A systematic review of platinum and taxane resistance from bench to clinic: an inverse relationship

We undertook a systematic review of the pre-clinical and clinical literature for studies investigating the relationship between platinum and taxane resistance. Medline was searched for (1) cell models of acquired drug resistance reporting platinum and taxane sensitivities and (2) clinical trials of platinum or taxane salvage therapy in ovarian cancer. One hundred and thirty-seven models of acquired drug resistance were identified. 68.1% of cisplatin-resistant cells were sensitive to paclitaxel and 66.7% of paclitaxel-resistant cells were sensitive to cisplatin. A similar inverse pattern was observed for cisplatin vs. docetaxel, carboplatin vs. paclitaxel and carboplatin vs. docetaxel. These associations were independent of cancer type, agents used to develop resistance and reported mechanisms of resistance. Sixty-five eligible clinical trials of paclitaxel-based salvage after platinum therapy were identified. Studies of single agent paclitaxel in platinum-resistant ovarian cancer where patients had previously recieved paclitaxel had a pooled response rate of 35.3%, n=232, compared to 22% in paclitaxel naïve patients n=1918 (p<0.01, Chi-squared). Suggesting that pre-treatment with paclitaxel may improve the response of salvage paclitaxel therapy. The response rate to paclitaxel/platinum combination regimens in platinum-sensitive ovarian cancer was 79.5%, n=88 compared to 49.4%, n=85 for paclitaxel combined with other agents (p<0.001, Chi-squared), suggesting a positive interaction between taxanes and platinum. Therefore, the inverse relationship between platinum and taxanes resistance seen in cell models is mirrored in the clinical response to these agents in ovarian cancer. An understanding of the cellular and molecular mechanisms responsible would be valuable in predicting response to salvage chemotherapy and may identify new therapeutic targets

Examination of outsourcing in an accounting firm : a shift in the unit analysis : ethnographic study of blocks to knowledge sharing

In the last few years accountancy firms have started to use outsourcing due to market pressure to be competitive. The industry is highly regulated, and outsourcing poses constraints including confidentiality of information, regulatory restriction and ethical implications. The legal and ethical responsibility of any work outsourced remains with the accounting firm that has purchased the outsourcing service, and not with the outsourcer. Since the aim of outsourcing is to make the accounting firm more efficient, it needs to be sure that the benefits of outsourcing will exceeds the costs and risks of the process. As a knowledge-based industry, this gives the sharing of knowledge a central role in outsourcing. Outsourcing in accounting creates a relationship not only between two organisations, but more importantly among those organisations' workers. The main asset of an accounting firm is its staff and their specialist knowledge. Most outsourcing studies focus on the relationship between organisations, with little emphasis on the relationship between workers. A particular quality of accounting is that workers are the owners of their own knowledge, and firms employ these workers without having a definitive right to the sharing of their knowledge. An efficient working environment stems from the workers' ability to share their knowledge (their assets) within the organisation and in an outsourcing process. The objective of this research is to understand the blocks to knowledge-sharing in a medium-sized accounting firm from an individual unit of analysis with focus on its outsourcing operations. This study examines the following research questions: What is the influence of trust and power on knowledge-sharing from the individual perspective? How does accounting outsourcing create a shift in the unit of analysis, and how does it differ from other types of outsourcing? From the perspective of the individuals involved, what are the blocks to knowledge-sharing within the firm and within its outsourcing operations? To be able to study worker relationships and behaviour in detail, data for analysis was gathered using the participant observation method. The study finds that trust and power are important elements that can influence the sharing of knowledge among individuals. The main types of trust that influence knowledge-sharing, particularly in head office, are found to be benevolence and competence trust, while one of the main factors to influence trust within the outsourcing context is communication. Lack of communication creates fear among in-house staff and thus makes outsourcing contractors less trustworthy. Power is mainly driven by specificity of knowledge and individualism; these two factors promote the use of knowledge as a power tool. Trust and power are blocks to knowledge-sharing in the organisation's in-house activities, but are less influential in blocking knowledge in outsourcing, where the two main blockages are: (i) Physical distance and lack of suitable technological platform to share knowledge, and (ii) Gap in knowledge awareness between the accounting firm and the outsourcing provider. Accounting outsourcing is shown to be different from other types because it is the outsourcing of a core competence (known as third generation outsourcing), and also of knowledge-based work. The accounting firm uses outsourcing within its legal and ethical limits, reducing costs indirectly, because it has to negotiate the profession's constraints. In this context there are two types of outsourcing, namely internal and external outsourcing. This research applies participant observation to an original context and shows the importance of using such a method in future management studies.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

ICT, human capital development and Emiratisation of the labour market in the United Arab Emirates

The UAE's labour market policy of Emiratisation is intended to replace expatriates with local workers by imposing restrictions on the employment of expatriate workers in the public sector and enforcing the private sector to employ nationals in certain types of jobs. This policy has been focused rather narrowly on administrative jobs in the finance and oil sector, and has not addressed the newly emerging ICT sector which is a cornerstone of the government's long-term economic growth strategy. Moreover, strategies such as the Emiratisation policy and investment in the ICT sector are not currently taking place within the context of a proper analysis of labour market needs and problems. The main aim of this study is to make a significant contribution to the knowledge base from which a sustainable national human resource policy in the UAE can be developed, by exploring the current barriers to successful working environments, and by assessing how the Emiratisation policy can be redesigned to focus more on new high-growth sectors, especially the ICT sector. The study also contributes more generally to the field of knowledge about how human capital supply can be improved through policy interventions and technology implementation. Furthermore, by adopting a conceptual framework based on established labour market and social network theories, the study is expected to improve understanding of the UAE economy and potential solutions to current labour market problems, thus offering considerable practical value to UAE decision-makers and policy officials. The study employs a multi-disciplinary approach to the study of the relationship between human capital and ICT with special emphasis on harmonization. This is a mixed-methods study consisting of both quantitative and qualitative primary research data collection, as well as a review of literature. The quantitative research method used a semi-structured online questionnaire survey targeted at managers in the Oil/Gas and Banking/Finance sectors, future job-seekers (students), and other UAE labour market stakeholders and experts. This was followed up by in-depth interviews with ICT expert informants, to provide qualitative data. The results of the quantitative and qualitative components were integrated in a process of triangulation, to draw out their overall significance. The principle finding of this research is that the mismatch between the supply and demand sides of the labour market in terms of skills and expectations is the main barrier to emiratisation. High percentages of Emirati students do not enter the labour market following graduation. UAE nationals have high job and salary expectations, and mainly focus on the public sector. Employers surveyed believe that the types of skills and qualifications they need are in short supply among UAE nationals, especially in relation to managerial and professional jobs. The cultural importance of contacts makes the recruitment process inefficient on both sides. Emiratisation can be expensive for organisations, would be more sustainable if compliance were better enforced by the UAE government, and needs to be better supported by a good education/training system which prepares UAE nationals for the needs of the labour market. The study concludes by advocating a gradual shift towards the knowledge economy as a way of rebalancing the labour market, proposing potential further research on the ICT field within the UAE's private sector, with close attention to indigenization. On the demand side, more detailed nationally representative data might be collected on the skills requirements of private sector jobs in a range of sectors, so that the UAE education system can be better designed to meet the needs of the economy through human resource development.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Configuring a Co-operative Information System - Theoretical and Methodological Issues

The focus of the study is on the generation and use of common information spaces, and how the computer system acts as an informative artefact for the users of the system; its implications are discussed as to the role of multimedia in communication, and the representation of information in teamwork. The domain examined was the construction industry: construction teams are temporary structures, and their members are frequently geographically dispersed. This has implications for the design of appropriate technology to support the collaborative aspects of teamwork. An experimental web-based multimedia application has been developed to study the potential of multimedia for enabling novel patterns of communication and cooperation in these construction teams. This technology provides a valuable elicitation tool that has helped us to discover how people learn about one another and to explicate what social knowledge they bring to a collaboration. The paper uses ethnographic methods to study the..