The lipase‐catalyzed synthesis of ester bonds has been well‐documented lately and is of much current commercial interest. Immobilization of a fungal lipase on a unique macroporous support allows not only the ability to operate in non‐aqueous media but to catalyze ester synthesis in quantitative yields, employing attractive commercial conditions. Catalyst dose and process configurations will be illustrated. The capability of the catalyst to operate efficiently in reverse under a variety of unnatural, hostile, solvent‐containing environments will be discussed. The range of substrates for this immobilized lipase, Lipzome, has been investigated. The enzyme will catalyze ester synthesis with saturated, unsaturated and a variety of branched carboxylic acids. The alcohol specificity for this enzyme also is equally broad. A wide variety of straight‐chain, branched and polar alcohols can be substrates. In addition, some examples of alcohol specificity for kinetic isomer resolution will be cited.

This study illustrates the difficulties that GPs may have in applying the relevant evidence for the successful management of back pain. A desire to avoid conflict in the relationship with patients explained much of the problem of implementing evidence in general practice. This indicates a need for insightful educational strategies that involve active GP participation.

A series of six interprofessional palliative care meetings used narrative, with participants sharing stories from their professional experience in facilitated small groups. The course was attended by doctors, nurses, social workers and emergency care practitioners. The course was evaluated by telephone interview with 19 of the 28 participants. Respondents reported effects including changed behaviours and benefit to patients. The use of narrative, as a starting point for shared learning, discussion and evaluation is unusual. Five months after the end of the course, many participants described changed professional behaviour which they believed led to improved patient outcomes.

Interpersonal or relationship continuity and management continuity are vital to the process of optimising the patient experience of OOH palliative care. While recent service innovations are tackling some of the issues highlighted, this research reinforces the value patients with palliative care needs places on continuity and the need to improve this aspect of care management.

Given the reported mechanism of action of the 'herbal high' dietary supplements, it would seem possible that they may be able to precipitate a psychotic episode in vulnerable individuals. With the increasing use of these substances, it is important for clinicians to be alert to this possibility.