Research support: models and professionalisation

This presentation was given by Mr Simon Kerridge, Secretary of the Association of Research Managers and Administrators (ARMA), at the BRAM-NET Annual Event on the 17th February 2011. The event was organised by Dr Rosa Scoble and hosted at Brunel University. BRAM-NET (The Brunel Research Administrators & Managers Network) is a forum to share best practice and information on new initiatives between colleagues supporting research in the centre and academic areas at Brunel University

Is it too late to turn back the clock of managerialism and neoliberalism?

The esteemed health economist, Gavin Mooney, who died in tragic circumstances in December 2012, devoted his last book The Health of Nations: Towards a New Political Economy[1] to exposing the pernicious effects of neoliberalism on healthcare. He argued compellingly that the consequences of ‘neoliberalism’ – in his usage, the reliance on market mechanisms to address all the needs of a society in the areas of healthcare, education, social welfare and even the arts – have been disastrous for the health system and have exacerbated inequalities in access to care at both the national and global levels. They have led to inappropriate and perverse social outcomes, distorted the kinds of medicines and technologies that are employed, increased the equity gap, and exacerbated environmental destruction. He posed the question of whether it is possible to reverse what has, until now, been largely assumed to be an inexorable trend and, using case studies drawn from both developed and developing countries, drew attention to several possible alternative strategies for designing and delivering the sort of healthcare that may enrich communities, increase equity and properly address the social determinants of health

Independent therapeutic advice: How achievable is it?

This supplement is likely to be of interest to anyone involved in the development of clinical guidelines and clinical research, including: • health professionals, trainees and students who use guidelines as a basis for their decision making • policy makers and others working to improve the quality of health care • people involved in university, college and hospital education. The supplement outlines the issues discussed at an Independence Forum hosted by Therapeutic Guidelines Limited in Melbourne, Australia, on 29 October 2012. It puts forward recommendations to overcome limitations of the evidence base and improve the trustworthiness of guidelines. Therapeutic Guidelines is an independent, not-forprofit organisation that was established to promote the quality use of medicines through the publication of clear, concise and ready to use guidelines. Therapeutic Guidelines convened the Independence Forum to discuss issues of independence and conflicts of interest in the context of the development of therapeutic guidelines for health professionals. Two eminent overseas speakers, Professor Silvio Garattini from the Mario Negri Institute, Italy, and Assistant Professor Barbara Mintzes from the University of British Columbia, Canada, gave keynote presentations on the complexity of the therapeutic environment and clinical evidence base. Key Australian commentators and health ethicists – Professor Paul Komesaroff from the Centre for the Study of Ethics in Medicine and Society at Monash University, and Associate Professor Ian Kerridge from the Centre for Values, Ethics and the Law in Medicine at the University of Sydney – focused on the influence of vested interests in clinical research trials and guideline development, citing high profile examples such as the case of hormone therapy after menopause. Panel discussions provided insights on these issues from a range of perspectives, including government, evidence-based medicine, clinical research, health professionals and community. During the last session, speakers and participants worked in small groups to formulate recommendations and strategies to improve the suitability of the evidence base and trustworthiness of therapeutic recommendations and guidelines.NP

A review of strategies to improve rational prescribing in asthma.

Background: There are well-recognised gaps between evidence-based recommendations and prescribing practices in asthma. While different strategies have been devised to improve rational prescribing, the impact of these is uncertain. Aim: To examine the characteristics and effectiveness of strategies to improve rational prescribing in asthma. Method: We systematically searched electronic databases to find studies that reported on strategies to improve prescribing in asthma, or included rational prescribing as one of the main components of the program. Results: There were thirteen relevant studies. All of the strategies described in these studies involved physician education using a variety of modalities; two of the trials also included patient-specific prescribing direction. Twelve of thirteen studies reported improved prescribing practice. There was significant heterogeneity in the interventions and outcome criteria employed by the studies. Conclusion: Strategies to improve rational prescribing in asthma show promise, but the significant methodological heterogeneity, and the absence in most cases of demonstrable clinical benefit, raise concerns about their applicability in clinical practice. Keywords: asthma, inappropriate prescribing, medication therapy management, physician's practice patterns, quality improvemen

Independent therapeutic advice: How achievable is it?

This supplement is likely to be of interest to anyone involved in the development of clinical guidelines and clinical research, including: • health professionals, trainees and students who use guidelines as a basis for their decision making • policy makers and others working to improve the quality of health care • people involved in university, college and hospital education. The supplement outlines the issues discussed at an Independence Forum hosted by Therapeutic Guidelines Limited in Melbourne, Australia, on 29 October 2012. It puts forward recommendations to overcome limitations of the evidence base and improve the trustworthiness of guidelines. Therapeutic Guidelines is an independent, not-forprofit organisation that was established to promote the quality use of medicines through the publication of clear, concise and ready to use guidelines. Therapeutic Guidelines convened the Independence Forum to discuss issues of independence and conflicts of interest in the context of the development of therapeutic guidelines for health professionals. Two eminent overseas speakers, Professor Silvio Garattini from the Mario Negri Institute, Italy, and Assistant Professor Barbara Mintzes from the University of British Columbia, Canada, gave keynote presentations on the complexity of the therapeutic environment and clinical evidence base. Key Australian commentators and health ethicists – Professor Paul Komesaroff from the Centre for the Study of Ethics in Medicine and Society at Monash University, and Associate Professor Ian Kerridge from the Centre for Values, Ethics and the Law in Medicine at the University of Sydney – focused on the influence of vested interests in clinical research trials and guideline development, citing high profile examples such as the case of hormone therapy after menopause. Panel discussions provided insights on these issues from a range of perspectives, including government, evidence-based medicine, clinical research, health professionals and community. During the last session, speakers and participants worked in small groups to formulate recommendations and strategies to improve the suitability of the evidence base and trustworthiness of therapeutic recommendations and guidelines.NP

Advancing the time of ripeness of grapes by the application of methyl 2-(ureidooxy) propionate (a growth retardant)

Methyl 2-(ureidooxy) propionate (MUP), a plant growth retardant, hastened the ripening of grape berries of Vitis vinifera L. cultivars Mataro and Sultana by about 2 weeks and 1 week, respectively. The vines were sprayed with 0.1 % solution of MUP about halfway :through the first rapid growth phase of the fruit and again 2 weeks later. Terminal and lateral shoot growth was inhibited. Ripening of berries was advanced as measured by development of colour, and changes in titratable acid and reducing sugar content. The earlier ripening of the berries may have been due to hormonal changes but the advancement was much greater than that found previously with abscisic acid or ethylene applied during the slow growth stage of berry development.Die Beschleunigung des Reifezeitpunktes von Trauben durch die Anwendung vonMethyl-2-(ureidooxy)-Propionat, einen WachstumsdämpferMethyl-2-(ureidooxy)-Propionat (MUP), welches das Pflanzenwachstum verlangsamt, beschleunigte bei den Vitis-vinifera-Sorten Mataro und Sultana die Beerenreife um etwa 2 Wochen bzw. 1 Woche. Die Reben wurden etwa in der Mitte der ersten raschen Wachstumsphase der Beeren und ein weiteres Mal 2 Wochen später mit einer 0,1%igen MUP-Lösung besprüht. Das terminale und laterale Triebwachstum war gehemmt. Die Beerenreife war beschleunigt, wie die Entwicklung der Beerenfarbe und die Veränderungen im Gehalt an titrierbarer Säure und reduzierenden Zuckern zeigten. Die frühzeitigere Beerenreife könnte auf hormonale Veränderungen zurückgehen; allerdings war die Reife viel stärker beschleunigt als im Fall früherer Versuche, in denen während der langen Wachstumsphase der Beerenentwicklung Abscisinsäure oder Äthylen angewandt worden waren

Cassini: Mission to Saturn and Titan

The Cassini Mission to Saturn and Titan represents an important step into the exploration of the outerplanets. It will expand on the flyby encounters of Pioneer and Voyager and parallel the detailed exploration of the Jupiter system to be accomplished by the Galileo Mission. By continuing the study of the two giant planets and enabling detailed comparisons of their structure and behavior, Cassini will provide a tremendous insight into the formation and evolution of the solar system. In addition, by virtue of its focus on the Saturnian satellite Titan, Cassini will return detailed data on an environment whose atmospheric chemistry may resemble that of the primitive Earth. The scientific objectives can be divided into five categories: Titan, Saturn, rings, icy satellites, and magnetospheres. The key area of interest to exobiologists is Titan; the other four scientific categories will be discussed briefly to provide a comprehensive overview of the Cassini Mission

Investigation of the reactivity of AlCl3 and CoCl2 toward molten alkali-metal nitrates in order to synthesize CoAl2O4

Cobalt aluminate CoAl2O4 powder, constituted of nano-sized crystallites, is prepared, involving the reactivity of AlCl3 and CoCl2 with molten alkali-metal nitrates. The reaction at 450 °C for 2 h leads to a mixture of spinel oxide Co3O4 and amorphous γ-Al2O3. It is transformed into the spinel oxide CoAl2O4 by heating at 1000 °C. The powders are mainly characterized by XRD, FTIR, ICP, electron microscopy and diffraction, X-EDS and diffuse reflection. Their properties are compared to those of powders obtained by solid state reactions of a mechanical mixture of chlorides or oxides submitted to the same thermal treatment

Oral chronic graft-versus-host disease (GvHD) in Australia: clinical features and challenges in management

Data from the Australasian Bone Marrow Transplant Recipient Registry show a steady increase in the number of allogeneic haemopoietic stem cell transplantations (HSCT) performed annually in Australia and New Zealand. In 2012, 629 allogeneic HSCT were performed. Allogeneic HSCT is associated with numerous potential complications, including chronic graft-versus-host disease (cGVHD). The oral cavity is one of the most frequent sites affected by cGvHD, often leading to significant disability and reduced quality of life. Management strategies are often complex, of variable efficacy and influenced by the availability of various therapeutic agents, access to compounding pharmacies and associated costs. This paper summarises the current status of allogeneic HSCT in Australia and New Zealand with a focus on oral cGvHD and the associated challenges in its management. Key words: graft-versus-host disease, oral mucosa, saliva