The integrin adhesome network at a glance.

The adhesion nexus is the site at which integrin receptors bridge intracellular cytoskeletal and extracellular matrix networks. The connection between integrins and the cytoskeleton is mediated by a dynamic integrin adhesion complex (IAC), the components of which transduce chemical and mechanical signals to control a multitude of cellular functions. In this Cell Science at a Glance article and the accompanying poster, we integrate the consensus adhesome, a set of 60 proteins that have been most commonly identified in isolated IAC proteomes, with the literature-curated adhesome, a theoretical network that has been assembled through scholarly analysis of proteins that localise to IACs. The resulting IAC network, which comprises four broad signalling and actin-bridging axes, provides a platform for future studies of the regulation and function of the adhesion nexus in health and disease.

Dealing with drug-seeking behaviour.

People who misuse prescription drugs most commonly seek prescriptions for opioids and benzodiazepines. Other prescription drugs that are misused include the newer antipsychotics such as quetiapine and olanzapine, and stimulants such as dexamphetamine and methylphenidate. Health professionals should be aware of behaviours that may indicate drug seeking, but dependency on prescription drugs can occur at any age, within any cultural group and across any educational class. Patients with dependencies may not necessarily display obvious drug-seeking behaviours. All general practices should have a practice policy on prescribing drugs of dependence. GPs should register with the Prescription Shopping Information Service. There is strong evidence in Australia of increasing harms from prescription drugs of dependence, including deaths from overdose. Before prescribing any drug of dependence, health professionals require an understanding of the patient's biopsychosocial status, and the evidence-based indications and potential significant harms of these drugs.

Connectivity and Dispersal Patterns of Protected Biogenic Reefs: Implications for the Conservation of Modiolus modiolus (L.) in the Irish Sea.

Biogenic reefs created by Modiolus modiolus (Linnaeus, 1758) (horse mussel reefs) are marine habitats which support high levels of species biodiversity and provide valuable ecosystem services. Currently, M. modiolus reefs are listed as a threatened and/or declining species and habitat in all OSPAR regions and thus are highlighted as a conservation priority under the EU Marine Strategy Framework Directive (MSFD). Determining patterns of larval dispersal and genetic connectivity of remaining horse mussel populations can inform management efforts and is a critical component of effective marine spatial planning (MSP). Larval dispersal patterns and genetic structure were determined for several M. modiolus bed populations in the Irish Sea including those in Wales (North Pen Llyn), Isle of Man (Point of Ayre) and Northern Ireland (Ards Peninsula and Strangford Lough). Simulations of larval dispersal suggested extant connectivity between populations within the Irish Sea. Results from the genetic analysis carried out using newly developed microsatellite DNA markers were consistent with those of the biophysical model. Results indicated moderately significant differentiation between the Northern Ireland populations and those in the Isle of Man and Wales. Simulations of larval dispersal over a 30 day pelagic larval duration (PLD) suggest that connectivity over a spatial scale of 150km is possible between some source and sink populations. However, it appears unlikely that larvae from Northern Ireland will connect directly with sites on the Llyn or Isle of Man. It also appears unlikely that larvae from the Llyn connect directly to any of the other sites. Taken together the data establishes a baseline for underpinning management and conservation of these important and threatened marine habitats in the southern part of the known range.

The practice of confidentiality in an Aboriginal medical service--what do GPs need to know?

BACKGROUND: The medical ethic of confidentiality is usually taught from a western ethical perspective based on the Hippocratic oath. This study at an urban Aboriginal medical service aimed to explore how confidentiality is understood in a community controlled Aboriginal health service, with a view to informing the training of general practitioners. METHOD: Twenty-three people, comprising staff, patients and general practice registrars, were interviewed about confidentiality between July 2007 and February 2008. RESULTS: Six themes were identified: overlapping contexts of confidentiality, key sensitivities, sharing of patient information, importance of consent, multiple roles, and consequences of maintaining or breaching confidentiality. DISCUSSION: Perspectives on confidentiality in this community included issues of social justice, the importance of public demonstrations of confidentiality, and the challenge of protecting all relationships when staff have multiple roles. Incorporation of community perspectives into the teaching of confidentiality may help doctors to understand the responsibilities of practising confidentiality in certain communities.

The management of women with apparent early ovarian cancer in the south-west region of England.

This study investigated the management of women with apparent early ovarian cancer in the South West region of England. This was retrospective review of prospectively collected data supplement by case note review. All women registered with stage 1 ovarian cancer in the 2 years from January 1997 to December 1998 were identified from the database of the Regional Cancer Organisation (RCO). Data on staging and subsequent management were obtained from the RCO database. Additional information was collected from the patients' casenotes. We considered the accuracy of staging, consideration of fertility-sparing surgery, evidence of multidisciplinary approach to management, appropriateness of oncological referral and adjuvant therapy. Of 222 cases of stage 1 ovarian cancer identified from the RCO database, 168 casenotes were available for inspection. Eighty-seven cases were confirmed as FIGO stage 1 but the substage was amended in 21 cases. There were insufficient data available in 75 cases to confirm the stage assigned. Six cases were re-staged to FIGO stage 3a. Fertility-sparing surgery was considered in four of 10 nulliparous patients of reproductive age. Thirty-nine patients with disease more advanced than FIGO stage 1b were not referred for onco1 logical opinion. Even after Calmine-Hine guidelines are implemented, women with early ovarian cancer may still be treated in general hospitals. There is an urgent need to provide clear local guidelines for the management of these patients.