Learning a novel technique to identify possible melanomas: are Australian general practitioners better than their U.K. colleagues?

Abstract Background Spectrophotometric intracutaneous analysis (SIAscopy™) is a multispectral imaging technique that is used to identify 'suspicious' (i.e. potentially malignant) pigmented skin lesions for further investigation. The MoleMate™ system is a hand-held scanner that captures SIAscopy™ images that are then classified by the clinician using a computerized diagnostic algorithm designed for the primary health care setting. The objectives of this study were to test the effectiveness of a computer program designed to train health care workers to identify the diagnostic features of SIAscopy™ images and compare the results of a group of Australian and a group of English general practitioners (GPs). Methods Thirty GPs recruited from the Perth (Western Australia) metropolitan area completed the training program at a workshop held in March 2008. The accuracy and speed of their pre- and post-test scores were then compared with those of a group of 18 GPs (including 10 GP registrars) who completed a similar program at two workshops held in Cambridge (U.K.) in March and April, 2007. Results The median test score of the Australian GPs improved from 79.5% to 86.5% (median increase 5.5%; p < 0.001) while the median test score of the English GPs improved from 74.5% to 86.5% (median increase 9.5%; p < 0.001). The Australian GPs had significantly higher pre-test scores but there were no significant differences in post-test scores between the Australian and English GPs or between the GPs and GP registrars. There was no significant difference in scores between GPs with previous dermoscopy experience or dermatology training. Conclusion Most of the SIAscopy™ features can be learnt to a reasonable degree of accuracy with this brief computer training program. Although the Australian GPs scored higher in the pre-test, both groups had similar levels of accuracy and speed in interpreting the SIAscopy™ features after completing the program. Scores were not affected by previous dermoscopy experience or dermatology training, which suggests that the MoleMate™ system is relatively easy to learn

Attitudes and practices of recording diabetic patient information within an Australian general practice setting: an exploratory study

Background An accurate diabetes register enables a general practice to effectively monitor and manage the services for their patients with diabetes. This pilot project builds on the National Primary Care Collaboratives Program (a quality improvement programme for general practice) as the first change principle for managing chronic diseases. Objectives The main aim of the project was to improve the systems management of electronic registers of people with diabetes in the general practice setting. The pilot project assessed the uptake, awareness and confidence levels amongst practice staff in improving the diabetes register. Method This was completed by conducting a survey of general practitioners and practice nurses within one general practice in Perth, Western Australia. In addition, focus groups per and post intervention were facilitated to obtain practice staff 's views upon the issues around maintaining an efficient and updated patient register within a busy practice setting. Results By the end of the project the general practice had an established diabetes register with defined and agreed practice systems

Provenancing of lightweight volcanic stones used in ancient Roman concrete vaulting: Evidence from Rome

This paper presents the geochemical analysis of lightweight scoria and pumice used in concrete vaults from ancient Rome. The geochemical signatures of dark scoria indicates a provenance of the 36-18 ka lavas of Vesuvius, as opposed to the more recent events on which Pompeii was built, as previously thought. The light-coloured pumices analysed, which were originally thought to belong to the Sabatini volcanic system (north of Rome), corresponded instead to products from Campi Flegrei. These results provoke re-evaluation of the trade and acquisition of these specialized materials destined for imperial projects in the capital city

The neurotransmitter serotonin interrupts α-synuclein amyloid maturation

Indolic derivatives can affect fibril growth of amyloid forming proteins. The neurotransmitter serotonin (5-HT) is of particular interest, as it is an endogenous molecule with a possible link to neuropsychiatric symptoms of Parkinson disease. A key pathomolecular mechanism of Parkinson disease is the misfolding and aggregation of the intrinsically unstructured protein α-synuclein. We performed a biophysical study to investigate an influence between these two molecules. In an isolated in vitro system, 5-HT interfered with α-synuclein amyloid fiber maturation, resulting in the formation of partially structured, SDS-resistant intermediate aggregates. The C-terminal region of α-synuclein was essential for this interaction, which was driven mainly by electrostatic forces. 5-HT did not bind directly to monomeric α-synuclein molecules and we propose a model where 5-HT interacts with early intermediates of α-synuclein amyloidogenesis, which disfavors their further conversion into amyloid fibrils