)

This paper examines the determinants of capital flight in sub Saharan African countries (SSA) by introducing corruption as a focus variable in the model. The econometric analysis is based on data from 25 SSA countries over the period 1986-2010 using dynamic panel data estimation methods: Corruption, our focus variable retains its expected positive sign and is statistically significant across all the estimations. The relationship remains very strong even when other standard control variables are taken into account. These results confirm our hypothesis that the nature of corruption in SSA is such that it encourages and promotes capital flight. The empirical findings also indicate that the capital flight in SSA countries is driven mainly by corruption, lag capital flight, external debt, foreign direct investment, and macroeconomic uncertainty. Based on these results, the paper recommends that governments in the region should manage their external debt efficiently, and stabilize their monetary and macroeconomic policies in order to curtail capital flight. Finally, our results are also robust to different specifications, measures of corruption, and econometrics estimation techniques

The Economic Aspects of Chilli Production in Central Java

This study analyses the economic aspects of chilli in Central Java where chilli is massively and intensively cultivated. Data for this study is compiled during 2009-2011 in three chilli producing districts: Brebes, Magelang and Rembang. Analyses is conducted using qualitative and quantitative approaches. The results indicate that many important findings related to economic aspects of chilli. There are various ranges of economic aspects across regions. The main findings is that chilli provided positive net returns, has relatively high economic risk and intensive use of chemicals. The policies related to improvement of chilli cultivation need to be formulated based on local specific constraints

“Hummingbird” floral traits interact synergistically to discourage visitation by bumble bee foragers

Pollination syndromes are suites of floral traits presumed to reflect adaptations to attract and utilize a “primary” type of animal pollinator. However, syndrome traits may also function to deter “secondary” flower visitors that reduce plant fitness through their foraging activities. Here we use the hummingbird-pollinated plant species Mimulus cardinalis as a model to investigate the potential deterrent effects of classic bird syndrome traits on bumble bee foragers. To establish that M. cardinalis flowers elicit an avoidance response in bees, we assessed the choice behavior of individual foragers on a mixed experimental array of M. cardinalis and its bee-pollinated sister species M. lewisii. As expected, bees showed a strong preference against M. cardinalis flowers (only 22% of total bee visits were to M. cardinalis), but surprisingly also showed a high degree of individual specialization (95.2% of total plant transitions were between conspecifics). To determine M. cardinalis floral traits that discourage bee visitation, we then assessed foraging responses of individuals to M. cardinalis-like and M. lewisii-like floral models differing in color, orientation, reward, and combinations thereof. Across experiments, M. cardinalis-like trait combinations consistently produced a higher degree of flower avoidance behavior and individual specialization than expected based on bee responses to each trait in isolation. We then conducted a series of flower discrimination experiments to assess the ability of bees to utilize traits and trait combinations associated with each species. Relative to M. lewisii-like alternatives, M. cardinalis-like traits alone had a minimal effect on bee foraging proficiency but together increased the time bees spent searching for rewarding flowers from 1.49 to 2.65 s per visit. Collectively, our results show that M. cardinalis flowers impose foraging costs on bumble bees sufficient to discourage visitation and remarkably, generate such costs through synergistic color-orientation and color-reward trait interactions. Floral syndromes therefore represent complex adaptations to multiple pollinator groups, rather than simply the primary pollinator

Biogeography of a Plant Invasion: Plant–Herbivore Interactions

Theory predicts that native plant species should exhibit latitudinal gradients in the strength of their interactions with herbivores. We hypothesize that if an invasive plant species exhibits a different latitudinal gradient in response to herbivores (e.g., a nonparallel gradient), it can create large-scale heterogeneities in community resistance/susceptibility to the invasive species. We conducted a study of latitudinal variation in the strength of herbivory and defenses of native genotypes of Phragmites australis in North America (NA) and Europe (EU) and European invasive genotypes in NA. Within NA, we tested whether (1) invasive genotypes are better defended and suffer less herbivory than co-occurring native genotypes, (2) herbivory and defenses of native P. australis decreases with increasing latitude; and (3) invasive genotypes exhibit either no latitudinal gradient, or a nonparallel latitudinal gradient in herbivory and defenses compared to native genotypes. For the European genotypes, we tested two additional hypotheses: (4) defenses, nutritional condition, and herbivory would differ between the native (EU) and invasive ranges (NA) and (5) latitudinal gradients in defenses and herbivory would be similar between ranges. Within NA, chewing damage, internal stem-feeding incidence, and aphid abundance were 650%, 300%, and 70% lower, respectively, on invasive than native P. australis genotypes. Genotypes in NA also differed in nutritional condition (percent N, C:N ratio), but there was little support for invasive genotypes being better defended than native genotypes. For the European genotypes, herbivory was significantly lower in the invaded than native range, supporting the enemy-release hypothesis. Defense levels (leaf toughness and total phenolics) and tissue percent C and percent N were higher in the invaded than native range for European genotypes. Overall, latitudinal gradients in P. australis nutritional condition, defenses, and herbivory were common. Interestingly, chewing damage and stem-feeder incidence decreased with latitude for native P. australis genotypes in NA and EU, but no latitudinal gradients in response to herbivores were evident for invasive genotypes in NA. Nonparallel latitudinal gradients in herbivory between invasive and native P. australis suggest that the community may be more susceptible to invasion at lower than at higher latitudes. Our study points to the need for invasion biology to include a biogeographic perspective

Self‐Assembled Monolayers of Carbohydrate Derivatives on Gold Surfaces

Self‐assembled monolayers (SAMs) presenting carbohydrates (glycans) have been widely prepared on gold surfaces to mimic the carbohydrate surfaces that are involved in molecular recognition phenomena in living cells. The binding affinity of carbohydrate immbolized on SAM surfaces to various carbohydrate‐binding proteins (such as lectins) can be studied by optical, electrochemical, piezoelectrical and thermal sensing techniques. The lectins present on the surface of pathogens (e.g., bacteria or viruses) can be used as targets for capturing onto carbohydrates immobilized on SAM surfaces. The immobilized carbohydrates can also be used for detecting different types of disease biomarkers present in bodily fluids. Synergistic properties of carbohydrate SAMs and gold nanoparticles can be used for vaccine preparation and drug delivery. By studying different types of glycans, their properties, and the behavior toward recognition of specific pathogens and biomarkers, we can develop not only new therapeutics but also enhance the diagnostic strategies of various diseases. In this chapter, we discuss carbohydrate‐terminated SAMs and their common preparation strategies. Next, we focus on roles of different components of SAMs, characterization techniques, and applications

Disparities in Major Joint Replacement Surgery among Adults with Medicare Supplement Insurance

The objective of this study was to determine if disparities in hip and knee replacement surgery exist among osteoarthritis patients with AARP-branded Medicare supplement plan (ie, Medigap) coverage provided by UnitedHealthcare. Patients were selected into the study if they had 1 or more medical claims with a diagnosis of osteoarthritis from July 1, 2006 to June 30, 2007. Logistic regression analyses tested for age-, sex-, race-, or income-related differences in the likelihood of receiving a hip or knee replacement surgery. The regression models controlled for socioeconomics, health status, type of supplement plan, and residential location. Of the 2.2 million Medigap insureds eligible for this study, 529,652 (24%) had osteoarthritis. Of these, 32,527 (6.1%) received a hip or knee replacement. Males were 6% (P-<-0.001) more likely than females to have a replacement surgery. Patients living in minority or lower income neighborhoods were less likely to receive a hip or knee replacement. Supplement plan type was not a strong predictor of the likelihood of hip or knee replacement. Disparities were much greater by comorbid condition and residential location. Disparities in hip and knee replacement surgery existed by age, sex, race, and income levels. Larger disparities were found by residential location and comorbid condition. Interventions are being considered to address these disparities. (Population Health Management 2011;14:231-238)Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90479/1/pop-2E2010-2E0042.pd