Seeking Higher Ground:Navigating the FM Industry’s Transformation

Facility management has recently met several inflection points that call for new working methods; therefore, IFMA must foster and facilitate discussions to help set a new course for the industry. FM should build upon a history of innovation and use the field's complexity and multidisciplinarity to its advantage. By understanding current and emergent end-user needs and societal requirements, FM practitioners can identify new opportunities for future development. By understanding how building layers interact across disparate time scales, facility managers can enact systemic change for the benefit of end users, organizations and communities. Facility managers have an opportunity to be at the forefront of transformative change and lead the industry to higher ground

Formulating a convincing rationale for a research study

Explaining the purpose of a research study and providing a compelling rationale is an important part of any coaching research project, enabling the work to be set in the context of both existing evidence (and theory) and its practical applications. This necessitates formulating a clear research question and deriving specific research objectives, thereby justifying and contextualising the study. In this research note we consider the characteristics of good research questions and research objectives and the role of theory in developing these. We conclude with a summary and a checklist to help ensure the rationale for a coaching research study is convincing

Raman Spectroscopy of the Human Nail: A Potential Tool for Evaluating Bone Health?

Dual X-ray absorptiometry (DEXA) is the current gold standard for the diagnosis of osteoporosis. However, patients can suffer osteoporotic fractures despite normal bone mineral density, partly because of unmeasured influences of both the protein and mineral phases of bone that are affected in osteoporosis. There is currently no clinically applicable method of evaluating the health of the protein phase. The proteins in human nail (keratin) and bone (collagen) require sulphation and disulphide bond (S-S) formation for structural integrity and disorders of either sulphur metabolism or cystathione beta-synthase can lead to structural abnormalities in these tissues. Raman protein spectra provide a method of non-invasive measurement of the degree of sulphation of structurally related proteins that may be indicative of bone health. Raman spectroscopy was used to evaluate the disulphide (S-S) content of fingernails. The nail samples came from from 169 women (84 pre- and 85 post-menopausal), of which 39 had a history of osteoporotic fracture. BMD was measured by DXA at the spine. Analyses included parametric and non-parametric tests, dependent on the distribution of the test variable. Mean disulphide content of the nail reduced with age and was slightly higher in pre-, compared to post-menopausal women (P = 0.187). Significantly lower disulphide content was observed in nails obtained from subjects with a history of fracture (P = 0.025). When either disulphide content or BMD was used as a predictor, the odds ratio of these two measures were found to be comparable predictors for fracture status. This suggests that measurements of change in the protein phase of structural proteins such as keratin in the human nail may be correlated with clinically relevant changes in bone proteins that are important in fracture risk. © 2007 Springer Science+Business Media, LLC

The Making Assessment Count (MAC) consortium- maximising assessment and feedback design by working together

The Making Assessment Count (MAC) project started at the University of Westminster in 2008. It sought to align staff and student expectations of feedback and support greater use of feed-forward approaches. A baseline analysis of staff views in the School of Life Sciences suggested that students did not make strategic use of the feedback they received. A similar analysis of the student position revealed that as a group they felt that the feedback provided to them was often insufficiently helpful. To address this dichotomy, a MAC process was developed in the School of Life Sciences and trialled with a cohort of about 350 first year undergraduate students. The process was based on a student-centred, three-stage model of feedback: Subject specific, Operational, and Strategic (SOS model). The student uses the subject tutor’s feedback on an assignment to complete an online self-review questionnaire delivered by a simple tool. The student answers are processed by a web application called e-Reflect to generate a further feedback report. Contained within this report are personalised graphical representations of performance, time management, satisfaction and other operational feedback designed to help the student reflect on their approach to preparation and completion of future work. The student then writes in an online learning journal, which is shared with their personal tutor to support the personal tutorial process and the student’s own development plan (PDP). Since the initial development and implementation of the MAC process within Life Sciences at Westminster, a consortium of universities has worked together to maximise the benefits of the project outcomes and collaboratively explore how the SOS model and e-Reflect can be exploited in different institutional and subject contexts. This paper presents and discusses an evaluation of the use of the MAC process within Life Sciences at Westminster from both staff and student perspective. In addition, the paper will show how the consortium is working to develop a number of scenarios for utilisation of the process as a whole as well as the key individual process components, the SOS model and e-Reflec

Flow impacts on estuarine finfish fisheries of the Gulf of Carpentaria

The estuaries of Australia s tropical rivers support commercial fisheries for finfish and shellfish valued at over $220 million per annum. There are also significant tourism-related and local recreational and indigenous fisheries for icon species such as barramundi. Development of water resources in Australia's Tropical Rivers region is being considered for the Flinders, Mitchell, McArthur, Roper, Daly and Victoria catchments. Greater knowledge of the freshwater requirements of tropical aquatic ecosystems, including estuaries is crucial, so that the communities of catchments where water resource development occurs can be assured that the downstream effects of such development are considered and managed based on the best available knowledge

Is monitoring of plasma 5-fluorouracil levels in metastatic / advanced colorectal cancer clinically effective? A systematic review

Background: Pharmacokinetic guided dosing of 5-fluorouracil chemotherapies to bring plasma 5-fluorouracil into a desired therapeutic range may lead to fewer side effects and better patient outcomes. High performance liquid chromatography and a high throughput nanoparticle immunoassay (My5-FU) have been used in conjunction with treatment algorithms to guide dosing. The objective of this study was to assess accuracy, clinical effectiveness and safety of plasma 5-fluorouracil guided dose regimen(s) versus standard regimens based on body surface area in colorectal cancer. Methods: We undertook a systematic review. MEDLINE; MEDLINE In-Process & Other Non-Indexed Citations; EMBASE; Cochrane Library; Science Citation Index and Conference Proceedings (Web of Science); and NIHR Health Technology Assessment Programme were searched from inception to January 2014. We reviewed evidence on accuracy of My5-FU for estimating plasma 5-fluorouracil and on the clinical effectiveness of pharmacokinetic dosing compared to body surface area dosing. Estimates of individual patient data for overall survival and progression-free survival were reconstructed from published studies. Survival and adverse events data were synthesised and examined for consistency across studies. Results: My5-FU assays were found to be consistent with reference liquid chromatography tandem mass spectrometry. Comparative studies pointed to gains in overall survival and in progression-free survival with pharmacokinetic dosing, and were consistent across multiple studies. Conclusions: Although our analyses are encouraging, uncertainties remain because evidence is mainly from outmoded 5-fluorouracil regimens; a randomised controlled trial is urgently needed to investigate new dose adjustment methods in modern treatment regimens

A dynamic programming approach for the alignment of signal peaks in multiple gas chromatography-mass spectrometry experiments

<p>Abstract</p> <p>Background</p> <p>Gas chromatography-mass spectrometry (GC-MS) is a robust platform for the profiling of certain classes of small molecules in biological samples. When multiple samples are profiled, including replicates of the same sample and/or different sample states, one needs to account for retention time drifts between experiments. This can be achieved either by the alignment of chromatographic profiles prior to peak detection, or by matching signal peaks after they have been extracted from chromatogram data matrices. Automated retention time correction is particularly important in non-targeted profiling studies.</p> <p>Results</p> <p>A new approach for matching signal peaks based on dynamic programming is presented. The proposed approach relies on both peak retention times and mass spectra. The alignment of more than two peak lists involves three steps: (1) all possible pairs of peak lists are aligned, and similarity of each pair of peak lists is estimated; (2) the guide tree is built based on the similarity between the peak lists; (3) peak lists are progressively aligned starting with the two most similar peak lists, following the guide tree until all peak lists are exhausted. When two or more experiments are performed on different sample states and each consisting of multiple replicates, peak lists within each set of replicate experiments are aligned first (within-state alignment), and subsequently the resulting alignments are aligned themselves (between-state alignment). When more than two sets of replicate experiments are present, the between-state alignment also employs the guide tree. We demonstrate the usefulness of this approach on GC-MS metabolic profiling experiments acquired on wild-type and mutant <it>Leishmania mexicana </it>parasites.</p> <p>Conclusion</p> <p>We propose a progressive method to match signal peaks across multiple GC-MS experiments based on dynamic programming. A sensitive peak similarity function is proposed to balance peak retention time and peak mass spectra similarities. This approach can produce the optimal alignment between an arbitrary number of peak lists, and models explicitly within-state and between-state peak alignment. The accuracy of the proposed method was close to the accuracy of manually-curated peak matching, which required tens of man-hours for the analyzed data sets. The proposed approach may offer significant advantages for processing of high-throughput metabolomics data, especially when large numbers of experimental replicates and multiple sample states are analyzed.</p

management and grading of egfr inhibitor induced cutaneous toxicity

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The consent process: enabling or disabling patients’ active participation?

Standards expected by doctors’ regulatory bodies in respect of the process of consent to treatment have arguably sought to restructure the nature of the doctor-patient relationship from one of paternalism to that of shared decision-making. Yet, few studies have explored empirically, from patients’ perspectives, the extent to which the process of consent to treatment enables or disables patients’ participation in medical decision-making. Our paper examines patients’ attitudes towards the consent process, exploring how and why these attitudes influence patients’ active participation in decision-making and considering possible consequent medico-legal issues. Data were collected longitudinally using semi-structured interviews and field observations involving 35 patients and 19 of their caregivers, in an English hospital between February and November 2014. These indicate that generally patients defer to the doctor in respect of treatment decision-making. Although most patients and their caregivers wanted detailed information and discussion, they did not necessarily expect that this would be provided. Further, patients perceived that signing the consent form was an obligatory routine principally to protect doctors from legal action should something go wrong. Our study suggests that patients’ predominantly paternalistic perceptions of the consent process can not only undermine attempts by doctors to involve them in decision-making but, as patients are now considered in law as informed actors, their perceptions of the consent form as not being in their interests could be a self-fulfilling prophecy if signing is undertaken without due consideration to the content